Substitute House Bill No. 7172
Substitute House Bill No. 7172
PUBLIC ACT NO. 93-228
AN ACT REFORMING THE WORKERS' COMPENSATION SYSTEM.
Section 1. Section 31-275 of the general
statutes is repealed and the following is
substituted in lieu thereof:
As used in this chapter, unless the context
otherwise provides:
(1) "Arising out of and in the course of his
employment" means an accidental injury happening
to an employee or an occupational disease of an
employee originating while he has been engaged in
the line of his duty in the business or affairs of
the employer upon the employer's premises, or
while engaged elsewhere upon the employer's
business or affairs by the direction, express or
implied, of the employer, provided: (A) For a
policeman and a fireman, "in the course of his
employment" shall encompass his departure from his
place of abode to duty, his duty, and his return
to his place of abode after duty; (B) a personal
injury shall not be deemed to arise out of the
employment unless causally traceable to the
employment other than through weakened resistance
or lowered vitality; (C) in the case of an
accidental injury, a disability or a death due to
the [habitual] use of alcohol or narcotic drugs
shall not be construed to be a compensable injury;
(D) for aggravation of a preexisting disease,
compensation shall be allowed only for that
proportion of the disability or death due to the
aggravation of the preexisting disease as may be
reasonably attributed to the injury upon which the
claim is based. FOR PURPOSES OF SUBPARAGRAPH (C)
OF THIS SUBDIVISION, "NARCOTIC DRUGS" MEANS ALL
CONTROLLED SUBSTANCES, AS DESIGNATED BY THE
COMMISSIONER OF CONSUMER PROTECTION PURSUANT TO
SUBSECTION (c) OF SECTION 21a-243, BUT DOES NOT
INCLUDE DRUGS PRESCRIBED IN THE COURSE OF MEDICAL
TREATMENT OR IN A PROGRAM OF RESEARCH OPERATED
UNDER THE DIRECTION OF A PHYSICIAN OR
PHARMACOLOGIST.
(2) "Commission" means the workers'
compensation commission.
(3) "Commissioner" means the compensation
commissioner who has jurisdiction in the matter
referred to in the context.
(4) "Compensation" means benefits or payments
mandated by the provisions of this chapter,
including, but not limited to, indemnity, medical
and surgical aid or hospital and nursing service
required under section 31-294d and any type of
payment for disability, whether for total or
partial disability of a permanent or temporary
nature, death benefit, funeral expense, payments
made under the provisions of section 31-284b,
31-293a or 31-310, AS AMENDED BY SECTION 22 OF
THIS ACT, or any adjustment in benefits or
payments required by this chapter.
(5) "Date of the injury" means, for an
occupational disease, the date of total or partial
incapacity to work as a result of such disease.
(6) "Dependent" means a member of the injured
employee's family or next of kin who was wholly or
partly dependent upon the earnings of the employee
at the time of the injury.
(7) "Dependent in fact" means a person
determined to be a dependent of an injured
employee, in any case where there is no
presumptive dependent, in accordance with the
facts existing at the date of the injury.
(8) "Disfigurement" means impairment of or
injury to the beauty, symmetry or appearance of a
person that renders the person unsightly,
misshapen or imperfect, or deforms the person in
some manner, or otherwise causes a detrimental
change in the external form of the person. [; and
"significant disfigurement" means any
disfigurement that is of such a character that it
substantially detracts from the appearance of the
person bearing the disfigurement.]
(9) (A) "Employee" means any person who:
(i) Has entered into or works under any
contract of service or apprenticeship with an
employer, whether the contract contemplated the
performance of duties within or without the state;
(ii) Is a sole proprietor or business partner
who accepts the provisions of this chapter in
accordance with subsection (10) of this section;
(iii) Is elected to serve as a member of the
general assembly of this state;
(iv) Is a salaried officer or paid member of
any police department or fire department;
(v) Is a volunteer police officer, whether
the officer is designated as special or auxiliary,
upon vote of the legislative body of the town,
city or borough in which the officer serves; or
(vi) Is an elected or appointed official or
agent of any town, city or borough in the state,
upon vote of the proper authority of the town,
city or borough, including the elected or
appointed official or agent, irrespective of the
manner in which he is appointed or employed.
Nothing in this subsection shall be construed as
affecting any existing rights as to pensions which
such persons or their dependents had on July 1,
1927, or as preventing any existing custom of
paying the full salary of any such person during
disability due to injury arising out of and in the
course of his employment.
(B) "Employee" shall not be construed to
include:
(i) Any person to whom articles or material
are given to be treated in any way on premises not
under the control or management of the person who
gave them out;
(ii) One whose employment is of a casual
nature and who is employed otherwise than for the
purposes of the employer's trade or business;
(iii) A member of the employer's family
dwelling in his house; but, if, in any contract of
insurance, the wages or salary of a member of the
employer's family dwelling in his house is
included in the payroll on which the premium is
based, then that person shall, if he sustains an
injury arising out of and in the course of his
employment, be deemed an employee and compensated
in accordance with the provisions of this chapter;
(iv) Any person engaged in any type of
service in or about a private dwelling provided he
is not regularly employed by the owner or occupier
over twenty-six hours per week; [or]
(v) An employee of a corporation who is a
corporate officer and who elects to be excluded
from coverage under this chapter by notice in
writing to his employer and to the commissioner;
OR
(vi) ANY PERSON WHO IS NOT A RESIDENT OF THIS
STATE BUT IS INJURED IN THIS STATE DURING THE
COURSE OF HIS EMPLOYMENT, UNLESS SUCH PERSON (I)
WORKS FOR AN EMPLOYER WHO HAS A PLACE OF
EMPLOYMENT OR A BUSINESS FACILITY LOCATED IN THIS
STATE AT WHICH SUCH PERSON SPENDS AT LEAST FIFTY
PER CENT OF HIS EMPLOYMENT TIME, OR (II) WORKS FOR
AN EMPLOYER PURSUANT TO AN EMPLOYMENT CONTRACT TO
BE PERFORMED PRIMARILY IN THIS STATE.
(10) "Employer" means any person,
corporation, firm, partnership, voluntary
association, joint stock association, the state
and any public corporation within the state using
the services of one or more employees for pay, or
the legal representative of any such employer, but
all contracts of employment between an employer
employing persons excluded from the definition of
employee and any such employee shall be
conclusively presumed to include the following
mutual agreements between employer and employee:
(A) That the employer may accept and become bound
by the provisions of this chapter by immediately
complying with section 31-284; (B) that, if the
employer accepts the provisions of this chapter,
the employee shall then be deemed to accept and be
bound by such provisions unless the employer
neglects or refuses to furnish immediately to the
employee, on his written request, evidence of
compliance with section 31-284 in the form of a
certificate from the commissioner, the insurance
commissioner or the insurer, as the case may be;
(C) that the employee may, at any time, withdraw
his acceptance of, and become released from, the
provisions of this chapter by giving written or
printed notice of his withdrawal to the
commissioner and to the employer, and the
withdrawal shall take effect immediately from the
time of its service on the commissioner and the
employer; and (D) that the employer may withdraw
his acceptance and the acceptance of the employee
by filing a written or printed notice of his
withdrawal with the commissioner and with the
employee, and the withdrawal shall take effect
immediately from the time of its service on the
commissioner and the employee. The notices of
acceptance and withdrawal to be given by an
employer employing persons excluded from the
definition of employee and the notice of
withdrawal to be given by the employee, as
provided in this subsection, shall be served upon
the commissioner, employer or employee, either by
personal presentation or by registered or
certified mail. In determining the number of
employees employed by an individual, the employees
of a partnership of which he is a member shall not
be included. A person who is the sole proprietor
of a business [or who is a partner in a business]
may accept the provisions of this chapter by
notifying the commissioner, in writing, of his
intent to do so. If such person accepts the
provisions of this chapter he shall be considered
to be an employer and shall insure his full
liability in accordance with subdivision (2) of
subsection (b) of section 31-284. Such person may
withdraw his acceptance by giving notice of his
withdrawal, in writing, to the commissioner. ANY
PERSON WHO IS A PARTNER IN A BUSINESS SHALL BE
DEEMED TO HAVE ACCEPTED THE PROVISIONS OF THIS
CHAPTER AND SHALL INSURE HIS FULL LIABILITY IN
ACCORDANCE WITH SUBDIVISION (2) OF SUBSECTION (b)
OF SECTION 31-284, UNLESS THE PARTNERSHIP ELECTS
TO BE EXCLUDED FROM THE PROVISIONS OF THIS CHAPTER
BY NOTICE, IN WRITING AND BY SIGNED AGREEMENT OF
EACH PARTNER, TO THE COMMISSIONER.
(11) "Full-time student" means any student
enrolled for at least seventy-five per cent of a
full-time student load at a postsecondary
educational institution which has been approved by
a state-recognized or federally-recognized
accrediting agency or body. "Full-time student
load" means the number of credit hours, quarter
credits or academic units required for a degree
from such institution, divided by the number of
academic terms needed to complete the degree.
(12) "Medical and surgical aid or hospital
and nursing service", when requested by an injured
employee and approved by the commissioner,
includes treatment by prayer or spiritual means
through the application or use of the principles,
tenets or teachings of any established church
without the use of any drug or material remedy,
provided sanitary and quarantine regulations are
complied with, and provided all those ministering
to the injured employee are bona fide members of
such church.
(13) "Member" includes all parts of the human
body referred to in subsection (b) of section
31-308, AS AMENDED BY SECTION 19 OF THIS ACT.
(14) "Nursing" means the practice of nursing
as defined in subsection (a) of section 20-87a,
and "nurse" means a person engaged in such
practice.
(15) "Occupational disease" includes any
disease peculiar to the occupation in which the
employee was engaged and due to causes in excess
of the ordinary hazards of employment as such, and
includes any disease due to or attributable to
exposure to or contact with any radioactive
material by an employee in the course of his
employment.
(16) (A) "Personal injury" or "injury"
includes, in addition to accidental injury which
may be definitely located as to the time when and
the place where the accident occurred, an injury
to an employee which is causally connected with
his employment and is the direct result of
repetitive trauma or repetitive acts incident to
such employment, and occupational disease.
(B) "PERSONAL INJURY" OR "INJURY" SHALL NOT
BE CONSTRUED TO INCLUDE:
(i) AN INJURY TO AN EMPLOYEE WHICH RESULTS
FROM HIS VOLUNTARY PARTICIPATION IN ANY ACTIVITY
THE MAJOR PURPOSE OF WHICH IS SOCIAL OR
RECREATIONAL, INCLUDING, BUT NOT LIMITED TO,
ATHLETIC EVENTS, PARTIES AND PICNICS, WHETHER OR
NOT THE EMPLOYER PAYS SOME OR ALL OF THE COST OF
SUCH ACTIVITY;
(ii) A MENTAL OR EMOTIONAL IMPAIRMENT, UNLESS
SUCH IMPAIRMENT ARISES FROM A PHYSICAL INJURY OR
OCCUPATIONAL DISEASE; OR
(iii) A MENTAL OR EMOTIONAL IMPAIRMENT WHICH
RESULTS FROM A PERSONNEL ACTION, INCLUDING, BUT
NOT LIMITED TO, A TRANSFER, PROMOTION, DEMOTION OR
TERMINATION.
(17) "Physician" includes any person licensed
and authorized to practice a healing art as
defined in section 20-1 and licensed under the
provisions of chapters 370, 371, 372 and 373 to
practice in this state.
(18) "Podiatrist" means any practitioner of
podiatry, as defined in section 20-50, and duly
licensed under the provisions of chapter 375 to
practice in this state.
(19) "Presumptive dependents" means the
following persons who are conclusively presumed to
be wholly dependent for support upon a deceased
employee: (A) A wife upon a husband with whom she
lives at the time of his injury or from whom she
receives support regularly; (B) a husband upon a
wife with whom he lives at the time of her injury
or from whom he receives support regularly; (C)
any child under the age of eighteen, or over the
age of eighteen but physically or mentally
incapacitated from earning, upon the parent with
whom he is living or from whom he is receiving
support regularly, at the time of the injury of
the parent; (D) any unmarried child who has
attained the age of eighteen but has not attained
the age of twenty-two and who is a full-time
student, upon the parent with whom he is living or
from whom he is receiving support regularly,
provided, any child who has attained the age of
twenty-two while a full-time student but has not
completed the requirements for, or received, a
degree from a postsecondary educational
institution shall be deemed not to have attained
the age of twenty-two until the first day of the
first month following the end of the quarter or
semester in which he is enrolled at the time, or
if he is not enrolled in a quarter or semester
system, until the first day of the first month
following the completion of the course in which he
is enrolled or until the first day of the third
month beginning after such time, whichever occurs
first.
(20) "Previous disability" means an
employee's preexisting condition caused by the
total or partial loss of, or loss of use of, one
hand, one arm, one foot or one eye resulting from
accidental injury, disease or congenital causes,
or other permanent physical impairment.
(21) "Scar" means the mark left on the skin
after the healing of a wound or sore, or any mark,
damage or lasting effect resulting from past
injury. [; and "significant scar" means any scar
that is of such a character that it substantially
detracts from the appearance of the person bearing
the scar.]
(22) "Second disability" means a disability
arising out of a second injury.
(23) "Second injury" means an injury,
incurred by accident, repetitive trauma,
repetitive acts or disease arising out of and in
the course of employment, to an employee with a
previous disability.
Sec. 2. Section 31-276 of the general
statutes is repealed and the following is
substituted in lieu thereof:
(a) There shall be a workers' compensation
commission to administer the workers' compensation
system. There shall be [fourteen] SIXTEEN workers'
compensation commissioners. On or before the date
of the expiration of the term of each commissioner
or upon the occurrence of a vacancy in the office
of any commissioner for any reason, the governor
shall nominate a competent person to fill that
office, provided, in the case of terms expiring or
other vacancies occurring on and after January 1,
1992, the governor, in nominating persons to be
commissioners, shall ensure that not less than two
commissioners reside in each United States
congressional district within the state.
SUBSEQUENT TO THE EFFECTIVE DATE OF THIS ACT, EACH
PERSON NOMINATED BY THE GOVERNOR TO SERVE AS A
COMMISSIONER SHALL HAVE BEEN A MEMBER IN GOOD
STANDING OF THE CONNECTICUT BAR FOR AT LEAST FIVE
YEARS PRECEDING THE NOMINATION, PROVIDED THE
GOVERNOR SHALL NOT BE PRECLUDED FROM RENOMINATING
AN INDIVIDUAL WHO HAS PREVIOUSLY SERVED AS A
COMMISSIONER. The commissioners shall, upon
nomination by the governor, be appointed by the
general assembly as prescribed by law. They shall
serve for a term of five years, but may be removed
by impeachment. The governor shall from time to
time select one of the fourteen commissioners to
serve as chairman of the workers' compensation
commission at the pleasure of the governor. The
commissioner selected by the governor to be
chairman shall have previously served as a
compensation commissioner in this state for at
least one year.
(b) Notwithstanding the provisions of
subsection (a), on and after October 1, 1988, any
commissioner whose term expires on December
thirty-first shall continue to serve until the
next succeeding March thirty-first.
(c) Each nomination made by the governor to
the general assembly for a compensation
commissioner shall be referred, without debate, to
the committee on the judiciary, which shall report
thereon within thirty legislative days from the
time of reference, but no later than seven
legislative days before the adjourning of the
general assembly. Each appointment by the general
assembly of a compensation commissioner shall be
by concurrent resolution. The action on the
passage of each such resolution in the house and
in the senate shall be by vote taken on the
electrical roll-call device. No resolution shall
contain the name of more than one nominee. The
governor shall, within five days after he has
notice that any nomination for a compensation
commissioner made by him has failed to be approved
by the affirmative concurrent action of both
houses of the general assembly, make another
nomination to such office.
(d) Notwithstanding the provisions of section
4-19, no vacancy in the position of a compensation
commissioner shall be filled by the governor when
the general assembly is not in session unless,
prior to such filling, the governor submits the
name of the proposed vacancy appointee to the
committee on the judiciary. Within ten days, the
committee on the judiciary may, upon the call of
either chairman, hold a special meeting for the
purpose of approving or disapproving such proposed
vacancy appointee by majority vote. Failure of the
committee to act on such proposed vacancy
appointee within such ten-day period shall be
deemed to be an approval.
(e) Each commissioner shall be sworn to a
faithful performance of his duties. After notice
and public hearing the governor may remove any
commissioner for cause and the good of the public
service. Each compensation commissioner shall
devote his full time to the duties of his office
and shall not be otherwise gainfully employed.
Sec. 3. Section 31-279 of the general
statutes is repealed and the following is
substituted in lieu thereof:
(a) The chairman of the workers' compensation
commission shall adopt regulations, in accordance
with the provisions of chapter 54, specifying the
minimum information to be contained in a notice of
the availability of compensation which shall be
posted in the workplace by each employer subject
to the provisions of this chapter pursuant to
subsection (f) of section 31-284.
(b) The chairman of the workers' compensation
commission shall, not later than July 1, 1991,
adopt regulations, in accordance with chapter 54,
to create a uniform system to be used by medical
professionals in determining the degree of
physical impairment of persons receiving
compensation under this chapter.
(c) On or after January 1, 1992, any employer
or any insurer acting on behalf of an employer,
may establish a plan, subject to the approval of
the chairman of the workers' compensation
commission under subsection (d) of this section,
for the provision of medical care which the
employer provides for treatment of any injury or
illness under this chapter. Each plan shall
contain such information as the chairman shall
require, including, but not limited to: (1) A
listing of all persons who will provide services
under the plan, along with appropriate evidence
that each person listed has met any licensing,
certification or registration requirement
necessary for the person to legally provide the
service in this state; (2) a designation of the
times, places and manners in which the services
will be provided; (3) a description of how the
quality and quantity of medical care will be
managed; [(4) for employers having fifty or more
employees, the designation of a labor-management
safety committee to prevent accidents and injuries
in the workplace; and (5)] AND (4) such other
provisions as the employer and the employees may
agree to, subject to the approval of the chairman.
[Any] THE ELECTION BY AN employee covered by a
plan established under this subsection [may] TO
obtain medical care and treatment from a provider
of medical services who is not listed in the plan
SHALL SUSPEND HIS RIGHT TO COMPENSATION, SUBJECT
TO THE ORDER OF THE COMMISSIONER. [if (A) the
provider has met any licensing, certification or
registration requirements necessary to legally
provide the services in this state, (B) the
employer is required to pay no more than the
amount required to be paid for the same or similar
services under the plan and (C) the employer is
authorized to require the employee, upon
reasonable notice and at a reasonable time and
place, to submit to an examination performed by a
provider listed in the plan. The refusal of an
injured employee to submit himself to such
examination shall suspend his right to
compensation, subject to the order of the
commissioner.]
(d) Each plan established under subsection
(c) of this section shall be submitted to the
chairman for his approval at least one hundred
twenty days before the proposed effective date of
the plan and each approved plan, along with any
proposed changes therein, shall be resubmitted to
the chairman every two years thereafter for
reapproval. The chairman shall approve or
disapprove such plans on the basis of standards
established by the chairman in consultation with a
medical advisory panel appointed by the chairman.
Such standards shall include, but not be limited
to: (1) The ability of the plan to provide all
medical and health care services that may be
required under this chapter in a manner that is
timely, effective and convenient for the
employees; (2) the inclusion in the plan of all
categories of medical service and of an adequate
number of providers of each type of medical
service in accessible locations to ensure that
employees are given an adequate choice of
providers; (3) the provision in the plan for
appropriate financial incentives to reduce service
costs and utilization without a reduction in the
quality of service; (4) the inclusion in the plan
of fee screening, peer review, service utilization
review and dispute resolution procedures designed
to prevent inappropriate or excessive treatment;
and (5) the inclusion in the plan of a procedure
by which information on medical and health care
service costs and utilization will be reported to
the chairman in order for him to determine the
effectiveness of the plan.
[(e) Upon the reasonable request of an
injured employee covered by a plan approved by the
chairman under subsection (d) of this section, or
at the direction of the commissioner, the injured
employee shall submit himself to examination by a
reputable practicing physician or surgeon other
than a physician or surgeon listed in the plan.
The examination shall be performed to determine
the nature of the injury and the incapacity
resulting from the injury. The physician or
surgeon shall be selected by the employee from an
approved list of physicians and surgeons prepared
by the chairman of the workers' compensation
commission and shall be paid by the employer. At
any examination requested by the injured employee
or directed by the commissioner under this
subsection, the injured employee shall be allowed
to have in attendance any reputable practicing
physician or surgeon that the employee obtains and
pays for himself. Any medical reports resulting
from the examination shall be furnished within
thirty days after the completion of the reports,
at the same time and in the same manner, to the
employer and the employee or his attorney. The
refusal of an injured employee to submit himself
to a reasonable examination under this subsection
at the direction of the commissioner shall suspend
his right to compensation during such refusal.]
Sec. 4. Section 31-280 of the general
statutes is repealed and the following is
substituted in lieu thereof:
(a) There shall continue to be a chairman of
the workers' compensation commission selected by
the governor as provided in section 31-276, AS
AMENDED BY SECTION 2 OF THIS ACT. The chairman may
not hear any matter arising under this chapter,
except appeals brought before the compensation
review board AND EXCEPT AS PROVIDED IN SUBDIVISION
(14) OF SUBSECTION (b) OF THIS SECTION. The
chairman shall prepare the forms used by the
commission, shall have custody of the insurance
coverage cards, shall prepare and keep a list of
self-insurers, shall prepare the annual report to
the governor and shall publish, when necessary,
bulletins showing the changes in the compensation
law, with annotations to the Connecticut cases.
The chairman shall be provided with sufficient
staff to assist him in the performance of his
duties. The chairman may, within available
appropriations, appoint acting compensation
commissioners on a per diem basis from among
former workers' compensation commissioners or
qualified members of the bar of this state. Any
acting compensation commissioner appointed under
this subsection shall be paid on a per diem basis
in an amount to be determined by the commissioner
of administrative services, subject to the
provisions of section 4-40, and shall have all the
powers and duties of compensation commissioners.
The workers' compensation commission shall not be
construed to be a commission or board subject to
the provisions of section 4-9a.
(b) The chairman of the workers' compensation
commission shall:
(1) Establish workers' compensation districts
and district offices within the state and assign
compensation commissioners to the districts to
hear all matters arising under this chapter within
the districts;
(2) Adopt such rules as the chairman, in
consultation with the advisory board, deems
necessary for the conduct of the internal affairs
of the workers' compensation commission;
(3) Adopt regulations, in consultation with
the advisory board and in accordance with the
provisions of chapter 54, to carry out his
responsibilities under this chapter;
(4) Prepare and adopt an annual budget and
plan of operation in consultation with the
advisory board;
(5) Prepare and submit an annual report to
the governor and the general assembly;
(6) Allocate the resources of the commission
to carry out the purposes of this chapter;
(7) Establish an organizational structure and
such divisions for the commission, consistent with
this chapter, as the chairman deems necessary for
the efficient and prompt operation of the
commission;
(8) Establish policy for all matters over
which the commission has jurisdiction, including
rehabilitation, education, statistical support and
administrative appeals;
(9) Appoint such supplementary advisory
panels as the chairman deems necessary and
helpful;
(10) Establish, in consultation with the
advisory board, (A) an approved list of practicing
physicians, surgeons, podiatrists, OPTOMETRISTS
and dentists from which an injured employee shall
choose for examination and treatment under the
provisions of this chapter, which shall include,
but not be limited to, classifications of approved
practitioners by specialty, and (B) standards for
the approval and removal of physicians, surgeons,
podiatrists, OPTOMETRISTS and dentists from the
list by the chairman;
(11) (A) Establish standards in consultation
with the advisory board for approving all fees for
services rendered under this chapter by attorneys,
physicians, surgeons, podiatrists, OPTOMETRISTS,
dentists and other persons;
(B) IN CONSULTATION WITH EMPLOYERS, THEIR
INSURANCE CARRIERS, UNION REPRESENTATIVES,
PHYSICIANS AND THIRD-PARTY REIMBURSEMENT
ORGANIZATIONS ESTABLISH, NOT LATER THAN OCTOBER 1,
1993, AND PUBLISH ANNUALLY THEREAFTER, A FEE
SCHEDULE SETTING THE FEES PAYABLE BY AN EMPLOYER
OR ITS INSURANCE CARRIER FOR SERVICES RENDERED
UNDER THIS CHAPTER BY AN APPROVED PHYSICIAN,
SURGEON, PODIATRIST, OPTOMETRIST OR DENTIST,
PROVIDED THE FEE SCHEDULE SHALL NOT APPLY TO
SERVICES RENDERED TO A CLAIMANT WHO IS
PARTICIPATING IN AN EMPLOYER'S MANAGED CARE PLAN
PURSUANT TO SECTION 31-279, AS AMENDED BY SECTION
3 OF THIS ACT. THE FEE SCHEDULE SHALL LIMIT THE
ANNUAL GROWTH IN TOTAL MEDICAL FEES TO THE ANNUAL
PERCENTAGE INCREASE IN THE CONSUMER PRICE INDEX
FOR ALL URBAN WORKERS. PAYMENT OF THE ESTABLISHED
FEES BY THE EMPLOYER OR ITS INSURANCE CARRIER
SHALL CONSTITUTE PAYMENT IN FULL TO THE
PRACTITIONER, AND THE PRACTITIONER MAY NOT RECOVER
ANY ADDITIONAL AMOUNT FROM THE CLAIMANT TO WHOM
SERVICES HAVE BEEN RENDERED;
(C) ISSUE, NOT LATER THAN OCTOBER 1, 1993,
AND PUBLISH ANNUALLY THEREAFTER, GUIDELINES FOR
THE MAXIMUM FEES PAYABLE BY A CLAIMANT FOR ANY
LEGAL SERVICES RENDERED BY AN ATTORNEY IN
CONNECTION WITH THE PROVISIONS OF THIS CHAPTER,
WHICH FEES SHALL BE APPROVED IN ACCORDANCE WITH
THE STANDARDS ESTABLISHED BY THE CHAIRMAN PURSUANT
TO SUBPARAGRAPH (A) OF THIS SUBDIVISION;
(12) Approve applications for
employer-sponsored medical care plans, based on
standards developed in consultation with a medical
advisory panel as provided in section 31-279, AS
AMENDED BY SECTION 3 OF THIS ACT;
(13) Establish procedures for the hiring,
dismissing or otherwise disciplining and promoting
employees of the commission, subject where
appropriate to the provisions of chapter 67;
(14) Control the hearing calendars of the
compensation commissioners, AND IF NECESSARY,
PRESIDE OVER INFORMAL HEARINGS IN REGARD TO
COMPENSATION UNDER THE PROVISIONS OF THIS CHAPTER
in order to facilitate the timely and efficient
processing of cases;
(15) Enter into contracts with consultants
and such other persons as necessary for the proper
functioning of the commission;
(16) Direct and supervise all administrative
affairs of the commission;
(17) Keep and maintain a record of all
advisory board proceedings;
(18) Assign and reassign a district manager
and other staff to each of the commission's
district offices;
(19) Collect and analyze statistical data
concerning the administration of the workers'
compensation commission;
(20) Direct and supervise the implementation
of a uniform case filing and processing system in
each of the district offices that will include,
but not be limited to, the ability to provide data
on the number of cases having multiple hearings,
the number of postponed hearings and hearing
schedules for each district office;
(21) Establish staff development, training
and education programs designed to improve the
quality of service provided by the commission,
including, but not limited to, a program to train
district office staff in the screening of hearing
requests;
(22) Develop standard forms for requesting
hearings and standard policies regarding limits on
the number of informal hearings that will be
allowed under this chapter, and limits on the
number of postponements that will be permitted
before a formal hearing is held pursuant to
section 31-297; [and]
(23) Develop guidelines for expediting
disputed cases;
(24) ESTABLISH AN ONGOING TRAINING PROGRAM,
IN CONSULTATION WITH THE ADVISORY BOARD, DESIGNED
TO ASSIST THE COMMISSIONERS IN THE FULFILLMENT OF
THEIR DUTIES PURSUANT TO THE PROVISIONS OF SECTION
31-278, WHICH PROGRAM SHALL INCLUDE INSTRUCTION IN
THE FOLLOWING AREAS: DISCOVERY, EVIDENCE,
STATUTORY INTERPRETATION, MEDICAL TERMINOLOGY,
LEGAL DECISION WRITING AND THE PURPOSE AND
PROCEDURES OF INFORMAL AND FORMAL HEARINGS;
(25) EVALUATE, IN CONJUNCTION WITH THE
ADVISORY BOARD, THE PERFORMANCE OF EACH
COMMISSIONER BIANNUALLY AND, NOTWITHSTANDING THE
PROVISIONS OF SUBSECTION (b) OF SECTION 1-19 AND
CHAPTER 55, MAKE THE PERFORMANCE EVALUATION OF ANY
COMMISSIONER AVAILABLE ONLY TO THE GOVERNOR, THE
MEMBERS OF THE JOINT STANDING COMMITTEE ON THE
JUDICIARY AND THE RESPECTIVE COMMISSIONER PRIOR TO
ANY PUBLIC HEARING ON THE REAPPOINTMENT OF ANY
SUCH COMMISSIONER. ANY INFORMATION DISCLOSED TO
SUCH PERSONS SHALL BE USED BY SUCH PERSONS ONLY
FOR THE PURPOSE FOR WHICH IT WAS GIVEN AND SHALL
NOT BE DISCLOSED TO ANY OTHER PERSON;
(26) (A) IN CONSULTATION WITH INSURERS AND
PRACTITIONERS, ESTABLISH NOT LATER THAN OCTOBER 1,
1993, AND PUBLISH ANNUALLY THEREAFTER,
PRACTITIONER BILLING GUIDELINES FOR EMPLOYERS,
WORKERS' COMPENSATION INSURANCE CARRIERS AND
PRACTITIONERS APPROVED BY THE CHAIRMAN PURSUANT TO
SUBDIVISION (10) OF THIS SUBSECTION. THE
GUIDELINES SHALL INCLUDE PROCEDURES FOR THE
RESOLUTION OF BILLING DISPUTES AND SHALL PROHIBIT
A PRACTITIONER FROM BILLING OR SOLICITING PAYMENTS
FROM A CLAIMANT FOR SERVICES RENDERED TO THE
CLAIMANT UNDER THE PROVISIONS OF THIS CHAPTER (i)
DURING A PAYMENT DISPUTE BETWEEN THE PRACTITIONER
AND THE EMPLOYER OR ITS WORKERS' COMPENSATION
INSURANCE CARRIER, OR (ii) IN EXCESS OF THE
MAXIMUM FEES ESTABLISHED PURSUANT TO SUBPARAGRAPH
(B) OF SUBDIVISION (11) OF THIS SUBSECTION;
(B) IN CONSULTATION WITH PRACTITIONERS AND
INSURERS, DEVELOP NOT LATER THAN JULY 1, 1994,
PRACTICE PROTOCOLS FOR REASONABLE AND APPROPRIATE
TREATMENT OF A CLAIMANT UNDER THE PROVISIONS OF
THIS CHAPTER, BASED ON THE DIAGNOSIS OF INJURY OR
ILLNESS. THE COMMISSION SHALL ANNUALLY PUBLISH THE
PRACTICE PROTOCOLS FOR USE BY APPROVED
PRACTITIONERS, EMPLOYERS, WORKERS' COMPENSATION
INSURANCE CARRIERS AND COMMISSIONERS IN EVALUATING
THE NECESSITY AND APPROPRIATENESS OF CARE PROVIDED
TO A CLAIMANT UNDER THE PROVISIONS OF THIS
CHAPTER;
(C) IN CONSULTATION WITH PRACTITIONERS AND
INSURERS, DEVELOP NOT LATER THAN JULY 1, 1994,
UTILIZATION REVIEW PROCEDURES FOR REASONABLE AND
APPROPRIATE TREATMENT OF A CLAIMANT UNDER THE
PROVISIONS OF THIS CHAPTER. THE CHAIRMAN SHALL
ANNUALLY PUBLISH THE PROCEDURES FOR USE BY
APPROVED PRACTITIONERS, EMPLOYERS WORKERS'
COMPENSATION INSURANCE CARRIERS AND COMMISSIONERS
IN EVALUATING THE NECESSITY AND APPROPRIATENESS OF
CARE PROVIDED TO A CLAIMANT UNDER THE PROVISIONS
OF THIS CHAPTER.
(c) The chairman, as soon as practicable
after April first of each year, shall submit to
the comptroller an estimated budget of
expenditures which shall include all direct and
indirect costs incurred by the workers'
compensation commission for the succeeding fiscal
year commencing on July first next. The workers'
compensation commission, for the purposes of
administration, shall not expend more than the
amounts specified in such estimated budget for
each item of expenditure except as authorized by
the comptroller. The chairman shall include in his
annual report to the governor a statement showing
the expenses of administering the workers'
compensation act for the preceding fiscal year.
(d) The chairman and the comptroller, as soon
as practicable after August first in each year,
shall ascertain the total amount of expenses
incurred by the commission, including, in addition
to the direct cost of personnel services, the cost
of maintenance and operation, rentals for space
occupied in state leased offices and all other
direct and indirect costs, incurred by the
commission during the preceding fiscal year in
connection with the administration of the workers'
compensation act and the total noncontributory
payments required to be made to the treasurer
towards commissioners' retirement salaries as
provided in sections 51-49, 51-50, 51-50a and
51-50b. An itemized statement of the expenses as
so ascertained shall be available for public
inspection in the office of the chairman of the
workers' compensation commission for thirty days
after notice to all insurance carriers, and to all
employers permitted to pay compensation directly
affected thereby.
Sec. 5. Section 31-284a of the general
statutes is repealed and the following is
substituted in lieu thereof:
(a) Notwithstanding the provisions of
sections 4a-19 and 4a-20 to the contrary, the
commissioner of administrative services shall
solicit proposals from any management firm engaged
in the business of administering workers'
compensation claims, or from any authorized mutual
insurance company or stock company or subsidiary
thereof writing workers' compensation or
employer's liability insurance in this state, for
the purposes of administering the workers'
compensation claims filed against the state, or of
insuring the state's full liability under workers'
compensation and administering such claims. Said
commissioner may, at his discretion, reject any or
all of such proposals if they are deemed to be
inadequate to effectively serve the needs of the
state concerning workers' compensation. Any funds
appropriated in section 1 of special act 81-22*
for workers' compensation payments by the state
and administrative expenses for the state workers'
compensation program shall be available and may be
transferred with the approval of the governor to
meet the necessary expenses of contracting for
such services.
(b) THE COMMISSIONER OF ADMINISTRATIVE
SERVICES SHALL ADOPT REGULATIONS, IN ACCORDANCE
WITH THE PROVISIONS OF CHAPTER 54, WHICH ESTABLISH
THE FEES PAYABLE BY THIS STATE FOR ITS EMPLOYEES
UNDER THE PROVISIONS OF THIS CHAPTER, BASED ON THE
MEDICAL PROCEDURE, COMBINATION OF PROCEDURES OR
DIAGNOSIS OF THE PATIENT, PROVIDED THE FEE
SCHEDULE SHALL NOT APPLY TO SERVICES RENDERED TO A
CLAIMANT WHO IS PARTICIPATING IN THE STATE'S
MANAGED CARE PLAN. THE REGULATIONS SHALL LIMIT
ANNUAL GROWTH IN TOTAL MEDICAL FEES PAYABLE BY THE
STATE TO NO MORE THAN THE ANNUAL PERCENTAGE
INCREASE IN THE CONSUMER PRICE INDEX FOR ALL URBAN
WORKERS. SAID COMMISSIONER MAY EXCLUDE FROM
PARTICIPATION IN THE STATE WORKERS' COMPENSATION
MANAGED CARE PROGRAM ANY MEDICAL PROVIDER FOUND,
THROUGH A SYSTEMATIC PROGRAM OF UTILIZATION
REVIEW, TO EXCEED GENERALLY ACCEPTED STANDARDS OF
THE SCOPE, DURATION OR INTENSITY OF SERVICES
RENDERED TO PATIENTS WITH SIMILAR DIAGNOSTIC
CHARACTERISTICS. THE STATE SHALL NOT MAKE ANY
PAYMENT TO A FACILITY OWNED IN WHOLE OR IN PART BY
THE REFERRING PRACTITIONER.
Sec. 6. Section 31-288 of the general
statutes is repealed and the following is
substituted in lieu thereof:
(a) If an employer wilfully fails to conform
to any other provision of this chapter, he shall
be fined not more than two hundred fifty dollars
for each such failure.
(b) Whenever (1) through the fault or neglect
of an employer or insurer, the adjustment or
payment of compensation due under this chapter is
unduly delayed, or (2) either party to a claim
under this chapter has unreasonably, and without
good cause, delayed the completion of the hearings
on such claim, the delaying party or parties may
be assessed a civil penalty of not more than five
hundred dollars by the commissioner hearing the
claim for each such case of delay. Any appeal of a
penalty assessed pursuant to this subsection shall
be taken in accordance with the provisions of
section 31-301.
(c) If, upon investigation of a complaint or
inspection of information available to the
workers' compensation commission, a commissioner
has reason to believe that an employer is not in
compliance with the insurance and self-insurance
requirements of subsection (b) of section 31-284,
the commissioner shall conduct a hearing, after
sufficient notice to the employer, wherein the
employer shall be required to present sufficient
evidence of his compliance with said requirements.
Whenever the commissioner finds that the employer
is not in compliance with said requirements he may
assess a civil penalty of not more than [one] TEN
thousand dollars against the employer. Any appeal
of a penalty assessed pursuant to this subsection
shall be taken in accordance with the provisions
of section 31-301.
(d) ANY EMPLOYER WHO, WITH THE INTENT TO
INJURE, DEFRAUD OR DECEIVE ANY INSURANCE COMPANY
INSURING THE LIABILITY OF SUCH EMPLOYER UNDER THIS
CHAPTER (1) KNOWINGLY MISREPRESENTS ONE OR MORE
EMPLOYEES AS INDEPENDENT CONTRACTORS, OR (2)
KNOWINGLY PROVIDES FALSE, INCOMPLETE OR MISLEADING
INFORMATION TO SUCH COMPANY CONCERNING THE NUMBER
OF EMPLOYEES, FOR THE PURPOSE OF PAYING A LOWER
PREMIUM ON A POLICY OBTAINED FROM SUCH COMPANY
SHALL BE GUILTY OF A CLASS D FELONY.
Sec. 7. Section 31-293 of the general
statutes is repealed and the following is
substituted in lieu thereof:
(a) When any injury for which compensation is
payable under the provisions of this chapter has
been sustained under circumstances creating in a
third person other than the employer a legal
liability to pay damages for the injury, the
injured employee may claim compensation under the
provisions of this chapter, but the payment or
award of compensation shall not affect the claim
or right of action of the injured employee against
the third person, but the injured employee may
proceed at law against the third person to recover
damages for the injury; and any employer having
paid, or having become obligated to pay,
compensation under the provisions of this chapter
may bring an action against the third person to
recover any amount that he has paid or has become
obligated to pay as compensation to the injured
employee. If either the employee or the employer
brings an action against the third person, he
shall immediately notify the other, in writing, by
personal presentation or by registered or
certified mail, of the action and of the name of
the court to which the writ is returnable, and the
other may join as a party plaintiff in the action
within thirty days after such notification, and,
if the other fails to join as a party plaintiff,
his right of action against the third person shall
abate. In any case in which an employee brings an
action against a third party in accordance with
the provisions of this section, and the employer
is a party defendant in the action, the employer
may join as a party plaintiff in the action. The
bringing of any action against an employer shall
not constitute notice to the employer within the
meaning of this section. If the employer and the
employee join as parties plaintiff in the action
and any damages are recovered, the damages shall
be so apportioned that the claim of the employer,
as defined in this section, shall take precedence
over that of the injured employee in the proceeds
of the recovery, after the deduction of reasonable
and necessary expenditures, including attorneys'
fees, incurred by the employee in effecting the
recovery. The rendition of a judgment in favor of
the employee or the employer against the third
party shall not terminate the employer's
obligation to make further compensation which the
commissioner thereafter deems payable to the
injured employee. If the damages, after deducting
the employee's expenses as provided in this
subsection, are more than sufficient to reimburse
the employer, damages shall be assessed in his
favor in a sum sufficient to reimburse him for his
claim, and the excess shall be assessed in favor
of the injured employee. No compromise with the
third person by either the employer or the
employee shall be binding upon or affect the
rights of the other, unless assented to by him.
For the purposes of this section, the claim of the
employer shall consist of (1) the amount of any
compensation which he has paid on account of the
injury which is the subject of the suit and (2) an
amount equal to the present worth of any probable
future payments which he has by award become
obligated to pay on account of the injury. The
word "compensation", as used in this section,
shall be construed to include incapacity payments
to an injured employee, payments to the dependents
of a deceased employee, sums paid out for
surgical, medical and hospital services to an
injured employee, the burial fee provided by
subdivision (1) of subsection (a) of section
31-306, AS AMENDED BY SECTION 15 OF THIS ACT,
payments made under the provisions of sections
31-312 and 31-313, and payments made under the
provisions of section 31-284b in the case of an
action brought under this section by the employer
or an action brought under this section by the
employee in which the employee has alleged and
been awarded such payments as damages. EACH
EMPLOYEE WHO BRINGS AN ACTION AGAINST A
THIRD-PARTY IN ACCORDANCE WITH THE PROVISIONS OF
THIS SUBSECTION SHALL INCLUDE IN HIS COMPLAINT (A)
THE AMOUNT OF ANY COMPENSATION PAID BY THE
EMPLOYER ON ACCOUNT OF THE INJURY WHICH IS THE
SUBJECT OF THE SUIT AND (B) THE AMOUNT EQUAL TO
THE PRESENT WORTH OF ANY PROBABLE FUTURE PAYMENTS
WHICH THE EMPLOYERS HAS, BY AWARD, BECOME
OBLIGATED TO PAY ON ACCOUNT OF THE INJURY.
NOTWITHSTANDING THE PROVISIONS OF THIS SUBSECTION,
WHEN ANY INJURY FOR WHICH COMPENSATION IS PAYABLE
UNDER THE PROVISIONS OF THIS CHAPTER HAS BEEN
SUSTAINED UNDER CIRCUMSTANCES CREATING IN A THIRD
PERSON OTHER THAN THE EMPLOYER A LEGAL LIABILITY
TO PAY DAMAGES FOR THE INJURY AND THE INJURED
EMPLOYEE HAS RECEIVED COMPENSATION FOR THE INJURY
FROM HIS EMPLOYER OR ITS WORKERS' COMPENSATION
INSURANCE CARRIER PURSUANT TO THE PROVISIONS OF
THIS CHAPTER, THE EMPLOYER OR INSURANCE CARRIER
SHALL HAVE A LIEN UPON ANY JUDGMENT RECEIVED BY
THE EMPLOYEE AGAINST THE THIRD PARTY OR ANY
SETTLEMENT RECEIVED BY THE EMPLOYEE FROM THE THIRD
PARTY, PROVIDED THE EMPLOYER OR INSURANCE CARRIER
SHALL GIVE WRITTEN NOTICE OF THE LIEN TO THE THIRD
PARTY PRIOR TO SUCH JUDGMENT OR SETTLEMENT.
(b) WHEN AN INJURY FOR WHICH COMPENSATION IS
PAYABLE UNDER THE PROVISIONS OF THIS CHAPTER IS
DETERMINED TO BE THE RESULT OF A MOTOR VEHICLE
ACCIDENT OR OTHER ACCIDENT OR CIRCUMSTANCE IN
WHICH A THIRD PERSON OTHER THAN THE EMPLOYER WAS
NEGLIGENT AND THE CLAIM IS SUBROGATED BY THE
EMPLOYER OR ITS WORKERS' COMPENSATION INSURANCE
CARRIER, THE INSURANCE CARRIER SHALL PROVIDE A
RATE ADJUSTMENT TO THE EMPLOYER'S WORKERS'
COMPENSATION POLICY TO REFLECT THE RECOVERY OF ANY
COMPENSATION PAID BY THE INSURANCE CARRIER PRIOR
TO SUBROGATION.
[(b)] (c) Notwithstanding the provisions of
subsection (a) of this section, no construction
design professional who is retained to perform
professional services on a construction project,
or any employee of a construction design
professional who is assisting or representing the
construction design professional in the
performance of professional services on the site
of the construction project, shall be liable for
any injury on the construction project for which
compensation is payable under the provisions of
this chapter, unless responsibility for safety
practices is specifically assumed by contract. The
immunity provided by this subsection to any
construction design professional shall not apply
to the negligent preparation of design plans or
specifications. For the purposes of this
subsection "construction design professional"
means (1) any person licensed as an architect
under the provisions of chapter 390, (2) any
person licensed, or exempted from licensure, as an
engineer under the provisions of chapter 391, or
(3) any corporation organized to render
professional services through the practice of
either or both of such professions in this state.
[(c)] (d) Notwithstanding the provisions of
subsection (a) of this section, the furnishing of
or the failure to furnish safety inspections or
safety advisory services (1) by an insurer
incident to providing workers' compensation
insurance to an employer, (2) pursuant to a
contract providing for safety inspections or
safety advisory services between an employer and a
self-insurance service organization incident to
providing workers' compensation related services
or (3) by a union representing employees of the
employer, shall not subject the insurer or
self-insurance service organization or their
agents or employees, or the union, its members or
the members of its safety committee, to third
party liability for damages for injury, death or
loss resulting therefrom unless the liability
arises from a breach of a duty of fair
representation of its members by a union. The
immunity from liability extended under this
subsection shall not be extended to any insurer or
self-insurance service organization other than
where the immunity is incident to the provision of
workers' compensation insurance or workers'
compensation related services.
Sec. 8. Section 31-294c of the general
statutes is repealed and the following is
substituted in lieu thereof:
(a) No proceedings for compensation under the
provisions of this chapter shall be maintained
unless a written notice of claim for compensation
is given within one year from the date of the
accident or within three years from the first
manifestation of a symptom of the occupational
disease, as the case may be, which caused the
personal injury, provided, if death has resulted
within two years from the date of the accident or
first manifestation of a symptom of the
occupational disease, a dependent or dependents,
or the legal representative of the deceased
employee, may make claim for compensation within
the two-year period or within one year from the
date of death, whichever is later. Notice of a
claim for compensation may be given to the
employer or any commissioner and shall state, in
simple language, the date and place of the
accident and the nature of the injury resulting
from the accident, or the date of the first
manifestation of a symptom of the occupational
disease and the nature of the disease, as the case
may be, and the name and address of the employee
and of the person in whose interest compensation
is claimed. An employee of the state shall send a
copy of the notice to the commissioner of
administrative services. As used in this section,
"manifestation of a symptom" means manifestation
to an employee claiming compensation, or to some
other person standing in such relation to him that
the knowledge of the person would be imputed to
him, in a manner that is or should be recognized
by him as symptomatic of the occupational disease
for which compensation is claimed.
(b) Whenever liability to pay compensation is
contested by the employer, he shall file with the
commissioner, on or before the twenty-eighth day
after he has received a written notice of claim, a
notice in accord with a form prescribed by the
chairman of the workers' compensation commission
stating that the right to compensation is
contested, the name of the claimant, the name of
the employer, the date of the alleged injury or
death and the specific grounds on which the right
to compensation is contested. The employer shall
send a copy of the notice to the employee in
accordance with section 31-321. If the employer or
his legal representative fails to file the notice
contesting liability [within the time prescribed
in this subsection] ON OR BEFORE THE TWENTY-EIGHTH
DAY AFTER HE HAS RECEIVED THE WRITTEN NOTICE OF
CLAIM, the employer shall, [be conclusively
presumed to have accepted the compensability of
the alleged injury or death and shall have no
right thereafter to] COMMENCE PAYMENT OF
COMPENSATION FOR SUCH INJURY OR DEATH ON OR BEFORE
THE TWENTY-EIGHTH DAY AFTER HE HAS RECEIVED THE
WRITTEN NOTICE OF CLAIM, BUT THE EMPLOYER MAY
contest the employee's right to receive
compensation on any grounds or the extent of his
disability WITHIN ONE YEAR FROM THE RECEIPT OF THE
WRITTEN NOTICE OF CLAIM, provided the employer
shall not be [conclusively presumed to have
accepted compensability] REQUIRED TO COMMENCE
PAYMENT OF COMPENSATION when the written notice of
claim has not been properly served in accordance
with section 31-321 or when the written notice of
claim fails to include a warning that (1) the
employer, IF HE HAS COMMENDED PAYMENT FOR THE
ALLEGED INJURY OR DEATH ON OR BEFORE THE
TWENTY-EIGHTH DAY AFTER RECEIVING A WRITTEN NOTICE
OF CLAIM, shall be precluded from contesting
liability unless a notice contesting liability is
filed within [the time period set forth in this
subsection] ONE YEAR FROM THE RECEIPT OF THE
WRITTEN NOTICE OF CLAIM, AND (2) THE EMPLOYER
SHALL BE CONCLUSIVELY PRESUMED TO HAVE ACCEPTED
THE COMPENSABILITY OF THE ALLEGED INJURY OR DEATH
UNLESS THE EMPLOYER EITHER FILES A NOTICE
CONTESTING LIABILITY ON OR BEFORE THE
TWENTY-EIGHTH DAY AFTER RECEIVING A WRITTEN NOTICE
OF CLAIM OR COMMENCES PAYMENT FOR THE ALLEGED
INJURY OR DEATH ON OR BEFORE SUCH TWENTY-EIGHTH
DAY. AN EMPLOYER SHALL BE ENTITLED, IF HE
PREVAILS, TO REIMBURSEMENT FROM THE CLAIMANT OF
ANY COMPENSATION PAID BY THE EMPLOYER ON AND AFTER
THE DATE THE COMMISSIONER RECEIVES WRITTEN NOTICE
FROM THE EMPLOYER OR HIS LEGAL REPRESENTATIVE, IN
ACCORDANCE WITH THE FORM PRESCRIBED BY THE
CHAIRMAN OF THE WORKERS' COMPENSATION COMMISSION,
STATING THAT THE RIGHT TO COMPENSATION IS
CONTESTED. NOTWITHSTANDING THE PROVISIONS OF THIS
SUBSECTION, AN EMPLOYER WHO FAILS TO CONTEST
LIABILITY FOR AN ALLEGED INJURY OR DEATH ON OR
BEFORE THE TWENTY-EIGHTH DAY AFTER RECEIVING A
WRITTEN NOTICE OF CLAIM AND WHO FAILS TO COMMENCE
PAYMENT FOR THE ALLEGED INJURY OR DEATH ON OR
BEFORE SUCH TWENTY-EIGHTH DAY, SHALL BE
CONCLUSIVELY PRESUMED TO HAVE ACCEPTED THE
COMPENSABILITY OF THE ALLEGED INJURY OR DEATH.
(c) Failure to provide a notice of claim
under subsection (a) of this section shall not bar
maintenance of the proceedings if there has been a
hearing or a written request for a hearing or an
assignment for a hearing within a one-year period
from the date of the accident or within a
three-year period from the first manifestation of
a symptom of the occupational disease, as the case
may be, or if a voluntary agreement has been
submitted within the applicable period, or if
within the applicable period an employee has been
furnished, for the injury with respect to which
compensation is claimed, with medical or surgical
care as provided in section 31-294d. No defect or
inaccuracy of notice of claim shall bar
maintenance of proceedings unless the employer
shows that he was ignorant of the facts concerning
the personal injury and was prejudiced by the
defect or inaccuracy of the notice. Upon
satisfactory showing of ignorance and prejudice,
the employer shall receive allowance to the extent
of the prejudice.
Sec. 9. Section 31-295 of the general
statutes is repealed and the following is
substituted in lieu thereof:
(a) No compensation shall be payable for
total or partial incapacity under the provisions
of this chapter on account of any injury which
does not incapacitate the injured employee for a
period of more than three days from earning full
wages at his customary employment. If the
incapacity continues for a period of more than
three days but less than seven days, compensation
shall begin at the expiration of the first three
days of total or partial incapacity. If the
incapacity continues for a period of seven days,
compensation shall begin from the date of the
injury.
(b) The injured employee shall be entitled to
full wages for the entire day of the injury and
that day shall not be counted as a day of
incapacity.
(c) If the employee is entitled to receive
compensation for permanent disability to an
injured member in accordance with the provisions
of SUBSECTION (b) OF section 31-308, AS AMENDED BY
SECTION 19 OF THIS ACT, the compensation shall be
paid to him beginning not later than thirty days
following the date of the maximum improvement of
the member or members and, if the compensation
payments are not so paid, the employer shall, in
addition to the compensation rate, pay interest at
the rate of [six] TEN per cent per annum on such
sum or sums from the date of maximum improvement.
The employer shall ascertain at least monthly
whether employees are entitled to compensation
because of a loss of wages as a result of the
injury and, if there is a loss of wages, shall pay
the compensation. The chairman of the workers'
compensation commission shall adopt regulations,
in accordance with the provisions of chapter 54,
for the purpose of assuring prompt payment by the
employer or his insurance carrier.
Sec. 10. Section 31-297a of the general
statutes is repealed and the following is
substituted in lieu thereof:
In any informal hearing held by the
commissioner OR CHAIRMAN OF THE WORKERS'
COMPENSATION COMMISSION in regard to compensation
under the provisions of this chapter, any
recommendations made by the commissioner OR
CHAIRMAN at the informal hearing shall be reduced
to writing and, if the parties accept such
recommendations, the recommendations shall be as
binding upon both parties as an award by the
commissioner OR CHAIRMAN. The commissioner OR
CHAIRMAN shall not postpone any such informal
hearing if one party fails to attend unless both
parties agree to the postponement.
Sec. 11. Section 31-298 of the general
statutes is repealed and the following is
substituted in lieu thereof:
Both parties may appear at any hearing,
either in person or by attorney or other
accredited representative, and no formal pleadings
shall be required, beyond any informal notices
that the commission approves. In all cases and
hearings under the provisions of this chapter, the
commissioner shall proceed, so far as possible, in
accordance with the rules of equity. He shall not
be bound by the ordinary common law or statutory
rules of evidence or procedure, but shall make
inquiry, through oral testimony, DEPOSITION
TESTIMONY or written and printed records, in a
manner that is best calculated to ascertain the
substantial rights of the parties and carry out
the provisions and intent of this chapter. No fees
shall be charged to either party by the
commissioner in connection with any hearing or
other procedure, but the commissioner shall
furnish at cost (1) certified copies of any
testimony, award or other matter which may be of
record in his office, and (2) duplicates of audio
cassette recordings of any formal hearings.
Witnesses subpoenaed by the commissioner shall be
allowed the fees and traveling expenses that are
allowed in civil actions, to be paid by the party
in whose interest the witnesses are subpoenaed.
Sec. 12. Section 31-229a of the general
statutes is repealed and the following is
substituted in lieu thereof:
(a) Where an employer contests the
compensability of an employee's claim for
compensation, proof of payment made under a group
health, medical or hospitalization plan or policy
shall not be a defense to a claim for compensation
under this chapter.
(b) Where an employer contests the
compensability of an employee's claim for
compensation, and the employee has also filed a
claim for benefits or services under the
employer's group health, medical, disability or
hospitalization plan or policy, the employer's
health insurer may not delay or deny payment of
benefits due to the employee under the terms of
the plan or policy by claiming that treatment for
the employee's injury or disease is the
responsibility of the employer's workers'
compensation insurer. THE HEALTH INSURER MAY FILE
A CLAIM IN ITS OWN RIGHT AGAINST THE EMPLOYER FOR
THE VALUE OF BENEFITS PAID BY THE INSURER WITHIN
TWO YEARS FROM PAYMENT OF THE BENEFITS. The health
insurer shall NOT have a lien on the proceeds of
any award or approval of any compromise made by
the commissioner pursuant to the employee's
compensation claim, in accordance with the
provisions of section 38a-470, UNLESS THE HEALTH
INSURER ACTUALLY PAID BENEFITS TO OR ON BEHALF OF
THE EMPLOYEE.
Sec. 13. Section 31-300 of the general
statutes is repealed and the following is
substituted in lieu thereof:
As soon as may be after the conclusion of any
hearing, but no later than one hundred twenty days
after such conclusion, the commissioner shall send
to each party a written copy of his findings and
award. The commissioner shall, as part of the
written award, inform the employee or his
dependent, as the case may be, of any rights the
individual may have to an annual cost-of-living
adjustment or to participate in a rehabilitation
program under the provisions of this chapter. He
shall retain the original findings and award in
his office. If no appeal from his decision is
taken by either party within ten days thereafter,
such award shall be final and may be enforced in
the same manner as a judgment of the superior
court. The court may issue execution upon any
uncontested or final award of a commissioner in
the same manner as in cases of judgments rendered
in the superior court; and, upon the filing of an
application to the court for an execution, the
commissioner in whose office the award is on file
shall, upon the request of the clerk of said
court, send to him a certified copy of such
findings and award. In cases where, through the
fault or neglect of the employer or insurer,
adjustments of compensation have been unduly
delayed, or where through such fault or neglect,
payments have been unduly delayed, the
commissioner may include in his award interest at
the rate prescribed in section 37-3a and a
reasonable attorney's fee in the case of undue
delay in adjustments of compensation and may
include in his award in the case of undue delay in
payments of compensation, interest at twelve per
cent per annum and a reasonable attorney's fee.
Payments not commenced within thirty-five days
after the filing of a written notice of claim
shall be presumed to be unduly delayed unless a
notice to contest the claim is filed in accordance
with section 31-297. In cases where there has been
delay in either adjustment or payment, which delay
has not been due to the fault or neglect of the
employer or insurer, whether such delay was caused
by appeals or otherwise, the commissioner may
allow interest at such rate, not to exceed the
rate prescribed in section 37-3a, as may be fair
and reasonable, taking into account whatever
advantage the employer or insurer, as the case may
be, may have had from the use of the money, the
burden of showing that the rate in such case
should be less than the rate prescribed in section
37-3a to be upon the employer or insurer. In cases
where the claimant prevails and the commissioner
finds that the employer or insurer has
unreasonably contested liability, the commissioner
may allow to the claimant a reasonable attorney's
fee. No employer or insurer shall discontinue or
reduce payment on account of total or partial
incapacity under any such award, if it is claimed
by or on behalf of the injured person that his
incapacity still continues, unless such employer
or insurer notifies the commissioner and the
employee of such proposed discontinuance or
reduction in the manner prescribed in section
31-296 and the commissioner specifically approves
such discontinuance or reduction in writing. The
commissioner shall render his decision within
fourteen days of receipt of such notice AND SHALL
FORWARD TO ALL PARTIES TO THE CLAIM A COPY OF HIS
DECISION NOT LATER THAN SEVEN DAYS AFTER HIS
DECISION HAS BEEN RENDERED. If the decision of the
commissioner finds for the employer or insurer,
the injured person shall return any wrongful
payments received from the day DESIGNATED BY the
commissioner [receives] AS THE EFFECTIVE DATE FOR
the [notice of] discontinuance or reduction [until
the day of approval of such discontinuance or
reduction] OF BENEFITS. ANY EMPLOYEE WHOSE
BENEFITS FOR TOTAL INCAPACITY ARE DISCONTINUED
UNDER THE PROVISIONS OF THIS SECTION AND WHO IS
ENTITLED TO RECEIVE BENEFITS FOR PARTIAL
INCAPACITY AS A RESULT OF AN AWARD, SHALL RECEIVE
THOSE BENEFITS COMMENCING THE DAY FOLLOWING THE
DESIGNATED EFFECTIVE DATE FOR THE DISCONTINUANCE
OF BENEFITS FOR TOTAL INCAPACITY. In any case
where the commissioner finds that the employer or
insurer has discontinued or reduced any such
payment without having given such notice and
without the commissioner having approved such
discontinuance or reduction in writing, the
commissioner shall allow the claimant a reasonable
attorney's fee together with interest at the rate
prescribed in section 37-3a on the discontinued or
reduced payments.
Sec. 14. Section 31-303 of the general
statutes is repealed and the following is
substituted in lieu thereof:
Payments agreed to under a voluntary
agreement shall commence on or before the tenth
day from the date of agreement. Payments due under
an award shall commence on or before the tenth day
from the date of such award. Payments due from the
second injury fund shall be payable on or before
the tenth business day after receipt of a fully
executed agreement. ANY EMPLOYER WHO FAILS TO PAY
WITHIN THE PRESCRIBED TIME LIMITATIONS OF THIS
SECTION SHALL PAY A PENALTY FOR EACH LATE PAYMENT,
IN THE AMOUNT OF TWENTY PER CENT OF SUCH PAYMENT,
IN ADDITION TO ANY OTHER INTEREST OR PENALTY
IMPOSED PURSUANT TO THE PROVISIONS OF THIS
CHAPTER.
Sec. 15. Section 31-306 of the general
statutes is repealed and the following is
substituted in lieu thereof:
(a) Compensation shall be paid to dependents
on account of death resulting from an accident
arising out of and in the course of employment or
from an occupational disease as follows:
(1) Four thousand dollars shall be paid for
burial expenses in any case where the employee
died on or after October 1, 1988. If there is no
one wholly or partially dependent upon the
deceased employee, the burial expenses of four
thousand dollars shall be paid to the person who
assumes the responsibility of paying the funeral
expenses.
(2) To those wholly dependent upon the
deceased employee at the date of his injury, a
weekly compensation equal to [eighty] SEVENTY-FIVE
per cent of the average weekly earnings of the
deceased calculated pursuant to section 31-310, AS
AMENDED BY SECTION 22 OF THIS ACT, after such
earnings have been reduced by any deduction for
federal OR STATE taxes, OR BOTH, and for the
federal Insurance Contributions Act made from such
employee's total wages received during the period
of calculation of the employee's average weekly
wage pursuant to said section 31-310, as of the
date of the injury but not more than the maximum
weekly compensation rate set forth in section
31-309, AS AMENDED BY SECTION 21 OF THIS ACT, for
the year in which the injury occurred or less than
twenty dollars weekly. (A) The weekly compensation
rate of each dependent entitled to receive
compensation under this section as a result of
death arising from a compensable injury occurring
on or after October 1, 1977, AND BEFORE THE
EFFECTIVE DATE OF THIS ACT, shall be adjusted
annually as provided in this subdivision as of the
following October first, and each subsequent
October first, to provide the dependent with a
cost-of-living adjustment in his weekly
compensation rate as determined as of the date of
the injury under section 31-309, AS AMENDED BY
SECTION 21 OF THIS ACT. If the maximum weekly
compensation rate, as determined under the
provisions of SAID section 31-309, to be effective
as of any October first following the date of the
injury, is greater than the maximum weekly
compensation rate prevailing at the date of the
injury, the weekly compensation rate which the
injured employee was entitled to receive at the
date of the injury shall be increased by the
percentage of the increase in the maximum weekly
compensation rate required by the provisions of
SAID section 31-309 from the date of the injury to
such October first. The cost-of-living increases
provided under this subdivision shall be paid by
the employer without any order or award from the
commissioner. The adjustments shall apply to each
payment made in the next succeeding twelve-month
period commencing with the October first next
succeeding the date of the injury. (B) The weekly
compensation rate of each dependent entitled to
receive compensation under this section as a
result of death arising from a compensable injury
occurring on or before September 30, 1977, shall
be adjusted as of October 1, 1977, and October 1,
1980, and thereafter, as provided in this
subdivision to provide the dependent with partial
cost-of-living adjustments in his weekly
compensation rate. As of October 1, 1977, the
weekly compensation rate paid prior to October 1,
1977, to the dependent shall be increased by
twenty-five per cent. The partial cost-of-living
adjustment provided under this subdivision shall
be paid by the employer without any order or award
from the commissioner. In addition, as of October
1, 1980, and on each subsequent October first, the
weekly compensation rate of each dependent shall
be increased to provide further cost-of-living
adjustments in his weekly compensation rate. If
the maximum weekly compensation rate as determined
under the provisions of SAID section 31-309
existing on October 1, 1977, to be effective as of
any October first following October 1, 1979, is
greater than the compensation rate prevailing on
October 1, 1979, the weekly compensation rate
shall be increased by the percentage of the
increase in the maximum compensation rate over the
maximum compensation rate of October 1, 1979, as
determined under the provisions of SAID section
31-309 existing on October 1, 1977. The cost of
the adjustments shall be paid by the employer or
his insurance carrier who shall be reimbursed
therefor from the second injury fund as provided
in section 31-354, AS AMENDED BY SECTION 26 OF
THIS ACT, upon presentation of any vouchers and
information that the treasurer shall require.
(3) If the surviving spouse is the sole
presumptive dependent, compensation shall be paid
until death or remarriage.
(4) If there is a presumptive dependent
spouse surviving and also one or more presumptive
dependent children, all of which children are
either children of the surviving spouse or are
living with the surviving spouse, the entire
compensation shall be paid to the surviving spouse
in the same manner and for the same period as if
the surviving spouse were the sole dependent. If,
however, any of the presumptive dependent children
are neither children of the surviving spouse nor
living with the surviving spouse, the compensation
shall be divided into as many parts as there are
presumptive dependents. The shares of any children
having a presumptive dependent parent shall be
added to the share of the parent and shall be paid
to the parent. The share of any dependent child
not having a surviving dependent parent shall be
paid to the father or mother of the child with
whom the child may be living, or to the legal
guardian of the child, or to any other person, for
the benefit of the child, as the commissioner may
direct.
(5) If the compensation being paid to the
surviving presumptive dependent spouse terminates
for any reason, or if there is no surviving
presumptive dependent spouse at the time of the
death of the employee, but there is at either time
one or more presumptive dependent children, the
compensation shall be paid to the children as a
class, each child sharing equally with the others.
Each child shall receive compensation until the
child reaches the age of eighteen or dies before
reaching age eighteen, provided the child shall
continue to receive compensation up to the
attainment of the age of twenty-two if unmarried
and a full-time student, except any child who has
attained the age of twenty-two while a full-time
student but has not completed the requirements
for, or received, a degree from a postsecondary
educational institution shall be deemed not to
have attained age twenty-two until the first day
of the first month following the end of the
quarter or semester in which he is enrolled at the
time, or if he is not enrolled in a quarter or
semester system, until the first day of the first
month following the completion of the course in
which he is enrolled or until the first day of the
third month beginning after such time, whichever
occurs first. When a child's participation ceases,
his share shall be divided among the remaining
eligible dependent children, provided if any
child, when he reaches the age of eighteen years,
is physically or mentally incapacitated from
earning, his right to compensation shall not
terminate but shall continue for the full period
of incapacity.
(6) In all cases where there are no
presumptive dependents, but where there are one or
more persons wholly dependent in fact, the
compensation in case of death shall be divided
according to the relative degree of their
dependence. Compensation payable under this
subdivision shall be paid for not more than three
hundred and twelve weeks from the date of the
death of the employee. The compensation, if paid
to those wholly dependent in fact, shall be paid
at the full compensation rate. The compensation,
if paid to those partially dependent in fact upon
the deceased employee as of the date of the
injury, shall not, in total, be more than the full
compensation rate nor less than twenty dollars
weekly, nor, if the average weekly sum contributed
by the deceased at the date of the injury to those
partially dependent in fact is more than twenty
dollars weekly, not more than the sum so
contributed.
(7) When the sole presumptive dependents are,
at the time of the injury, nonresident aliens and
the deceased has in this state some person or
persons who are dependent in fact, the
commissioner may in his discretion equitably
apportion the sums payable as compensation to the
dependents.
(b) The dependents of any deceased employee
who was injured on or after January 1, 1974, and
who died not later than November 1, 1991, shall be
paid compensation on account of the death
retroactively to the date of the employee's death.
The cost of the payment or adjustment shall be
paid by the employer or his insurance carrier who
shall be reimbursed therefor from the second
injury fund as provided in section 31-354, AS
AMENDED BY SECTION 26 OF THIS ACT, upon
presentation of any vouchers and information that
the treasurer shall require.
(c) The dependents of any deceased employee
who was injured in an accident arising out of and
in the course of employment before January 1,
1952, and who died, as a result of those injuries,
after October 1, 1991, shall be paid compensation,
under the provisions of this section, effective as
of the date of death of any such employee.
Notwithstanding the provisions of subsection (a)
of this section, the weekly compensation rate for
such dependents shall equal the amount of
compensation the injured employee was receiving
prior to death pursuant to section 31-307, AS
AMENDED BY SECTION 16 OF THIS ACT. Such weekly
compensation rate shall hereafter be adjusted in
accordance with the provisions of subsection (a)
of this section. The cost of such payment or
adjustment shall be paid by the employer or the
insurance carrier of such employer who shall be
reimbursed therefor from the second injury fund
provided for in section 31-354, AS AMENDED BY
SECTION 26 OF THIS ACT.
Sec. 16. Section 31-307 of the general
statutes is repealed and the following is
substituted in lieu thereof:
(a) If any injury for which compensation is
provided under the provisions of this chapter
results in total incapacity to work, the injured
employee shall be paid a weekly compensation equal
to [eighty] SEVENTY-FIVE per cent of his average
weekly earnings as of the date of the injury,
calculated pursuant to section 31-310, AS AMENDED
BY SECTION 22 OF THIS ACT, after such earnings
have been reduced by any deduction for federal OR
STATE taxes, OR BOTH, and for the federal
Insurance Contributions Act made from such
employee's total wages received during the period
of calculation of the employee's average weekly
wage pursuant to said section 31-310; but the
compensation shall not be more than the maximum
weekly benefit rate set forth in section 31-309,
AS AMENDED BY SECTION 21 OF THIS ACT, for the year
in which the injury occurred. No employee entitled
to compensation under this section shall receive
less than twenty per cent of the maximum weekly
compensation rate, as provided in SAID section
31-309, provided the minimum payment shall not
exceed [eighty] SEVENTY-FIVE per cent of the
employee's average weekly wage, as determined
under SAID section 31-310, and the compensation
shall not continue longer than the period of total
incapacity.
(b) Notwithstanding the provisions of
subsection (a) of this section, any employee who
suffers any injury or illness caused by his
employer's violation of any health or safety
regulation adopted pursuant to chapter 571 or
adopted by the federal Occupational Safety and
Health Administration and listed in 29 CFR,
Chapter XVII, after the violation has been cited
in accordance with the provisions of section
31-375 or the provisions of the Occupational
Safety and Health Act of 1970, 84 Stat. 1601
(1970), 29 USC 658 and not abated within the time
fixed by the citation, provided the citation has
not been set aside by appeal to the appropriate
agency or court having jurisdiction, shall receive
a weekly compensation equal to one hundred per
cent of the employee's average weekly earnings at
the time of the injury or illness.
(c) The following injuries of any person
shall be considered as causing total incapacity
and compensation shall be paid accordingly: (1)
Total and permanent loss of sight of both eyes, or
the reduction to one-tenth or less of normal
vision; (2) the loss of both feet at or above the
ankle; (3) the loss of both hands at or above the
wrist; (4) the loss of one foot at or above the
ankle and one hand at or above the wrist; (5) any
injury resulting in permanent and complete
paralysis of the legs or arms or of one leg and
one arm; (6) any injury resulting in incurable
imbecility or mental illness.
(d) An employee who has suffered the loss or
loss of the use of one of the members of his body,
or part of one of the members of his body, or the
reduction of vision in one eye to one-tenth or
less of normal vision, shall not receive
compensation for the later injury in excess of the
compensation allowed for the injury when
considered by itself and not in conjunction with
the previous incapacity except as provided in this
chapter.
(e) NOTWITHSTANDING ANY PROVISION OF THE
GENERAL STATUTES TO THE CONTRARY, COMPENSATION
PAID TO AN EMPLOYEE FOR AN EMPLOYEE'S TOTAL
INCAPACITY SHALL BE REDUCED WHILE THE EMPLOYEE IS
ENTITLED TO RECEIVE OLD AGE INSURANCE BENEFITS
PURSUANT TO THE FEDERAL SOCIAL SECURITY ACT. THE
AMOUNT OF EACH REDUCED WORKERS' COMPENSATION
PAYMENT SHALL EQUAL THE EXCESS, IF ANY, OF THE
WORKERS' COMPENSATION PAYMENT OVER THE OLD AGE
INSURANCE BENEFITS.
Sec. 17. Section 31-307a of the general
statutes is repealed and the following is
substituted in lieu thereof:
(a) The weekly compensation rate of each
employee entitled to receive compensation under
section 31-307, AS AMENDED BY SECTION 16 OF THIS
ACT, as a result of an injury sustained on or
after October 1, 1969, AND BEFORE THE EFFECTIVE
DATE OF THIS ACT, which totally disables the
employee continuously or intermittently for any
period extending to the following October first or
thereafter, shall be adjusted annually as provided
in this subsection as of the following October
first, and each subsequent October first, to
provide the injured employee with a cost-of-living
adjustment in his weekly compensation rate as
determined as of the date of the injury under
section 31-309, AS AMENDED BY SECTION 21 OF THIS
ACT. If the maximum weekly compensation rate as
determined under the provisions of SAID section
31-309, to be effective as of any October first
following the date of the injury, is greater than
the maximum weekly compensation rate prevailing as
of the date of the injury, the weekly compensation
rate which the injured employee was entitled to
receive at the date of the injury shall be
increased by the percentage of the increase in the
maximum weekly compensation rate required by the
provisions of SAID section 31-309 from the date of
the injury to such October first. The
cost-of-living increases provided under this
subsection shall be paid by the employer without
any order or award from the commissioner. The
adjustments shall apply to each payment made in
the next succeeding twelve-month period commencing
with the October first next succeeding the date of
the injury.
(b) The weekly compensation rate of each
employee entitled to receive compensation under
section 31-307, AS AMENDED BY SECTION 16 OF THIS
ACT, as a result of an injury sustained prior to
October 1, 1969, which has disabled the employee
for a period extending to October 1, 1969, or
thereafter shall be adjusted as of October 1,
1969, and annually thereafter, as provided in this
subsection to provide the injured employee with a
partial cost-of-living adjustment in his weekly
compensation rate. The weekly compensation rate
paid prior to October 1, 1969, to the injured
employee shall be increased as of October 1, 1969,
by the amount that the maximum weekly compensation
rate as determined under section 31-309, AS
AMENDED BY SECTION 21 OF THIS ACT, to be effective
for injuries sustained on or after October 1,
1969, is greater than the maximum weekly
compensation rate as determined under SAID section
31-309 to be effective for injuries sustained on
or after October 1, 1965, or the date of the
injury, whichever is later, but not more than
fifteen dollars per week. Thereafter, increases,
if any, for cost-of-living as provided in
subsection (a) of this section shall be added to
the amount of weekly compensation payable as of
the date of the injury and the initial adjustment
provided in this subsection. The partial
cost-of-living adjustments provided under this
subsection shall be paid by the employer without
any order or award from the commissioner. The
adjustments shall apply to each payment made in
the next twelve-month period, on or after October
1, 1969. The cost of the adjustments shall be paid
by the employer or his insurance carrier who shall
be reimbursed therefor from the second injury fund
as provided in section 31-354, AS AMENDED BY
SECTION 26 OF THIS ACT, upon presentation of any
vouchers and information that the treasurer shall
require.
Sec. 18. Section 31-307b of the general
statutes is repealed and the following is
substituted in lieu thereof:
If any employee who receives compensation
under section 31-307, AS AMENDED BY SECTION 16 OF
THIS ACT, returns to work after recovery from his
injury and subsequently suffers total or partial
incapacity caused by a relapse from the recovery
from, or a recurrence of, the injury, the employee
shall be paid a weekly compensation equal to
[eighty] SEVENTY-FIVE per cent of his average
weekly earnings as of the date of the original
injury or at the time of his relapse or at the
time of the recurrence of the injury, whichever is
the greater sum, calculated pursuant to section
31-310, AS AMENDED BY SECTION 22 OF THIS ACT,
after such earnings have been reduced by any
deduction for federal OR STATE taxes, OR BOTH, and
for the federal Insurance Contributions Act made
from such employee's total wages received during
the period of calculation of the employee's
average weekly wage pursuant to said section
31-310, but not more than (1) the maximum
compensation rate set pursuant to section 31-309,
AS AMENDED BY SECTION 21 OF THIS ACT, if the
employee suffers total incapacity, or (2) one
hundred per cent, raised to the next even dollar,
of the average weekly earnings of production and
related workers in manufacturing in the state, as
determined in accordance with the provisions of
SAID section 31-309, if the employee suffers
partial incapacity, for the year in which the
employee suffered the relapse or recurrent injury
and the minimum rate under this chapter for that
year, and provided (A) the compensation shall not
continue longer than the period of total or
partial incapacity following the relapse or
recurrent injury and (B) no employee eligible for
compensation for specific injuries set forth in
section 31-308, AS AMENDED BY SECTION 19 OF THIS
ACT, shall receive compensation under this
section. The employee shall also be entitled to
receive the cost-of-living adjustment provided in
accordance with the provisions of section 31-307a,
AS AMENDED BY SECTION 17 OF THIS ACT, commencing
on October first following the relapse or
recurrent injury which disables him. If the injury
occurred originally prior to October 1, 1969, the
difference between the employee's original weekly
compensation rate and the rate required by this
section and the cost-of-living adjustment, if any,
thereafter due shall be paid initially by the
employer or his insurance carrier who shall be
reimbursed for such payment from the second injury
fund as provided by section 31-354, AS AMENDED BY
SECTION 26 OF THIS ACT, upon presentation of any
vouchers and information that the treasurer shall
require. In no event shall the employee receive
more than the prevailing maximum compensation.
Sec. 19. Section 31-308 of the general
statutes is repealed and the following is
substituted in lieu thereof:
(a) If any injury for which compensation is
provided under the provisions of this chapter
results in partial incapacity, the injured
employee shall be paid a weekly compensation equal
to [eighty] SEVENTY-FIVE per cent of the
difference between the wages currently earned by
an employee in a position comparable to the
position held by the injured employee before his
injury, after such wages have been reduced by any
deduction for federal OR STATE taxes, OR BOTH, and
for the federal Insurance Contributions Act in
accordance with section 31-310, AS AMENDED BY
SECTION 22 OF THIS ACT, and the amount he is able
to earn after the injury, after such amount has
been reduced by any deduction for federal OR STATE
taxes, OR BOTH, and for the federal Insurance
Contributions Act in accordance with SAID section
31-310, except that when (1) the physician
attending an injured employee certifies that the
employee is unable to perform his usual work but
is able to perform other work, (2) the employee is
ready and willing to perform other work in the
same locality and (3) no other work is available,
the employee shall be paid his full weekly
compensation subject to the provisions of this
section. Compensation paid under this subsection
shall not be more than one hundred per cent,
raised to the next even dollar, of the average
weekly earnings of production and related workers
in manufacturing in the state, as determined in
accordance with the provisions of section 31-309,
AS AMENDED BY SECTION 21 OF THIS ACT, and shall
continue during the period of partial incapacity,
but no longer than [seven hundred eighty] FIVE
HUNDRED TWENTY weeks. If the employer procures
employment for an injured employee that is
suitable to his capacity, the wages offered in
such employment shall be taken as the earning
capacity of the injured employee during the period
of the employment.
(b) With respect to the following injuries,
the compensation, in addition to the usual
compensation for total incapacity but in lieu of
all other payments for compensation, shall be
[eighty] SEVENTY-FIVE per cent of the average
weekly earnings of the injured employee,
calculated pursuant to section 31-310, AS AMENDED
BY SECTION 22 OF THIS ACT, after such earnings
have been reduced by any deduction for federal OR
STATE taxes, OR BOTH, and for the federal
Insurance Contributions Act made from such
employee's total wages received during the period
of calculation of the employee's average weekly
wage pursuant to said section 31-310, but in no
case more than one hundred per cent, raised to the
next even dollar, of the average weekly earnings
of production and related workers in manufacturing
in the state, as determined in accordance with the
provisions of section 31-309, AS AMENDED BY
SECTION 21 OF THIS ACT, or less than fifty dollars
weekly. All of the following injuries include the
loss of the member OR ORGAN and the complete and
permanent loss of use of the member OR ORGAN
referred to:
WEEKS OF
MEMBER INJURY COMPENSATION
Arm
Master arm Loss at or above
elbow [312] 208
Other arm Loss at or above
elbow [291] 194
Hand
Master hand Loss at or above
wrist [252] 168
Other hand Loss at or above
wrist [232] 155
One leg Loss at or above
knee [238] 155
One foot Loss at or above
ankle [188] 125
Hearing
Both ears [156] 104
One ear [52] 35
One eye
Complete and
permanent loss of
sight in, or
reduction of sight
to one-tenth or
less of normal
vision [235] 157
Thumb *
On master hand [95] 63
On other hand [81] 54
Fingers **
First finger [54] 36
Second finger [44] 29
Third finger [31] 21
Fourth finger [26] 17
Toes ***
Great toe [42] 28
Other toes [13] 9
Back
Number of weeks
which the
proportion of
incapacity
represents to a
maximum of [520]
374 weeks.
HEART 520
BRAIN 520
CAROTID ARTERY 520
PANCREAS 416
LIVER 347
STOMACH 260
LOSS OF BLADDER 233
SPEECH 163
LUNG 117
CERVICAL SPINE 117
KIDNEY 117
RIB CAGE (BILATERAL) 69
TESTIS 35
MAMMARY 35
NOSE (SENSE AND RESPIRATORY FUNCTION) 35
JAW (MASTIFICATION) 35
PENIS 35 - 104
COCCYX (ACTUAL REMOVAL) 35
SENSE OF SMELL 17
SENSE OF TASTE 17
SPLEEN (IN ADDITION TO SCAR) 13
GALL BLADDER 13
TOOTH (MINIMUM) 1
LOSS OF DRAINAGE DUCT OF EYE
(IF CORRECTED BY PROSTHESIS) 17 FOR EACH
LOSS OF DRAINAGE DUCT OF EYE
(IF UNCORRECTED BY PROSTHESIS) 33 FOR EACH
PELVIS (PERCENTAGE OF BACK)
*The loss or loss of use of one phalanx of a
thumb shall be construed as seventy-five per cent
of the loss of the thumb.
**The loss or loss of use of one phalanx of a
finger shall be construed as fifty per cent of the
loss of the finger. The loss of or loss of use of
two phalanges of a finger shall be construed as
ninety per cent of the loss of the finger.
***The loss or loss of use of one phalanx of
a great toe shall be construed as sixty-six and
two-thirds per cent of the loss of the great toe.
The loss of the greater part of any phalanx shall
be construed as the loss of a phalanx and shall be
compensated accordingly.
If the injury consists of the loss of a
substantial part of a member resulting in a
permanent partial loss of the use of a member, or
if the injury results in a permanent partial loss
of function, the commissioner may, in his
discretion, in lieu of other compensation, award
to the injured employee the proportion of the sum
provided in this subsection for the total loss of,
or the loss of the use of, the member or for
incapacity or both that represents the proportion
of total loss or loss of use found to exist, and
any voluntary agreement submitted in which the
basis of settlement is such proportionate payment
may, if otherwise conformable to the provisions of
this chapter, be approved by the commissioner in
his discretion. NOTWITHSTANDING THE PROVISIONS OF
THIS SUBSECTION, THE COMPLETE LOSS OR LOSS OF USE
OF AN ORGAN WHICH RESULTS IN THE DEATH OF AN
EMPLOYEE SHALL BE COMPENSABLE PURSUANT ONLY TO
SECTION 31-306, AS AMENDED BY SECTION 15 OF THIS
ACT.
[(c) In addition to compensation for total or
partial incapacity, or for a specific loss of a
member or loss of use of the function of a member
of the body, the commissioner may award
compensation as he deems just for the loss or loss
of use of the function of any organ or part of the
body not otherwise provided for in this section,
taking into account the age and sex of the
claimant, the disabling effect of the loss of or
loss of function of the organ involved and the
necessity of the organ or complete functioning of
the organ with respect to the entire body. The
commissioner may not award more than the sum
equivalent to compensation for seven hundred and
eighty weeks under this subsection.
(d) In the case of an injury to any portion
of the body referred to in subsection (b) of this
section, or to a phalanx or phalanges of the
thumb, finger or toe, the commissioner may, in his
discretion, award compensation for the
proportionate loss or loss of use of the member of
the body affected by the injury. Where the injury
results in a loss of earnings, the commissioner
shall, in his discretion, direct that the claimant
be paid partial compensation for loss of earnings,
as provided in this section, if it is in the
interest of the injured employee to be paid the
partial compensation even if the injured member
may have attained maximum improvement. Partial
compensation shall be paid under this subsection
for as long as the loss of earnings continues. If
the injured employee's loss of earnings ends, he
shall be paid for permanent injuries in accordance
with the provisions of subsection (b) of this
section, minus any payments for partial
compensation, for weeks subsequent to the date on
which maximum improvement in the injured member
had been attained. If there is no loss of earnings
resulting from the injury, payments shall be made
in accordance with the provisions of subsection
(b) of this section.]
[(e)] (c) In addition to compensation for
total or partial incapacity or for a specific loss
of a member or use of the function of a member of
the body, the commissioner, not earlier than one
year from the date of the injury AND NOT LATER
THAN TWO YEARS FROM THE DATE OF THE INJURY OR THE
SURGERY DATE OF THE INJURY, may award compensation
[as he deems just,] equal to [eighty] SEVENTY-FIVE
per cent of the average weekly earnings of the
injured employee, calculated pursuant to section
31-310, AS AMENDED BY SECTION 22 OF THIS ACT,
after such earnings have been reduced by any
deduction for federal OR STATE taxes, OR BOTH, and
for the federal Insurance Contributions Act made
from such employee's total wages received during
the period of calculation of the employee's
average weekly wage pursuant to said section
31-310, but not more than one hundred per cent,
raised to the next even dollar, of the average
weekly earnings of production and related workers
in manufacturing in the state, as determined in
accordance with the provisions of section 31-309,
AS AMENDED BY SECTION 21 OF THIS ACT, for up to
two hundred eight weeks, for any permanent
significant disfigurement of, or permanent
significant scar on, [any part of the body] (A)
THE FACE, HEAD OR NECK, OR (B) ON ANY OTHER AREA
OF THE BODY WHICH HANDICAPS THE EMPLOYEE IN
OBTAINING OR CONTINUING TO WORK. The commissioner
may not award compensation under this subsection
when the disfigurement was caused solely by the
loss of or the loss of use of a member of the body
for which compensation is provided under
subsection (b) of this section or for any scar
resulting from an inguinal hernia operation or any
spinal surgery. In making any award under this
subsection, the commissioner shall consider (1)
the location of the scar or disfigurement, (2) the
size of the scar or disfigurement, (3) the
visibility of the scar or disfigurement due to
hyperpigmentation or depigmentation, whether
hypertrophic or keloidal, (4) whether the scar or
disfigurement causes a tonal or textural skin
change, causes loss of symmetry of the affected
area or results in noticeable bumps or depressions
in the affected area, and (5) other relevant
factors. Notwithstanding the provisions of this
subsection, no compensation shall be awarded for
any scar or disfigurement [on any part of the
body] which is not [easily discernible upon
viewing by the commissioner] LOCATED ON (A) THE
FACE, HEAD OR NECK, OR (B) ANY OTHER AREA OF THE
BODY WHICH HANDICAPS THE EMPLOYEE IN OBTAINING OR
CONTINUING TO WORK. In addition to the
requirements contained in section 31-297, the
commissioner shall provide written notice to the
employer prior to any hearing held by the
commissioner to consider an award for any scar or
disfigurement under this subsection.
[(f)] (d) Any award OR AGREEMENT for
compensation made pursuant to this section shall
be paid to the employee, or in the event of the
employee's death, WHETHER OR NOT A FORMAL AWARD
HAS BEEN MADE PRIOR TO THE DEATH, to his surviving
spouse or, if he has no surviving spouse, to his
dependents in equal shares or, if he has no
surviving spouse or dependents, to his children,
in equal shares, regardless of their age.
Sec. 20. Section 31-308a of the general
statutes is repealed and the following is
substituted in lieu thereof:
(a) In addition to the compensation benefits
provided by section 31-308, AS AMENDED BY SECTION
19 OF THIS ACT, for specific loss of a member or
use of the function of a member of the body, or
any personal injury covered by this chapter, the
commissioner, after such payments provided by said
section 31-308 have been paid for the period set
forth in said section, may award additional
compensation benefits for such partial permanent
disability equal to [eighty] SEVENTY-FIVE per cent
of the difference between the wages currently
earned by an employee in a position comparable to
the position held by such injured employee prior
to his injury, after such wages have been reduced
by any deduction for federal OR STATE taxes, OR
BOTH, and for the federal Insurance Contributions
Act in accordance with section 31-310, AS AMENDED
BY SECTION 22 OF THIS ACT, and the weekly amount
which such employee will probably be able to earn
thereafter, after such amount has been reduced by
any deduction for federal OR STATE taxes, OR BOTH,
and for the federal Insurance Contributions Act in
accordance with SAID section 31-310, to be
determined by the commissioner based upon the
nature and extent of the injury, the training,
education and experience of the employee, the
availability of work for persons with such
physical condition and at the employee's age, but
not more than one hundred per cent, raised to the
next even dollar, of the average weekly earnings
of production and related workers in manufacturing
in the state, as determined in accordance with the
provisions of section 31-309, AS AMENDED BY
SECTION 21 OF THIS ACT. If evidence of exact loss
of earnings is not available, such loss may be
computed from the proportionate loss of physical
ability or earning power caused by the injury. The
duration of such additional compensation shall be
determined upon a similar basis by the
commissioner, BUT IN NO EVENT SHALL THE DURATION
OF SUCH ADDITIONAL COMPENSATION EXCEED THE LESSER
OF (1) THE DURATION OF THE EMPLOYEE'S PERMANENT
PARTIAL DISABILITY BENEFITS, OR (2) FIVE HUNDRED
TWENTY WEEKS. ADDITIONAL BENEFITS PROVIDED UNDER
THIS SECTION SHALL BE AVAILABLE ONLY TO EMPLOYEES
WHO ARE WILLING AND ABLE TO PERFORM WORK IN THIS
STATE.
(b) NOTWITHSTANDING THE PROVISIONS OF
SUBSECTION (a) OF THIS SECTION, ADDITIONAL
BENEFITS PROVIDED UNDER THIS SECTION SHALL BE
AVAILABLE ONLY WHEN THE NATURE OF THE INJURY AND
ITS EFFECT ON THE EARNING CAPACITY OF AN EMPLOYEE
WARRANT ADDITIONAL COMPENSATION.
Sec. 21. Section 31-309 of the general
statutes is repealed and the following is
substituted in lieu thereof:
(a) Except as provided in section 31-307, AS
AMENDED BY SECTION 16 OF THIS ACT, the weekly
compensation received by an injured employee under
the provisions of this chapter shall in no case be
more than one hundred [fifty] per cent, raised to
the next even dollar, of the average weekly
earnings of [production and related workers in
manufacturing] ALL WORKERS in the state as
hereinafter defined for the year in which the
injury occurred except that the weekly
compensation received by an injured employee whose
injury occurred before [October 1, 1991] JULY 1,
1993, shall be computed according to the
provisions of law in effect at the time of his
injury. In the case of an occupational disease,
the time of injury shall be the date of total or
partial incapacity to work as a result of such
disease.
(b) (1) THE AVERAGE WEEKLY EARNINGS OF ALL
WORKERS IN THE STATE SHALL BE DETERMINED BY THE
LABOR COMMISSIONER ON OR BEFORE THE FIFTEENTH DAY
OF AUGUST OF EACH YEAR, TO BE EFFECTIVE THE
FOLLOWING OCTOBER FIRST, AND SHALL BE THE AVERAGE
OF ALL WORKERS' WEEKLY EARNINGS FOR THE YEAR
ENDING THE PREVIOUS JUNE THIRTIETH AND SHALL BE SO
DETERMINED IN ACCORDANCE WITH THE STANDARDS FOR
THE DETERMINATION OF AVERAGE WEEKLY EARNINGS OF
ALL WORKERS ESTABLISHED BY THE UNITED STATES
DEPARTMENT OF LABOR, BUREAU OF LABOR STATISTICS.
(2) PRIOR TO JULY 1, 1993, THE LABOR
COMMISSIONER SHALL DETERMINE THE AVERAGE WEEKLY
EARNINGS OF ALL WORKERS IN THE STATE TO BE
EFFECTIVE DURING THE PERIOD JULY 1, 1993, TO
OCTOBER 1, 1993.
[(b)] (c) The average weekly earnings of
production and related workers in manufacturing in
the state shall be determined by the labor
commissioner on or before the fifteenth day of
August of each year, to be effective the following
October first, and shall be the average of the
manufacturing production and related workers'
weekly earnings for the year ending the previous
June thirtieth and shall be so determined in
accordance with the standards for the
determination of average weekly earnings of
production and related workers in manufacturing
established by the United States Department of
Labor, Bureau of Labor Statistics.
Sec. 22. Section 31-310 of the general
statutes is repealed and the following is
substituted in lieu thereof:
(a) For the purposes of this chapter, the
average weekly wage shall be ascertained by
dividing the total wages received by the injured
employee from the employer in whose service he is
injured during the [twenty-six] FIFTY-TWO calendar
weeks immediately preceding the week during which
he was injured, by the number of calendar weeks
during which, or any portion of which, the
employee was actually employed by the employer,
but, in making the computation, absence for seven
consecutive calendar days, although not in the
same calendar week, shall be considered as absence
for a calendar week. When the employment commenced
otherwise than at the beginning of a calendar
week, that calendar week and wages earned during
that week shall be excluded in making the
computation. When the period of employment
immediately preceding the injury is computed to be
less than a net period of two calendar weeks, the
employee's weekly wage shall be considered to be
equivalent to the average weekly wage prevailing
in the same or similar employment in the same
locality at the date of the injury except that,
when the employer has agreed to pay a certain
hourly wage to the employee, the hourly wage so
agreed upon shall be the hourly wage for the
injured employee and his average weekly wage shall
be computed by multiplying the hourly wage by the
regular number of hours that is permitted each
week in accordance with the agreement. For the
purpose of determining the amount of compensation
to be paid in the case of a minor under the age of
eighteen who has sustained an injury entitling him
to compensation for total or partial incapacity
for a period of fifty-two or more weeks, or to
specific indemnity for any injury under the
provisions of section 31-308, AS AMENDED BY
SECTION 19 OF THIS ACT, the commissioner may add
fifty per cent to his average weekly wage, except
in the case of a minor under the age of sixteen,
the commissioner may add one hundred per cent to
his average weekly wage. When the injured employee
is a trainee or apprentice receiving a subsistence
allowance from the United States because of war
service, the allowance shall be added to his
actual earnings in determining the average weekly
wage. Where the injured employee has worked for
more than one employer as of the date of the
injury and the average weekly wage received from
the employer in whose employ he was injured, as
determined under the provisions of this section,
are insufficient for him to obtain the maximum
weekly compensation rate from the employer under
section 31-309, AS AMENDED BY SECTION 21 OF THIS
ACT, prevailing as of the date of the injury, his
average weekly wages shall be calculated upon the
basis of wages earned from all such employers in
the period of concurrent employment not in excess
of [twenty-six] FIFTY-TWO weeks prior to the date
of the injury, but the employer in whose employ
the injury occurred shall be liable for all
medical and hospital costs and a pro rata portion
of the compensation rate based upon the ratio of
the amount of wages paid by him to the total wages
paid the employee in that average week but not
less than an amount equal to the minimum
compensation rate prevailing as of the date of the
injury. The remaining portion of the applicable
compensation rate shall be paid from the second
injury fund upon submission to the treasurer by
the employer or the employer's insurance carrier
of such vouchers and information as the treasurer
may require. In cases which involve concurrent
employment and in which there is a claim against a
third party, the injured employee or the employer
in whose employ the injury was sustained or the
employer's insurer shall advise the custodian of
the second injury fund if there is a third party
claim, and the employee, employer or employer's
insurer shall pursue its subrogation rights as
provided for in section 31-293, AS AMENDED BY
SECTION 7 OF THIS ACT, and shall include in its
claim all compensation paid by the second injury
fund and shall reimburse the second injury fund
for all payments made for compensation in the
event of a recovery against the third party.
(b) Each August fifteenth, the chairman of
the workers' compensation commission, in
consultation with the advisory board, shall
publish tables of the average weekly wage and
[eighty] SEVENTY-FIVE per cent of the average
weekly wage after being reduced by any deduction
for federal OR STATE taxes, OR BOTH, and for the
federal Insurance Contributions Act, to be
effective the following October first, EXCEPT THAT
NOT LATER THAN JUNE THIRTIETH, THE CHAIRMAN, IN
CONSULTATION WITH THE ADVISORY BOARD, SHALL
PUBLISH TABLES OF THE AVERAGE WEEKLY WAGE AND
SEVENTY-FIVE PER CENT OF THE AVERAGE WEEKLY WAGE
AFTER BEING REDUCED BY ANY DEDUCTION FOR FEDERAL
OR STATE TAXES, OR BOTH, AND FOR THE FEDERAL
INSURANCE CONTRIBUTIONS ACT, TO BE EFFECTIVE
DURING THE PERIOD JULY 1, 1993, TO OCTOBER 1,
1993. Such tables shall be conclusive for the
purpose of determining [eighty] SEVENTY-FIVE per
cent of the average weekly earnings of an injured
employee after such earnings have been reduced by
any deduction for federal OR STATE taxes, OR BOTH,
and for the federal Insurance Contributions Act
made from such employee's total wages received
during the period of calculation of the employee's
average weekly wage for purposes of sections
31-306, 31-307 [,] and 31-308, AS AMENDED BY
SECTIONS 15, 16 AND 19, RESPECTIVELY, OF THIS ACT.
Sec. 23. Section 31-310c of the general
statutes is repealed and the following is
substituted in lieu thereof:.
For the purposes of this chapter, in the case
of an occupational disease the average weekly wage
shall be calculated as of the date of total or
partial incapacity to work. However, in the case
of an occupational disease which manifests itself
at a time when the worker has not worked during
the twenty-six weeks immediately preceding the
diagnosis of such disease, the claimant's average
weekly wage shall be considered to be equivalent
to the greater of (1) the average weekly wage
determined pursuant to section 31-310, AS AMENDED
BY SECTION 22 OF THIS ACT, and adjusted pursuant
to section 31-307a, AS AMENDED BY SECTION 17 OF
THIS ACT, or (2) the average weekly wage earned by
the claimant during the [twenty-six] FIFTY-TWO
calendar weeks last worked by the claimant, which
wage shall be determined in accordance with said
section 31-310 and adjusted pursuant to said
section 31-307a.
Sec. 24. Section 31-349 of the general
statutes is repealed and the following is
substituted in lieu thereof:
(a) The fact that an employee has suffered a
previous disability, shall not preclude him from
compensation for a second injury, nor preclude
compensation for death resulting from the second
injury. If an employee having a previous
disability incurs a second disability from a
second injury resulting in a permanent disability
caused by both the previous disability and the
second injury which is materially and
substantially greater than the disability that
would have resulted from the second injury alone,
he shall receive compensation for (1) the entire
amount of disability, including total disability,
less any compensation payable or paid with respect
to the previous disability, and (2) necessary
medical care, as provided in this chapter,
notwithstanding the fact that part of the
disability was due to a previous disability. FOR
PURPOSES OF THIS SUBSECTION, "COMPENSATION PAYABLE
OR PAID WITH RESPECT TO THE PREVIOUS DISABILITY"
INCLUDES COMPENSATION PAYABLE OR PAID PURSUANT TO
THE PROVISIONS OF THIS CHAPTER, AS WELL AS ANY
OTHER COMPENSATION PAYABLE OR PAID IN CONNECTION
WITH THE PREVIOUS DISABILITY, REGARDLESS OF THE
SOURCE OF SUCH COMPENSATION.
(b) As a condition precedent to the liability
of the second injury fund, the employer or his
insurance carrier shall, ninety days before the
expiration of the first one hundred four weeks of
disability, notify the custodian of the second
injury fund of the pending case and shall furnish
to the custodian a copy of the agreement or award
together with all information supporting his claim
as to the liability of the second injury fund, and
shall make available to the custodian any medical
reports that the custodian requests. The employer
by whom the employee is employed at the time of
the second injury, or his insurance carrier, shall
in the first instance pay all awards of
compensation and all medical expenses provided by
this chapter for the first one hundred four weeks
of disability. Failure on the part of the employer
or the carrier to comply does not relieve the
employer or carrier of its obligation to continue
furnishing compensation under the provisions of
this chapter. If the custodian rejects the claim
of the employer and its insurer, the question
shall be submitted to the commissioner having
jurisdiction, as promptly as possible, and the
employer or carrier shall continue furnishing
compensation until the outcome is finally decided.
If the employer or carrier prevails, all payments
made beyond the one-hundred-four-week period shall
be reimbursed to the employer or carrier by the
second injury fund. After the employer or its
insurer has completed payment for the
one-hundred-four-week period, he shall file with
the commissioner having jurisdiction, and with the
custodian of the second injury fund, a form
indicating that all compensation and medical bills
have been paid for the one-hundred-four-week
period, and indicating the date the custodian was
notified of the pending case. Thereafter, all
responsibility for compensation and medical
treatment shall be with the custodian of the
second injury fund.
(c) If the second injury of an employee
results in the death of the employee, and it is
determined that either the second injury or death
would not have occurred except for a preexisting
permanent physical impairment, the employer or his
insurance carrier shall, in the first instance,
pay the funeral expense described in this chapter,
and shall pay death benefits as may be due for the
first one hundred four weeks. Ninety days before
the expiration of the one-hundred-four-week
period, the employer or his insurance carrier
shall notify the custodian of the second injury
fund of the pending case and shall furnish to the
custodian a copy of the agreement or award. After
the employer or its insurer has completed the
payment for the one-hundred-four-week period, he
shall file with the commissioner having
jurisdiction, and with the custodian of the second
injury fund, a form indicating that all
compensation has been paid for the
one-hundred-four-week period, and indicating the
date that the custodian was notified of the
pending case. Thereafter, all responsibility for
compensation shall be with the custodian of the
second injury fund.
(d) Employees shall not be denied any
compensation provided by any provisions of this
chapter by reason of the execution of an
acknowledgment of any physical condition which
imposes upon his employer or prospective employer
a further or unusual hazard, but the compensation
specified in this chapter which would be payable
except for the execution of the acknowledgment
shall be paid entirely out of the second injury
fund. Claims for compensation shall be filed with
the commissioner, who shall refer such claims to
the custodian of the second injury fund. The
custodian of the second injury fund may make
payment by way of final settlement in any matter
concerning the fund, subject to the approval of
the commissioner, when it is for the best
interests of the injured employee.
(e) In any case where compensation payments
to an individual for total incapacity under the
provisions of section 31-307, AS AMENDED BY
SECTION 16 OF THIS ACT, continue for more than one
hundred four weeks, the cost of accident and
health insurance or life insurance coverage
required under section 31-284b shall be paid to
the employer as reimbursement out of the second
injury fund after the one-hundred-fourth week. As
a condition precedent to the liability of the
second injury fund, the employer shall, no earlier
than sixty days before the expiration of the
one-hundred-four-week period, notify the custodian
of the second injury fund that such payment is
required. The employer shall also furnish to the
custodian all information supporting the claim as
to liability of the second injury fund, and shall
make available to the custodian all medical
reports as the custodian shall request. The fund's
liability for the costs of the coverage shall
begin sixty days after the date the custodian is
so notified. Failure on the part of the employer
to comply does not relieve the employer of its
obligation to continue furnishing compensation
under the provisions of section 31-284b.
(f) On or after January 1, 1985, if an
employer removes all or substantially all of its
industrial or commercial operations to a location
outside the state of Connecticut or permanently
shuts down all its operations within a business
facility located in this state and fails to comply
with the provisions of section 31-284b, the cost
of accident and health insurance coverage for any
employee receiving compensation pursuant to this
chapter shall be paid out of the second injury
fund. The employee shall notify the custodian of
the second injury fund that coverage is needed
with due diligence upon notification to the
employee of the employer's failure to comply with
said section 31-284b. The fund shall be liable for
the cost of insurance coverage which is equivalent
to the coverage provided for the employee prior to
the relocation or shutdown of the employer's
operations. The fund's liability for the costs of
the coverage shall begin fifteen days after the
custodian is so notified and shall continue as
long as the individual receives compensation
pursuant to this chapter provided the fund shall
not be liable for any costs incurred by the
individual (1) prior to the date the notice is
received or (2) during the fifteen-day period
after the notice is received if the custodian
determines during such period that the individual
is ineligible for the costs of the coverage under
this subsection.
(g) The second injury fund shall be liable
for the cost of insurance coverage for any
employee being paid out of the second injury fund
on or after January 1, 1990, who was injured on or
after January 1, 1980, but before January 1, 1982,
and is otherwise eligible to be paid out of the
fund pursuant to subsection (f) of this section.
Sec. 25. Section 31-349a of the general
statutes is repealed and the following is
substituted in lieu thereof:
Any investigator in the investigations unit
of [office of the state treasurer] WORKERS'
COMPENSATION COMMISSION, when investigating
[second injury fund] claims which may violate the
requirements of this chapter and when
[investigating compliance by employers with the
provisions of section 31-284 at the direction of
the commissioner] CONDUCTING AN INVESTIGATION AT
THE REQUEST OF THE COMMISSION OR A COMMISSIONER,
shall have the powers, as described in section
54-1f, of a peace officer as defined in
subdivision (9) of section 53a-3.
Sec. 26. Section 31-354 of the general
statutes is repealed and the following is
substituted in lieu thereof:
There shall be a fund to be known as the
second injury fund. Each employer, other than the
state, shall, within thirty days after notice
given by the treasurer, pay to the state treasurer
for the use of the state a sum not to exceed five
per cent of the total amount of money expended by
the employer, by a private insurance carrier on
his behalf, by an interlocal risk management
agency on his behalf or by the fund pursuant to
section 31-355 in payment of his liability under
this chapter for the preceding calendar year. Any
employer who fails to pay the sum to the treasurer
within the time prescribed by this section shall
pay interest to the treasurer on the sum at the
rate of fifteen per cent per annum from the date
the sum should have been paid until the date of
payment. The treasurer shall notify each employer
of the penalty provision with the notice of
assessment. The assessment shall be levied by the
state treasurer at any time the balance remaining
in the fund is so reduced that he deems it
necessary to request further assessments to cover
expenditures and to maintain a reserve of one
million dollars but not to exceed five per cent
per assessment. Effective July 1, 1993, whenever
the assessment is levied, the treasurer shall pay
to the fund, on behalf of the state, a sum not to
exceed [five per cent of] the total amount of
money expended by the [state or by a private
insurance carrier] FUND on behalf of [the state in
payment of the liability of the state under this
chapter for the preceding calendar year] STATE
EMPLOYEES DURING THE PERIOD FOLLOWING THE LAST
ASSESSMENT. The sums received shall be kept
separate and apart from all other state moneys and
the faith and credit of the state of Connecticut
is pledged for their safekeeping. The treasurer
shall be the custodian of the fund and all
disbursements from the fund shall be made by him
or his deputies. The moneys of the fund shall be
invested by him in accordance with applicable law.
Interest, income and dividends from the
investments shall be credited to the fund. Each
employer, each private insurance carrier acting on
behalf of any employer and each interlocal risk
management agency acting on behalf of any employer
shall annually, on or before April first, report
to the treasurer, in the form prescribed by the
treasurer, the amount of money expended by or on
behalf of the employer in payments for the
preceding calendar year. The fund shall be used to
provide the benefits set forth in section 31-306,
AS AMENDED BY SECTION 15 OF THIS ACT, for
adjustments in the compensation rate and payment
of certain death benefits, in section 31-307b, AS
AMENDED BY SECTION 18 OF THIS ACT, for adjustments
where there are relapses after a return to work,
in section 31-307c for totally disabled persons
injured prior to October 1, 1953, in section
31-349, AS AMENDED BY SECTION 24 OF THIS ACT, for
disabled or handicapped employees and in section
31-355 for the payment of benefits due injured
employees whose employers or insurance carriers
have failed to pay the compensation, and medical
expenses required by this chapter, or any other
compensation payable from the fund as may be
required by any provision contained in this
chapter or any other statute and to reimburse
employers or insurance carriers for payments made
under subsection (b) of section 31-307a, AS
AMENDED BY SECTION 17 OF THIS ACT. The assessment
required by this section is a condition of doing
business in this state and failure to pay the
assessment, when due, shall result in the denial
of the privilege of doing business in this state
or to self-insure under section 31-284. Any
administrative or other costs or expenses incurred
by the treasurer in connection with carrying out
the provisions of this part, including the hiring
of necessary employees, shall be paid from the
fund.
Sec. 27. (NEW) Whenever an employer wilfully
and repeatedly fails to comply with the
requirements of chapter 568 of the general
statutes, as amended by this act, the attorney
general may bring a civil action in the superior
court for the judicial district of Hartford-New
Britain to enjoin the employer from conducting
business in this state until the employer fully
complies with the requirements of said chapter
568.
Sec. 28. (NEW) (a) In order to promote health
and safety in places of employment in this state,
each employer of twenty-five or more employees in
this state, including the state and any political
subdivision of the state, and each employer whose
rate of work related injury and illness exceeds
the average incidence rate of all industries in
this state, shall administer a safety and health
committee in accordance with regulations adopted
pursuant to subsection (b) of this section. For
purposes of this subsection, "incidence rate"
means the number of federal Occupational Safety
and Health Administration recordable injuries and
illnesses per one hundred full-time employees.
(b) The chairman of the workers' compensation
commission, in consultation with the labor
commissioner and in accordance with the provisions
of chapter 54 of the general statutes, shall adopt
regulations to carry out the provisions of this
section. The regulations shall (1) prescribe the
membership of safety and health committees to
ensure representation of employees and employers;
(2) specify the frequency of committee meetings;
(3) require employers to make, file and maintain
adequate written records of each committee meeting
subject to inspection by the chairman or his
authorized designee; (4) require employers to
compensate employee representatives at their
regular hourly wage while the employee
representatives are engaged in safety and health
committee training or are attending committee
meetings; (5) prescribe the duties and functions
of safety and health committees, which shall
include (A) establishing procedures for workplace
safety inspections by the committee, (B)
establishing procedures for investigating all
safety incidents, accidents, illnesses and deaths,
(C) evaluating accident and illness prevention
programs, (D) establishing training programs for
the identification and reduction of hazards in the
workplace which damage the reproductive systems of
employees, and (E) establishing training programs
to assist committee members in understanding and
identifying the effects of employee substance
abuse on workplace accidents and safety; and (6)
prescribe guidelines for the training of safety
and health committee members.
(c) Notwithstanding the provisions of this
section, each employer who, on the effective date
of this act, has an existing health and safety
program or other program determined by the
chairman of the workers' compensation commission
to be effective in the promotion of health and
safety in the workplace, shall not be required to
comply with this section. The chairman of the
workers' compensation commission, in consultation
with the labor commissioner, shall adopt
regulations, in accordance with the provisions of
chapter 54 of the general statutes, establishing
the criteria for evaluating such programs.
Sec. 29. (NEW) Not later than July 1, 1994,
the labor commissioner, in consultation with the
commissioner of health services shall issue
guidelines establishing standards for the use of
video display terminals by state employees. Such
standards shall include, but not be limited to:
(1) Maximum time limits that state employees may
be required to work with a video display terminal
without a rest break and the duration of the rest
break; (2) requirements for protective screens or
other safety devices; and (3) requirements
designed to reduce or eliminate the adverse
effects of repetitive motion in connection with
the use of such terminals.
Sec. 30. The chairman of the workers'
compensation commission, in consultation with the
commissioner of consumer protection and the
workers' compensation advisory board, shall study
the feasibility of establishing a system to review
and monitor the prescribing and dispensing of
schedule II and III controlled substances by
medical practitioners seeking reimbursement for
services rendered under chapter 568 of the general
statutes. The study shall consider (1) whether
prescription monitoring should be accomplished
using an electronic data transfer system to send
information required under section 21a-249 of the
general statutes related to the dispensing of
schedule II and III controlled substances to the
workers' compensation commission and the
department of consumer protection; (2)
establishing a medical review committee to assist
the commissioner of consumer protection and the
chairman of the workers' compensation commission
in reviewing information generated by the
monitoring system, together with the committee's
membership and function; (3) time limits for
transmitting the information; (4) the format of
the information; (5) issues of confidentiality;
(6) procedures for reviewing and monitoring the
prescription information; and (7) criteria for
exempting any practitioners from these
requirements. Not later than February 1, 1994, the
commissioner and the chairman shall report their
findings and recommendations to the joint standing
committees of the general assembly having
cognizance of matters relating to labor and public
employees and general law, in accordance with the
provisions of section 11-4a of the general
statutes.
Sec. 31. (a) The legislative program review
and investigations committee, in conjunction with
the joint standing committee of the general
assembly having cognizance of matters relating to
labor and public employees, shall conduct a study
of the second injury fund which shall include, but
not be limited to, (1) a determination of the
impact that dissolution of the fund would have on
businesses located in this state, (2) a
determination of the unfunded liability, (3) a
determination of the impact of the federal
Americans with Disabilities Act upon the fund, and
(4) an analysis of factors and conditions
associated with the explosive growth of the
workers' compensation system and its impact on the
second injury fund.
(b) Not later than January 1, 1994, the
legislative program review and investigations
committee and the joint standing committee of the
general assembly having cognizance of matters
relating to labor and public employees shall
report its findings to the general assembly, in
accordance with the provisions of section 11-4a of
the general statutes.
Sec. 32. (NEW) (a) On or before July 1, 1993,
each insurer writing workers' compensation
insurance in this state, either individually or
through a rating organization licensed pursuant to
section 38a-672 of the general statutes of which
the insurer is a member or subscriber, shall file
new voluntary pure premium and assigned risk rates
effective for the period July 1, 1993, to June 30,
1994, containing a nineteen per cent benefit level
reduction and allowing due consideration for
changes in loss costs based upon experience
updated through the end of 1992.
(b) Upon receipt of any rate filing made
under this section by a rating organization
licensed pursuant to section 38a-672 of the
general statutes, the insurance commissioner shall
conduct a public hearing regarding the filing and
consult with an independent actuary engaged for
the purpose of certifying the accuracy of the
benefit level reduction set forth in subsection
(a) of this section and determining whether the
filed rates are excessive, inadequate or unfairly
discriminatory as determined by the provisions of
section 38a-665 of the general statutes. The rates
approved for the period July 1, 1993 to June 30,
1994, shall reflect (i) the actual loss costs
experience through the end of 1992 and (ii) the
savings from benefit level reductions effective
July 1, 1993, as achieved by this act.
(c) Within thirty days of the insurance
commissioner's final decision regarding a filing
by a rating organization made pursuant to this
section, each insurer writing workers'
compensation insurance in this state shall file
revised rates for the voluntary market in
accordance with the provisions of section 38a-676
of the general statutes. Such revised rates shall
be applicable to all new and renewal workers'
compensation insurance policies effective on or
after July 1, 1993. For any policy in effect as of
June 30, 1993, during the period from July 1,
1993, through the end of the policy period, the
premium shall be reduced by a percentage which
equals the benefit level reduction certified
pursuant to subsection (b) of this section. With
respect to new and renewal policies effective on
or after July 1, 1993, and before the final
approval of the rates filed pursuant to this
subsection, each workers' compensation insurance
carrier shall, not later than forty-five days
after the rates approved pursuant to this section
become final, adjust the premium of such new or
renewal policy for the period after July 1, 1993,
to reflect the difference between the premium on
the policy as issued and the premium which
reflects the rates as finally approved, which
rates shall reflect the specific savings achieved
by this act.
Sec. 33. Not later than July 1, 1993, the
state shall commence negotiations with the State
Employees Bargaining Agent Coalition concerning
the establishment and administration of an
alternative work assignment program designed to
enable an injured state employee who is eligible
to receive workers' compensation benefits pursuant
to the provisions of chapter 568 of the general
statutes, as amended by this act, and whose
attending physician certifies that the injured
employee is unable to perform his usual work but
is able to perform other work, to be placed in a
suitable alternative work assignment within the
agency for which the injured employee performed
services prior to the date of his injury or within
any other state agency.
Sec. 34. Section 52-572r of the general
statutes is repealed.
Sec. 35. This act shall take effect July 1,
1993, except that subdivision (2) of subsection
(b) of section 21 and subsection (b) of section 22
shall take effect from passage.