HB 522 -- Workers' Compensation

Sponsor:  Fisher

This bill changes the laws regarding workers' compensation and
the Second Injury Fund.  In its main provisions, the bill:

(1)  Specifies that compensation from the fund will be suspended
if a claimant becomes incarcerated;

(2)  Specifies that eligibility to receive compensation from the
fund is contingent upon the employee being able to legally work
in the United States;

(3)  Prohibits claims for permanent partial disability from being
made against the fund beginning August 28, 2009;

(4)  Requires all claims for disability filed prior to August 28,
2009, to be accompanied by a determination of disability based on
objective medical findings certified by a physician;

(5)  Prohibits any compromise settlement paid by the fund from
exceeding $40,000 beginning August 28, 2009;

(6)  Specifies that the reasonableness of medical charges or fees
may be disputed based upon audits of medical bills and allows the
State Treasurer to present evidence with respect to the audit
findings on the medical charges;

(7)  Changes the occurrence of required actuarial studies of the
fund from once every three years to annually and requires the
first actuarial study to be completed prior to July 1, 2010;

(8)  Specifies that a claimant will be subject to an independent
medical evaluation, appropriate vocational testing or a
vocational assessment, and an evidentiary hearing attended by the
claimant before an administrative law judge who is required to
submit written findings if the claimant does not settle a claim
for compensation for a lump-sum settlement of $40,000 or less;

(9)  Specifies that, beginning August 28, 2009, claims are
compensable only if there was a medically documented pre-existing
disability resulting from active military duty or a pre-existing
compensable permanent partial disability which equals a minimum
of 50 weeks of compensation or if a major extremity injury only,
equals a minimum of 15% permanent partial disability and sustains
a subsequent work-related injury together with a compensable
injury which results in permanent total disability;

(10)  Specifies that in cases where permanent partial disability
is from a medically documented pre-existing disability as a
direct result of military duty or a compensable pre-existing
permanent partial disability together with a compensable injury
from a subsequent work-related injury that results in permanent
total disability, the employer will be liable only for the costs
associated with the injury incurred while working for him or her.
The fund will be responsible for any additional costs associated
with the permanent total disability;

(11)  Requires a person receiving permanent total disability
benefits to annually submit to the Division of Workers'
Compensation within the Department of Labor and Industrial
Relations proof of continued eligibility including the results of
a medical evaluation, appropriate vocational rehabilitation
assessment, and any pertinent information requested by the
division.  Costs associated with the vocational rehabilitation
assessment will be paid by the fund;

(12)  Specifies that the State Treasurer will be the custodian of
the fund;

(13)  Requires an employee in cases of recovery against the fund
for permanent total disability to name the State Treasurer as a
party and to submit to appropriate vocational testing, a
vocational rehabilitation assessment, and an independent medical
evaluation;

(14)  Subjects all awards for permanent total disability,
medical, or death benefits to an employee of an uninsured
employer affecting the fund to review and appeal;

(15)  Requires benefits payable to be based on the average weekly
wage calculated under Section 287.250, RSMo, as of the date of
the injury;

(16)  Specifies that the fund will pay fair, reasonable, and
necessary expenses to cure and relieve the effects of the injury
or of an injured worker employed by an uninsured employer.  In
the case of the death of an employee of an uninsured employer,
the fund will pay certain specified expenses.  Any moneys
received by the employee or the employee's dependents through
civil action or other action may be recovered for reimbursement
of the fund.  The Office of the Attorney General must bring suit
in the county circuit court against the uninsured employer for
reimbursement;

(17)  Allows the life time payment for permanent total disability
to be suspended if the worker is able to obtain suitable gainful
employment or be self-employed based on the nature and severity
of the injury or is eligible for Social Security coverage;

(18)  Requires a $200 fee for any second or subsequent claim
filed on behalf of a claimant against the fund;

(19)  Requires lump-sum settlements, exclusive of medical
expenses, to be compensated at a rate not to exceed $10,000 per
year, until the settlement amount is satisfied;

(20)  Specifies that an employee may not file a claim for
compensation in Missouri if he or she pursues a settlement in
another state with jurisdiction over the employee's injury,
accident, or occupational disease;

(21)  Prohibits a claimant from receiving compensation for
injuries in which the aggregate total of disability exceeds 100%;

(22)  Limits attorney fees to up to 15% of any award, lump-sum
settlement, or annuity settlement against the fund;

(23)  Requires, upon the request of the division director, the
Department of Insurance, Financial Institutions and Professional
Registration to audit the workers' compensation insurance
policies of companies insured in multiple states for the purpose
of determining the amount of the insurance premium that is
applicable to Missouri workers;

(24)  Specifies that beginning January 1, 2010, the tax rate for
the funding of the Workers' Compensation Fund will be an annual
rate of not less than 0.5% or more than 2%;

(25)  Allows the Director of the Division of Workers'
Compensation to advance moneys from the Workers' Compensation
Fund to the Second Injury Fund and requires the advance to be
repaid no later than December 31 of the fifth year following the
advance;

(26)  Specifies that a surcharge payment to the fund is deemed
made the earlier of either the date postmarked by the United
States Post Office or the date certified by a commercial delivery
service when the customer deposited the envelope or parcel; and

(27)  Specifies that an insurer or self-insurer, upon application
to the Director of the Division of Workers' Compensation
regarding a surcharge overpayment, may receive a refund of the
amount of credit from the Director of the Department of Revenue
if no other state obligation is owed.

Missouri House of Representatives
95th General Assembly, 1st Regular Session
Last Updated November 17, 2009 at 9:25 am