Bill Text: MI HB5089 | 2017-2018 | 99th Legislature | Introduced

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Bill Title: Worker's compensation; disabilities; disabilities; presumption of occupational causation; add breast cancer. Amends sec. 405 of 1969 PA 317 (MCL 418.405).

Spectrum: Partisan Bill (Democrat 1-0)

Status: (Introduced - Dead) 2017-10-12 - Bill Electronically Reproduced 10/11/2017 [HB5089 Detail]

Download: Michigan-2017-HB5089-Introduced.html

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HOUSE BILL No. 5089

 

 

October 11, 2017, Introduced by Reps. Brinks, Sabo, Elder, Sneller, Schor, Gay-Dagnogo, Yanez, Durhal, Sowerby, Hoadley, Wittenberg, Hammoud, LaGrand, Lucido, Pagan, Zemke, Greimel, Hertel and Jones and referred to the Committee on Insurance.

 

     A bill to amend 1969 PA 317, entitled

 

"Worker's disability compensation act of 1969,"

 

by amending section 405 (MCL 418.405), as amended by 2014 PA 515.

 

THE PEOPLE OF THE STATE OF MICHIGAN ENACT:

 

     Sec. 405. (1) In the case of For a member of a fully paid fire

 

department of an airport operated by a county, public airport

 

authority, or state university or college; a member of a fully paid

 

fire or police department of a city, township, or incorporated

 

village employed and compensated upon on a full-time basis; a

 

member of a fully paid public fire authority employed and

 

compensated upon on a full-time basis; a county sheriff and the

 

deputies of the county sheriff; a member of the state police; a

 

conservation officer; or an officer of the motor carrier

 

enforcement division of the department of state police, "personal

 

injury" includes respiratory and heart diseases, or illnesses

 

resulting therefrom, from respiratory and heart diseases, that

 

develop or manifest themselves during a period while the member of

 

the department is in the active service of the department and that

 

result from the performance of duties for the department.

 

     (2) A member of a fully paid fire department or public fire

 

authority who is in active service of the fire department or public

 

fire authority, has been employed 60 months or more in the active

 

service of the department or public fire authority at the time the

 

cancer manifests itself, and is exposed to the hazards incidental

 

to fire suppression, rescue, or emergency medical services in the

 

performance of his or her work-related duties with the department

 

or authority shall suspend a claim against his or her employer

 

under this act and may claim like benefits from the first responder

 

presumed coverage fund created under subsection (6) for any

 

respiratory tract, bladder, skin, brain, kidney, blood, thyroid,

 

testicular, prostate, breast, or lymphatic cancer. The cancers

 

described in this subsection are presumed to arise out of and in

 

the course of employment only with respect to a claim against the

 

fund and in the absence of non-work-related causation or specific

 

incidents that establish a cause independent of the employment.

 

Neither mere evidence that the condition was preexisting, nor an

 

abstract medical opinion that the employment was not the cause of

 

the disease or condition, is sufficient to overcome the presumption

 

for purposes of a claim against the first responder presumed

 

coverage fund. The presumption under this subsection may be

 

rebutted by scientific evidence that the member of the fully paid

fire department or public fire authority was a substantial and

 

consistent user of cigarettes or other tobacco products within the

 

10 years immediately preceding the date of injury, and that this

 

use was a significant factor in the cause, aggravation, or

 

progression of the cancer. The suspension of the member's claim

 

against his or her employer under this subsection is in effect only

 

during the period the member receives like benefits from the first

 

responder presumed coverage fund. If a redemption agreement between

 

the first responder presumed coverage fund and the claimant is

 

approved, the suspension of a claim against an employer under this

 

subsection continues indefinitely. A claimant may not receive

 

benefits covering the same time period from both the first

 

responder presumed coverage fund and the employer. The presumption

 

created in this subsection applies only to a claim for like

 

benefits against the first responder presumed coverage fund.

 

     (3) Respiratory and heart diseases or illnesses resulting

 

therefrom from respiratory and heart diseases as described in

 

subsection (1) are presumed to arise out of and in the course of

 

employment in the absence of evidence to the contrary.

 

     (4) As a condition precedent to filing an application for

 

benefits, a claimant described in subsection (1) or a claimant

 

under subsection (2) shall first apply for and do all things

 

necessary to qualify for any pension benefits to which he or she,

 

or his or her decedent, may be entitled or shall demonstrate that

 

he or she, or his or her decedent, is ineligible for any pension

 

benefits. If a final determination is made that pension benefits

 

shall must not be awarded or that the claimant or his or her

decedent is ineligible for any pension benefits, then the

 

presumption designation of "personal injury" as provided in

 

subsection (1) or the presumption under subsection (2) applies. The

 

employer or employee may request 2 copies of the determination

 

denying pension benefits, 1 copy of which shall must be filed with

 

the workers' compensation agency upon on request.

 

     (5) If an employee described in subsection (1) or (2) is

 

eligible for any pension benefits, that eligibility does not

 

prohibit the employee or dependents of that employee from receiving

 

benefits under section 315 for the medical expenses or portion of

 

medical expenses that are not provided for by the pension program.

 

     (6) The first responder presumed coverage fund is created as a

 

separate fund in the state treasury. The state treasurer may

 

receive money or other assets from any source for deposit into the

 

fund. The state treasurer shall direct the investment of the fund.

 

The state treasurer shall credit to the fund interest and earnings

 

from fund investments. The director shall be is the administrator

 

of the fund for auditing purposes. The director shall expend money

 

from the fund only for the purpose of paying claims authorized

 

under subsection (2) and costs of administration. The department of

 

treasury shall cause to be paid from the first responder presumed

 

coverage fund those amounts and at those times as are prescribed by

 

the director to pay claims under subsection (2) pursuant to under

 

this subsection and subsection (7). Money in the fund at the close

 

of the fiscal year shall must remain in the fund and shall must not

 

lapse to the general fund. If there is insufficient money in the

 

fund to pay claims authorized under subsection (2), claims that are

approved but not paid shall must be paid if fund revenues become

 

available, and those claims shall must be paid before subsequently

 

approved claims. The director shall develop and implement a process

 

to notify the legislature that money in the first responder

 

presumed coverage fund may be insufficient to cover future claims

 

when the director reasonably believes that within 60 days the money

 

in the fund will be insufficient to pay claims. The process shall,

 

must, at a minimum, do all of the following:

 

     (a) Identify a specific date by which the money in the fund

 

will become insufficient to pay claims.

 

     (b) Outline a clear process indicating the order in which

 

claims pending with the fund will be paid.

 

     (c) Outline a clear process indicating the order in which

 

claims that were pending with the fund when money became

 

insufficient will be paid, if money subsequently becomes available.

 

     (7) The director shall develop the application, approval, and

 

compliance process necessary to operate and manage the first

 

responder presumed coverage fund. The director shall develop and

 

implement the use of an application form to be used by a claimant

 

for benefits payable by the fund under subsection (2). When a claim

 

under subsection (2) is received, the director shall notify the

 

employer against whom a claim is suspended or the carrier. The

 

employer or carrier may access all information the agency receives

 

respecting the claim and may request that the agency obtain

 

specific additional information. The fund standards, guidelines,

 

templates, and any other forms used by the director to implement

 

the first responder presumed coverage fund shall must be posted and

maintained on the department's website. The director shall review

 

and consider claims in the order in which they are received and

 

shall approve or deny a claim within 30 days after receipt of the

 

claim.

 

     (8) The director shall submit an annual report to the state

 

budget director and the senate and house of representatives

 

standing committees on appropriations not later than April 1 of

 

each year that includes, but is not limited to, all of the

 

following:

 

     (a) The total number of claims received under the first

 

responder presumed coverage fund in the immediately preceding

 

calendar year.

 

     (b) The number of claims approved and the total dollar amount

 

of claims paid by the first responder presumed coverage fund in the

 

immediately preceding calendar year.

 

     (c) The costs of administering the first responder presumed

 

coverage fund in the immediately preceding calendar year.

 

     (9) The department shall not implement the first responder

 

presumed coverage fund until the legislature has appropriated money

 

to the fund.

 

     (9) (10) By March 31 of each year, the worker's compensation

 

agency shall report to the chairs of the appropriations committees

 

of the senate and the house of representatives the estimated amount

 

of both of the following:

 

     (a) The anticipated cost of benefits in the next fiscal year

 

for claims authorized under subsection (2) and payable by the first

 

responder presumed coverage fund.

     (b) The amount of any anticipated shortfall in the first

 

responder presumed coverage fund that would prevent payment of

 

claims under subsection (6) for the current fiscal year.

 

     (10) (11) The first responder presumed coverage fund has the

 

same rights under this act as an employer or carrier.

 

     Enacting section 1. This amendatory act takes effect 90 days

 

after the date it is enacted into law.