FIRSTREGULARSESSION
[PERFECTED]
HOUSECOMMITTEESUBSTITUTEFOR
HOUSEBILLNO.497
103RDGENERALASSEMBLY
0786H.02P JOSEPHENGLER,ChiefClerk
ANACT
Torepealsections287.020,287.067,287.140,287.243,287.270,287.510,and287.655,
RSMo,andtoenactinlieuthereofeightnewsectionsrelatingtoworkers'
compensation,withanemergencyclause.
BeitenactedbytheGeneralAssemblyofthestateofMissouri,asfollows:
SectionA.Sections287.020,287.067,287.140,287.243,287.270,287.510,and
2287.655,RSMo,arerepealedandeightnewsectionsenactedinlieuthereof,tobeknownas
3sections287.020,287.067,287.140,287.243,287.270,287.445,287.510,and287.655,to
4readasfollows:
287.020.1.Theword"employee"asusedinthischaptershallbeconstruedtomean
2everypersonintheserviceofanyemployer,asdefinedinthischapter,underanycontractof
3hire,expressorimplied,oralorwritten,orunderanyappointmentorelection,including
4executiveofficersofcorporations.Exceptasotherwiseprovidedinsection287.200,any
5referencetoanyemployeewhohasbeeninjuredshall,whentheemployeeisdead,also
6includehisorherdependents,andotherpersonstowhomcompensationmaybepayable.The
7word"employee"shallalsoincludeallminorswhoworkforanemployer,whetherornot
8suchminorsareemployedinviolationoflaw,andallsuchminorsareherebymadeoffullage
9forallpurposesunder,inconnectionwith,orarisingoutofthischapter.Theword
10"employee"shallnotincludeanindividualwhoistheowner,asdefinedinsection301.010,
11andoperatorofamotorvehiclewhichisleasedorcontractedwithadrivertoafor-hiremotor
12carrieroperatingwithinacommercialzoneasdefinedinsection390.020orasdescribedin
13section390.041,oroperatingunderacertificateissuedbytheMissouridepartmentof
14transportationorbytheUnitedStatesDepartmentofTransportation,oranyofits
EXPLANATION—Matterenclosedinbold-facedbrackets[thus] intheabovebillisnotenactedandis
intendedtobeomittedfromthelaw.Matterinbold-facetypeintheabovebillisproposedlanguage. 15subagencies.Theword"employee"alsoshallnotincludeanypersonperformingservicesfor
16board,lodging,aid,orsustenancereceivedfromanyreligious,charitable,orrelief
17organization.
18 2.Theword"accident"asusedinthischaptershallmeananunexpectedtraumatic
19eventorunusualstrainidentifiablebytimeandplaceofoccurrenceandproducingatthetime
20objectivesymptomsofaninjurycausedbyaspecificeventduringasingleworkshift.An
21injuryisnotcompensablebecauseworkwasatriggeringorprecipitatingfactor.
22 3.(1)Inthischaptertheterm"injury"isherebydefinedtobeaninjurywhichhas
23arisenoutofandinthecourseofemployment.Aninjurybyaccidentiscompensableonlyif
24theaccidentwastheprevailingfactorincausing[both] theinjury,theresultingmedical
25condition[and],thedisability, andtheneedfortreatment. "Theprevailingfactor"is
26definedtobetheprimaryfactor,inrelationtoanyotherfactor,causing[both] theinjury,the
27resultingmedicalconditionanddisability.
28 (2)Aninjuryshallbedeemedtoariseoutofandinthecourseoftheemployment
29onlyif:
30 (a)Itisreasonablyapparent,uponconsiderationofallthecircumstances,thatthe
31accidentistheprevailingfactorincausingtheinjury;and
32 (b)Itdoesnotcomefromahazardorriskunrelatedtotheemploymenttowhich
33workerswouldhavebeenequallyexposedoutsideofandunrelatedtotheemploymentin
34normalnonemploymentlife.
35 (3)Aninjuryresultingdirectlyorindirectlyfromidiopathiccausesisnot
36compensable.
37 (4)Acardiovascular,pulmonary,respiratory,orotherdisease,orcerebrovascular
38accidentormyocardialinfarctionsufferedbyaworkerisaninjuryonlyiftheaccidentisthe
39prevailingfactorincausingtheresultingmedicalcondition.
40 (5)Theterms"injury"and"personalinjuries"shallmeanviolencetothephysical
41structureofthebodyandtothepersonalpropertywhichisusedtomakeupthephysical
42structureofthebody,suchasartificialdentures,artificiallimbs,glasseyes,eyeglasses,and
43otherprostheseswhichareplacedinoronthebodytoreplacethephysicalstructureandsuch
44diseaseorinfectionasnaturallyresultstherefrom.Thesetermsshallinnocaseexceptas
45specificallyprovidedinthischapterbeconstruedtoincludeoccupationaldiseaseinanyform,
46norshalltheybeconstruedtoincludeanycontagiousorinfectiousdiseasecontractedduring
47thecourseoftheemployment,norshalltheyincludedeathduetonaturalcausesoccurring
48whiletheworkerisatwork.
49 4."Death"whenmentionedasabasisfortherighttocompensationmeansonlydeath
50resultingfromsuchviolenceanditsresultanteffectsoccurringwithinthreehundredweeks
HCSHB497 2 51aftertheaccident;exceptthatincasesofoccupationaldisease,thelimitationofthreehundred
52weeksshallnotbeapplicable.
53 5.Injuriessustainedincompany-ownedorsubsidizedautomobilesinaccidentsthat
54occurwhiletravelingfromtheemployee'shometotheemployer'sprincipalplaceofbusiness
55orfromtheemployer'sprincipalplaceofbusinesstotheemployee'shomearenot
56compensable.Theextensionofpremisesdoctrineisabrogatedtotheextentitextends
57liabilityforaccidentsthatoccuronpropertynotownedorcontrolledbytheemployerevenif
58theaccidentoccursoncustomary,approved,permitted,usualoracceptedroutesusedbythe
59employeetogettoandfromtheirplaceofemployment.
60 6.Theterm"totaldisability"asusedinthischaptershallmeaninabilitytoreturnto
61anyemploymentandnotmerelymeaninabilitytoreturntotheemploymentinwhichthe
62employeewasengagedatthetimeoftheaccident.
63 7.Asusedinthischapterandallactsamendatorythereof,theterm"commission"
64shallhereafterbeconstruedasmeaningandreferringexclusivelytothelaborandindustrial
65relationscommissionofMissouri,andtheterm"director"shallhereafterbeconstruedas
66meaningthedirectorofthedepartmentofcommerceandinsuranceofthestateofMissourior
67suchagencyofgovernmentasshallexercisethepowersanddutiesnowconferredand
68imposeduponthedepartmentofcommerceandinsuranceofthestateofMissouri.
69 8.Theterm"division"asusedinthischaptermeansthedivisionofworkers'
70compensationofthedepartmentoflaborandindustrialrelationsofthestateofMissouri.
71 9.Forthepurposesofthischapter,theterm"minor"meansapersonwhohasnot
72attainedtheageofeighteenyears;exceptthat,forthepurposeofcomputingthecompensation
73providedforinthischapter,theprovisionsofsection287.250shallcontrol.
74 10.Inapplyingtheprovisionsofthischapter,itistheintentofthelegislaturetoreject
75andabrogateearliercaselawinterpretationsonthemeaningofordefinitionof"accident",
76"occupationaldisease","arisingoutof",and"inthecourseoftheemployment"toinclude,but
77notbelimitedto,holdingsin:Bennettv.ColumbiaHealthCareandRehabilitation,80
78S.W.3d524(Mo.App.W.D.2002);Kaslv.BristolCare,Inc.,984S.W.2d852(Mo.banc
791999);andDrewesv.TWA,984S.W.2d512(Mo.banc1999)andallcasesciting,
80interpreting,applying,orfollowingthosecases.
81 11.Forthepurposesofthischapter,"occupationaldiseasesduetotoxicexposure"
82shallonlyincludethefollowing:mesothelioma,asbestosis,berylliosis,coalworker's
83pneumoconiosis,brochiolitisobliterans,silicosis,silicotuberculosis,manganism,acute
84myelogenousleukemia,andmyelodysplasticsyndrome.
85 12.Forthepurposesofthischapter,"maximummedicalimprovement"shallmean
86thepointatwhichtheinjuredemployee'smedicalconditionhasstabilizedandcannolonger
HCSHB497 3 87reasonablyimprovewithadditionalmedicalcare,asdeterminedwithinareasonabledegreeof
88medicalcertainty.
287.067.1.Inthischaptertheterm"occupationaldisease"isherebydefinedtomean,
2unlessadifferentmeaningisclearlyindicatedbythecontext,anidentifiablediseasearising
3withorwithouthumanfaultoutofandinthecourseoftheemployment.Ordinarydiseasesof
4lifetowhichthegeneralpublicisexposedoutsideoftheemploymentshallnotbe
5compensable,exceptwherethediseasesfollowasanincidentofanoccupationaldiseaseas
6definedinthissection.Thediseaseneednottohavebeenforeseenorexpectedbutafterits
7contractionitmustappeartohavehaditsorigininariskconnectedwiththeemploymentand
8tohaveflowedfromthatsourceasarationalconsequence.
9 2.Aninjuryordeathbyoccupationaldiseaseiscompensableonlyiftheoccupational
10exposurewastheprevailingfactorincausing[both] theinjury,theresultingmedical
11condition[and],thedisability, andtheneedfortreatment. The"prevailingfactor"is
12definedtobetheprimaryfactor,inrelationtoanyotherfactor,causing[both] theinjury,the
13resultingmedicalcondition[and],thedisability, andtheneedfortreatment. Ordinary,
14gradualdeterioration,orprogressivedegenerationofthebodycausedbyagingorbythe
15normalactivitiesofday-to-daylivingshallnotbecompensable.
16 3.Aninjuryduetorepetitivemotionisrecognizedasanoccupationaldiseasefor
17purposesofthischapter.Anoccupationaldiseaseduetorepetitivemotioniscompensable
18onlyiftheoccupationalexposurewastheprevailingfactorincausing[both] theinjury,the
19resultingmedicalcondition[and],thedisability, andtheneedfortreatment. The
20"prevailingfactor"isdefinedtobetheprimaryfactor,inrelationtoanyotherfactor,causing
21[both] theinjury,theresultingmedicalcondition[and],thedisability, andtheneedfor
22treatment. Ordinary,gradualdeterioration,orprogressivedegenerationofthebodycaused
23byagingorbythenormalactivitiesofday-to-daylivingshallnotbecompensable.
24 4."Lossofhearingduetoindustrialnoise"isrecognizedasanoccupationaldisease
25forpurposesofthischapterandisherebydefinedtobealossofhearinginoneorbothears
26duetoprolongedexposuretoharmfulnoiseinemployment."Harmfulnoise"meanssound
27capableofproducingoccupationaldeafness.
28 5."Radiationdisability"isrecognizedasanoccupationaldiseaseforpurposesofthis
29chapterandisherebydefinedtobethatdisabilityduetoradioactivepropertiesorsubstances
30ortoRoentgenrays(X-rays)orexposuretoionizingradiationcausedbyanyprocess
31involvingtheuseofordirectcontactwithradiumorradioactivepropertiesorsubstancesor
32theuseofordirectexposuretoRoentgenrays(X-rays)orionizingradiation.
33 6.Diseaseofthelungsorrespiratorytract,hypotension,hypertension,ordiseaseof
34theheartorcardiovascularsystem,includingcarcinoma,mayberecognizedasoccupational
35diseasesforthepurposesofthischapterandaredefinedtobedisabilityduetoexposureto
HCSHB497 4 36smoke,gases,carcinogens,inadequateoxygen,ofpaidfirefightersofapaidfiredepartment
37orpaidpoliceofficersofapaidpolicedepartmentcertifiedunderchapter590ifadirect
38causalrelationshipisestablished,orpsychologicalstressoffirefightersofapaidfire
39departmentorpaidpeaceofficersofapolicedepartmentwhoarecertifiedunderchapter590
40ifadirectcausalrelationshipisestablished.
41 7.Anyemployeewhoisexposedtoandcontractsanycontagiousorcommunicable
42diseasearisingoutofandinthecourseofhisorheremploymentshallbeeligibleforbenefits
43underthischapterasanoccupationaldisease.
44 8.Withregardtooccupationaldiseaseduetorepetitivemotion,iftheexposuretothe
45repetitivemotionwhichisfoundtobethecauseoftheinjuryisforaperiodoflessthanthree
46monthsandtheevidencedemonstratesthattheexposuretotherepetitivemotionwiththe
47immediateprioremployerwastheprevailingfactorincausingtheinjury,theprioremployer
48shallbeliableforsuchoccupationaldisease.
49 9.(1)(a)Posttraumaticstressdisorder(PTSD),asdescribedintheDiagnosticand
50StatisticalManualofMentalHealthDisorders,FifthEdition,publishedbytheAmerican
51PsychiatricAssociation,(DSM-5)isrecognizedasacompensableoccupationaldiseasefor
52purposesofthischapterwhendiagnosedinafirstresponder,asthattermisdefinedunder
53section67.145.
54 (b)Benefitspayabletoafirstresponderunderthissectionshallnotrequireaphysical
55injurytothefirstresponder,andarenotsubjecttoanypreexistingPTSD.
56 (c)Benefitspayabletoafirstresponderunderthissectionarecompensableonlyif
57demonstratedbyclearandconvincingevidencethatPTSDhasresultedfromthecourseand
58scopeofemployment,andthefirstresponderisexaminedanddiagnosedwithPTSDbyan
59authorizedtreatingphysician,duetothefirstresponderexperiencingoneofthefollowing
60qualifyingevents:
61 a.Seeingforoneselfadeceasedminor;
62 b.Witnessingdirectlythedeathofaminor;
63 c.Witnessingdirectlytheinjurytoaminorwhosubsequentlydiedpriortoorupon
64arrivalatahospitalemergencydepartment,participatinginthephysicaltreatmentof,or
65manuallytransporting,aninjuredminorwhosubsequentlydiedpriortooruponarrivalata
66hospitalemergencydepartment;
67 d.Seeingforoneselfapersonwhohassufferedseriousphysicalinjuryofanature
68thatshockstheconscience;
69 e.Witnessingdirectlyadeath,includingsuicide,duetoseriousphysicalinjury;or
70homicide,includingmurder,masskillings,manslaughter,self-defense,misadventure,and
71negligence;
HCSHB497 5 72 f.Witnessingdirectlyaninjurythatresultsindeath,ifthepersonsufferedserious
73physicalinjurythatshockstheconscience;
74 g.Participatinginthephysicaltreatmentofaninjury,includingattemptedsuicide,or
75manuallytransportinganinjuredpersonwhosufferedseriousphysicalinjury,iftheinjured
76personsubsequentlydiedpriortooruponarrivalatahospitalemergencydepartment;or
77 h.Involvementinaneventthatcausedormayhavecausedseriousinjuryorharmto
78thefirstresponderorhadthepotentialtocausethedeathofthefirstresponder,whether
79accidentalorbyanintentionalactofanotherindividual.
80 (2)ThetimefornoticeofinjuryordeathincasesofcompensablePTSDunderthis
81sectionismeasuredfromexposuretooneofthequalifyingstressorslistedintheDSM-5
82criteria,orthediagnosisofthedisorder,whicheverislater.Anyclaimforcompensationfor
83suchinjuryshallbeproperlynoticedwithinfifty-twoweeksafterthequalifyingexposure,or
84thediagnosisofthedisorder,whicheverislater.
287.140.1.Inadditiontoallothercompensationpaidtotheemployeeunderthis
2section,theemployeeshallreceiveandtheemployershallprovidesuchmedical,surgical,
3chiropractic,andhospitaltreatment,includingnursing,custodial,ambulanceandmedicines,
4asmayreasonablyberequiredaftertheinjuryordisability,tocureandrelievefromthe
5effectsoftheinjury.Foranemployeetoreceivesuchtreatment,theaccidentor
6occupationaldiseaseshallbetheprevailingfactorincausingtheinjury,theresulting
7medicalcondition,andtheneedfortreatment.Iftheemployeedesires,heshallhavethe
8righttoselecthisownphysician,surgeon,orothersuchrequirementathisownexpense.
9Wheretherequirementsarefurnishedbyapublichospitalorotherinstitution,payment
10thereforshallbemadetotheproperauthorities.Regardlessofwhetherthehealthcare
11providerisselectedbytheemployerorisselectedbytheemployeeattheemployee'sexpense,
12thehealthcareprovidershallhavetheaffirmativedutytocommunicatefullywiththe
13employeeregardingthenatureoftheemployee'sinjuryandrecommendedtreatment
14exclusiveofanyevaluationforapermanentdisabilityrating.Failuretoperformsuchdutyto
15communicateshallconstituteadisciplinaryviolationbytheprovidersubjecttotheprovisions
16ofchapter[620]334.Whenanemployeeisrequiredtosubmittomedicalexaminationsor
17necessarymedicaltreatmentataplaceoutsideofthelocalormetropolitanareafromthe
18employee'sprincipalplaceofemployment,theemployeroritsinsurershalladvanceor
19reimbursetheemployeeforallnecessaryandreasonableexpenses;exceptthataninjured
20employeewhoresidesoutsidethestateofMissouriandwhoisemployedbyanemployer
21locatedinMissourishallhavetheoptionofselectingthelocationofservicesprovidedinthis
22sectioneitheratalocationwithinonehundredmilesoftheinjuredemployee'sresidence,
23placeofinjuryorplaceofhirebytheemployer.Thechoiceofproviderwithinthelocation
24selectedshallcontinuetobemadebytheemployer.Incaseofamedicalexaminationifa
HCSHB497 6 25disputearisesastowhatexpensesshallbepaidbytheemployer,themattershallbepresented
26tothelegaladvisor,theadministrativelawjudgeorthecommission,whoshallsetthesumto
27bepaidandsameshallbepaidbytheemployerpriortothemedicalexamination.Innoevent,
28however,shalltheemployeroritsinsurerberequiredtopaytransportationcostsforagreater
29distancethantwohundredfiftymileseachwayfromplaceoftreatment.
30 2.Ifitbeshowntothedivisionorthecommissionthattherequirementsarebeing
31furnishedinsuchmannerthatthereisreasonablegroundforbelievingthatthelife,health,or
32recoveryoftheemployeeisendangeredthereby,thedivisionorthecommissionmayordera
33changeinthephysician,surgeon,hospitalorotherrequirement.
34 3.Allfeesandchargesunderthischaptershallbefairandreasonable,shallbesubject
35toregulationbythedivisionorthecommission,ortheboardofrehabilitationinrehabilitation
36cases.Ahealthcareprovidershallnotchargeafeefortreatmentandcarewhichisgoverned
37bytheprovisionsofthischaptergreaterthantheusualandcustomaryfeetheprovider
38receivesforthesametreatmentorservicewhenthepayorforsuchtreatmentorserviceisa
39privateindividualoraprivatehealthinsurancecarrier.Thedivisionorthecommission,orthe
40boardofrehabilitationinrehabilitationcases,shallalsohavejurisdictiontohearand
41determinealldisputesastosuchcharges.Ahealthcareproviderisboundbythe
42determinationuponthereasonablenessofhealthcarebills.
43 4.Thedivisionshall,byregulation,establishmethodstoresolvedisputesconcerning
44thereasonablenessofmedicalcharges,services,oraids.Thisregulationshallgovern
45resolutionofdisputesbetweenemployersandmedicalprovidersoverfeescharged,whether
46ornotpaid,andshallbeinlieuofanyotheradministrativeprocedureunderthischapter.The
47employeeshallnotbeapartytoadisputeovermedicalcharges,norshalltheemployee's
48recoveryinanywaybejeopardizedbecauseofsuchdispute.Anyapplicationforpaymentof
49additionalreimbursement,assuchtermisusedin8CSR50-2.030,asamended,shallbefiled
50notlaterthan:
51 (1)Twoyearsfromthedatethefirstnoticeofdisputeofthemedicalchargewas
52receivedbythehealthcareproviderifsuchserviceswererenderedbeforeJuly1,2013;and
53 (2)Oneyearfromthedatethefirstnoticeofdisputeofthemedicalchargewas
54receivedbythehealthcareproviderifsuchserviceswererenderedafterJuly1,2013.
55
56Noticeshallbepresumedtooccurnolaterthanfivebusinessdaysaftertransmissionby
57certifiedUnitedStatesmail.
58 5.Nocompensationshallbepayableforthedeathordisabilityofanemployee,ifand
59insofarasthedeathordisabilitymaybecaused,continuedoraggravatedbyanyunreasonable
60refusaltosubmittoanymedicalorsurgicaltreatmentoroperation,theriskofwhichis,inthe
61opinionofthedivisionorthecommission,inconsiderableinviewoftheseriousnessofthe
HCSHB497 7 62injury.Iftheemployeediesasaresultofanoperationmadenecessarybytheinjury,thedeath
63shallbedeemedtobecausedbytheinjury.
64 6.Thetestimonyofanyphysicianorchiropracticphysicianwhotreatedtheemployee
65shallbeadmissibleinevidenceinanyproceedingsforcompensationunderthischapter,
66subjecttoalloftheprovisionsofsection287.210.
67 7.Everyhospitalorotherpersonfurnishingtheemployeewithmedicalaidshall
68permititsrecordtobecopiedbyandshallfurnishfullinformationtothedivisionorthe
69commission,theemployer,theemployeeorhisorherdependentsandanyotherpartytoany
70proceedingsforcompensationunderthischapter,andcertifiedcopiesoftherecordsshallbe
71admissibleinevidenceinanysuchproceedings.
72 8.Theemployermayberequiredbythedivisionorthecommissiontofurnishan
73injuredemployeewithartificiallegs,arms,hands,surgicalorthopedicjoints,oreyes,or
74braces,asneeded,forlifewheneverthedivisionorthecommissionshallfindthattheinjured
75employeemaybepartiallyorwhollyrelievedoftheeffectsofapermanentinjurybytheuse
76thereof.Thedirectorofthedivisionshallestablishaprocedurewherebyaclaimfor
77compensationmaybereactivatedaftersettlementofsuchclaimiscompleted.Theclaimshall
78bereactivatedonlyaftertheclaimantcanshowgoodcauseforthereactivationofthisclaim
79andtheclaimshallbemadeonlyforthepaymentofmedicalproceduresinvolvinglife-
80threateningsurgicalproceduresoriftheclaimantrequirestheuseofanew,orthe
81modification,alterationorexchangeofanexisting,prostheticdevice.Forthepurposeofthis
82subsection,"lifethreatening"shallmeanasituationorconditionwhich,ifnottreated
83immediately,willlikelyresultinthedeathoftheinjuredworker.
84 9.Nothinginthischaptershallpreventanemployeebeingprovidedtreatmentforhis
85orherinjuriesbyprayerorspiritualmeansiftheemployerdoesnotobjecttothetreatment.
86 10.Theemployershallhavetherighttoselectthelicensedtreatingphysician,
87surgeon,chiropracticphysician,orotherhealthcareprovider;provided,however,thatsuch
88physicians,surgeonsorotherhealthcareprovidersshallofferonlythoseservicesauthorized
89withinthescopeoftheirlicenses.Forthepurposeofthissubsection,subsection2ofsection
90287.030shallnotapply.
91 11.Anyphysicianorotherhealthcareproviderwhoorders,directsorrefersapatient
92fortreatment,testing,therapyorrehabilitationatanyinstitutionorfacilityshall,atorpriorto
93thetimeofthereferral,discloseinwritingifsuchhealthcareprovider,anyofhisorher
94partnersorhisorheremployerhasafinancialinterestintheinstitutionorfacilitytowhich
95thepatientisbeingreferred,tothefollowing:
96 (1)Thepatient;
97 (2)Theemployerofthepatientwithworkers'compensationliabilityfortheinjuryor
98diseasebeingtreated;
HCSHB497 8 99 (3)Theworkers'compensationinsurerofsuchemployer;and
100 (4)Theworkers'compensationadjustingcompanyforsuchinsurer.
101 12.Violationofsubsection11ofthissectionisaclassAmisdemeanor.
102 13.(1)Nohospital,physicianorotherhealthcareprovider,otherthanahospital,
103physicianorhealthcareproviderselectedbytheemployeeathisorherownexpense
104pursuanttosubsection1ofthissection,shallbillorattempttocollectanyfeeoranyportion
105ofafeeforservicesrenderedtoanemployeeduetoawork-relatedinjuryorreporttoany
106creditreportingagencyanyfailureoftheemployeetomakesuchpayment,whenaninjury
107coveredbythischapterhasoccurredandsuchhospital,physicianorhealthcareproviderhas
108receivedactualnoticegiveninwritingbytheemployee,theemployerortheemployer's
109insurer.Actualnoticeshallbedeemedreceivedbythehospital,physicianorhealthcare
110providerfivedaysaftermailingbycertifiedmailbytheemployerorinsurertothehospital,
111physicianorhealthcareprovider.
112 (2)Thenoticeshallinclude:
113 (a)Thenameoftheemployer;
114 (b)Thenameoftheinsurer,ifknown;
115 (c)Thenameoftheemployeereceivingtheservices;
116 (d)Thegeneralnatureoftheinjury,ifknown;and
117 (e)Whereaclaimhasbeenfiled,theclaimnumber,ifknown.
118 (3)Whenaninjuryisfoundtobenoncompensableunderthischapter,thehospital,
119physicianorotherhealthcareprovidershallbeentitledtopursuetheemployeeforanyunpaid
120portionofthefeeorotherchargesforauthorizedservicesprovidedtotheemployee.Any
121applicablestatuteoflimitationsforanactionforsuchfeesorotherchargesshallbetolled
122fromthetimenoticeisgiventothedivisionbyahospital,physicianorotherhealthcare
123providerpursuanttosubdivision(6)ofthissubsection,untiladeterminationof
124noncompensabilityinregardtotheinjurywhichisthebasisofsuchservicesismade,or
125intheeventthereisanappealtothelaborandindustrialrelationscommission,untila
126decisionisrenderedbythatcommission.
127 (4)Ifahospital,physicianorotherhealthcareprovideroradebtcollectoronbehalf
128ofsuchhospital,physicianorotherhealthcareproviderpursuesanyactiontocollectfroman
129employeeaftersuchnoticeisproperlygiven,theemployeeshallhaveacauseofaction
130againstthehospital,physicianorotherhealthcareproviderforactualdamagessustainedplus
131uptoonethousanddollarsinadditionaldamages,costsandreasonableattorney'sfees.
132 (5)Ifanemployerorinsurerfailstomakepaymentforauthorizedservicesprovided
133totheemployeebyahospital,physicianorotherhealthcareproviderpursuanttothischapter,
134thehospital,physicianorotherhealthcareprovidermayproceedpursuanttosubsection4of
HCSHB497 9 135thissectionwithadisputeagainsttheemployerorinsurerforanyfeesorotherchargesfor
136servicesprovided.
137 (6)Ahospital,physicianorotherhealthcareproviderwhoseserviceshavebeen
138authorizedinadvancebytheemployerorinsurermaygivenoticetothedivisionofanyclaim
139forfeesorotherchargesforservicesprovidedforawork-relatedinjurythatiscoveredbythis
140chapter,withcopiesofthenoticetotheemployee,employerandtheemployer'sinsurer.
141Wheresuchnoticehasbeenfiled,theadministrativelawjudgemayorderdirectpayment
142fromtheproceedsofanysettlementorawardtothehospital,physicianorotherhealthcare
143providerforsuchfeesasaredeterminedbythedivision.Thenoticeshallbeonaform
144prescribedbythedivision.
145 14.Theemployermayalloworrequireanemployeetouseanyoftheemployee's
146accumulatedpaidleave,personalleave,ormedicalorsickleavetoattendtomedical
147treatment,physicalrehabilitation,ormedicalevaluationsduringworktime.Theintentofthis
148subsectionistospecificallysupercedeandabrogateanycaselawthatcontradictstheexpress
149languageofthissection.
287.243.1.Thissectionshallbeknownandmaybecitedasthe"LineofDuty
2CompensationAct".
3 2.Asusedinthissection,unlessotherwiseprovided,thefollowingwordsshallmean:
4 (1)"Airambulancepilot",apersoncertifiedasanairambulancepilotinaccordance
5withsections190.001to190.245andcorrespondingregulationsapplicabletoairambulances
6adoptedbythedepartmentofhealthandseniorservices;
7 (2)"Airambulanceregisteredprofessionalnurse",apersonlicensedasaregistered
8professionalnurseinaccordancewithsections335.011to335.096andcorresponding
9regulationsadoptedbythestateboardofnursing,20CSR2200-4,etseq.,whoprovides
10registeredprofessionalnursingservicesasaflightnurseinconjunctionwithanairambulance
11programthatiscertifiedinaccordancewithsections190.001to190.245andthe
12correspondingregulationsapplicabletosuchprograms;
13 (3)"Airambulanceregisteredrespiratorytherapist",apersonlicensedasaregistered
14respiratorytherapistinaccordancewithsections334.800to334.930andcorresponding
15regulationsadoptedbythestateboardforrespiratorycare,whoprovidesrespiratorytherapy
16servicesinconjunctionwithanairambulanceprogramthatiscertifiedinaccordancewith
17sections190.001to190.245andcorrespondingregulationsapplicabletosuchprograms;
18 (4)"Child",anynatural,illegitimate,adopted,orposthumouschildorstepchildofa
19deceasedpublicsafetyofficerwho,atthetimeofthepublicsafetyofficer'sfatalityis:
20 (a)Eighteenyearsofageorunder;
21 (b)Overeighteenyearsofageandastudent,asdefinedin5U.S.C.Section8101;or
HCSHB497 10 22 (c)Overeighteenyearsofageandincapableofself-supportbecauseofphysicalor
23mentaldisability;
24 (5)"Emergencymedicaltechnician",apersonlicensedinemergencymedicalcarein
25accordancewithstandardsprescribedbysections190.001to190.245andbyrulesadoptedby
26thedepartmentofhealthandseniorservicesundersections190.001to190.245;
27 (6)"Firefighter",anyperson,includingavolunteerfirefighter,employedbythestate
28oralocalgovernmentalentityasanemployerdefinedundersubsection1ofsection287.030,
29orotherwiseservingasamemberorofficerofafiredepartmenteitherforthepurposeofthe
30preventionorcontroloffireortheunderwaterrecoveryofdrowningvictims;
31 (7)"Flightcrewmember",anindividualengagedinflightresponsibilitieswithanair
32ambulancelicensedinaccordancewithsections190.001to190.245andcorresponding
33regulationsapplicabletosuchprograms;
34 (8)"Killedinthelineofduty",whenanypersondefinedinthissectionloseshisor
35herlifewhen:
36 (a)Deathiscausedbyanaccidentorthewillfulactofviolenceofanother;
37 (b)Thepublicsafetyofficerisintheactiveperformanceofhisorherdutiesinhisor
38herrespectiveprofessionandthereisarelationshipbetweentheaccidentorcommissionof
39theactofviolenceandtheperformanceoftheduty,eveniftheindividualisoffduty;the
40publicsafetyofficeristravelingtoorfromemployment;orthepublicsafetyofficeristaking
41anymealbreakorotherbreakwhichtakesplacewhilethatindividualisonduty;
42 (c)Deathisthenaturalandprobableconsequenceoftheinjury;and
43 (d)Deathoccurswithinthreehundredweeksfromthedatetheinjurywasreceived.
44
45Thetermexcludesdeathresultingfromthewillfulmisconductorintoxicationofthepublic
46safetyofficer.Thedivisionofworkers'compensationshallhavetheburdenofprovingsuch
47willfulmisconductorintoxication;
48 (9)"Lawenforcementofficer",anypersonemployedbythestateoralocal
49governmentalentityasapoliceofficer,peaceofficercertifiedunderchapter590,orservingas
50anauxiliarypoliceofficerorinsomelikepositioninvolvingtheenforcementofthelawand
51protectionofthepublicinterestattheriskofthatperson'slife;
52 (10)"Localgovernmentalentity",includescounties,municipalities,townships,board
53orotherpoliticalsubdivision,citiesunderspecialcharter,orunderthecommissionformof
54government,fireprotectiondistricts,ambulancedistricts,andmunicipalcorporations;
55 (11)"Publicsafetyofficer",anylawenforcementofficer,firefighter,uniformed
56employeeoftheofficeofthestatefiremarshal,emergencymedicaltechnician,policeofficer,
57capitolpoliceofficer,paroleofficer,probationofficer,statecorrectionalemployee,water
58safetyofficer,parkranger,conservationofficer,orhighwaypatrolmanemployedbythestate
HCSHB497 11 59ofMissouriorapoliticalsubdivisionthereofwhoiskilledinthelineofdutyorany
60emergencymedicaltechnician,airambulancepilot,airambulanceregisteredprofessional
61nurse,airambulanceregisteredrespiratorytherapist,orflightcrewmemberwhoiskilledin
62thelineofduty;
63 (12)"State",thestateofMissourianditsdepartments,divisions,boards,bureaus,
64commissions,authorities,andcollegesanduniversities;
65 (13)"Volunteerfirefighter",apersonhavingprincipalemploymentotherthanasa
66firefighter,butwhoiscarriedontherollsofaregularlyconstitutedfiredepartmenteitherfor
67thepurposeofthepreventionorcontroloffireortheunderwaterrecoveryofdrowning
68victims,themembersofwhichareunderthejurisdictionofthecorporateauthoritiesofacity,
69village,incorporatedtown,orfireprotectiondistrict.Volunteerfirefightershallnotmeanan
70individualwhovolunteersassistancewithoutbeingregularlyenrolledasafirefighter.
71 3.(1)Aclaimforcompensationunderthissectionshallbefiledbysurvivorsofthe
72deceasedwiththedivisionofworkers'compensationnotlaterthanoneyearfromthedateof
73deathofapublicsafetyofficer.Ifaclaimismadewithinoneyearofthedateofdeathofa
74publicsafetyofficerkilledinthelineofduty,compensationshallbepaid,ifthedivisionfinds
75thattheclaimantisentitledtocompensationunderthissection.
76 (2)Theamountofcompensationpaidtotheclaimantshallbetwenty-fivethousand
77dollars,subjecttoappropriation,fordeathoccurringonorafterJune19,2009.
78 4.Anycompensationawardedundertheprovisionsofthissectionshallbedistributed
79asfollows:
80 (1)Tothesurvivingspouseofthepublicsafetyofficerifthereisnochildwho
81survivedthepublicsafetyofficer;
82 (2)Fiftypercenttothesurvivingchild,orchildren,inequalshares,andfiftypercent
83tothesurvivingspouseifthereisatleastonechildwhosurvivedthepublicsafetyofficer,and
84asurvivingspouseofthepublicsafetyofficer;
85 (3)Tothesurvivingchild,orchildren,inequalshares,ifthereisnosurvivingspouse
86ofthepublicsafetyofficer;
87 (4)Ifthereisnosurvivingspouseofthepublicsafetyofficerandnosurvivingchild:
88 (a)Tothesurvivingindividual,orindividuals,insharesperthedesignationor,
89otherwise,inequalshares,designatedbythepublicsafetyofficertoreceivebenefitsunder
90thissubsectioninthemostrecentlyexecuteddesignationofbeneficiaryofthepublicsafety
91officeronfileatthetimeofdeathwiththepublicsafetyagency,organization,orunit;or
92 (b)Tothesurvivingindividual,orindividuals,inequalshares,designatedbythe
93publicsafetyofficertoreceivebenefitsunderthemostrecentlyexecutedlifeinsurancepolicy
94ofthepublicsafetyofficeronfileatthetimeofdeathwiththepublicsafetyagency,
95organization,orunitifthereisnoindividualqualifyingunderparagraph(a);
HCSHB497 12 96 (5)Tothesurvivingparent,orparents,inequalshares,ofthepublicsafetyofficerif
97thereisnoindividualqualifyingundersubdivision(1),(2),(3),or(4)ofthissubsection;or
98 (6)Tothesurvivingindividual,orindividuals,inequalshares,whowouldqualify
99underthedefinitionoftheterm"child"butforageifthereisnoindividualqualifyingunder
100subdivision(1),(2),(3),(4),or(5)ofthissubsection.
101 5.Notwithstandingsubsection3ofthissection,nocompensationispayableunder
102thissectionunlessaclaimisfiledwithinthetimespecifiedunderthissectionsettingforth:
103 (1)Thename,address,andtitleordesignationofthepositioninwhichthepublic
104safetyofficerwasservingatthetimeofhisorherdeath;
105 (2)Thenameandaddressoftheclaimant;
106 (3)Afull,factualaccountofthecircumstancesresultinginorthecourseofevents
107causingthedeathatissue;and
108 (4)Suchotherinformationthatisreasonablyrequiredbythedivision.
109
110Whenaclaimisfiled,thedivisionofworkers'compensationshallmakeaninvestigationfor
111substantiationofmatterssetforthintheapplication.
112 6.Thecompensationprovidedforunderthissectionisinadditionto,andnot
113exclusiveof,anypensionrights,deathbenefits,orothercompensationtheclaimantmay
114otherwisebeentitledtobylaw.
115 7.Neitheremployersnorworkers'compensationinsurersshallhavesubrogation
116rightsagainstanycompensationawardedforclaimsunderthissection.Suchcompensation
117shallnotbeassignable,shallbeexemptfromattachment,garnishment,andexecution,and
118shallnotbesubjecttosetofforcounterclaim,orbeinanywayliableforanydebt,exceptthat
119thedivisionorcommissionmayallowaslienonthecompensation,reasonableattorney'sfees
120forservicesinconnectionwiththeproceedingsforcompensationiftheservicesarefoundto
121benecessary.Suchfeesaresubjecttoregulationassetforthinsection287.260.
122 8.Anypersonseekingcompensationunderthissectionwhoisaggrievedbythe
123decisionofthedivisionofworkers'compensationregardinghisorhercompensationclaim,
124maymakeapplicationforahearingasprovidedinsection287.450.Theprocedures
125applicabletotheprocessingofsuchhearingsanddeterminationsshallbethoseestablishedby
126thischapter.Decisionsoftheadministrativelawjudgeunderthissectionshallbebinding,
127subjecttoreviewbyeitherpartyundertheprovisionsofsection287.480.
128 9.Pursuanttosection23.253oftheMissourisunsetact:
129 (1)Theprovisionsofthe[new] programauthorizedunderthissectionshall
130automaticallysunset[six]twelveyearsafter[June19,2019] June30,2025, unless
131reauthorizedbyanactofthegeneralassembly;and
HCSHB497 13 132 (2)Ifsuchprogramisreauthorized,theprogramauthorizedunderthissectionshall
133automaticallysunsettwelveyearsaftertheeffectivedateofthereauthorizationofthissection;
134and
135 (3)ThissectionshallterminateonSeptemberfirstofthecalendaryearimmediately
136followingthecalendaryearinwhichtheprogramauthorizedunderthissectionissunset.
137 10.Theprovisionsofthissection,unlessspecified,shallnotbesubjecttoother
138provisionsofthischapter.
139 11.Thereisherebycreatedinthestatetreasurythe"LineofDutyCompensation
140Fund",whichshallconsistofmoneysappropriatedtothefundandanyvoluntary
141contributions,gifts,orbequeststothefund.Thestatetreasurershallbecustodianofthe
142fundandshallapprovedisbursementsfromthefundinaccordancewithsections30.170and
14330.180.Uponappropriation,moneyinthefundshallbeusedsolelyforpayingclaimsunder
144thissection.Notwithstandingtheprovisionsofsection33.080tothecontrary,anymoneys
145remaininginthefundattheendofthebienniumshallnotreverttothecreditofthegeneral
146revenuefund.Thestatetreasurershallinvestmoneysinthefundinthesamemannerasother
147fundsareinvested.Anyinterestandmoneysearnedonsuchinvestmentsshallbecreditedto
148thefund.
149 12.Thedivisionshallpromulgaterulestoadministerthissection,includingbutnot
150limitedtotheappointmentofclaimstomultipleclaimants,recordretention,andprocedures
151forinformationrequests.Anyruleorportionofarule,asthattermisdefinedinsection
152536.010,thatiscreatedundertheauthoritydelegatedinthissectionshallbecomeeffective
153onlyifitcomplieswithandissubjecttoalloftheprovisionsofchapter536and,ifapplicable,
154section536.028.Thissectionandchapter536arenonseverableandifanyofthepowers
155vestedwiththegeneralassemblyunderchapter536toreview,todelaytheeffectivedate,or
156todisapproveandannularulearesubsequentlyheldunconstitutional,thenthegrantof
157rulemakingauthorityandanyruleproposedoradoptedafterJune19,2009,shallbeinvalid
158andvoid.
287.270.[Nosavingsorinsuranceoftheinjuredemployee,noranybenefitsderived
2fromanyothersourcethantheemployerortheemployer'sinsurerforliabilityunderthis
3chapter,shallbeconsideredindeterminingthecompensationduehereunder;exceptas
4providedinsubsection3ofsection287.170,and]1.Anysavingsfrominsurancefromall
5governmentalorprivatesourcesutilizedbytheinjuredemployee,anybenefitsfromthe
6employerortheemployer'sinsurerforliabilityunderthischapter,andanysavingsor
7paymentsthroughinsuranceprocured,provided,orsponsoredbytheemployershallbe
8appliedwhendeterminingthecompensationdueunderthischapterandshallbe
9deductedfromthecompensationotherwisedueunderthischapter.Nothinginthis
10sectionaffectstherightsoftheinjuredemployeeundersubsection13ofsection287.140.
HCSHB497 14 11Employersofprofessionalathletesundercontractshallbeentitledtofullcreditforwagesor
12benefitspaidtotheemployeeaftertheinjury, includingmedical,surgical,orhospitalbenefits
13paidtoorfortheprofessionalathleteemployeeorhisorherdependentsonaccountofthe
14injury,disability,ordeath,pursuanttotheprovisionsofthecontract.
15 2.Ifmedicalbillsareindisputeandtheadministrativelawjudgeorthe
16commissiondeterminesthattheemployerisresponsibleforthedisputedmedicalbills,
17theadministrativelawjudgeorthecommissionshallhavetheauthoritytoorderthe
18employerresponsibleforthemedicalbillsandshallhavetheauthoritytoorderthe
19employertomakeapaymentonlytothemedicalproviderorproviderstowhomthe
20billsaredue.
287.445.1.Withinonehundredeightydaysofthefilingoftheclaim,ifthe
2matterhasnotalreadybeensetforadivisionprehearingconference,mediation
3conference,orhearing,theemployermayfileamotiontodismissthematter.The
4employermayfilethemotiontodismisstospecificallyraiseoneormoreofthefollowing
5arguments:
6 (1)Thattheemployeedidnotnotifytheemployerinatimelymannerorfilethe
7claiminatimelymannerundersections287.420and287.430;
8 (2)Thattheemployeewasnotperformingworkfortheemployeratthetime
9whentheallegedinjuryoccurred;
10 (3)Thattheemployerisnotliableduetotheemployee'sintoxicationfromuseof
11alcoholorcontrolledsubstancesundersection287.120;
12 (4)Thattheclaimantwasnotemployedbytheemployerwhenthealleged
13incidentoccurred;or
14 (5)Thattheemployeehasotherwisefailedtocomplywiththissectioninsetting
15forthavalidclaimforcompensationirrespectiveofwhethertheemployeehassuffered
16aninjuryorthedegreeoftheseverityoftheallegedinjury.
17 2.Followingthefilingofamotiontodismiss,thedivisionshallsetadatefora
18hearing,whichshallbeheldassoonaspracticable,andshallnotifytheinterested
19partiesofthetimeandplaceofthehearing.
20 3.Atthehearingforthemotiontodismiss,thedivision,throughan
21administrativelawjudge,shallconsiderevidencesubmittedbythepartiesatissue
22andtheirrepresentativesandwitnesses.Suchevidenceshallberelatedonlytotheissue
23orissuesraisedbytheemployerinitsmotiontodismiss.Ifthedivisiondeterminesthat,
24byapreponderanceoftheevidence,theemployerhasestablishedthatthemattershould
25bedismissedforoneormoreoftheargumentsmadeinitsmotiontodismiss,the
26divisionshallissueanorderwithinthirtydaysdismissingtheclaim.Suchdismissal
HCSHB497 15 27shallbesubjecttoreviewandappeal,subjecttotheprovisionsofsections287.470,
28287.480,and287.490.
287.510.Inanycaseatemporaryorpartialawardofcompensationmaybemade,and
2thesamemaybemodifiedfromtimetotimetomeettheneedsofthecase,andthesamemay
3bekeptopenuntilafinalawardcanbemade[, andifthesamebenotcompliedwith,the
4amountequaltothevalueofcompensationorderedandunpaidmaybedoubledinthefinal
5award,ifthefinalawardshallbeinaccordancewiththetemporaryorpartialaward]. The
6temporaryorpartialawardofcompensationshallbesubjecttoreviewandappealafter
7thedateofthefinalaward,subjecttotheprovisionsofsections287.470,287.480,and
8287.490.
287.655.1.Anyclaimbeforethedivisionmaybedismissedforfailuretoprosecute
2oruponmotionoftheemployer,asprovidedherein,inaccordancewithrulesand
3regulationspromulgatedbythecommission.Suchnoticeshallbemadeinamanner
4determinedbythedivision,exceptthatfortheemployeesuchnoticeshallbebycertifiedor
5registeredmailunlesstheemployeetowhomnoticeisdirectedisrepresentedbycounseland
6counselisalsogivensuchnotice.Todismissaclaimtheadministrativelawjudgeshallenter
7anorderofdismissalwhichshallbedeemedanawardandsubjecttoreviewandappealinthe
8samemannerasprovidedforotherawardsinthischapter.
9 2.Withinonehundredeightydaysofthefilingoftheclaim,ifthematterhasnot
10alreadybeensetforadivisionprehearingconference,mediationconference,orhearing,
11theemployermayfileamotiontodismissthematter.Theemployermayfilethemotion
12todismisstospecificallyraiseoneormoreofthefollowingarguments:
13 (1)Thattheemployeedidnotnotifytheemployerinatimelymannerorfilethe
14claiminatimelymannerundersections287.420and287.430;
15 (2)Thattheemployeewasnotperformingworkfortheemployeratthetime
16whentheallegedinjuryoccurred;
17 (3)Thattheemployerisnotliableduetotheemployee'sintoxicationfromuseof
18alcoholorcontrolledsubstancesundersection287.120;or
19 (4)Thattheclaimantwasnotemployedbytheemployerwhenthealleged
20incidentoccurred.
SectionB.
2Becauseimmediateactionisnecessarytoreauthorizethelineofdutycompensationactbefore
3expirationtopreventalapseincoverageandensurethecontinuedpaymentofbenefits,the
4repealandreenactmentofsection287.243ofsectionAofthisactisdeemednecessaryforthe
5immediatepreservationofthepublichealth,welfare,peace,andsafety,andisherebydeclared
6tobeanemergencyactwithinthemeaningoftheconstitution,andtherepealandreenactment
HCSHB497 16 7ofsection287.243ofsectionAofthisactshallbeinfullforceandeffectuponitspassageand
8approval.
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HCSHB497 17