Summary of Original Version

Amend KRS 342.0011, relating to workers' compensation, to expand the definition of " injury" to include a diagnosis of class 2 or greater post-traumatic stress disorder from a death or threatened death by direct exposure or witnessing a death, threat of death, or its immediate aftermath; define "medical professional"; amend KRS 342.020 to allow an administrative law judge to rely upon objective medical opinions or data when determining medical benefits; require a carrier or a third-party administrator to provide the guidelines relied upon to deny medical treatment and provide the guidelines to the employee and medical provider; provide that the requirement for the medical provider to submit a statement for services within 45 days after treatment does not apply until after the injured worker and the medical provider have received notification from the employer, insurer, or medical payment obligor that the claim has been determined to be compensable, or there has been an initial determination of compensability by an administrative law judge; require the notice of compensability to advise the injured worker and the medical provider of necessary information regarding the process by which and the location where statements for services shall be sent; entitle a prevailing employee in a medical fee dispute to attorney's fees and permit the employee to submit a bill of costs to be considered by the administrative law judge; amend KRS 342.033 to expand "physician" to include all "medical professionals"; amend KRS 342.035 to prohibit a medical provider from seeking payment when a statement for services was submitted more than 45 days after the treatment date; amend KRS 342.125 to allow an administrative law judge to reopen and review any award or order for post-award request for vocational rehabilitation; add entitlement to rehabilitation to reasons a claim may be reopened more than four years after the original award date; amend KRS 342.276 to require the commissioner to promulgate regulations requiring parties to demonstrate attempts have been made to reach a settlement; amend KRS 342.281 to provide that after an order on reconsideration has been rendered, subsequent petitions for reconsideration shall not toll the time to appeal unless the petition for reconsideration is filed to correct a patent error in the order; amend KRS 342.310 to provide that if an administrative law judge determines a medical dispute was filed frivolously or for the purpose of harassment by an employer, its third-party administrator, or the responsible insurer, attorney's fees may be assessed and the administrative law judge may fine the employer no less than $1,000 and not more than $5,000 to be paid to the employee; amend KRS 342.315 to add the University of Pikeville to the medical schools that the commissioner shall contract with to evaluate workers; delete "physicians" and insert "medical professionals" who are qualified as "B" readers in cases involving coal workers' pneumoconiosis and occupational hearing loss; add audiologists to the medical professionals who may perform hearing loss evaluations; amend KRS 342.316 to delete "physician" and insert "medical professional" as being required provide at least one written medical report in filing occupational disease claims; delete "physician" and insert "medical professional" as to interpret X-rays; delete "physicians" and insert "medical professional" as qualified as "B" readers in cases involving coal workers' pneumoconiosis; amend KRS 342.320 to delete "physicians" and insert "medical professionals" fees which are subject to approval of an administrative law judge; require the commissioner to promulgate administrative regulations establishing a schedule of fees that may be charged by court reporters for services rendered; amend KRS 342.730 to prohibit temporary total and permanent total disability from being offset by unemployment insurance benefits; amend KRS 342.794 to delete "physicians who are licensed in the Commonwealth" and insert "medical professionals" in the definitions of "B" reader list; delete "physician" and insert "medical professionals" in the '"B' reader" and "Board-certified pulmonary specialist"; amend KRS 342.122 to require the special fund assessment rate to be sufficient to finance the administration, operation, and expenditures when the claim liabilities are fully funded or prefunded; amend KRS 342.610 to include when a legal or illegal intoxicating substance is knowingly introduced into the employee's body, liability for compensation shall not apply to the injury, occupational disease, or death to the employee, if the intoxicating substance is determined to be the proximate cause of the employee's injury, occupational disease, or death.

Statutes affected:
Introduced: 342.0011, 342.020, 342.033, 342.035, 342.125, 342.276, 342.281, 342.310, 342.315, 342.316, 342.320, 342.730, 342.794, 342.122, 342.610