Tuesday, February 22, 2011

Senate Committee Passes Governor’s Workers’ Compensation Bill

Gov. Mary Fallin
Legislation designed by Governor Mary Fallin’s Workers’ Compensation Study Group and authored by Senator Anthony Sykes and Senator Patrick Anderson was unveiled and passed today at a Senate Judiciary Committee hearing. The legislation, SB 878, is a comprehensive overhaul of the current workers’ compensation system and would reduce costs to businesses while maintaining a fair playing field for both workers and employers.

“Oklahoma’s workers’ compensation system is one of the most expensive, least efficient systems of its kind in the nation,” said Governor Fallin. “Unfortunately, it represents a real obstacle to business recruitment and retention and drives jobs out of state. The reforms we are offering today will change that, by reducing medical and legal costs so that employers can spend their money on job creation and business expansion instead of litigation. Our plan creates a system that is fair to both workers and employers, lowers costs and helps us in our mission of creating a better environment for business growth and job creation in Oklahoma.”

The new law offers the first rewrite of Title 85, the statute outlining the current workers’ compensation system, in 34 years. SB 878 would:

· reduce medical and legal costs to Oklahoma businesses
· bring quicker resolution to cases
· require all parties within the system to be held accountable
· shorten the timeline for resolution of cases
· collect accurate data to measure cost-drivers within the system and to aid in future reform efforts
· reduce litigation with an emphasis on alternative dispute resolution such as mediation and the Ombudsman Program

SB 878 Fact Sheet

The new Title 85:

1. Substantially impacts the scope and duration of medical treatment and time that an injured worker is off work. Medical treatment to be controlled by nationally recognized Official Disability Guidelines (ODG).
2. Cuts medical costs by tying the fee schedule for hospitals, doctors, and other medical service providers and for prosthetics and supplies to the Medicare fee schedule.
3. Makes the Court transparent with public release of reports of judicial performance. Requires specific information to be provided by the Administrator so success of reforms can be measured. An electronic data interchange system will be implemented.
4. Cuts the maximum time to draw temporary total disability (TTD) benefits from 300 weeks to 156 weeks. Should bring quicker resolution of cases.
5. Expands counselor or ombudsman program and mediation. Mediators don’t have to be lawyers. Special program for early mediation without attorneys involved. No Form 3 must be filed to use the counselor or mediation program. Requires court to provide training to adjusters, including information about ombudsman program and the availability of mediation with attorney involvement.
6. Limits discretion of judges by putting more decision-making in the hands of medical experts (Independent Medical Examiners) which can be appointed on any issue at any time. The act prevents doctor-shopping by injured workers.
7. Dramatically changes the definition of permanent total disability. Such benefits to be awarded only if permanent physical or mental restrictions prevent the worker from gainful employment.
8. Severely limits abuse of pain management and continuing medical maintenance. Provides that employers are not liable for pain management unless recommended by treating physician or an independent medical examiner or pre-approved by the insurance carrier. Judges are given no discretion in awarding pain management.
9. Employer’s providing of prompt medical treatment will not be construed as an admission of compensability of the injury.
10. Employee cannot draw TTD if receiving unemployment or short term disability benefits.
11. The treating doctor’s opinion on TTD and need for medical treatment to be given more weight.
12. A “consequential” injury is strictly defined to require causal connection between the original injury and consequential injury.
13. Eliminates excessive penalties for employers or insurance companies who pay medical bills late. Sets up reasonable interest penalty for late payment.
14. Encourages early return to work. Vocational rehabilitation can be ordered while injured worker is still TTD and under active medical care. A Vocational Rehabilitation Director is authorized to be hired by the Court to develop programs to get workers back into the workforce quickly.
15. Unnecessary surgeries and duplicate medical care will be reduced with liberal use of medical experts early in the case.
16. Allows no attorneys fee in uncontested death cases, value of vocational rehabilitation in a settlement, or the amount designated as a Medicare Set Aside trust. Also provides that attorney may not collect a fee on TTD being paid at the time the lawyer is hired. Removes any reason for lawyer to prolong payment of TTD.
17. Tightens exclusive remedy for employers. Makes clear that worker who is alleging intentional tort loses such district court action by pursuing workers’ comp benefits.
18. Eliminates abuse of TTD payments in non surgical strain and sprain cases. No more stacking of body parts for TTD.
19. Eliminates the possibility of a judge awarding more than 100 % permanent disability without amputations or surgeries from latest accident.
20. Requires Form 3 to include information about the worker’s Social Security Disability status, a major issue for employers and carriers.
21. Allows subrogation by employers and insurance companies in death cases.
22. Adds specific definition for terms used in the workers’ compensation system to reduce litigation in disputes of interpretation.
23. Streamlines Multiple Injury Trust Fund to encourage Court to relieve the employer from permanent total benefits from the last injury.
24. Freezes maximum PPD rate at $323 for another four years.
25. Gives Supreme Court immediate power to strictly review orders of the Comp Court.
26. Cuts the statute of limitations in cumulative trauma claims to one year.
27. Sets up mechanism that will result in huge savings in the cost of prescription drugs.
28. Prohibits the award of permanent partial disability for body parts to which no medical treatment was provided.
29. Allows full and final compromise settlements without the filing of a Form 3, a lawyer, or the intervention of a judge.
30. Prohibits judicial conduct which shows favoritism to any party and which reflects badly upon the Court and the workers’ compensation system.
31. Changes waiting period to draw TTD from 3 to 7 days.
32. If no notice of an injury is given within 30 days, the employee forfeits the first three weeks of TTD.
33. TTD can be terminated if an employee misses three consecutive medical appointments without a valid excuse.
34. Eliminates conflicts of interest between judges, doctors, lawyers, the court, and guaranty associations.
35. Punishes abusive practices of healthcare providers with fines and sanctions.
36. Provides for mandatory review of permanent and total disability recipients every one year, with an affidavit to be filed that the worker is not gainfully employed.
37. Gives more power to the Administrator in effecting settlements. The Administrator can approve settlements reached in mediation, without the intervention of a judge.
38. Requires quick decisions. A judge must render a decision within 60 days of the trial.
39. Fines employers or insurance companies for not paying travel reimbursement within 60 days.
40. Fines employers or insurance companies for not promptly paying TTD in admitted injury cases.
41. Attempts to take politics out of judicial rulings by allowing Judge to only serve one 8-year term.
42. Penalizes employers for not promptly paying bills for authorized medical treatment.
43. Reduces from three to two years that a claim can be reopened on change of condition.
Related Posts Plugin for WordPress, Blogger...