Summary of Amendments to the WC ACT Approved by the WCAC
The maximum weekly benefit rates for permanent partial disability (PPD) are increased from $302 to $312 for injuries occurring on and after the effective date and to $322 for injuries occurring on and after January 1, 2013. The maximum weekly benefit rate will be set at $317 for injuries on and after January 1, 2013 if the audit of the certified data bases is not begun within six (6) months after the effective date of the bill. S. 102.11 (1).
Insurance carriers and self-insured employers will be required to file a final treating practitioner’s report with the Department when an employee sustains an eye injury requiring treatment on three (3) or more occasions outside of the employer’s premises. S. 102.13 (2) (c).
A final treating practitioner’s report will not be required in cases where there are uncontested denials of indemnity claims. S. 102.13 (2) (c).
The formula amount for resolving reasonableness of health service fee disputes will be reduced from 1.4 to1.2 standard deviations above the mean. The standard deviation will be set at 1.3 above the mean on January 1, 2013 if the Department does not commence an audit of the certified data bases within six (6) months after the effective date of the bill. S. 102.16 (2) (d).
Payment for treatment or burial expense has no effect on the statute of limitations for claims involving occupational diseases. S. 102.17 (4).
The Work Injury Supplemental Benefit Fund will be liable for payment of benefits and treatment expense for the specified barred traumatic injuries on claims where the applicable statute of limitations will expire before April 1, 2018. S. 102.17 (4).
The Work Injury Supplemental Benefit Fund will be authorized to share in the distribution of proceeds from third party settlements. S. 102.29 (1).
Interest on surcharges will accrue when the surcharges are not paid within 30 days rather than 90 days to synchronize with the Department’s financial system. S. 102.35 (1).
There will be no reduction in compensation for vocational rehabilitation training based on wages earned by employees working part-time for the first 24 hours of employment during periods of retraining, and employees will be required to report wages to WC insurance carriers and self-insured employers. There will be a two (2) year sunset for this amendment. S. 102.43 (5).
In previous legislation the Revisor of Statutes incorrectly inserted May 6, 2010 as the effective date for supplemental benefit increases. This bill corrects the error and specifies May 1, 2010 as the effective date. S 102.44 (1) (am) & (b).
Insurance carriers and self-insured employers will have 12 months to claim reimbursement from the Department for supplemental benefit payments to injures employees, S. 102.44 (1) (c).
Compensation for disfigurement will be paid only for cases where the employee sustains an actual wage loss. S. 102.56
An employee will be limited to only one (1) claim from the Second Injury Fund. S. 102.59 (1).
Insurance carriers and self-insured employers will be liable for reasonable costs of the retraining program including the cost of tuition, fees, and books in cases where the Division of Vocational Rehabilitation provides services for the rehabilitative training program. S. 102.61(1).
The Department will be authorized to retain the Department of Administration to handle claims involving the Work Injury Supplemental Benefit Fund. S. 102.65.
The Department will be authorized to prioritize, decrease or cease payments from the Work Injury Supplemental Benefit Fund if the fund becomes encumbered more than 85% by known claims. S. 102.65.
The Worker’s Compensation Advisory Council agreed to create a committee for the purpose of determining the scope of an audit of the data bases certified by the Department that are used for resolving reasonable of fee disputes. The committee will be comprised of one labor representative, one management representative, one Department representative and one medical provider liaison. The audit is to commence within six (6) months of the effective date of the bill. If the audit is not begun within six (6) months of the effective date of the bill beginning January 1, 2013 the standard deviation will be set at 1.3 above the mean and the increase for the maximum permanent partial disability weekly rate will be $317 for injuries occurring on and after January 1, 2013. SS. 102.11 (1), 102.16 (2) (d) and non-statutory.
A committee will be formed to study the means of funding PTD increases in the future. Non-statutory.