SB-0211, As Passed House, December 18, 2014

SUBSTITUTE FOR

SENATE BILL NO. 211

     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 1980 PA 457.

THE PEOPLE OF THE STATE OF MICHIGAN ENACT:

     Sec. 405. (1) In the case of a member of a full fully paid

fire department of an airport run operated by a county, road

commission in counties of 1,000,000 population or more public

airport authority, or by a state university or college; , or a

member of a full fully paid fire or police department of a city,

township, or incorporated village employed and compensated upon a

full-time basis; , a 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; , members a member of the

state police; , a conservation officers, and officer; or an officer

of the motor carrier inspectors of the Michigan public service

commission, "personal injury" shall be construed to include

enforcement division of the department of state police, "personal

injury" includes respiratory and heart diseases, or illnesses

resulting therefrom, which 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 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 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 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.

(3) (2) Such respiratory Respiratory and heart diseases or

illnesses resulting therefrom as described in subsection (1) are

deemed presumed to arise out of and in the course of employment in

the absence of evidence to the contrary.

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

benefits, the a claimant , if he or she is one of those enumerated

described in subsection (1) , or a claimant under subsection (2)

shall first make application 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 to or shall 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 not be awarded or that the claimant or his or her

decedent is ineligible for any pension benefits, then the

presumption of "personal injury" as provided in this section shall

apply. 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 may shall

be filed with the bureau.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

Senate Bill No. 211 as amended May 21, 2014

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

the fiscal year shall remain in the fund and shall 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 be paid if fund revenues become available, and

those claims shall 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 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

Senate Bill No. 211 as amended May 21, 2014

>> 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 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.

     (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.

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

rights under this act as an employer or carrier.