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Sponsors: Reps. Cato, Harrell, Sandifer, Leach, Walker, Loftis, Bingham, Townsend, Simrill, Haley, Anthony, Littlejohn, Davenport, Clark, Taylor, Young, Vaughn, Witherspoon, Bailey, Barfield, Battle, Ceips, Chalk, Chellis, Clemmons, Cooper, Dantzler, Duncan, Edge, Hamilton, Herbkersman, Hinson, Hiott, Huggins, Kirsh, McCraw, Norman, Owens, Perry, E.H. Pitts, Rice, Scarborough, Skelton, D.C. Smith, G.M. Smith, G.R. Smith, J.R. Smith, Stewart, Tripp, White, Thompson, Mitchell, Mahaffey, Hagood and Cotty
Document Path: l:\council\bills\dka\3536dw06.doc
Introduced in the House on January 12, 2006
Introduced in the Senate on April 11, 2006
Last Amended on April 5, 2006
Currently residing in the Senate Committee on Judiciary
Summary: Workers' Compensation
HISTORY OF LEGISLATIVE ACTIONS
Date Body Action Description with journal page number ------------------------------------------------------------------------------- 1/12/2006 House Introduced and read first time HJ-23 1/12/2006 House Referred to Committee on Labor, Commerce and Industry HJ-25 1/17/2006 House Member(s) request name removed as sponsor: Toole 1/18/2006 House Member(s) request name added as sponsor: White 2/8/2006 House Member(s) request name added as sponsor: Thompson 2/14/2006 House Member(s) request name added as sponsor: Mitchell 2/21/2006 House Member(s) request name added as sponsor: Bowers 3/15/2006 House Member(s) request name added as sponsor: Mahaffey 3/15/2006 House Committee report: Favorable with amendment Labor, Commerce and Industry HJ-96 3/15/2006 Scrivener's error corrected 3/16/2006 House Member(s) request name removed as sponsor: Bowers 3/16/2006 House Requests for debate-Rep(s). Chellis, Thompson, Weeks, Sandifer, Emory, Cotty, Cato, Leach, Hamilton, Bannister, Scarborough, Davenport, Hiott, Skelton, Mahaffey, Coates, JH Neal, Howard, Jefferson, and Dantzler HJ-22 3/16/2006 Scrivener's error corrected 3/22/2006 House Debate adjourned until Tuesday, April 4, 2006 HJ-23 4/5/2006 House Member(s) request name added as sponsor: Hagood, Cotty 4/5/2006 House Amended HJ-32 4/5/2006 House Read second time HJ-90 4/5/2006 House Roll call Yeas-92 Nays-16 HJ-90 4/6/2006 House Read third time and sent to Senate HJ-41 4/6/2006 Scrivener's error corrected 4/11/2006 Senate Introduced and read first time SJ-10 4/11/2006 Senate Referred to Committee on Judiciary SJ-10 4/11/2006 Senate Referred to Subcommittee: Martin (ch), Ford, Rankin, Elliott, Hutto, Ritchie, Bryant, Lourie
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VERSIONS OF THIS BILL
Indicates Matter Stricken
Indicates New Matter
April 5, 2006
Introduced by Reps. Cato, Harrell, Sandifer, Leach, Walker, Loftis, Bingham, Townsend, Simrill, Haley, Anthony, Littlejohn, Davenport, Clark, Taylor, Young, Vaughn, Witherspoon, Bailey, Barfield, Battle, Ceips, Chalk, Chellis, Clemmons, Cooper, Dantzler, Duncan, Edge, Hamilton, Herbkersman, Hinson, Hiott, Huggins, Kirsh, McCraw, Norman, Owens, Perry, E.H. Pitts, Rice, Scarborough, Skelton, D.C. Smith, G.M. Smith, G.R. Smith, J.R. Smith, Stewart, Tripp, White, Thompson, Mitchell, Mahaffey, Hagood and Cotty
S. Printed 4/5/06--H. [SEC 4/6/06 3:17 PM]
Read the first time January 12, 2006.
TO AMEND THE CODE OF LAWS OF SOUTH CAROLINA, 1976, BY ADDING SECTION 42-1-180 SO AS TO DEFINE "PROFESSIONAL SPORTS TEAM PLAYER" FOR PURPOSES OF THE SOUTH CAROLINA WORKERS' COMPENSATION LAW; BY ADDING SECTION 42-1-378 SO AS TO ELIMINATE CONCURRENT JURISDICTION BETWEEN THE SOUTH CAROLINA WORKERS' COMPENSATION ACT AND THE FEDERAL EMPLOYERS' LIABILITY ACT, THE LONGSHORE AND HARBOR WORKERS' COMPENSATION ACT, OR ANY OF ITS EXTENSIONS, AND THE JONES ACT; BY ADDING SECTION 42-7-315 SO AS TO PROVIDE FOR THE ORDERLY DISSOLUTION OF THE SECOND INJURY FUND AND TO PROVIDE FOR SUBSEQUENT ACTIONS TO BE TAKEN BY THE BUDGET AND CONTROL BOARD RELATING TO THE WINDING DOWN OF OPERATIONS OF THE FUND; BY ADDING SECTION 42-15-85 SO AS TO PROVIDE THAT THE BURDEN OF PROOF IS ON THE EMPLOYEE, AND TO PROVIDE HOW CAUSATION IN MEDICALLY COMPLEX WORKERS' COMPENSATION CASES MUST BE PROVEN, TO PROVIDE AN EXCEPTION, AND TO DEFINE "EXPERT WITNESS" FOR PURPOSES OF THIS SECTION; BY AMENDING SECTION 38-55-530, AS AMENDED, RELATING TO DEFINITIONS AS USED IN OMNIBUS INSURANCE FRAUD AND REPORTING IMMUNITY ACT, SO AS TO FURTHER DEFINE "FALSE STATEMENT AND MISREPRESENTATION"; BY AMENDING SECTION 38-55-540, RELATING TO CRIMINAL PENALTIES FOR MAKING FALSE STATEMENTS OR MISREPRESENTATIONS, SO AS TO PROVIDE REVISED CRIMINAL PENALTIES FOR MAKING FALSE STATEMENTS OR MISREPRESENTATIONS IN CONNECTION WITH AN INSURANCE TRANSACTION; BY AMENDING SECTION 38-55-560, RELATING TO THE INSURANCE FRAUD DIVISION BY THE OFFICE OF THE ATTORNEY GENERAL, SO AS TO AUTHORIZE THE ATTORNEY GENERAL TO HIRE A FORENSIC ACCOUNTANT; BY AMENDING SECTION 42-1-160, AS AMENDED, RELATING TO THE DEFINITIONS OF "INJURY" AND "PERSONAL INJURY", SO AS TO FURTHER DEFINE THESE TERMS; BY AMENDING SECTION 42-1-360, RELATING TO EXEMPTION OF CASUAL EMPLOYEES AND CERTAIN OTHER EMPLOYMENTS FROM THE SOUTH CAROLINA WORKERS' COMPENSATION LAW, SO AS TO INCLUDE "PROFESSIONAL SPORTS TEAM PLAYER" IN THE EXEMPTION; BY AMENDING SECTION 42-3-20, RELATING TO THE MEMBERSHIP, TERMS OF OFFICE, VACANCIES, AND DUTIES OF THE WORKERS' COMPENSATION COMMISSION, SO AS TO INCREASE THE COMMISSION'S MEMBERSHIP AND REVISE THE PROCEDURE FOR HEARING CONTESTED CASES; BY AMENDING SECTION 42-9-30, AS AMENDED, RELATING TO THE AMOUNT OF COMPENSATION AND THE PERIOD OF DISABILITY FOR CERTAIN INJURIES, SO AS TO PROVIDE FOR THE DEFINITION OF "PERMANENT MEDICAL IMPAIRMENT"; BY AMENDING SECTION 42-9-60, RELATING TO COMPENSATION THAT IS NOT ALLOWED WHEN INJURY OR DEATH IS CAUSED BY INTOXICATION OR WILFUL INTENTION OF EMPLOYEE, SO AS TO EXCLUDE FROM COVERAGE INJURIES CAUSED BY THE INFLUENCE OF ALCOHOL OR ILLEGAL DRUGS; BY AMENDING SECTION 42-9-360, AS AMENDED, RELATING TO THE ASSIGNMENTS OF COMPENSATION AND THE EXEMPTIONS FROM CLAIMS OF CREDITORS AND TAXES, SO AS TO MAKE CLAIMS FOR COMPENSATION NOT SUBJECT TO ASSIGNMENT; BY AMENDING SECTION 42-11-10, RELATING TO THE DEFINITION OF "OCCUPATIONAL DISEASE", SO AS TO FURTHER DEFINE THIS TERM; BY AMENDING SECTION 42-15-60, RELATING TO MEDICAL TREATMENT AND SUPPLIES BEING FURNISHED AND AN EMPLOYEE'S REFUSAL TO ACCEPT TREATMENT, SO AS TO PROVIDE FOR THE TERMINATION OF THE EMPLOYER'S OBLIGATION TO PROVIDE MEDICAL BENEFITS UNDER CERTAIN CIRCUMSTANCES; BY AMENDING SECTION 42-15-80, RELATING TO PRIVILEGED INFORMATION COMMUNICATED AT EMPLOYEE EXAMINATIONS, SO AS TO PROVIDE THAT A PHYSICIAN, SURGEON, OR OTHER HEALTH CARE PROVIDER, WITHOUT THE PERMISSION OF THE EMPLOYEE, MAY DISCUSS AND COMMUNICATE AN EMPLOYEE'S MEDICAL HISTORY, DIAGNOSIS, CAUSATION, COURSE OF TREATMENT, PROGNOSIS, WORK RESTRICTIONS, AND IMPAIRMENTS WITH THE REPRESENTATIVE OF THE INSURANCE CARRIER, THE EMPLOYER, THE EMPLOYEE, THEIR ATTORNEY, THE REHABILITATION PROFESSIONAL, OR THE COMMISSION; BY AMENDING SECTION 42-15-90, RELATING TO FEES OF ATTORNEYS AND PHYSICIANS AND HOSPITAL CHARGES APPROVED BY THE COMMISSION, SO AS TO PROVIDE FOR THE ATTORNEY'S FEES FOR REPRESENTING AN EMPLOYEE BEFORE THE COMMISSION; BY AMENDING SECTION 42-15-95, AS AMENDED, RELATING TO WORKERS' COMPENSATION CLAIMS AND THE DISCLOSURE OF INFORMATION BY HEALTH CARE PROVIDERS, SO AS TO DEFINE "MEDICAL AND VOCATIONAL INFORMATION", TO PROVIDE THAT ALL MEDICAL AND VOCATIONAL INFORMATION INSTEAD OF ALL INFORMATION COMPILED BY A HEALTH CARE FACILITY OR PROVIDER BE PROVIDED WITHIN A CERTAIN TIME, AND TO PROVIDE THAT THE MANNER OF COMMUNICATION BETWEEN THE HEALTH CARE PROVIDER AND THE EMPLOYER IS NOT LIMITED IF THE INFORMATION IS RELATED TO A WORKERS' COMPENSATION CLAIM; AND BY AMENDING SECTION 42-17-90, RELATING TO THE REVIEW OF AN AWARD ON CHANGE OF A CONDITION, SO AS TO PROVIDE THAT IN OCCUPATIONAL DISEASE CASES, A REVIEW MUST NOT BE MADE AFTER TWELVE MONTHS FROM THE DATE OF THE LAST PAYMENT OF BENEFITS.
Amend Title To Conform
Be it enacted by the General Assembly of the State of South Carolina:
SECTION 1. Section 42-1-10 of the 1976 Code is amended to read:
This title shall be known and cited as 'The South Carolina Workers' Compensation Law'. All references in this title to "workmen's compensation" shall mean "workers' compensation"; provided, however, all state agencies and departments and all political subdivisions of the State must exhaust the use of all current forms, stationery, and any other printed material before using, printing, or preparing any new forms, stationery, or printed material reflecting the change effected by this section. (A) This title shall be known and cited as the 'South Carolina Workers' Compensation Law.
(B) This title must be strictly construed and applied to promote its underlying purposes as set forth in this section. Any and all case law inconsistent with the purposes set forth herein is specifically overruled.
(C) The purposes of this title and of the Workers' Compensation law are:
(1) to pay timely temporary and permanent benefits to all legitimately injured workers that suffer an injury or disease arising out of and in the course and scope of their employment;
(2) to pay reasonable and necessary medical expenses resulting from these injuries or diseases;
(3) to improve workplace safety;
(4) to encourage the return to work of injured workers;
(5) to deter and punish fraud of agents, employers, employees, or any other party in the procurement of workers' compensation coverage, the provision or denial of benefits, or the provision of medical treatment;
(6) to promote the equitable and efficient resolution of workers' compensation claims; and
(7) to ensure an economically viable workers' compensation system in South Carolina."
SECTION 2. Article 3, Chapter 1, Title 42 of the 1976 Code is amended by adding:
"Section 42-1-378. This title does not apply to employees covered by the Federal Employers' Liability Act, the Longshore and Harbor Workers' Compensation Act, or any of its extensions, or the Jones Act."
SECTION 3. Article 1, Chapter 1, Title 42 of the 1976 Code is amended by adding:
"Section 42-1-180. 'Professional sports team player' means a person who participates in the game of professional sports for wages, earnings, or salary, within the meaning of this title, as an employee of an employer."
SECTION 4. Section 42-1-360 of the 1976 Code is amended by adding at the end:
"(6) Professional sports team player, as defined in Section 42-1-180; unless the employer voluntarily elects to be bound by this title."
SECTION 5. A. Section 42-9-400(d) of the 1976 Code is amended to read:
"(d)(1) As used in this section, 'permanent physical impairment' means any
permanent condition, whether congenital or due to injury or disease, of such seriousness as to constitute a hindrance or obstacle to obtaining employment or to obtaining reemployment if the employee should become unemployed.
When an employer establishes his prior knowledge of the permanent impairment, then there shall be a presumption that the condition is permanent and that a hindrance or obstacle to employment or reemployment exists when the condition is one of the following impairments:
(3) Cardiac disease
(5)(i) Amputated foot, leg, arm or hand
(6)(ii) Loss of sight of one or both eyes or partial loss of uncorrected vision of more than seventy-five percent bilateral
(7) Residual disability from Poliomyelitis
(8) Cerebral palsy
(9) Multiple sclerosis
(10) Parkinson's disease
(11) Cerebral vascular accident
(14) Psychoneurotic disability following treatment in a recognized medical or mental institution
(16) Chronic ostemyelitis
(17) Ankylosis of joints
(19) Muscular dystrophy
(22) Varicose Veins
(23) Heavy metal poisoning
(24) Ionizing radiation injury
(25) Compressed air sequelae
(26)(iii) Ruptured intervertebral disc
(27) Hodgkins disease
(28) Brain damage
(31) Sickle-cell anemia
(32) Pulmonary disease
(33) Mental retardation provided the employee's intelligence quotient is such that he falls within the lowest percentile of the general population. However, it shall not be necessary for the employer to know the employee's actual intelligence quotient or actual relative ranking in relation to the intelligence quotient of the general population.
(34) Any other pre-existing disease, condition or impairment which is permanent in nature and which:
(a) Would qualify for payment of weekly disability benefits of seventy-eight weeks or more under Section 42-9-30 exclusive of benefits payable for disfigurement; or
(b) Would support a rating of seventy-eight or more weeks of weekly disability benefits when evaluated according to the standards applied to Workers' Compensation claims in South Carolina, or combines with a subsequent injury to cause a permanent impairment rated at seventy-eight weeks or more under Section 42-9-30.
(2) If the paid claims of the fund for the fiscal year ending June 30, 2012, equal or exceed the total sum of eight million dollars, the Second Injury Fund shall not reimburse an employer or insurance carrier for an otherwise qualifying injury that occurs after June 30, 2012, but shall continue reimbursing employers and insurance carriers for qualifying claims resulting from injuries occurring on or before June 30, 2012. The Budget and Control Board must provide for the efficient and expeditious closure of the fund with the orderly winding down of the affairs of the fund so that the remaining liabilities of the fund are paid utilizing assessments, accelerated assessments, annuities, loss portfolio transfers, or such other mechanisms as may be reasonably determined necessary to fund any remaining liabilities of the fund.
(3) If the paid claims of the fund for the fiscal year ending June 30, 2012, do not exceed the total sum of eight million dollars, the Budget and Control Board shall require an audit to be conducted of fund liabilities as of June 30, 2012. Funding for this audit must be obtained from funds deposited in the fund's trust fund. Based on the information in the audit, the Budget and Control Board shall prepare a report to the Speaker of the House of Representatives and to the President Pro Tempore of the Senate, not later than January 1, 2013. The report must include its evaluation of the fund's operations."
B. On or after the effective date of this act, the Second Injury Fund shall not accept a claim for reimbursement from any employer or insurance carrier for any subsequent impairment unless the preexisting impairment is one of the permanent physical impairments enumerated in Section 42-9-400(d)(1).
C. The amendment to section 42-9-400(D) of the 1976 Code as contained in this section is not intended to effect workers' compensation benefits to injured employees provided in any other provision of law.
SECTION 6. Chapter 15, Title 42 of the 1976 Code is amended by adding:
"Section 42-15-85. (A) The burden of proof in a workers' compensation claim is on the employee. Causation must be proven with expert medical evidence stated to a reasonable degree of medical certainty in all claims, except claims for an occupational disease pursuant to the provisions of Chapter 11 of this title and claims for a change of condition pursuant to the provisions of Section 42-17-90. In claims for an occupational disease, the employee shall establish that the occupational disease arose directly and naturally from exposure in this State to the hazards peculiar to the particular employment with clear and convincing medical evidence. In claims for a change of condition, the employee shall establish by clear and convincing evidence that there has been a physical change of condition caused by the original injury, subsequent to the last payment of compensation.
(B) As used in this section, 'expert witness' means an expert who is qualified by reason of education, training, and experience to render an opinion as to the nature and extent of an employee's medical condition and who:
(1) is licensed by an appropriate regulatory agency to practice a profession in the location in which the expert practices or teaches;
(2)(a) is board certified by a national or international association or academy that administers written and oral examinations for certification in the area of practice or specialty about which the opinion is offered; or
(b) has actual professional knowledge and experience in the area of practice or specialty in which the opinion is to be given as the result of having been regularly engaged in:
(i) the active practice of the area of specialty of a profession for at least three of the last five years immediately preceding the opinion;
(ii) the teaching of the area of practice or specialty of a profession for at least half of his professional time as an employed member of the faculty of an educational institution that is accredited in the teaching of his profession for at least three of the last five years immediately preceding the opinion; or
(iii) any combination of the active practice or the teaching of a profession in a manner that meets the requirements of subitems (i) and (ii) for at least three of the last five years immediately preceding the opinion; and
(3) is an individual not covered by items (1) or (2), that has scientific, technical, or other specialized knowledge that may assist the trier of fact in understanding the evidence and determining a fact or issue in the case, by reason of the individual's study, experience, or both."
SECTION 7. Section 38-55-530(D) of the 1976 Code is amended to read:
"(D) 'False statement and misrepresentation' means a statement or representation made by a person that is false, material, made with the person's knowledge of the falsity of the statement, and made with the intent of obtaining or causing another to obtain or attempting to obtain or causing another to obtain an undeserved economic advantage or benefit or made with the intent to deny or cause another to deny any benefit or payment in connection with an insurance transaction and such shall constitute fraud. 'False statement and misrepresentation' specifically includes, but is not limited to, an intentional false report of business activities or the intentional miscount or misclassification by an employer of its employees to obtain a favorable insurance premium, payment schedule, or other economic benefit."
SECTION 8. Section 38-55-540 of the 1976 Code is amended to read:
"Section 38-55-540. (A)
Any A person or an insurer who makes a false statement or misrepresentation, and any other person knowingly, with an intent to injure, defraud, or deceive, who assists, abets, solicits, or conspires with such a person or an insurer to make a false statement or misrepresentation, is guilty of a:
(1) misdemeanor, for a first offense violation, if the amount of the economic advantage benefit received is less than one thousand dollars. Upon conviction, the person must be
punished by a fine fined not to exceed less than one hundred nor more than five hundred dollars or by imprisonment imprisoned not to exceed more than thirty days;
(2) misdemeanor, for a first offense violation, if the amount of the economic advantage benefit received is one thousand dollars or more but less than ten thousand dollars. Upon conviction, the person must be
punished by a fine fined not to exceed less than two thousand nor more than fifty ten thousand dollars or by imprisonment for a term imprisoned not to exceed more than three years, or by both, such fine and imprisonment and must pay the amount of restitution and tax owed;
(3) felony, for a first offense violation, if the amount of the economic advantage benefit received is ten thousand dollars or more but less than fifty thousand dollars. Upon conviction, the person must be fined not less than ten thousand nor more than fifty thousand dollars or imprisoned not more than five years, or both, and must pay the amount of restitution and tax owed;
(4) felony, for a first offense violation, if the amount of the economic advantage benefit received is fifty thousand dollars or more. Upon conviction, the person must be fined not less than twenty thousand nor more than one hundred thousand dollars or imprisoned not more than ten years, or both, and must pay the amount of restitution and tax owed;
(5) felony, for a second or subsequent violation, regardless of the amount of the economic advantage benefit received. Upon conviction, the person must be
punished by a fine fined not to exceed less than ten thousand nor more than fifty thousand dollars or by imprisonment for a term imprisoned not to exceed more than ten years, or by both, such fine and imprisonment and must pay the amount of restitution and tax owed.
Any A person or an insurer convicted under pursuant to the provisions of this section must be ordered to make full restitution to the a victim or victims for any economic advantage or benefit which has been obtained by the person or insurer as a result of that violation."
SECTION 9. Section 38-55-560 of the 1976 Code is amended by adding at the end:
"(E) The Attorney General is authorized to hire, employ, and reasonably equip one forensic accountant, and this forensic accountant must be assigned to the Insurance Fraud Division of the Attorney General's Office. A person is not qualified to be hired and the Insurance Fraud Division may not hire a forensic accountant unless he possesses and maintains a current license to engage in the practice of accounting pursuant to the provisions of Chapter 2, Title 40."
SECTION 10. Section 42-1-160 of the 1976 Code, as last amended by Act 424 of 1996, is further amended to read:
"Section 42-1-160. (A) 'Injury' and 'personal injury'
shall mean means only injury by accident arising out of and in the course of the employment and shall does not include a disease in any form, except when it results naturally and unavoidably from the accident and except such those diseases as are compensable under as provided by the provisions of Chapter 11 of this title. The burden of proving an 'injury' or 'personal injury' is the greater weight or preponderance of the evidence and is upon the employee. Causation of a medically complex condition must be supported by qualified expert testimony. Nothing contained in this section must be considered to preclude the commission from considering lay testimony or other evidence in conjunction with expert testimony in determining causation. In construing this section, an accident arising out of and in the course of employment shall include includes employment of an employee of a municipality outside the corporate limits of the municipality when the employment was ordered by a duly authorized employee of the municipality.
(B) Any stress, mental injury, heart attack, stroke, embolism, or aneurism arising out of
and in the course of employment, unaccompanied by other physical injury and resulting in mental illness or injury is not a is not considered a personal injury unless it is established by clear and convincing medical evidence that the stressful employment conditions causing the stress, mental injury, heart attack, stroke, embolism, or aneurism were extraordinary and unusual in comparison to the normal conditions of the particular employment.
(C) Any stress, mental injury, heart attack, stroke, embolism, or aneurism arising out of
and in the course of employment unaccompanied by other physical injury is not considered compensable if it results from any event or series of events which is incidental to normal employer/employee relations including, but not limited to, personnel actions by the employer such as disciplinary actions, work evaluations, transfers, promotions, demotions, salary reviews, or terminations, except when these actions are taken in an extraordinary and unusual manner.
(D) 'Injury by accident', as used in this section, means an injury which is not expected or intended by the worker whether or not the time or place of the occurrence is identifiable or whether or not the symptoms of the injury arose suddenly or gradually over time."
SECTION 11. Section 42-11-10 of the 1976 Code is amended to read:
"Section 42-11-10. (A)
The words 'Occupational disease' mean means a disease arising out of and in the course of employment which that is due to hazards in excess of those ordinarily incident to employment and is peculiar to the occupation in which the employee is engaged. A disease shall be deemed is considered an occupational disease only if caused by a hazard recognized as peculiar to a particular trade, process, occupation, or employment as a direct result of continuous exposure to the normal working conditions thereof of that particular trade, process, occupation, or employment. In claims for an occupational disease, the employee shall establish that the occupational disease arose directly and naturally from exposure in this State to the hazards peculiar to the particular employment with clear and convincing evidence.
No A disease shall be deemed is not considered an occupational disease when if it:
It does not result directly and naturally from exposure in this State to the hazards peculiar to the particular employment;
It results from exposure to outside climatic conditions;
It is a contagious disease resulting from exposure to fellow employees or from a hazard to which the workman would have been equally exposed outside of his employment;
It is one of the ordinary diseases of life to which the general public is equally exposed , unless such disease follows as a complication and a natural incident of an occupational disease or unless there is a constant exposure peculiar to the occupation itself which makes such disease a hazard inherent in such occupation;
It is any disease of the cardiac, pulmonary, or circulatory system not resulting directly from abnormal external gaseous pressure exerted upon the body or the natural entrance into the body through the skin or natural orifices thereof of the body of foreign organic or inorganic matter under circumstances peculiar to the employment and the processes utilized therein in that particular trade, process, occupation, or employment; or
It is any a chronic disease of the skeletal joints; or
(7) is a condition of the neck, back, or spinal column.
(C) Compensation is not payable for any occupational disease unless the claimant suffers disability as described in Section 42-9-10 or 42-9-20, and disability from an occupational disease is not compensable pursuant to the provisions of Section 42-9-30."
SECTION 12. Section 42-15-80 of the 1976 Code is amended to read:
"Section 42-15-80. (A) After an injury and so long as he claims compensation, the employee, if so requested by his employer or ordered by the commission, shall submit himself to examination, at reasonable times and places, by a duly qualified physician or surgeon designated and paid by the employer or the commission. The employee shall have the right to have present at such examination any duly qualified physician or surgeon provided and paid by him. No fact communicated to or otherwise learned by any physician or surgeon who may have attended or examined the employee, or who may have been present at any examination, shall be privileged, either in hearings provided for by this title or any action at law brought to recover damages against any employer who may have accepted the compensation provisions of this title. If the employee refuses to submit himself to or in any way obstructs
such the examination requested by and provided for by the employer, his right to compensation and his right to take or prosecute any proceedings under this title shall must be suspended until such the refusal or objection ceases and no compensation shall is not payable at any time be payable for the period of suspension unless in the opinion of the commission the circumstances justify the refusal or obstruction. The employer or the commission may require in any case of death require an autopsy at the expense of the person requesting it.
(B) A physician, surgeon, or other health care provider may discuss and otherwise communicate an employee's medical history, diagnosis, causation, course of treatment, prognosis, work restrictions, and impairments with the representative of the insurance carrier, the employer, the employee, their respective attorney, rehabilitation professional, or the commission without the employee's permission. A discussion, disclosure, or communication made by a physician, surgeon, or other health care provider pursuant to this section is not a violation of physician-patient confidentiality."
SECTION 13. Section 42-15-95 of the 1976 Code, as last amended by Act 468 of 1994, is further amended to read:
"Section 42-15-95. (A) As used in this section, 'medical and vocational information' means information collected in the process of assessing, planning, coordinating, monitoring, or evaluating the services required to address a claimant's health care needs through quality care promoting optimal recovery and rehabilitation.
All existing information compiled by A health care facility, as defined in Section 44-7-130, or a health care provider licensed pursuant to Title 40 shall furnish all medical and vocational information pertaining directly to a workers' compensation claim must be provided to the insurance carrier, the employer, the employee, their attorneys or rehabilitation professionals, or the South Carolina Workers' Compensation Commission, within fourteen days after receipt of written request.
(C) A health care facility and a health care provider may charge a fee for the search and duplication of a medical record, but the fee may not exceed sixty-five cents
per for each page for the first thirty pages and fifty cents per for each page for all other pages, and a clerical fee for searching and handling not to exceed fifteen dollars per for each request plus actual postage and applicable sales tax. The facility or provider may charge a patient or the patient's representative no more than the actual cost of reproduction of an X-ray. 'Actual cost' means the cost of materials and supplies used to duplicate the X-ray and the labor and overhead costs associated with the duplication.
(D) If a treatment facility or physician fails to
send furnish the requested information within forty-five days after receipt of the request, the person or entity making the request may apply to the commission for an appropriate penalty payable to the commission, not to exceed two hundred dollars."
SECTION 14. If any section, subsection, paragraph, subparagraph, sentence, clause, phrase, or word of this act is for any reason held to be unconstitutional or invalid, such holding shall not affect the constitutionality or validity of the remaining portions of this act, the General Assembly hereby declaring that it would have passed this act, and each and every section, subsection, paragraph, subparagraph, sentence, clause, phrase, and word thereof, irrespective of the fact that any one or more other sections, subsections, paragraphs, subparagraphs, sentences, clauses, phrases, or words hereof may be declared to be unconstitutional, invalid, or otherwise ineffective.
SECTION 15. Section 42-9-30 of the 1976 Code, as last amended by Act 412 of 1988, is further amended by adding a new paragraph at the end to read:
An award by the commission granted in accordance with this section shall set forth in writing the commission's finding as to the medical impairment rating of the injured employee. Medical impairment determinations shall be based upon the most current editions of the Guides to Evaluation of Permanent Impairment published by the American Medical Association.
SECTION 16. Section 42-3-20 of the 1976 Code is amended by adding a new paragraph at the end to read:
Notwithstanding any other provision of law, upon the expiration of the terms of the members of the Workers' Compensation Commission serving in office on January 1, 2007, their successors shall be elected by the General Assembly for terms of six years each and until their successors are selected and qualify. These elected members shall be screened, nominated, and elected in the same manner that members of the Employment Security Commission are screened, nominated, and elected.
SECTION 17. This act takes effect upon approval by the Governor, except that Sections 6, 10, and 11 take effect October 1, 2006, and only apply to workers' compensation claims arising on or after that date.
The Department of Insurance shall employ an outside actuary to perform a study determining the cost savings realized from the provisions of this act for the period January 1, 2007, to December 31, 2012, and shall report the results to the Speaker of the House of Representatives, President Pro Tempore of the Senate, and the Governor not later than December 31, 2006. Each member of the General Assembly shall receive a summary of the report from the Department of Insurance by December 31, 2006.
In this report, the Department of Insurance shall also make such recommendations to the General Assembly as it considers appropriate as to how to further reduce workers compensation costs in this State.
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