34A-2-407 - Reporting of industrial injuries -- Regulation of health care providers -- Funeral expenses.
34A-2-407. Reporting of industrial injuries -- Regulation of health care providers --Funeral expenses.
(1) As used in this section, "physician" is as defined in Section 34A-2-111.
(2) (a) An employee sustaining an injury arising out of and in the course of employmentshall provide notification to the employee's employer promptly of the injury.
(b) If the employee is unable to provide the notification required by Subsection (2)(a),the following may provide notification of the injury to the employee's employer:
(i) the employee's next-of-kin; or
(ii) the employee's attorney.
(c) An employee claiming benefits under this chapter, or Chapter 3, Utah OccupationalDisease Act, shall comply with rules adopted by the commission regarding disclosure of medicalrecords of the employee medically relevant to the industrial accident or occupational diseaseclaim.
(3) (a) An employee is barred for any claim of benefits arising from an injury if theemployee fails to notify within the time period described in Subsection (3)(b):
(i) the employee's employer in accordance with Subsection (2); or
(ii) the division.
(b) The notice required by Subsection (3)(a) shall be made within:
(i) 180 days of the day on which the injury occurs; or
(ii) in the case of an occupational hearing loss, the time period specified in Section34A-2-506.
(4) The following constitute notification of injury required by Subsection (2):
(a) an employer's or physician's injury report filed with:
(i) the division;
(ii) the employer; or
(iii) the employer's insurance carrier; or
(b) the payment of any medical or disability benefits by:
(i) the employer; or
(ii) the employer's insurance carrier.
(5) (a) In the form prescribed by the division, an employer shall file a report with thedivision of a:
(i) work-related fatality; or
(ii) work-related injury resulting in:
(A) medical treatment;
(B) loss of consciousness;
(C) loss of work;
(D) restriction of work; or
(E) transfer to another job.
(b) The employer shall file the report required by Subsection (5)(a) within seven daysafter:
(i) the occurrence of a fatality or injury;
(ii) the employer's first knowledge of a fatality or injury; or
(iii) the employee's notification of a fatality or injury.
(c) (i) An employer shall file a subsequent report with the division of a previouslyreported injury that later results in death.
(ii) The subsequent report required by this Subsection (5)(c) shall be filed with thedivision within seven days following:
(A) the death; or
(B) the employer's first knowledge or notification of the death.
(d) A report is not required to be filed under this Subsection (5) for a minor injury, suchas a cut or scratch that requires first-aid treatment only, unless:
(i) a treating physician files a report with the division in accordance with Subsection (9);or
(ii) a treating physician is required to file a report with the division in accordance withSubsection (9).
(6) An employer required to file a report under Subsection (5) shall provide the employeewith:
(a) a copy of the report submitted to the division; and
(b) a statement, as prepared by the division, of the employee's rights and responsibilitiesrelated to the industrial injury.
(7) An employer shall maintain a record in a manner prescribed by the commission byrule of all:
(a) work-related fatalities; or
(b) work-related injuries resulting in:
(i) medical treatment;
(ii) loss of consciousness;
(iii) loss of work;
(iv) restriction of work; or
(v) transfer to another job.
(8) (a) Except as provided in Subsection (8)(b), an employer who refuses or neglects tomake a report, maintain a record, or file a report with the division as required by this section is:
(i) guilty of a class C misdemeanor; and
(ii) subject to a civil assessment:
(A) imposed by the division, subject to the requirements of Title 63G, Chapter 4,Administrative Procedures Act; and
(B) that may not exceed $500.
(b) An employer is not subject to the civil assessment or guilty of a class C misdemeanorunder this Subsection (8) if:
(i) the employer submits a report later than required by this section; and
(ii) the division finds that the employer has shown good cause for submitting a reportlater than required by this section.
(c) (i) A civil assessment collected under this Subsection (8) shall be deposited into theUninsured Employers' Fund created in Section 34A-2-704 to be used for a purpose specified inSection 34A-2-704.
(ii) The administrator of the Uninsured Employers' Fund shall collect money required tobe deposited into the Uninsured Employers' Fund under this Subsection (8)(c) in accordance withSection 34A-2-704.
(9) (a) A physician attending an injured employee shall comply with rules established bythe commission regarding:
(i) fees for physician's services;
(ii) disclosure of medical records of the employee medically relevant to the employee'sindustrial accident or occupational disease claim; and
(iii) reports to the division regarding:
(A) the condition and treatment of an injured employee; or
(B) any other matter concerning industrial cases that the physician is treating.
(b) A physician who is associated with, employed by, or bills through a hospital issubject to Subsection (9)(a).
(c) A hospital providing services for an injured employee is not subject to therequirements of Subsection (9)(a) except for rules made by the commission that are described inSubsection (9)(a)(ii) or (iii).
(d) The commission's schedule of fees may reasonably differentiate remuneration to bepaid to providers of health services based on:
(i) the severity of the employee's condition;
(ii) the nature of the treatment necessary; and
(iii) the facilities or equipment specially required to deliver that treatment.
(e) This Subsection (9) does not prohibit a contract with a provider of health servicesrelating to the pricing of goods and services.
(10) A copy of the initial report filed under Subsection (9)(a)(iii) shall be furnished to:
(a) the division;
(b) the employee; and
(c) (i) the employer; or
(ii) the employer's insurance carrier.
(11) (a) Subject to appellate review under Section 34A-1-303, the commission hasexclusive jurisdiction to hear and determine:
(i) whether goods provided to or services rendered to an employee are compensablepursuant to this chapter or Chapter 3, Utah Occupational Disease Act, including:
(A) medical, nurse, or hospital services;
(B) medicines; and
(C) artificial means, appliances, or prosthesis;
(ii) the reasonableness of the amounts charged or paid for a good or service described inSubsection (11)(a)(i); and
(iii) collection issues related to a good or service described in Subsection (11)(a)(i).
(b) Except as provided in Subsection (11)(a), Subsection 34A-2-211 (6), or Section34A-2-212, a person may not maintain a cause of action in any forum within this state other thanthe commission for collection or payment for goods or services described in Subsection (11)(a)that are compensable under this chapter or Chapter 3, Utah Occupational Disease Act.
Amended by Chapter 288, 2009 General Session
Amended by Chapter 347, 2009 General Session