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.