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1 Compen MONTANASTATELIBRARY Yews yrkers' I i8.4105 3 0864 001 2549 3 F i •99 VOL 5 NO 1 Jerry Keck, Administrator 444-1555 John Weida, BureauChief WorkCompClaims 444-4661 I'olunu.-5- Issue I - IVW KeithMessmer, BureauChief Regulations 444-6541 JohnMoloney, Bureau Chief Safety 444-1605 £bflnges ^**i JohnAndrew, BureauChief Labor Standards 444-4619 Kathy Helland, ActingBureau Chief SUMMARY OF 1999 LEGISLATIVE CHANGES Human Rights 444-4345 The following article summarizes the laws enacted by the 1999 CUantihnysuBrreodwEnm-pKlouymemre'rs Fund 444-7720 Legislature which affectworkers' compensation and safety. Ifyou have any question pertainingto these changes, please call the appropriate staff Jeanne Johns person listed to the right. Regulations Section 444-6526 BENEFITS DreaBrown SJR 15 requires the Legislative Council to use an interim commit- ICnodnetpraecntdoerntReCgoinsttrraacttioornExem4p4t4io-n95&86 tee to study the current level of benefits paid to injured workers, and the frequency ofindemnityclaims under the Workers' Compensation Act. Carol Gleed Findingsand recommendationsare to be reported tothe 57th Legislature. Claims Unit 444-6539 The Legislative Interim Committee on Laborand Employment Relations is assigned the study. GaryHolt DataManagement Unit 444-6527 SAFETY Charlotte Payne SB 21 mandates the Safety Bureau to assume responsibility forthe Mediation 444-0083 Montana Occupational HealthAct. The Occupational and Radiological Health Bureau, which had INSIDE THIS ISSUE been the seatofadministration ofthe Occupational Health Act (OHA), wasdisbanded duringthe reorganization ofthe DepartmentofEnviron- mental Quality and those functionswere most recently located in LegislativeSummary 1 DEQ's Financial and Technical Assistance Bureau. Saving Trees & Key Strokes 4 Because ofa change offocus and a lack ofappropriate resources, Beware! 4 the staffat DEQ are able to work only in the area ofindoorairquality, Governor's Conference 5 a very specific subspecialty of industrial hygiene. Consequently, they could do very little work in the area ofgeneral occupational health, Governor'sConference Registration... 6 opting instead to refer health hazards to the Safety Bureau at the Who'son First 7 DepartmentofLaborand Industry. The Safety Bureau has been responsible for enforcement ofthe Montana SafetyActand hasstaffin place to inspect, advise and instruct EDITOR: public employers in Montana on the various aspects ofworkplace RainiWilliams safety. With only one Industrial Hygienist, the Bureau was able to work DepartmentofLaborandIndustry on a limited numberofworkplace "health" issues, although thatwas EmploymentRelationsDivision notthe original charge ofthe Montana SafetyAct. POBox8011 The Safety Bureau had been "unofficially" enforcingcertain health HelenaMT59604-801 standards forsome time underan Memorandum ofUnderstandingwith 406-444-1574 the previous DepartmentofHealth and Environmental Sciences. nvilliams(q)state.mt.us continuedonpage 2 Montana DepartmentofLaborStIndustry-EmploymentRelationsDivision JF'OCUS Issue* 1999 Workers'CompensationNews I, Changes - continuedfrompage I Personnel in the Bureau feel it is in the best interest ofoccupational health and safety in Montana to "officially" take the appropriate action to become the enforcementagencyforthe OHA. They feel thatoccupational health and safety should be unified, as there is very little distinction between them. Unifying safety and health enforcement will serve to make efforts in these areas less fragmented. The SafetyBureau can offersubstantial supporttothe Occupational Health Act in terms oftraining, equipment, expertise ofcurrentstaff, and statistical information regarding high hazard employers. It is natural to have the administration ofsafetyand health in the same agency. On July 1, one industrial hygienist from DEQ will transferto the Safety Bureau and will have initial authority forthe Montana Occupational Health Act. That position is currently filled byJudy Murphy, who is very familiar to the current staff. Everyone is looking forward to having her in the Bureau. ADMINISTRATIVE ASSESSMENT SB1 1 7 establishes the assessment percentage used to fund the administration ofthe DepartmentofLaborand Industry'sworkers' compensation regulatory functions. The ratewas set at3% ofthe compensation and medical benefits paid to injured workers in the previous calendar year. Additionally, the bill requires each insurer providing workers' compensation insurance to collectfrom theirpolicyholders an amount equal tothe insurer's portion ofthe Workers' Compensation administrative assessment through a surcharge based on premium. Self-insureds will pay 3% ofthe actual compensation and medical benefits paid. What this means to you as a policyholder is that you will now see a line item on your insurance bill identified as the "workers' compensation regulatory assess- mentsurcharge". As the description indicates, this assessment surcharge is used to fund the workers' compensation regulatory functions performed bythe DepartmentofLaborand Industry. These regulatoryfunctionsare not new. Thecost ofregulation has not increased from FY 1999 to FY2000. Previously, the cost ofthese functions was built into the overall premium charged bythe insurer. The DepartmentofLaborand Industry's Employment Relations Division provides a wide variety ofservices and regulation related to industrial safety and workers' compensation laws. These functions include such things as: workplace safety inspections in the public sector, inspections ofsurface and underground mines, review of industrial injuryand occupational disease claims, collection ofdata related to the workers' compensation system, mediation ofdisputes, self-insurance regulation, and developmentofmedical costcontainmenttools. Anothersurcharge that will be added to your premium notices will be the "Workers' Compensation Subsequent Injury Fund surcharge". This surcharge will finance the Subsequent Injury Fund which is used to provide an incentive for employers to hire individuals who have permanent impair- mentsthatcreateasubstantial obstacle to the individual obtainingemploy- ment. Again, this program is not new. The Fund was established in 1973. Senate Bill 1 17 also made achange to the Subsequent Injury Fund certification process. The amendment will allow certification ofworkers who have been employed for more than 60 days. Previously, ifthe workerwas continuedonpage 3 Montana DepartmentofLaborSrIndustry- EmploymentRelationsDivision JF&CUS Workers'CompensationNews Issue#1. 1999 Changes - continuedfrompage2 not certified within 60 days ofreturningto work, the employerwas not eligible forthe protection ofthe Fund. SB 1 17 amends Section 39-71-610, MCA. This Section applies in cases where the insurer has terminated biweekly benefits and the injured worker disputes that termination. The law allows the department to orderthe insurerto payadditional compensation (not to exceed 49 days) priortoa hearing. The 1999 legislature amended this section to clarify that benefits can be ordered priorto a mediation conference aswell as a court hearing. MANAGED CARE ORGANIZATIONS HB 430 (effective October 1, 1999) provides that ifa workeris referred toa managed care organization (MCO), written notice is required afterthe date ofinjuryand must advise the workerofthe right to choose the initial treating physician. The bill also provides that workers must be given written notice ofreferral to a preferred providerand the notice must cite the rightofthe worker to choose the initial treating physician. SILICOSIS HB 495 (effectiveJuly 1, 1999) provides foran increase of$25 per month for each individual who receives silicosis benefits. DISCLOSURE HB 557 (effective April 27, 1999) provides that a signed workers' compensation claim authorizes disclosure ofrelevant information to insurers and is effective only as long as the claimant is claiming benefits. Disclosure includes information relevant to the claimant's condition, including past historyofsimilar conditions, conditions forwhich benefits are claimed, and otherconditions related to the same body part orcondi- tionsthatmayaffect recovery. EMPLOYMENT RELATED DISPUTES HB 592 signed by Governor Racicot on April 23, and sponsored by Representative Hibbard, came aboutasthe resultofrecommendations made by an interim studygroup. The group was charged with reviewing processes used in the Department of Laborand Industryto resolve employment related disputes, includingworkers' compensation matters. Ofparticularinteresttothe workers' compensation communityare changes thatwill treat all benefit related matters in a similar fashion. Prior to HB 592, cases involving benefit issues, such as occupational disease and palliative and maintenance care, were required to go through the contested case procedure ofthe DepartmentofLaborpriortosubmis- sion to the Court. Other benefit issues proceeded to mediation and then to the Court. HB 592 provides that all benefit issues will proceed to mediation and then to the Court, thus relievingthe parties of the contested case process and placingthe emphasis on mediation and more timely, efficient resolution ofdisputes. Otherchanges brought about bythe legislation addressthe occupational disease review process as well asjurisdictional questions involving the Workers' Compensation Court and the District Courts. The change will place workers' compensation matters in the purview ofthe CompCourtand notthe DistrictCourts. The Department is presentlystudying the changes and preparing additional information to implementthe provisionsofHB592. MontanaDepartmentofLaborStIndustry-EmploymentRelationsDivision FOCUS 1 Issue#1. 1999 Workers'CompensationNews SAVING TREES AND KEY STROKES MONTANA IN LoriWilliams The 1999 legislature, in SB 1 17, added to39-71-225 MCA, language that mandates electronic reportingofworkers' compensation information. This law specifiesthat, "beginningJuly 1, 2000, an insurerora third-partyadmin- istratorwho submitted 50 or more "first reports ofinjury" (FROI) tothe department in the preceding calendaryearshall electronically submit the reports and any other reports related to the reported claims in a nationally recognized format "... The electronic submission of first reports of injury has worked well in Montana for those who have already volunteered. This electronic reporting is more commonly known as Electronic Data Interchange, or EDI. Banks, retailers and wholesalers have used this technology for many . 'years. EDI is now used in many other industries. The Kennedy/ Kassenbaum Health Care PortabilityAct mandates EDI in the health care industry. This mandate includes the First Report of Injury. MontanajoinsTexas, Florida, South Carolina, Kentucky, Californiaand new Mexico which have similar mandates in place. There is software available that provides this technology to employers so the FROI may be sent electronically from the employer to the insurer and on to the state. Trading partners receive an acknowledgement for their records similar to a return receipt from the post office. The International Association ofIndustrial Accident Boards and Com- missions offers an EDI vendorcertification program. For more information see theirweb site at; www.iaiabc.org, orcall them at (785) 840-9103. Lori (Williams is the EDI Coordinator forthe Employment Relations Division. You maycontact herat; [email protected] (406) 444-0080. BEWARE! Julia Crane Ithas cometo ourattention thatthere are companies who are purchasing First ReportofInjury(FROI)formsatthemodestcostof$14.15 perhundredintriplicate through ERD andthen sellingthem atavery inflatedprice. Oneperson hasmentioned she hated to get any more because they are so expensive. She said hersuppliercharges over$100.00 perhundred. Atthis point, itappearsthere isnowayto legallystopthese companiesfrom purchasingthese forms. Ifyou need FROIs, please send yourcheck in advanceto Sue Schaff, Accounting, IF YOU ARE INSURED DMeTpartmentofLaborandIndustry,EmploymentRelationsDivision,POBox 1728,Helena, 59604-1728. BY THE STATE FUND, Shewould be happy to sendyou an orderform which lists the otherformsthatare YOU MAY CALL available. Ifyouorder"nocharge" itemsorneedorderforms,pleasecontactJuliaat(406) 1-800-243-9121 444-6543orwritetoJuliaattheDepartmentofLaborandIndustry,EmploymentRelations AND SUBMIT YOUR Division,POBox8011,Helena,MT59601-81 FIRST REPORT OF Also,FROIsareavailableelectronicallythroughLoriWilliamsat [email protected] INJURY. Pleasehelp spread this information to all employers, adjusters, attorneys oranyone whomayneedFROIs. Thanks! 4 MontanaDepartmentofLabor&Industry- EmploymentRelationsDivision OCCJS Workers CompensationNews Issue#1, 1999 TIME IT'S FOR THE GOVERNOR'S CONFERENCE ON WORKERS' COMPENSATION AND OCCUPATIONAL SAFETY The annual Governor's Conference on Workers' Compensation and Occupational Safety will be held at Big Sky's Huntley Lodge on September 15-17, 1999. This year's agenda promises to be lievely and informative. The conference will once again contain a Workers' Compensation trackand an Occupational Safetytrack. Speakers and topics for the * What Issues are Facing safety portion ofthe conference j$F Insurers and Claimants Today include: in Workers' Compensation? - A Legal Perspective, Tom Safety and Health Murphy, OliverGoe, Leo Ward Management Systems, Bob J*f Winston, ValorInsurance 3D Presentation on Spinal J5v Injuries, Dr. PaulYoung, Confined Spaces - Myths, MicrosurgeryandBrainResearch Urban Legends and the Facts, Institute, St. Louis, Missouri JohnRekus, Private Consultant Workers' Compensation M Hazard Communication, Kathy Court, JudgeMike &t Smit, Maxim Technologies, Inc. McCarter TO OSHACompliancefitLiability, Be sure to stay for he REGISTER, John Rekus CALL KEITH closing keynote by Richard Pimentel. Mr. MESSMER AT Workplace Violance, Chuck O'Reilly, Sheriff, LewisandClark sPipmeiankteerlwisitahdlyotnsamoficgreat 406-444-6541 County(Retired) information. To register, please Speakers and topics for the workers' contactKeith Messmerat444- compensation portion ofthe 6541, [email protected]. If conference include: you want to participate as a spon- sor, call LaceyCulverat406-444- The Future ofDisability and 0776, [email protected]. We also jjf Early Return to Work, Richard have room fora few more exhibitor Pimentel-Milt Wrightand booths. Ifyou're interested in Associates, Inc. being an exhibitor, please call JeanneJohnsat406-444-6526, Workers' Compensation From [email protected]. jlf the Workers' Perspective, Don Judge, ExecutiveDirector, SAFETY AWARD WINNERS MontanaAFL-CIO Safety Award winners for 1998, awarded at last year's conference, were: * Ethical Considerations in ffc Rehab and Case Management, Private employers: Big Sky Coal Company ofColstrip and the US filter/ Tom Lewisand WillLynn EOS ofGreat Falls Public Employers: UniversityofMontana, Missoulaandthe Butte/Silver Bow Fire Department MontanaDepartmentofLaborScIndustry- EmploymentRelationsDivision D REGISTRATION GOVERNOR'S CONFERENCE ON WORKERS' 1999 COMPENSATION AND OCCUPATIONAL SAFETY September 15-17, 1999 Big Sky, Montana Duplicate/use additional paper as necessary; mail completed registration to: EMPLOYMENT RELATIONS DIVISION DEPARTMENT OF LABOR & INDUSTRY ATTENTION: KEITH MESSMER P.O. BOX 1728 HELENA, MT 59624 Name/Title (as it will appear on name tag) Business/Agency (as it will appear on name tag) Address Street/P.O. Box City State Zip Advanced Registration - enclose $100.00 per participant. Please make checks payable to "Governor's Conference."Registration at conference - $125.00 Please check if you plan to attend the banquet on Thursday evening, September"!6th J ROOM RESERVATIONS Please make your own room reservations Huntley Lodge Best Westerm Buck's T4 Lodge (406) 995-5000 (in state) 1-800-822-4484 1-800-548-4486(out-of-state) Standard Deluxe 1 to 2 people -$100 Sgl $67 $75 3 people - $110; 4 people - $120 Dbl $77 $85 Shoshone Condominiums - Trpl $87 $95 Suite (sleeps four) - $150 Quad $97 $105 Big Horn Condominiums Includes hot breakfast buffet 3-bedroom, sleeps 8 - $215 Make your reservations early - rooms will be held atthis rate until 8/15/99. Be sure to mention Department of Labor and Industry or Governor's Conference on Workers' Compensation and Safety wocus Workers'CompensationNews Issue# 1999 I, Who's on First? ANSWERS TO MOST FREQUENTLY ASKED QUESTIONS The following questionsare some ofthosewe hearmostfre- quentlyatthe Assistance for Business Clinics held twice ayear throughoutthestate. Ifyou havea questionyou'd likeanswered andyou don'tfind ithere, please [email protected]. I'll research theanswerand printitin the followingissue ofFOCUS. WHENDOWAGE LOSS HOWLONGDOESAN BENEFITS BEGIN? EMPLOYERHAVETO Benefitsbeginwhenaclaimis PAYTHEINJURED acceptedbytheinsurerorplacedunder WORKER'S FRINGE areservation ofrights, and wage loss BENEFITS? exceeds48hoursorsixlostworkshifts. Thisisatthediscretionofthebusiness /0\ DOESAN EMPLOYER HOWLONGDOESAN V/J^) \\? HAVETO HIREAN EMPLOYEEHAVETO \J INJURED WORKER C^ NOTDTYTHEm BACK? EMPLOYEROFAN FOR MORE DETAILED Aninjuredworkermustbegivenahiring INJURY? ANSWERD TO THESE preferencefortwoyearsfromthedate Although aworkerisgiven thirty(30) QUESTIONS, PLEASE CALL oftheinjury. Thepreferenceappliesto daystoreportaninjurytotheiremployer, CAROL GLEED AT a comparable position that becomes we recommend that employeesreport 444-6539 OR vacant ifthepositionisconsistentwith all on-the-job injuriestotheiremployer E-MAU. CAROL AT theworker'sphysicalcondition. as soon aspossible. a [email protected] CANAN EMPLOYER HOW LONGDOESAN (Jj\ FILLTHE INJURED Vf? INJUREDWORKER WORKER'S POSITION? HAVETOFILEA Yes WORKERS'COMPENSATION CLAIM? /O) CANAN EMPLOYER A written and signed First Report of \\? ACCESSAN INJURED Injury(FROI)mustbesubmittedwithin ij WORKER'SMEDICAL twelve(12)monthsofthedateofinjury. RECORDS? This form can be submitted to the Notunlesstheclaimant signsawritten employer, theworkers' compensation releaseauthorizingtheemployertohave insurer, ortheDepartmentofLaborand accesstotheirrecords. Industry. HOW LONGDOESAN /0\ DOESAN INJURED EMPOYERHAVETO V,p WORKERHAVETHEIR FTLEACLAIM? \J CHOICEOFINITIAL Employershavesix(6) daysto TREATINGPHYSICIAN? notifytheirinsurerofareportedinjury. Yes. Theinjuredworkerhas Montana DepartmentofLabor&Industry-EmploymentRelationsDivision FO US C Issue#I. 1999 Workers'CompensationNews thechoiceofinitialtreatingphysician.However,theinsurercandirecttheinjured workertoaManagedCareOrganization (MCO)orpreferredproviderfor furthercare. AN INJUREDWORKERRESPONSIBLE FORMEDICAL IS PAYMENTS? Possibly. Afterthefirstvisittoamedicalprovider,claimantsmaybecharged aco-paymentof$10.00,or20%ofthecostofeachfollowingvisit(whicheveris less). Afterthefirstvisittoanemergencyroom,claimantsareresponsiblefora $25.00co-paymentforeachfollowingvisittotheemergencyroom. Ifthe injured worker is directed to a managed care organization or a preferredprovider,theinjuredworkerisnotresponsiblefortheco-payment. WHEREDOWE GETTHEFIRSTREPORTOFINJURY (fib ^f< (FROI)FORM? EmployerscanorderasupplyofblankformsbycallingtheEmployment RelationsDivisionat(406)444-6543. YourlocalJobServiceofficemayalsohave formsavailable. DEPARTMENT OF LABOR AND INDUSTRY BULKRATE EMPLOYMENT RELATIONS DIVISION POSTAGE U.S. P.O. BOX 8011 PAID HELENA, MT 59604-8011 HELENA,MT PERMITNO. 89 RETURN SERVICE REQUESTED DEADHEAD LBRY COMM ATTN PERS OFCR (8) 1515 E6TH HELENA MT 59620-1800 3300 copies ofthispublicdocument werepublishedatan estimatedcost of39<tpercopy,fora totalcost of $1287.00, which includes $937.00forprinting and$350.00fordistribution. MontanaDepartmentofLaborScIndustry- EmploymentRelationsDivision