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IC 22-3-7-1
Repealed
(Repealed by P.L.28-1988, SEC.118.)
IC 22-3-7-2
Applicability; burden of proof; police and firefighter coverage
Sec. 2. (a) Every employer and every employee, except as stated
in this chapter, shall comply with this chapter, requiring the
employer and employee to pay and accept compensation for
disablement or death by occupational disease arising out of and in
the course of the employment, and shall be bound thereby. The
burden of proof is on the employee. The proof by the employee of an
element of a claim does not create a presumption in favor of the
employee with regard to another element of the claim.
(b) This chapter does not apply to the following:
(1) A person who enters into an independent contractor
agreement with a nonprofit corporation that is recognized as tax
exempt under Section 501(c)(3) of the Internal Revenue Code
(as defined in IC 6-3-1-11(a)) to perform youth coaching
services on a part-time basis.
(2) A nonprofit corporation that is recognized as tax exempt
under Section 501(c)(3) of the Internal Revenue Code (as
defined in IC 6-3-1-11(a)) to the extent the corporation enters
into an independent contractor agreement with a person for the
performance of youth coaching services on a part-time basis.
(c) This chapter does not apply to employees of municipal
corporations in Indiana who are members of:
(1) the fire department or police department of any such
municipality; and
(2) a firefighters' pension fund or a police officers' pension
fund.
However, if the common council elects to purchase and procure
worker's occupational disease insurance to insure said employees
with respect to medical benefits under this chapter, the medical
provisions apply to members of the fire department or police
department of any such municipal corporation who are also members
of a firefighters' pension fund or a police officers' pension fund.
(d) When any municipal corporation purchases or procures
worker's occupational disease insurance covering members of the fire
department or police department who are also members of a
firefighters' pension fund or a police officers' pension fund and pays
the premium or premiums for the insurance, the payment of the
premiums is a legal and allowable expenditure of funds of any
municipal corporation.
(e) Except as provided in subsection (f), where the common
council has procured worker's occupational disease insurance as
provided under this section, any member of the fire department or
police department employed in the city carrying the worker's
occupational disease insurance under this section is limited to
recovery of medical and surgical care, medicines, laboratory,
curative and palliative agents and means, x-ray, diagnostic and
therapeutic services to the extent that the services are provided for in
the worker's occupational disease policy so procured by the city, and
may not also recover in addition to that policy for the same benefits
provided in IC 36-8-4.
(f) If the medical benefits provided under a worker's occupational
disease policy procured by the common council terminate for any
reason before the police officer or firefighter is fully recovered, the
common council shall provide medical benefits that are necessary
until the police officer or firefighter is no longer in need of medical
care.
(g) Nothing in this section affects the rights and liabilities of
employees and employers had by them prior to April 1, 1963, under
this chapter.
(Formerly: Acts 1937, c.69, s.2; Acts 1963, c.388, s.1; Acts 1974,
P.L.109, SEC.1.) As amended by Acts 1981, P.L.11, SEC.126;
P.L.28-1988, SEC.49; P.L.217-1989, SEC.2; P.L.201-2005, SEC.6;
P.L.134-2006, SEC.8.
IC 22-3-7-2.5
School to work student
Sec. 2.5. (a) As used in this section, "school to work student"
refers to a student participating in on-the-job training under the
federal School to Work Opportunities Act (20 U.S.C. 6101 et seq.).
(b) A school to work student is entitled to the following
compensation and benefits under this chapter:
(1) Medical benefits.
(2) Permanent partial impairment compensation under section
16 of this chapter. Permanent partial impairment compensation
for a school to work student shall be paid in a lump sum upon
agreement or final award.
(3) In the case that death results from the injury:
(A) death benefits in a lump sum amount of one hundred
seventy-five thousand dollars ($175,000), payable upon
agreement or final award to any dependents of the student
under sections 11 through 14 of this chapter, or, if the
student has no dependents, to the student's parents; and
(B) burial compensation under section 15 of this chapter.
(c) For the sole purpose of modifying an award under section 27
of this chapter, a school to work student's average weekly wage is
presumed to be equal to the federal minimum wage.
(d) A school to work student is not entitled to the following
compensation under this chapter:
(1) Temporary total disability compensation under section 16 of
this chapter.
(2) Temporary partial disability compensation under section 19
of this chapter.
IC 22-3-7-3
Waiver of exemption from act by employer; notice of acceptance;
filing
Sec. 3. (a) An employer who is exempt under this section from the
operation of the compensation provisions of this chapter may at any
time waive such exemption and thereby accept the provisions of this
chapter by giving notice as provided in subsection (b).
(b) The notice of acceptance referred to in subsection (a) shall be
given thirty (30) days prior to any accident resulting in injury or
death, provided that if any such injury occurred less than thirty (30)
days after the date of employment, notice of acceptance given at the
time of employment shall be sufficient notice thereof. The notice
shall be in writing or print in a substantial form prescribed by the
worker's compensation board and shall be given by the employer by
posting the same in a conspicuous place in the plant, shop, office,
room, or place where the employee is employed, or by serving it
personally upon the employee. The notice shall be given by the
employee by sending the same in registered letter addressed to the
employer at his last known residence or place of business, or by
giving it personally to the employer, or any of his agents upon whom
a summons in civil actions may be served under the laws of the state.
(c) A copy of the notice in prescribed form shall also be filed with
the worker's compensation board, within five (5) days after its
service in such manner upon the employee or employer.
(Formerly: Acts 1937, c.69, s.3; Acts 1963, c.388, s.2; Acts 1974,
P.L.109, SEC.2.) As amended by P.L.28-1988, SEC.50.
IC 22-3-7-4
Repealed
(Repealed by Acts 1974, P.L.109, SEC.8.)
IC 22-3-7-5
Coal mining; application of law
Sec. 5. On and after April 1, 1963, the provisions of this chapter
shall apply to the state, to all political divisions thereof, to all
municipal corporations within the state, to persons, partnerships,
limited liability companies, and corporations engaged in mining coal,
and to employees thereof, without any right of exemption from the
compensation provisions of this chapter, except as provided in
section 34(i) of this chapter.
(Formerly: Acts 1937, c.69, s.4b; Acts 1963, c.388, s.5.) As amended
by P.L.144-1986, SEC.57; P.L.8-1993, SEC.283.
IC 22-3-7-6
Exclusive remedies
Sec. 6. The rights and remedies granted under this chapter to an
employee subject to this chapter on account of disablement or death
by occupational disease arising out of and in the course of the
employment shall exclude all other rights and remedies of such
employee, his personal representatives, dependents, or next of kin,
at common law or otherwise, on account of such disablement or
death.
(Formerly: Acts 1937, c.69, s.4c; Acts 1963, c.388, s.6.) As amended
by P.L.144-1986, SEC.58.
IC 22-3-7-7
Statutory duties; application of law
Sec. 7. Nothing in this chapter shall be construed to relieve any
employer or employee from penalty for failure or neglect to perform
any statutory duty.
(Formerly: Acts 1937, c.69, s.4d; Acts 1963, c.388, s.7.) As amended
by P.L.144-1986, SEC.59.
IC 22-3-7-8
Place of exposure; foreign states or foreign countries
Sec. 8. Every employer and employee under this chapter shall be
bound by the provisions of this chapter whether exposure and
disablement therefrom or death resulting from an occupational
disease occurs within the state or in some other state or in a foreign
country.
(Formerly: Acts 1937, c.69, s.4e; Acts 1963, c.388, s.8.) As amended
by P.L.144-1986, SEC.60.
IC 22-3-7-9
Definitions; applicability of chapter; exemptions
Sec. 9. (a) As used in this chapter, "employer" includes the state
and any political subdivision, any municipal corporation within the
state, any individual or the legal representative of a deceased
individual, firm, association, limited liability company, or
corporation or the receiver or trustee of the same, using the services
of another for pay. A parent corporation and its subsidiaries shall
each be considered joint employers of the corporation's, the parent's,
or the subsidiaries' employees for purposes of sections 6 and 33 of
this chapter. Both a lessor and a lessee of employees shall each be
considered joint employers of the employees provided by the lessor
to the lessee for purposes of sections 6 and 33 of this chapter. The
term also includes an employer that provides on-the-job training
under the federal School to Work Opportunities Act (20 U.S.C. 6101
et seq.) to the extent set forth under section 2.5 of this chapter. If the
employer is insured, the term includes the employer's insurer so far
as applicable. However, the inclusion of an employer's insurer within
this definition does not allow an employer's insurer to avoid payment
for services rendered to an employee with the approval of the
employer. The term does not include a nonprofit corporation that is
recognized as tax exempt under Section 501(c)(3) of the Internal
Revenue Code (as defined in IC 6-3-1-11(a)) to the extent the
corporation enters into an independent contractor agreement with a
person for the performance of youth coaching services on a part-time
basis.
(b) As used in this chapter, "employee" means every person,
including a minor, in the service of another, under any contract of
hire or apprenticeship written or implied, except one whose
employment is both casual and not in the usual course of the trade,
business, occupation, or profession of the employer. For purposes of
this chapter the following apply:
(1) Any reference to an employee who has suffered
disablement, when the employee is dead, also includes the
employee's legal representative, dependents, and other persons
to whom compensation may be payable.
(2) An owner of a sole proprietorship may elect to include the
owner as an employee under this chapter if the owner is actually
engaged in the proprietorship business. If the owner makes this
election, the owner must serve upon the owner's insurance
carrier and upon the board written notice of the election. No
owner of a sole proprietorship may be considered an employee
under this chapter unless the notice has been received. If the
owner of a sole proprietorship is an independent contractor in
the construction trades and does not make the election provided
under this subdivision, the owner must obtain an affidavit of
exemption under section 34.5 of this chapter.
(3) A partner in a partnership may elect to include the partner
as an employee under this chapter if the partner is actually
engaged in the partnership business. If a partner makes this
election, the partner must serve upon the partner's insurance
carrier and upon the board written notice of the election. No
partner may be considered an employee under this chapter until
the notice has been received. If a partner in a partnership is an
independent contractor in the construction trades and does not
make the election provided under this subdivision, the partner
must obtain an affidavit of exemption under section 34.5 of this
chapter.
(4) Real estate professionals are not employees under this
chapter if:
(A) they are licensed real estate agents;
(B) substantially all their remuneration is directly related to
sales volume and not the number of hours worked; and
(C) they have written agreements with real estate brokers
stating that they are not to be treated as employees for tax
purposes.
(5) A person is an independent contractor in the construction
trades and not an employee under this chapter if the person is an
independent contractor under the guidelines of the United States
Internal Revenue Service.
(6) An owner-operator that provides a motor vehicle and the
services of a driver under a written contract that is subject to
IC 8-2.1-24-23, 45 IAC 16-1-13, or 49 CFR 1057, to a motor
carrier is not an employee of the motor carrier for purposes of
this chapter. The owner-operator may elect to be covered and
have the owner-operator's drivers covered under a worker's
compensation insurance policy or authorized self-insurance that
insures the motor carrier if the owner-operator pays the
premiums as requested by the motor carrier. An election by an
owner-operator under this subdivision does not terminate the
independent contractor status of the owner-operator for any
purpose other than the purpose of this subdivision.
(7) An unpaid participant under the federal School to Work
Opportunities Act (20 U.S.C. 6101 et seq.) is an employee to
the extent set forth under section 2.5 of this chapter.
(8) A person who enters into an independent contractor
agreement with a nonprofit corporation that is recognized as tax
exempt under Section 501(c)(3) of the Internal Revenue Code
(as defined in IC 6-3-1-11(a)) to perform youth coaching
services on a part-time basis is not an employee for purposes of
this chapter.
(c) As used in this chapter, "minor" means an individual who has
not reached seventeen (17) years of age. A minor employee shall be
considered as being of full age for all purposes of this chapter.
However, if the employee is a minor who, at the time of the last
exposure, is employed, required, suffered, or permitted to work in
violation of the child labor laws of this state, the amount of
compensation and death benefits, as provided in this chapter, shall be
double the amount which would otherwise be recoverable. The
insurance carrier shall be liable on its policy for one-half (1/2) of the
compensation or benefits that may be payable on account of the
disability or death of the minor, and the employer shall be wholly
liable for the other one-half (1/2) of the compensation or benefits. If
the employee is a minor who is not less than sixteen (16) years of age
and who has not reached seventeen (17) years of age, and who at the
time of the last exposure is employed, suffered, or permitted to work
at any occupation which is not prohibited by law, the provisions of
this subsection prescribing double the amount otherwise recoverable
do not apply. The rights and remedies granted to a minor under this
chapter on account of disease shall exclude all rights and remedies
of the minor, his parents, his personal representatives, dependents,
or next of kin at common law, statutory or otherwise, on account of
any disease.
(d) This chapter does not apply to casual laborers as defined in
subsection (b), nor to farm or agricultural employees, nor to
household employees, nor to railroad employees engaged in train
service as engineers, firemen, conductors, brakemen, flagmen,
baggagemen, or foremen in charge of yard engines and helpers
assigned thereto, nor to their employers with respect to these
employees. Also, this chapter does not apply to employees or their
employers with respect to employments in which the laws of the
United States provide for compensation or liability for injury to the
health, disability, or death by reason of diseases suffered by these
employees.
(e) As used in this chapter, "disablement" means the event of
becoming disabled from earning full wages at the work in which the
employee was engaged when last exposed to the hazards of the
occupational disease by the employer from whom the employee
claims compensation or equal wages in other suitable employment,
and "disability" means the state of being so incapacitated.
(f) For the purposes of this chapter, no compensation shall be
payable for or on account of any occupational diseases unless
disablement, as defined in subsection (e), occurs within two (2) years
after the last day of the last exposure to the hazards of the disease
except for the following:
(1) In all cases of occupational diseases caused by the
inhalation of silica dust or coal dust, no compensation shall be
payable unless disablement, as defined in subsection (e), occurs
within three (3) years after the last day of the last exposure to
the hazards of the disease.
(2) In all cases of occupational disease caused by the exposure
to radiation, no compensation shall be payable unless
disablement, as defined in subsection (e), occurs within two (2)
years from the date on which the employee had knowledge of
the nature of the employee's occupational disease or, by
exercise of reasonable diligence, should have known of the
existence of such disease and its causal relationship to the
employee's employment.
(3) In all cases of occupational diseases caused by the
inhalation of asbestos dust, no compensation shall be payable
unless disablement, as defined in subsection (e), occurs within
three (3) years after the last day of the last exposure to the
hazards of the disease if the last day of the last exposure was
before July 1, 1985.
(4) In all cases of occupational disease caused by the inhalation
of asbestos dust in which the last date of the last exposure
occurs on or after July 1, 1985, and before July 1, 1988, no
compensation shall be payable unless disablement, as defined
in subsection (e), occurs within twenty (20) years after the last
day of the last exposure.
(5) In all cases of occupational disease caused by the inhalation
of asbestos dust in which the last date of the last exposure
occurs on or after July 1, 1988, no compensation shall be
payable unless disablement (as defined in subsection (e)) occurs
within thirty-five (35) years after the last day of the last
exposure.
(g) For the purposes of this chapter, no compensation shall be
payable for or on account of death resulting from any occupational
disease unless death occurs within two (2) years after the date of
disablement. However, this subsection does not bar compensation for
death:
(1) where death occurs during the pendency of a claim filed by
an employee within two (2) years after the date of disablement
and which claim has not resulted in a decision or has resulted in
a decision which is in process of review or appeal; or
(2) where, by agreement filed or decision rendered, a
compensable period of disability has been fixed and death
occurs within two (2) years after the end of such fixed period,
but in no event later than three hundred (300) weeks after the
date of disablement.
(h) As used in this chapter, "billing review service" refers to a
person or an entity that reviews a medical service provider's bills or
statements for the purpose of determining pecuniary liability. The
term includes an employer's worker's compensation insurance carrier
if the insurance carrier performs such a review.
(i) As used in this chapter, "billing review standard" means the
data used by a billing review service to determine pecuniary liability.
(j) As used in this chapter, "community" means a geographic
service area based on zip code districts defined by the United States
Postal Service according to the following groupings:
(1) The geographic service area served by zip codes with the
first three (3) digits 463 and 464.
(2) The geographic service area served by zip codes with the
first three (3) digits 465 and 466.
(3) The geographic service area served by zip codes with the
first three (3) digits 467 and 468.
(4) The geographic service area served by zip codes with the
first three (3) digits 469 and 479.
(5) The geographic service area served by zip codes with the
first three (3) digits 460, 461 (except 46107), and 473.
(6) The geographic service area served by the 46107 zip code
and zip codes with the first three (3) digits 462.
(7) The geographic service area served by zip codes with the
first three (3) digits 470, 471, 472, 474, and 478.
(8) The geographic service area served by zip codes with the
first three (3) digits 475, 476, and 477.
(k) As used in this chapter, "medical service provider" refers to a
person or an entity that provides medical services, treatment, or
supplies to an employee under this chapter.
(l) As used in this chapter, "pecuniary liability" means the
responsibility of an employer or the employer's insurance carrier for
the payment of the charges for each specific service or product for
human medical treatment provided under this chapter in a defined
community, equal to or less than the charges made by medical
service providers at the eightieth percentile in the same community
for like services or products.
(Formerly: Acts 1937, c.69, s.5; Acts 1955, c.131, s.1; Acts 1955,
c.195, s.1; Acts 1961, c.240, s.1; Acts 1963, c.48, s.16; Acts 1969,
c.101, s.1; Acts 1974, P.L.109, SEC.3.) As amended by Acts 1979,
P.L.228, SEC.2; P.L.224-1985, SEC.1; P.L.95-1988, SEC.12;
P.L.75-1993, SEC.5; P.L.8-1993, SEC.284; P.L.1-1994, SEC.111;
P.L.110-1995, SEC.34; P.L.216-1995, SEC.5; P.L.2-1996, SEC.266;
P.L.258-1997(ss), SEC.13; P.L.235-1999, SEC.7; P.L.31-2000,
SEC.7; P.L.202-2001, SEC.8; P.L.201-2005, SEC.7.
IC 22-3-7-9.2
"Violation of the child labor laws of this state"
Sec. 9.2. As used in section 9(c) of this chapter, the term
"violation of the child labor laws of this state" means a violation of
IC 20-33-3-35. The term does not include a violation of any other
provision of IC 20-33-3.
As added by P.L.37-1985, SEC.32. Amended by P.L.106-1992,
SEC.12; P.L.1-2005, SEC.183.
IC 22-3-7-10
Definitions; course of employment
Sec. 10. (a) As used in this chapter, "occupational disease" means
a disease arising out of and in the course of the employment.
Ordinary diseases of life to which the general public is exposed
outside of the employment shall not be compensable, except where
such diseases follow as an incident of an occupational disease as
defined in this section.
(b) A disease arises out of the employment only if there is
apparent to the rational mind, upon consideration of all of the
circumstances, a direct causal connection between the conditions
under which the work is performed and the occupational disease, and
which can be seen to have followed as a natural incident of the work
as a result of the exposure occasioned by the nature of the
employment, and which can be fairly traced to the employment as the
proximate cause, and which does not come from a hazard to which
workers would have been equally exposed outside of the
employment. The disease must be incidental to the character of the
business and not independent of the relation of employer and
employee. The disease need not have been foreseen or expected but
after its contraction it must appear to have had its origin in a risk
connected with the employment and to have flowed from that source
as a rational consequence.
(Formerly: Acts 1937, c.69, s.6.) As amended by P.L.144-1986,
SEC.61; P.L.28-1988, SEC.51.
IC 22-3-7-10.5
Average weekly wages of public employee; determination
Sec. 10.5. For purposes of this chapter, the average weekly wages
of a public employee shall be determined without regard to any
salary reduction agreement under Section 125 of the Internal
Revenue Code.
As added by P.L.5-1992, SEC.9.
c.290, s.1; Acts 1947, c.164, s.1; Acts 1949, c.242, s.3; Acts 1951,
c.250, s.3; Acts 1957, c.353, s.1; Acts 1967, c.313, s.1; Acts 1969,
c.101, s.2; Acts 1974, P.L.109, SEC.4.) As amended by Acts 1976,
P.L.112, SEC.4.
IC 22-3-7-12
Dependents; classification
Sec. 12. (a) Dependents under this chapter shall consist of the
following three (3) classes:
(1) Presumptive dependents.
(2) Total dependents in fact.
(3) Partial dependents in fact.
(b) Presumptive dependents shall be entitled to compensation to
the complete exclusion of total dependents in fact and partial
dependents in fact and shall be entitled to such compensation in
equal shares.
(c) Total dependents in fact shall be entitled to compensation to
the complete exclusion of partial dependents in fact and shall be
entitled to such compensation, if more than one (1) such dependent
exists, in equal shares. The question of total dependency shall be
determined as of the time of death.
(d) Partial dependents in fact shall not be entitled to any
compensation if any other class of dependents exist. The weekly
compensation to persons partially dependent in fact shall be in the
same proportion to the weekly compensation of persons wholly
dependent as the average amount contributed weekly by the deceased
to such partial dependent in fact bears to his average weekly wages
at the time of the disablement. The question of partial dependency in
fact shall be determined as of the time of the disablement.
(Formerly: Acts 1937, c.69, s.7a; Acts 1947, c.164, s.2.) As amended
by P.L.144-1986, SEC.62.
IC 22-3-7-13
Presumptive dependents; termination of dependency
Sec. 13. (a) The following persons are conclusively presumed to
be wholly dependent for support upon a deceased employee and shall
constitute the class known as presumptive dependents in section 12
of this chapter:
(1) A wife upon a husband with whom she is living at the time
of his death, or upon whom the laws of the state impose the
obligation of her support at such time. The term "wife", as used
in this subdivision, shall exclude a common law wife unless
such common law relationship was entered into before January
1, 1958, and, in addition, existed openly and notoriously for a
period of not less than five (5) years immediately preceding the
death.
(2) A husband upon his wife with whom he is living at the time
of her death. The term "husband", as used in this subdivision,
shall exclude a common law husband unless such common law
relationship was entered into before January 1, 1958, and, in
addition existed openly and notoriously for a period of not less
than five (5) years immediately preceding the death.
(3) An unmarried child under the age of twenty-one (21) years
upon the parent with whom the child is living at the time of the
death of such parent.
(4) An unmarried child under twenty-one (21) years upon the
parent with whom the child may not be living at the time of the
death of such parent, but upon whom at such time, the laws of
the state impose the obligation to support such child.
(5) A child over the age of twenty-one (21) years who has never
been married and who is either physically or mentally
incapacitated from earning the child's own support, upon a
parent upon whom the laws of the state impose the obligation
of the support of such unmarried child.
(6) A child over the age of twenty-one (21) years who has never
been married and who at the time of the death of the parent is
keeping house for and living with such parent and is not
otherwise gainfully employed.
(b) As used in this section, the term "child" includes stepchildren,
legally adopted children, posthumous children, and acknowledged
children born out of wedlock. The term "parent" includes stepparents
and parents by adoption.
(c) The dependency of a child under subsections (a)(3) and (a)(4)
shall terminate when the child attains the age of twenty-one (21).
(d) The dependency of any person as a presumptive dependent
shall terminate upon the marriage of such dependent subsequent to
the death of the employee, and such dependency shall not be
reinstated by divorce. However, for deaths from injuries occurring on
and after July 1, 1977, a surviving spouse who is a presumptive
dependent and who is the only surviving dependent of the deceased
is entitled to receive, upon remarriage before the expiration of the
maximum statutory compensation period, a lump sum settlement
equal to the smaller of one hundred four (104) weeks of
compensation or the compensation for the remainder of the
maximum statutory period.
(e) The dependency of any child under subsection (a)(6) shall be
terminated at such time as such dependent becomes gainfully
employed or marries.
(Formerly: Acts 1937, c.69, s.7b; Acts 1947, c.164, s.3; Acts 1963,
c.388, s.9.) As amended by Acts 1977, P.L.261, SEC.4;
P.L.152-1987, SEC.7; P.L.134-1990, SEC.2.
IC 22-3-7-14
Dependents; total or partial dependents; relatives; termination of
dependency
Sec. 14. Total or partial dependents in fact shall include only
those persons related to the deceased employee by blood or by
marriage, except an unmarried child under eighteen (18) years of age.
Any such person who is actually totally or partially dependent upon
the deceased employee is entitled to compensation as such dependent
in fact. The right to compensation of any person totally or partially
dependent in fact shall be terminated by the marriage of such
dependent subsequent to the death of the employee and such
dependency shall not be reinstated by divorce.
(Formerly: Acts 1937, c.69, s.7c; Acts 1947, c.164, s.4.)
IC 22-3-7-15
Death benefits; burial expenses
Sec. 15. In cases of the death of an employee from an
occupational disease arising out of and in the course of the
employee's employment under circumstances that the employee
would have been entitled to compensation if death had not resulted,
the employer shall pay the burial expenses of such employee, not
exceeding seven thousand five hundred dollars ($7,500).
(Formerly: Acts 1937, c.69, s.7d; Acts 1947, c.164, s.5; Acts 1955,
c.241, s.1; Acts 1963, c.388, s.10; Acts 1967, c.313, s.2; Acts 1971,
P.L.354, SEC.1.) As amended by P.L.225-1983, SEC.3; P.L.95-1988,
SEC.13; P.L.170-1991, SEC.18; P.L.201-2005, SEC.8.
IC 22-3-7-16
Disablements; awards
Sec. 16. (a) Compensation shall be allowed on account of
disablement from occupational disease resulting in only temporary
total disability to work or temporary partial disability to work
beginning with the eighth day of such disability except for the
medical benefits provided for in section 17 of this chapter.
Compensation shall be allowed for the first seven (7) calendar days
only as provided in this section. The first weekly installment of
compensation for temporary disability is due fourteen (14) days after
the disability begins. Not later than fifteen (15) days from the date
that the first installment of compensation is due, the employer or the
employer's insurance carrier shall tender to the employee or to the
employee's dependents, with all compensation due, a properly
prepared compensation agreement in a form prescribed by the board.
Whenever an employer or the employer's insurance carrier denies or
is not able to determine liability to pay compensation or benefits, the
employer or the employer's insurance carrier shall notify the worker's
compensation board and the employee in writing on a form
prescribed by the worker's compensation board not later than thirty
(30) days after the employer's knowledge of the claimed disablement.
If a determination of liability cannot be made within thirty (30) days,
the worker's compensation board may approve an additional thirty
(30) days upon a written request of the employer or the employer's
insurance carrier that sets forth the reasons that the determination
could not be made within thirty (30) days and states the facts or
circumstances that are necessary to determine liability within the
additional thirty (30) days. More than thirty (30) days of additional
time may be approved by the worker's compensation board upon the
filing of a petition by the employer or the employer's insurance
carrier that sets forth:
for the disabilities.
(i) For disabilities occurring on and after July 1, 1989, and before
July 1, 1990, from occupational disease in the schedule set forth in
subsection (j), the employee shall receive in addition to disability
benefits, not exceeding seventy-eight (78) weeks on account of the
occupational disease, a weekly compensation of sixty percent (60%)
of the employee's average weekly wages, not to exceed one hundred
eighty-three dollars ($183) average weekly wages, for the period
stated for the disabilities.
(j) For disabilities occurring on and after July 1, 1990, and before
July 1, 1991, from occupational disease in the following schedule,
the employee shall receive in addition to disability benefits, not
exceeding seventy-eight (78) weeks on account of the occupational
disease, a weekly compensation of sixty percent (60%) of the
employee's average weekly wages, not to exceed two hundred dollars
($200) average weekly wages, for the period stated for the
disabilities.
(1) Amputations: For the loss by separation, of the thumb, sixty
(60) weeks; of the index finger, forty (40) weeks; of the second
finger, thirty-five (35) weeks; of the third or ring finger, thirty
(30) weeks; of the fourth or little finger, twenty (20) weeks; of
the hand by separation below the elbow, two hundred (200)
weeks; of the arm above the elbow joint, two hundred fifty
(250) weeks; of the big toe, sixty (60) weeks; of the second toe,
thirty (30) weeks; of the third toe, twenty (20) weeks; of the
fourth toe, fifteen (15) weeks; of the fifth or little toe, ten (10)
weeks; of the foot below the knee joint, one hundred fifty (150)
weeks; and of the leg above the knee joint, two hundred (200)
weeks. The loss of more than one (1) phalange of a thumb or
toe shall be considered as the loss of the entire thumb or toe.
The loss of more than two (2) phalanges of a finger shall be
considered as the loss of the entire finger. The loss of not more
than one (1) phalange of a thumb or toe shall be considered as
the loss of one-half (1/2) of the thumb or toe and compensation
shall be paid for one-half (1/2) of the period for the loss of the
entire thumb or toe. The loss of not more than two (2)
phalanges of a finger shall be considered as the loss of one-half
(1/2) the finger and compensation shall be paid for one-half
(1/2) of the period for the loss of the entire finger.
(2) Loss of Use: The total permanent loss of the use of an arm,
hand, thumb, finger, leg, foot, toe, or phalange shall be
considered as the equivalent of the loss by separation of the
arm, hand, thumb, finger, leg, foot, toe, or phalange and the
compensation shall be paid for the same period as for the loss
thereof by separation.
(3) Partial Loss of Use: For the permanent partial loss of the use
of an arm, hand, thumb, finger, leg, foot, toe, or phalange,
compensation shall be paid for the proportionate loss of the use
of such arm, hand, thumb, finger, leg, foot, toe, or phalange.
(4) For disablements for occupational disease resulting in total
permanent disability, five hundred (500) weeks.
(5) For the loss of both hands, or both feet, or the total sight of
both eyes, or any two (2) of such losses resulting from the same
disablement by occupational disease, five hundred (500) weeks.
(6) For the permanent and complete loss of vision by
enucleation of an eye or its reduction to one-tenth (1/10) of
normal vision with glasses, one hundred fifty (150) weeks, and
for any other permanent reduction of the sight of an eye,
compensation shall be paid for a period proportionate to the
degree of such permanent reduction without correction or
glasses. However, when such permanent reduction without
correction or glasses would result in one hundred percent
(100%) loss of vision, but correction or glasses would result in
restoration of vision, then compensation shall be paid for fifty
percent (50%) of such total loss of vision without glasses plus
an additional amount equal to the proportionate amount of such
reduction with glasses, not to exceed an additional fifty percent
(50%).
(7) For the permanent and complete loss of hearing, two
hundred (200) weeks.
(8) In all other cases of permanent partial impairment,
compensation proportionate to the degree of such permanent
partial impairment, in the discretion of the worker's
compensation board, not exceeding five hundred (500) weeks.
(9) In all cases of permanent disfigurement, which may impair
the future usefulness or opportunities of the employee,
compensation in the discretion of the worker's compensation
board, not exceeding two hundred (200) weeks, except that no
compensation shall be payable under this paragraph where
compensation shall be payable under subdivisions (1) through
(8). Where compensation for temporary total disability has been
paid, this amount of compensation shall be deducted from any
compensation due for permanent disfigurement.
(k) With respect to disablements in the following schedule
occurring on and after July 1, 1991, the employee shall receive in
addition to temporary total disability benefits, not exceeding one
hundred twenty-five (125) weeks on account of the disablement,
compensation in an amount determined under the following schedule
to be paid weekly at a rate of sixty-six and two-thirds percent (66
2/3%) of the employee's average weekly wages during the fifty-two
(52) weeks immediately preceding the week in which the
disablement occurred:
(1) Amputation: For the loss by separation of the thumb, twelve
(12) degrees of permanent impairment; of the index finger,
eight (8) degrees of permanent impairment; of the second
finger, seven (7) degrees of permanent impairment; of the third
or ring finger, six (6) degrees of permanent impairment; of the
fourth or little finger, four (4) degrees of permanent
impairment; of the hand by separation below the elbow joint,
forty (40) degrees of permanent impairment; of the arm above
the elbow, fifty (50) degrees of permanent impairment; of the
big toe, twelve (12) degrees of permanent impairment; of the
second toe, six (6) degrees of permanent impairment; of the
third toe, four (4) degrees of permanent impairment; of the
fourth toe, three (3) degrees of permanent impairment; of the
fifth or little toe, two (2) degrees of permanent impairment; of
separation of the foot below the knee joint, thirty-five (35)
degrees of permanent impairment; and of the leg above the knee
joint, forty-five (45) degrees of permanent impairment.
(2) Amputations occurring on or after July 1, 1997: For the loss
by separation of any of the body parts described in subdivision
(1) on or after July 1, 1997, the dollar values per degree
applying on the date of the injury as described in subsection (l)
shall be multiplied by two (2). However, the doubling provision
of this subdivision does not apply to a loss of use that is not a
loss by separation.
(3) The loss of more than one (1) phalange of a thumb or toe
shall be considered as the loss of the entire thumb or toe. The
loss of more than two (2) phalanges of a finger shall be
considered as the loss of the entire finger. The loss of not more
than one (1) phalange of a thumb or toe shall be considered as
the loss of one-half (1/2) of the degrees of permanent
impairment for the loss of the entire thumb or toe. The loss of
not more than one (1) phalange of a finger shall be considered
as the loss of one-third (1/3) of the finger and compensation
shall be paid for one-third (1/3) of the degrees payable for the
loss of the entire finger. The loss of more than one (1) phalange
of the finger but not more than two (2) phalanges of the finger
shall be considered as the loss of one-half (1/2) of the finger
and compensation shall be paid for one-half (1/2) of the degrees
payable for the loss of the entire finger.
(4) For the loss by separation of both hands or both feet or the
total sight of both eyes or any two (2) such losses in the same
accident, one hundred (100) degrees of permanent impairment.
(5) For the permanent and complete loss of vision by
enucleation or its reduction to one-tenth (1/10) of normal vision
with glasses, thirty-five (35) degrees of permanent impairment.
(6) For the permanent and complete loss of hearing in one (1)
ear, fifteen (15) degrees of permanent impairment, and in both
ears, forty (40) degrees of permanent impairment.
(7) For the loss of one (1) testicle, ten (10) degrees of
permanent impairment; for the loss of both testicles, thirty (30)
degrees of permanent impairment.
(8) Loss of use: The total permanent loss of the use of an arm,
a hand, a thumb, a finger, a leg, a foot, a toe, or a phalange shall
be considered as the equivalent of the loss by separation of the
arm, hand, thumb, finger, leg, foot, toe, or phalange, and
compensation shall be paid in the same amount as for the loss
by separation. However, the doubling provision of subdivision
(2) does not apply to a loss of use that is not a loss by
separation.
(9) Partial loss of use: For the permanent partial loss of the use
of an arm, a hand, a thumb, a finger, a leg, a foot, a toe, or a
phalange, compensation shall be paid for the proportionate loss
of the use of the arm, hand, thumb, finger, leg, foot, toe, or
phalange.
(10) For disablements resulting in total permanent disability, the
amount payable for impairment or five hundred (500) weeks of
compensation, whichever is greater.
(11) For any permanent reduction of the sight of an eye less
than a total loss as specified in subdivision (5), the
compensation shall be paid in an amount proportionate to the
degree of a permanent reduction without correction or glasses.
However, when a permanent reduction without correction or
glasses would result in one hundred percent (100%) loss of
vision, then compensation shall be paid for fifty percent (50%)
of the total loss of vision without glasses, plus an additional
amount equal to the proportionate amount of the reduction with
glasses, not to exceed an additional fifty percent (50%).
(12) For any permanent reduction of the hearing of one (1) or
both ears, less than the total loss as specified in subdivision (6),
compensation shall be paid in an amount proportionate to the
degree of a permanent reduction.
(13) In all other cases of permanent partial impairment,
compensation proportionate to the degree of a permanent partial
impairment, in the discretion of the worker's compensation
board, not exceeding one hundred (100) degrees of permanent
impairment.
(14) In all cases of permanent disfigurement which may impair
the future usefulness or opportunities of the employee,
compensation, in the discretion of the worker's compensation
board, not exceeding forty (40) degrees of permanent
impairment except that no compensation shall be payable under
this subdivision where compensation is payable elsewhere in
this section.
(l) With respect to disablements occurring on and after July 1,
1991, compensation for permanent partial impairment shall be paid
according to the degree of permanent impairment for the disablement
determined under subsection (k) and the following:
(1) With respect to disablements occurring on and after July 1,
1991, and before July 1, 1992, for each degree of permanent
impairment from one (1) to thirty-five (35), five hundred dollars
($500) per degree; for each degree of permanent impairment
from thirty-six (36) to fifty (50), nine hundred dollars ($900)
per degree; for each degree of permanent impairment above
fifty (50), one thousand five hundred dollars ($1,500) per
degree.
(2) With respect to disablements occurring on and after July 1,
1992, and before July 1, 1993, for each degree of permanent
impairment from one (1) to twenty (20), five hundred dollars
($500) per degree; for each degree of permanent impairment
from twenty-one (21) to thirty-five (35), eight hundred dollars
($800) per degree; for each degree of permanent impairment
from thirty-six (36) to fifty (50), one thousand three hundred
dollars ($1,300) per degree; for each degree of permanent
impairment above fifty (50), one thousand seven hundred
dollars ($1,700) per degree.
(3) With respect to disablements occurring on and after July 1,
1993, and before July 1, 1997, for each degree of permanent
impairment from one (1) to ten (10), five hundred dollars
($500) per degree; for each degree of permanent impairment
from eleven (11) to twenty (20), seven hundred dollars ($700)
per degree; for each degree of permanent impairment from
twenty-one (21) to thirty-five (35), one thousand dollars
($1,000) per degree; for each degree of permanent impairment
from thirty-six (36) to fifty (50), one thousand four hundred
dollars ($1,400) per degree; for each degree of permanent
impairment above fifty (50), one thousand seven hundred
dollars ($1,700) per degree.
(4) With respect to disablements occurring on and after July 1,
1997, and before July 1, 1998, for each degree of permanent
impairment from one (1) to ten (10), seven hundred fifty dollars
($750) per degree; for each degree of permanent impairment
from eleven (11) to thirty-five (35), one thousand dollars
($1,000) per degree; for each degree of permanent impairment
from thirty-six (36) to fifty (50), one thousand four hundred
dollars ($1,400) per degree; for each degree of permanent
impairment above fifty (50), one thousand seven hundred
dollars ($1,700) per degree.
(5) With respect to disablements occurring on and after July 1,
1998, and before July 1, 1999, for each degree of permanent
impairment from one (1) to ten (10), seven hundred fifty dollars
($750) per degree; for each degree of permanent impairment
from eleven (11) to thirty-five (35), one thousand dollars
($1,000) per degree; for each degree of permanent impairment
from thirty-six (36) to fifty (50), one thousand four hundred
dollars ($1,400) per degree; for each degree of permanent
impairment above fifty (50), one thousand seven hundred
dollars ($1,700) per degree.
(6) With respect to disablements occurring on and after July 1,
1999, and before July 1, 2000, for each degree of permanent
impairment from one (1) to ten (10), nine hundred dollars
($900) per degree; for each degree of permanent impairment
from eleven (11) to thirty-five (35), one thousand one hundred
dollars ($1,100) per degree; for each degree of permanent
impairment from thirty-six (36) to fifty (50), one thousand six
hundred dollars ($1,600) per degree; for each degree of
permanent impairment above fifty (50), two thousand dollars
($2,000) per degree.
(7) With respect to disablements occurring on and after July 1,
2000, and before July 1, 2001, for each degree of permanent
impairment from one (1) to ten (10), one thousand one hundred
dollars ($1,100) per degree; for each degree of permanent
impairment from eleven (11) to thirty-five (35), one thousand
three hundred dollars ($1,300) per degree; for each degree of
permanent impairment from thirty-six (36) to fifty (50), two
thousand dollars ($2,000) per degree; for each degree of
permanent impairment above fifty (50), two thousand five
hundred fifty dollars ($2,500) per degree.
(8) With respect to disablements occurring on and after July 1,
2001, and before July 1, 2007, for each degree of permanent
impairment from one (1) to ten (10), one thousand three
hundred dollars ($1,300) per degree; for each degree of
permanent impairment from eleven (11) to thirty-five (35), one
thousand five hundred dollars ($1,500) per degree; for each
degree of permanent impairment from thirty-six (36) to fifty
(50), two thousand four hundred dollars ($2,400) per degree; for
each degree of permanent impairment above fifty (50), three
thousand dollars ($3,000) per degree.
(9) With respect to disablements occurring on and after July 1,
2007, and before July 1, 2008, for each degree of permanent
impairment from one (1) to ten (10), one thousand three
hundred forty dollars ($1,340) per degree; for each degree of
permanent impairment from eleven (11) to thirty-five (35), one
thousand five hundred forty-five dollars ($1,545) per degree;
for each degree of permanent impairment from thirty-six (36) to
fifty (50), two thousand four hundred seventy-five dollars
($2,475) per degree; for each degree of permanent impairment
above fifty (50), three thousand one hundred fifty dollars
($3,150) per degree.
(10) With respect to disablements occurring on and after July 1,
2008, and before July 1, 2009, for each degree of permanent
impairment from one (1) to ten (10), one thousand three
hundred sixty-five dollars ($1,365) per degree; for each degree
of permanent impairment from eleven (11) to thirty-five (35),
one thousand five hundred seventy dollars ($1,570) per degree;
for each degree of permanent impairment from thirty-six (36) to
fifty (50), two thousand five hundred twenty-five dollars
($2,525) per degree; for each degree of permanent impairment
above fifty (50), three thousand two hundred dollars ($3,200)
per degree.
(11) With respect to disablements occurring on and after July 1,
2009, and before July 1, 2010, for each degree of permanent
impairment from one (1) to ten (10), one thousand three
hundred eighty dollars ($1,380) per degree; for each degree of
permanent impairment from eleven (11) to thirty-five (35), one
thousand five hundred eighty-five dollars ($1,585) per degree;
for each degree of permanent impairment from thirty-six (36) to
fifty (50), two thousand six hundred dollars ($2,600) per
degree; for each degree of permanent impairment above fifty
(50), three thousand three hundred dollars ($3,300) per degree.
(12) With respect to disablements occurring on and after July 1,
2010, for each degree of permanent impairment from one (1) to
ten (10), one thousand four hundred dollars ($1,400) per degree;
for each degree of permanent impairment from eleven (11) to
thirty-five (35), one thousand six hundred dollars ($1,600) per
degree; for each degree of permanent impairment from
thirty-six (36) to fifty (50), two thousand seven hundred dollars
($2,700) per degree; for each degree of permanent impairment
above fifty (50), three thousand five hundred dollars ($3,500)
per degree.
(m) The average weekly wages used in the determination of
compensation for permanent partial impairment under subsections
(k) and (l) shall not exceed the following:
(1) With respect to disablements occurring on or after July 1,
1991, and before July 1, 1992, four hundred ninety-two dollars
($492).
(2) With respect to disablements occurring on or after July 1,
1992, and before July 1, 1993, five hundred forty dollars
($540).
(3) With respect to disablements occurring on or after July 1,
1993, and before July 1, 1994, five hundred ninety-one dollars
($591).
(4) With respect to disablements occurring on or after July 1,
1994, and before July 1, 1997, six hundred forty-two dollars
($642).
(5) With respect to disablements occurring on or after July 1,
1997, and before July 1, 1998, six hundred seventy-two dollars
($672).
(6) With respect to disablements occurring on or after July 1,
1998, and before July 1, 1999, seven hundred two dollars
($702).
(7) With respect to disablements occurring on or after July 1,
1999, and before July 1, 2000, seven hundred thirty-two dollars
($732).
(8) With respect to disablements occurring on or after July 1,
2000, and before July 1, 2001, seven hundred sixty-two dollars
($762).
(9) With respect to injuries occurring on or after July 1, 2001,
and before July 1, 2002, eight hundred twenty-two dollars
($822).
(10) With respect to injuries occurring on or after July 1, 2002,
and before July 1, 2006, eight hundred eighty-two dollars
($882).
(11) With respect to injuries occurring on or after July 1, 2006,
and before July 1, 2007, nine hundred dollars ($900).
(12) With respect to injuries occurring on or after July 1, 2007,
and before July 1, 2008, nine hundred thirty dollars ($930).
(13) With respect to injuries occurring on or after July 1, 2008,
and before July 1, 2009, nine hundred fifty-four dollars ($954).
result in total permanent disability or permanent total impairment,
compensation shall be payable for such permanent total disability or
impairment, but payments made for the previous disability or
impairment shall be deducted from the total payment of
compensation due.
(r) When an employee has been awarded or is entitled to an award
of compensation for a definite period from an occupational disease
wherein disablement occurs on and after April 1, 1963, and such
employee dies from other causes than such occupational disease,
payment of the unpaid balance of such compensation not exceeding
three hundred fifty (350) weeks shall be paid to the employee's
dependents of the second and third class as defined in sections 11
through 14 of this chapter and compensation, not exceeding five
hundred (500) weeks shall be made to the employee's dependents of
the first class as defined in sections 11 through 14 of this chapter.
(s) Any payment made by the employer to the employee during
the period of the employee's disability, or to the employee's
dependents, which, by the terms of this chapter, was not due and
payable when made, may, subject to the approval of the worker's
compensation board, be deducted from the amount to be paid as
compensation, but such deduction shall be made from the distal end
of the period during which compensation must be paid, except in
cases of temporary disability.
(t) When so provided in the compensation agreement or in the
award of the worker's compensation board, compensation may be
paid semimonthly, or monthly, instead of weekly.
(u) When the aggregate payments of compensation awarded by
agreement or upon hearing to an employee or dependent under
eighteen (18) years of age do not exceed one hundred dollars ($100),
the payment thereof may be made directly to such employee or
dependent, except when the worker's compensation board shall order
otherwise.
(v) Whenever the aggregate payments of compensation, due to
any person under eighteen (18) years of age, exceed one hundred
dollars ($100), the payment thereof shall be made to a trustee,
appointed by the circuit or superior court, or to a duly qualified
guardian, or, upon the order of the worker's compensation board, to
a parent or to such minor person. The payment of compensation, due
to any person eighteen (18) years of age or over, may be made
directly to such person.
(w) If an employee, or a dependent, is mentally incompetent, or
a minor at the time when any right or privilege accrues to the
employee under this chapter, the employee's guardian or trustee may,
in the employee's behalf, claim and exercise such right and privilege.
(x) All compensation payments named and provided for in this
section, shall mean and be defined to be for only such occupational
diseases and disabilities therefrom as are proved by competent
evidence, of which there are or have been objective conditions or
symptoms proven, not within the physical or mental control of the
employee.
IC 22-3-7-17
Medical attendance and treatment; prosthetic devices; emergency
treatment; liability to providers
Sec. 17. (a) During the period of disablement, the employer shall
furnish or cause to be furnished, free of charge to the employee, an
attending physician for the treatment of his occupational disease, and
in addition thereto such surgical, hospital, and nursing services and
supplies as the attending physician or the worker's compensation
board may deem necessary. If the employee is requested or required
by the employer to submit to treatment outside the county of
employment, the employer shall also pay the reasonable expense of
travel, food, and lodging necessary during the travel, but not to
exceed the amount paid at the time of the travel by the state of
Indiana to its employees. If the treatment or travel to or from the
place of treatment causes a loss of working time to the employee, the
employer shall reimburse the employee for the loss of wages using
the basis of the employee's average daily wage.
(b) During the period of disablement resulting from the
occupational disease, the employer shall furnish such physician,
services, and supplies, and the worker's compensation board may, on
proper application of either party, require that treatment by such
physician and such services and supplies be furnished by or on behalf
of the employer as the board may deem reasonably necessary. After
an employee's occupational disease has been adjudicated by
agreement or award on the basis of permanent partial impairment and
within the statutory period for review in such case as provided in
section 27(i) of this chapter, the employer may continue to furnish a
physician or a surgeon and other medical services and supplies, and
the board may, within such statutory period for review as provided
in section 27(i) of this chapter, on a proper application of either
party, require that treatment by such physician or surgeon and such
services and supplies be furnished by and on behalf of the employer
as the board may deem necessary to limit or reduce the amount and
extent of such impairment. The refusal of the employee to accept
such services and supplies when so provided by or on behalf of the
employer, shall bar the employee from all compensation otherwise
payable during the period of such refusal and his right to prosecute
any proceeding under this chapter shall be suspended and abated
until such refusal ceases. The employee must be served with a notice
setting forth the consequences of the refusal under this section. The
notice must be in a form prescribed by the worker's compensation
board. No compensation for permanent total impairment, permanent
partial impairment, permanent disfigurement, or death shall be paid
or payable for that part or portion of such impairment, disfigurement,
or death which is the result of the failure of such employee to accept
such treatment, services, and supplies, provided that an employer
may at any time permit an employee to have treatment for his disease
or injury by spiritual means or prayer in lieu of such physician,
services, and supplies.
(c) Regardless of when it occurs, where a compensable
occupational disease results in the amputation of a body part, the
enucleation of an eye, or the loss of natural teeth, the employer shall
furnish an appropriate artificial member, braces, and prosthodontics.
The cost of repairs to or replacements for the artificial members,
braces, or prosthodontics that result from a compensable
occupational disease pursuant to a prior award and are required due
to either medical necessity or normal wear and tear, determined
according to the employee's individual use, but not abuse, of the
artificial member, braces, or prosthodontics, shall be paid from the
second injury fund upon order or award of the worker's
compensation board. The employee is not required to meet any other
requirement for admission to the second injury fund.
(d) If an emergency or because of the employer's failure to
provide such attending physician or such surgical, hospital, or nurse's
services and supplies or such treatment by spiritual means or prayer
as specified in this section, or for other good reason, a physician
other than that provided by the employer treats the diseased
employee within the period of disability, or necessary and proper
surgical, hospital, or nurse's services and supplies are procured
within the period, the reasonable cost of such services and supplies
shall, subject to approval of the worker's compensation board, be
paid by the employer.
(e) This section may not be construed to prohibit an agreement
between an employer and employees that has the approval of the
board and that:
(1) binds the parties to medical care furnished by providers
selected by agreement before or after disablement; or
(2) makes the findings of a provider chosen in this manner
binding upon the parties.
(f) The employee and the employee's estate do not have liability
to a health care provider for payment for services obtained under this
section. The right to order payment for all services provided under
this chapter is solely with the board. All claims by a health care
provider for payment for services are against the employer and the
employer's insurance carrier, if any, and must be made with the board
under this chapter.
(Formerly: Acts 1937, c.69, s.9; Acts 1947, c.164, s.6; Acts 1963,
c.388, s.12.) As amended by P.L.144-1986, SEC.63; P.L.28-1988,
SEC.52; P.L.95-1988, SEC.15; P.L.170-1991, SEC.20;
P.L.258-1997(ss), SEC.15; P.L.31-2000, SEC.9.
IC 22-3-7-17.2
Billing review service standards
Sec. 17.2. (a) A billing review service shall adhere to the
following requirements to determine the pecuniary liability of an
employer or an employer's insurance carrier for a specific service or
product covered under this chapter:
(1) The formation of a billing review standard, and any
subsequent analysis or revision of the standard, must use data
that is based on the medical service provider billing charges as
submitted to the employer and the employer's insurance carrier
from the same community. This subdivision does not apply
when a unique or specialized service or product does not have
sufficient comparative data to allow for a reasonable
comparison.
(2) Data used to determine pecuniary liability must be compiled
on or before June 30 and December 31 of each year.
(3) Billing review standards must be revised for prospective
future payments of medical service provider bills to provide for
payment of the charges at a rate not more than the charges made
by eighty percent (80%) of the medical service providers during
the prior six (6) months within the same community. The data
used to perform the analysis and revision of the billing review
standards may not be more than two (2) years old and must be
periodically updated by a representative inflationary or
deflationary factor. Reimbursement for these charges may not
exceed the actual charge invoiced by the medical service
provider.
(4) The billing review standard shall include the billing charges
of all hospitals in the applicable community for the service or
product.
(b) A medical service provider may request an explanation from
a billing review service if the medical service provider's bill has been
reduced as a result of application of the eightieth percentile or of a
Current Procedural Terminology (CPT) coding change. The request
must be made not later than sixty (60) days after receipt of the notice
of the reduction. If a request is made, the billing review service must
provide:
(1) the name of the billing review service used to make the
reduction;
(2) the dollar amount of the reduction;
(3) the dollar amount of the medical service at the eightieth
percentile; and
(4) in the case of a CPT coding change, the basis upon which
the change was made;
not later than thirty (30) days after the date of the request.
(c) If after a hearing the worker's compensation board finds that
a billing review service used a billing review standard that did not
comply with subsection (a)(1) through (a)(4) in determining the
pecuniary liability of an employer or an employer's insurance carrier
for a health care provider's charge for services or products covered
under occupational disease compensation, the worker's compensation
board may assess a civil penalty against the billing review service in
an amount not less than one hundred dollars ($100) and not more
than one thousand dollars ($1,000).
As added by P.L.216-1995, SEC.7. Amended by P.L.202-2001,
SEC.9.
IC 22-3-7-18
Awards; lump sum payments
Sec. 18. (a) Any employer or employee or beneficiary who shall
desire to have such compensation, or any unpaid part thereof, paid in
a lump sum, may petition the worker's compensation board, asking
that such compensation be so paid, and if, upon proper notice to the
interested parties, and a proper showing made before the worker's
compensation board, or any member thereof, it appears to the best
interest of the parties that such compensation be so paid, the worker's
compensation board may order the commutation of the compensation
to an equivalent lump sum, which commutation shall be an amount
which will equal the total sum of the probable future payments
capitalized at their present value upon the basis of interest calculated
at three percent (3%) per year with annual rests. In cases indicating
complete disability, no petition for a commutation to a lump sum
basis shall be entertained by the board until after the expiration of six
(6) months from the date of the disablement.
(b) Whenever the worker's compensation board deems it
expedient, any lump sum under this section shall be paid by the
employer to some suitable person or corporation appointed by the
circuit or superior court, as trustee, to administer the same for the
benefit of the person entitled thereto, in the manner authorized by the
court appointing such trustee. The receipt of such trustee for the
amount so paid shall discharge the employer or anyone else who is
liable therefor.
IC 22-3-7-19
Awards; computation; average weekly wages
Sec. 19. (a) In computing compensation for temporary total
disability, temporary partial disability, and total permanent disability,
with respect to occupational diseases occurring on and after July 1,
1985, and before July 1, 1986, the average weekly wages are
considered to be:
(1) not more than two hundred sixty-seven dollars ($267); and
(2) not less than seventy-five dollars ($75).
(b) In computing compensation for temporary total disability,
temporary partial disability, and total permanent disability, with
respect to occupational diseases occurring on and after July 1, 1986,
and before July 1, 1988, the average weekly wages are considered to
be:
(1) not more than two hundred eighty-five dollars ($285); and
(2) not less than seventy-five dollars ($75).
(c) In computing compensation for temporary total disability,
temporary partial disability, and total permanent disability, with
respect to occupational diseases occurring on and after July 1, 1988,
and before July 1, 1989, the average weekly wages are considered to
be:
(1) not more than three hundred eighty-four dollars ($384); and
(2) not less than seventy-five dollars ($75).
(d) In computing compensation for temporary total disability,
temporary partial disability, and total permanent disability, with
respect to occupational diseases occurring on and after July 1, 1989,
and before July 1, 1990, the average weekly wages are considered to
be:
(1) not more than four hundred eleven dollars ($411); and
(2) not less than seventy-five dollars ($75).
(e) In computing compensation for temporary total disability,
temporary partial disability, and total permanent disability, with
respect to occupational diseases occurring on and after July 1, 1990,
and before July 1, 1991, the average weekly wages are considered to
be:
(1) not more than four hundred forty-one dollars ($441); and
(2) not less than seventy-five dollars ($75).
(f) In computing compensation for temporary total disability,
temporary partial disability, and total permanent disability, with
respect to occupational diseases occurring on and after July 1, 1991,
and before July 1, 1992, the average weekly wages are considered to
be:
(1) not more than four hundred ninety-two dollars ($492); and
(2) not less than seventy-five dollars ($75).
(g) In computing compensation for temporary total disability,
temporary partial disability, and total permanent disability, with
respect to occupational diseases occurring on and after July 1, 1992,
and before July 1, 1993, the average weekly wages are considered to
be:
(1) not more than five hundred forty dollars ($540); and
(2) not less than seventy-five dollars ($75).
(h) In computing compensation for temporary total disability,
temporary partial disability, and total permanent disability, with
respect to occupational diseases occurring on and after July 1, 1993,
and before July 1, 1994, the average weekly wages are considered to
be:
(1) not more than five hundred ninety-one dollars ($591); and
(2) not less than seventy-five dollars ($75).
(i) In computing compensation for temporary total disability,
temporary partial disability and total permanent disability, with
respect to occupational diseases occurring on and after July 1, 1994,
and before July 1, 1997, the average weekly wages are considered to
be:
(1) not more than six hundred forty-two dollars ($642); and
(2) not less than seventy-five dollars ($75).
(j) In computing compensation for temporary total disability,
temporary partial disability, and total permanent disability, the
average weekly wages are considered to be:
(1) with respect to occupational diseases occurring on and after
July 1, 1997, and before July 1, 1998:
(A) not more than six hundred seventy-two dollars ($672);
and
(B) not less than seventy-five dollars ($75);
(2) with respect to occupational diseases occurring on and after
July 1, 1998, and before July 1, 1999:
(A) not more than seven hundred two dollars ($702); and
(B) not less than seventy-five dollars ($75);
(3) with respect to occupational diseases occurring on and after
July 1, 1999, and before July 1, 2000:
(A) not more than seven hundred thirty-two dollars ($732);
and
(B) not less than seventy-five dollars ($75);
(4) with respect to occupational diseases occurring on and after
July 1, 2000, and before July 1, 2001:
(A) not more than seven hundred sixty-two dollars ($762);
and
(B) not less than seventy-five dollars ($75);
(5) with respect to disablements occurring on and after July 1,
2001, and before July 1, 2002:
(A) not more than eight hundred twenty-two dollars ($822);
and
(B) not less than seventy-five dollars ($75);
(6) with respect to disablements occurring on and after July 1,
2002, and before July 1, 2006:
(A) not more than eight hundred eighty-two dollars ($882);
and
(B) not less than seventy-five dollars ($75);
that shall be paid for occupational disease and the results thereof
under this chapter or under any combination of the provisions of this
chapter may not exceed one hundred sixty-four thousand dollars
($164,000) in any case.
(q) The maximum compensation with respect to disability or
death occurring on and after July 1, 1992, and before July 1, 1993,
that shall be paid for occupational disease and the results thereof
under this chapter or under any combination of the provisions of this
chapter may not exceed one hundred eighty thousand dollars
($180,000) in any case.
(r) The maximum compensation with respect to disability or death
occurring on and after July 1, 1993, and before July 1, 1994, that
shall be paid for occupational disease and the results thereof under
this chapter or under any combination of the provisions of this
chapter may not exceed one hundred ninety-seven thousand dollars
($197,000) in any case.
(s) The maximum compensation with respect to disability or death
occurring on and after July 1, 1994, and before July 1, 1997, that
shall be paid for occupational disease and the results thereof under
this chapter or under any combination of the provisions of this
chapter may not exceed two hundred fourteen thousand dollars
($214,000) in any case.
(t) The maximum compensation that shall be paid for
occupational disease and the results of an occupational disease under
this chapter or under any combination of the provisions of this
chapter may not exceed the following amounts in any case:
(1) With respect to disability or death occurring on and after
July 1, 1997, and before July 1, 1998, two hundred twenty-four
thousand dollars ($224,000).
(2) With respect to disability or death occurring on and after
July 1, 1998, and before July 1, 1999, two hundred thirty-four
thousand dollars ($234,000).
(3) With respect to disability or death occurring on and after
July 1, 1999, and before July 1, 2000, two hundred forty-four
thousand dollars ($244,000).
(4) With respect to disability or death occurring on and after
July 1, 2000, and before July 1, 2001, two hundred fifty-four
thousand dollars ($254,000).
(5) With respect to disability or death occurring on and after
July 1, 2001, and before July 1, 2002, two hundred seventy-four
thousand dollars ($274,000).
(6) With respect to disability or death occurring on and after
July 1, 2002, and before July 1, 2006, two hundred ninety-four
thousand dollars ($294,000).
(7) With respect to disability or death occurring on and after
July 1, 2006, and before July 1, 2007, three hundred thousand
dollars ($300,000).
(8) With respect to disability or death occurring on and after
July 1, 2007, and before July 1, 2008, three hundred ten
thousand dollars ($310,000).
disability or is injured has no physician or surgeon present at the
examination, it shall be the duty of the physician or surgeon making
the examination to deliver to the injured employee, or the employee's
representative, a statement in writing of the conditions evidenced by
such examination. The statement shall disclose all facts that are
reported by the physician or surgeon to the employer. This statement
shall be furnished to the employee or the employee's representative
as soon as practicable, but not later than thirty (30) days before the
time the case is set for hearing. The statement may be submitted by
either party as evidence by that physician or surgeon at a hearing
before the worker's compensation board if the statement meets the
requirements of subsection (f). If the physician or surgeon fails or
refuses to furnish the employee or the employee's representative with
such statement thirty (30) days before the hearing, then the statement
may not be submitted as evidence, and the physician shall not be
permitted to testify before the worker's compensation board as to any
facts learned in the examination. All of the requirements of this
subsection apply to all subsequent examinations requested by the
employer.
(e) In all cases where an examination of an employee is made by
a physician or surgeon engaged by the employee, and the employer
has no physician or surgeon present at such examination, it shall be
the duty of the physician or surgeon making the examination to
deliver to the employer or the employer's representative a statement
in writing of the conditions evidenced by such examination. The
statement shall disclose all the facts that are reported by such
physician or surgeon to the employee. The statement shall be
furnished to the employer or the employer's representative as soon as
practicable, but not later than thirty (30) days before the time the
case is set for hearing. The statement may be submitted by either
party as evidence by that physician or surgeon at a hearing before the
worker's compensation board if the statement meets the requirements
of subsection (f). If the physician or surgeon fails or refuses to
furnish the employer or the employer's representative with such
statement thirty (30) days before the hearing, then the statement may
not be submitted as evidence, and the physician or surgeon shall not
be permitted to testify before the worker's compensation board as to
any facts learned in such examination. All of the requirements of this
subsection apply to all subsequent examinations made by a physician
or surgeon engaged by the employee.
(f) All statements of physicians or surgeons required by this
section, whether those engaged by employee or employer, shall
contain the following information:
(1) The history of the injury, or claimed injury, as given by the
patient.
(2) The diagnosis of the physician or surgeon concerning the
patient's physical or mental condition.
(3) The opinion of the physician or surgeon concerning the
causal relationship, if any, between the injury and the patient's
physical or mental condition, including the physician's or
surgeon's reasons for the opinion.
(4) The opinion of the physician or surgeon concerning whether
the injury or claimed injury resulted in a disability or
impairment and, if so, the opinion of the physician or surgeon
concerning the extent of the disability or impairment and the
reasons for the opinion.
(5) The original signature of the physician or surgeon.
Notwithstanding any hearsay objection, the worker's compensation
board shall admit into evidence a statement that meets the
requirements of this subsection unless the statement is ruled
inadmissible on other grounds.
(g) Delivery of any statement required by this section may be
made to the attorney or agent of the employer or employee and such
an action shall be construed as delivery to the employer or employee.
(h) Any party may object to a statement on the basis that the
statement does not meet the requirements of subsection (e). The
objecting party must give written notice to the party providing the
statement and specify the basis for the objection. Notice of the
objection must be given no later than twenty (20) days before the
hearing. Failure to object as provided in this subsection precludes
any further objection as to the adequacy of the statement under
subsection (f).
(i) The employer upon proper application, or the worker's
compensation board, shall have the right in any case of death to
require an autopsy at the expense of the party requesting the same.
If, after a hearing, the board orders an autopsy and the autopsy is
refused by the surviving spouse or next of kin, in this event any claim
for compensation on account of the death shall be suspended and
abated during the refusal. The surviving spouse or dependent must
be served with a notice setting forth the consequences of the refusal
under this subsection. The notice must be in a form prescribed by the
worker's compensation board. No autopsy, except one performed by
or on the authority or order of the coroner in discharge of the
coroner's duties, shall be held in any case by any person without
notice first being given to the surviving spouse or next of kin, if they
reside in Indiana or their whereabouts can reasonably be ascertained,
of the time and place thereof, and reasonable time and opportunity
shall be given such surviving spouse or next of kin to have a
representative or representatives present to witness same. However,
if such notice is not given, all evidence obtained by the autopsy shall
be suspended on motion duly made to the board.
(Formerly: Acts 1937, c.69, s.12a; Acts 1963, c.388, s.14; Acts 1975,
P.L.235, SEC.5.) As amended by P.L.28-1988, SEC.54; P.L.95-1988,
SEC.17; P.L.109-1992, SEC.2; P.L.99-2007, SEC.183.
IC 22-3-7-21
Awards; disqualification
Sec. 21. (a) No compensation is allowed for any condition of
physical or mental ill-being, disability, disablement, or death for
which compensation is recoverable on account of accidental injury
under chapters 2 through 6 of this article.
(b) No compensation is allowed for any disease or death
knowingly self-inflicted by the employee, or due to his intoxication,
his commission of an offense, his knowing failure to use a safety
appliance, his knowing failure to obey a reasonable written or printed
rule of the employer which has been posted in a conspicuous position
in the place of work, or his knowing failure to perform any statutory
duty. The burden of proof is on the defendant.
(Formerly: Acts 1937, c.69, s.14.) As amended by Acts 1978, P.L.2,
SEC.2212.
IC 22-3-7-22
Industrial board; expenses; office space; meetings
Sec. 22. (a) The members of the board and its assistants shall be
entitled to receive from the state their actual and necessary expenses
while traveling on the business of the board, but such expenses shall
be sworn to by the person who incurred the same, and shall be
approved by the chairman of the board before payment is made. All
expenses of the board in connection with this chapter shall be audited
and paid out of the state treasury in the manner prescribed for similar
expenses in other departments or branches of the state service.
(b) The board shall be provided with adequate offices in the
capitol or some other suitable building in the city of Indianapolis in
which the records shall be kept and its official business be transacted
during regular business hours. It shall also be provided with
necessary office furniture, stationery, and other supplies. The board
or any member thereof may hold sessions at any place within the
state as may be deemed necessary.
(Formerly: Acts 1937, c.69, s.15.) As amended by P.L.144-1986,
SEC.64.
IC 22-3-7-23
Jurisdiction; administration
Sec. 23. The worker's compensation board shall have jurisdiction
over the operation and administration of the compensation provisions
of this chapter, the board shall perform all of the duties imposed
upon it by the provisions of this chapter, and such further duties as
may be imposed by law and the rules of the board not inconsistent
with this chapter.
(Formerly: Acts 1937, c.69, s.16.) As amended by P.L.144-1986,
SEC.65; P.L.28-1988, SEC.55.
IC 22-3-7-24
Rules; hearings; subpoenas; production of books and papers;
attorney's fees
Sec. 24. (a) The worker's compensation board may make rules not
inconsistent with this chapter for carrying out the provisions of this
chapter. Processes and procedures under this chapter shall be as
summary and simple as reasonably may be. The board, or any
member thereof, shall have the power, for the purpose of this
chapter, to subpoena witnesses, administer or cause to have
administered oaths, and to examine or cause to have examined such
parts of the books and records of the parties to a proceeding as relate
to questions in dispute. The county sheriff shall serve all subpoenas
of the board and shall receive the same fees as provided by law for
like service in civil actions. Each witness who appears in obedience
to such subpoena of the board shall receive for attendance the fees
and mileage for witnesses in civil cases in the courts. The circuit or
superior court shall, on application of the board or any member
thereof, enforce by proper proceedings the attendance and testimony
of witnesses and the production and examination of books, papers,
and records.
(b) The fees of attorneys and physicians and charges of nurses and
hospitals for services under this chapter shall be subject to the
approval of the worker's compensation board. When any claimant for
compensation is represented by an attorney in the prosecution of his
claim, the board shall fix and state in the award, if compensation be
awarded, the amount of the claimant's attorney's fees. The fee so
fixed shall be binding upon both the claimant and his attorney, and
the employer shall pay to the attorney, out of the award, the fee so
fixed, and the receipt of the attorney therefor shall fully acquit the
employer for an equal portion of the award.
(c) Whenever the worker's compensation board shall determine
upon hearing of a claim that the employer has acted in bad faith in
adjusting and settling said award, or whenever the board shall
determine upon hearing of a claim that the employer has not pursued
the settlement of said claim with diligence, then the board shall, if
compensation be awarded, fix the amount of the claimant's attorney's
fees and such attorney's fees shall be paid to the attorney and shall
not be charged against the award to the claimant. Such fees as are
fixed and awarded on account of a lack of diligence or because of
bad faith on the part of the employer shall not be less than one
hundred fifty dollars ($150).
(d) The worker's compensation board may withhold the approval
of the fees of the attending physician in any case until he shall file a
report with the board on the form prescribed by such board.
(Formerly: Acts 1937, c.69, s.17; Acts 1965, c.206, s.2.) As amended
by P.L.144-1986, SEC.66; P.L.28-1988, SEC.56.
IC 22-3-7-25
Forms and literature; reports; confidential information
Sec. 25. The board shall prepare and cause to be printed, and upon
request furnish free of charge to any employer or employee, such
blank forms and literature as it shall deem requisite to facilitate or
promote the efficient administration of this chapter. The reports of
occupational diseases and reports of attending physicians shall be the
private records of the board, which shall be open to the inspection of
the employer, the employee, and their legal representatives, but not
to the public unless, in the opinion of the board, the public interest
shall so require.
IC 22-3-7-26
Disputes; settlement
Sec. 26. All disputes arising under this chapter, except section 3
of this chapter, if not settled by the agreement of the parties
interested therein, with the approval of the board, shall be determined
by the board.
(Formerly: Acts 1937, c.69, s.19.) As amended by P.L.144-1986,
SEC.68.
IC 22-3-7-27
Awards; modification; hearings; appeals; investigations
Sec. 27. (a) If the employer and the employee or the employee's
dependents disagree in regard to the compensation payable under this
chapter, or, if they have reached such an agreement, which has been
signed by them, filed with and approved by the worker's
compensation board, and afterward disagree as to the continuance of
payments under such agreement, or as to the period for which
payments shall be made, or as to the amount to be paid, because of
a change in conditions since the making of such agreement, either
party may then make an application to the board for the
determination of the matters in dispute. When compensation which
is payable in accordance with an award or by agreement approved by
the board is ordered paid in a lump sum by the board, no review shall
be had as in this subsection mentioned.
(b) The application making claim for compensation filed with the
worker's compensation board shall state the following:
(1) The approximate date of the last day of the last exposure
and the approximate date of the disablement.
(2) The general nature and character of the illness or disease
claimed.
(3) The name and address of the employer by whom employed
on the last day of the last exposure, and if employed by any
other employer after such last exposure and before disablement,
the name and address of such other employer or employers.
(4) In case of death, the date and place of death.
(5) Amendments to applications making claim for compensation
which relate to the same disablement or disablement resulting
in death originally claimed upon may be allowed by the board
in its discretion, and, in the exercise of such discretion, it may,
in proper cases, order a trial de novo. Such amendment shall
relate back to the date of the filing of the original application so
amended.
(c) Upon the filing of such application, the board shall set the date
of hearing, which shall be as early as practicable, and shall notify the
parties, in the manner prescribed by the board, of the time and place
of hearing. The hearing of all claims for compensation on account of
occupational disease shall be held in the county in which the last
exposure occurred or in any adjoining county, except when the
parties consent to a hearing elsewhere. Claims assigned to an
individual board member that are considered to be of an emergency
nature by that board member, may be heard in any county within the
board member's jurisdiction.
(d) The board by any or all of its members shall hear the parties
at issue, their representatives, and witnesses, and shall determine the
dispute in a summary manner. The award shall be filed with the
record of proceedings, and a copy thereof shall immediately be sent
by registered mail to each of the parties in dispute.
(e) If an application for review is made to the board within thirty
(30) days from the date of the award made by less than all the
members, the full board, if the first hearing was not held before the
full board, shall review the evidence, or, if deemed advisable, hear
the parties at issue, their representatives, and witnesses as soon as
practicable, and shall make an award and file the same with the
finding of the facts on which it is based and send a copy thereof to
each of the parties in dispute, in like manner as specified in
subsection (d).
(f) An award of the board by less than all of the members as
provided in this section, if not reviewed as provided in this section,
shall be final and conclusive. An award by the full board shall be
conclusive and binding unless either party to the dispute, within
thirty (30) days after receiving a copy of such award, appeals to the
court of appeals under the same terms and conditions as govern
appeals in ordinary civil actions. The court of appeals shall have
jurisdiction to review all questions of law and of fact. The board, of
its own motion, may certify questions of law to the court of appeals
for its decision and determination. An assignment of errors that the
award of the full board is contrary to law shall be sufficient to
present both the sufficiency of the facts found to sustain the award
and the sufficiency of the evidence to sustain the finding of facts. All
such appeals and certified questions of law shall be submitted upon
the date filed in the court of appeals, shall be advanced upon the
docket of the court, and shall be determined at the earliest practicable
date, without any extensions of time for filing briefs. An award of the
full board affirmed on appeal, by the employer, shall be increased
th