HOUSE BILL No. 5296

 

 

November 30, 2017, Introduced by Reps. Yaroch, Lucido, Hertel, Sabo, Cochran, Yanez, Green, Sowerby, Chang and Brann and referred to the Committee on Insurance.

 

     A bill to amend 1969 PA 317, entitled

 

"Worker's disability compensation act of 1969,"

 

by amending section 405 (MCL 418.405), as amended by 2014 PA 515.

 

THE PEOPLE OF THE STATE OF MICHIGAN ENACT:

 

     Sec. 405. (1) In the case of For a full-time, part-time, paid

 

on-call, or volunteer member of a fully paid fire department of an

 

airport operated by a county, public airport authority, or state

 

university or college; a full-time, part-time, paid on-call, or

 

volunteer member of a fully paid fire or police department of a

 

city, township, or incorporated village; employed and compensated

 

upon a full-time basis; a full-time, part-time, paid on-call, or

 

volunteer member of a fully paid public fire authority; employed

 


and compensated upon a full-time basis; a county sheriff and the

 

deputies of the county sheriff; a member of the state police; a

 

conservation officer; or an officer of the motor carrier

 

enforcement division of the department of state police, "personal

 

injury" includes respiratory and heart diseases, or illnesses

 

resulting therefrom, that develop or manifest themselves during a

 

period while the member of the department is in the active service

 

of the department and that result from the performance of duties

 

for the department.

 

     (2) A full-time, part-time, paid on-call, or volunteer member

 

of a fully paid fire department or public fire authority who is in

 

active service of the fire department or public fire authority, has

 

been employed 60 months or more in the active service of in the

 

department or public fire authority at the time the cancer

 

manifests itself, and is exposed to the hazards incidental to fire

 

suppression, rescue, or emergency medical services in the

 

performance of his or her work-related duties with the department

 

or authority shall suspend a claim he or she may have against his

 

or her employer under this act and may claim like benefits from the

 

first responder presumed coverage fund created under subsection (6)

 

for any respiratory tract, bladder, skin, brain, kidney, blood,

 

thyroid, testicular, prostate, or lymphatic cancer. The cancers

 

described in this subsection are presumed to arise out of and in

 

the course of employment only with respect to a claim against the

 

fund and in the absence of non-work-related causation or specific

 

incidents that establish a cause independent of the employment.

 

Neither mere evidence that the condition was preexisting, nor an


abstract medical opinion that the employment was not the cause of

 

the disease or condition, is sufficient to overcome the presumption

 

for purposes of a claim against the first responder presumed

 

coverage fund. The presumption under this subsection may be

 

rebutted by scientific evidence that the member of the fully paid

 

fire department or public fire authority was a substantial and

 

consistent user of cigarettes or other tobacco products within the

 

10 years immediately preceding the date of injury, and that this

 

use was a significant factor in the cause, aggravation, or

 

progression of the cancer. The suspension of the member's claim

 

against his or her employer under this subsection is in effect only

 

during the period the member receives like benefits from the first

 

responder presumed coverage fund. If a redemption agreement between

 

the first responder presumed coverage fund and the claimant is

 

approved, the suspension of a claim against an employer under this

 

subsection continues indefinitely. A claimant may not receive

 

benefits covering the same time period from both the first

 

responder presumed coverage fund and the employer. The presumption

 

created in this subsection applies only to a claim for like

 

benefits against the first responder presumed coverage fund. For

 

purposes of a claim against the presumed coverage fund, a fire

 

department or public fire authority is considered the employer of a

 

volunteer member.

 

     (3) Respiratory and heart diseases or illnesses resulting

 

therefrom as described in subsection (1) are presumed to arise out

 

of and in the course of employment in the absence of evidence to

 

the contrary.


     (4) As a condition precedent to filing an application for

 

benefits, a claimant described in subsection (1) or a claimant

 

under subsection (2) shall first apply for and do all things

 

necessary to qualify for any pension benefits to which he or she,

 

or his or her decedent, may be entitled or shall must demonstrate

 

that he or she, or his or her decedent, is ineligible for any

 

pension benefits. If a final determination is made that pension

 

benefits shall will not be awarded or that the claimant or his or

 

her decedent is ineligible for any pension benefits, then the

 

presumption designation of "personal injury" as provided in

 

subsection (1) or the presumption under subsection (2) applies. The

 

employer or employee may request 2 copies of the determination

 

denying pension benefits, 1 copy of which shall be filed with the

 

workers' compensation agency upon request.

 

     (5) If an employee described in subsection (1) or (2) is

 

eligible for any pension benefits, that eligibility does not

 

prohibit the employee or dependents of that employee from receiving

 

benefits under section 315 for the medical expenses or portion of

 

medical expenses that are not provided for by the pension program.

 

     (6) The first responder presumed coverage fund is created as a

 

separate fund in the state treasury. The state treasurer may

 

receive money or other assets from any source for deposit into the

 

fund. The state treasurer shall direct the investment of the fund.

 

The state treasurer shall credit to the fund interest and earnings

 

from fund investments. The director shall be the administrator of

 

the fund for auditing purposes. The director shall expend money

 

from the fund only for the purpose of paying claims authorized


under subsection (2) and costs of administration. The department of

 

treasury shall cause to be paid from the first responder presumed

 

coverage fund those amounts and at those times as are prescribed by

 

the director to pay claims under subsection (2) pursuant to this

 

subsection and subsection (7). Money in the fund at the close of

 

the fiscal year shall must remain in the fund and shall does not

 

lapse to the general fund. If there is insufficient money in the

 

fund to pay claims authorized under subsection (2), claims that are

 

approved but not paid shall must be paid if fund revenues become

 

available, and those claims shall must be paid before subsequently

 

approved claims. The director shall develop and implement a process

 

to notify the legislature that money in the first responder

 

presumed coverage fund may be insufficient to cover future claims

 

when the director reasonably believes that within 60 days the money

 

in the fund will be insufficient to pay claims. The process shall,

 

at a minimum, do all of the following:

 

     (a) Identify a specific date by which the money in the fund

 

will become insufficient to pay claims.

 

     (b) Outline a clear process indicating the order in which

 

claims pending with the fund will be paid.

 

     (c) Outline a clear process indicating the order in which

 

claims that were pending with the fund when money became

 

insufficient will be paid, if money subsequently becomes available.

 

     (7) The director shall develop the application, approval, and

 

compliance process necessary to operate and manage the first

 

responder presumed coverage fund. The director shall develop and

 

implement the use of an application form to be used by a claimant


for benefits payable by the fund under subsection (2). When a claim

 

under subsection (2) is received, the director shall notify the

 

employer against whom a claim is suspended or the carrier. The

 

employer or carrier may access all information the agency receives

 

respecting the claim and may request that the agency obtain

 

specific additional information. The fund standards, guidelines,

 

templates, and any other forms used by the director to implement

 

the first responder presumed coverage fund shall must be posted and

 

maintained on the department's website. The director shall review

 

and consider claims in the order in which they are received and

 

shall approve or deny a claim within 30 days after receipt of the

 

claim.

 

     (8) The director shall submit an annual report to the state

 

budget director and the senate and house of representatives

 

standing committees on appropriations not later than April 1 of

 

each year that includes, but is not limited to, all of the

 

following:

 

     (a) The total number of claims received under the first

 

responder presumed coverage fund in the immediately preceding

 

calendar year.

 

     (b) The number of claims approved and the total dollar amount

 

of claims paid by the first responder presumed coverage fund in the

 

immediately preceding calendar year.

 

     (c) The costs of administering the first responder presumed

 

coverage fund in the immediately preceding calendar year.

 

     (9) The department shall not implement the first responder

 

presumed coverage fund until the legislature has appropriated money


to the fund.

 

     (9) (10) By March 31 of each year, the worker's compensation

 

agency shall report to the chairs of the appropriations committees

 

of the senate and the house of representatives the estimated amount

 

of both of the following:

 

     (a) The anticipated cost of benefits in the next fiscal year

 

for claims authorized under subsection (2) and payable by the first

 

responder presumed coverage fund.

 

     (b) The amount of any anticipated shortfall in the first

 

responder presumed coverage fund that would prevent payment of

 

claims under subsection (6) for the current fiscal year.

 

     (10) (11) The first responder presumed coverage fund has the

 

same rights under this act as an employer or carrier.

 

     Enacting section 1. This amendatory act takes effect 90 days

 

after the date it is enacted into law.