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H0850.....................................................by WAYS AND MEANS
WORKER'S COMPENSATION - Amends existing law relating to worker's
compensation to revise the definition of "injury"; and to revise provisions
applicable to compensation for psychological accidents and injuries.
03/24 House intro - 1st rdg - to printing
03/27 Rpt prt - to St Aff
]]]] LEGISLATURE OF THE STATE OF IDAHO ]]]]
Fifty-eighth Legislature Second Regular Session - 2006
IN THE HOUSE OF REPRESENTATIVES
HOUSE BILL NO. 850
BY WAYS AND MEANS COMMITTEE
1 AN ACT
2 RELATING TO WORKER'S COMPENSATION; AMENDING SECTION 72-102, IDAHO CODE, TO
3 REVISE THE DEFINITION OF "INJURY"; AND AMENDING SECTION 72-451, IDAHO
4 CODE, TO REVISE PROVISIONS APPLICABLE TO COMPENSATION FOR PSYCHOLOGICAL
5 ACCIDENTS AND INJURIES.
6 Be It Enacted by the Legislature of the State of Idaho:
7 SECTION 1. That Section 72-102, Idaho Code, be, and the same is hereby
8 amended to read as follows:
9 72-102. DEFINITIONS. Words and terms used in the worker's compensation
10 law, unless the context otherwise requires, are defined in the subsections
11 which follow:
12 (1) "Alien" means a person who is not a citizen, a national or a resident
13 of the United States or Canada. Any person not a citizen or national of the
14 United States who relinquishes or is about to relinquish his residence in the
15 United States shall be regarded as an alien.
16 (2) "Beneficiary" means any person who is entitled to income benefits or
17 medical and related benefits under this law.
18 (3) "Burial expenses" means a sum, not to exceed six thousand dollars
19 ($6,000) for funeral and burial or cremation, together with the actual
20 expenses of transportation of the employee's body to his place of residence
21 within the United States or Canada.
22 (4) "Commission" means the industrial commission.
23 (5) "Community service worker" means:
24 (a) Any person who has been convicted of a criminal offense, any juvenile
25 who has been found to be within the purview of chapter 5, title 20, Idaho
26 Code, and who has been informally diverted under the provisions of section
27 20-511, Idaho Code, or any person or youth who has been diverted from the
28 criminal or juvenile justice system and who performs a public service for
29 any department, institution, office, college, university, authority, divi-
30 sion, board, bureau, commission, council, or other entity of the state, or
31 any city, county, school district, irrigation district or other taxing
32 district authorized to levy a tax or an assessment or any other political
33 subdivision or any private not-for-profit agency which has elected wor-
34 ker's compensation insurance coverage for such person; or
35 (b) Parolees under department of correction supervision, probationers
36 under court order or department of correction supervision and offender
37 residents of community work centers under the direction or order of the
38 board of correction who are performing public service or community service
39 work for any of the entities specified in paragraph (5)(a) of this section
40 other than the department of correction.
41 (6) "Compensation" used collectively means any or all of the income bene-
42 fits and the medical and related benefits and medical services.
43 (7) "Custom farmer" means a person who contracts to supply operated
2
1 equipment to a proprietor of a farm for the purpose of performing part or all
2 of the activities related to raising or harvesting agricultural or horticul-
3 tural commodities.
4 (8) "Death" means death resulting from an injury or occupational disease.
5 (9) Dependency limitations.
6 (a) "Adopted" and "adoption" include cases where persons are treated as
7 adopted as well as those of legal adoption unless legal adoption is spe-
8 cifically provided.
9 (b) "Brother" and "sister" include stepbrothers and stepsisters, half
10 brothers and half sisters, and brothers and sisters by adoption.
11 (c) "Child" includes adopted children, posthumous children, and acknowl-
12 edged illegitimate children, but does not include stepchildren unless
13 actually dependent.
14 (d) "Grandchild" includes children of legally adopted children and chil-
15 dren of stepchildren, but does not include stepchildren of children,
16 stepchildren of stepchildren, or stepchildren of adopted children unless
17 actually dependent.
18 (e) "Parent" includes stepparents and parents by adoption.
19 (f) "Grandparent" includes parents of parents by adoption, but does not
20 include parents of stepparents, stepparents of parents, or stepparents of
21 stepparents.
22 (10) "Disability," for purposes of determining total or partial temporary
23 disability income benefits, means a decrease in wage-earning capacity due to
24 injury or occupational disease, as such capacity is affected by the medical
25 factor of physical impairment, and by pertinent nonmedical factors as provided
26 in section 72-430, Idaho Code.
27 (11) "Employee" is synonymous with "workman" and means any person who has
28 entered into the employment of, or who works under contract of service or
29 apprenticeship with, an employer. It does not include any person engaged in
30 any of the excepted employments enumerated in section 72-212, Idaho Code,
31 unless an election as provided in section 72-213, Idaho Code, has been filed.
32 Any reference to an employee who has been injured shall, where the employee is
33 dead, include a reference to his dependents as herein defined, if the context
34 so requires, or, where the employee is a minor or incompetent, to his commit-
35 tee or guardian or next friend.
36 (12) (a) "Employer" means any person who has expressly or impliedly hired
37 or contracted the services of another. It includes contractors and subcon-
38 tractors. It includes the owner or lessee of premises, or other person who
39 is virtually the proprietor or operator of the business there carried on,
40 but who, by reason of there being an independent contractor or for any
41 other reason, is not the direct employer of the workers there employed. If
42 the employer is secured, it means his surety so far as applicable.
43 (b) "Professional employer" means a professional employer as defined in
44 chapter 24, title 44, Idaho Code.
45 (c) "Temporary employer" means the employer of temporary employees as
46 defined in section 44-2403(7), Idaho Code.
47 (d) "Work site employer" means the client of the temporary or profes-
48 sional employer with whom a worker has been placed.
49 (13) "Farm labor contractor" means any person or his agent or subcontrac-
50 tor who, for a fee, recruits and employs farm workers and performs any farm
51 labor contracting activity.
52 (14) "Gender and number." The masculine gender includes the feminine and
53 neuter; "husband" or "wife" includes "spouse"; the singular number includes
54 plural and the plural the singular.
55 (15) "Income benefits" means payments provided for or made under the pro-
3
1 visions of this law to the injured employee disabled by an injury or occupa-
2 tional disease, or his dependents in case of death, excluding medical and
3 related benefits.
4 (16) "Independent contractor" means any person who renders service for a
5 specified recompense for a specified result, under the right to control or
6 actual control of his principal as to the result of his work only and not as
7 to the means by which such result is accomplished. For the purposes of wor-
8 ker's compensation law, a custom farmer is considered to be an independent
9 contractor.
10 (17) "Injury" and "accident."
11 (a) "Injury" means a personal injury caused by an accident arising out of
12 and in the course of any employment covered by the worker's compensation
13 law.
14 (b) "Accident" means an unexpected, undesigned, and unlooked for mishap,
15 or untoward event, connected with the industry in which it occurs, and
16 which can be reasonably located as to time when and place where it
17 occurred, causing an injury.
18 (c) "Injury" and "personal injury" shall be construed to include only an
19 injury caused by an accident, which results in violence to the physical
20 structure of the body or in a psychological injury, disorder or condition
21 as set forth in section 72-451, Idaho Code. The terms shall in no case be
22 construed to include an occupational disease and only such nonoccupational
23 diseases as result directly from an injury.
24 (18) "Manifestation" means the time when an employee knows that he has an
25 occupational disease, or whenever a qualified physician shall inform the
26 injured worker that he has an occupational disease.
27 (19) "Medical and related benefits" means payments provided for or made
28 for medical, hospital, burial and other services as provided in this law other
29 than income benefits.
30 (20) "Medical services" means medical, surgical, dental or other atten-
31 dance or treatment, nurse and hospital service, medicines, apparatus, appli-
32 ances, prostheses, and related services, facilities and supplies.
33 (21) "Occupational diseases."
34 (a) "Occupational disease" means a disease due to the nature of an
35 employment in which the hazards of such disease actually exist, are char-
36 acteristic of, and peculiar to the trade, occupation, process, or employ-
37 ment, but shall not include psychological injuries, disorders or condi-
38 tions unless the conditions set forth in section 72-451, Idaho Code, are
39 met.
40 (b) "Contracted" and "incurred," when referring to an occupational dis-
41 ease, shall be deemed the equivalent of the term "arising out of and in
42 the course of" employment.
43 (c) "Disablement," except in the case of silicosis, means the event of an
44 employee's becoming actually and totally incapacitated because of an occu-
45 pational disease from performing his work in the last occupation in which
46 injuriously exposed to the hazards of such disease, and "disability" means
47 the state of being so incapacitated.
48 (d) "Disablement," in the case of silicosis, means the event of first
49 becoming actually incapacitated, because of such disease, from performing
50 any work in any remunerative employment; and "disability" means the state
51 of being so incapacitated.
52 (e) "Silicosis" means the characteristic fibrotic condition of the lungs
53 caused by the inhalation of silicon dioxide (SiO ) dust.
54 (22) "Outworker" means a person to whom articles or materials are fur-
55 nished to be treated in any way on premises not under the control or manage-
4
1 ment of the person who furnished them.
2 (23) "Person" means the state or any political subdivision thereof, or any
3 individual, partnership, firm, association, trust, corporation, including the
4 state insurance fund, or any representative thereof.
5 (24) "Physician" means medical physicians and surgeons, ophthalmologists,
6 otorhinolaryngologists, dentists, osteopaths, osteopathic physicians and sur-
7 geons, optometrists, podiatrists, chiropractic physicians, and members of any
8 other healing profession licensed or authorized by the statutes of this state
9 to practice such profession within the scope of their practice as defined by
10 the statutes of this state and as authorized by their licenses.
11 (25) "Secretary" means the secretary of the commission.
12 (26) "Self-insurer" means an employer who has been authorized under the
13 provisions of this law to carry his own liability to his employees covered by
14 this law.
15 (27) "State" includes any state, district, commonwealth, zone or territory
16 of the United States or any province of Canada.
17 (28) "Surety" means any insurer authorized to insure or guarantee payment
18 of worker's compensation liability of employers in any state; it also includes
19 the state insurance fund, a self-insurer and an inter-insurance exchange.
20 (29) "United States," when used in a geographic sense, means the several
21 states, the District of Columbia, the Commonwealth of Puerto Rico, the Canal
22 Zone and the territories of the United States.
23 (30) "Wages" and "wage earning capacity" prior to the injury or disable-
24 ment from occupational disease mean the employee's money payments for services
25 as calculated under section 72-419, Idaho Code, and shall additionally include
26 the reasonable market value of board, rent, housing, lodging, fuel, and other
27 advantages which can be estimated in money which the employee receives from
28 the employer as part of his remuneration, and gratuities received in the
29 course of employment from others than the employer. "Wages" shall not include
30 sums which the employer has paid to the employee to cover any special expenses
31 entailed on him by the nature of his employment.
32 (31) "Wages" and "wage earning capacity" after the injury or disablement
33 from occupational disease shall be presumed to be the actual earnings after
34 the injury or disablement, which presumption may be overcome by showing that
35 those earnings do not fairly and reasonably represent wage earning capacity;
36 in such a case wage earning capacity shall be determined in the light of all
37 factors and circumstances which may affect the worker's capacity to earn
38 wages.
39 (32) "Work experience student" means any person enrolled in the public
40 school districts of this state and who, as part of his instruction, is
41 enrolled in a class or program for academic credit and for which the student
42 is employed by, or works for, a private or governmental entity. The student
43 need not receive wages from the private or governmental entity in order to be
44 classified as a work experience student.
45 (33) "Worker's compensation law" or "workmen's compensation law" means and
46 includes the worker's compensation law of this state and any like or similar
47 law of any state, United States, territory, or province of Canada.
48 SECTION 2. That Section 72-451, Idaho Code, be, and the same is hereby
49 amended to read as follows:
50 72-451. PSYCHOLOGICAL ACCIDENTS AND INJURIES. Psychological injuries,
51 disorders or conditions shall not be compensated under this title, unless the
52 following conditions are met:
53 (1) Such injuries of any kind or nature emanating from the workplace
5
1 shall be compensated only if caused by accident and physical injury as defined
2 in section 72-102(157)(a) through (15)(c), Idaho Code, or only if accompanying
3 an occupational disease with resultant physical injury, except that a psycho-
4 logical mishap or event may constitute an accident where: (i) it results in
5 resultant physical injury so long as the psychological mishap or event meets
6 the other criteria of this section, and (ii) it is readily recognized and
7 identifiable as having occurred in the workplace, and (iii) it must be the
8 product of a sudden and extraordinary event; and
9 (2) No compensation shall be paid for such injuries arising from condi-
10 tions generally inherent in every working situation or from a personnel
11 related action including, but not limited to, disciplinary action, changes in
12 duty, job evaluation or employment termination; and
13 (3) Such accident and injury must be the predominant cause as compared to
14 all other causes combined of any consequence for which benefits are claimed
15 under this section; and
16 (4) Where psychological causes or injuries are recognized by this sec-
17 tion, such causes or injuries must exist in a real and objective sense; and
18 (5) Any permanent impairment or permanent disability for psychological
19 injury recognizable under the Idaho worker's compensation law must be based on
20 a condition sufficient to constitute a diagnosis using the terminology and
21 criteria of the American psychiatric association's diagnostic and statistics
22 manual of mental disorders, third edition revised, or any successor manual
23 promulgated by the American psychiatric association, and must be made by a
24 psychologist, or psychiatrist duly licensed to practice in the jurisdiction in
25 which treatment is rendered; and
26 (6) Clear and convincing evidence that the psychological injuries arose
27 out of and in the course of the employment from an accident or occupational
28 disease as contemplated in this section is required.
29 Nothing herein shall be construed as allowing compensation for psychologi-
30 cal injuries from psychological causes without an accompanying physical injury
31 work-related accident.
32 This section shall apply to accidents and injuries occurring on or after
33 July 1, 1994, and to causes of action for benefits accruing on or after July
34 1, 1994, notwithstanding that the original worker's compensation claim may
35 have occurred prior to July 1, 1994.
STATEMENT OF PURPOSE
RS 16278C1
This legislation changes the Idaho Code regarding workers
compensation claims to allow compensation for a work-related
severe psychological injury. Current rules require that
compensation is available only if accompanied by physical injury,
thereby excluding coverage for psychologic disorders induced by
an exceptional workplace event. The legislation retains the
requirements that the psychological injury be exceptional, not
related to disciplinary action or firing, and that a work-related
accident be the cause of the psychological injury.
FISCAL NOTE
The expected cost to the general fund for the increased premium
for workers compensation coverage is undetermined but is expected
to be minimal.
Contact
Name: Bruce Newcomb, Speaker of the House
Representatives John Rusche, Margaret Henbest, Darrell Bolz
Phone: (208) 332-1000
STATEMENT OF PURPOSE/FISCAL NOTE H 850