WEST virginia Legislature
2016 regular session
Senate Bill 616
By Senators Boso, Ashley, Blair, Kirkendoll, Sypolt, Walters, Yost and Ferns
Referred to the Committee on the Judiciary; and then to the Committee on Finance.]
A BILL to amend and reenact §23-4-1 of the Code of West Virginia, 1931, as amended, relating to workers compensation disability and death benefits; defining “professional firefighter”; and requiring the Insurance Commissioner to study the effects of the rebuttable presumptions created on the premiums charged for workers' compensation for professional firefighters and the overall impact of the risk management programs, wage replacement, premium calculation for the cost providing coverage and the separation of professional firefighter functions from nonactive, nonfirefighting or support functions in volunteer fire departments.
Be it enacted by the Legislature of West Virginia:
That §23-4-1 of the Code of West Virginia, 1931, as amended, be amended and reenacted to read as follows:
ARTICLE 4. Disability and Death Benefits.
'23-4-1. To whom compensation fund disbursed; occupational pneumoconiosis and other occupational diseases included in “injury” and “personal injury”; definition of occupational pneumoconiosis and other occupational diseases; rebuttable presumption for cardiovascular injury and disease or pulmonary disease for firefighters.
(a) Subject to the provisions and limitations elsewhere in this chapter, workers compensation benefits shall be paid the Workers Compensation Fund, to the employees of employers subject to this chapter who have received personal injuries in the course of and resulting from their covered employment or to the dependents, if any, of the employees in case death has ensued, according to the provisions hereinafter made: Provided, That in the case of any employees of the state and its political subdivisions, including: Counties; municipalities; cities; towns; any separate corporation or instrumentality established by one or more counties, cities or towns as permitted by law; any corporation or instrumentality supported in most part by counties, cities or towns; any public corporation charged by law with the performance of a governmental function and whose jurisdiction is coextensive with one or more counties, cities or towns; any agency or organization established by the Department of Mental Health for the provision of community health or mental retardation services and which is supported, in whole or in part, by state, county or municipal funds; board, agency, commission, department or spending unit, including any agency created by rule of the Supreme Court of Appeals, who have received personal injuries in the course of and resulting from their covered employment, the employees are ineligible to receive compensation while the employees are at the same time and for the same reason drawing sick leave benefits. The state employees may only use sick leave for nonjob-related absences consistent with sick leave use and may draw workers compensation benefits only where there is a job-related injury. This proviso shall not apply to permanent benefits: Provided, however, That the employees may collect sick leave benefits until receiving temporary total disability benefits. The Division of Personnel shall promulgate rules pursuant to article three, chapter twenty-nine-a of this code relating to use of sick leave benefits by employees receiving personal injuries in the course of and resulting from covered employment: Provided further, That in the event an employee is injured in the course of and resulting from covered employment and the injury results in lost time from work and the employee for whatever reason uses or obtains sick leave benefits and subsequently receives temporary total disability benefits for the same time period, the employee may be restored sick leave time taken by him or her as a result of the compensable injury by paying to his or her employer the temporary total disability benefits received or an amount equal to the temporary total disability benefits received. The employee shall be restored sick leave time on a day-for-day basis which corresponds to temporary total disability benefits paid to the employer: And provided further, That since the intent of this subsection is to prevent an employee of the state or any of its political subdivisions from collecting both temporary total disability benefits and sick leave benefits for the same time period, nothing in this subsection prevents an employee of the state or any of its political subdivisions from electing to receive either sick leave benefits or temporary total disability benefits, but not both.
(b) For the purposes of this chapter, the terms
(1) “Injury” and “personal injury” include occupational pneumoconiosis and any other occupational disease, as hereinafter defined, and workers compensation benefits shall be paid to the employees of the employers in whose employment the employees have been exposed to the hazards of occupational pneumoconiosis or other occupational disease and in this state have contracted occupational pneumoconiosis or other occupational disease, or have suffered a perceptible aggravation of an existing pneumoconiosis or other occupational disease, or to the dependents, if any, of the employees, in case death has ensued, according to the provisions hereinafter made: Provided, That compensation shall not be payable for the disease of occupational pneumoconiosis, or death resulting from the disease, unless the employee has been exposed to the hazards of occupational pneumoconiosis in the State of West Virginia over a continuous period of not less than two years during the ten years immediately preceding the date of his or her last exposure to such hazards, or for any five of the fifteen years immediately preceding the date of his or her last exposure. An application for benefits on account of occupational pneumoconiosis shall set forth the name of the employer or employers and the time worked for each. The commission may allocate to and divide any charges resulting from such claim among the employers by whom the claimant was employed for as much as sixty days during the period of three years immediately preceding the date of last exposure to the hazards of occupational pneumoconiosis. The allocation shall be based upon the time and degree of exposure with each employer; and
(2) “Professional firefighter” means a member of a fire department that has received not less than the minimum education and training as provided in section five-d, article three, chapter twenty-nine of this code and performs functions for suppressing fire, performing rescue, controlling hazardous material releases and other related duties regardless of compensation as a volunteer or career firefighter.
(c) For the purposes of this chapter, disability or death resulting from occupational pneumoconiosis, as defined in subsection (d) of this section, shall be treated and compensated as an injury by accident.
(d) Occupational pneumoconiosis is a disease of the lungs caused by the inhalation of minute particles of dust over a period of time due to causes and conditions arising out of and in the course of the employment. The term “occupational pneumoconiosis” includes, but is not limited to, such diseases as silicosis, anthracosilicosis, coal workers pneumoconiosis, commonly known as black lung or miners asthma, silicotuberculosis (silicosis accompanied by active tuberculosis of the lungs), coal workers pneumoconiosis accompanied by active tuberculosis of the lungs, asbestosis, siderosis, anthrax and any and all other dust diseases of the lungs and conditions and diseases caused by occupational pneumoconiosis which are not specifically designated in this section meeting the definition of occupational pneumoconiosis set forth in this subsection.
(e) In determining the presence of occupational pneumoconiosis, X-ray evidence may be considered, but shall not be accorded greater weight than any other type of evidence demonstrating occupational pneumoconiosis.
(f) For the purposes of this chapter, occupational disease means a disease incurred in the course of and resulting from employment. No ordinary disease of life to which the general public is exposed outside of the employment is compensable except when it follows as an incident of occupational disease as defined in this chapter. Except in the case of occupational pneumoconiosis, a disease shall be considered to have been incurred in the course of or to have resulted from the employment only if it is apparent to the rational mind, upon consideration of all the circumstances: (1) That there is a direct causal connection between the conditions under which work is performed and the occupational disease; (2) that it can be seen to have followed as a natural incident of the work as a result of the exposure occasioned by the nature of the employment; (3) that it can be fairly traced to the employment as the proximate cause; (4) that it does not come from a hazard to which workmen would have been equally exposed outside of the employment; (5) that it is incidental to the character of the business and not independent of the relation of employer and employee; and (6) that it appears to have had its origin in a risk connected with the employment and to have flowed from that source as a natural consequence, though it need not have been foreseen or expected before its contraction: Provided, That compensation shall not be payable for an occupational disease or death resulting from the disease unless the employee has been exposed to the hazards of the disease in the State of West Virginia over a continuous period that is determined to be sufficient, by rule of the board of managers, for the disease to have occurred in the course of and resulting from the employees employment. An application for benefits on account of an occupational disease shall set forth the name of the employer or employers and the time worked for each. The commission may allocate to and divide any charges resulting from such claim among the employers by whom the claimant was employed. The allocation shall be based upon the time and degree of exposure with each employer.
(g) No award shall be made under the provisions of this chapter for any occupational disease contracted prior to July 1, 1949. An employee shall be considered to have contracted an occupational disease within the meaning of this subsection if the disease or condition has developed to such an extent that it can be diagnosed as an occupational disease.
(h) (1) For purposes of this chapter, a rebuttable presumption that a professional firefighter who has developed a cardiovascular or pulmonary disease or sustained a cardiovascular injury has received an injury or contracted a disease arising out of and in the course of his or her employment exists if: (i) The person has been actively employed by a fire department as a professional firefighter for a minimum of two years prior to the cardiovascular injury or onset of a cardiovascular or pulmonary disease or death; and (ii) the injury or onset of the disease or death occurred within six months of having participated in firefighting or a training or drill exercise which actually involved firefighting. When the above conditions are met, it shall be presumed that sufficient notice of the injury, disease or death has been given and that the injury, disease or death was not self inflicted.
(2) The Insurance
Commissioner shall study the effects of the rebuttable presumptions created in
this subsection on the premiums charged for workers compensation for
municipal firefighters; the probable effects of
extending these presumptions to volunteer firefighters; and the overall
impact of the risk management programs, wage replacement, premium calculation, the
number of hours worked per volunteer, treatment of nonactive, nonfirefighting
or support functions A social @ members of
a volunteer crew fire department and the feasibility of combining
various volunteer fire departments under a single policy on the
availability and cost of providing worker’s compensation coverage to volunteer
professional firefighter functions in volunteer fire departments and
separating individuals providing nonactive, nonfirefighting or support
functions in volunteer fire departments. The Insurance Commissioner shall
file the report with the Joint Committee on Government and Finance no later
than December 1, 2008 November 1, 2016.
(i) Claims for occupational disease as defined in subsection (f) of this section, except occupational pneumoconiosis for all workers and pulmonary disease and cardiovascular injury and disease for professional firefighters, shall be processed in like manner as claims for all other personal injuries.
(j) On or before January 1, 2004, the Workers Compensation Commission shall adopt standards for the evaluation of claimants and the determination of a claimants degree of whole-body medical impairment in claims of carpal tunnel syndrome.
NOTE: The purpose of this bill is relating to; define “professional firefighter” for purposes of Workers Compensation disability and death benefits and to require the Insurance Commissioner to study the effects of the rebuttable presumptions created in this section on the premiums charged for workers' compensation for professional firefighters and the overall impact of the risk management programs, wage replacement, premium calculation for the cost providing coverage to professional firefighters and the separation of professional firefighter functions from nonactive, nonfirefighting or support functions in volunteer fire departments.
Strike-throughs indicate language that would be stricken from a heading or the present law and underscoring indicates new language that would be added.