SB1403 - 552R

Be it enacted by the Legislature of the State of Arizona:

Section 1. Section 23-947, Arizona Revised Statutes, is amended to read:

START_STATUTE23-947. Time within which hearing must be requested; definition

A. A hearing on any question relating to a claim shall not be granted unless the employee has previously filed an application for compensation within the time and in the manner prescribed by section 23-1061 or the insurance carrier has filed a compensation claim with the commission on behalf of the employee pursuant to section 23-1061 and the request for a hearing is filed within ninety days after the notice sent under section 23-1061, subsection F or within ninety days of notice of a determination by the commission, insurance carrier or self-insuring employer under section 23-1047 or 23-1061, except that an employer who is subject to and fails to comply with section 23-961 or 23-962 must file a request for a hearing within thirty days of after notice of a determination by the commission, or within ten days of after all other awards issued by the commission.

B. As used in For the purposes of this section, "filed" means that the request for a hearing is in the possession of the commission. Failure to file with the commission within the required time by a party means that the determination by the commission, insurance carrier or self-insuring employer is final and res judicata to all parties. The industrial commission or any court shall not excuse a late filing unless any of the following applies:

1. The person to whom the notice is sent does not request a hearing because of justifiable reliance on a representation by the commission, employer or insurance carrier. In For the purposes of this paragraph, "justifiable reliance" means that the person to whom the notice is sent has made reasonably diligent efforts to verify the representation, regardless of whether the representation is made pursuant to statutory or other legal authority.

2. At the time the notice is sent the person to whom it is sent is suffering from insanity or legal incompetence or incapacity, including minority.

3. The person to whom the notice is sent shows by clear and convincing evidence that the notice was not received.

C. The late filing shall not be excused under subsection B of this section if the person to whom the notice is sent or the person's legal counsel knew or, with the exercise of reasonable care and diligence, should have known of the fact of the notice at any time during the filing period. END_STATUTE

Sec. 2. Section 23-1043.04, Arizona Revised Statutes, is amended to read:

START_STATUTE23-1043.04. Methicillin-resistant staphylococcus aureus; spinal meningitis; tuberculosis; establishing exposure; definitions

A. A claim for a condition, infection, disease or disability involving or related to methicillin-resistant staphylococcus aureus, spinal meningitis or tuberculosis shall include the occurrence of a significant exposure as defined in this section and, except as provided in subsection B of this section, shall be processed and determined under this chapter and applicable principles of law.

B. Notwithstanding any other law, an employee who satisfies the following criteria presents a prima facie claim for a condition, infection, disease or disability involving or related to methicillin-resistant staphylococcus aureus, spinal meningitis or tuberculosis if the medical evidence shows to a reasonable degree of medical probability that the employee sustained a significant exposure within the meaning of this section:

1. The employee's regular course of employment involves handling of or exposure to methicillin-resistant staphylococcus aureus, spinal meningitis or tuberculosis.

2. Within thirty calendar days after a possible significant exposure that arises out of and in the course of employment, the employee reports in writing to the employer the details of the exposure. The employer shall notify its insurance carrier or claims processor of the report. Failure of the employer to notify the insurance carrier is not a defense to a claim by the employee.

3. For a claim involving methicillin-resistant staphylococcus aureus, the employee must be diagnosed with methicillin-resistant staphylococcus aureus within fifteen days after the employee reports pursuant to paragraph 2 of this subsection.

4. For a claim involving spinal meningitis, the employee is diagnosed with spinal meningitis within two to eighteen days of after the possible significant exposure.

5. For a claim involving tuberculosis, the employee is diagnosed with tuberculosis within twelve weeks of after the possible significant exposure.

C. On presentation or showing of a prima facie claim under this section, the employer may produce specific, relevant and probative evidence to dispute the underlying facts, to contest whether the exposure was significant as defined in this section or to establish an alternative significant exposure involving the presence of methicillin-resistant staphylococcus aureus, spinal meningitis or tuberculosis.

D. A person alleged to be a source of a significant exposure shall not be compelled by subpoena or other court order to release confidential information relating to methicillin-resistant staphylococcus aureus, spinal meningitis or tuberculosis either by document or by oral testimony. Evidence of the alleged source's methicillin-resistant staphylococcus aureus, spinal meningitis or tuberculosis status may be introduced by either party if the alleged source knowingly and willingly consents to the release of that information.

E. Notwithstanding title 36, chapter 6, article 4, medical information regarding the employee obtained by a physician or surgeon is subject to section 23-908, subsection D.

F. The commission by rule shall prescribe requirements and forms regarding employee notification of the requirements of this section and the proper documentation of a significant exposure.

G. Notwithstanding any other law, expenses for postexposure evaluation and follow-up, including reasonably required prophylactic treatment, for spinal meningitis or tuberculosis, shall be a medical benefit under section 23-1061 or 23-1062 for any significant exposure that arises out of and in the course of employment if the employee files a claim under this article for the significant exposure, or the employee reports in writing to the employer the details of the exposure or the insurance carrier files a compensation claim with the commission on behalf of the employee pursuant to section 23-1061. Providing postexposure evaluation and follow-up, including prophylactic treatment, does not constitute acceptance of a claim for a condition, infection, disease or disability involving or related to the significant exposure.

H. For the purposes of this section:

1. "Employee" means firefighters, law enforcement officers, corrections officers, probation officers, emergency medical technicians and paramedics who are not employed by a health care institution as defined in section 36-401.

2. "Significant exposure":

(a) Means exposure in the course of employment to aerosolized bacteria for claims under this section relating to methicillin-resistant staphylococcus aureus, spinal meningitis or tuberculosis. Significant exposure

(b) Includes exposure in the course of employment to bodily fluids or skin for claims under this section relating to methicillin-resistant staphylococcus aureus. END_STATUTE

Sec. 3. Section 23-1061, Arizona Revised Statutes, is amended to read:

START_STATUTE23-1061. Notice of accident; form of notice; claim for compensation; reopening; payment of compensation

A. Notwithstanding section 23-908, subsection E, no claim for compensation shall be valid or enforceable unless the claim is filed with the commission or the insurance carrier by the employee, or if resulting in death by the parties entitled to compensation, or someone on their behalf, in writing within one year after the injury occurred or the right thereto accrued. The time for filing a compensation claim begins to run when the injury becomes manifest or when the claimant knows or in the exercise of reasonable diligence should know that the claimant has sustained a compensable injury. Except as provided in subsection B of this section, neither the commission nor any court shall have jurisdiction to consider a claim that is not timely filed under this subsection, except if the employee or other party entitled to file the claim has delayed in doing so because of justifiable reliance on a material representation by the commission, employer or insurance carrier or if the employee or other party entitled to file the claim is insane or legally incompetent or incapacitated at the time the injury occurs or the right to compensation accrues or during the one-year period thereafter. If the insanity or legal incompetence or incapacity occurs after the one-year period has commenced, the running of the remainder of the one-year period shall be suspended during the period of insanity or legal incompetence or incapacity. If the employee or other party is insane or legally incompetent or incapacitated when the injury occurs or the right to compensation accrues, the one-year period commences to run immediately on the termination of insanity or legal incompetence or incapacity. The commission on receiving a claim shall give notice to the insurance carrier. An insurance carrier shall file a compensation claim with the commission on behalf of any employee who files a workers' compensation claim with the insurance carrier.

B. Failure of an employee or any other party entitled to compensation to file a claim with the commission or the insurance carrier within one year or to comply with section 23-908 shall not bar a claim if the insurance carrier or employer has commenced payment of compensation benefits under section 23-1044, 23-1045 or 23-1046, except that the payments provided for by section 23-1046, subsection A, paragraph 1 and section 23-1065, subsection A shall not be considered compensation benefits for the purposes of this section.

C. If the commission receives a notification of the injury, the commission shall send a claim form to the employee.

D. The issue of failure to file a claim must be raised at the first hearing on a claim for compensation in respect to the injury or death.

E. Within ten days after receiving notice of an accident, the employer shall inform the employer's insurance carrier and the commission on such forms as may be prescribed by the commission.

F. Each insurance carrier and self-insuring employer shall report to the commission a notice of the first payment of compensation and shall serve on the commission and the employee any denial of a claim, any change in the amount of compensation and the termination thereof of compensation, except that claims for medical, surgical and hospital benefits that are not denied shall be reported to the commission in the form and manner determined by the commission. In all cases where compensation is payable, the insurance carrier or self-insuring employer shall promptly determine the average monthly wage pursuant to section 23-1041. Within thirty days of after the payment of the first installment of compensation, the insurance carrier or self-insuring employer shall notify the employee and commission of the average monthly wage of the claimant as calculated, and the basis for such determination. The commission shall then make its own independent determination of the average monthly wage pursuant to section 23-1041. The commission, within thirty days after receipt of such notice, shall notify the employee, employer and insurance carrier of such determination. The amount determined by the commission shall be payable retroactive to the first date of entitlement. The first payment of compensation shall be accompanied by a notice on a form prescribed by the commission stating the manner in which the amount of compensation was determined.

G. Except as otherwise provided by law, the insurance carrier or self-insuring employer shall process and pay compensation and provide medical, surgical and hospital benefits, without the necessity for the making of an award or determination by the commission.

H. On a claim that has been previously accepted, an employee may reopen the claim to secure an increase or rearrangement of compensation or additional benefits by filing with the commission a petition requesting the reopening of the employee's claim on the basis of a new, additional or previously undiscovered temporary or permanent condition, which petition shall be accompanied by a statement from a physician setting forth the physical condition of the employee relating to the claim. A claim shall not be reopened if the initial claim for compensation was previously denied by a notice of claim status or determination by the commission and the notice or determination was allowed to become final and no exception applies under section 23-947 excusing a late filing to request a hearing. A claim shall not be reopened because of increased subjective pain if the pain is not accompanied by a change in objective physical findings. A claim shall not be reopened solely for additional diagnostic or investigative medical tests, but expenses for any reasonable and necessary diagnostic or investigative tests that are causally related to the injury shall be paid by the employer or the employer's insurance carrier. Expenses for reasonable and necessary medical and hospital care and laboratory work shall be paid by the employer or the employer's insurance carrier if the claim is reopened as provided by law and if these expenses are incurred within fifteen days after the date that the petition to reopen is filed. The payment for such reasonable and necessary medical, hospital and laboratory work expense shall be paid for by the employer or the employer's insurance carrier if the claim is reopened as provided by law and if such expenses are incurred within fifteen days after the filing of the petition to reopen. Surgical benefits are not payable for any period prior to before the date of filing a petition to reopen, except that surgical benefits are payable for a period prior to before the date of filing the petition to reopen not to exceed seven days if a bona fide medical emergency precludes the employee from filing a petition to reopen prior to before the surgery. No monetary compensation is payable for any period prior to before the date of filing the petition to reopen.

I. On the filing of a petition to reopen a claim, the commission shall in writing notify the employer's insurance carrier or the self-insuring employer, which shall in writing notify the commission and the employee within twenty-one days after the date of such notice of its acceptance or denial of the petition. The reopened claim shall be processed thereafter in like manner as a new claim.

J. The commission shall investigate and review any claim in which it appears to the commission that the claimant has not been granted the benefits to which such claimant is entitled. If the commission determines that payment or denial of compensation is improper in any way, it shall hold a hearing pursuant to section 23-941 within sixty days after receiving notice of such impropriety. Any claim for temporary partial disability benefits under this subsection must be filed with the commission within two years after the date the claimed entitlement to compensation accrued or within two years after the date on which an award for benefits encompassing the entitlement period becomes final. A claim for temporary partial disability compensation shall be deemed to accrue when the employee knew or with the exercise of reasonable diligence should have known that the insurance carrier, self-insured employer or special fund denied or improperly paid compensation. A claim for temporary partial disability benefits shall not be deemed to have accrued any earlier than September 26, 2008.

K. When there is a dispute as to which employer or insurance carrier is liable for the payment of a compensable claim, the commission, by order, may designate the employer or insurance carrier that shall pay the claim. Payment shall begin within fourteen days after the employer or insurance carrier has been ordered by the commission to commence payment. When a final determination has been made as to which employer or insurance carrier is actually liable, the commission shall direct any necessary monetary adjustment or reimbursement among the parties or insurance carriers involved.

L. On application to the commission and for good cause shown, the commission may direct that a document filed as a claim for compensation benefits be designated as a petition to reopen, effective as of the original date of filing. In like manner on application and good cause shown, the commission may direct that a document filed as a petition to reopen be designated as a claim for compensation benefits, effective as of the original date of filing.

M. N. If the insurance carrier or self-insurer does not issue a notice of claim status denying the claim within twenty-one days after the date the insurance carrier is notified by the commission of a claim or of a petition to reopen, the insurance carrier shall pay immediately compensation as if the claim were accepted, from the date the insurance carrier is notified by the commission of a claim or petition to reopen until the date on which the insurance carrier issues a notice of claim status denying such claim. Compensation includes medical, surgical and hospital benefits. This section shall not apply to cases involving seven days or less of time lost from work. END_STATUTE