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S1092.......................................by COMMERCE AND HUMAN RESOURCES
WORKER'S COMPENSATION - Amends existing law relating to worker's
compensation to specify limitations; and to revise provisions applicable to
a claimant's right to medical benefits.
02/04 Senate intro - 1st rdg - to printing
02/07 Rpt prt - to Com/HuRes
02/11 Rpt out - rec d/p - to 2nd rdg
02/14 2nd rdg - to 3rd rdg
02/18 3rd rdg - PASSED - 33-0-2
AYES -- Andreason, Broadsword, Bunderson, Burkett, Burtenshaw,
Cameron, Coiner, Compton, Corder, Darrington, Davis, Gannon, Geddes,
Goedde, Hill, Jorgenson, Kelly, Keough, Langhorst, Little, Lodge,
Malepeai, Marley, McGee, McKenzie, Noble, Pearce, Richardson,
Schroeder, Stegner, Stennett, Werk, Williams
NAYS -- None
Absent and excused -- Brandt, Sweet
Floor Sponsor - Goedde
Title apvd - to House
02/21 House intro - 1st rdg - to Com/HuRes
03/16 Rpt out - rec d/p - to 2nd rdg
03/17 2nd rdg - to 3rd rdg
03/18 3rd rdg - PASSED - 69-0-1
AYES -- Anderson, Andrus, Barraclough, Barrett, Bastian, Bayer,
Bedke, Bell, Bilbao, Black, Block, Boe, Bolz, Bradford, Cannon,
Chadderdon, Clark, Collins, Crow, Deal, Denney, Edmunson, Ellsworth,
Eskridge, Field(18), Field(23), Garrett, Hart, Harwood, Henbest,
Henderson, Jaquet, Jones, Kemp, Lake, LeFavour, Loertscher, Martinez,
Mathews, McGeachin, McKague, Miller, Mitchell, Moyle, Nielsen,
Nonini, Pasley-Stuart, Pence, Raybould, Ring, Ringo, Roberts, Rusche,
Rydalch, Sali, Sayler, Schaefer, Shepherd(2), Shepherd(8), Shirley,
Skippen, Smith(30), Smith(24), Smylie, Snodgrass, Stevenson, Trail,
Wills, Wood
NAYS -- None
Absent and excused -- Mr. Speaker
Floor Sponsor - Trail
Title apvd - to Senate
03/21 To enrol
03/22 Rpt enrol - Pres signed
03/23 Sp signed
03/24 To Governor
03/28 Governor signed
Session Law Chapter 161
Effective: 07/01/05
]]]] LEGISLATURE OF THE STATE OF IDAHO ]]]]
Fifty-eighth Legislature First Regular Session - 2005
IN THE SENATE
SENATE BILL NO. 1092
BY COMMERCE AND HUMAN RESOURCES COMMITTEE
1 AN ACT
2 RELATING TO WORKER'S COMPENSATION PROCEDURES; AMENDING SECTION 72-432, IDAHO
3 CODE, TO SPECIFY LIMITATIONS AND TO MAKE A TECHNICAL CORRECTION; AND
4 AMENDING SECTION 72-706, IDAHO CODE, TO REVISE PROVISIONS APPLICABLE TO A
5 CLAIMANT'S RIGHT TO MEDICAL BENEFITS.
6 Be It Enacted by the Legislature of the State of Idaho:
7 SECTION 1. That Section 72-432, Idaho Code, be, and the same is hereby
8 amended to read as follows:
9 72-432. MEDICAL SERVICES, APPLIANCES AND SUPPLIES -- REPORTS. (1) Subject
10 to the provisions of section 72-706, Idaho Code, tThe employer shall provide
11 for an injured employee such reasonable medical, surgical or other attendance
12 or treatment, nurse and hospital services, medicines, crutches and apparatus,
13 as may be reasonably required by the employee's physician or needed immedi-
14 ately after an injury or manifestation of an occupational disease, and for a
15 reasonable time thereafter. If the employer fails to provide the same, the
16 injured employee may do so at the expense of the employer.
17 (2) The employer shall also furnish necessary replacements or repairs of
18 appliances and prostheses, unless the need therefor is due to lack of proper
19 care by the employee. If the appliance or prosthesis is damaged or destroyed
20 in an industrial accident, the employer, for whom the employee was working at
21 the time of accident, will be liable for replacement or repair, but not for
22 any subsequent replacement or repair not directly resulting from the accident.
23 (3) In addition to the income benefits otherwise payable, the employee
24 who is entitled to income benefits shall be paid an additional sum in an
25 amount as may be determined by the commission as by it deemed necessary, as a
26 medical service, when the constant service of an attendant is necessary by
27 reason of total blindness of the employee or the loss of both hands or both
28 feet or the loss of use thereof, or by reason of being paralyzed and unable to
29 walk, or by reason of other disability resulting from the injury or disease
30 actually rendering him so helpless as to require constant attendance. The com-
31 mission shall have authority to determine the necessity, character and suffi-
32 ciency of any medical services furnished or to be furnished and shall have
33 authority to order a change of physician, hospital or rehabilitation facility
34 when in its judgment such change is desirable or necessary.
35 (4) (a) The employee upon reasonable grounds, may petition the commission
36 for a change of physician to be provided by the employer; however, the
37 employee must give written notice to the employer or surety of the
38 employee's request for a change of physicians to afford the employer the
39 opportunity to fulfill its obligations under this section. If proper
40 notice is not given, the employer shall not be obligated to pay for the
41 services obtained. Nothing in this section shall limit the attending phy-
42 sician from arranging for consultation, referral or specialized care with-
43 out permission of the employer. Upon receiving such written notice, the
2
1 employer shall render its written decision on the claimant's request
2 within fourteen (14) days. If any dispute arises over the issue of a
3 request for change of physician, the industrial commission shall conduct
4 an expedited hearing to determine whether or not the request for change of
5 physician should be granted, and shall render a decision within fourteen
6 (14) days after the filing of the response by the employer.
7 (b) The industrial commission shall, no later than December 31, 1997,
8 promulgate a rule for the expeditious handling of a petition for change of
9 physician pursuant to this section. Nothing herein shall prevent the com-
10 mission from making periodic amendments, as may become necessary, to any
11 rule for a petition for change of physician.
12 (5) Any employee who seeks medical care in a manner not provided for in
13 this section, or as ordered by the industrial commission pursuant to this sec-
14 tion, shall not be entitled to reimbursement for costs of such care.
15 (6) An employee shall not be responsible for charges of physicians, hos-
16 pitals or other providers of medical services to whom he has been referred for
17 treatment of his injury or occupational disease by an employer designated phy-
18 sician or by the commission, except for charges for personal items or extended
19 services which the employee has requested for his convenience and which are
20 not required for treatment of his injury or occupational disease.
21 (7) The employer or surety shall not be subject to tort liability to any
22 health care provider for complying with the provisions of this law.
23 (8) Nothing in this chapter shall be construed to require a workman who
24 in good faith relies on Christian Science treatment by a duly accredited
25 Christian Science practitioner to undergo any medical or surgical treatment,
26 providing that neither he nor his dependents shall be entitled to income bene-
27 fits of any kind beyond those reasonably expected to have been paid had he
28 undergone medical or surgical treatment, and the employer or insurance carrier
29 may pay for such spiritual treatment.
30 (9) The commission shall promulgate rules requiring physicians and other
31 practitioners providing treatment to make regular reports to the commission
32 containing such information as may be required by the commission. The commis-
33 sion shall promulgate such rules with the counsel, advice, cooperation and
34 expertise of representatives of industry, labor, sureties and the legal and
35 medical professions as well as institutions, hospitals and clinics having
36 physical rehabilitation facilities.
37 (10) All medical information relevant to or bearing upon a particular
38 injury or occupational disease shall be provided to the employer, surety, man-
39 ager of the industrial special indemnity fund, or their attorneys or autho-
40 rized representatives, the claimant, the claimant's attorneys or authorized
41 representatives, or the commission without liability on the part of the physi-
42 cian, hospital or other provider of medical services and information developed
43 in connection with treatment or examination for an injury or disease for which
44 compensation is sought shall not be privileged communication. When a physician
45 or hospital willfully fails to make a report required under this section,
46 after written notice by the commission that such report is due, the commis-
47 sion may order forfeiture of all or part of payments due for services rendered
48 in connection with the particular case. An attorney representing the employer,
49 surety, claimant or industrial special indemnity fund shall have the right to
50 confer with any health care provider without the presence of the opposing
51 attorney, representative or party, except for a health care provider who is
52 retained only as an expert witness.
53 (11) Physicians or others providing services under this section shall
54 assist in the rehabilitation program provided in section 72-501A, Idaho Code.
55 They shall cooperate with specialists from the commission's rehabilitation
3
1 staff and with employer rehabilitation personnel in furthering the physical or
2 vocational rehabilitation of the employee. The extension of total temporary
3 disability benefits during retraining as authorized by section 72-450, Idaho
4 Code, shall be the responsibility of the commission, however, the physician
5 shall inform the commission as soon as it is medically apparent that the
6 employee may be unable to return to the job in which he sustained injury or
7 occupational disease following treatment and maximum recovery.
8 (12) An injured employee shall be reimbursed for his expenses of necessary
9 travel in obtaining medical care under this section. Reimbursement for trans-
10 portation expenses, if the employee utilizes a private vehicle, shall be at
11 the mileage rate allowed by the state board of examiners for state employees;
12 provided however, that the employee shall not be reimbursed for the first fif-
13 teen (15) miles of any round trip, nor for traveling any round trip of fifteen
14 (15) miles or less. Such distance shall be calculated by the shortest practi-
15 cal route of travel.
16 (13) An employee who leaves the locality where employed at the time of the
17 industrial accident, or manifestation of an occupational disease, or the
18 locality in which the employee is currently receiving medical treatment for
19 the injury, shall give timely notice to the employer and surety of the
20 employee's leaving the locality. The employer or surety may require the
21 claimant to report to the treating physician for examination prior to leaving
22 the locality, if practical. If an examination by the treating physician is not
23 practical prior to leaving the locality, the employer or surety may assist in
24 arranging an examination by an appropriate physician in the new locality.
25 After receiving notice of relocation, the employer or surety shall have the
26 same responsibility to furnish care as set forth in subsection (1) of this
27 section.
28 SECTION 2. That Section 72-706, Idaho Code, be, and the same is hereby
29 amended to read as follows:
30 72-706. LIMITATION ON TIME ON APPLICATION FOR HEARING. (1) When no com-
31 pensation paid. When a claim for compensation has been made and no compensa-
32 tion has been paid thereon, the claimant, unless misled to his prejudice by
33 the employer or surety, shall have one (1) year from the date of making claim
34 within which to make and file with the commission an application requesting a
35 hearing and an award under such claim.
36 (2) When compensation discontinued. When payments of compensation have
37 been made and thereafter discontinued, the claimant shall have five (5) years
38 from the date of the accident causing the injury or date of first manifesta-
39 tion of an occupational disease within which to make and file with the commis-
40 sion an application requesting a hearing for further compensation and award.
41 (3) When income benefits discontinued. If income benefits have been paid
42 and discontinued more than four (4) years from the date of the accident caus-
43 ing the injury or the date of first manifestation of an occupational disease,
44 the claimant shall have one (1) year from the date of the last payment of
45 income benefits within which to make and file with the commission an applica-
46 tion requesting a hearing for additional income benefits.
47 (4) Medical benefits. The payment of medical benefits beyond five (5)
48 years from the date of the accident causing the injury or the date of first
49 manifestation of an occupational disease shall not extend the time for filing
50 a claim or an application requesting a hearing for additional income benefits
51 as provided in this section.
52 (5) Right to medical benefits not affected. The provisions of this sec-
53 tion shall not affect a Except under circumstances provided in subsection (1)
4
1 of this section, the claimant's right to medical benefits under the provisions
2 of section 72-432(1), Idaho Code, shall not be otherwise barred by this sec-
3 tion.
4 (6) Relief barred. In the event an application is not made and filed as
5 in this section provided, relief on any such claim shall be forever barred.
STATEMENT OF PURPOSE
RS 14497c1
The amendment clarifies issues relating to the impact and meaning
of Idaho Code section 72-706 (5) as it was amended in 1991, and
has been subsequently interpreted by the Idaho Industrial
Commission. The amendment removes concerns over the absence of a
statute of limitations on medical benefits in denied worker's
compensation claims.
FISCAL IMPACT
none
Contact
Name: Sen. John Goedde
Phone: 332-1331
STATEMENT OF PURPOSE/FISCAL NOTE S 1092