2006 Legislation
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HOUSE BILL NO. 649 – Workers comp, no balance billing


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Bill Status

H0649.......................................by COMMERCE AND HUMAN RESOURCES
WORKER'S COMPENSATION - Amends existing law relating to worker's
compensation to prohibit balance billing.
02/10    House intro - 1st rdg - to printing
02/13    Rpt prt - to Com/HuRes
02/14    Rpt out - rec d/p - to 2nd rdg
02/15    2nd rdg - to 3rd rdg
02/21    3rd rdg - PASSED - 67-0-3
      AYES -- Anderson, Andrus, Barraclough, Bastian, Bayer, Bedke, Bell,
      Bilbao, Black, Block, Boe, Bolz, Brackett, Bradford, Cannon,
      Chadderdon, Clark, Collins, Crow, Deal, Denney, Edmunson, Ellsworth,
      Eskridge, Field(18), Field(23), Garrett, Hart, Harwood, Henbest,
      Henderson, Jaquet, Kemp, Lake, LeFavour, Loertscher, Martinez,
      Mathews, McGeachin, McKague, Miller, Mitchell, Moyle, Nielsen,
      Nonini, Pasley-Stuart, Pence, Raybould, Ring, Ringo, Roberts, Rusche,
      Rydalch, Sali(Sali), Sayler, Schaefer, Shepherd(2), Shepherd(8),
      Shirley, Skippen, Smith(30), Smith(24), Smylie, Stevenson, Trail,
      Wills, Wood
      NAYS -- None
      Absent and excused -- Barrett, Snodgrass, Mr. Speaker
    Floor Sponsor - Garrett
    Title apvd - to Senate
02/22    Senate intro - 1st rdg - to Com/HuRes
03/10    Rpt out - rec d/p - to 2nd rdg
03/13    2nd rdg - to 3rd rdg
03/16    3rd rdg - PASSED - 35-0-0
      AYES -- Andreason, Brandt, Broadsword, Bunderson, Burkett,
      Burtenshaw, Cameron, Coiner, Compton, Corder, Darrington, Davis,
      Fulcher, Gannon, Geddes, Goedde, Hill, Jorgenson, Kelly, Keough,
      Langhorst, Little, Lodge, Malepeai, Marley, McGee, McKenzie, Pearce,
      Richardson, Schroeder, Stegner, Stennett, Sweet, Werk, Williams
      NAYS -- None
      Absent and excused -- None
    Floor Sponsor - Goedde
    Title apvd - to House
03/17    To enrol
03/20    Rpt enrol - Sp signed
03/21    Pres signed - To Governor
03/24    Governor signed
         Session Law Chapter 206
         Effective: 07/01/06

Bill Text

  ]]]]              LEGISLATURE OF THE STATE OF IDAHO             ]]]]
 Fifty-eighth Legislature                   Second Regular Session - 2006
                              IN THE HOUSE OF REPRESENTATIVES
                                     HOUSE BILL NO. 649
  1                                        AN ACT
 10    Be It Enacted by the Legislature of the State of Idaho:
 11        SECTION 1.  That Section 72-102, Idaho Code, be, and the  same  is  hereby
 12    amended to read as follows:
 13        72-102.  DEFINITIONS.  Words  and  terms used in the worker's compensation
 14    law, unless the context otherwise requires, are  defined  in  the  subsections
 15    which follow:
 16        (1)  "Alien" means a person who is not a citizen, a national or a resident
 17    of  the  United  States or Canada. Any person not a citizen or national of the
 18    United States who relinquishes or is about to relinquish his residence in  the
 19    United States shall be regarded as an alien.
 20        (2)  "Balance billing" means charging, billing, or otherwise attempting to
 21    collect  directly  from  an  injured  employee payment for medical services in
 22    excess of amounts allowable in compensable claims as provided by rules promul-
 23    gated by the commission pursuant to section 72-508, Idaho Code.
 24        (3)  "Beneficiary" means any person who is entitled to income benefits  or
 25    medical and related benefits under this law.
 26        (34)  "Burial  expenses"  means  a sum, not to exceed six thousand dollars
 27    ($6,000) for funeral  and  burial  or  cremation,  together  with  the  actual
 28    expenses  of  transportation  of the employee's body to his place of residence
 29    within the United States or Canada.
 30        (45)  "Commission" means the industrial commission.
 31        (56)  "Community service worker" means:
 32        (a)  Any person who has been convicted of a criminal offense, any juvenile
 33        who has been found to be within the purview of chapter 5, title 20,  Idaho
 34        Code, and who has been informally diverted under the provisions of section
 35        20-511,  Idaho Code, or any person or youth who has been diverted from the
 36        criminal or juvenile justice system and who performs a public service  for
 37        any department, institution, office, college, university, authority, divi-
 38        sion, board, bureau, commission, council, or other entity of the state, or
 39        any  city,  county,  school  district, irrigation district or other taxing
 40        district authorized to levy a tax or an assessment or any other  political
 41        subdivision  or  any  private not-for-profit agency which has elected wor-
 42        ker's compensation insurance coverage for such person; or
 43        (b)  Parolees under department  of  correction  supervision,  probationers
  1        under  court  order  or  department of correction supervision and offender
  2        residents of community work centers under the direction or  order  of  the
  3        board of correction who are performing public service or community service
  4        work  for  any of the entities specified in paragraph (56)(a) of this sec-
  5        tion other than the department of correction.
  6        (67)  "Compensation" used collectively means any or all of the income ben-
  7    efits and the medical and related benefits and medical services.
  8        (78)  "Custom farmer" means a person  who  contracts  to  supply  operated
  9    equipment  to a proprietor of a farm for the purpose of performing part or all
 10    of the activities related to raising or harvesting agricultural  or  horticul-
 11    tural commodities.
 12        (89)  "Death"  means  death  resulting from an injury or occupational dis-
 13    ease.
 14        (910) Dependency limitations.
 15        (a)  "Adopted" and "adoption" include cases where persons are  treated  as
 16        adopted  as  well as those of legal adoption unless legal adoption is spe-
 17        cifically provided.
 18        (b)  "Brother" and "sister" include  stepbrothers  and  stepsisters,  half
 19        brothers and half sisters, and brothers and sisters by adoption.
 20        (c)  "Child"  includes adopted children, posthumous children, and acknowl-
 21        edged illegitimate children, but  does  not  include  stepchildren  unless
 22        actually dependent.
 23        (d)  "Grandchild"  includes children of legally adopted children and chil-
 24        dren of stepchildren, but  does  not  include  stepchildren  of  children,
 25        stepchildren  of  stepchildren, or stepchildren of adopted children unless
 26        actually dependent.
 27        (e)  "Parent" includes stepparents and parents by adoption.
 28        (f)  "Grandparent" includes parents of parents by adoption, but  does  not
 29        include  parents of stepparents, stepparents of parents, or stepparents of
 30        stepparents.
 31        (101) "Disability," for purposes of determining total or partial temporary
 32    disability income benefits, means a decrease in wage-earning capacity  due  to
 33    injury  or  occupational  disease, as such capacity is affected by the medical
 34    factor of physical impairment, and by pertinent nonmedical factors as provided
 35    in section 72-430, Idaho Code.
 36        (112) "Employee" is synonymous with "workman" and means any person who has
 37    entered into the employment of, or who works  under  contract  of  service  or
 38    apprenticeship  with,  an  employer. It does not include any person engaged in
 39    any of the excepted employments enumerated  in  section  72-212,  Idaho  Code,
 40    unless  an election as provided in section 72-213, Idaho Code, has been filed.
 41    Any reference to an employee who has been injured shall, where the employee is
 42    dead, include a reference to his dependents as herein defined, if the  context
 43    so  requires, or, where the employee is a minor or incompetent, to his commit-
 44    tee or guardian or next friend.
 45        (123) (a)  "Employer" means any person  who  has  expressly  or  impliedly
 46        hired  or  contracted the services of another. It includes contractors and
 47        subcontractors. It includes the owner or lessee of premises, or other per-
 48        son who is virtually the proprietor or operator of the business there car-
 49        ried on, but who, by reason of there being an  independent  contractor  or
 50        for  any  other  reason,  is  not the direct employer of the workers there
 51        employed. If the employer is secured, it means his surety so far as appli-
 52        cable.
 53        (b)  "Professional employer" means a professional employer as  defined  in
 54        chapter 24, title 44, Idaho Code.
 55        (c)  "Temporary  employer"  means  the  employer of temporary employees as
  1        defined in section 44-2403(7), Idaho Code.
  2        (d)  "Work site employer" means the client of  the  temporary  or  profes-
  3        sional employer with whom a worker has been placed.
  4        (134) "Farm labor contractor" means any person or his agent or subcontrac-
  5    tor  who,  for  a fee, recruits and employs farm workers and performs any farm
  6    labor contracting activity.
  7        (145) "Gender and number." The masculine gender includes the feminine  and
  8    neuter;  "husband"  or  "wife" includes "spouse"; the singular number includes
  9    plural and the plural the singular.
 10        (156) "Income benefits" means payments provided for or made under the pro-
 11    visions of this law to the injured employee disabled by an injury  or  occupa-
 12    tional  disease,  or  his  dependents  in case of death, excluding medical and
 13    related benefits.
 14        (167) "Independent contractor" means any person who renders service for  a
 15    specified  recompense  for  a  specified result, under the right to control or
 16    actual control of his principal as to the result of his work only and  not  as
 17    to  the  means  by which such result is accomplished. For the purposes of wor-
 18    ker's compensation law, a custom farmer is considered  to  be  an  independent
 19    contractor.
 20        (178) "Injury" and "accident."
 21        (a)  "Injury" means a personal injury caused by an accident arising out of
 22        and  in  the course of any employment covered by the worker's compensation
 23        law.
 24        (b)  "Accident" means an unexpected, undesigned, and unlooked for  mishap,
 25        or  untoward  event,  connected  with the industry in which it occurs, and
 26        which can be reasonably located  as  to  time  when  and  place  where  it
 27        occurred, causing an injury.
 28        (c)  "Injury"  and "personal injury" shall be construed to include only an
 29        injury caused by an accident, which results in violence  to  the  physical
 30        structure  of the body. The terms shall in no case be construed to include
 31        an occupational disease and only such nonoccupational diseases  as  result
 32        directly from an injury.
 33        (189) "Manifestation" means the time when an employee knows that he has an
 34    occupational  disease,  or  whenever  a  qualified  physician shall inform the
 35    injured worker that he has an occupational disease.
 36        (1920) "Medical and related benefits" means payments provided for or  made
 37    for medical, hospital, burial and other services as provided in this law other
 38    than income benefits.
 39        (201) "Medical  services"  means medical, surgical, dental or other atten-
 40    dance or treatment, nurse and hospital service, medicines,  apparatus,  appli-
 41    ances, prostheses, and related services, facilities and supplies.
 42        (212) "Occupational diseases."
 43        (a)  "Occupational  disease"  means  a  disease  due  to  the nature of an
 44        employment in which the hazards of such disease actually exist, are  char-
 45        acteristic  of, and peculiar to the trade, occupation, process, or employ-
 46        ment, but shall not include psychological injuries,  disorders  or  condi-
 47        tions  unless  the conditions set forth in section 72-451, Idaho Code, are
 48        met.
 49        (b)  "Contracted" and "incurred," when referring to an  occupational  dis-
 50        ease,  shall  be  deemed the equivalent of the term "arising out of and in
 51        the course of" employment.
 52        (c)  "Disablement," except in the case of silicosis, means the event of an
 53        employee's becoming actually and totally incapacitated because of an occu-
 54        pational disease from performing his work in the last occupation in  which
 55        injuriously exposed to the hazards of such disease, and "disability" means
  1        the state of being so incapacitated.
  2        (d)  "Disablement,"  in  the  case  of silicosis, means the event of first
  3        becoming actually incapacitated, because of such disease, from  performing
  4        any  work in any remunerative employment; and "disability" means the state
  5        of being so incapacitated.
  6        (e)  "Silicosis" means the characteristic fibrotic condition of the  lungs
  7        caused by the inhalation of silicon dioxide          dust.
  8        (223) "Outworker"  means  a  person to whom articles or materials are fur-
  9    nished to be treated in any way on premises not under the control  or  manage-
 10    ment of the person who furnished them.
 11        (234) "Person"  means  the  state or any political subdivision thereof, or
 12    any individual, partnership, firm, association, trust, corporation,  including
 13    the state insurance fund, or any representative thereof.
 14        (245) "Physician" means medical physicians and surgeons, ophthalmologists,
 15    otorhinolaryngologists,  dentists, osteopaths, osteopathic physicians and sur-
 16    geons, optometrists, podiatrists, chiropractic physicians, and members of  any
 17    other  healing profession licensed or authorized by the statutes of this state
 18    to practice such profession within the scope of their practice as  defined  by
 19    the statutes of this state and as authorized by their licenses.
 20        (26) "Provider" means any person, firm, corporation, partnership, associa-
 21    tion, agency, institution, or other legal entity providing any kind of medical
 22    services related to the treatment of an injured employee which are compensable
 23    under Idaho's worker's compensation law.
 24        (257) "Secretary" means the secretary of the commission.
 25        (268) "Self-insurer"  means  an employer who has been authorized under the
 26    provisions of this law to carry his own liability to his employees covered  by
 27    this law.
 28        (279) "State"  includes  any state, district, commonwealth, zone or terri-
 29    tory of the United States or any province of Canada.
 30        (2830) "Surety" means any insurer authorized to insure or  guarantee  pay-
 31    ment  of  worker's  compensation  liability of employers in any state; it also
 32    includes the state insurance  fund,  a  self-insurer  and  an  inter-insurance
 33    exchange.
 34        (2931) "United States," when used in a geographic sense, means the several
 35    states,  the  District of Columbia, the Commonwealth of Puerto Rico, the Canal
 36    Zone and the territories of the United States.
 37        (302) "Wages" and "wage earning capacity" prior to the injury or  disable-
 38    ment from occupational disease mean the employee's money payments for services
 39    as calculated under section 72-419, Idaho Code, and shall additionally include
 40    the  reasonable market value of board, rent, housing, lodging, fuel, and other
 41    advantages which can be estimated in money which the  employee  receives  from
 42    the  employer  as  part  of  his  remuneration, and gratuities received in the
 43    course of employment from others than the employer. "Wages" shall not  include
 44    sums which the employer has paid to the employee to cover any special expenses
 45    entailed on him by the nature of his employment.
 46        (313) "Wages"  and "wage earning capacity" after the injury or disablement
 47    from occupational disease shall be presumed to be the  actual  earnings  after
 48    the  injury  or disablement, which presumption may be overcome by showing that
 49    those earnings do not fairly and reasonably represent wage  earning  capacity;
 50    in  such  a case wage earning capacity shall be determined in the light of all
 51    factors and circumstances which may  affect  the  worker's  capacity  to  earn
 52    wages.
 53        (324) "Work  experience  student"  means any person enrolled in the public
 54    school districts of this state  and  who,  as  part  of  his  instruction,  is
 55    enrolled  in  a class or program for academic credit and for which the student
  1    is employed by, or works for, a private or governmental  entity.  The  student
  2    need  not receive wages from the private or governmental entity in order to be
  3    classified as a work experience student.
  4        (335) "Worker's compensation law" or "workmen's compensation   law"  means
  5    and includes the worker's compensation law of this state and any like or simi-
  6    lar law of any state, United States, territory, or province of Canada.
  7        SECTION  2.  That  Section  72-432, Idaho Code, be, and the same is hereby
  8    amended to read as follows:
 10    to the provisions of section 72-706, Idaho Code, the  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
 44        employer  shall  render  its  written  decision  on the claimant's request
 45        within fourteen (14) days. If any dispute  arises  over  the  issue  of  a
 46        request  for  change of physician, the industrial commission shall conduct
 47        an expedited hearing to determine whether or not the request for change of
 48        physician should be granted, and shall render a decision  within  fourteen
 49        (14) days after the filing of the response by the employer.
 50        (b)  The  industrial  commission  shall,  no later than December 31, 1997,
 51        promulgate a rule for the expeditious handling of a petition for change of
 52        physician pursuant to this section. Nothing herein shall prevent the  com-
 53        mission  from  making periodic amendments, as may become necessary, to any
  1        rule for a petition for change of physician.
  2        (5)  Any employee who seeks medical care in a manner not provided  for  in
  3    this section, or as ordered by the industrial commission pursuant to this sec-
  4    tion, shall not be entitled to reimbursement for costs of such care.
  5        (6)  No  provider  shall  engage  in balance billing as defined in section
  6    72-102, Idaho Code.
  7        (7)  An employee shall not be responsible for charges of physicians,  hos-
  8    pitals or other providers of medical services to whom he has been referred for
  9    treatment of his injury or occupational disease by an employer designated phy-
 10    sician or by the commission, except for charges for personal items or extended
 11    services  which  the  employee has requested for his convenience and which are
 12    not required for treatment of his injury or occupational disease.
 13        (78)  The employer or surety shall not be subject to tort liability to any
 14    health care provider for complying with the provisions of this law.
 15        (89)  Nothing in this chapter shall be construed to require a workman  who
 16    in  good  faith  relies  on  Christian  Science treatment by a duly accredited
 17    Christian Science practitioner to undergo any medical or  surgical  treatment,
 18    providing that neither he nor his dependents shall be entitled to income bene-
 19    fits  of  any  kind  beyond those reasonably expected to have been paid had he
 20    undergone medical or surgical treatment, and the employer or insurance carrier
 21    may pay for such spiritual treatment.
 22        (910) The commission shall promulgate rules requiring physicians and other
 23    practitioners providing treatment to make regular reports  to  the  commission
 24    containing  such information as may be required by the commission. The commis-
 25    sion shall promulgate such rules with the  counsel,  advice,  cooperation  and
 26    expertise  of  representatives  of industry, labor, sureties and the legal and
 27    medical professions as well as  institutions,  hospitals  and  clinics  having
 28    physical rehabilitation facilities.
 29        (101) All  medical  information  relevant  to or bearing upon a particular
 30    injury or occupational disease shall be provided to the employer, surety, man-
 31    ager of the industrial special indemnity fund, or their  attorneys  or  autho-
 32    rized  representatives,  the  claimant, the claimant's attorneys or authorized
 33    representatives, or the commission without liability on the part of the physi-
 34    cian, hospital or other provider of medical services and information developed
 35    in connection with treatment or examination for an injury or disease for which
 36    compensation is sought shall not be privileged communication. When a physician
 37    or hospital willfully fails to make a  report  required  under  this  section,
 38    after  written   notice by the commission that such report is due, the commis-
 39    sion may order forfeiture of all or part of payments due for services rendered
 40    in connection with the particular case. An attorney representing the employer,
 41    surety, claimant or industrial special indemnity fund shall have the right  to
 42    confer  with  any  health  care  provider without the presence of the opposing
 43    attorney, representative or party, except for a health care  provider  who  is
 44    retained only as an expert witness.
 45        (112) Physicians  or  others  providing  services under this section shall
 46    assist in the rehabilitation program provided in section 72-501A, Idaho  Code.
 47    They  shall  cooperate  with  specialists from the commission's rehabilitation
 48    staff and with employer rehabilitation personnel in furthering the physical or
 49    vocational rehabilitation of the employee. The extension  of  total  temporary
 50    disability  benefits  during retraining as authorized by section 72-450, Idaho
 51    Code, shall be the responsibility of the commission,  however,  the  physician
 52    shall  inform  the  commission  as  soon  as it is medically apparent that the
 53    employee may be unable to return to the job in which he  sustained  injury  or
 54    occupational disease following treatment and maximum recovery.
 55        (123) An  injured employee shall be reimbursed for his expenses  of neces-
  1    sary travel in obtaining medical care under this  section.  Reimbursement  for
  2    transportation  expenses, if the employee utilizes a private vehicle, shall be
  3    at the mileage rate allowed by the state board of examiners for state  employ-
  4    ees; provided however, that the employee shall not be reimbursed for the first
  5    fifteen (15) miles of any round trip, nor for traveling any round trip of fif-
  6    teen  (15)  miles  or  less. Such distance shall be calculated by the shortest
  7    practical route of travel.
  8        (134) An employee who leaves the locality where employed at  the  time  of
  9    the  industrial  accident, or manifestation of an occupational disease, or the
 10    locality in which the employee is currently receiving  medical  treatment  for
 11    the  injury,  shall  give  timely  notice  to  the  employer and surety of the
 12    employee's leaving the locality. The employer or surety may require the claim-
 13    ant to report to the treating physician for examination prior to  leaving  the
 14    locality,  if  practical.  If  an examination by the treating physician is not
 15    practical prior to leaving the locality, the employer or surety may assist  in
 16    arranging  an  examination  by  an  appropriate physician in the new locality.
 17    After receiving notice of relocation, the employer or surety  shall  have  the
 18    same  responsibility  to  furnish  care as set forth in subsection (1) of this
 19    section.
 20        SECTION 3.  That Section 20-245, Idaho Code, be, and the  same  is  hereby
 21    amended to read as follows:
 23    Offender labor on state projects. The state board of correction shall have the
 24    authority to use, under such rules as they may prescribe, the labor of offend-
 25    ers either within or without the walls of the penitentiary and on  all  public
 26    works  done  under  the direct control of the state; that offender labor under
 27    control of the state board of correction shall manufacture  and  repair  state
 28    highway  signs,  except  for  highways  and projects where federal regulations
 29    would prohibit the use of signs so manufactured;  provided,  that  so  far  as
 30    practicable  any manufacture conducted within the walls shall be in connection
 31    with metal motor license plates, road or street signs furnished by  the  state
 32    or  used  by its municipalities, wearing apparel, articles and containers, for
 33    state use in the various departments or institutions of the state not for sale
 34    upon the open market. When any product produced by the offender shall be  used
 35    by any department or other institution of the state, the current appropriation
 36    shall  receive from such department or institution such reimbursement therefor
 37    as may be fixed by the state board of correction  with  the  approval  of  the
 38    state board of examiners.
 39        (2)  Offender labor on community service projects. The state board of cor-
 40    rection  shall  have the authority to assign parolees under department of cor-
 41    rection supervision, probationers under court order or department  of  correc-
 42    tion  supervision  and  offender residents of community work centers under the
 43    direction or order of the board of correction, as community service workers as
 44    set forth in section 72-102(56), Idaho Code. The  state  board  of  correction
 45    shall have the authority to charge offenders performing community service work
 46    an hourly fee in an amount to be determined by the state insurance fund, to be
 47    remitted  to  the state insurance fund for purposes of providing worker's com-
 48    pensation insurance for parolees, probationers or community work center  resi-
 49    dents assigned as community service workers.
 50        SECTION  4.  That  Section  72-436, Idaho Code, be, and the same is hereby
 51    amended to read as follows:
  1        72-436.  BURIAL EXPENSES. If death results from the injury within four (4)
  2    years, the employer shall pay to the person entitled to  compensation,  or  if
  3    there  is  none  then to the personal representative of the deceased employee,
  4    the actual amount of burial expenses as defined in section  72-102(34),  Idaho
  5    Code.
  6        SECTION  5.  That  Section  72-438, Idaho Code, be, and the same is hereby
  7    amended to read as follows:
  8        72-438.  OCCUPATIONAL DISEASES. Compensation shall be payable for disabil-
  9    ity or death of an employee resulting from  the  following  occupational  dis-
 10    eases:
 11        (1)  Poisoning by lead, mercury, arsenic, zinc, or manganese, their prepa-
 12    rations  or  compounds  in  any occupation involving direct contact therewith,
 13    handling thereof, or exposure thereto.
 14        (2)  Carbon monoxide poisoning or chlorine poisoning  in  any  process  or
 15    occupation  involving direct exposure to carbon monoxide or chlorine in build-
 16    ings, sheds, or inclosed places.
 17        (3)  Poisoning by methanol,  carbon  bisulphide,  hydrocarbon  distillates
 18    (naphthas  and  others)  or halogenated hydrocarbons, or any preparations con-
 19    taining these chemicals or any of them, in  any  occupation  involving  direct
 20    contact therewith, handling thereof, or exposure thereto.
 21        (4)  Poisoning  by  benzol  or  by  nitro,  amido, or amino-derivatives of
 22    benzol (dinitro-benzol, anilin and others) or their preparations or  compounds
 23    in  any  occupation  involving  direct contact therewith, handling thereof, or
 24    exposure thereto.
 25        (5)  Glanders in the care or handling of any equine animal or the  carcass
 26    of any such animal.
 27        (6)  Radium  poisoning  by  or disability due to radioactive properties of
 28    substances or to Roentgenray (X-ray) in any occupation involving  direct  con-
 29    tact therewith, handling thereof, or exposure thereto.
 30        (7)  Poisoning  by  or ulceration from chromic acid or bichromate of ammo-
 31    nium, potassium, or sodium or their preparations, or  phosphorus  preparations
 32    or  compounds,  in any occupation involving direct contact therewith, handling
 33    thereof, or exposure thereto.
 34        (8)  Ulceration due to tar, pitch, bitumen, mineral oil, or  paraffin,  or
 35    any compound product, or residue of any of these substances, in any occupation
 36    involving direct contact therewith, handling thereof, or exposure thereto.
 37        (9)  Dermatitis  venenata, that is, infection or inflammation of the skin,
 38    furunculosis excepted, due to oils, cutting  compounds,  lubricants,  liquids,
 39    fumes,  gases, or vapors in any occupation involving direct contact therewith,
 40    handling thereof or exposure thereto.
 41        (10) Anthrax occurring in any occupation  involving  the  handling  of  or
 42    exposure  to  wool,  hair, bristles, hides, skins, or bodies of animals either
 43    alive or dead.
 44        (11) Silicosis in any occupation involving direct contact  with,  handling
 45    of, or exposure to dust of silicon dioxide       .
 46        (12) Cardiovascular  or  pulmonary or respiratory diseases of a paid fire-
 47    man, employed by a municipality, village or fire district as a regular  member
 48    of  a lawfully established fire department, caused by overexertion in times of
 49    stress or danger or by proximate exposure or by  cumulative  exposure  over  a
 50    period of four (4) years or more to heat, smoke, chemical fumes or other toxic
 51    gases arising directly out of, and in the course of, his employment.
 52        (13) Acquired  immunodeficiency  syndrome  (AIDS),  AIDS related complexes
 53    (ARC), other manifestations of human immunodeficiency virus (HIV)  infections,
  1    infectious  hepatitis  viruses  and  tuberculosis  in any occupation involving
  2    exposure to human blood or body fluids.
  3        Recognizing that additional toxic or harmful substances or matter are con-
  4    tinually being discovered and used or misused, the  above  enumerated  occupa-
  5    tional diseases are not intended to be exclusive, but such additional diseases
  6    shall  not include hazards which are common to the public in general and which
  7    are not within the meaning of section 72-102(212)(a), Idaho Code, and the dis-
  8    eases enumerated in subsection (12) of this section pertaining to paid firemen
  9    shall not be subject to the limitations prescribed in  section  72-439,  Idaho
 10    Code.
 11        SECTION  6.  That  Section  72-451, Idaho Code, be, and the same is hereby
 12    amended to read as follows:
 13        72-451.  PSYCHOLOGICAL ACCIDENTS  AND  INJURIES.  Psychological  injuries,
 14    disorders  or conditions shall not be compensated under this title, unless the
 15    following conditions are met:
 16        (1)  Such injuries of any kind or  nature  emanating  from  the  workplace
 17    shall be compensated only if caused by accident and physical injury as defined
 18    in  section 72-102(158)(a) through (158)(c), Idaho Code, or only if accompany-
 19    ing an occupational disease with resultant physical injury, except that a psy-
 20    chological mishap or event may constitute an accident where: (i) it results in
 21    resultant physical injury so long as the psychological mishap or  event  meets
 22    the  other  criteria  of  this  section, and (ii) it is readily recognized and
 23    identifiable as having occurred in the workplace, and (iii)  it  must  be  the
 24    product of a sudden and extraordinary event; and
 25        (2)  No  compensation  shall be paid for such injuries arising from condi-
 26    tions generally inherent in  every  working  situation  or  from  a  personnel
 27    related  action including, but not limited to, disciplinary action, changes in
 28    duty, job evaluation or employment termination; and
 29        (3)  Such accident and injury must be the predominant cause as compared to
 30    all  other  causes  combined of any consequence for which benefits are claimed
 31    under this section; and
 32        (4)  Where psychological causes or injuries are recognized  by  this  sec-
 33    tion, such causes or injuries must exist in a real and objective sense; and
 34        (5)  Any  permanent  impairment  or permanent disability for psychological
 35    injury recognizable under the Idaho worker's compensation law must be based on
 36    a condition sufficient to constitute a diagnosis  using  the  terminology  and
 37    criteria  of  the American psychiatric association's diagnostic and statistics
 38    manual of mental disorders, third edition revised,  or  any  successor  manual
 39    promulgated  by  the  American  psychiatric association, and must be made by a
 40    psychologist, or psychiatrist duly licensed to practice in the jurisdiction in
 41    which treatment is rendered; and
 42        (6)  Clear and convincing evidence that the psychological  injuries  arose
 43    out  of  and  in the course of the employment from an accident or occupational
 44    disease as contemplated in this section is required.
 45        Nothing herein shall be construed as allowing compensation for psychologi-
 46    cal injuries from psychological causes without accompanying physical injury.
 47        This section shall apply to accidents and injuries occurring on  or  after
 48    July  1,  1994, and to causes of action for benefits accruing on or after July
 49    1, 1994, notwithstanding that the original  worker's  compensation  claim  may
 50    have occurred prior to July 1, 1994.

Statement of Purpose / Fiscal Impact

                       STATEMENT OF PURPOSE

                            RS 15458C1

The purpose of this legislation is to define balance billing
under the Worker's Compensation statue and to clarify that
balance billing is not permitted.

                           FISCAL NOTE

There is no impact on the General Fund.

Name: Rep. Kathie Garrett 
Phone: 332-1000

STATEMENT OF PURPOSE/FISCAL NOTE                         H 649