34 | 27 | | |
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35 | 28 | | ENGROSSED SENATE |
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36 | 29 | | BILL NO. 1076 By: Murdock of the Senate |
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37 | 30 | | |
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38 | 31 | | and |
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39 | 32 | | |
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40 | 33 | | Newton of the House |
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41 | 34 | | |
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42 | 35 | | |
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43 | 36 | | |
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44 | 37 | | |
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45 | 38 | | An Act relating to the Administrative Workers ’ |
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46 | 39 | | Compensation Act; amending 85A O.S. 2021, Section 2, |
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47 | 40 | | which relates to definitions; modifying definitions; |
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48 | 41 | | updating statutory language; updating statutory |
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49 | 42 | | references; and providing an effective date . |
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50 | 43 | | |
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51 | 44 | | |
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52 | 45 | | |
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53 | 46 | | |
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54 | 47 | | |
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55 | 48 | | BE IT ENACTED BY THE PEOPLE OF THE STATE OF OKLAHOMA: |
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56 | 49 | | SECTION 1. AMENDATORY 85A O.S. 2021, Section 2, is |
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57 | 50 | | amended to read as follows: |
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58 | 51 | | Section 2. As used in the Administrative Workers ’ Compensation |
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59 | 52 | | Act: |
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60 | 53 | | 1. “Actually dependent” means a surviving spouse, a child or |
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61 | 54 | | any other person who receives one -half (1/2) or more of his or her |
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62 | 55 | | support from the employee; |
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63 | 56 | | 2. “Carrier” means any stock company, mu tual company, or |
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64 | 57 | | reciprocal or interinsurance exchange authorized to write or car ry |
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65 | 58 | | on the business of workers ’ compensation insurance in this state. |
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96 | 88 | | 3. “Case management” means the ongoing coordination, by a case |
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97 | 89 | | manager, of health care services provided to an injured or disabled |
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98 | 90 | | worker, including but not limited to systematically monitoring the |
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99 | 91 | | treatment rendered an d the medical progress of the injured or |
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100 | 92 | | disabled worker; ensuring that any treat ment plan follows all |
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101 | 93 | | appropriate treatment protocols, utilization controls and practice |
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102 | 94 | | parameters; assessing whether alternative health care services are |
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103 | 95 | | appropriate and delivered in a cost-effective manner based upon |
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104 | 96 | | acceptable medical standards; and ensuring that the injured or |
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105 | 97 | | disabled worker is following the prescribed health care plan; |
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106 | 98 | | 4. “Case manager” means a person who is a registered nurse with |
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107 | 99 | | a current, active une ncumbered license from the Oklahoma Board of |
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108 | 100 | | Nursing, or possesses one or more of the following certifications |
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109 | 101 | | which indicate the individual has a minimum number of years of case |
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110 | 102 | | management experience, has passed a national competency test and |
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111 | 103 | | regularly obtains continuing education hours to maintain |
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112 | 104 | | certification: |
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113 | 105 | | a. Certified Disability Management Specialist (CDMS), |
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114 | 106 | | b. Certified Case Manager (CCM), |
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115 | 107 | | c. Certified Rehabilitation Registered Nurse (CRRN), |
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116 | 108 | | d. Case Manager - Certified (CMC), |
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147 | 138 | | 5. “Certified workplace medical plan ” means an organization of |
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148 | 139 | | health care providers or any other entity, certified by the State |
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149 | 140 | | Commissioner of Health, that is autho rized to enter into a |
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150 | 141 | | contractual agreement with an employer, a group self-insurance |
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151 | 142 | | association plan, an employer’s workers’ compensation insurance |
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152 | 143 | | carrier, a third-party administrator or an insured to provide |
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153 | 144 | | medical care under the Administrative Workers ’ Compensation Act. |
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154 | 145 | | Certified plans shall only include plans which provide medic al |
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155 | 146 | | services and payment for services on a fee -for-service basis to |
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156 | 147 | | medical providers; |
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157 | 148 | | 6. “Child” means a natural or adopted son or daughter of the |
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158 | 149 | | employee under eighteen (18 ) years of age; or a natural or adopted |
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159 | 150 | | son or daughter of an employee eighteen (18) years of age or over |
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160 | 151 | | who is physically or mentally incapable of self -support; or any |
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161 | 152 | | natural or adopted son or daughter of an employee eighteen (18) |
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162 | 153 | | years of age or over w ho is actually dependent; or any natural or |
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163 | 154 | | adopted son or daughter of an employe e between eighteen (18) and |
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164 | 155 | | twenty-three (23) years of age who is enrolled as a full -time |
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165 | 156 | | student in any accredited educational institution. The term “child” |
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166 | 157 | | child includes a posthumous child, a child legally adopted or one |
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167 | 158 | | for whom adoption proceedings are pending at the time of death, an |
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197 | 187 | | 7. “Claimant” means a person who claims bene fits for an injury |
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198 | 188 | | or occupational disease pursuant to the provisions of the |
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199 | 189 | | Administrative Workers’ Compensation Act; |
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200 | 190 | | 8. “Commission” means the Oklahoma Workers’ Compensation |
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201 | 191 | | Commission; |
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202 | 192 | | 9. a. “Compensable injury” means damage or harm to the |
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203 | 193 | | physical structure of the body, or damage or harm to |
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204 | 194 | | prosthetic appliances, including eyeglasses, contact |
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205 | 195 | | lenses, or hearing aids, of which the major cause is |
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206 | 196 | | either an accident, cumulative trauma or occupational |
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207 | 197 | | disease arising out of the course and scope of |
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208 | 198 | | employment. An “accident” means an event involving |
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209 | 199 | | factors external to the employee that : |
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210 | 200 | | (1) was unintended, unanticipated, unforeseen, |
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211 | 201 | | unplanned and unexpected, |
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212 | 202 | | (2) occurred at a specifically identifiable time and |
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213 | 203 | | place, |
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214 | 204 | | (3) occurred by chance or from unknown c auses, or |
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215 | 205 | | (4) was independent of sickness, mental incapacity, |
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216 | 206 | | bodily infirmity or any other cause. |
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217 | 207 | | b. “Compensable injury” Compensable injury does not |
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218 | 208 | | include: |
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248 | 237 | | workplace, are the result of non -employment- |
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249 | 238 | | related hostility or animus of one, both, or all |
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250 | 239 | | of the combatants and which assault or combat |
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251 | 240 | | amounts to a deviation from customary duties; |
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252 | 241 | | provided, however, injuries caused by horseplay |
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253 | 242 | | shall not be consider ed to be compensable |
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254 | 243 | | injuries, except for innocent victims, |
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255 | 244 | | (2) injury incurred while engaging in or performing |
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256 | 245 | | or as the result of engaging in or performing any |
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257 | 246 | | recreational or social activities for the |
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258 | 247 | | employee’s personal pleasure, |
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259 | 248 | | (3) injury which was inflicted on the employee at a |
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260 | 249 | | time when employment services were not being |
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261 | 250 | | performed or before the employee was hired or |
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262 | 251 | | after the employment relationship was terminated, |
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263 | 252 | | (4) injury if the accident was caused by the use of |
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264 | 253 | | alcohol, illegal drugs, or prescr iption drugs |
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265 | 254 | | used in contravention of physician ’s orders. If |
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266 | 255 | | a biological specimen is collected within twenty - |
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267 | 256 | | four (24) hours of the employee being injured or |
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268 | 257 | | reporting an injury, or if at any time after the |
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269 | 258 | | injury a biological specimen is collected by th e |
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299 | 287 | | least twenty-four (24) hours after the injury and |
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300 | 288 | | the employee tests positive for intoxication, an |
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301 | 289 | | illegal controlled substance, or a legal |
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302 | 290 | | controlled substance used in contravention to a |
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303 | 291 | | treating physician’s orders, or refuses to |
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304 | 292 | | undergo the drug and alcohol testing, there shall |
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305 | 293 | | be a rebuttable presumption that the injury was |
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306 | 294 | | caused by the use of alcohol, illegal drugs, or |
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307 | 295 | | prescription drugs used in contraventio n of |
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308 | 296 | | physician’s orders. This presumption may only be |
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309 | 297 | | overcome if the employee p roves by clear and |
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310 | 298 | | convincing evidence that his or her state of |
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311 | 299 | | intoxication had no causal relationship to the |
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312 | 300 | | injury, |
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313 | 301 | | (5) any strain, degeneration, damage or harm to, or |
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314 | 302 | | disease or condition of, the eye or |
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315 | 303 | | musculoskeletal structure or other body part |
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316 | 304 | | resulting from the natural results of aging, |
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317 | 305 | | osteoarthritis, arthritis, or degenerative |
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318 | 306 | | process including, but not limited to, |
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319 | 307 | | degenerative joint disease, degenerative disc |
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320 | 308 | | disease, degenerative |
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350 | 337 | | (6) any preexisting condition except when the |
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351 | 338 | | treating physician clearly confirms an |
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352 | 339 | | identifiable and significant aggravation incurred |
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353 | 340 | | in the course and scope of employment. |
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354 | 341 | | c. A compensable injury shall be established by medical |
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355 | 342 | | evidence supported by objective findings as defined in |
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356 | 343 | | paragraph 31 of this section. |
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357 | 344 | | d. The injured employee shall prove by a preponderance of |
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358 | 345 | | the evidence that he or she has suffered a compensable |
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359 | 346 | | injury. |
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360 | 347 | | e. Benefits shall not be payable for a condition which |
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361 | 348 | | results from a non-work-related independent |
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362 | 349 | | intervening cause following a compensable injury which |
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363 | 350 | | causes or prolongs disability , or aggravation, or |
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364 | 351 | | requires treatment. A non -work-related independent |
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365 | 352 | | intervening cause does not require negligence or |
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366 | 353 | | recklessness on the part of a claimant. |
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367 | 354 | | f. An employee who suffers a compensable injury shall be |
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368 | 355 | | entitled to receive compensation as prescribed in this |
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369 | 356 | | act the Administrative Workers ’ Compensation Act. |
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370 | 357 | | Notwithstanding other provisions of law, if it is |
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371 | 358 | | determined that a compensable injury did not occur, |
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400 | 386 | | under this act the Administrative Workers ’ |
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401 | 387 | | Compensation Act; |
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402 | 388 | | 10. “Compensation” means the money allowance payabl e to the |
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403 | 389 | | employee or to his or her dependents and includes the medical |
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404 | 390 | | services and supplies provided for in Section 50 of this title and |
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405 | 391 | | funeral expenses; |
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406 | 392 | | 11. “Consequential injury ” means injury or harm to a part of |
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407 | 393 | | the body that is a direct result of th e injury or medical treatment |
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408 | 394 | | to the part of the body originally injured in the c laim. The |
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409 | 395 | | Commission shall not make a finding of a consequential injury unless |
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410 | 396 | | it is established by objective medical evidence that medical |
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411 | 397 | | treatment for such part of the bod y is required; |
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412 | 398 | | 12. “Continuing medical maintenance ” means medical treatment |
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413 | 399 | | that is reasonable and necessary to maintain a claimant’s condition |
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414 | 400 | | resulting from the compensable injury or illness after reaching |
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415 | 401 | | maximum medical improvement. Continuing medica l maintenance shall |
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416 | 402 | | not include diagnostic tests, surgery, injections, counseling , |
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417 | 403 | | physical therapy, or pain management devices or equipment; |
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418 | 404 | | 13. “Course and scope of employment ” means an activity of any |
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419 | 405 | | kind or character for which the employee was hired and that relates |
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420 | 406 | | to and derives from the work, business, trade or profession of an |
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421 | 407 | | employer, and is performed by an employee in the furtherance of the |
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422 | 408 | | affairs or business of an employer. The term includes activities |
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451 | 436 | | designated by an employer and travel by an employee in fu rtherance |
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452 | 437 | | of the affairs of an employer that is specifically directed by the |
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453 | 438 | | employer. This term does not include: |
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454 | 439 | | a. an employee’s transportation to and from his or her |
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455 | 440 | | place of employment, |
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456 | 441 | | b. travel by an employee in furtherance of the affairs of |
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457 | 442 | | an employer if the travel is also in furtherance of |
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458 | 443 | | personal or private affairs of the employee, |
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459 | 444 | | c. any injury occurring in a parking lot or other common |
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460 | 445 | | area adjacent to an employe r’s place of business |
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461 | 446 | | before the employee clocks in or otherwise begins work |
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462 | 447 | | for the employer or after the employee clocks out or |
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463 | 448 | | otherwise stops work for the employer unless the |
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464 | 449 | | employer owns or maintains exclusive control over the |
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465 | 450 | | area, or |
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466 | 451 | | d. any injury occurring while an employee is on a work |
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467 | 452 | | break, unless the injury occurs while the employee is |
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468 | 453 | | on a work break inside the employer ’s facility or in |
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469 | 454 | | an area owned by or exclusively controlled by the |
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470 | 455 | | employer and the work break is authorized by the |
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471 | 456 | | employee’s supervisor; |
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472 | 457 | | 14. “Cumulative trauma” means an injury to an employee that is |
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473 | 458 | | caused by the combined effect of repetitive physical activities |
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502 | 486 | | employment. Cumulative trauma shall not mean fatigue, soreness or |
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503 | 487 | | general aches and pain that may have been caused, aggravated, |
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504 | 488 | | exacerbated or accelerated by the employee ’s course and scope of |
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505 | 489 | | employment. Cumulative trauma shall have resulted directly and |
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506 | 490 | | independently of all other causes; |
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507 | 491 | | 15. “Death” means only death resulting from compensable injury |
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508 | 492 | | as defined in paragraph 9 of this s ection; |
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509 | 493 | | 16. “Disability” means incapacity because of compensable injury |
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510 | 494 | | to earn, in the same or any other employment, substantially the same |
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511 | 495 | | amount of wages the employee was receiving at the time of the |
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512 | 496 | | compensable injury; |
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513 | 497 | | 17. “Drive-away operations” includes every person engaged in |
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514 | 498 | | the business of transporting and delivering new or used vehicles by |
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515 | 499 | | driving, either singly or by towbar, saddle -mount or full-mount |
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516 | 500 | | method, or any combination thereof, with or without towing a |
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517 | 501 | | privately owned vehicle; |
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518 | 502 | | 18. a. “Employee” means any person, including a minor, in the |
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519 | 503 | | service of an employer under any contract of hire or |
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520 | 504 | | apprenticeship, written or oral, expressed or implied, |
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521 | 505 | | but excluding one whose employment is casual and not |
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522 | 506 | | in the course of the trade, business, profession, or |
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523 | 507 | | occupation of his or her employer and excluding one |
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524 | 508 | | who is required to perform work for a municipality or |
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553 | 536 | | been convicted of a criminal offense or while |
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554 | 537 | | incarcerated. “Employee” Employee shall also include |
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555 | 538 | | a member of the Oklahoma National Guard while in the |
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556 | 539 | | performance of duties only while in response to state |
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557 | 540 | | orders and any authorized voluntary or uncompensated |
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558 | 541 | | worker, rendering services as a firefighter, law |
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559 | 542 | | enforcement officer or emergency management worker. |
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560 | 543 | | Travel by a police officer, fireman, or a member of a |
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561 | 544 | | first aid or rescue squad, in responding to and |
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562 | 545 | | returning from an emergency, shall be deemed to be in |
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563 | 546 | | the course of employment. |
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564 | 547 | | b. The term “employee” employee shall not include: |
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565 | 548 | | (1) any person for whom an employer is liable under |
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566 | 549 | | any Act of Congress for providing compensation to |
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567 | 550 | | employees for injuries, disease or death arising |
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568 | 551 | | out of and in the course of employment including, |
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569 | 552 | | but not limited to, the Federal Employees ’ |
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570 | 553 | | Compensation Act, the Federal Employers ’ |
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571 | 554 | | Liability Act, the Longshore and Harbor Workers ’ |
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572 | 555 | | Compensation Act and the Jones Act, to the extent |
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573 | 556 | | his or her employees are subject to such acts, |
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574 | 557 | | (2) any person who is employed in agriculture, |
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575 | 558 | | ranching, or horticulture by an emplo yer who had |
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604 | 586 | | year of less than One Hundred Thousand Dollars |
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605 | 587 | | ($100,000.00) One Hundred Fifty Thousand Dollars |
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606 | 588 | | ($150,000.00) wages for agricultural, ranching or |
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607 | 589 | | horticultural workers, or any person who is |
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608 | 590 | | employed in agriculture, ranching or horticulture |
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609 | 591 | | who is not engaged in operation of motorized |
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610 | 592 | | machines. This exemption applies to any period |
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611 | 593 | | of time for which such employment exi sts, |
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612 | 594 | | irrespective of whether or not the person is |
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613 | 595 | | employed in other activities fo r which the |
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614 | 596 | | exemption does not apply. If the person is |
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615 | 597 | | employed for part of a year in exempt activities |
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616 | 598 | | and for part of a year in nonexempt activities, |
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617 | 599 | | the employer shall be responsible for providing |
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618 | 600 | | workers’ compensation only for the period of time |
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619 | 601 | | for which the person is employed in nonexempt |
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620 | 602 | | activities, |
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621 | 603 | | (3) any person who is a licensed real estate sales |
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622 | 604 | | associate or broker, paid on a commission basis, |
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623 | 605 | | (4) any person employed by an employer with five or |
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624 | 606 | | fewer total employees, all of whom are related |
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625 | 607 | | within the second degree by blood or marriage to |
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626 | 608 | | the employer, all of whom are dependents living |
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655 | 636 | | are a combination of such relativ es and |
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656 | 637 | | dependents. If the employer is not a natural |
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657 | 638 | | person such relative shall be related within the |
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658 | 639 | | second degree by blood or marriage to a person |
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659 | 640 | | who owns fifty percent (50%) or more of the |
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660 | 641 | | employer, or such dependent shall be in the |
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661 | 642 | | household of a person who owns fifty percent |
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662 | 643 | | (50%) or more of the employer, |
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663 | 644 | | (5) any person employed by an employer which is a |
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664 | 645 | | youth sports league which qualifies for exemption |
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665 | 646 | | from federal income taxation pursuant to federal |
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666 | 647 | | law, |
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667 | 648 | | (6) sole proprietors, members of a partnershi p, |
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668 | 649 | | individuals who are party to a franchise |
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669 | 650 | | agreement as set out by the Federal Trade |
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670 | 651 | | Commission franchise disclosure rule, 16 CFR |
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671 | 652 | | 436.1 through 436.11, members of a limited |
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672 | 653 | | liability company who own at least ten percent |
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673 | 654 | | (10%) of the capital of the limited liability |
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674 | 655 | | company or any stockholder -employees of a |
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675 | 656 | | corporation who own ten perc ent (10%) or more |
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676 | 657 | | stock in the corporation, unless they elect to be |
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677 | 658 | | covered by a policy of insurance covering |
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704 | 684 | | |
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705 | 685 | | benefits under the Administrative Workers ’ |
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706 | 686 | | Compensation Act, |
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707 | 687 | | (7) any person providing or performing voluntary |
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708 | 688 | | service who receives no wages for the services |
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709 | 689 | | other than meals, drug or alcohol rehabilitative |
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710 | 690 | | therapy, transportation, lodging or reimbursement |
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711 | 691 | | for incidental expenses except for volunteers |
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712 | 692 | | specifically provided for in subparagraph a of |
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713 | 693 | | this paragraph, |
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714 | 694 | | (8) a person, commonly referred to as an owner- |
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715 | 695 | | operator, who owns or leases a truck -tractor or |
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716 | 696 | | truck for hire, if the owner -operator actually |
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717 | 697 | | operates the truck-tractor or truck and if the |
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718 | 698 | | person contracting with the owner-operator is not |
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719 | 699 | | the lessor of the truck -tractor or truck. |
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720 | 700 | | Provided, however, an owner -operator shall not be |
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721 | 701 | | precluded from workers ’ compensation coverage |
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722 | 702 | | under the Administrative Workers ’ Compensation |
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723 | 703 | | Act if the owner-operator elects to partici pate |
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724 | 704 | | as a sole proprietor, |
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725 | 705 | | (9) a person referred to as a drive -away owner- |
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726 | 706 | | operator who privately owns and utilizes a tow |
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727 | 707 | | vehicle in drive-away operations and operates |
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728 | 708 | | independently for hire, if the drive -away owner- |
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755 | 734 | | |
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756 | 735 | | operator actually utilizes the tow vehicl e and if |
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757 | 736 | | the person contracting with the drive -away owner- |
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758 | 737 | | operator is not the lessor of the tow vehicle. |
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759 | 738 | | Provided, however, a drive -away owner-operator |
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760 | 739 | | shall not be precluded from workers ’ compensation |
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761 | 740 | | coverage under the Administrative Workers ’ |
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762 | 741 | | Compensation Act if the drive-away owner-operator |
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763 | 742 | | elects to participate as a sole proprieto r, and |
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764 | 743 | | (10) any person who is employed as a domestic servant |
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765 | 744 | | or as a casual worker in and about a private home |
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766 | 745 | | or household, which private home or household had |
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767 | 746 | | a gross annual payroll in the preceding calendar |
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768 | 747 | | year of less than Fifty Thousand Dollars |
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769 | 748 | | ($50,000.00) for such workers , and |
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770 | 749 | | (11) any person who is a dependent child of an owner |
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771 | 750 | | of a farm, ranch, livestock market, or other |
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772 | 751 | | agricultural business and the dependent child i s |
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773 | 752 | | employed by such; |
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774 | 753 | | 19. “Employer” means a natural person, partnership, |
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775 | 754 | | association, limited liability company, corporation, and the legal |
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776 | 755 | | representatives of a deceased employer, or the receiver or trustee |
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777 | 756 | | of a person, partnership, association, corporatio n, or limited |
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778 | 757 | | liability company, departments, instrumentalities and institutions |
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779 | 758 | | of this state and divisions thereof, counties and divisions thereof, |
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803 | 781 | | 22 |
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804 | 782 | | 23 |
---|
805 | 783 | | 24 |
---|
806 | 784 | | |
---|
807 | 785 | | public trusts, boards of education and incorporated cities or towns |
---|
808 | 786 | | and divisions thereof, employing a per son included within the term |
---|
809 | 787 | | “employee” employee as defined in this section. Emp loyer may also |
---|
810 | 788 | | mean the employer’s workers’ compensation insurance carrier, if |
---|
811 | 789 | | applicable. Except as provided otherwise, this act the |
---|
812 | 790 | | Administrative Workers ’ Compensation Act applies to all public and |
---|
813 | 791 | | private entities and institutions; |
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814 | 792 | | 20. “Employment” includes work or labor in a trade, business, |
---|
815 | 793 | | occupation or activity carried on by an employer or any authorized |
---|
816 | 794 | | voluntary or uncompensated worker rendering services as a |
---|
817 | 795 | | firefighter, peace officer or emergency management worker; |
---|
818 | 796 | | 21. “Evidence-based” means expert-based, literature-supported |
---|
819 | 797 | | and outcomes validated by well -designed randomized trials when such |
---|
820 | 798 | | information is available and which uses the best available evidence |
---|
821 | 799 | | to support medical decision making; |
---|
822 | 800 | | 22. “Gainful employment” means the capacity to perform |
---|
823 | 801 | | employment for wages for a period of time that is not part -time, |
---|
824 | 802 | | occasional or sporadic; |
---|
825 | 803 | | 23. “Impaired self-insurer” means a private self -insurer or |
---|
826 | 804 | | group self-insurance association that fails to pay its workers ’ |
---|
827 | 805 | | compensation obligations, or is fin ancially unable to do so and is |
---|
828 | 806 | | the subject of any proceeding under the Federal Bankruptcy Reform |
---|
829 | 807 | | Act of 1978, and any subsequent amendments or is the subject of any |
---|
830 | 808 | | proceeding in which a receiver, custodian, liquidator, |
---|
831 | 809 | | |
---|
834 | 811 | | 2 |
---|
835 | 812 | | 3 |
---|
836 | 813 | | 4 |
---|
837 | 814 | | 5 |
---|
838 | 815 | | 6 |
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839 | 816 | | 7 |
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840 | 817 | | 8 |
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841 | 818 | | 9 |
---|
842 | 819 | | 10 |
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843 | 820 | | 11 |
---|
844 | 821 | | 12 |
---|
845 | 822 | | 13 |
---|
846 | 823 | | 14 |
---|
847 | 824 | | 15 |
---|
848 | 825 | | 16 |
---|
849 | 826 | | 17 |
---|
850 | 827 | | 18 |
---|
851 | 828 | | 19 |
---|
852 | 829 | | 20 |
---|
853 | 830 | | 21 |
---|
854 | 831 | | 22 |
---|
855 | 832 | | 23 |
---|
856 | 833 | | 24 |
---|
857 | 834 | | |
---|
858 | 835 | | rehabilitator, trustee or similar officer has been appointed by a |
---|
859 | 836 | | court of competent jurisdiction to act in lieu of or on behalf of |
---|
860 | 837 | | the self-insurer; |
---|
861 | 838 | | 24. “Incapacity” means inadequate strength or ability to |
---|
862 | 839 | | perform a work-related task; |
---|
863 | 840 | | 25. “Insurance Commissioner ” means the Insurance Comm issioner |
---|
864 | 841 | | of the State of Oklahoma this state; |
---|
865 | 842 | | 26. “Insurance Department ” means the Insurance Department of |
---|
866 | 843 | | the State of Oklahoma this state; |
---|
867 | 844 | | 27. “Major cause” means more than fifty percent (50%) of the |
---|
868 | 845 | | resulting injury, disease or illness. A finding of major cause |
---|
869 | 846 | | shall be established by a preponderance of the evidence. A finding |
---|
870 | 847 | | that the workplace was not a major cause of the injury, disease or |
---|
871 | 848 | | illness shall not adversely affect the exclusive remedy provisions |
---|
872 | 849 | | of this act the Administrative Workers ’ Compensation Act and shall |
---|
873 | 850 | | not create a separate cause of action outside this act the |
---|
874 | 851 | | Administrative Workers ’ Compensation Act; |
---|
875 | 852 | | 28. “Maximum medical improvement ” means that no further |
---|
876 | 853 | | material improvement would reasonably be expected from medical |
---|
877 | 854 | | treatment or the passage of time; |
---|
878 | 855 | | 29. “Medical services” means those services specified in |
---|
879 | 856 | | Section 50 of this title; |
---|
880 | 857 | | 30. “Misconduct” shall include the following: |
---|
881 | 858 | | a. unexplained absenteeism or tardiness, |
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882 | 859 | | |
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885 | 861 | | 2 |
---|
886 | 862 | | 3 |
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887 | 863 | | 4 |
---|
888 | 864 | | 5 |
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889 | 865 | | 6 |
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890 | 866 | | 7 |
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891 | 867 | | 8 |
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892 | 868 | | 9 |
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893 | 869 | | 10 |
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894 | 870 | | 11 |
---|
895 | 871 | | 12 |
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896 | 872 | | 13 |
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897 | 873 | | 14 |
---|
898 | 874 | | 15 |
---|
899 | 875 | | 16 |
---|
900 | 876 | | 17 |
---|
901 | 877 | | 18 |
---|
902 | 878 | | 19 |
---|
903 | 879 | | 20 |
---|
904 | 880 | | 21 |
---|
905 | 881 | | 22 |
---|
906 | 882 | | 23 |
---|
907 | 883 | | 24 |
---|
908 | 884 | | |
---|
909 | 885 | | b. willful or wanton indifference to or neglect of the |
---|
910 | 886 | | duties required, |
---|
911 | 887 | | c. willful or wanton breach of any duty required by the |
---|
912 | 888 | | employer, |
---|
913 | 889 | | d. the mismanagement of a position of employment by |
---|
914 | 890 | | action or inaction, |
---|
915 | 891 | | e. actions or omissions t hat place in jeopardy the |
---|
916 | 892 | | health, life, or property of self or others, |
---|
917 | 893 | | f. dishonesty, |
---|
918 | 894 | | g. wrongdoing, |
---|
919 | 895 | | h. violation of a law, or |
---|
920 | 896 | | i. a violation of a policy or rule adopted to ensure |
---|
921 | 897 | | orderly work or the safety of self or others; |
---|
922 | 898 | | 31. a. (1) “Objective findings” are those findings which |
---|
923 | 899 | | cannot come under the voluntary control of the |
---|
924 | 900 | | patient. |
---|
925 | 901 | | (2) (a) When determining permanent disability, a |
---|
926 | 902 | | physician, any other medical provider, an |
---|
927 | 903 | | administrative law judge, the Commission or |
---|
928 | 904 | | the courts shall not consider complain ts of |
---|
929 | 905 | | pain. |
---|
930 | 906 | | (b) For the purpose of making permanent |
---|
931 | 907 | | disability ratings to the spine, physicians |
---|
932 | 908 | | shall use criteria established by the Sixth |
---|
933 | 909 | | |
---|
936 | 911 | | 2 |
---|
937 | 912 | | 3 |
---|
938 | 913 | | 4 |
---|
939 | 914 | | 5 |
---|
940 | 915 | | 6 |
---|
941 | 916 | | 7 |
---|
942 | 917 | | 8 |
---|
943 | 918 | | 9 |
---|
944 | 919 | | 10 |
---|
945 | 920 | | 11 |
---|
946 | 921 | | 12 |
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947 | 922 | | 13 |
---|
948 | 923 | | 14 |
---|
949 | 924 | | 15 |
---|
950 | 925 | | 16 |
---|
951 | 926 | | 17 |
---|
952 | 927 | | 18 |
---|
953 | 928 | | 19 |
---|
954 | 929 | | 20 |
---|
955 | 930 | | 21 |
---|
956 | 931 | | 22 |
---|
957 | 932 | | 23 |
---|
958 | 933 | | 24 |
---|
959 | 934 | | |
---|
960 | 935 | | Edition of the American Medical Association |
---|
961 | 936 | | “Guides to the Evaluation of Permanent |
---|
962 | 937 | | Impairment”. |
---|
963 | 938 | | (3) (a) Objective evidence necessary to prove |
---|
964 | 939 | | permanent disability in occupational hearing |
---|
965 | 940 | | loss cases may be established by medically |
---|
966 | 941 | | recognized and accepted clinical diagnostic |
---|
967 | 942 | | methodologies, including, but not limited |
---|
968 | 943 | | to, audiological tests that measure air and |
---|
969 | 944 | | bone conduction thresholds and speech |
---|
970 | 945 | | discrimination ability. |
---|
971 | 946 | | (b) Any difference in the baseline hearing |
---|
972 | 947 | | levels shall be confirmed by subsequent |
---|
973 | 948 | | testing; provided, however, such test shall |
---|
974 | 949 | | be given within four (4) weeks of the |
---|
975 | 950 | | initial baseline hearing level test but n ot |
---|
976 | 951 | | before five (5) days after being adjusted |
---|
977 | 952 | | for presbycusis. |
---|
978 | 953 | | b. Medical opinions addressing compensability and |
---|
979 | 954 | | permanent disability shall be stated within a |
---|
980 | 955 | | reasonable degree of medical certainty; |
---|
981 | 956 | | 32. “Official Disability Guidelines ” or “ODG” means the current |
---|
982 | 957 | | edition of the Official Disability Guidelines and the ODG Treatment |
---|
983 | 958 | | in Workers’ Comp as published by the Work Loss Data Institute; |
---|
984 | 959 | | |
---|
987 | 961 | | 2 |
---|
988 | 962 | | 3 |
---|
989 | 963 | | 4 |
---|
990 | 964 | | 5 |
---|
991 | 965 | | 6 |
---|
992 | 966 | | 7 |
---|
993 | 967 | | 8 |
---|
994 | 968 | | 9 |
---|
995 | 969 | | 10 |
---|
996 | 970 | | 11 |
---|
997 | 971 | | 12 |
---|
998 | 972 | | 13 |
---|
999 | 973 | | 14 |
---|
1000 | 974 | | 15 |
---|
1001 | 975 | | 16 |
---|
1002 | 976 | | 17 |
---|
1003 | 977 | | 18 |
---|
1004 | 978 | | 19 |
---|
1005 | 979 | | 20 |
---|
1006 | 980 | | 21 |
---|
1007 | 981 | | 22 |
---|
1008 | 982 | | 23 |
---|
1009 | 983 | | 24 |
---|
1010 | 984 | | |
---|
1011 | 985 | | 33. “Permanent disability ” means the extent, expressed as a |
---|
1012 | 986 | | percentage, of the loss of a portion of the total physiol ogical |
---|
1013 | 987 | | capabilities of the human body as established by competent medical |
---|
1014 | 988 | | evidence and based on the Sixth Edition of the American Medical |
---|
1015 | 989 | | Association “Guides to the Evaluation of Permanent Impairment ”, if |
---|
1016 | 990 | | the impairment is contained therein; |
---|
1017 | 991 | | 34. “Permanent partial disability ” means a permanent disability |
---|
1018 | 992 | | or loss of use after maximum medical improvement has been reached |
---|
1019 | 993 | | which prevents the injured employee, who has been released to return |
---|
1020 | 994 | | to work by the treating physician, from returning to his or her pre - |
---|
1021 | 995 | | injury or equivalent job. All evaluations of permanent partial |
---|
1022 | 996 | | disability must be supported by objective findings; |
---|
1023 | 997 | | 35. “Permanent total disability ” means, based on objective |
---|
1024 | 998 | | findings, incapacity, based upon accidental injury or occupational |
---|
1025 | 999 | | disease, to earn wages in any employment for which the employee may |
---|
1026 | 1000 | | become physically suited and reasonably fitted by education, |
---|
1027 | 1001 | | training, experience or vocational rehabilitation provided under |
---|
1028 | 1002 | | this act the Administrative Workers ’ Compensation Act. Loss of both |
---|
1029 | 1003 | | hands, both feet, both legs, or both eyes, or any two thereof, shall |
---|
1030 | 1004 | | constitute permanent total disability; |
---|
1031 | 1005 | | 36. “Preexisting condition ” means any illness, injury, disease, |
---|
1032 | 1006 | | or other physical or mental condition, whether or not work -related, |
---|
1033 | 1007 | | for which medical advic e, diagnosis, care or treatment was |
---|
1034 | 1008 | | recommended or received preceding the date of injury; |
---|
1035 | 1009 | | |
---|
1038 | 1011 | | 2 |
---|
1039 | 1012 | | 3 |
---|
1040 | 1013 | | 4 |
---|
1041 | 1014 | | 5 |
---|
1042 | 1015 | | 6 |
---|
1043 | 1016 | | 7 |
---|
1044 | 1017 | | 8 |
---|
1045 | 1018 | | 9 |
---|
1046 | 1019 | | 10 |
---|
1047 | 1020 | | 11 |
---|
1048 | 1021 | | 12 |
---|
1049 | 1022 | | 13 |
---|
1050 | 1023 | | 14 |
---|
1051 | 1024 | | 15 |
---|
1052 | 1025 | | 16 |
---|
1053 | 1026 | | 17 |
---|
1054 | 1027 | | 18 |
---|
1055 | 1028 | | 19 |
---|
1056 | 1029 | | 20 |
---|
1057 | 1030 | | 21 |
---|
1058 | 1031 | | 22 |
---|
1059 | 1032 | | 23 |
---|
1060 | 1033 | | 24 |
---|
1061 | 1034 | | |
---|
1062 | 1035 | | 37. “Pre-injury or equivalent job ” means the job that the |
---|
1063 | 1036 | | claimant was working for the employer at the time the injury |
---|
1064 | 1037 | | occurred or any other employment offered by th e claimant’s employer |
---|
1065 | 1038 | | that pays at least one hundred percent (100%) of the employ ee’s |
---|
1066 | 1039 | | average weekly wage; |
---|
1067 | 1040 | | 38. “Private self-insurer” means a private employer that has |
---|
1068 | 1041 | | been authorized to self -insure its workers’ compensation obligations |
---|
1069 | 1042 | | pursuant to this act the Administrative Workers ’ Compensation Act, |
---|
1070 | 1043 | | but does not include group self -insurance associations authorized by |
---|
1071 | 1044 | | this act the Administrative Workers ’ Compensation Act, or any public |
---|
1072 | 1045 | | employer that self-insures pursuant to this act the Administrative |
---|
1073 | 1046 | | Workers’ Compensation Act; |
---|
1074 | 1047 | | 39. “Prosthetic” means an artificial device used to rep lace a |
---|
1075 | 1048 | | part or joint of the body that is lost or injured in an accident or |
---|
1076 | 1049 | | illness covered by this act the Administrative Workers ’ Compensation |
---|
1077 | 1050 | | Act; |
---|
1078 | 1051 | | 40. “Scheduled member” or “member” means hands, fingers, arms, |
---|
1079 | 1052 | | legs, feet, toes, and eyes. In addition, for purposes of the |
---|
1080 | 1053 | | Multiple Injury Trust Fund only, “scheduled member” scheduled member |
---|
1081 | 1054 | | means hearing impairment; |
---|
1082 | 1055 | | 41. “Scientifically based ” involves the application of |
---|
1083 | 1056 | | rigorous, systematic, and objective procedures to obtain reliable |
---|
1084 | 1057 | | and valid knowledge relevant to medical testing, diagnoses and |
---|
1085 | 1058 | | treatment; is adequate to justify the general conclusions drawn; and |
---|
1086 | 1059 | | |
---|
1089 | 1061 | | 2 |
---|
1090 | 1062 | | 3 |
---|
1091 | 1063 | | 4 |
---|
1092 | 1064 | | 5 |
---|
1093 | 1065 | | 6 |
---|
1094 | 1066 | | 7 |
---|
1095 | 1067 | | 8 |
---|
1096 | 1068 | | 9 |
---|
1097 | 1069 | | 10 |
---|
1098 | 1070 | | 11 |
---|
1099 | 1071 | | 12 |
---|
1100 | 1072 | | 13 |
---|
1101 | 1073 | | 14 |
---|
1102 | 1074 | | 15 |
---|
1103 | 1075 | | 16 |
---|
1104 | 1076 | | 17 |
---|
1105 | 1077 | | 18 |
---|
1106 | 1078 | | 19 |
---|
1107 | 1079 | | 20 |
---|
1108 | 1080 | | 21 |
---|
1109 | 1081 | | 22 |
---|
1110 | 1082 | | 23 |
---|
1111 | 1083 | | 24 |
---|
1112 | 1084 | | |
---|
1113 | 1085 | | has been accepted by a peer -review journal or approved by a pan el of |
---|
1114 | 1086 | | independent experts through a comparably rigorous, objective, and |
---|
1115 | 1087 | | scientific review; |
---|
1116 | 1088 | | 42. “State average weekly wage ” means the state average weekly |
---|
1117 | 1089 | | wage determined by the Oklahoma Employment Security Commission in |
---|
1118 | 1090 | | the preceding calendar year. If su ch determination is not |
---|
1119 | 1091 | | available, the Commission shall determine the wage annual ly after |
---|
1120 | 1092 | | reasonable investigation; |
---|
1121 | 1093 | | 43. “Subcontractor” means a person, firm, corporation or other |
---|
1122 | 1094 | | legal entity hired by the general or prime contractor to perform a |
---|
1123 | 1095 | | specific task for the completion of a work -related activity; |
---|
1124 | 1096 | | 44. “Surgery” does not include an injection, or the forcing of |
---|
1125 | 1097 | | fluids beneath the skin, for treatment or diagnosis; |
---|
1126 | 1098 | | 45. “Surviving spouse” means the employee’s spouse by reason of |
---|
1127 | 1099 | | a legal marriage recog nized by the State of Oklahoma this state or |
---|
1128 | 1100 | | under the requirements of a common l aw marriage in this state, as |
---|
1129 | 1101 | | determined by the Oklahoma Workers’ Compensation Commission; |
---|
1130 | 1102 | | 46. “Temporary partial disability ” means an injured employee |
---|
1131 | 1103 | | who is temporarily una ble to perform his or her job, but may perform |
---|
1132 | 1104 | | alternative work offered by the employer; |
---|
1133 | 1105 | | 47. “Time of accident” or “date of accident” means the time or |
---|
1134 | 1106 | | date of the occurrence of the accidental incident from which |
---|
1135 | 1107 | | compensable injury, disability, or death r esults; and |
---|
1136 | 1108 | | |
---|
1139 | 1110 | | 2 |
---|
1140 | 1111 | | 3 |
---|
1141 | 1112 | | 4 |
---|
1142 | 1113 | | 5 |
---|
1143 | 1114 | | 6 |
---|
1144 | 1115 | | 7 |
---|
1145 | 1116 | | 8 |
---|
1146 | 1117 | | 9 |
---|
1147 | 1118 | | 10 |
---|
1148 | 1119 | | 11 |
---|
1149 | 1120 | | 12 |
---|
1150 | 1121 | | 13 |
---|
1151 | 1122 | | 14 |
---|
1152 | 1123 | | 15 |
---|
1153 | 1124 | | 16 |
---|
1154 | 1125 | | 17 |
---|
1155 | 1126 | | 18 |
---|
1156 | 1127 | | 19 |
---|
1157 | 1128 | | 20 |
---|
1158 | 1129 | | 21 |
---|
1159 | 1130 | | 22 |
---|
1160 | 1131 | | 23 |
---|
1161 | 1132 | | 24 |
---|
1162 | 1133 | | |
---|
1163 | 1134 | | 48. “Wages” means money compensation received for employment at |
---|
1164 | 1135 | | the time of the accident, including the reasonable value of board, |
---|
1165 | 1136 | | rent, housing, lodging, or similar advantage received from the |
---|
1166 | 1137 | | employer and includes the amount of tips required to be reported by |
---|
1167 | 1138 | | the employer under Section 6053 of the Internal Revenue Code and the |
---|
1168 | 1139 | | regulations promulgated pursuant thereto or the amount of actual |
---|
1169 | 1140 | | tips reported, whichever amount is greater. |
---|
1170 | 1141 | | SECTION 2. This act shall become effective November 1, 2025. |
---|