Businesses, counties and municipalities could see a potentially significant increase in workers’ compensation benefits under legislation introduced in the House of Representatives involving permanent partial disability awards that have been reopened and modified due to worsening conditions.
HR 504 impacts reversed or modified workers’ compensation awards or a court appeal that changes the amount of the award. The new compensation figure would be subject to a monetary credit for the compensation for any amounts previously paid.
If approved, the bill would not affect compensation awards before the bill’s effective date, Oct. 1, according to the Department of Legislative Services.
The department said the proposed legislation could have a “potentially significant” impact on state expenditures and the Chesapeake Employers’ Insurance Co., as well as on county and municipal budgets.
It would also have a “potentially meaningful” impact on small businesses, the department said.
It is one of several workers’ compensation bills introduced in the state legislature and assigned to the House Economic Matters Committee.
House Bill 693 would cut weekly benefits nearly $60 a week to injured workers. If passed, the measure would decrease the maximum weekly compensation benefit that a covered employee may receive for a permanent partial disability with a duration of less than 75 weeks from 16.7% of the state average weekly wage to $114. The bill’s change only applies to a claim arising from events that occur on or after Jan. 1, 2017.
For injured workers, the $114 figure would be an eight-year rollback to what workers’ compensation law was in 2008, when the maximum weekly benefit was pegged at that number. In 2016, the figure is $172.
HB 710 would set a 45-day time limit for a medical service provider who treats a covered employee under workers’ compensation to document the services provided and bill an employer or its insurer.
If the bill is submitted after the 45-day limit, the employer or insurer may not be required to pay unless either of the following apply:
The medical service provider files an application for payment with the Workers’ Compensation Commission (WCC) within three years from the date the service is provided, and the WCC excuses the late submission for good cause.
The extent of any cost savings depends on future compensation cases and medical expenses and cannot be reliably estimated, according to the Department of Legislative Services.
The effect on small business could be potentially meaningful, the department said.
Besides monetary compensation, the employer or its insurer may be required to pay for medical care and treatment, including hospital and nursing services, medicine, crutches and artificial arms, feet, hands, and legs and other prosthetic appliances.
This medical care and treatment must be provided for an appropriate time period, depending on the nature and type of personal injury, compensable hernia, or occupational disease.
The bill, if passed, might be a headache for Chesapeake, which said its data system cannot organize its case files based on the number of days between treatments and billing, the Department of Legislative Services said.
The carrier does have historic data on the average cost per medical bill over the six-year period between 2010 and 2015. The six-year average cost per medical bill was $336, while the average cost per medical bill in 2015 was $351. It paid $77,396,582 for 220,652 medical bills over the course of the year, the department said.
For each medical service that is billed later than the 45-day time limit established by the bill and not excused by WCC, using Chesapeake’s data as an example, an employer’s or insurer’s expenditures decrease by $336, on average, the department said.
HB 943 would entitle an employer or its insurer for a credit or compensation paid to a covered employee who is temporarily totally disabled due to an accidental personal injury or an occupational disease if the employee’s medical treatment for the injury or disease is delayed or suspended due solely to an unrelated injury, disease, or medical condition.
The credit must be allowed only for compensation paid during the period in which the employee’s medical treatment was delayed or suspended.
The bill applies prospectively and may not be applied or interpreted to have any effect on or application to any claims for workers’ compensation benefits filed before the bill’s Oct. 1, 2016 effective date. .
HB 1058 would require the Workers’ Compensation Commission to hold any compensation hearing for a covered employee of a county, county board of education, bicounty agency, or municipality at the regional hearing location closest to the county’s government offices if other hearings are not scheduled in the employer’s county.
HB 1160 would make proceedings, records, files, and orders of the State Board of Physicians (MBP), its disciplinary panels, and any of its other investigatory bodies discoverable and admissible in evidence for Workers’ Compensation. It would essentially give claimants and employers a tool to impeach the credibility of medical providers and experts.
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Photo courtesy of: Medical Coding News
Originally Published On: WorkCompCentral
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