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General Assembly Substitute Bill No. 5250
February Session, 2022
AN ACT CONCERNING MINOR AND TECHNICAL CHANGES TO THE
WORKERS' COMPENSATION ACT.
Be it enacted by the Senate and House of Representatives in General
Assembly convened:
Section 1. Subdivision (10) of section 31-275 of the 2022 supplement 1
to the general statutes is repealed and the following is substituted in lieu 2
thereof (Effective from passage): 3
(10) "Employer" means any person, corporation, limited liability 4
company, firm, partnership, voluntary association, joint stock 5
association, the state and any public corporation within the state using 6
the services of one or more employees for pay, or the legal 7
representative of any such employer, but all contracts of employment 8
between an employer employing persons excluded from the definition 9
of employee and any such employee shall be conclusively presumed to 10
include the following mutual agreements between employer and 11
employee: (A) That the employer may accept and become bound by the 12
provisions of this chapter by immediately complying with section 31-13
284, as amended by this act; (B) that, if the employer accepts the 14
provisions of this chapter, the employee shall then be deemed to accept 15
and be bound by such provisions unless the employer neglects or 16
refuses to furnish immediately to the employee, on his or her written 17
request, evidence of compliance with section 31-284, as amended by this 18 Substitute Bill No. 5250
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act, in the form of a certificate from the administrative law judge, the 19
Insurance Commissioner or the insurer, as the case may be; (C) that the 20
employee may, at any time, withdraw his or her acceptance of, and 21
become released from, the provisions of this chapter by giving written 22
or printed notice of his or her withdrawal to the [administrative law 23
judge] chairperson and to the employer, and the withdrawal shall take 24
effect immediately from the time of its service on the [administrative 25
law judge] chairperson and the employer; and (D) that the employer 26
may withdraw his or her acceptance and the acceptance of the employee 27
by filing a written or printed notice of his or her withdrawal with the 28
[administrative law judge] chairperson and with the employee, and the 29
withdrawal shall take effect immediately from the time of its service on 30
the [administrative law judge] chairperson and the employee. The 31
notices of acceptance and withdrawal to be given by an employer 32
employing persons excluded from the definition of employee and the 33
notice of withdrawal to be given by the employee, as provided in this 34
subdivision, shall be served upon the [administrative law judge] 35
chairperson, employer or employee, [either by personal presentation or 36
by registered or certified mail] in accordance with section 31-321, as 37
amended by this act. In determining the number of employees 38
employed by an individual, the employees of a partnership of which he 39
is a member shall not be included. A person who is the sole proprietor 40
of a business may accept the provisions of this chapter by notifying the 41
[administrative law judge] chairperson, in writing, of his or her intent 42
to do so. If such person accepts the provisions of this chapter he shall be 43
considered to be an employer and shall insure his or her full liability in 44
accordance with subdivision (2) of subsection (b) of section 31-284, as 45
amended by this act. Such person may withdraw his or her acceptance 46
by giving notice of his or her withdrawal, in writing, to the 47
[administrative law judge] chairperson. Any person who is a partner in 48
a business shall be deemed to have accepted the provisions of this 49
chapter and shall insure his or her full liability in accordance with 50
subdivision (2) of subsection (b) of section 31-284, as amended by this 51
act, unless the partnership elects to be excluded from the provisions of 52
this chapter by notice, in writing and by signed agreement of each 53 Substitute Bill No. 5250
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partner, to the [administrative law judge] chairperson. 54
Sec. 2. Subsections (a) and (b) of section 31-294c of the general statutes 55
are repealed and the following is substituted in lieu thereof (Effective 56
from passage): 57
(a) No proceedings for compensation under the provisions of this 58
chapter shall be maintained unless a written notice of claim for 59
compensation is given within one year from the date of the accident or 60
within three years from the first manifestation of a symptom of the 61
occupational disease, as the case may be, which caused the personal 62
injury, provided, if death has resulted within two years from the date of 63
the accident or first manifestation of a symptom of the occupational 64
disease, a dependent or dependents, or the legal representative of the 65
deceased employee, may make claim for compensation within the two-66
year period or within one year from the date of death, whichever is later. 67
Notice of claim for compensation may be given to the employer or any 68
administrative law judge and shall state, in simple language, the date 69
and place of the accident and the nature of the injury resulting from the 70
accident, or the date of the first manifestation of a symptom of the 71
occupational disease and the nature of the disease, as the case may be, 72
and the name and address of the employee and of the person in whose 73
interest compensation is claimed. An employee of the state shall send a 74
copy of the notice to the Commissioner of Administrative Services. An 75
employee of a municipality shall send a copy of the notice to the town 76
clerk of the municipality in which he or she is employed. An employer, 77
other than the state or a municipality, may opt to post a copy of where 78
notice of a claim for compensation shall be sent by an employee in the 79
workplace location where other labor law posters required by the Labor 80
Department are prominently displayed. In addition, an employer, 81
opting to post where notice of a claim for compensation by an employee 82
shall be sent, shall forward the address of where notice of a claim for 83
compensation shall be sent to the Workers' Compensation Commission 84
and the commission shall post such address on its Internet web site. An 85
employer shall be responsible for verifying that information posted at a 86 Substitute Bill No. 5250
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workplace location is consistent with the information posted on the 87
commission's Internet web site. If an employee, other than an employee 88
of the state or a municipality, opts to mail to his or her employer the 89
written notice of a claim for compensation required under the 90
provisions of this section, such written notice shall be sent by the 91
employee to the employer [by certified mail] in accordance with section 92
31-321, as amended by this act. As used in this section, "manifestation of 93
a symptom" means manifestation to an employee claiming 94
compensation, or to some other person standing in such relation to him 95
that the knowledge of the person would be imputed to him, in a manner 96
that is or should be recognized by him as symptomatic of the 97
occupational disease for which compensation is claimed. 98
(b) Whenever liability to pay compensation is contested by the 99
employer, he shall file with the administrative law judge, on or before 100
the twenty-eighth day after he has received a written notice of claim, a 101
notice in accord with a form prescribed by the [chairman] chairperson 102
of the Workers' Compensation Commission stating that the right to 103
compensation is contested, the name of the claimant, the name of the 104
employer, the date of the alleged injury or death and the specific 105
grounds on which the right to compensation is contested. The employer 106
shall send a copy of the notice to the employee in accordance with 107
section 31-321, as amended by this act. If the employer or his legal 108
representative fails to file the notice contesting liability on or before the 109
twenty-eighth day after he has received the written notice of claim, the 110
employer shall commence payment of compensation for such injury or 111
death on or before the twenty-eighth day after he has received the 112
written notice of claim, but the employer may contest the employee's 113
right to receive compensation on any grounds or the extent of his 114
disability within one year from the receipt of the written notice of claim, 115
provided the employer shall not be required to commence payment of 116
compensation when the written notice of claim has not been properly 117
served in accordance with section 31-321 or when the written notice of 118
claim fails to include a warning that (1) the employer, if he has 119
commenced payment for the alleged injury or death on or before the 120 Substitute Bill No. 5250
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twenty-eighth day after receiving a written notice of claim, shall be 121
precluded from contesting liability unless a notice contesting liability is 122
filed within one year from the receipt of the written notice of claim, and 123
(2) the employer shall be conclusively presumed to have accepted the 124
compensability of the alleged injury or death unless the employer either 125
files a notice contesting liability on or before the twenty-eighth day after 126
receiving a written notice of claim or commences payment for the 127
alleged injury or death on or before such twenty-eighth day. An 128
employer shall be entitled, if he prevails, to reimbursement from the 129
claimant of any compensation paid by the employer on and after the 130
date the administrative law judge receives written notice from the 131
employer or his legal representative, in accordance with the form 132
prescribed by the [chairman] chairperson of the Workers' Compensation 133
Commission, stating that the right to compensation is contested. 134
Notwithstanding the provisions of this subsection, an employer who 135
fails to contest liability for an alleged injury or death on or before the 136
twenty-eighth day after receiving a written notice of claim and who fails 137
to commence payment for the alleged injury or death on or before such 138
twenty-eighth day, shall be conclusively presumed to have accepted the 139
compensability of the alleged injury or death. If an employer has opted 140
to post an address of where notice of a claim for compensation by an 141
employee shall be sent, as described in subsection (a) of this section, the 142
twenty-eight-day period set forth in this subsection shall begin on the 143
date when such employer receives written notice of a claim for 144
compensation at such posted address. 145
Sec. 3. Subsection (b) of section 31-296 of the 2022 supplement to the 146
general statutes is repealed and the following is substituted in lieu 147
thereof (Effective from passage): 148
(b) Before discontinuing or reducing payment on account of total or 149
partial incapacity under any such agreement, the employer or the 150
employer's insurer, if it is claimed by or on behalf of the injured 151
employee that such employee's incapacity still continues, shall notify 152
the administrative law judge and the employee, [by certified mail] in 153 Substitute Bill No. 5250
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accordance with section 31-321, as amended by this act, of the proposed 154
discontinuance or reduction of such payments. Such notice shall specify 155
the reason for the proposed discontinuance or reduction and the date 156
such proposed discontinuance or reduction will commence. No 157
discontinuance or reduction shall become effective unless specifically 158
approved in writing by the administrative law judge. The employee 159
may request a hearing on any such proposed discontinuance or 160
reduction not later than fifteen days after receipt of such notice. Any 161
such request for a hearing shall be given priority over requests for 162
hearings on other matters. The administrative law judge shall not 163
approve any such discontinuance or reduction prior to the expiration of 164
the period for requesting a hearing or the completion of such hearing, 165
whichever is later. In any case where the administrative law judge finds 166
that an employer has discontinued or reduced any payments made in 167
accordance with this section without the approval of the administrative 168
law judge, such employer shall be required to pay to the employee the 169
total amount of all payments so discontinued or the total amount by 170
which such payments were reduced, as the case may be, and shall be 171
required to pay interest to the employee, at a rate of one and one-quarter 172
per cent per month or portion of a month, on any payments so 173
discontinued or on the total amount by which such payments were 174
reduced, as the case may be, plus reasonable attorney's fees incurred by 175
the employee in relation to such discontinuance or reduction. 176
Sec. 4. Section 31-321 of the general statutes is repealed and the 177
following is substituted in lieu thereof (Effective from passage): 178
Unless otherwise specifically provided, or unless the circumstances 179
of the case or the rules of the commission direct otherwise, any notice 180
required under this chapter to be served upon an employer, employee, 181
[or] administrative law judge or the chairperson shall be by written or 182
printed notice, service personally or by registered or certified mail 183
addressed to the person upon whom it is to be served at the person's 184
last-known residence or place of business. Notices on behalf of a minor 185
shall be given by or to such minor's parent or guardian or, if there is no 186 Substitute Bill No. 5250
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parent or guardian, then by or to such minor. 187
Sec. 5. Section 31-276 of the general statutes is repealed and the 188
following is substituted in lieu thereof (Effective from passage): 189
(a) There shall be a Workers' Compensation Commission to 190
administer the workers' compensation system. There shall be sixteen 191
administrative law judges. On or before the date of the expiration of the 192
term of each administrative law judge or upon the occurrence of a 193
vacancy in the office of any administrative law judge for any reason, the 194
Governor shall nominate a competent person to fill that office. 195
Subsequent to July 1, 1993, each person nominated by the Governor to 196
serve as an administrative law judge shall have been a member in good 197
standing of the Connecticut bar for at least five years preceding the 198
nomination, provided the Governor shall not be precluded from 199
renominating an individual who has previously served as an 200
administrative law judge. The administrative law judges shall, upon 201
nomination by the Governor, be appointed by the General Assembly as 202
prescribed by law. They shall serve for a term of five years, but may be 203
removed by impeachment. The Governor shall from time to time select 204
one of the sixteen administrative law judges to serve as [chairman] 205
chairperson of the Workers' Compensation Commission at the pleasure 206
of the Governor. The administrative law judge selected by the Governor 207
to be [chairman] chairperson shall have previously served as an 208
administrative law judge in this state for at least one year. 209
(b) Notwithstanding the provisions of subsection (a) of this section, 210
on and after October 1, 1988, any administrative law judge whose term 211
expires on December thirty-first shall continue to serve until the next 212
succeeding March thirty-first. 213
(c) Each nomination made by the Governor to the General Assembly 214
for an administrative law judge shall be referred, without debate, to the 215
committee on the judiciary, which shall report thereon within thirty 216
legislative days from the time of reference, but no later than seven 217
legislative days before the adjourning of the General Assembly. Each 218 Substitute Bill No. 5250
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appointment by the General Assembly of an administrative law judge 219
shall be by concurrent resolution. The action on the passage of each such 220
resolution in the House and in the Senate shall be by vote taken on the 221
electrical roll-call device. No resolution shall contain the name of more 222
than one nominee. The Governor shall, within five days after he has 223
notice that any nomination for an administrative law judge made by him 224
has failed to be approved by the affirmative concurrent action of both 225
houses of the General Assembly, make another nomination to such 226
office. 227
(d) Notwithstanding the provisions of section 4-19, no vacancy in the 228
position of an administrative law judge shall be filled by the Governor 229
when the General Assembly is not in session unless, prior to such filling, 230
the Governor submits the name of the proposed vacancy appointee to 231
the committee on the judiciary. Within forty-five days, the committee on 232
the judiciary may, upon the call of either [chairman] chairperson, hold 233
a special meeting for the purpose of approving or disapproving such 234
proposed vacancy appointee by majority vote. The Governor shall not 235
administer the oath of office to such proposed vacancy appointee until 236
the committee has approved such proposed vacancy appointee. If the 237
committee determines that it cannot complete its investigation and act 238
on such proposed vacancy appointee within such forty-five-day period, 239
it may extend such period by an additional fifteen days. The committee 240
shall notify the Governor in writing of any such extension. Failure of the 241
committee to act on such proposed vacancy appointee within such 242
forty-five-day period or any fifteen-day extension period shall be 243
deemed to be an approval. 244
(e) Each administrative law judge shall be sworn to a faithful 245
performance of his duties. After notice and public hearing the Governor 246
may remove any administrative law judge for cause and the good of the 247
public service. Each administrative law judge shall devote his full time 248
to the duties of his office and shall not be otherwise gainfully employed. 249
Sec. 6. Subsection (a) of section 31-277 of the general statutes is 250
repealed and the following is substituted in lieu thereof (Effective from 251 Substitute Bill No. 5250
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passage): 252
(a) Each administrative law judge shall, during his first year of service 253
as an administrative law judge, receive an annual salary of six thousand 254
dollars less than the highest step level of a Superior Court judge; during 255
his second year of service as an administrative law judge, each 256
administrative law judge shall receive an annual salary of five thousand 257
dollars less than the highest step level of a Superior Court judge; during 258
his third year of service as an administrative law judge, he shall receive 259
an annual salary of four thousand dollars less than the highest step level 260
of a Superior Court judge; during his fourth year of service as an 261
administrative law judge, he shall receive an annual salary of three 262
thousand dollars less than the highest step level of a Superior Court 263
judge; during his fifth year of service as an administrative law judge, he 264
shall receive an annual salary of two thousand dollars less than the 265
highest step level of a Superior Court judge; and during his sixth year 266
of service as an administrative law judge, he shall receive an annual 267
salary of one thousand dollars less than the highest step level of a 268
Superior Court judge, together with his necessary clerical, office and 269
travel expenses as approved by the Comptroller; and the [chairman] 270
chairperson of the Workers' Compensation Commission shall receive in 271
addition ten thousand dollars annually. Each administrative law judge 272
shall devote his entire time to the duties of his office and shall not be 273
otherwise gainfully employed. 274
Sec. 7. Section 31-278 of the general statutes is repealed and the 275
following is substituted in lieu thereof (Effective from passage): 276
Each administrative law judge shall, for the purposes of this chapter, 277
have power to summon and examine under oath such witnesses, and 278
may direct the production of, and examine or cause to be produced or 279
examined, such books, records, vouchers, memoranda, documents, 280
letters, contracts or other papers in relation to any matter at issue as he 281
may find proper, and shall have the same powers in reference thereto as 282
are vested in magistrates taking depositions and shall have the power 283
to order depositions pursuant to section 52-148. He shall have power to 284 Substitute Bill No. 5250
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certify to official acts and shall have all powers necessary to enable him 285
to perform the duties imposed upon him by the provisions of this 286
chapter. Each administrative law judge shall hear all claims and 287
questions arising under this chapter in the district to which the 288
administrative law judge is assigned and all such claims shall be filed in 289
the district in which the claim arises, provided, if it is uncertain in which 290
district a claim arises, or if a claim arises out of several injuries or 291
occupational diseases which occurred in one or more districts, the 292
administrative law judge to whom the first request for hearing is made 293
shall hear and determine such claim to the same extent as if it arose 294
solely within his own district. If an administrative law judge is 295
disqualified or temporarily incapacitated from hearing any matter, or if 296
the parties shall so request and the [chairman] chairperson of the 297
Workers' Compensation Commission finds that it will facilitate a 298
speedier disposition of the claim, he shall designate some other 299
administrative law judge to hear and decide such matter. The Superior 300
Court, on application of an administrative law judge or the [chairman] 301
chairperson or the Attorney General, may enforce, by appropriate 302
decree or process, any provision of this chapter or any proper order of 303
an administrative law judge or the [chairman] chairperson rendered 304
pursuant to any such provision. Any administrative law judge, after 305
ceasing to hold office as such administrative law judge, may settle and 306
dispose of all matters relating to appealed cases, including correcting 307
findings and certifying records, as well as any other unfinished matters 308
pertaining to causes theretofore tried by him, to the same extent as if he 309
were still such administrative law judge. 310
Sec. 8. Section 31-279 of the general statutes is repealed and the 311
following is substituted in lieu thereof (Effective from passage): 312
(a) The [chairman] chairperson of the Workers' Compensation 313
Commission shall adopt regulations, in accordance with the provisions 314
of chapter 54, specifying the minimum information to be contained in a 315
notice of the availability of compensation which shall be posted in the 316
workplace by each employer subject to the provisions of this chapter 317 Substitute Bill No. 5250
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pursuant to subsection (f) of section 31-284. 318
(b) The [chairman] chairperson of the Workers' Compensation 319
Commission shall, not later than July 1, 1991, adopt regulations, in 320
accordance with chapter 54, to create a uniform system to be used by 321
medical professionals in determining the degree of physical impairment 322
of persons receiving compensation under this chapter. 323
(c) (1) Any employer or any insurer acting on behalf of an employer, 324
may establish a plan, subject to the approval of the [chairman] 325
chairperson of the Workers' Compensation Commission under 326
subsection (d) of this section, for the provision of medical care that the 327
employer provides for treatment of any injury or illness under this 328
chapter. Each plan shall contain such information as the [chairman] 329
chairperson shall require, including, but not limited to: 330
(A) A listing of all persons who will provide services under the plan, 331
along with appropriate evidence that each person listed has met any 332
licensing, certification or registration requirement necessary for the 333
person to legally provide the service in this state; 334
(B) A listing of all pharmacies that will provide services under the 335
plan, to which the employer, any insurer acting on behalf of the 336
employer, or any other entity acting on behalf of the employer or insurer 337
shall make direct payments for any prescription drug prescribed by a 338
physician participating in the plan; 339
(C) A designation of the times, places and manners in which the 340
services will be provided; 341
(D) A description of how the quality and quantity of medical care will 342
be managed; and 343
(E) Such other provisions as the employer and the employees may 344
agree to, subject to the approval of the [chairman] chairperson. 345
(2) The election by an employee covered by a plan established under 346 Substitute Bill No. 5250
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this subsection to obtain medical care and treatment from a provider of 347
medical services who is not listed in the plan shall suspend the 348
employee's right to compensation, subject to the order of the 349
administrative law judge. 350
(d) Each plan established under subsection (c) of this section shall be 351
submitted to the [chairman] chairperson for his approval at least one 352
hundred twenty days before the proposed effective date of the plan and 353
each approved plan, along with any proposed changes therein, shall be 354
resubmitted to the [chairman] chairperson every two years thereafter 355
for reapproval. The [chairman] chairperson shall approve or disapprove 356
such plans on the basis of standards established by the [chairman] 357
chairperson in consultation with a medical advisory panel appointed by 358
the [chairman] chairperson. Such standards shall include, but not be 359
limited to: (1) The ability of the plan to provide all medical and health 360
care services that may be required under this chapter in a manner that 361
is timely, effective and convenient for the employees; (2) the inclusion 362
in the plan of all categories of medical service and of an adequate 363
number of providers of each type of medical service in accessible 364
locations to ensure that employees are given an adequate choice of 365
providers; (3) the provision in the plan for appropriate financial 366
incentives to reduce service costs and utilization without a reduction in 367
the quality of service; (4) the inclusion in the plan of fee screening, peer 368
review, service utilization review and dispute resolution procedures 369
designed to prevent inappropriate or excessive treatment; and (5) the 370
inclusion in the plan of a procedure by which information on medical 371
and health care service costs and utilization will be reported to the 372
[chairman] chairperson in order for him to determine the effectiveness 373
of the plan. 374
(e) Any person who serves as a member of the medical advisory 375
panel, appointed by the [chairman] chairperson of the Workers' 376
Compensation Commission pursuant to subsection (d) of this section, 377
shall be deemed to be a state officer or employee for purposes of 378
indemnification and defense under section 5-141d. 379 Substitute Bill No. 5250
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Sec. 9. Section 31-280 of the general statutes is repealed and the 380
following is substituted in lieu thereof (Effective from passage): 381
(a) There shall continue to be a [chairman] chairperson of the 382
Workers' Compensation Commission selected by the Governor as 383
provided in section 31-276, as amended by this act. The [chairman] 384
chairperson may not hear any matter arising under this chapter, except 385
appeals brought before the Compensation Review Board and except as 386
provided in subdivision (14) of subsection (b) of this section. The 387
[chairman] chairperson shall prepare the forms used by the commission, 388
shall have custody of the insurance coverage cards, shall prepare and 389
keep a list of self-insurers, shall prepare the annual report to the 390
Governor and shall publish, when necessary, bulletins showing the 391
changes in the compensation law, with annotations to the Connecticut 392
cases. The [chairman] chairperson shall be provided with sufficient staff 393
to assist him in the performance of his duties. The [chairman] 394
chairperson may, within available appropriations, appoint acting 395
administrative law judges on a per diem basis from among former 396
administrative law judges or qualified members of the bar of this state. 397
Any acting administrative law judge appointed under this subsection 398
shall be paid on a per diem basis in an amount to be determined by the 399
Commissioner of Administrative Services, subject to the provisions of 400
section 4-40, and shall have all the powers and duties of administrative 401
law judges. The Workers' Compensation Commission shall not be 402
construed to be a commission or board subject to the provisions of 403
section 4-9a. 404
(b) The [chairman] chairperson of the Workers' Compensation 405
Commission shall: 406
(1) Establish workers' compensation districts and district offices 407
within the state, assign administrative law judges to the districts to hear 408
all matters arising under this chapter within the districts and may 409
reassign administration law judges once each year, except that when 410
there is a vacancy, illness or other emergency, or when unexpected 411
caseload increases require, the [chairman] chairperson may reassign 412 Substitute Bill No. 5250
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administrative law judges more than once each year; 413
(2) Adopt such rules as the [chairman] chairperson, in consultation 414
with the advisory board, deems necessary for the conduct of the internal 415
affairs of the Workers' Compensation Commission; 416
(3) Adopt regulations, in consultation with the advisory board and in 417
accordance with the provisions of chapter 54, to carry out his 418
responsibilities under this chapter; 419
(4) Prepare and adopt an annual budget and plan of operation in 420
consultation with the advisory board; 421
(5) Prepare and submit an annual report to the Governor and the 422
General Assembly; 423
(6) Allocate the resources of the commission to carry out the purposes 424
of this chapter; 425
(7) Establish an organizational structure and such divisions for the 426
commission, consistent with this chapter, as the [chairman] chairperson 427
deems necessary for the efficient and prompt operation of the 428
commission; 429
(8) Establish policy for all matters over which the commission has 430
jurisdiction, including education, statistical support and administrative 431
appeals; 432
(9) Appoint such supplementary advisory panels as the [chairman] 433
chairperson deems necessary and helpful; 434
(10) Establish, in consultation with the advisory board, (A) an 435
approved list of practicing physicians, surgeons, podiatrists, 436
optometrists and dentists from which an injured employee shall choose 437
for examination and treatment under the provisions of this chapter, 438
which shall include, but not be limited to, classifications of approved 439
practitioners by specialty, and (B) standards for the approval and 440 Substitute Bill No. 5250
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removal of physicians, surgeons, podiatrists, optometrists and dentists 441
from the list by the [chairman] chairperson; 442
(11) (A) Establish standards in consultation with the advisory board 443
for approving all fees for services rendered under this chapter by 444
attorneys, physicians, surgeons, podiatrists, optometrists, dentists and 445
other persons; 446
(B) In consultation with employers, their insurance carriers, union 447
representatives, physicians and third-party reimbursement 448
organizations establish, not later than October 1, 1993, and publish 449
annually thereafter, a fee schedule setting the fees payable by an 450
employer or its insurance carrier for services rendered under this 451
chapter by an approved physician, surgeon, podiatrist, optometrist, 452
dentist and other persons, provided the fee schedule shall not apply to 453
services rendered to a claimant who is participating in an employer's 454
managed care plan pursuant to section 31-279, as amended by this act. 455
On and after April 1, 2008, the [chairman] chairperson shall implement 456
and annually update relative values based on the Medicare resource-457
based relative value scale and implement coding guidelines in 458
conformance with the Correct Coding Initiative used by the federal 459
Centers for Medicare and Medicaid Services. The conversion to the 460
Medicare resource-based relative value scale shall be revenue-neutral. 461
The fee schedule shall limit the annual growth in total medical fees to 462
the annual percentage increase in the consumer price index for all urban 463
workers. The [chairman] chairperson may make necessary adjustments 464
to the fee schedule for services rendered under this chapter where there 465
is no established Medicare resource-based relative value. Payment of 466
the established fees by the employer or its insurance carrier shall 467
constitute payment in full to the practitioner, and the practitioner may 468
not recover any additional amount from the claimant to whom services 469
have been rendered; 470
(C) Issue, not later than October 1, 1993, and publish annually 471
thereafter, guidelines for the maximum fees payable by a claimant for 472
any legal services rendered by an attorney in connection with the 473 Substitute Bill No. 5250
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provisions of this chapter, which fees shall be approved in accordance 474
with the standards established by the [chairman] chairperson pursuant 475
to subparagraph (A) of this subdivision; 476
(12) Approve applications for employer-sponsored medical care 477
plans, based on standards developed in consultation with a medical 478
advisory panel as provided in section 31-279, as amended by this act; 479
(13) Establish procedures for the hiring, dismissing or otherwise 480
disciplining and promoting employees of the commission, subject 481
where appropriate to the provisions of chapter 67; 482
(14) Control the hearing calendars of the administrative law judges, 483
and if necessary, preside over informal hearings in regard to 484
compensation under the provisions of this chapter in order to facilitate 485
the timely and efficient processing of cases; 486
(15) Enter into contracts with consultants and such other persons as 487
necessary for the proper functioning of the commission; 488
(16) Direct and supervise all administrative affairs of the commission; 489
(17) Keep and maintain a record of all advisory board proceedings; 490
(18) Assign and reassign a district manager and other staff to each of 491
the commission's district offices; 492
(19) Collect and analyze statistical data concerning the administration 493
of the Workers' Compensation Commission; 494
(20) Direct and supervise the implementation of a uniform case filing 495
and processing system in each of the district offices that will include, but 496
not be limited to, the ability to provide data on the number of cases 497
having multiple hearings, the number of postponed hearings and 498
hearing schedules for each district office; 499
(21) Establish staff development, training and education programs 500
designed to improve the quality of service provided by the commission, 501 Substitute Bill No. 5250
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including, but not limited to, a program to train district office staff in the 502
screening of hearing requests; 503
(22) Develop standard forms for requesting hearings and standard 504
policies regarding limits on the number of informal hearings that will 505
be allowed under this chapter, and limits on the number of 506
postponements that will be permitted before a formal hearing is held 507
pursuant to section 31-297; 508
(23) Develop guidelines for expediting disputed cases; 509
(24) Establish an ongoing training program, in consultation with the 510
advisory board, designed to assist the administrative law judges in the 511
fulfillment of their duties pursuant to the provisions of section 31-278, 512
as amended by this act, which program shall include instruction in the 513
following areas: Discovery, evidence, statutory interpretation, medical 514
terminology, legal decision writing and the purpose and procedures of 515
informal and formal hearings; 516
(25) Evaluate, in conjunction with the advisory board, the 517
performance of each administrative law judge biannually and, 518
notwithstanding the provisions of subsection (b) of section 1-210 and 519
chapter 55, make the performance evaluation of any administrative law 520
judge available only to the Governor, the members of the joint standing 521
committee on the judiciary and the respective administrative law judge 522
prior to any public hearing on the reappointment of any such 523
administrative law judge. Any information disclosed to such persons 524
shall be used by such persons only for the purpose for which it was 525
given and shall not be disclosed to any other person; 526
(26) (A) In consultation with insurers and practitioners, establish not 527
later than October 1, 1993, and publish annually thereafter, practitioner 528
billing guidelines for employers, workers' compensation insurance 529
carriers and practitioners approved by the [chairman] chairperson 530
pursuant to subdivision (10) of this subsection. The guidelines shall 531
include procedures for the resolution of billing disputes and shall 532 Substitute Bill No. 5250
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prohibit a practitioner from billing or soliciting payments from a 533
claimant for services rendered to the claimant under the provisions of 534
this chapter (i) during a payment dispute between the practitioner and 535
the employer or its workers' compensation insurance carrier, or (ii) in 536
excess of the maximum fees established pursuant to subparagraph (B) 537
of subdivision (11) of this subsection; 538
(B) In consultation with practitioners and insurers, develop not later 539
than July 1, 1994, practice protocols for reasonable and appropriate 540
treatment of a claimant under the provisions of this chapter, based on 541
the diagnosis of injury or illness. The commission shall annually publish 542
the practice protocols for use by approved practitioners, employers, 543
workers' compensation insurance carriers and administrative law 544
judges in evaluating the necessity and appropriateness of care provided 545
to a claimant under the provisions of this chapter; 546
(C) In consultation with practitioners and insurers, develop not later 547
than July 1, 1994, utilization review procedures for reasonable and 548
appropriate treatment of a claimant under the provisions of this chapter. 549
The [chairman] chairperson shall annually publish the procedures for 550
use by approved practitioners, employers, workers' compensation 551
insurance carriers and administrative law judges in evaluating the 552
necessity and appropriateness of care provided to a claimant under the 553
provisions of this chapter. 554
(c) The [chairman] chairperson, as soon as practicable after April first 555
of each year, shall submit to the Comptroller an estimated budget of 556
expenditures which shall include all direct and indirect costs incurred 557
by the Workers' Compensation Commission for the succeeding fiscal 558
year commencing on July first next. The Workers' Compensation 559
Commission, for the purposes of administration, shall not expend more 560
than the amounts specified in such estimated budget for each item of 561
expenditure except as authorized by the Comptroller. The [chairman] 562
chairperson shall include in his annual report to the Governor a 563
statement showing the expenses of administering the Workers' 564
Compensation Act for the preceding fiscal year. 565 Substitute Bill No. 5250
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(d) The [chairman] chairperson and the Comptroller, as soon as 566
practicable after August first in each year, shall ascertain the total 567
amount of expenses incurred by the commission, including, in addition 568
to the direct cost of personnel services, the cost of maintenance and 569
operation, rentals for space occupied in state leased offices and all other 570
direct and indirect costs, incurred by the commission and the expenses 571
incurred by the Department of Aging and Disability Services in 572
providing rehabilitation services for employees suffering compensable 573
injuries in accordance with the provisions of section 31-283a, during the 574
preceding fiscal year in connection with the administration of the 575
Workers' Compensation Act and the total noncontributory payments 576
required to be made to the Treasurer towards administrative law judges' 577
retirement salaries as provided in sections 51-49, 51-50, 51-50a and 51-578
50b. An itemized statement of the expenses as so ascertained shall be 579
available for public inspection in the office of the [chairman] 580
chairperson of the Workers' Compensation Commission for thirty days 581
after notice to all insurance carriers, and to all employers permitted to 582
pay compensation directly affected thereby. 583
Sec. 10. Subsections (a) to (c), inclusive, of section 31-280a of the 2022 584
supplement to the general statutes are repealed and the following is 585
substituted in lieu thereof (Effective from passage): 586
(a) There shall be an Advisory Board of the Workers' Compensation 587
Commission to advise the [chairman] chairperson on matters 588
concerning policy for and the operation of the commission. The 589
advisory board shall consist of eight members, who shall be appointed 590
by the Governor, with the advice and consent of the General Assembly. 591
Four of such members shall represent employees and four shall 592
represent employers. One of such members representing employees 593
shall be an individual who has suffered an extensive disability arising 594
out of and in the course of his employment. One of such members 595
representing employers shall be a representative of a major general 596
hospital in the state. On or before January 1, 1992, the Governor shall 597
appoint, and the General Assembly shall confirm, such members of the 598 Substitute Bill No. 5250
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advisory board as follows: Two shall serve a term of four years from 599
said date, one of whom shall represent employees and one of whom 600
shall represent employers; two shall serve a term of three years from 601
said date, one of whom shall represent employees and one of whom 602
shall represent employers; two shall serve a term of two years from said 603
date, one of whom shall represent employees and one of whom shall 604
represent employers; and two shall serve a term of one year from said 605
date, one of whom shall represent employees and one of whom shall 606
represent employers. Thereafter such members shall be appointed for a 607
term of four years from January first in the year of their appointment. 608
Any vacancy on the advisory board shall be filled for the remainder of 609
the term in the same manner as the original appointment. The 610
[chairman] chairperson of the Workers' Compensation Commission 611
shall serve as an ex-officio member of the advisory board without the 612
power to vote. 613
(b) The appointed members of the advisory board shall select a ninth 614
member who shall be impartial and shall serve as the [chairman] 615
chairperson of the advisory board. The members of the advisory board 616
shall serve without compensation. Each member shall be reimbursed for 617
expenses necessarily incurred by the member in the performance of his 618
duties. The advisory board shall not be construed to be a board or 619
commission subject to the provisions of section 4-9a. The Workers' 620
Compensation Commission shall provide such staff as is necessary for 621
the performance of the functions and duties of the advisory board. 622
(c) The advisory board shall meet at least once in each calendar 623
quarter and at such other times as the [chairman] chairperson or the 624
[chairman] chairperson of the Workers' Compensation Commission 625
deem necessary. All actions of the advisory board shall require the 626
affirmative vote of six members of the advisory board. The advisory 627
board may bring any matter related to the operation of the workers' 628
compensation system to the attention of the [chairman] chairperson of 629
the Workers' Compensation Commission. The advisory board may 630
adopt any rules of procedure that the board deems necessary to carry 631 Substitute Bill No. 5250
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out its duties under this chapter. 632
Sec. 11. Subsection (a) of section 31-280b of the general statutes is 633
repealed and the following is substituted in lieu thereof (Effective from 634
passage): 635
(a) There shall be a Compensation Review Board within the Workers' 636
Compensation Commission. The [chairman] chairperson of the 637
Workers' Compensation Commission shall serve as chief of the 638
Compensation Review Board and shall have responsibility for the 639
operation of the board. On or before January 1, 1992, the [chairman] 640
chairperson shall appoint a chief clerk of the Compensation Review 641
Board under the provisions of chapter 67 who shall be responsible to the 642
[chairman] chairperson for the efficient operation of the board. 643
Sec. 12. Section 31-283g of the general statutes is repealed and the 644
following is substituted in lieu thereof (Effective from passage): 645
The Workers' Compensation Commission shall provide, in 646
convenient locations throughout the state, education services to 647
employees concerning the prevention of occupational diseases and 648
injuries, training for nonmanagement employees in workers' 649
compensation procedures and substantive rights, information to 650
employers concerning known and suspected workplace hazards and 651
training and information for medical professionals in workers' 652
compensation procedures, standards and requirements. The [chairman] 653
chairperson shall be provided with sufficient staff to assist him in the 654
performance of his duties. The [chairman] chairperson of the Workers' 655
Compensation Commission may adopt regulations, in accordance with 656
the provisions of chapter 54, to implement the provisions of this section. 657
Sec. 13. Subsections (b) and (c) of section 31-284 of the general statutes 658
are repealed and the following is substituted in lieu thereof (Effective 659
from passage): 660
(b) Each employer who does not furnish to the [chairman] 661
chairperson of the Workers' Compensation Commission satisfactory 662 Substitute Bill No. 5250
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proof of his solvency and financial ability to pay directly to injured 663
employees or other beneficiaries compensation provided by this chapter 664
shall insure his full liability under this chapter, other than his liability 665
for assessments pursuant to sections 31-345, as amended by this act, and 666
31-354 in one of the following ways: (1) By filing with the Insurance 667
Commissioner in form acceptable to him security guaranteeing the 668
performance of the obligations of this chapter by the employer; or (2) by 669
insuring his full liability under this part, exclusive of any liability 670
resulting from the terms of section 31-284b, in any stock or mutual 671
companies or associations that are or may be authorized to take such 672
risks in this state; or (3) by any combination of the methods provided in 673
subdivisions (1) and (2) of this subsection as he may choose, subject to 674
the approval of the Insurance Commissioner. If the employer fails to 675
comply with the requirements of this subsection, an employee may 676
bring an action against such employer for damages on account of 677
personal injury sustained by such employee arising out of and in the 678
course of his employment or on account of death resulting from 679
personal injury so sustained, except that there shall be no liability under 680
this section to an individual on the part of the employer if such 681
individual held himself out to the employer as an independent 682
contractor and the employer, in good faith, relied on that representation 683
as well as other indicia of such status and classified such individual as 684
an independent contractor. In case of an alleged noncompliance with the 685
provisions of this subsection, a certificate of noncompliance under oath, 686
by the [chairman] chairperson of the Workers' Compensation 687
Commission, shall constitute prima facie evidence of noncompliance. 688
(c) Each employer who does not furnish to the [chairman] 689
chairperson of the Workers' Compensation Commission satisfactory 690
proof of his solvency and financial ability to pay directly to the State 691
Treasurer the assessments required in sections 31-345, as amended by 692
this act, and 31-354 shall insure his full liability for the assessments in 693
one of the following ways: (1) By filing with the Insurance 694
Commissioner in form acceptable to him security guaranteeing the 695
payment of the assessments by the employer; (2) by insuring his full 696 Substitute Bill No. 5250
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liability for the assessments in any stock or mutual companies or 697
associations that are or may be authorized to take such risks in this state; 698
or (3) by any combination of the methods provided in subdivisions (1) 699
and (2) of this subsection as he may choose, subject to the approval of 700
the Insurance Commissioner. The payment of the assessments required 701
under sections 31-345, as amended by this act, and 31-354 is a condition 702
of doing business in this state and failure to pay the assessments, when 703
due, shall result in the denial of the privilege of doing business in this 704
state or to self-insure under subsections (b) and (c) of this section. If the 705
liability for the assessments is insured, the insurance shall be by 706
endorsement to a policy meeting all of the requirements of the Insurance 707
Commissioner, or by a separate policy insuring the liability for the 708
assessments, and otherwise meeting all of the requirements of the 709
Insurance Commissioner. In the case of any employer who files 710
acceptable security guaranteeing the liability for the assessments, failure 711
to pay the assessments, when due, shall result in the denial of the 712
privilege to self-insure under subsections (b) and (c) of this section. 713
Sec. 14. Subsection (e) of section 31-288 of the general statutes is 714
repealed and the following is substituted in lieu thereof (Effective from 715
passage): 716
(e) The [chairman] chairperson of the Workers' Compensation 717
Commission shall notify the State Treasurer and the Attorney General 718
of the imposition of any penalty, the date it was imposed, the amount 719
and whether there has been an appeal of said penalty. Any civil penalty 720
order issued pursuant to subsection (c) or (d) of this section shall state 721
that payment shall be made to the Second Injury Fund of the State 722
Treasurer, and that failure to pay within ninety days may result in civil 723
action to double the penalty. The State Treasurer shall collect any 724
penalty owed, and if the penalty is not paid within ninety days, the State 725
Treasurer shall notify the [chairman] chairperson of the Workers' 726
Compensation Commission and the Attorney General so that civil 727
action may be brought pursuant to section 31-289. Any appeal of a 728
penalty assessed pursuant to the provisions of subsections (c) and (d) of 729 Substitute Bill No. 5250
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this section shall be taken in accordance with the provisions of section 730
31-301, as amended by this act. The [chairman] chairperson shall adopt 731
regulations for the administrative law judges to use in setting fines 732
which shall require the administrative law judges to take into account 733
the nature of the employer's business and his number of employees. 734
Sec. 15. Section 31-289a of the general statutes is repealed and the 735
following is substituted in lieu thereof (Effective from passage): 736
(a) If any civil penalty imposed pursuant to any provision of this 737
chapter is not paid within ninety days of its imposition by an 738
administrative law judge, or within ninety days of the final disposition 739
of an appeal, as the case may be, the [chairman] chairperson of the 740
Workers' Compensation Commission shall immediately notify the 741
Attorney General of such failure to pay. Upon such notification, the 742
Attorney General may bring a civil action in the name of the state of 743
Connecticut in the superior court for the judicial district where the 744
administrative law judge imposed the civil penalty, to recover double 745
the amount of the civil penalty together with reasonable attorney's fees 746
and costs as taxed by the court. Any recovery under this section shall be 747
disbursed in the same manner as recoveries pursuant to section 31-355, 748
as amended by this act. 749
(b) An affidavit sworn to or affirmed by the [chairman] chairperson 750
of the Workers' Compensation Commission, or by the administrative 751
law judge who imposed the civil penalty referred to in the affidavit, 752
stating the name of the administrative law judge who imposed the civil 753
penalty, the amount of the civil penalty, the name of the violator against 754
whom the civil penalty was imposed, whether or not an appeal was 755
taken, the disposition of the appeal and whether or not the penalty was 756
paid, shall constitute prima facie proof of the facts contained in the 757
affidavit. Copies of the records of the Workers' Compensation 758
Commission, or of any administrative law judge, certified by said 759
[chairman] chairperson or by the administrative law judge having 760
custody of the records, containing the name of the administrative law 761
judge who imposed a civil penalty, the amount of the civil penalty, the 762 Substitute Bill No. 5250
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name of the violator against whom the civil penalty was imposed, 763
whether or not an appeal was taken, the disposition of the appeal and 764
whether or not the penalty was paid, shall constitute prima facie proof 765
of the facts contained in the records. 766
(c) Civil actions pursuant to this section shall be privileged in their 767
assignment for trial. 768
Sec. 16. Subsection (b) of section 31-290a of the 2022 supplement to 769
the general statutes is repealed and the following is substituted in lieu 770
thereof (Effective from passage): 771
(b) Any employee who is so discharged, disciplined or discriminated 772
against or who has been deliberately misinformed or deliberately 773
dissuaded from filing a claim for workers' compensation benefits or a 774
claim for payment of benefits from the Connecticut Essential Workers 775
COVID-19 Assistance Fund may either: (1) Bring a civil action in the 776
superior court for the judicial district where the employer has its 777
principal office for the reinstatement of his previous job, payment of 778
back wages and reestablishment of employee benefits to which he 779
would have otherwise been entitled if he had not been discriminated 780
against or discharged and any other damages caused by such 781
discrimination or discharge. The court may also award punitive 782
damages. Any employee who prevails in such a civil action shall be 783
awarded reasonable attorney's fees and costs to be taxed by the court; 784
or (2) file a complaint with the [chairman] chairperson of the Workers' 785
Compensation Commission alleging violation of the provisions of 786
subsection (a) of this section. Upon receipt of any such complaint, the 787
[chairman] chairperson shall select an administrative law judge to hear 788
the complaint, provided any administrative law judge who has 789
previously rendered any decision concerning the claim shall be 790
excluded. The hearing shall be held in the workers' compensation 791
district where the employer has its principal office. After the hearing, 792
the administrative law judge shall send each party a written copy of his 793
decision. The administrative law judge may award the employee the 794
reinstatement of his previous job, payment of back wages and 795 Substitute Bill No. 5250
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reestablishment of employee benefits to which he otherwise would have 796
been eligible if he had not been discriminated against or discharged. 797
Any employee who prevails in such a complaint shall be awarded 798
reasonable attorney's fees. Any party aggrieved by the decision of the 799
administrative law judge may appeal the decision to the Appellate 800
Court. 801
Sec. 17. Subsections (a) and (b) of section 31-290d of the general 802
statutes are repealed and the following is substituted in lieu thereof 803
(Effective from passage): 804
(a) There shall be a workers' compensation fraud unit within the 805
office of the Chief State's Attorney in the Division of Criminal Justice. 806
The unit, under the supervision of the Chief State's Attorney, may, upon 807
receipt of a complaint, at the request of the [chairman] chairperson of 808
the Workers' Compensation Commission or on its own initiative, 809
investigate cases of alleged fraud involving any claim for benefits, any 810
receipt or payment of benefits, or the insurance or self-insurance of 811
liability under sections 31-275 to 31-355a, inclusive, as amended by this 812
act. Upon conclusion of the investigation, the Chief State's Attorney 813
shall take appropriate action to enforce the laws of this state. 814
(b) The workers' compensation fraud unit shall submit a quarterly 815
report detailing its activities to the [chairman] chairperson and the 816
Advisory Board of the Workers' Compensation Commission and to the 817
Insurance Commissioner. 818
Sec. 18. Section 31-294d of the 2022 supplement to the general statutes 819
is repealed and the following is substituted in lieu thereof (Effective from 820
passage): 821
(a) (1) The employer, as soon as the employer has knowledge of an 822
injury, shall provide a competent physician, surgeon, physician 823
assistant or advanced practice registered nurse to attend the injured 824
employee and, in addition, shall furnish any medical and surgical aid or 825
hospital and nursing service, including medical rehabilitation services 826 Substitute Bill No. 5250
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and prescription drugs, as the physician, surgeon, physician assistant or 827
advanced practice registered nurse deems reasonable or necessary. The 828
employer, any insurer acting on behalf of the employer, or any other 829
entity acting on behalf of the employer or insurer shall be responsible 830
for paying the cost of such prescription drugs directly to the provider. 831
If the employer utilizes an approved providers list, when an employee 832
reports a work-related injury or condition to the employer the employer 833
shall provide the employee with such approved providers list within 834
two business days of such reporting. 835
(2) If the injured employee is a local or state police officer, state 836
marshal, judicial marshal, correction officer, emergency medical 837
technician, paramedic, ambulance driver, firefighter, or active member 838
of a volunteer fire company or fire department engaged in volunteer 839
duties, who has been exposed in the line of duty to blood or bodily fluids 840
that may carry blood-borne disease, the medical and surgical aid or 841
hospital and nursing service provided by the employer shall include any 842
relevant diagnostic and prophylactic procedure for and treatment of any 843
blood-borne disease. 844
(b) The employee shall select the physician, surgeon, physician 845
assistant or advanced practice registered nurse from an approved list of 846
physicians, surgeons, physician assistants and advanced practice 847
registered nurses prepared by the [chairman] chairperson of the 848
Workers' Compensation Commission. If the employee is unable to make 849
the selection, the employer shall do so, subject to ratification by the 850
employee or his next of kin. If the employer has a full-time staff 851
physician, physician assistant or advanced practice registered nurse or 852
if a physician, physician assistant or advanced practice registered nurse 853
is available on call, the initial treatment required immediately following 854
the injury may be rendered by that physician, physician assistant or 855
advanced practice registered nurse, but the employee may thereafter 856
select his own physician, physician assistant or advanced practice 857
registered nurse as provided by this chapter for any further treatment 858
without prior approval of the administrative law judge. 859 Substitute Bill No. 5250
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(c) The administrative law judge may, without hearing, at the request 860
of the employer or the injured employee, when good reason exists, or 861
on his own motion, authorize or direct a change of physician, surgeon, 862
physician assistant or advanced practice registered nurse or hospital or 863
nursing service provided pursuant to subsection (a) of this section. 864
(d) (1) The pecuniary liability of the employer for the medical and 865
surgical service required by this section shall be limited to the charges 866
that prevail in the same community or similar communities for similar 867
treatment of injured persons of a like standard of living when the similar 868
treatment is paid for by the injured person. Notwithstanding the 869
provisions of chapter 368z, prior to the date the liability of the employer 870
is established pursuant to subdivision (2) of this subsection, the liability 871
of the employer for hospital service shall be determined exclusively by 872
the provisions of this subdivision and shall remain the amount it 873
actually costs the hospital to render the service, as determined by the 874
administrative law judge, except in the case of state humane institutions, 875
the liability of the employer shall be the per capita cost as determined 876
by the Comptroller under the provisions of section 17b-223. All disputes 877
concerning liability for hospital services in workers' compensation cases 878
shall be filed not later than one year from the date the initial payment 879
for services was remitted, regardless of the date such services were 880
provided, unless any applicable law, rule or regulation establishes a 881
shorter time frame, and shall be settled by the administrative law judge 882
in accordance with this chapter. 883
(2) Commencing ninety days after the formulas established by the 884
[chairman] chairperson of the Workers' Compensation Commission 885
have been published pursuant to subsection (e) of this section, unless 886
the employer and hospital or ambulatory surgical center have otherwise 887
negotiated to determine the liability of the employer for hospital or 888
ambulatory surgical center services required by this section, the liability 889
of the employer for hospital or ambulatory surgical center services shall 890
be: (A) If such services are covered by Medicare, limited to the 891
reimbursements listed in such formulas published pursuant to 892 Substitute Bill No. 5250
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subsection (e) of this section, or (B) if such services are not covered by 893
Medicare, determined by the [chairman] chairperson, in consultation 894
with employers and their insurance carriers, self-insured employers, 895
hospitals, ambulatory surgical centers, third-party reimbursement 896
organizations and other entities as deemed necessary by the Workers' 897
Compensation Commission. 898
(e) Not later than January 1, 2015, the [chairman] chairperson of the 899
Workers' Compensation Commission shall, in consultation with 900
employers and their insurance carriers, self-insured employers, 901
hospitals, ambulatory surgical centers, third-party reimbursement 902
organizations and other entities as deemed necessary by the Workers' 903
Compensation Commission, establish and publish Medicare-based 904
formulas, when available, to set the liability of employers for hospital 905
and ambulatory surgical center services required by this section that are 906
covered by Medicare. After the initial publication of such formulas, the 907
[chairman] chairperson shall publish such formulas on each January 908
first thereafter. 909
(f) If the employer fails to promptly provide a physician, surgeon, 910
physician assistant or advanced practice registered nurse or any medical 911
and surgical aid or hospital and nursing service as required by this 912
section, the injured employee may obtain a physician, surgeon, 913
physician assistant or advanced practice registered nurse, selected from 914
the approved list prepared by the [chairman] chairperson, or such 915
medical and surgical aid or hospital and nursing service at the expense 916
of the employer. 917
Sec. 19. Subsection (a) of section 31-294f of the general statutes is 918
repealed and the following is substituted in lieu thereof (Effective from 919
passage): 920
(a) An injured employee shall submit himself to examination by a 921
reputable practicing physician or surgeon, at any time while claiming or 922
receiving compensation, upon the reasonable request of the employer 923
or at the direction of the administrative law judge. The examination 924 Substitute Bill No. 5250
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shall be performed to determine the nature of the injury and the 925
incapacity resulting from the injury. The physician or surgeon shall be 926
selected by the employer from an approved list of physicians and 927
surgeons prepared by the [chairman] chairperson of the Workers' 928
Compensation Commission and shall be paid by the employer. At any 929
examination requested by the employer or directed by the 930
administrative law judge under this section, the injured employee shall 931
be allowed to have in attendance any reputable practicing physician or 932
surgeon that the employee obtains and pays for himself. The employee 933
shall submit to all other physical examinations as required by this 934
chapter. The refusal of an injured employee to submit himself to a 935
reasonable examination under this section shall suspend his right to 936
compensation during such refusal. 937
Sec. 20. Subsection (c) of section 31-295 of the general statutes is 938
repealed and the following is substituted in lieu thereof (Effective from 939
passage): 940
(c) If the employee is entitled to receive compensation for permanent 941
disability to an injured member in accordance with the provisions of 942
subsection (b) of section 31-308, the compensation shall be paid to him 943
beginning not later than thirty days following the date of the maximum 944
improvement of the member or members and, if the compensation 945
payments are not so paid, the employer shall, in addition to the 946
compensation rate, pay interest at the rate of ten per cent per annum on 947
such sum or sums from the date of maximum improvement. The 948
employer shall ascertain at least monthly whether employees are 949
entitled to compensation because of a loss of wages as a result of the 950
injury and, if there is a loss of wages, shall pay the compensation. The 951
[chairman] chairperson of the Workers' Compensation Commission 952
shall adopt regulations, in accordance with the provisions of chapter 54, 953
for the purpose of assuring prompt payment by the employer or his 954
insurance carrier. 955
Sec. 21. Section 31-297a of the general statutes is repealed and the 956
following is substituted in lieu thereof (Effective from passage): 957 Substitute Bill No. 5250
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In any informal hearing held by the administrative law judge or 958
[chairman] chairperson of the Workers' Compensation Commission in 959
regard to compensation under the provisions of this chapter, any 960
recommendations made by the administrative law judge or [chairman] 961
chairperson at the informal hearing shall be reduced to writing and, if 962
the parties accept such recommendations, the recommendations shall be 963
as binding upon both parties as an award by the administrative law 964
judge or [chairman] chairperson. The administrative law judge or 965
[chairman] chairperson shall not postpone any such informal hearing if 966
one party fails to attend unless both parties agree to the postponement. 967
Sec. 22. Subsection (e) of section 31-301 of the general statutes is 968
repealed and the following is substituted in lieu thereof (Effective from 969
passage): 970
(e) When an appeal is taken to the Compensation Review Board, the 971
chief clerk thereof shall notify the administrative law judge from whose 972
award the appeal was taken, in writing, of any action of the 973
Compensation Review Board thereon and of the final disposition of the 974
appeal, whether by judgment, withdrawal or otherwise, and shall upon 975
the decision of the appeal, furnish the administrative law judge with a 976
copy of the decision. Whenever any appeal is pending, if it appears to 977
the Compensation Review Board that justice so requires, the 978
Compensation Review Board shall order a certified copy of the evidence 979
for the use of the employer, the employee or both, and the certified copy 980
shall be made a part of the record on the appeal. The procedure in 981
appealing from an award of the administrative law judge shall be the 982
same as the procedure employed in an appeal from the Superior Court 983
to the Supreme Court, where applicable. The [chairman] chairperson of 984
the Workers' Compensation Commission shall adopt regulations, in 985
accordance with the provisions of chapter 54, to establish rules, methods 986
of procedure and forms as the [chairman] chairperson deems expedient 987
for the purposes of this chapter. 988
Sec. 23. Subsection (b) of section 31-306b of the general statutes is 989
repealed and the following is substituted in lieu thereof (Effective from 990 Substitute Bill No. 5250
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passage): 991
(b) Not later than October 1, 1998, the [chairman] chairperson of the 992
Workers' Compensation Commission shall develop a standard form 993
that may be used by employers and insurers to provide the notice 994
required under subsection (a) of this section. 995
Sec. 24. Subsection (b) of section 31-310 of the general statutes is 996
repealed and the following is substituted in lieu thereof (Effective from 997
passage): 998
(b) Each August fifteenth, the [chairman] chairperson of the Workers' 999
Compensation Commission, in consultation with the advisory board, 1000
shall publish tables of the average weekly wage and seventy-five per 1001
cent of the average weekly wage after being reduced by any deduction 1002
for federal or state taxes, or both, and for the federal Insurance 1003
Contributions Act, to be effective the following October first, except that 1004
not later than June thirtieth, the [chairman] chairperson, in consultation 1005
with the advisory board, shall publish tables of the average weekly 1006
wage and seventy-five per cent of the average weekly wage after being 1007
reduced by any deduction for federal or state taxes, or both, and for the 1008
federal Insurance Contributions Act, to be effective during the period 1009
July 1, 1993, to October 1, 1993. Such tables shall be conclusive for the 1010
purpose of determining seventy-five per cent of the average weekly 1011
earnings of an injured employee after such earnings have been reduced 1012
by any deduction for federal or state taxes, or both, and for the federal 1013
Insurance Contributions Act made from such employee's total wages 1014
received during the period of calculation of the employee's average 1015
weekly wage for purposes of sections 31-306, 31-307 and 31-308. 1016
Sec. 25. Subsection (a) of section 31-316 of the general statutes is 1017
repealed and the following is substituted in lieu thereof (Effective from 1018
passage): 1019
(a) Each employer shall keep a record of the injuries sustained by his 1020
employees in the course of their employment that result in incapacity 1021 Substitute Bill No. 5250
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for one day or more. Each employer shall send to the [chairman] 1022
chairperson of the Workers' Compensation Commission, in duplicate, 1023
each week, or more often if so directed, a report of all injuries that the 1024
rules prescribed by the [chairman] chairperson determine, including the 1025
time of each injury, together with notices of claims for compensation 1026
that have been served upon the employer under section 31-294c, as 1027
amended by this act, within one week of the receipt of the notices of 1028
claims. The employer shall inform the [chairman] chairperson as to the 1029
extent to which he provides accident and health insurance and life 1030
insurance coverage for his employees, and his payment or contribution 1031
requirements for any employee welfare plan, as defined in section 31-1032
284b. No other report of injuries to employees shall be required by any 1033
department or office of the state from employers. The duplicates of the 1034
reports shall be immediately transmitted to the Labor Commissioner. 1035
Sec. 26. Section 31-326 of the general statutes is repealed and the 1036
following is substituted in lieu thereof (Effective from passage): 1037
Whenever the [chairman] chairperson of the Workers' Compensation 1038
Commission finds that any insurance company or association insuring 1039
the liability of an employer under the provisions of this chapter is 1040
conducting such business improperly or is dilatory in investigating and 1041
adjusting claims or making payments, or fails to comply with the 1042
provisions of this chapter or the rules, methods or procedure and forms 1043
adopted by the [chairman] chairperson, the [chairman] chairperson 1044
shall notify the Insurance Commissioner, in writing, setting forth the 1045
facts, and thereupon the Insurance Commissioner shall fix a time and 1046
place for a hearing thereon, giving reasonable notice to the [chairman] 1047
chairperson and to such company or association of such hearing, and, if 1048
he finds the allegations to be true, he shall either suspend for a time or 1049
revoke the license of such company or association to transact such 1050
business in this state. Whenever an administrative law judge has reason 1051
to believe that any employer who has furnished proof of his financial 1052
ability or filed with the Insurance Commissioner security for the 1053
performance of the obligations of this chapter in accordance with section 1054 Substitute Bill No. 5250
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31-284, as amended by this act, is dilatory in investigating or adjusting 1055
claims or in making payments, or fails to comply with the provisions of 1056
this chapter or the rules, methods of procedure and forms adopted by 1057
the [chairman] chairperson, he may notify the Insurance Commissioner, 1058
in writing, setting forth the facts, and thereupon the Insurance 1059
Commissioner shall fix the time and place for a hearing thereon, giving 1060
reasonable notice to the administrative law judge and to such employer, 1061
and, if he finds the allegations to be true, then, after ten days from the 1062
notice of such findings to such employer, the compliance of such 1063
employer with the terms of section 31-284, as amended by this act, shall 1064
be, as to any future injuries, null and void. 1065
Sec. 27. Subsection (b) of section 31-345 of the general statutes is 1066
repealed and the following is substituted in lieu thereof (Effective from 1067
passage): 1068
(b) (1) When, after the close of a fiscal year ending prior to July 1, 1069
1990, the [chairman] chairperson of the Workers' Compensation 1070
Commission and the Comptroller have determined the total amount of 1071
expenses of the Workers' Compensation Commission in accordance 1072
with the provisions of subsection (d) of section 31-280, as amended by 1073
this act, the Treasurer shall thereupon assess upon and collect from each 1074
employer, other than the state and any municipality participating for 1075
purposes of its liability under this chapter as a member in an interlocal 1076
risk management agency pursuant to chapter 113a, the proportion of 1077
such expenses that the total compensation and payment for hospital, 1078
medical and nursing care made by such self-insured employer or 1079
private insurance carrier acting on behalf of any such employer bore to 1080
the total compensation and payments for hospital, medical and nursing 1081
care made by all such insurance carriers and self-insurers. The amount 1082
so secured shall be used to reimburse the Treasurer for appropriations 1083
theretofore made by the state for the payment in the first instance of the 1084
expenses of administering this chapter. On and after July 1, 1986, the 1085
Treasurer shall, as soon as possible after the close of a fiscal year ending 1086
prior to July 1, 1990, estimate the pro rata cost to each employer based 1087 Substitute Bill No. 5250
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upon the costs assessed to such employer in the immediately preceding 1088
fiscal year and shall assess upon and collect from each such employer 1089
such estimated costs annually which shall be payable as provided in 1090
subsection (a) of this section except each annual assessment shall 1091
include an amount which represents the difference between the 1092
payments collected and the actual costs assessed to such employer for 1093
the immediately preceding fiscal year. The Treasurer is authorized to 1094
make credits or rebates for overpayments made under this subsection 1095
by any employer for any fiscal year. 1096
(2) The [chairman] chairperson of the Workers' Compensation 1097
Commission shall annually, on or after July first of each fiscal year, 1098
determine an amount sufficient in the [chairman's] chairperson's 1099
judgment to meet the expenses incurred by the Workers' Compensation 1100
Commission and the Department of Aging and Disability Services in 1101
providing rehabilitation services for employees suffering compensable 1102
injuries in accordance with section 31-283a. Such expenses shall include 1103
(A) the costs of the Division of Workers' Rehabilitation and the 1104
programs established by its director, for fiscal years prior to the fiscal 1105
year beginning July 1, 2011, (B) the costs of the Division of Worker 1106
Education and the programs established by its director, and (C) funding 1107
for the occupational health clinic program created pursuant to sections 1108
31-396 to 31-402, inclusive. The Treasurer shall thereupon assess upon 1109
and collect from each employer, other than the state and any 1110
municipality participating for purposes of its liability under this chapter 1111
as a member in an interlocal risk management agency pursuant to 1112
chapter 113a, the proportion of such expenses, based on the 1113
immediately preceding fiscal year, that the total compensation and 1114
payment for hospital, medical and nursing care made by such 1115
self-insured employer or private insurance carrier acting on behalf of 1116
any such employer bore to the total compensation and payments for the 1117
immediately preceding fiscal year for hospital, medical and nursing care 1118
made by such insurance carriers and self-insurers. For the fiscal years 1119
ending June 30, 2000, and June 30, 2001, such assessments shall not 1120
exceed five per cent of such total compensation and payments made by 1121 Substitute Bill No. 5250
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such insurance carriers and self-insurers. For the fiscal years ending 1122
June 30, 2002, and June 30, 2003, such assessments shall not exceed four 1123
and one-half per cent of such total compensation and payments made 1124
by such insurance carriers and self-insurers. For any fiscal year ending 1125
on or after June 30, 2004, such assessment shall not exceed four per cent 1126
of such total compensation and payments made by such insurance 1127
carriers and self-insurers. Such assessments and expenses shall not 1128
exceed the budget estimates submitted in accordance with subsection 1129
(c) of section 31-280, as amended by this act. For each fiscal year, such 1130
assessment shall be reduced pro rata by the amount of any surplus from 1131
the assessments of prior fiscal years. Said surplus shall be determined in 1132
accordance with subdivision (3) of this subsection. Such assessments 1133
shall be made in one annual assessment upon receipt of the [chairman's] 1134
chairperson's expense determination by the Treasurer. All assessments 1135
shall be paid not later than sixty days following the date of the 1136
assessment by the Treasurer. Any employer who fails to pay such 1137
assessment to the Treasurer within the time prescribed by this 1138
subdivision shall pay interest to the Treasurer on the assessment at the 1139
rate of eight per cent per annum from the date the assessment is due 1140
until the date of payment. All assessments received by the Treasurer 1141
pursuant to this subdivision to meet the expenses of the Workers' 1142
Compensation Commission shall be deposited in the Workers' 1143
Compensation Administration Fund established under section 31-344a. 1144
All assessments received by the Treasurer pursuant to this subdivision 1145
to meet the expenses incurred by the Department of Aging and 1146
Disability Services in providing rehabilitation services for employees 1147
suffering compensable injuries in accordance with section 31-283a shall 1148
be deposited in the Workers' Compensation Administration Fund. The 1149
Treasurer is hereby authorized to make credits or rebates for 1150
overpayments made under this subsection by any employer for any 1151
fiscal year. 1152
(3) As soon as practicable after the close of the state fiscal year, the 1153
Comptroller shall examine the Workers' Compensation Administration 1154
Fund and shall direct the State Treasurer to set aside within said fund 1155 Substitute Bill No. 5250
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amounts in excess of fifty per cent of the expenditures of the Workers' 1156
Compensation Commission for the most recently completed fiscal year, 1157
which shall be considered a surplus for purposes of subdivision (2) of 1158
subsection (b) of this section. 1159
Sec. 28. Section 31-348 of the general statutes is repealed and the 1160
following is substituted in lieu thereof (Effective from passage): 1161
Every insurance company writing compensation insurance or its 1162
duly appointed agent shall report in writing or by other means to the 1163
[chairman] chairperson of the Workers' Compensation Commission, in 1164
accordance with rules prescribed by the [chairman] chairperson, the 1165
name of the person or corporation insured, including the state, the day 1166
on which the policy becomes effective and the date of its expiration, 1167
which report shall be made within fifteen days from the date of the 1168
policy. The cancellation of any policy so written and reported shall not 1169
become effective until fifteen days after notice of such cancellation has 1170
been filed with the [chairman] chairperson. Any insurance company 1171
violating any provision of this section shall be fined not less than one 1172
hundred nor more than one thousand dollars for each offense. 1173
Sec. 29. Section 31-349c of the general statutes is repealed and the 1174
following is substituted in lieu thereof (Effective from passage): 1175
(a) The custodian of the Second Injury Fund and an insurer or self-1176
insured employer seeking to transfer a claim to the fund shall submit all 1177
controverted issues regarding the existence of a previous disability 1178
under section 31-349 to the [chairman] chairperson of the Workers' 1179
Compensation Commission. The [chairman] chairperson shall appoint 1180
a panel of three physicians, as defined in subdivision (17) of section 31-1181
275, and submit such dispute to the panel, along with whatever 1182
evidence and materials he deems necessary for consideration in the 1183
matter. The panel may examine the claimant, who shall submit to any 1184
examination such panel may require. Within sixty days of receiving the 1185
submission, the panel shall file its opinion, in writing, with the 1186
[chairman] chairperson, who shall forward it, along with any records 1187 Substitute Bill No. 5250
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generated by the panel's work on the case, to the administrative law 1188
judge having jurisdiction over the claim in which the dispute arose. The 1189
panel's opinion shall be determined by a majority vote of the three 1190
members. Such opinion shall be binding on all parties to the claim and 1191
may not be appealed to the Compensation Review Board pursuant to 1192
section 31-301, as amended by this act. 1193
(b) The [chairman] chairperson of the Workers' Compensation 1194
Commission shall adopt regulations in accordance with the provisions 1195
of chapter 54 to establish a fee schedule for payment of medical panel 1196
members. Any fees paid pursuant to the provisions of this section shall 1197
be paid by the self-insured employer or insurer seeking fund 1198
reimbursement. 1199
Sec. 30. Subdivision (2) of subsection (a) of section 31-349g of the 1200
general statutes is repealed and the following is substituted in lieu 1201
thereof (Effective from passage): 1202
(2) "Self-insured employer" means an employer who is approved to 1203
self-insure its liabilities under this chapter by the [chairman] 1204
chairperson of the Workers' Compensation Commission. For the period 1205
commencing October 1, 2004, and ending December 31, 2004, "self-1206
insured employer" includes an employer mutual association organized 1207
prior to June 6, 1996, with a membership composed exclusively of health 1208
care providers and whose premium base is derived entirely from health 1209
care organizations. 1210
Sec. 31. Subsection (b) of section 31-355 of the general statutes is 1211
repealed and the following is substituted in lieu thereof (Effective from 1212
passage): 1213
(b) When an award of compensation has been made under the 1214
provisions of this chapter against an employer who failed, neglected, 1215
refused or is unable to pay any type of benefit coming due as a 1216
consequence of such award or any adjustment in compensation 1217
required by this chapter, and whose insurer failed, neglected, refused or 1218 Substitute Bill No. 5250
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is unable to pay the compensation, such compensation shall be paid 1219
from the Second Injury Fund. The administrative law judge, on a finding 1220
of failure or inability to pay compensation, shall give notice to the 1221
Treasurer of the award, directing the Treasurer to make payment from 1222
the fund. Whenever liability to pay compensation is contested by the 1223
Treasurer, the Treasurer shall file with the administrative law judge, on 1224
or before the twenty-eighth day after the Treasurer has received an 1225
order of payment from the administrative law judge, a notice in 1226
accordance with a form prescribed by the [chairman] chairperson of the 1227
Workers' Compensation Commission stating that the right to 1228
compensation is contested, the name of the claimant, the name of the 1229
employer, the date of the alleged injury or death and the specific 1230
grounds on which the right to compensation is contested. A copy of the 1231
notice shall be sent to the employee. The administrative law judge shall 1232
hold a hearing on such contested liability at the request of the Treasurer 1233
or the employee in accordance with the provisions of this chapter. If the 1234
Treasurer fails to file the notice contesting liability within the time 1235
prescribed in this section, the Treasurer shall be conclusively presumed 1236
to have accepted the compensability of such alleged injury or death from 1237
the Second Injury Fund and shall have no right thereafter to contest the 1238
employee's right to receive compensation on any grounds or contest the 1239
extent of the employee's disability. 1240
This act shall take effect as follows and shall amend the following
sections:
Section 1 from passage 31-275(10)
Sec. 2 from passage 31-294c(a) and (b)
Sec. 3 from passage 31-296(b)
Sec. 4 from passage 31-321
Sec. 5 from passage 31-276
Sec. 6 from passage 31-277(a)
Sec. 7 from passage 31-278
Sec. 8 from passage 31-279
Sec. 9 from passage 31-280
Sec. 10 from passage 31-280a(a) to (c)
Sec. 11 from passage 31-280b(a) Substitute Bill No. 5250
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Sec. 12 from passage 31-283g
Sec. 13 from passage 31-284(b) and (c)
Sec. 14 from passage 31-288(e)
Sec. 15 from passage 31-289a
Sec. 16 from passage 31-290a(b)
Sec. 17 from passage 31-290d(a) and (b)
Sec. 18 from passage 31-294d
Sec. 19 from passage 31-294f(a)
Sec. 20 from passage 31-295(c)
Sec. 21 from passage 31-297a
Sec. 22 from passage 31-301(e)
Sec. 23 from passage 31-306b(b)
Sec. 24 from passage 31-310(b)
Sec. 25 from passage 31-316(a)
Sec. 26 from passage 31-326
Sec. 27 from passage 31-345(b)
Sec. 28 from passage 31-348
Sec. 29 from passage 31-349c
Sec. 30 from passage 31-349g(a)(2)
Sec. 31 from passage 31-355(b)
LAB Joint Favorable Subst.