Key: (1) language to be deleted (2) new language
Laws of Minnesota 1985
CHAPTER 234-S.F.No. 986
An act relating to workers' compensation; excluding
certain injuries from coverage; providing the
conditions for organization of certain insurance
associations; providing for the workers' compensation
benefits; transferring certain duties from the
department of commerce to the department of labor and
industry; providing for miscellaneous changes;
amending Minnesota Statutes 1984, sections 66A.08,
subdivision 4; 79.37; 176.021, by adding subdivisions;
176.101, subdivisions 3e, 3i, and 3t; 176.102,
subdivisions 3 and 8; 176.103, subdivision 3; 176.136,
by adding a subdivision; 176.138; 176.191,
subdivisions 3 and 5; 176.511, subdivisions 1 and 2;
176.66, subdivision 10; and 352E.03; proposing coding
for new law in Minnesota Statutes, chapter 176;
repealing Minnesota Statutes 1984, sections 176.081,
subdivision 4; and 176.134.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:
Section 1. Minnesota Statutes 1984, section 66A.08,
subdivision 4, is amended to read:
Subd. 4. [EMPLOYERS' LIABILITY AND WORKERS' COMPENSATION.]
(1) [ORGANIZATION.] (a) [SUBSCRIBERS AND ARTICLES OF
INCORPORATION.] Twenty or more persons may form an incorporated
mutual employers' liability insurance association for the
purpose of insuring themselves and such other persons, firms, or
corporations as may become subscribers to the association
against liability for compensation payable under the terms of
the workers' compensation law and for the purpose of insuring
against loss or damage by the sickness, bodily injury, or death
by accident of any person employed by the insured or for whose
injury or death the insured is responsible.
They shall subscribe and acknowledge a certificate
specifying:
(aa) The name, general nature of its business, and the
principal place of transacting the same; (such name shall
distinguish it from all other corporations, domestic or foreign,
authorized to do business in this state and end with "company,"
"corporation," "association," or the word "incorporated");
(bb) The period of its duration;
(cc) The names and places of residence of the incorporators;
(dd) In what board its management shall be vested and the
names and addresses of those composing the board until the first
election, a majority of whom shall always be residents of the
state;
(ee) The highest amount of indebtedness or liability to
which the corporation shall at any time be subject; and
(ff) The territory within which the association may do
business.
It may contain any other lawful provisions defining and
regulating the powers or business of the corporation, its
officers, directors, trustees, and members.
The certificate of incorporation of every such corporation
shall be submitted to the commissioner for his approval and, if
he approves the same, one copy thereof shall be filed with the
secretary of state and one copy with the commissioner.
(b) [BYLAWS AND SEAL.] Such association shall have the
power to make bylaws for the government of its officers and the
conduct of its affairs, to alter and amend the same, and to
adopt a common seal.
(c) [ANNUAL MEETING; VOTING RIGHTS.] The annual meeting for
the election of directors shall be held at such time in the
month of January as the bylaws of the association may direct.
Of the time and place of the meeting at least 30 days previous
written or printed notice shall be given to the subscribers, or
the notice may be given by publication, not less than three
times, in at least two daily or weekly newspapers published in
the city or county wherein the association has its principal
office and in the legal periodical, if any, designated by the
rules of court of the proper county for the publication of legal
notices. Subscribers who, during the preceding calendar year,
have paid into the treasury of the association premiums
amounting to more than one-half of the total premiums received
by it during that year, shall constitute a quorum. At this
annual meeting the subscribers shall elect, by ballot, from
their own number, not less than five directors, a majority of
whom shall be residents of this state, to serve for at least one
year and until their successors are duly chosen. The
association may provide in its bylaws for the division of its
board of directors into two, three, or four classes, and for the
election thereof at its annual meetings in such manner that the
members of one class only shall retire and their successors be
chosen each year. Vacancies may be filled by election by the
board until the next annual meeting. In the choice of directors
and in all meetings of the association, each subscriber shall be
entitled to one vote for every $100, or any fraction thereof,
paid by him in premiums into the treasury of the association
during the preceding calendar year. Subscribers may vote by
proxy and the record of all votes shall be made by the secretary
and show whether the same were cast in person or by proxy and
shall be evidence of all these elections. Not less than three
directors shall constitute a quorum. The directors shall
annually choose by ballot a president, who shall be a member of
the board; a secretary; a treasurer, who may be either the
president or secretary; and such other officers as the bylaws
may provide; and fix the salaries of the president and the
secretary, as well as the salaries or compensation of such other
officers and agents as the bylaws prescribe. Vacancies in any
office may be filled by the directors or by the subscribers, as
the bylaws shall prescribe.
(2) [REQUIREMENTS.] (a) [NUMBER OF RISKS TO QUALIFY.] These
associations shall not begin to issue policies until a list of
subscribers with the number of employees of each which, in the
aggregate, must number not less than 5,000, together with such
other information as the commissioner may require, shall have
been filed at the department of commerce, nor until the
president and secretary of the association shall have certified
under oath that every subscription in the list so filed is
genuine and made with an agreement of all the subscribers that
they will take the policies subscribed for within 30 days of the
granting of a license by the commissioner. In case of
associations organized exclusively for the purpose of insuring
creameries, cheese factories, and livestock shipping
associations, these associations may begin to issue policies
when the number of employees insured aggregates 300.
Upon the filing of the certificate provided for in this
section, the commissioner shall make such investigations as he
may deem proper and, if his findings warrant it, grant a license
to the association to issue policies.
(b) [NUMBER OF RISKS REQUIRED TO CONTINUE IN BUSINESS.] If
at any time the number of subscribers falls below 20, or the
number of subscribers' employees within the state falls below
5,000, no further policies shall be issued until the total
number of subscribers amounts to not less than 20, whose
employees within the state are not less than 5,000. In case of
associations organized for the purpose of insuring creameries,
cheese factories, and livestock shipping associations, the
number of subscribers must not fall below 200, nor the number of
subscribers' employees within the state below 300.
(3) [ADDITIONAL POWERS.] (a) [MAY WRITE AUTOMOBILE
INSURANCE.] Any such company authorized to write workers'
compensation or liability insurance under this subdivision, when
its articles of incorporation so provide, shall be permitted to
insure against loss or damage to automobiles or other vehicles
and their contents by collision, fire, burglary, or theft, and
other perils of operation, and against liability for damage to
persons or property of others by collision with such vehicles,
and to insure against any loss or hazard incident to the
ownership, operation, or use of motor or other vehicles, as
specified in section 60A.06, subdivision 1, clause (12).
(b) [MAY WRITE GLASS INSURANCE.] Any company authorized to
write workers' compensation or liability insurance under this
subdivision when its articles of incorporation so provide shall
be permitted to insure against loss or damage by breakage of
glass located or in transit.
(c) [SPECIAL POWERS.] Any company organized under this
subdivision which, for 15 years prior to the passage of Laws
1935, Chapter 136, has exclusively insured creameries, cheese
factories, and livestock shipping associations, and which has
assets of $100,000 or more, may write public liability and
compensation insurance coverage of creameries, cheese factories,
shipping associations, farmers' elevators, cooperatively owned
warehouses, cooperative filling stations, cooperative oil
companies and all cooperatively owned or organized enterprises.
(4) [INTERNAL OPERATION.] (a) [POLICIES.] Policies of
insurance issued by any such association may be made either with
or without the seal thereof and they shall be signed by the
president, or such other officers as may be designated by the
directors for that purpose, and attested by the secretary.
(b) [CLASSIFICATION OF RISKS.] The board of directors may
divide the subscribers into groups in accordance with the nature
of their business and the probable risk of injury therein. In
such case they shall fix all premiums, make all assessments, and
determine and pay all dividends by and for each group in
accordance with the experience thereof, but all funds of the
association and the contingent liability of all subscribers
shall be available for the payment of any claim against the
association; provided, that (as between the association and its
subscribers) until the whole of the contingent liability of the
members of any group shall be exhausted, the general funds of
the association and the contingent liability of the members of
other groups shall not be available for the payment of losses
and expenses incurred by such group in excess of the earned
premiums paid by the members thereof.
(c) [CLASSIFICATION TO BE FILED.] A statement of any
proposed distribution of subscribers into groups shall be filed
with the department of commerce.
(d) [RATES.] The board of directors shall determine the
amount of premiums which the subscribers of the association
shall pay for their insurance in accordance with the nature of
the business in which the subscribers are engaged and the
probable risk of injury to their employees under existing
conditions, and it shall fix premiums at such amounts as in its
judgment shall be sufficient to enable the association to pay to
its subscribers all sums which may become due and payable to
their employees under provisions of law and the expenses of
conducting the business of the association. In fixing the
premium payable by any subscriber, the board of directors may
take into account the condition of the plant, workroom, shop,
farm, or premises of the subscriber in respect to the safety of
those employed therein as shown by the report of any inspector
appointed by the board and it may from time to time change the
amount of premiums payable by any of the subscribers as
circumstances may require and the condition of the plant,
workroom, shop, farm, or premises of the subscribers in respect
to the safety of their employees may justify and may increase
the premiums of any subscriber neglecting to provide safety
devices required by law, or disobeying the rules or regulations
made by the board of directors in accordance with the provisions
of clause (4) (g) of this subdivision.
(e) [PREMIUMS; CONTINGENT LIABILITY.] Every such company
shall charge and collect on each policy a premium equal to one
year's premium on the policy issued and state in the policy the
estimated annual premium and provide in its bylaws for the
determination of the actual premium and for the payment of same
when determined. The premium thus determined shall be known as
the annual premium on the policy. The company shall provide in
its bylaws and specify in its policies the maximum contingent
mutual liability of its members for the payment of losses and
expenses not provided for by its cash fund. The contingent
liability of a member shall not be less than a sum equal and in
addition to one annual premium, nor more than a sum equal to
five times the amount of the annual premium or, in case of a
policy written for less than one year, the contingent liability
shall not be less than the proportionate fractional part of the
annual premium, nor more than five times the proportionate
fractional part of the annual premium. The contingent liability
of the policyholder shall be plainly and legibly stated in each
policy as follows: "The maximum contingent liability of the
policyholder under this policy shall be a sum equal to .....
annual premium (or premiums)."
(f) [ASSESSMENTS.] When the liabilities, including unearned
premiums and such other reserves as are or may be required by
law and the commissioner, are in excess of the admitted assets
computed on the basis allowed for its annual statement, it shall
make an assessment upon its policyholders based upon the amount
of one annual premium as written in the policy and not to exceed
the amount of five annual premiums.
If it becomes necessary to levy the assessment, as provided
by this section, no policies shall be issued until the admitted
assets of the association are in excess of its liabilities.
(g) [POWER OF BOARD OF DIRECTORS.] The board of directors
shall be entitled to inspect the plant, workroom, shop, farm, or
premises of any subscriber and for this purpose to appoint
inspectors, who shall have free access to all such premises
during regular working hours, and the board of directors shall
likewise from time to time be entitled to examine by their
auditor or other agent the books, records, and payrolls of any
subscribers for the purpose of determining the amount of premium
chargeable to the subscriber.
The board of directors shall make reasonable rules and
regulations for the prevention of injuries upon the premises of
subscribers; and may refuse to insure, or may terminate the
insurance of, any subscriber who refuses to permit these
examinations and disregards such rules or regulations, and
forfeit all premiums previously paid by him, but the termination
of the insurance of any subscriber shall not release him from
liability for the payment of assessments then or thereafter made
by the board of directors to make up deficiencies existing at
the termination of his insurance.
(h) [INVESTMENTS.] The association shall invest and keep
invested all its funds of every description, excepting such cash
as may be required in the transaction of its business, in
accordance with the laws of this state or relating to the
investment of funds of domestic insurance companies.
No such association shall purchase, hold, or convey real
estate except as provided by section 60A.11, subdivision 6.
(i) [WITHDRAWAL OF SUBSCRIBER.] Any subscriber of the
association who has complied with all its rules and regulations
may withdraw therefrom by written notice to that effect sent by
the subscriber by certified mail to the association and this
withdrawal shall become effective on the first day of the month
immediately following the tenth day after the receipt of the
notice, but the withdrawal shall not release the subscriber from
liability for the payment of assessments thereafter made by the
board of directors to make up deficiencies existing at the date
of his withdrawal and the subscriber shall be entitled to his
share of any dividends earned at the date of his withdrawal.
(5) [MISCELLANEOUS.] (a) [PERJURY BY OFFICER.] If any
officer of the association shall falsely make oath to any
certificate required to be filed with the commissioner, he shall
be guilty of perjury.
(b) [FOREIGN MUTUAL EMPLOYERS' LIABILITY ASSOCIATION.] Any
mutual employers' liability insurance association of another
state, upon compliance with all laws governing such corporations
in general and the provisions of this subdivision may be
admitted to transact business in this state. These associations
shall pay to the department of commerce the fees prescribed by
section 60A.14, subdivision 1.
(c) [WINDING UP AFFAIRS.] When the contracts of insurance
issued by these associations shall cover in the aggregate less
than 5,000 employees or, in the case of associations organized
for the purpose of insuring creameries, cheese factories, and
livestock shipping associations, less than 300 employees, the
association shall forthwith notify the commissioner of that fact
and if, at the expiration of six months from the notice, the
aggregate number of employees covered by the contracts of
insurance shall be less than 5,000, or, in the case of
associations organized for the purpose of insuring creameries,
cheese factories, and livestock shipping associations, less than
300 employees, the commissioner shall proceed under the
provisions of chapter 60B.
Sec. 2. Minnesota Statutes 1984, section 79.37, is amended
to read:
79.37 [BOARD OF DIRECTORS.]
A board of directors of the reinsurance association is
created and is responsible for the operation of the reinsurance
association consistent with the plan of operation and sections
79.34 to 79.42. The board consists of 13 directors. Four
directors shall represent insurers, six two directors shall
represent employers, at least one, but not more than three of
whom two shall represent self-insurers; and three two directors
shall represent employees; the commissioner of finance and the
executive director of the state board of investment or their
designees shall serve as directors; and one director shall
represent the public. Insurer members of the reinsurance
association shall elect the directors who represent insurers;
self-insurer members of the reinsurance association shall elect
the directors who represent self-insurers; and the commissioner
of commerce labor and industry shall appoint the remaining
directors who represent employers and employees for the terms
authorized in the plan of operation. Each director is entitled
to one vote. Terms of the directors shall be staggered so that
the terms of all the directors do not expire at the same time
and so that a director does not serve a term of more than four
years. The board shall select a chairman and other officers it
deems appropriate.
A majority of the directors currently holding office
constitutes a quorum. Action may be taken by a majority vote of
the directors present.
The board shall take reasonable and prudent action
regarding the management of the reinsurance association
including but not limited to determining the entity who shall
manage the daily affairs of the reinsurance association. The
board shall report to the governor of its actions regarding the
entity selected to manage the reinsurance association and the
reasons for the selection.
Sec. 3. Minnesota Statutes 1984, section 176.021, is
amended by adding a subdivision to read:
Subd. 3b. [TEMPORARY AND PERMANENT PARTIAL.] If an
employee has returned to work for at least six months and has,
if applicable, completed a rehabilitation plan, this section
does not prevent the payment of compensation for permanent
partial disability because the employee is receiving
compensation for temporary partial disability. This subdivision
is procedural and applies regardless of the date of injury.
Sec. 4. Minnesota Statutes 1984, section 176.021, is
amended by adding a subdivision to read:
Subd. 9. [EMPLOYER RESPONSIBILITY FOR WELLNESS
PROGRAMS.] Injuries incurred while participating in voluntary
recreational programs sponsored by the employer, including
health promotion programs, athletic events, parties, and
picnics, do not arise out of and in the course of the employment
even though the employer pays some or all of the cost of the
program. This exclusion does not apply in the event that the
injured employee was ordered or assigned by the employer to
participate in the program.
Sec. 5. Minnesota Statutes 1984, section 176.101,
subdivision 3e, is amended to read:
Subd. 3e. [END OF TEMPORARY TOTAL COMPENSATION.] (a) 90
days after an employee has reached maximum medical improvement
or 90 days after the end of an approved retraining program,
whichever is later, the employee's temporary total compensation
shall cease. This cessation shall occur at an earlier date if
otherwise provided by this chapter.
(b) If at any time prior to the end of the 90-day period
described in clause (a) the employee retires or the employer
furnishes work to the employee that is consistent with an
approved plan of rehabilitation and meets the requirements of
section 176.102, subdivision 1, or, if no plan has been
approved, that the employee can do in his or her physical
condition and that job produces an economic status as close as
possible to that the employee would have enjoyed without the
disability, or the employer procures this employment with
another employer or the employee accepts this job with another
employer, temporary total compensation shall cease and the
employee shall, if appropriate, receive impairment compensation
pursuant to subdivision 3b. This impairment compensation is in
lieu of economic recovery compensation under subdivision 3a, and
the employee shall not receive both economic recovery
compensation and impairment compensation. Temporary total
compensation and impairment compensation shall not be paid
concurrently. Once temporary total compensation ceases no
further temporary total compensation is payable except as
specifically provided by this section.
(c) Upon receipt of a written medical report indicating
that the employee has reached maximum medical improvement, the
employer or insurer shall serve a copy of the report upon the
employee and shall file a copy with the division. The beginning
of the 90-day period shall commence on the day this report is
served on the employee for the purpose of determining whether a
job offer consistent with the requirements of this subdivision
is made. A job offer may be made before the employee reaches
maximum medical improvement.
(d) The job which is offered or procured by the employer or
accepted by the employee under clause (b) does not necessarily
have to commence immediately but shall commence within a
reasonable period after the end of the 90-day period described
in clause (a). Temporary total compensation shall not cease
under this subdivision until the job commences.
(e) If the job offered under clause (a) is not the job the
employee had at the time of injury it shall be offered in
writing and shall state the nature of the job, the rate of pay,
the physical requirements of the job, and any other information
necessary to fully and completely inform the employee of the job
duties and responsibilities.
The employee has 14 calendar days to accept or reject the
job offer. If the employee does not respond within this period
it is deemed a refusal of the offer. Where there is an
administrative conference to determine suitability under section
176.242, the period begins to run on the date of the
commissioner's decision.
(f) Self-employment may be an appropriate job under this
subdivision.
The commissioner shall monitor application of this
subdivision and may adopt rules to assure its proper application.
Sec. 6. Minnesota Statutes 1984, section 176.101,
subdivision 3i, is amended to read:
Subd. 3i. [LAY OFF BECAUSE OF LACK OF WORK OR RELEASED FOR
OTHER THAN SEASONAL CONDITIONS.] (a) If an employee accepts a
job under subdivision 3e and begins work at that job and is
subsequently unemployed at that job because of economic
conditions, other than seasonal conditions, the employee shall
receive monitoring period compensation pursuant to clause (b).
In addition, the employer who was the employer at the time of
the injury shall provide rehabilitation consultation by a
qualified rehabilitation consultant if the employee remains
unemployed for 45 calendar days. The commissioner may waive
this rehabilitation consultation if the commissioner deems it
appropriate. Further rehabilitation, if deemed appropriate, is
governed by section 176.102.
(b) Upon the employee's initial return to work the
monitoring period begins to run. If the employee is unemployed
for the reason in clause (a), prior to the end of the monitoring
period the employee shall receive monitoring period
compensation. This compensation shall be paid for the lesser of
until (1) the weeks remaining in the monitoring period expires,
or (2) the weeks equal to the monitoring period minus the
impairment compensation paid to the employee. For purposes of
this clause the impairment compensation shall be converted to
weeks by dividing the impairment compensation received by the
employee by the employee's compensation rate for temporary total
disability at the time of the injury the sum of monitoring
period compensation paid and impairment compensation paid or
payable is equal to the amount of economic recovery compensation
that would have been paid if that compensation were payable,
whichever occurs first. No monitoring period compensation is
payable if the unemployment occurs after the expiration of the
monitoring period. Monitoring period compensation is payable at
the same intervals and in at the same amount rate as when
temporary total compensation ceased, provided that the minimum
monitoring period compensation rate is 66-2/3 percent of the
weekly wage for permanent partial disability as determined by
section 176.011, subdivision 18 and subject to the maximums
specified therein.
(c) Compensation under this subdivision shall not be
escalated pursuant to section 176.645.
(d) If the employee returns to work and is still receiving
monitoring period compensation, this compensation shall cease.
Any period remaining in the monitoring period upon this return
to work shall be used to determine further benefits if the
employee is again unemployed under clause (a).
(e) Upon the employee's return to work pursuant to this
section the insurer shall notify the employee of the length of
the employee's monitoring period and shall notify the employee
of the amount of impairment to be paid and the date of payment.
Sec. 7. Minnesota Statutes 1984, section 176.101,
subdivision 3t, is amended to read:
Subd. 3t. [MINIMUM ECONOMIC RECOVERY COMPENSATION.] (a)
Economic recovery compensation pursuant to this section shall be
at least 120 percent of the impairment compensation the employee
would receive if that compensation were payable to the
employee. The monitoring period shall be at least 120 percent
of the weeks during which impairment compensation would be
payable if paid weekly.
(b) Where an employee has suffered a personal injury for
which temporary total compensation is payable but which produces
no permanent partial disability and the employee is unable to
return to his former employment for medical reasons attributable
to the injury, the employee shall receive 26 weeks of economic
recovery compensation. This paragraph shall not be used to
determine monitoring period compensation under subdivision 3i
and shall not be a minimum for determining the amount of
compensation when an employee has suffered a permanent partial
disability.
Sec. 8. Minnesota Statutes 1984, section 176.102,
subdivision 3, is amended to read:
Subd. 3. [REVIEW PANEL.] There is created a rehabilitation
review panel composed of the commissioner or a designee, who
shall serve as an ex officio member and two members each from
employers, insurers, rehabilitation, and medicine, one member
representing chiropractors, and four members representing
labor. The members shall be appointed by the commissioner and
shall serve four-year terms which may be renewed. Compensation
for members shall be governed by section 15.0575. The panel
shall select a chairman. The panel shall review and make a
determination with respect to (a) appeals regarding eligibility
for rehabilitation services, rehabilitation plans and
rehabilitation benefits under subdivisions 9 and 11; (b) appeals
on any other rehabilitation issue the commissioner determines
under this section; and (c) appeals regarding fee disputes,
penalties, discipline, certification approval or revocation of
registration of qualified rehabilitation consultants and
approved vendors. The panel shall continuously study
rehabilitation services and delivery and develop and recommend
rehabilitation rules to the commissioner.
The commissioner may appoint alternates for one-year terms
to serve as a member when a member is unavailable. The number
of alternates shall not exceed one labor member, one employer or
insurer member, and one member representing medicine,
chiropractic, or rehabilitation.
Sec. 9. Minnesota Statutes 1984, section 176.102,
subdivision 8, is amended to read:
Subd. 8. [PLAN MODIFICATION.] Upon request to the
commissioner by the employer, the insurer, or employee, or upon
the commissioner's own request, the plan may be suspended,
terminated or altered upon a showing of good cause, including:
(a) a physical impairment that does not allow the employee
to pursue the rehabilitation plan;
(b) the employee's performance level indicates the plan
will not be successfully completed;
(c) an employee does not cooperate with a plan;
(d) that the plan or its administration is substantially
inadequate to achieve the rehabilitation plan objectives.
An employee may request a change in a rehabilitation plan
once because the employee feels ill-suited for the type of work
for which rehabilitation is being provided. If the
rehabilitation plan includes retraining, this request must be
made within 90 days of the beginning of the retraining program.
Any decision of the commissioner regarding a change in a plan
may be appealed to the rehabilitation review panel within 30
days of the decision.
Sec. 10. Minnesota Statutes 1984, section 176.103,
subdivision 3, is amended to read:
Subd. 3. [MEDICAL SERVICES REVIEW BOARD; SELECTION;
POWERS.] (a) There is created a medical services review board
composed of the commissioner or the commissioner's designee as
an ex officio member, two persons representing chiropractic, one
person representing hospital administrators, and six physicians
representing different specialties which the commissioner
determines are the most frequently utilized by injured
employees. The board shall also have one person representing
employees, one person representing employers or insurers, and
one person representing the general public. The members shall
be appointed by the commissioner and shall be governed by
section 15.0575. Terms of the board's members may be renewed.
The board shall appoint from among its clinical members a
clinical advisory subcommittee on clinical quality and a
clinical advisory subcommittee on clinical cost containment.
Each subcommittee shall consist of at least three members one of
whom shall be a member who is not a chiropractor or licensed
physician.
The commissioner may appoint alternates for one-year terms
to serve as a member when a member is unavailable. The number
of alternates shall not exceed one chiropractor, one hospital
administrator, three physicians, one employee representative,
one employer or insurer representative, and one representative
of the general public.
The clinical quality subcommittee shall review clinical
results for adequacy and recommend to the commissioner scales
for disabilities and apportionment.
The clinical cost containment subcommittee shall review and
recommend to the commissioner rates for individual clinical
procedures and aggregate costs. The subcommittees shall make
regular reports to the board and the commissioner which shall
evaluate the reports for the purpose of determining whether or
not a particular health care provider continues to qualify for
payment under chapter 176 or is subject to any other sanctions
or penalties authorized under this section and to determine
whether an employee has been off work longer than necessary.
In evaluating the clinical consequences of the services
provided to an employee by a clinical health care provider, the
board shall consider the following factors in the priority
listed:
(1) the clinical effectiveness of the treatment;
(2) the clinical cost of the treatment; and
(3) the length of time of treatment.
In its consideration of these factors, the board shall
utilize the information and recommendations developed by the
subcommittees. In addition, the board shall utilize any other
data developed by the subcommittees pursuant to the duties
assigned to the subcommittees under this section.
After making a determination, the board shall submit its
recommendation in writing to the commissioner. The board shall
advise the commissioner on the adoption of rules regarding all
aspects of medical care and services provided to injured
employees.
(b) The board shall appoint three of its members to hear
appeals from decisions of the commissioner regarding quality
control and supervision of medical care; any other disputes
regarding medical, surgical, and hospital care; decisions
regarding the eligibility of medical providers to receive
payments; or any other determinations of the commissioner
pursuant to subdivision 2. The three-member panel shall be
composed of one member who does not represent a health care
specialty, one member who represents the same specialty as the
specialty at issue or, if the same specialty is not available,
one member whose specialty is as close as possible considering
the board's composition, and one member representing a different
specialty. The three-member panel shall conduct a hearing in
the same manner, giving the same notice and following other
procedures required of the rehabilitation review panel in
section 176.102, subdivision 3a. A majority vote of the
three-member panel constitutes the decision of the full board.
This decision may be appealed to the workers' compensation court
of appeals.
(c) In any situation where a conflict of interest prevents
the appointment of a full three-member panel or in any other
situation where the commissioner deems it necessary to resolve a
conflict of interest, the commissioner may appoint a temporary
substitute board member to serve until the situation creating
the conflict of interest has been resolved.
(d) The board may adopt rules of procedure. The rules may
be joint rules with the rehabilitation review panel.
Sec. 11. Minnesota Statutes 1984, section 176.136, is
amended by adding a subdivision to read:
Subd. 5. [PERMANENT RULES.] Where permanent rules have
been adopted to implement this section, the commissioner shall
annually give notice in the State Register of the 75th
percentile to meet the requirements of subdivision 1. The
notice shall be in lieu of the requirements of chapter 14 if the
75th percentile for the service meets the requirements of
paragraphs (a) to (e).
(a) The data base includes at least three different
providers of the service.
(b) The data base contains at least 20 billings for the
service.
(c) The standard deviation as a percentage of the mean of
billings for the service is 50 percent or less.
(d) The means of the Blue Cross and Blue Shield data base
and of the department of human services data base for the
service are within 20 percent of each other.
(e) The data is taken from the data base of Blue Cross and
Blue Shield or the department of human services.
Sec. 12. Minnesota Statutes 1984, section 176.138, is
amended to read:
176.138 [MEDICAL DATA; ACCESS.]
Notwithstanding any other state laws related to the privacy
of medical data or any private agreements to the contrary, the
release of medical data related to a current claim for
compensation under this chapter to the employee, employer, or
insurer who are parties to the claim, or to the department of
labor and industry, shall not require prior approval of any
party to the claim. This section does not preclude the release
of medical data under section 175.10 or 176.231, subdivision 9.
Requests for pertinent data shall be made in writing to the
person or organization that collected or currently possesses the
data. The data shall be provided by the collector or possessor
within seven working days of receiving the request. In all
cases of a request for the data, except when it is the employee
who is making the request, the employee shall be sent written
notification of the request by the party requesting the data at
the same time the request is made. This data shall be treated
as private data by the party who requests or receives the data
and the employee or the employee's attorney shall be provided
with a copy of all data requested by the requester.
Medical data which is not directly related to a current
injury or disability shall not be released without prior
authorization of the employee.
The commissioner may impose a penalty of up to $200 payable
to the special compensation fund against a party who does not
release the data in a timely manner. A party who does not treat
this data as private pursuant to this section is guilty of a
misdemeanor. This section applies only to written medical data
which exists at the time the request is made.
Sec. 13. Minnesota Statutes 1984, section 176.191,
subdivision 3, is amended to read:
Subd. 3. If a dispute exists as to whether an employee's
injury is compensable under this chapter and the employee is
otherwise covered by an insurer pursuant to chapters 62A, 62C
and 62D, that insurer shall pay any medical costs incurred by
the employee for the injury up to the limits of the applicable
coverage and shall make any disability payments otherwise
payable by that insurer in the absence of or in addition to
workers' compensation liability. If the injury is subsequently
determined to be compensable pursuant to this chapter, the
workers' compensation insurer shall be ordered to reimburse the
insurer that made the payments for all payments made under this
subdivision by the insurer, including interest at a rate of 12
percent a year. If a payment pursuant to this subdivision
exceeds the reasonable value as permitted by sections 176.135
and 176.136, the provider shall reimburse the workers'
compensation insurer for all the excess as provided by rules
promulgated by the commissioner.
Sec. 14. Minnesota Statutes 1984, section 176.191,
subdivision 5, is amended to read:
Subd. 5. Where a dispute exists between an employer,
insurer, the special compensation fund, the reopened case fund,
or the workers' compensation reinsurance association, regarding
benefits payable under this chapter, the dispute may be
submitted with consent of all interested parties to binding
arbitration pursuant to the rules of the American arbitration
association. The decision of the arbitrator shall be conclusive
with respect to all issues presented except as provided in
subdivisions 6 and 7. Consent of the employee is not required
for submission of a dispute to arbitration pursuant to this
section and the employee is not bound by the results of the
arbitration. An arbitration award shall not be admissible in
any other proceeding under this chapter. Notice of the
proceeding shall be given to the employee.
The employee, or any person with material information to
the facts to be arbitrated, shall attend the arbitration
proceeding if any party to the proceeding deems it necessary.
Nothing said by an employee in connection with any arbitration
proceeding may be used against the employee in any other
proceeding under this chapter. Reasonable expenses of meals,
lost wages, and travel of the employee or witnesses in attending
shall be reimbursed on a pro rata basis. Arbitration costs
shall be paid by the parties, except the employee, on a pro rata
basis.
Sec. 15. [176.2421] [RECOMMENCEMENT OF TEMPORARY TOTAL;
CONFERENCE.]
Subdivision 1. [WHEN RIGHT ACCRUES.] Following the receipt
of temporary total compensation, an employee who has returned to
work but is unable to continue working for at least 14 days
because of medical reasons associated with the injury has a
right to an administrative conference under this section to
determine whether compensation shall be recommenced.
Subd. 2. [WHEN HELD.] A request for an administrative
conference under this section shall be made within ten calendar
days after the employee ceased working. The commissioner shall
schedule an administrative conference within ten calendar days
after receiving a timely request. The conference shall be held
in accordance with section 176.243, subdivision 4, and the
provisions of section 176.243, subdivisions 5 to 7, are
applicable.
Sec. 16. Minnesota Statutes 1984, section 176.511,
subdivision 1, is amended to read:
Subdivision 1. [PARTIES NOT AWARDED COSTS.] Except as
provided otherwise by this chapter and specifically by this
section, in appeals before the workers' compensation court of
appeals or hearings before a compensation judge, the
rehabilitation review panel, or the medical services review
board costs shall not be awarded to either party.
Sec. 17. Minnesota Statutes 1984, section 176.511,
subdivision 2, is amended to read:
Subd. 2. [DISBURSEMENTS, TAXATION.] The compensation
judge, the commissioner on behalf of the rehabilitation review
panel or the medical services review board or on appeals to the
workers' compensation court of appeals, the workers'
compensation court of appeals may award the prevailing party
reimbursement for actual and necessary disbursements. These
disbursements shall be taxed upon five days written notice to
adverse parties.
Sec. 18. Minnesota Statutes 1984, section 176.66,
subdivision 10, is amended to read:
Subd. 10. [MULTIPLE EMPLOYERS OR INSURERS; LIABILITY.] The
employer liable for the compensation for a personal injury under
this chapter is the employer in whose employment the employee
was last exposed in a significant way to the hazard of the
occupational disease. In the event that the employer who is
liable for the compensation had multiple insurers during the
employee's term of employment, the insurer who was on the risk
during the employee's last significant exposure to the hazard of
the occupational disease is the liable party. If this last
employer had coverage for workers' compensation liability from
more than one insurer during the employment, the insurer on the
risk during the last period during which the employee was last
exposed to the hazard of the occupational disease shall pay
benefits as provided under section 176.191, subdivision 1,
whether or not this insurer was on risk during the last
significant exposure. The party making payments under this
section shall be reimbursed by the party who is subsequently
determined to be liable for the occupational disease, including
interest at a rate of 12 percent a year. For purposes of this
section, a self-insured employer shall be considered to be an
insurer and an employer. Where there is a dispute as to which
employer is liable under this section, the employer in whose
employment the employee is last exposed to the hazard of the
occupational disease shall pay benefits pursuant to section
176.191, subdivision 1. If this last employer had coverage for
workers' compensation liability from more than one insurer
during the employment the insurer on the risk during the last
period during which the employee was last exposed to the hazard
of the occupational disease shall pay benefits as provided under
section 176.191, subdivision 1, whether or not this insurer was
on risk during the last significant exposure. The party making
payments under this section shall be reimbursed by the party who
is subsequently determined to be liable for the occupational
disease, including interest at a rate of 12 percent a year. For
purposes of this section, a self-insured employer shall be
considered to be an insurer and an employer.
Sec. 19. Minnesota Statutes 1984, section 352E.03, is
amended to read:
352E.03 [WORKERS' COMPENSATION COURT OF APPEALS COURTS.]
Eligibility to receive benefits as herein provided shall be
determined by the workers' compensation court of appeals courts
in the manner provided by chapter 176. A decision of the
workers' compensation court of appeals hereunder may be reviewed
by the Minnesota supreme court in the same manner and subject to
the same procedures governing all other appeals from the
decisions of the workers' compensation court of appeals. The
time limitation for commencing an action under this chapter is
determined by section 176.151, clause (2).
Sec. 20. [TRANSFER OF POWER.]
The duties and responsibilities of the department of
commerce under Minnesota Statutes 1984, sections 79.34 to 79.40,
except section 79.34, subdivision 3, are hereby transferred to
the department of labor and industry.
Sec. 21. [INSTRUCTIONS TO THE REVISOR.]
The revisor of statutes shall substitute the term
"commissioner of labor and industry" or "department of labor and
industry" or similar terms as appropriate for the terms
"commissioner of commerce" or "department of commerce" or
similar terms wherever they appear in Minnesota Statutes,
sections 79.34 to 79.40, except section 79.34, subdivision 3.
Sec. 22. [REPEALER.]
Minnesota Statutes 1984, sections 176.081, subdivision 4;
and 176.134, are repealed.
Sec. 23. [EFFECTIVE DATE.]
Section 2 is effective on June 1, 1985. Within 30 days
thereafter, the insurer members of the reinsurance association
shall elect directors to replace those whose terms expire within
the next year; the self-insurer members of the association shall
elect two directors to replace the present self-insurer
representative and an employer representative whose term expires
within the next year; the commissioner of labor and industry
shall appoint a public director to replace an employer director
whose term expires in 1986 and an employer director to replace
an employer director whose term expires in 1986; the
commissioner of finance, or the commissioner's designee, shall
replace an employee director whose term expires within the next
year; and the executive director of the state board of
investment, or the executive director's designee, shall replace
an employer representative whose term shall expire in 1987. The
remaining directors will be replaced as provided in section 2 as
their terms expire.
Sections 20 and 21 are effective the day following final
enactment.
Sec. 24. [EFFECTIVE DATE.]
Sections 3, 5 to 14, 16 to 19, and 22 are effective the day
after final enactment. Section 15 is effective July 1, 1985.
Became law without the governor's signature May 24, 1985
Official Publication of the State of Minnesota
Revisor of Statutes