CCS HCS SS SCS SB 1 & 130 -- WORKERS' COMPENSATION

This bill changes the laws regarding workers' compensation.

EMPLOYER AND EMPLOYEE RIGHTS AND RESPONSIBILITIES

The bill:

(1)  Authorizes an employer to require an employee absent from
work due to medical reasons to use any accumulated paid leave to
offset the absence;

(2)  Requires an employee to submit to an employer-requested
vocational testing and rehabilitation assessment;

(3)  Specifies that a claimant is disqualified from receiving
temporary total disability benefits for the period of time he or
she is receiving unemployment compensation;

(4)  Specifies that an employee is ineligible to receive
temporary total or temporary partial disability benefits if the
employee is terminated from post-injury employment for
misconduct;

(5)  Specifies that an employee who fails to use safety devices
provided by the employer or to obey posted safety rules will have
his or her compensation or death benefit reduced by not less than
25% or more than 50%;

(6)  Specifies that an employee who fails to obey any rule or
policy related to a drug-free workplace or the use of alcohol
will have his or her compensation and death benefit reduced by
50%;

(7)  Specifies that an employee's refusal to take a test for
alcohol or a nonprescribed controlled substance will result in
the forfeiture of benefits;

(8)  Requires that a claimant who either accepts an employer's
initial offer or prevails in an action against an employer
receive 100% of the initial offer;

(9)  Requires that the claimant's attorney fee agreement be for a
portion of the amount of the claim in dispute;

(10)  Requires that certain claim information be given to the
employer within 30 days of the diagnosis of a condition; and

(11)  Requires that certain information must be provided to the
employer within 30 days of the diagnosis for a claimant to
receive compensation for any occupational disease or repetitive
trauma.

COMPENSABILITY

The bill:

(1)  Excludes as compensable any injury resulting from idiopathic
causes;

(2)  Requires that an injury sustained in a company-owned or
subsidized automobile while traveling to or from home or work is
not compensable;

(3)  Specifies that the ordinary deterioration of the body caused
by aging or ordinary activities performed in the course of
day-to-day living is not compensable;

(4)  Exempts as compensable any claim covered by federal law or
filed under the workers' compensation laws of another state;

(5)  Requires that an employee participating in a
workplace-related recreational activity resulting in an injury
not be compensable;

(6)  Requires that certain diseases resulting from exposure to
certain occupational hazards be recognized as an occupational
disease and compensable.  This provision applies to paid
firefighters and police officers and only if a direct causal
relationship is established;

(7)  Requires that an injury caused by repetitive motion is
compensable only if the occupational exposure is the prevailing
factor resulting in the medical condition and disability; and

(8)  Requires that an injury by occupational disease be
compensable only if the occupational exposure was the prevailing
factor in causing the resulting medical condition and disability.

DIVISION OF WORKERS' COMPENSATION

The bill:

(1)  Authorizes the Labor and Industrial Relations Commission or
the Director of the Division of Workers' Compensation to
determine the location of hearings;

(2)  Clarifies the quarterly premium tax amount calculation for
all self-insured employers and all insurance carriers insuring
employers against liability for personal injury;

(3)  Requires the division director, beginning October 31, 2005,
to estimate the amount of benefits payable from the Second Injury
Fund for the following year.  The division director is also
required to calculate the insured or self-insurer's employer
surcharge for the upcoming year;

(4)  Requires the division director, beginning January 1, 2006,
to calculate the employer surcharge, which is not to exceed 3% of
the projected following year requirement, less any remaining
balance from the previous year;

(5)  Requires that the failure of the division director to
calculate the surcharge by October 31 will result in the
surcharge not becoming effective for any calender quarter
beginning less than 60 days from the date of the calculation;

(6)  Requires that claims history data be provided to the
division rather than the Department of Health and Senior
Services; and

(7)  Requires that the chief legal counsel working in the
Jefferson City division office be compensated $2,000 above 80% of
the rate at which an associate circuit judge is compensated.

ADMINISTRATIVE LAW JUDGES

The bill:

(1)  Authorizes the Governor to appoint up to 40 administrative
law judges;

(2)  Specifies the appointment, terms, member qualification, and
duties of the Administrative Law Judge Review Committee;

(3)  Requires that all administrative law judges are subject to
an annual performance audit administered by the review committee;

(4)  Requires that an administrative law judge receiving two no
confidence votes by the committee resign;

(5)  Requires that an administrative law judge or the commission
approve a settlement agreement unless the agreement was found to
be unjust;

(6)  Requires, beginning January 1, 2006, that only
administrative law judges and the commission have the power to
review claims under the Workers' Compensation Law;

(7)  Eliminates the legal advisor position; and

(8)  Requires that the party initiating any proceeding found by
the division or the commission to be without grounds may be
assessed the costs of the proceedings.

GENERAL PROVISIONS

The bill:

(1)  Requires that any member appointed or serving on the Labor
and Industrial Relations Commission receive Senate confirmation
within 30 days after the Senate convenes for regular session or
immediately resign from the commission;

(2)  Requires that if a self-insured employer has filed for
bankruptcy, the division is to notify any employee of the
bankrupt employer having an open claim.  The employee is required
to provide certain information to the division, the court of
jurisdiction, and the Missouri Private Sector Self-Insurance
Guaranty Corporation.  An employee failing to provide the
required information within 30 days of the notice will bar the
division from invoking jurisdiction over any matter for which the
employee was entitled to workers' compensation benefits;

(3)  Requires the Attorney General, beginning January 1, 2006, to
annually provide the division and the General Assembly with a
report containing fraud and noncompliance prosecution costs and
other pertinent information;

(4)  Requires that an employer's experience rating not be
affected by a medical claim of less than $1,000;

(5)  Requires that the Director of the Department of Insurance
formulate trend factors that allow for comparison with trend
factors developed by the advisory organization for each job
classification;

(6)  Updates testing and standards pursuant to occupational
hearing loss;

(7)  Allows certain recognized religious sects to opt out of the
provisions of the Workers' Compensation Law;

(8)  Requires that a health care provider committing fraud under
the Workers' Compensation Law is guilty of a class A misdemeanor
and liable to the state for a fine of up to $20,000.  Any
subsequent violation is a class D felony;

(9)  Requires that an insurance company or self-insurer who
knowingly and intentionally refuses to comply with a compensation
obligation with the intent to defraud is guilty of a class D
felony;

(10)  Requires that any person who knowingly makes a false or
fraudulent statement to an investigator of the division in the
course of an investigation is guilty of a class A misdemeanor and
liable to the state for a fine of up to $10,000;

(11)  Requires that any entity falsely providing proof of
workers' compensation insurance is guilty of a class D felony and
liable to the state for a fine of up to $10,000 or double the
value of the fraud, whichever is the greater;

(12)  Requires that an employer who knowingly fails to insure his
workers' compensation liability is guilty of a class A
misdemeanor and a fine up to three times the cost of the
insurance premium or up to $50,000, whichever is greater.

(13)  Redefines "accident" to mean a specific, identifiable,
traumatic event during a single work shift;

(14)  Defines "prevailing factor" to mean that the accident is
the primary factor in relation to any other factor, causing both
the resulting medical condition and disability;

(15)  Requires that an injury due to an accident be compensable
only if the accident was the prevailing factor in causing the
resulting medical condition and disability;

(16)  Requires that cardiovascular, pulmonary, respiratory, or
other disease or a cerebrovascular accident or a myocardial
infarction is an injury only if the accident is the prevailing
factor in causing the resulting medical condition;

(17)  Requires that alcohol use be the proximate cause of the
injury, provided the employer required the alcohol use as part of
employment duties;

(18)  Requires that a permanent partial disability compensation
award be reduced to the extent that a pre-existing condition or
attributable aging process caused or prolonged the disability;

(19)  Requires that a finding of permanent partial disability or
permanent total disability be certified by a physician;

(20)  Requires that for the purpose of determining compensability
and disability, objective medical findings will prevail over
subjective medical findings;

(21)  Requires that, except where otherwise addressed, the
American Medical Association's "Guide to the Evaluation of
Permanent Impairment," 5th Edition, be used in determining the
level of disability;

(22)  Requires that in applying the provisions of the Workers'
Compensation Law it be the intent of the General Assembly to
reject and abrogate earlier case law interpreting the definition
of "accident," "occupational disease," "arising out of," and "in
the course of employment";

(23)  Excludes a limited monetary bonus from the employee's total
yearly pay when calculating the amount of compensation the
employee is entitled;

(24)  Excludes from admissibility any requested document,
information, or statement pursuant to a claim unless provided
within 30 days.  The term "statement" does not include video,
motion picture, or any reproduction of an image;

(25)  Requires that provisions of the Workers' Compensation Law
be construed strictly and conflicting evidence be weighed
impartially in the resolution of any conflict;

(26)  Requires that the burden of establishing any affirmative
defense be on the employer;

(27)  Requires that the burden of proving an entitlement to
compensation be on the employee or dependent; and

(28)  Specifies that a for-hire motor carrier not be determined
to be an employer of a lessor or driver employed by the lessor
and it is the intent of the legislature to reject and abrogate
earlier case law interpreting the meaning of "owner," as extended
in certain cases.

Missouri House of Representatives
93rd General Assembly, 1st Regular Session
Last Updated August 25, 2005 at 1:21 pm