Existing law provides for the payment of compensation under industrial insurance if, during the course of employment, an employee is injured or killed by a workplace accident or occupational disease. (Chapters 616A-617 of NRS) Existing law authorizes the Administrator of the Division of Industrial Relations of the Department of Business and Industry to order certain additional payments to a claimant in the form of benefit penalties, if the Administrator determines that an insurer, organization for managed care, health care provider, third-party administrator, employer or professional employer organization has committed certain violations. (NRS 616A.070, 616D.120) Sections 3 and 30 of this bill additionally authorize the imposition of benefit penalties under certain circumstances for: (1) failure to provide or unreasonably delaying payment to an injured employee or reimbursement to an insurer; or (2) concealing, falsifying or failing to provide certain evidence or documents before certain hearings which would have been useful to an injured employee in seeking benefits or compensation. Existing law requires an insurer to keep a list of physicians and chiropractic physicians from which an injured employee may choose to receive treatment from a panel established and maintained by the Administrator. Existing law also sets forth procedures and limitations governing the removal of a physician or chiropractic physician from an insurer's list. (NRS 616C.087, 616C.090) Section 14 of this bill: (1) prohibits an insurer from removing a physician or chiropractic physician from the insurer's list except as expressly provided in existing law; and (2) requires an insurer to replace any physician or chiropractic physician who is removed from the list within 60 days. Sections 4, 6, 7, 12 and 13 of this bill: (1) require an insurer to keep a list of certain providers of health care other than a physician or chiropractic physician, which section 1 of this bill designates as an “industrial provider of health care,” from which an injured employee may choose to receive treatment from a panel established and maintained by the Administrator; and (2) establish certain requirements and restrictions concerning the selection of such an industrial provider of health care. Section 2 of this bill makes a conforming change so that the definition of “industrial provider of health care” applies to the provisions of existing law governing industrial insurance. Section 8 of this bill authorizes a hearing officer or appeals officer of the Hearings Division of the Department of Administration to order any needed examination, assessment or treatment of an injured employee be conducted by any physician, chiropractic physician or industrial provider of health care who will accept the fee schedule adopted by the Administrator, whether located in this State or another state, if the hearing or appeals officer finds that there is a lack of physicians, chiropractic physicians or providers available. Section 9 of this bill establishes certain requirements for the filing and service of certain evidence and documents in advance of a hearing before a hearing officer or appeals officer. Existing law requires a treating physician, chiropractic physician, physician assistant or advanced practice registered nurse to complete and file a claim for compensation within 3 working days after first providing treatment for an injured employee, or delegate the duty to do so to a physician assistant or advanced practice registered nurse at a medical facility. (NRS 616C.040, 616C.045) Sections 10 and 11 of this bill similarly authorize a treating physician, chiropractic physician, physician assistant or advanced practice registered nurse to delegate the duty to complete and file the claim for compensation to an industrial provider of health care. Existing law provides that an injury or disease sustained by an employee that is caused by stress is compensable under industrial insurance if it arose out of and in the course of his or her employment. Existing law sets forth the manner by which such an injury must be proven to have arisen out of and in the course of the employment. Under existing law, with certain exceptions, such an injury is deemed to arise out of and in the course of employment only if the employee proves certain elements by clear and convincing medical or psychiatric evidence. (NRS 616C.180) Section 17 of this bill eliminates provisions that make such method of proof the only method, with certain exceptions, by which an employee may prove that such an injury arose in and out of the course of employment. Section 17 additionally eliminates the standard of clear and convincing evidence and instead requires proof by medical, psychological or psychiatric evidence. Section 20 of this bill requires the Chief of the Hearings Division of the Department of Administration to maintain and make accessible to the public on the Internet website of the Division, a calendar of all matters which are before hearing officers and appeals officers. Sections 23 and 25 of this bill revise provisions governing the circumstances under which: (1) an appeals officer may grant a motion to stay the enforcement of the decision of a hearing officer; and (2) an appeals officer or district court may grant a motion to stay the enforcement of the decision of an appeals officer. Sections 24 and 32 of this bill revise certain procedures for the judicial review of the decision of an appeals officer. If a claim for a period of temporary total disability is allowed, existing law requires an industrial insurer to make the first payment within 14 working days after receipt of the initial certification of disability, and regularly thereafter. (NRS 616C.475) Section 27 of this bill establishes the same requirements for payment when a claim for a period of temporary partial disability is allowed. Existing law authorizes hearing officers and appeals officers, under certain circumstances, to allow discovery by deposition or interrogatories according to the Nevada Rules of Civil Procedure. (NRS 616D.050, 616D.090) Sections 28 and 29 of this bill prohibit a hearing officer from allowing such discovery, and revise provisions governing the circumstances under which an appeals officer may allow discovery. Existing law sets forth certain procedures for appealing a final determination concerning accident benefits made by an organization for managed care. (NRS 616C.305) Existing law requires, for a determination of the percentage of disability resulting from occupational disease of the heart or lungs, that the determination be made jointly by the attending physician and examining physician of a claimant, or, under certain circumstances, a designated third physician or panel of physicians. (NRS 616C.459) Section 34 of this bill repeals those procedures and requirements, and sections 15, 16, 18, 19, 21-23, 26 and 31 of this bill make conforming changes to remove references to those procedures and requirements from existing law.

Statutes affected:
As Introduced: 616A.025, 616A.070, 616B.527, 616C.040, 616C.045, 616C.050, 616C.055, 616C.087, 616C.110, 616C.137, 616C.180, 616C.220, 616C.235, 616C.295, 616C.315, 616C.320, 616C.345, 616C.370, 616C.375, 616C.390, 616C.500, 616D.050, 616D.090, 616D.120, 617.401, 617.405
BDR: 616A.025, 616A.070, 616B.527, 616C.040, 616C.045, 616C.050, 616C.055, 616C.087, 616C.110, 616C.137, 616C.180, 616C.220, 616C.235, 616C.295, 616C.315, 616C.320, 616C.345, 616C.370, 616C.375, 616C.390, 616C.500, 616D.050, 616D.090, 616D.120, 617.401, 617.405