H 5184 Session 112 (1997-1998)
H 5184 General Bill, By Jennings
A BILL TO AMEND TITLE 42, CODE OF LAWS OF SOUTH CAROLINA, 1976, RELATING TO
WORKERS' COMPENSATION, BY ADDING SECTION 42-9-435 SO AS TO INCREASE THE
COMPENSATION BY TWENTY-FIVE PERCENT IN CASES OF WILFUL OR RECKLESS
NONCOMPLIANCE WITH REGULATIONS OR ORDERS; TO AMEND SECTION 42-1-160, AS
AMENDED, RELATING TO DEFINITIONS OF "INJURY" AND "PERSONAL INJURY", SO AS TO
INCLUDE GRADUAL INJURIES INCURRED BY REPEATED PERFORMANCE OF JOB DUTIES; TO
AMEND SECTION 42-1-540, RELATING TO TO EXCLUSIVITY OF REMEDY IN WORKERS'
COMPENSATION, SO AS TO PROVIDE FOR EMPLOYEE RIGHTS AGAINST AN EMPLOYER FOR
RECKLESS, WILFUL, WANTON, OR INTENTIONAL WRONGDOING; TO AMEND SECTION
42-1-560, RELATING TO RIGHTS AND REMEDIES AGAINST A THIRD PARTY, SO AS TO
PROVIDE FOR FORFEITURE OF THE CARRIER'S LIEN ON A RECOVERY WHEN THE CARRIER
FAILS TO PAY ONE-HALF THE EXPENSES OF PURSUING A THIRD-PARTY AS THE EXPENSES
ARE INCURRED; TO AMEND SECTION 42-3-20, RELATING TO THE MEMBERSHIP AND DUTIES
OF THE INDUSTRIAL COMMISSION, SO AS TO CHANGE THE MEMBERSHIP FROM SEVEN TO
NINE MEMBERS WHO ARE ELECTED BY THE GENERAL ASSEMBLY RATHER THAN APPOINTED BY
THE GOVERNOR; TO AMEND SECTION 42-5-20, AS AMENDED, RELATING TO PROOF OF
INSURANCE OR ABILITY TO PAY, TO PROVIDE FOR QUALIFICATION AND REGULATION OF
GROUP SELF-INSURERS BY THE DEPARTMENT OF INSURANCE; TO AMEND SECTION 42-9-10,
RELATING TO TOTAL DISABILITY, SO AS TO PROVIDE THAT COMPENSATION FOR TOTAL
DISABILITY APPLIES REGARDLESS OF THE AVAILABILITY OF OTHER COMPENSATION; TO
AMEND SECTION 42-9-30, AS AMENDED, RELATING TO A SCHEDULE FOR COMPENSATION FOR
CERTAIN INJURIES, SO AS TO INCREASE THE PERIODS OF DISABILITY FOR CERTAIN
INJURIES; TO AMEND SECTION 42-9-40, RELATING TO COMPENSATION FOR HERNIA, SO AS
TO PROVIDE FOR COMPENSATION FOR TOTAL DISABILITY; TO AMEND SECTION 42-9-390,
RELATING TO VOLUNTARY SETTLEMENTS SO AS TO PROVIDE PENALTIES FOR FAILURE TO
MAKE PAYMENTS IN A TIMELY FASHION; TO AMEND SECTION 42-15-60, RELATING TO
FURNISHING OF MEDICAL TREATMENT AND SUPPLIES BY THE EMPLOYER, SO AS TO REQUIRE
THAT THEY BE FURNISHED FOR THE LIFETIME OF THE EMPLOYEE; TO AMEND SECTION
42-15-90, RELATING TO FEES AND CHARGES, SO AS TO PROVIDE CRIMINAL PENALTIES
FOR A HEALTH CARE PROVIDER WHO DEMANDS PAYMENT BEFORE FINAL ADJUDICATION OF
THE CLAIM WHO CHARGES AN EXCESSIVE FEE AND TO REQUIRE TIMELY PAYMENT TO A
HEALTH CARE PROVIDER; TO AMEND SECTION 42-17-60, AS AMENDED, RELATING TO
APPEAL OF THE COMPENSATION AWARD, SO AS TO PROVIDE FOR AN APPEAL PROCEDURE
LIKE THE FAMILY COURT APPEAL PROCEDURE LIKE THE FAMILY COURT APPEAL PROCEDURE,
NOTWITHSTANDING THE ADMINISTRATIVE PROCEDURES ACT; TO AMEND SECTION 42-17-90,
RELATING TO CHANGE OF CONDITION, SO AS TO PROVIDE FOR A FORMULA FOR
DETERMINING ADDITIONAL COMPENSATION; AND TO REPEAL SECTION 42-17-50, RELATING
TO REVIEW AND REHEARING BY THE INDUSTRIAL COMMISSION.
05/26/98 House Introduced and read first time HJ-13
05/26/98 House Referred to Committee on Labor, Commerce and
Industry HJ-14
A BILL
TO AMEND TITLE 42, CODE OF LAWS OF SOUTH
CAROLINA, 1976, RELATING TO WORKERS'
COMPENSATION, BY ADDING SECTION 42-9-435 SO AS TO
INCREASE THE COMPENSATION BY TWENTY-FIVE
PERCENT IN CASES OF WILFUL OR RECKLESS
NONCOMPLIANCE WITH REGULATIONS OR ORDERS; TO
AMEND SECTION 42-1-160, AS AMENDED, RELATING TO
DEFINITIONS OF "INJURY" AND "PERSONAL
INJURY", SO AS TO INCLUDE GRADUAL INJURIES
INCURRED BY REPEATED PERFORMANCE OF JOB DUTIES;
TO AMEND SECTION 42-1-540, RELATING TO EXCLUSIVITY
OF REMEDY IN WORKERS' COMPENSATION, SO AS TO
PROVIDE FOR EMPLOYEE RIGHTS AGAINST AN EMPLOYER
FOR RECKLESS, WILFUL, WANTON, OR INTENTIONAL
WRONGDOING; TO AMEND SECTION 42-1-560, RELATING
TO RIGHTS AND REMEDIES AGAINST A THIRD PARTY, SO
AS TO PROVIDE FOR FORFEITURE OF THE CARRIER'S LIEN
ON A RECOVERY WHEN THE CARRIER FAILS TO PAY
ONE-HALF THE EXPENSES OF PURSUING A THIRD-PARTY
AS THE EXPENSES ARE INCURRED; TO AMEND SECTION
42-3-20, RELATING TO THE MEMBERSHIP AND DUTIES OF
THE INDUSTRIAL COMMISSION, SO AS TO CHANGE THE
MEMBERSHIP FROM SEVEN TO NINE MEMBERS WHO ARE
ELECTED BY THE GENERAL ASSEMBLY RATHER THAN
APPOINTED BY THE GOVERNOR; TO AMEND SECTION
42-5-20, AS AMENDED, RELATING TO PROOF OF
INSURANCE OR ABILITY TO PAY, TO PROVIDE FOR
QUALIFICATION AND REGULATION OF GROUP
SELF-INSURERS BY THE DEPARTMENT OF INSURANCE; TO
AMEND SECTION 42-9-10, RELATING TO TOTAL
DISABILITY, SO AS TO PROVIDE THAT COMPENSATION
FOR TOTAL DISABILITY APPLIES REGARDLESS OF THE
AVAILABILITY OF OTHER COMPENSATION; TO AMEND
SECTION 42-9-30, AS AMENDED, RELATING TO A
SCHEDULE FOR COMPENSATION FOR CERTAIN INJURIES,
SO AS TO INCREASE THE PERIODS OF DISABILITY FOR
CERTAIN INJURIES; TO AMEND SECTION 42-9-40,
RELATING TO COMPENSATION FOR HERNIA, SO AS TO
PROVIDE FOR COMPENSATION FOR TOTAL DISABILITY; TO
AMEND SECTION 42-9-390, RELATING TO VOLUNTARY
SETTLEMENTS SO AS TO PROVIDE PENALTIES FOR
FAILURE TO MAKE PAYMENTS IN A TIMELY FASHION; TO
AMEND SECTION 42-15-60, RELATING TO FURNISHING OF
MEDICAL TREATMENT AND SUPPLIES BY THE EMPLOYER,
SO AS TO REQUIRE THAT THEY BE FURNISHED FOR THE
LIFETIME OF THE EMPLOYEE; TO AMEND SECTION
42-15-90, RELATING TO FEES AND CHARGES, SO AS TO
PROVIDE CRIMINAL PENALTIES FOR A HEALTH CARE
PROVIDER WHO DEMANDS PAYMENT BEFORE FINAL
ADJUDICATION OF THE CLAIM OR WHO CHARGES AN
EXCESSIVE FEE AND TO REQUIRE TIMELY PAYMENT TO A
HEALTH CARE PROVIDER; TO AMEND SECTION 42-17-60,
AS AMENDED, RELATING TO APPEAL OF THE
COMPENSATION AWARD, SO AS TO PROVIDE FOR AN
APPEAL PROCEDURE LIKE THE FAMILY COURT APPEAL
PROCEDURE, NOTWITHSTANDING THE ADMINISTRATIVE
PROCEDURES ACT; TO AMEND SECTION 42-17-90,
RELATING TO CHANGE OF CONDITION, SO AS TO PROVIDE
FOR A FORMULA FOR DETERMINING ADDITIONAL
COMPENSATION; AND TO REPEAL SECTION 42-17-50,
RELATING TO REVIEW AND REHEARING BY THE
INDUSTRIAL COMMISSION.
Be it enacted by the General Assembly of the State of South
Carolina:
SECTION 1. Title 42 of the 1976 Code is amended by adding:
"Section 42-9-435. When an injury or death is caused by the
wilful or reckless failure of an employer to comply with any state or
federal statutory or regulatory requirement or decision, its own safety
regulations, or any lawful order of the commission, compensation
must be increased twenty-five percent. This increase is not subject
to the maximum compensation limit."
SECTION 2. Section 42-1-160 of the 1976 Code, as last amended
by Act 424 of 1996, is further amended to read:
"Section 42-1-160. (A) 'Injury' and 'personal
injury' shall mean means only injury by accident
arising out of and in the course of the employment and shall
does not include a disease in any form, except when it
results naturally and unavoidably from the accident and except
such those diseases as which are
compensable under pursuant to the provisions of
Chapter 11 of this title. In construing this section an accident arising
out of and in the course of employment shall include
includes employment of an employee of a municipality
outside the corporate limits of the municipality when the employment
was ordered by a duly authorized employee of the municipality.
'Injury' and 'personal injury' also include both injury by accident
suffered at a definite time and also injury by accident sustained
gradually as the result of repeated performance of job-related duties.
(B) Stress arising out of and in the course of employment
unaccompanied by physical injury and resulting in mental illness or
injury is not a personal injury unless it is established that the stressful
employment conditions causing the mental injury were extraordinary
and unusual in comparison to the normal conditions of the
employment.
(C) Stress arising out of and in the course of employment
unaccompanied by physical injury is not considered compensable if
it results from any an event or series of events which
is incidental to normal employer-employee relations including, but
not limited to, personnel actions by the employer such as disciplinary
actions, work evaluations, transfers, promotions, demotions, salary
reviews, or terminations, except when these actions are taken in an
extraordinary and unusual manner."
SECTION 3. Section 42-1-540 of the 1976 Code is amended to
read:
"Section 42-1-540. (A) The rights and remedies
granted by this title to an employee when he and his employer have
accepted the provisions of this title, respectively, to pay and
accept compensation on account of personal injury or death by
accident, shall exclude all other rights and remedies of
such the employee, his personal representative,
parents, dependents, or next of kin as against his employer,
at common law or otherwise, on account of such the
injury, loss of service, or death.
(B) Provided, however, This limitation of actions
shall does not apply to injuries resulting from acts of
a subcontractor of the employer or his employees or bar actions by an
employee of one subcontractor against another subcontractor or his
employees when both subcontractors are hired by a common
employer.
(C) This section does not bar an action by an employee
against an employer when the action is based on recklessness,
wilfulness, wantonness, or intentional wrongdoing by the employer,
or any of the employer's supervisory personnel, acting within the
course and scope of the employment."
SECTION 4. Section 42-1-560(b) of the 1976 Code is amended to
read:
"(b) The injured employee or, in the event of his death,
his the dependents of a deceased
employee, shall be are entitled to
receive the compensation and other benefits provided by this
title and to enforce by appropriate proceedings his or their
rights against the third party; provided, that an action
against the third party must be commenced not later than one year
after the carrier accepts liability for the payment of compensation or
makes its final payment pursuant to an award,
agreement, or settlement under pursuant to this
title, except as hereinafter otherwise provided. In
such case The carrier shall have a lien on the proceeds of any
recovery from the third party whether by judgment,
settlement, or otherwise, to the extent of the total amount of
compensation, including medical and other expenses, paid, or to be
paid by such the carrier, less the reasonable and
necessary expenses, including attorney fees, incurred in effecting the
recovery, and to the extent the recovery shall be deemed to be
is for the benefit of the carrier. A carrier who fails to
pay one-half the expenses incurred in preparation and litigation, or
either of them, of the third-party claim as the expenses are incurred
forfeits the lien on the recovery. Attorney fees owed and
payable by the carrier to the attorneys effecting the recovery shall
be are set by the commission, but shall
may not exceed one third of the total claim amount paid by
the carrier to the injured employee. Such Attorney
fees shall must be paid from the funds recovered by
the carrier. Any The balance remaining after
payment of necessary expenses and satisfaction of the carrier's lien
shall must be applied as a credit against future
compensation benefits for the same injury or death and shall
must be distributed as provided in subsection (g) of this
section. Notice of the commencement of the action shall
must be given within thirty days of commencement
thereafter to the Industrial Commission, the
employer, and carrier upon a form prescribed by the
Industrial Commission."
SECTION 5. Section 42-3-20 of the 1976 Code is amended to
read:
"Section 42-3-20. (A) The commission shall
consist of seven have nine members appointed by
the Governor with the advice and consent of the Senate
elected by the General Assembly in the same manner as circuit
court judges, including appearance before the Judicial Screening
Committee, for terms of six years and until their successors are
appointed and qualify. The Governor, with the advice and
consent of the Senate, shall designate one commissioner as
chairman for a term of two years. and The chairman
may serve two terms as chairman in his six-year
term, but not consecutively.
(B) The commissioners shall hear and determine all
contested cases, conduct informal conferences when necessary,
approve settlements, hear applications for full commission
reviews, and handle such other matters as
may that come before the department for judicial
disposition. A full commission reviews
review shall must be conducted by
six eight commissioners only, with the
original hearing commissioner not sitting at such reviews
the review. When one commissioner is temporarily
incapacitated or a vacancy exists on the commission, reviews
a review may be conducted by the five
seven remaining commissioners, but in such
cases decisions that event a decision of the hearing
commissioner shall may not be reversed except on
the vote of at least four five commissioners;
provided, however, that effective July 1, 1981 a full
commission reviews review may be conducted by
a three-member panels panel composed of
three commissioners appointed by the chairman, excluding
the original hearing commissioner. The chairman, with unanimous
approval of the other commissioners, shall determine which full
commission reviews shall be assigned to panels. The
decisions decision of such panels shall have
a panel has the same force and effect as a nonpanel
full commission reviews review."
SECTION 6. Section 42-5-20 of the 1976 Code, as last amended
by Act 459 of 1994, is further amended to read:
"Section 42-5-20. (A) Every employer who accepts
the provisions of this title relative to the payment of compensation
shall insure and keep insured his liability thereunder
pursuant to it in any authorized corporation, association,
organization, or mutual insurance association formed by a group of
employers so authorized or shall furnish to the commission
Department of Insurance satisfactory proof of his financial
ability to pay directly the compensation in the amount and manner
and when due as provided for in this title. The commission
Department of Insurance may, under such
rules and regulations as it may prescribe, may permit two or
more employers in businesses of a similar nature to enter into
agreements to pool their liabilities under the Workers' Compensation
Law for the purpose of qualifying as self-insurers. In the case of
self-insurers the commission Department of
Insurance shall require the deposit of an acceptable security,
indemnity, or bond to secure the payment of the compensation
liabilities as they are incurred.
(B) The Industrial Commission Department
of Insurance shall have has exclusive
jurisdiction of group self-insurers under this section, and such
group self-insurers shall not be deemed to be are
insurance companies for this purpose and shall not be
regulated by the Department of Insurance. Provided, further, that
if any a provision is made for the recognition of
reinsurance of the self-insured fund, such the
provision shall expressly must provide that the
reinsurance agreement or treaty must recognize
recognizes the right of the claimant to recover directly from
the reinsurer and that such the agreement
shall must provide for privity between the reinsurer
and the workers' compensation claimant.
(C) In lieu Instead of submitting audited
financial statements when an employer makes an application to
self-insure with the commission, the commission shall accept the
sworn statement or affidavit of an independent auditor verifying the
financial condition of the employer according to the required
financial ratios and guidelines established by regulation of the
commission. The independent auditor must be a certified public
accountant using generally acceptable accounting principles in the
preparation of the financial statements of the employer."
SECTION 7. Section 42-9-10 of the 1976 Code, is amended to
read:
"Section 42-9-10. (A) When the incapacity for
work resulting from an injury is total, the employer shall pay, or
cause to be paid, as provided in this chapter, to the injured employee
during the total disability a weekly compensation equal to sixty-six
and two-thirds percent of his average weekly wages, but not less than
seventy-five dollars a week so long as this amount does not exceed
his average weekly salary; if this amount does exceed his average
weekly salary, the injured employee may not be paid, each week, less
than his average weekly salary. The injured employee may not be
paid more each week than the average weekly wage in this State for
the preceding fiscal year. In no case may the period covered by the
compensation exceed five hundred weeks except as
hereinafter provided.
(B) The loss of both hands, arms, feet, legs, or vision in
both eyes, or any two thereof of these, constitutes
total and permanent disability to be compensated according to the
provisions of this section.
(C) Notwithstanding the five hundred week limitation
prescribed in this section or elsewhere in this title, any
a person determined to be totally and permanently disabled
who as a result of a compensable injury is a paraplegic, a
quadraplegic quadriplegic, or who has suffered
physical brain damage is not subject to the five hundred week
limitation and shall receive the benefits for life.
(D) Notwithstanding the provisions of Section 42-9-301,
no a total lump sum payment may not be
ordered by the commission in any a case under this
section where the injured person is entitled to lifetime benefits.
(E) Upon proof of total disability, the employee shall receive
compensation for total disability, notwithstanding the part, member,
or portion of the body injured and notwithstanding compensation
available pursuant to Section 42-9-30."
SECTION 8. Section 42-9-30 of the 1976 Code, as last amended
by Act 412 of 1988, is further amended to read:
"Section 42-9-30. In cases included in the following schedule,
the disability in each case shall be deemed is
considered to continue for the specified period
specified and the compensation so paid for
such the injury shall be is as
specified therein, to wit:
(1) For the loss of a thumb sixty-six and two-thirds percent of the
average weekly wages during sixty-five one hundred
ten weeks;
(2) For the loss of a first finger, commonly called the index finger,
sixty-six and two-thirds percent of the average weekly wages during
forty fifty-five weeks;
(3) For the loss of a second finger, sixty-six and two-thirds percent
of the average weekly wages during thirty-five
fifty-five weeks;
(4) For the loss of a third finger, sixty-six and two-thirds percent
of the average weekly wages during twenty-five weeks;
(5) For the loss of a fourth finger, commonly called the little
finger, sixty-six and two-thirds percent of the average weekly wages
during twenty twenty-five weeks;
(6) The loss of the first phalange of the thumb or any finger shall
be considered to be equal to the loss of one half of such thumb or
finger and the compensation shall be for one half of the periods of
time above specified;
(7) The loss of more than one phalange shall be considered the
loss of the entire finger or thumb; provided, however, that in no case
shall the amount received for more than one finger exceed the amount
provided in this schedule for the loss of a hand;
(8) For the loss of a great toe, sixty-six and two-thirds percent of
the average weekly wages during thirty-five weeks;
(9) For the loss of one of the toes other than a great toe, sixty-six
and two-thirds percent of the average weekly wages during ten
weeks;
(10) The loss of the first phalange of any toe shall be considered to
be equal to the loss of one half of such toe and the compensation shall
be for one half the periods of time above specified;
(11) The loss of more than one phalange shall be considered as the
loss of the entire toe;
(12) For the loss of a hand, sixty-six and two-thirds percent of the
average weekly wages during one two hundred
and eighty-five seventy weeks;
(13) For the loss of an arm, sixty-six and two-thirds percent of the
average weekly wages during two three hundred
twenty weeks;
(14) For the loss of a foot, sixty-six and two-thirds percent of the
average weekly wages during one hundred forty weeks;
(15) For the loss of a leg, sixty-six and two-thirds percent of the
average weekly wages during one two hundred
ninety-five weeks;
(16) For the loss of an eye, sixty-six and two-thirds percent of the
average weekly wages during one hundred forty weeks;
(17) For the complete loss of hearing in one ear, sixty-six and
two-thirds percent of the average weekly wages during eighty weeks;
and for the complete loss of hearing in both ears, sixty-six and
two-thirds percent of the average weekly wages during one hundred
sixty-five seventy-five weeks, and the commission
shall by regulation provide for the determination of proportional
benefits for total or partial loss of hearing based on accepted national
medical standards.
(18) Total loss of use of a member or loss of vision of an eye shall
be considered as equivalent to the loss of such member or eye. The
compensation for partial loss of or for partial loss of use of a member
or for partial loss of vision of an eye shall be such proportion of the
payments herein provided for total loss as such partial loss bears to
total loss.
(19) For the total loss of use of the back, sixty-six and two-thirds
percent of the average weekly wages during three hundred weeks.
The compensation for partial loss of use of the back shall be such
proportions of the periods of payment herein provided for total loss
as such partial loss bears to total loss, except that in cases where there
is fifty percent or more loss of use of the back, in which event the
injured employee shall be deemed to have suffered total and
permanent disability and compensated therefor under paragraph two
of Section 42-9-10.
(20) For the total or partial loss of, or loss of use of, a member,
organ or part of the body not covered herein and not covered under
Sections 42-9-10 or 42-9-20, sixty-six and two thirds of the average
weekly wages not to exceed five hundred weeks. The commission
shall by regulations prescribe the ratio which the partial loss or loss
or partial loss of use of a particular member, organ or body part bears
to the whole man, basing such ratios on accepted medical standards
and such ratios shall determine the benefits payable under this
subsection.
(21) Proper and equitable benefits shall be paid for serious
permanent disfigurement of the face, head, neck, or other
area on any part of the body normally exposed in
employment, not to exceed fifty five hundred weeks.
Where benefits are paid or payable for injury to or loss of a
particular member or organ under other provisions of this Title no
additional benefits shall be paid under this paragraph, except that
disfigurement shall also include compensation for serious burn scars
or keloid scars on the body resulting from injuries, in addition to any
other compensation These benefits are in addition to other
benefits or compensation payable pursuant to this title.
The weekly compensation payments referred to in this section
shall all be are subject to the same maximum and
minimum limitations as to maximum and minimum as set
out provided in Section 42-9-10."
SECTION 9. Section 42-9-40 of the 1976 Code is amended by
adding an undesignated new paragraph at the end to read:
"An employee who suffers any degree of permanent partial
loss of use shall receive additional compensation in the proportion
that the partial loss bears to the total loss, established here as one
hundred fifty weeks; provided that if the employee is permanently
and totally disabled as provided in Section 42-9-10, he must be
compensated for total disability."
SECTION 10. Section 42-9-390 of the 1976 Code, is further
amended to read:
"Section 42-9-390. (A) Nothing contained in this
chapter may be construed so as to prevent prevents
settlements made by and between an employee and employer so long
as the amount of compensation and the time and manner of payment
are in accordance with the provisions of this title. A copy of the
settlement agreement must be filed by the employer with and
approved by only one member of the commission if the employee is
represented by an attorney. If the employee is not represented by an
attorney, a copy of the settlement agreement must be filed by the
employer with and approved by four members of the commission.
(B) If a voluntary settlement is agreed upon in a case where
the claimant is receiving weekly compensation at the time of the
agreement, the employer shall continue payment of temporary total
compensation until the proposed settlement, with all necessary
signatures affixed to it, is mailed to the commission. If the settlement
is not approved by the commission, the employer shall restart
compensation payments immediately. Once a settlement is approved,
and notice of the approval is given to the respective parties, the
employer has three days to make payment pursuant to the settlement.
If payment is not made within three days, the employer shall pay to
the claimant an additional payment of ten percent of the amount
agreed upon in the settlement. If the payment is not received by the
claimant within fourteen days, the penalty increases to twenty-five
percent of the agreed-to amount. Settlements not timely paid, along
with applicable penalties, must bear interest at the judgment
rate."
SECTION 11. Section 42-15-60 of the 1976 Code is amended to
read:
"Section 42-15-60. Medical, surgical, hospital,
and other treatment, including medical and surgical supplies as
may reasonably may be required, for a period not
exceeding ten weeks from the date of an injury to effect a
cure, or give relief and for such additional time
as in the judgment of the Commission, or will
tend to lessen the period of disability and, in addition thereto,
such those original artificial members as may be
reasonably may be necessary at the end of the healing period
shall be provided by the employer for the lifetime of the
employee. In case of If a controversy
arising arises between employer and employee, the
commission may order such further medical, surgical,
hospital, or other treatment as may in the discretion
of the commission may be necessary.
(B) During the whole or any part of the remainder of
disability resulting from the injury, the employer
may, at his own option, may continue to furnish or
cause to be furnished, free of charge to the employee, and the
employee shall accept an attending physician, unless otherwise
ordered by the commission and, in addition, such surgical and
hospital service and supplies as may be deemed
considered necessary by such the attending
physician or the commission.
(C) The refusal of an employee to accept any
medical, hospital, surgical, or other treatment when provided
by the employer or ordered by the commission shall bar such
the employee from further compensation until such
the refusal ceases. and no Compensation
shall at any time may not be paid for the period of
suspension unless, in the opinion of the
commission, the circumstances justified the refusal, in
which case and the commission may order a change in
the medical or hospital service.
(D) If in an emergency on account
arises because of the employer's failure to provide the
medical care as specified in this section and a
physician other than one provided by the employer is called
to treat the injured employee, the reasonable cost of
such the service shall must be paid
by the employer if so ordered by the commission orders
it.
(E) In cases in which total and permanent disability
results, Reasonable and necessary nursing services, medicines,
prosthetic devices, sick travel, medical, hospital, and other
treatment or care shall must be paid during the life
of the injured employee, without regard to any limitation
limitations in this title, including the maximum
compensation limit. In cases of partial permanent disability,
prosthetic devices shall be also must be furnished
during the life of the injured employee or for so long as they
are necessary."
SECTION 12. Section 42-15-90 of the 1976 Code is amended to
read:
"Section 42-15-90. (A) Fees for attorneys and
physicians and charges of hospitals for services under this title
shall be are subject to the approval of the
commission; but no physician or hospital shall be entitled to
may collect fees from an employer or insurance carrier until
he has made the reports required by the commission in connection
with the case.
(B) Any A person who receives
any a fee or other consideration or any gratuity on
account of services so rendered, unless such when
the consideration or gratuity is has not been
approved by the commission or such the
court, or a person who makes it a is in
the business to of solicit
soliciting employment for a lawyer or for himself in
respect of any connection with a claim or award for
compensation shall be is guilty of a misdemeanor
and, upon conviction thereof, shall, for each offense,
must be punished by a fine fined of
not more than five hundred dollars or by imprisonment
imprisoned not to exceed more than one
year, or by both such fine and imprisonment for each
offense.
(C) It is unlawful for an authorized health care provider to
demand of or cause a demand to be made on a workers' compensation
claimant before the final adjudication of the claim. Nothing in this
section prohibits the collection from and demand for collection from
a workers' compensation insurance carrier or self-insured employer.
One who violates this section must pay a penalty of one thousand
dollars to the workers' compensation claimant.
(D) It is unlawful for an authorized health care provider to demand
of or cause a demand to be made on a workers' compensation
claimant for charges in excess of the fee provided by the
commission's applicable fee schedule, or to charge any fee in excess
of the fee provided by the schedule. One who violates this section
must pay a penalty of one thousand dollars to the workers'
compensation claimant.
(E) Payment to an authorized health care provider for services
must be made timely, and, in any event, no later than thirty days from
the date the authorized health care provider tenders request for
payment to the employer's representative, unless the commission has
received a request to review the medical bill."
SECTION 13. Section 42-17-60 of the 1976 Code, as last amended
by Act 439 of 1990, is further amended to read:
"Section 42-17-60. (A) The award of the
commission, as provided in Section 42-17-40, if not reviewed in due
time, or an award of the commission upon such review, as provided
in Section 42-17-50, is conclusive and binding as to all questions of
fact. However, Either party to the dispute, within thirty days from
the date of the award or within thirty days after receipt of notice
of the award to be sent by registered mail of the award,
but not thereafter, may appeal from the decision of the
commission to the court of common pleas of the county in which the
alleged accident happened, or in which the employer resides or has
his principal office, for errors of law under the same terms
and conditions and scope of review as govern appeals in
ordinary civil actions from the family court. Notice of
appeal must state the grounds of the appeal or the alleged errors
of law. In case of an appeal from the decision of the
commission on questions of law, The appeal does not operate as
a supersedeas and thereafter the employer is required to
make payment of pay the award involved in the
appeal or certification until the questions at issue
issues have been fully determined fully in
accordance with the provisions of this title.
(B) To the extent this section conflicts with the
Administrative Procedures Act, this section prevails."
SECTION 14. Section 42-17-90 of the 1976 Code is amended to
read:
"Section 42-17-90. (A) Upon its own motion or
upon the application of any a party in interest on the
ground of a change in condition, the commission may review
any an award and, on upon
such review, may make an award ending,
diminishing, or increasing the compensation previously
awarded, subject to the maximum or minimum limitations
provided in this title., and shall The
commission immediately shall send to the parties a
copy of the order changing the award. No such The
review shall may not affect such the
award as regards any moneys paid and no such review shall be
made after twelve months from the date of the last payment of
compensation pursuant to an award under this Title to
payments already made.
(B) Additional compensation to which an employee is found
to be entitled must be based on the greater of (1) the average weekly
wage applicable at the time of the change of condition or (2) the
average weekly wage applicable at the time of the initial
injury."
SECTION 15. Section 42-17-50 of the 1976 Code is repealed.
SECTION 16. This act takes effect upon approval by the Governor.
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