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S.98

Introduced by   Senator Illuzzi of Essex-Orleans District, Senator Condos of Chittenden District, Senator Dunne of Windsor District and Senator Miller of Chittenden District

Referred to Committee on

Date:

Subject:  Labor; workers' compensation; vocational rehabilitation; timely payment of compensation

Statement of purpose:  This bill proposes to assure that the rules regarding vocational rehabilitation enacted by the department of labor and industry reflect the legislative intent.  The bill also proposes to assure timely payment of compensation to claimants and that compensation continues when termination is not supported by evidence and to simplify an application for hearing by an unrepresented claimant.

AN ACT RELATING TO VOCATIONAL REHABILITATION AND PAYMENT OF COMPENSATION UNDER WORKERS' COMPENSATION

It is hereby enacted by the General Assembly of the State of Vermont:

Sec. 1.  21 V.S.A. § 641(a) is amended to read:

(a)  When as a result of an injury covered by this chapter, an employee is unable to perform work for which the employee has previous training or experience, the employee shall be entitled to vocational rehabilitation services, including retraining and job placement, as may be reasonably necessary to restore the employee to suitable employment.  Vocational rehabilitation services shall be provided as follows:

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(3)  The commissioner shall adopt rules to assure that a worker who requests services or who has received more than 90 days of continuous temporary total disability benefits is timely and cost-effectively screened for benefits under this section.  The rules shall provide for an initial screening for those injured workers to be conducted by a Vermont-certified vocational rehabilitation counselor to determine whether a full assessment is appropriate. An injured worker who is determined to be eligible for benefits shall have an appropriate initial vocational a full assessment shall be timely assessed and be offered appropriate vocational rehabilitation services.  The commissioner shall adopt rules to provide a mechanism for periodic and timely review of injured workers who are initially found not to be ready or eligible for vocational rehabilitation services until the injured worker returns to work or receives permanent total disability benefits.

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(5)  The commissioner may set by rule reasonable reimbursement rates for vocational rehabilitation benefits and services, provided access to vocational rehabilitation services is not diminished and reasonable choices and access to benefits and services are maintained.

(6)  The  commissioner shall meet periodically, but no less than twice a year, with vocation rehabilitation counselors or their representatives to consult regarding the effectiveness of the vocation rehabilitation program and the services provided and any changes to the program under consideration.

Sec. 2.  21 V.S.A. § 643a is amended to read:

§ 643a.  DISCONTINUANCE OF BENEFITS

Unless an injured worker has successfully returned to work, an employer shall notify both the commissioner and the employee prior to terminating benefits under either section 642 or section 646 of this title.  The notice of intention to discontinue payments shall be filed on forms prescribed by the commissioner and shall include the date of the proposed discontinuance and the reasons for it.  The liability for the payments shall continue for 7 seven days after the notice is received by the commissioner and the employee.  Those payments shall be made without prejudice to the employer and may be deducted from any amounts due pursuant to section 648 of this title if the commissioner determines that the discontinuance is warranted or if otherwise ordered by the commissioner.  Every notice shall be reviewed by the commissioner to determine the sufficiency of the basis for the proposed discontinuance.  If, upon review, the commissioner finds that the evidence does not reasonably support the proposed discontinuance, the commissioner may shall order that payments continue until a hearing is held and a decision is rendered.

Sec. 3.  21 V.S.A. § 650(e) is amended to read:

(e)  If weekly compensation benefits or weekly accrued benefits are not paid within 21 days after becoming due and payable pursuant to an order of the commissioner, or in cases in which the overdue benefit is not in dispute, ten percent of the overdue amount shall be added and paid to the employee, in addition to interest and any other penalties.  In the case of an initial claim, benefits are due and payable upon entering into an agreement pursuant to subsection 662(a) of this title, upon issuance of an order of the commissioner pursuant to subsection 662(b) of this title, or if the employer has not denied the claim within 21 days after the claim is filed.  Benefits are in dispute if the claimant has been provided actual written notice of the dispute within 21 days of the benefit being due and payable and the evidence reasonably supports the denial. Interest shall accrue and be paid on benefits that are found to be compensable during the period of nonpayment.  The commissioner shall promptly review requests for payment under this section and shall allow for the recovery of reasonable attorney fees associated with an employee’s successful request for payment under this subsection.


Sec. 4.  21 V.S.A § 662(b) is amended to read:

(b)  In the absence of an agreement pursuant to subsection (a) of this section, the employer or insurance carrier shall notify the commissioner and the employee in writing that the claim is denied and the reasons therefor.  Upon the employee's application for a hearing under section 663 of this title, within 60 days, the commissioner may shall review the evidence upon which denial is based and if the evidence does not reasonably support the denial, the commissioner may shall order that payments be made until a hearing is held and a decision is rendered.  Payments pursuant to this subsection shall not be deemed an admission of liability by the employer nor shall such payments preclude subsequent agreement under subsection (a) of this section or prejudice the rights of either party to hearing or appeal under this chapter.

For the purposes of this section, any communication by an unrepresented claimant that questions the denial shall be deemed to be an application for  hearing under section 663 of this title.

Sec. 5.  21 V.S.A. § 652(c) is added to read:

(c)  At the claimant's request, an order for lump sum payment of permanent

partial or permanent total disability benefits or a lump sum settlement of a disputed claim shall include a provision accounting for excludable expenses and prorating the remainder of the lump sum payment in the manner set forth by the Social Security Administration in order to protect the claimant's entitlement to Social Security benefits.



Published by:

The Vermont General Assembly
115 State Street
Montpelier, Vermont


www.leg.state.vt.us