Bill Text: IN SB0574 | 2011 | Regular Session | Introduced
Bill Title: Worker's compensation.
Spectrum: Partisan Bill (Democrat 1-0)
Status: (Introduced - Dead) 2011-01-20 - First reading: referred to Committee on Pensions and Labor [SB0574 Detail]
Download: Indiana-2011-SB0574-Introduced.html
Citations Affected: IC 22-3.
Synopsis: Worker's compensation. Requires a health care provider to
file a claim for payment with the worker's compensation board (board)
not later than two years after the last date the provider provided
services to an injured or disabled employee. Amends the definition of
"pecuniary liability" applying to the responsibility of an employer or
insurance carrier to recognize that the charge for services or products
provided after June 30, 2011, by a medical services facility is equal to
200% of the amount determined using the Medicare program
reimbursement methodologies, models, and values or weights,
including the coding, billing, and reporting payment policies in effect
on the date a service or product is provided. Increases benefit amounts
for injuries and disablements occurring on and after July 1, 2011.
Effective: July 1, 2011.
January 20, 2011, read first time and referred to Committee on Pensions and Labor.
PRINTING CODE. Amendments: Whenever an existing statute (or a section of the Indiana Constitution) is being amended, the text of the existing provision will appear in this style type, additions will appear in this style type, and deletions will appear in
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Conflict reconciliation: Text in a statute in this style type or
A BILL FOR AN ACT to amend the Indiana Code concerning labor
and safety.
(b) The employee and the employee's estate do not have liability to a health care provider for payment for services obtained under IC 22-3-3-4.
(c) The right to order payment for all services provided under IC 22-3-2 through IC 22-3-6 is solely with the board.
(d) 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 IC 22-3-2 through IC 22-3-6. A health care provider must file a claim for payment with the board not later than two (2) years after the last date the provider provided services to an injured employee. A medical services
facility may request the adjustment of a claim paid under a
Medicare fee schedule that is superseded not later than thirty (30)
days after the payment date by a Medicare fee schedule adopted by
the worker's compensation board under section 5.2(b) of this
chapter.
(e) The worker's compensation board may withhold the approval of
the fees of the attending physician in a case until the attending
physician files a report with the worker's compensation board on the
form prescribed by the board.
(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.
(b) This subsection applies to charges for medical services, treatment, or supplies provided after June 30, 2011, by a medical
services facility to an employee. The pecuniary liability of an
employer or an employer's insurance carrier for a specific service,
treatment, or supply covered under worker's compensation is
equal to two hundred percent (200%) of the amount determined
using the Medicare program reimbursement methodologies,
models, and values or weights, including the coding, billing, and
reporting payment policies, approved by the worker's
compensation board and in effect on the date a service, treatment,
or supply is provided. The worker's compensation board shall
adopt annually, not later than December 31 each year, the most
recent Medicare fee schedule. A medical services facility may
request the adjustment of a claim paid under a Medicare fee
schedule that is superseded not later than thirty (30) days after the
payment date by a Medicare fee schedule adopted by the worker's
compensation board under this subsection.
(b) (c) 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) or Medicare 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 or Medicare coding change, the basis
upon which the change was made;
not later than thirty (30) days after the date of the request.
(c) (d) 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) (a)(3) or subsection (b)
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 worker's 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).
the schedule set forth in subsection (d) occurring on and after July 1,
1979, and before July 1, 1988, the employee shall receive, in addition
to temporary total disability benefits not to exceed fifty-two (52) weeks
on account of the injury, a weekly compensation of sixty percent (60%)
of the employee's average weekly wages, not to exceed one hundred
twenty-five dollars ($125) average weekly wages, for the period stated
for the injury.
(b) With respect to injuries in the schedule set forth in subsection
(d) occurring on and after July 1, 1988, and before July 1, 1989, the
employee shall receive, in addition to temporary total disability benefits
not exceeding seventy-eight (78) weeks on account of the injury, a
weekly compensation of sixty percent (60%) of the employee's average
weekly wages, not to exceed one hundred sixty-six dollars ($166)
average weekly wages, for the period stated for the injury.
(c) With respect to injuries in the schedule set forth in subsection
(d) occurring on and after July 1, 1989, and before July 1, 1990, the
employee shall receive, in addition to temporary total disability benefits
not exceeding seventy-eight (78) weeks on account of the injury, 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 injury.
(d) With respect to injuries in the following schedule occurring on
and after July 1, 1990, and before July 1, 1991, the employee shall
receive, in addition to temporary total disability benefits not exceeding
seventy-eight (78) weeks on account of the injury, 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 injury.
(1) Amputation: 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 joint two hundred (200) weeks, or
the arm above the elbow 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, for loss occurring on and
after April 1, 1959, by separation of the foot below the knee joint,
one hundred seventy-five (175) weeks and of the leg above the
knee joint two hundred twenty-five (225) weeks. The loss of more
than one (1) phalange of a thumb or toes 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 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) the period 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 period for the loss of the entire finger.
(2) 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, five hundred (500) weeks.
(3) For the permanent and complete loss of vision by enucleation
or its reduction to one-tenth (1/10) of normal vision with glasses,
one hundred seventy-five (175) weeks.
(4) For the permanent and complete loss of hearing in one (1) ear,
seventy-five (75) weeks, and in both ears, two hundred (200)
weeks.
(5) For the loss of one (1) testicle, fifty (50) weeks; for the loss of
both testicles, one hundred fifty (150) weeks.
(e) With respect to injuries in the schedule set forth in subsection
(h) occurring on and after July 1, 1979, and before July 1, 1988, the
employee shall receive, in addition to temporary total disability benefits
not exceeding fifty-two (52) weeks on account of the injury, a weekly
compensation of sixty percent (60%) of the employee's average weekly
wages not to exceed one hundred twenty-five dollars ($125) average
weekly wages for the period stated for the injury.
(f) With respect to injuries in the schedule set forth in subsection (h)
occurring on and after July 1, 1988, and before July 1, 1989, the
employee shall receive, in addition to temporary total disability benefits
not exceeding seventy-eight (78) weeks on account of the injury, a
weekly compensation of sixty percent (60%) of the employee's average
weekly wages, not to exceed one hundred sixty-six dollars ($166)
average weekly wages, for the period stated for the injury.
(g) With respect to injuries in the schedule set forth in subsection
(h) occurring on and after July 1, 1989, and before July 1, 1990, the
employee shall receive, in addition to temporary total disability benefits
not exceeding seventy-eight (78) weeks on account of the injury, 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 injury.
(h) With respect to injuries in the following schedule occurring on
and after July 1, 1990, and before July 1, 1991, the employee shall
receive, in addition to temporary total disability benefits not exceeding
seventy-eight (78) weeks on account of the injury, 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 injury.
(1) 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 compensation shall
be paid for the same period as for the loss thereof by separation.
(2) 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.
(3) For injuries resulting in total permanent disability, five
hundred (500) weeks.
(4) For any permanent reduction of the sight of an eye less than a
total loss as specified in subsection (d)(3), 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 in such event
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%).
(5) For any permanent reduction of the hearing of one (1) or both
ears, less than the total loss as specified in subsection (d)(4),
compensation shall be paid for a period proportional to the degree
of such permanent reduction.
(6) 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.
(7) 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 subdivision where compensation is
payable elsewhere in this section.
(i) With respect to injuries 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 injury, 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 injury 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; by 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: For the loss by separation of any of the body
parts described in subdivision (1) on or after July 1, 1997, and for
the loss by separation of any of the body parts described in
subdivision (3), (5), or (8), on or after July 1, 1999, the dollar
values per degree applying on the date of the injury as described
in subsection (j) 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,
thirty-five (35) degrees of permanent impairment.
(6) For the reduction of vision to one-tenth (1/10) of normal
vision with glasses, thirty-five (35) degrees of permanent
impairment.
(7) 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.
(8) 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.
(9) 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.
(10) 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.
(11) For injuries resulting in total permanent disability, the
amount payable for impairment or five hundred (500) weeks of
compensation, whichever is greater.
(12) For any permanent reduction of the sight of an eye less than
a total loss as specified in subsection (h)(4), 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%).
(13) For any permanent reduction of the hearing of one (1) or both
ears, less than the total loss as specified in subsection (h)(5),
compensation shall be paid in an amount proportionate to the
degree of a permanent reduction.
(14) 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.
(15) 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.
(j) Compensation for permanent partial impairment shall be paid
according to the degree of permanent impairment for the injury
determined under subsection (i) and the following:
(1) With respect to injuries 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 injuries 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 injuries 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 injuries 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 injuries 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 injuries 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 injuries 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 injuries 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 injuries 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 injuries 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 injuries 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 injuries occurring on and after July 1, 2010,
and before July 1, 2011, 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.
(13) With respect to injuries occurring on and after July 1,
2011, for each degree of permanent impairment from one (1)
to ten (10), one thousand five hundred forty dollars ($1,540)
per degree; for each degree of permanent impairment from
eleven (11) to thirty-five (35), one thousand seven hundred
sixty dollars ($1,760) per degree; for each degree of
permanent impairment from thirty-six (36) to fifty (50), two
thousand nine hundred seventy dollars ($2,970) per degree;
for each degree of permanent impairment above fifty (50),
three thousand eight hundred fifty dollars ($3,850) per
degree.
(k) The average weekly wages used in the determination of
compensation for permanent partial impairment under subsections (i)
and (j) shall not exceed the following:
(1) With respect to injuries occurring on or after July 1, 1991, and
before July 1, 1992, four hundred ninety-two dollars ($492).
(2) With respect to injuries occurring on or after July 1, 1992, and
before July 1, 1993, five hundred forty dollars ($540).
(3) With respect to injuries occurring on or after July 1, 1993, and
before July 1, 1994, five hundred ninety-one dollars ($591).
(4) With respect to injuries occurring on or after July 1, 1994, and
before July 1, 1997, six hundred forty-two dollars ($642).
(5) With respect to injuries occurring on or after July 1, 1997, and
before July 1, 1998, six hundred seventy-two dollars ($672).
(6) With respect to injuries occurring on or after July 1, 1998, and
before July 1, 1999, seven hundred two dollars ($702).
(7) With respect to injuries occurring on or after July 1, 1999, and
before July 1, 2000, seven hundred thirty-two dollars ($732).
(8) With respect to injuries 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).
(14) With respect to injuries occurring on or after July 1, 2009,
and before July 1, 2011, nine hundred seventy-five dollars
($975).
(15) With respect to injuries occurring on or after July 1,
2011, one thousand seventy-five dollars ($1,075).
(1) not more than two hundred sixty-seven dollars ($267); and
(2) not less than seventy-five dollars ($75).
However, the weekly compensation payable shall not exceed the average weekly wages of the employee at the time of the injury.
(b) In computing compensation for temporary total disability, temporary partial disability, and total permanent disability, with respect to injuries 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).
However, the weekly compensation payable shall not exceed the average weekly wages of the employee at the time of the injury.
(c) In computing compensation for temporary total disability, temporary partial disability, and total permanent disability, with respect to injuries 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).
However, the weekly compensation payable shall not exceed the
average weekly wages of the employee at the time of the injury.
(d) In computing compensation for temporary total disability,
temporary partial disability, and total permanent disability, with respect
to injuries 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).
However, the weekly compensation payable shall not exceed the
average weekly wages of the employee at the time of the injury.
(e) In computing compensation for temporary total disability,
temporary partial disability, and total permanent disability, with respect
to injuries 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).
However, the weekly compensation payable shall not exceed the
average weekly wages of the employee at the time of the injury.
(f) In computing compensation for temporary total disability,
temporary partial disability, and total permanent disability, with respect
to injuries 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).
However, the weekly compensation payable shall not exceed the
average weekly wages of the employee at the time of the injury.
(g) In computing compensation for temporary total disability,
temporary partial disability, and total permanent disability, with respect
to injuries 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).
However, the weekly compensation payable shall not exceed the
average weekly wages of the employee at the time of the injury.
(h) In computing compensation for temporary total disability,
temporary partial disability, and total permanent disability, with respect
to injuries 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).
However, the weekly compensation payable shall not exceed the
average weekly wages of the employee at the time of the injury.
(i) In computing compensation for temporary total disability,
temporary partial disability, and total permanent disability, with respect
to injuries 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).
However, the weekly compensation payable shall not exceed the
average weekly wages of the employee at the time of the injury.
(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 injuries 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 injuries 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 injuries 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 injuries 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 injuries 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 injuries 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);
(7) with respect to injuries occurring on and after July 1, 2006,
and before July 1, 2007:
(A) not more than nine hundred dollars ($900); and
(B) not less than seventy-five dollars ($75);
(8) with respect to injuries occurring on and after July 1, 2007,
and before July 1, 2008:
(A) not more than nine hundred thirty dollars ($930); and
(B) not less than seventy-five dollars ($75);
(9) with respect to injuries occurring on and after July 1, 2008,
and before July 1, 2009:
(A) not more than nine hundred fifty-four dollars ($954); and
(B) not less than seventy-five dollars ($75); and
(10) with respect to injuries occurring on and after July 1, 2009,
and before July 1, 2011:
(A) not more than nine hundred seventy-five dollars ($975);
and
(B) not less than seventy-five dollars ($75).
(11) with respect to injuries occurring on and after July 1,
2011:
(A) not more than one thousand seventy-five dollars
($1,075); and
(B) not less than seventy-five dollars ($75).
However, the weekly compensation payable shall not exceed the
average weekly wages of the employee at the time of the injury.
(k) With respect to any injury occurring on and after July 1, 1985,
and before July 1, 1986, the maximum compensation, exclusive of
medical benefits, which may be paid for an injury under any provisions
of this law or any combination of provisions may not exceed
eighty-nine thousand dollars ($89,000) in any case.
(l) With respect to any injury occurring on and after July 1, 1986,
and before July 1, 1988, the maximum compensation, exclusive of
medical benefits, which may be paid for an injury under any provisions
of this law or any combination of provisions may not exceed
ninety-five thousand dollars ($95,000) in any case.
(m) With respect to any injury occurring on and after July 1, 1988,
and before July 1, 1989, the maximum compensation, exclusive of
medical benefits, which may be paid for an injury under any provisions
of this law or any combination of provisions may not exceed one
hundred twenty-eight thousand dollars ($128,000) in any case.
(n) With respect to any injury occurring on and after July 1, 1989,
and before July 1, 1990, the maximum compensation, exclusive of
medical benefits, which may be paid for an injury under any provisions
of this law or any combination of provisions may not exceed one
hundred thirty-seven thousand dollars ($137,000) in any case.
(o) With respect to any injury occurring on and after July 1, 1990,
and before July 1, 1991, the maximum compensation, exclusive of
medical benefits, which may be paid for an injury under any provisions
of this law or any combination of provisions may not exceed one
hundred forty-seven thousand dollars ($147,000) in any case.
(p) With respect to any injury occurring on and after July 1, 1991,
and before July 1, 1992, the maximum compensation, exclusive of
medical benefits, that may be paid for an injury under any provisions
of this law or any combination of provisions may not exceed one
hundred sixty-four thousand dollars ($164,000) in any case.
(q) With respect to any injury occurring on and after July 1, 1992,
and before July 1, 1993, the maximum compensation, exclusive of
medical benefits, that may be paid for an injury under any provisions
of this law or any combination of provisions may not exceed one
hundred eighty thousand dollars ($180,000) in any case.
(r) With respect to any injury occurring on and after July 1, 1993,
and before July 1, 1994, the maximum compensation, exclusive of
medical benefits, that may be paid for an injury under any provisions
of this law or any combination of provisions may not exceed one
hundred ninety-seven thousand dollars ($197,000) in any case.
(s) With respect to any injury occurring on and after July 1, 1994,
and before July 1, 1997, the maximum compensation, exclusive of
medical benefits, which may be paid for an injury under any provisions
of this law or any combination of provisions may not exceed two
hundred fourteen thousand dollars ($214,000) in any case.
(t) The maximum compensation, exclusive of medical benefits, that
may be paid for an injury under any provision of this law or any
combination of provisions may not exceed the following amounts in
any case:
(1) With respect to an injury occurring on and after July 1, 1997,
and before July 1, 1998, two hundred twenty-four thousand
dollars ($224,000).
(2) With respect to an injury occurring on and after July 1, 1998,
and before July 1, 1999, two hundred thirty-four thousand dollars
($234,000).
(3) With respect to an injury occurring on and after July 1, 1999,
and before July 1, 2000, two hundred forty-four thousand dollars
($244,000).
(4) With respect to an injury occurring on and after July 1, 2000,
and before July 1, 2001, two hundred fifty-four thousand dollars
($254,000).
(5) With respect to an injury occurring on and after July 1, 2001,
and before July 1, 2002, two hundred seventy-four thousand
dollars ($274,000).
(6) With respect to an injury occurring on and after July 1, 2002,
and before July 1, 2006, two hundred ninety-four thousand dollars
($294,000).
(7) With respect to an injury occurring on and after July 1, 2006,
and before July 1, 2007, three hundred thousand dollars
($300,000).
(8) With respect to an injury occurring on and after July 1, 2007,
and before July 1, 2008, three hundred ten thousand dollars
($310,000).
(9) With respect to an injury occurring on and after July 1, 2008,
and before July 1, 2009, three hundred eighteen thousand dollars
($318,000).
(10) With respect to an injury occurring on and after July 1, 2009,
and before July 1, 2011, three hundred twenty-five thousand
dollars ($325,000).
(11) With respect to an injury occurring on and after July 1,
2011, three hundred sixty thousand dollars ($360,000).
(a) "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 IC 22-3-2-6 and IC 22-3-3-31. 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 IC 22-3-2-6 and IC 22-3-3-31. 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 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 in IC 22-3-2-2.5. 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) "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.
(1) An executive officer elected or appointed and empowered in
accordance with the charter and bylaws of a corporation, other
than a municipal corporation or governmental subdivision or a
charitable, religious, educational, or other nonprofit corporation,
is an employee of the corporation under IC 22-3-2 through
IC 22-3-6. An officer of a corporation who is the sole officer of
the corporation is an employee of the corporation under IC 22-3-2
through IC 22-3-6, but may elect not to be an employee of the
corporation under IC 22-3-2 through IC 22-3-6. If an officer
makes this election, the officer must serve written notice of the
election on the corporation's insurance carrier and the board. An
officer of a corporation who is the sole officer of the corporation
may not be considered to be excluded as an employee under
IC 22-3-2 through IC 22-3-6 until the notice is received by the
insurance carrier and the board.
(2) An executive officer of a municipal corporation or other
governmental subdivision or of a charitable, religious,
educational, or other nonprofit corporation may, notwithstanding
any other provision of IC 22-3-2 through IC 22-3-6, be brought
within the coverage of its insurance contract by the corporation by
specifically including the executive officer in the contract of
insurance. The election to bring the executive officer within the
coverage shall continue for the period the contract of insurance is
in effect, and during this period, the executive officers thus
brought within the coverage of the insurance contract are
employees of the corporation under IC 22-3-2 through IC 22-3-6.
(3) Any reference to an employee who has been injured, when the
employee is dead, also includes the employee's legal
representatives, dependents, and other persons to whom
compensation may be payable.
(4) An owner of a sole proprietorship may elect to include the
owner as an employee under IC 22-3-2 through IC 22-3-6 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 IC 22-3-2 through IC 22-3-6 until 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 IC 22-3-2-14.5.
(5) A partner in a partnership may elect to include the partner as
an employee under IC 22-3-2 through IC 22-3-6 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 IC 22-3-2 through
IC 22-3-6 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
IC 22-3-2-14.5.
(6) Real estate professionals are not employees under IC 22-3-2
through IC 22-3-6 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.
(7) A person is an independent contractor in the construction
trades and not an employee under IC 22-3-2 through IC 22-3-6 if
the person is an independent contractor under the guidelines of
the United States Internal Revenue Service.
(8) 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 376 to a motor carrier
is not an employee of the motor carrier for purposes of IC 22-3-2
through IC 22-3-6. 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.
(9) A member or manager in a limited liability company may elect
to include the member or manager as an employee under
IC 22-3-2 through IC 22-3-6 if the member or manager is actually
engaged in the limited liability company business. If a member or
manager makes this election, the member or manager must serve
upon the member's or manager's insurance carrier and upon the
board written notice of the election. A member or manager may
not be considered an employee under IC 22-3-2 through IC 22-3-6
until the notice has been received.
(10) 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 in IC 22-3-2-2.5.
(11) 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 IC 22-3-2
through IC 22-3-6.
(c) "Minor" means an individual who has not reached seventeen
(17) years of age.
(1) Unless otherwise provided in this subsection, a minor
employee shall be considered as being of full age for all purposes
of IC 22-3-2 through IC 22-3-6.
(2) If the employee is a minor who, at the time of the accident, is
employed, required, suffered, or permitted to work in violation of
IC 20-33-3-35, the amount of compensation and death benefits,
as provided in IC 22-3-2 through IC 22-3-6, 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
injury or death of the minor, and the employer shall be 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 accident is employed, suffered, or permitted to
work at any occupation which is not prohibited by law, this
subdivision does not apply.
(3) A minor employee who, at the time of the accident, is a
student performing services for an employer as part of an
approved program under IC 20-37-2-7 shall be considered a
full-time employee for the purpose of computing compensation
for permanent impairment under IC 22-3-3-10. The average
weekly wages for such a student shall be calculated as provided
in subsection (d)(4).
(4) The rights and remedies granted in this subsection to a minor under IC 22-3-2 through IC 22-3-6 on account of personal injury or death by accident shall exclude all rights and remedies of the minor, the minor's parents, or the minor's personal representatives, dependents, or next of kin at common law, statutory or otherwise, on account of the injury or death. This subsection does not apply to minors who have reached seventeen (17) years of age.
(d) "Average weekly wages" means the earnings of the injured employee in the employment in which the employee was working at the time of the injury during the period of fifty-two (52) weeks immediately preceding the date of injury, divided by fifty-two (52), except as follows:
(1) If the injured employee lost seven (7) or more calendar days during this period, although not in the same week, then the earnings for the remainder of the fifty-two (52) weeks shall be divided by the number of weeks and parts thereof remaining after the time lost has been deducted.
(2) Where the employment prior to the injury extended over a period of less than fifty-two (52) weeks, the method of dividing the earnings during that period by the number of weeks and parts thereof during which the employee earned wages shall be followed, if results just and fair to both parties will be obtained. Where by reason of the shortness of the time during which the employee has been in the employment of the employee's employer or of the casual nature or terms of the employment it is impracticable to compute the average weekly wages, as defined in this subsection, regard shall be had to the average weekly amount which during the fifty-two (52) weeks previous to the injury was being earned by a person in the same grade employed at the same work by the same employer or, if there is no person so employed, by a person in the same grade employed in the same class of employment in the same district.
(3) Wherever allowances of any character made to an employee in lieu of wages are a specified part of the wage contract, they shall be deemed a part of the employee's earnings.
(4) In computing the average weekly wages to be used in calculating an award for permanent impairment under IC 22-3-3-10 for a student employee in an approved training program under IC 20-37-2-7, the following formula shall be used. Calculate the product of:
(A) the student employee's hourly wage rate; multiplied by
(B) forty (40) hours.
The result obtained is the amount of the average weekly wages for the student employee.
(e) "Injury" and "personal injury" mean only injury by accident arising out of and in the course of the employment and do not include a disease in any form except as it results from the injury.
(f) "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.
(g) "Billing review standard" means the data used by a billing review service to determine pecuniary liability.
(h) "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.
(i) "Medical service provider" refers to a person or an entity that provides medical services, treatment, or supplies to an employee under IC 22-3-2 through IC 22-3-6.
(j) "Medical services facility" means a hospital, clinic, surgery center, nursing home, rehabilitation center, or other health care facility that provides services, treatment, or supplies to an employee under IC 22-3-2 through IC 22-3-6.
under IC 22-3-2 through IC 22-3-6 determined using one (1) of the
following:
(1) Except as provided in subdivision (2), for services or
products provided 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.
(2) For services or products provided after June 30, 2011, by
a medical services facility, equal to two hundred percent
(200%) of the amount determined using the Medicare
program reimbursement methodologies, models, and values
or weights, including the Medicare coding, billing, and
reporting payment policies, approved by the worker's
compensation board and in effect on the date a service or
product is provided.
(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 376, 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.
(9) An officer of a corporation who is the sole officer of the
corporation is an employee of the corporation under this chapter.
An officer of a corporation who is the sole officer of the
corporation may elect not to be an employee of the corporation
under this chapter. If an officer makes this election, the officer
must serve written notice of the election on the corporation's
insurance carrier and the board. An officer of a corporation who
is the sole officer of the corporation may not be considered to be
excluded as an employee under this chapter until the notice is
received by the insurance carrier and the board.
(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,
the minor's parents, the minor's 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, "medical services facility" means a
hospital, clinic, surgery center, nursing home, rehabilitation center,
or other health care facility that provides services, treatment, or
supplies to an employee under this chapter.
(l) (m) 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 determined using one
(1) of the following:
(1) Except as provided in subdivision (2), for services or
products provided 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.
(2) For services or products provided after June 30, 2011, by
a medical services facility, equal to two hundred percent
(200%) of the amount determined using the Medicare
program reimbursement methodologies, models, and values
or weights, including the Medicare coding, billing, and
reporting payment policies, approved by the worker's
compensation board and in effect on the date a service or
product is provided.
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:
(1) the extraordinary circumstances that have precluded a
determination of liability within the initial sixty (60) days;
(2) the status of the investigation on the date the petition is filed;
(3) the facts or circumstances that are necessary to make a
determination; and
(4) a timetable for the completion of the remaining investigation.
An employer who fails to comply with this section is subject to a civil
penalty of fifty dollars ($50), to be assessed and collected by the board
upon notice and hearing. Civil penalties collected under this section
shall be deposited in the state general fund.
(b) Once begun, temporary total disability benefits may not be
terminated by the employer unless:
(1) the employee has returned to work;
(2) the employee has died;
(3) the employee has refused to undergo a medical examination
under section 20 of this chapter;
(4) the employee has received five hundred (500) weeks of
temporary total disability benefits or has been paid the maximum
compensation allowable under section 19 of this chapter; or
(5) the employee is unable or unavailable to work for reasons
unrelated to the compensable disease.
In all other cases the employer must notify the employee in writing of
the employer's intent to terminate the payment of temporary total
disability benefits, and of the availability of employment, if any, on a
form approved by the board. If the employee disagrees with the
proposed termination, the employee must give written notice of
disagreement to the board and the employer within seven (7) days after
receipt of the notice of intent to terminate benefits. If the board and
employer do not receive a notice of disagreement under this section,
the employee's temporary total disability benefits shall be terminated.
Upon receipt of the notice of disagreement, the board shall immediately
contact the parties, which may be by telephone or other means and
attempt to resolve the disagreement. If the board is unable to resolve
the disagreement within ten (10) days of receipt of the notice of
disagreement, the board shall immediately arrange for an evaluation of
the employee by an independent medical examiner. The independent
medical examiner shall be selected by mutual agreement of the parties
or, if the parties are unable to agree, appointed by the board under
IC 22-3-4-11. If the independent medical examiner determines that the
employee is no longer temporarily disabled or is still temporarily
disabled but can return to employment that the employer has made
available to the employee, or if the employee fails or refuses to appear
for examination by the independent medical examiner, temporary total
disability benefits may be terminated. If either party disagrees with the
opinion of the independent medical examiner, the party shall apply to
the board for a hearing under section 27 of this chapter.
(c) An employer is not required to continue the payment of
temporary total disability benefits for more than fourteen (14) days
after the employer's proposed termination date unless the independent
medical examiner determines that the employee is temporarily disabled
and unable to return to any employment that the employer has made
available to the employee.
(d) If it is determined that as a result of this section temporary total
disability benefits were overpaid, the overpayment shall be deducted
from any benefits due the employee under this section and, if there are
no benefits due the employee or the benefits due the employee do not
equal the amount of the overpayment, the employee shall be
responsible for paying any overpayment which cannot be deducted
from benefits due the employee.
(e) For disablements occurring on and after July 1, 1976, from occupational disease resulting in temporary total disability for any work there shall be paid to the disabled employee during the temporary total disability weekly compensation equal to sixty-six and two-thirds percent (66 2/3%) of the employee's average weekly wages, as defined in section 19 of this chapter, for a period not to exceed five hundred (500) weeks. Compensation shall be allowed for the first seven (7) calendar days only if the disability continues for longer than twenty-one (21) days.
(f) For disablements occurring on and after July 1, 1974, from occupational disease resulting in temporary partial disability for work there shall be paid to the disabled employee during such disability a weekly compensation equal to sixty-six and two-thirds percent (66 2/3%) of the difference between the employee's average weekly wages, as defined in section 19 of this chapter, and the weekly wages at which the employee is actually employed after the disablement, for a period not to exceed three hundred (300) weeks. Compensation shall be allowed for the first seven (7) calendar days only if the disability continues for longer than twenty-one (21) days. In case of partial disability after the period of temporary total disability, the latter period shall be included as a part of the maximum period allowed for partial disability.
(g) For disabilities occurring on and after July 1, 1979, and before July 1, 1988, from occupational disease in the schedule set forth in subsection (j), the employee shall receive in addition to disability benefits, not exceeding fifty-two (52) 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 twenty-five dollars ($125) average weekly wages, for the period stated for the disabilities.
(h) For disabilities occurring on and after July 1, 1988, and before July 1, 1989, 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 sixty-six dollars ($166) average weekly wages, for the period stated 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, and before July 1, 2011, 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.
(13) With respect to disablements occurring on and after July
1, 2011, for each degree of permanent impairment from one
(1) to ten (10), one thousand five hundred forty dollars
($1,540) per degree; for each degree of permanent
impairment from eleven (11) to thirty-five (35), one thousand
seven hundred sixty dollars ($1,760) per degree; for each
degree of permanent impairment from thirty-six (36) to fifty
(50), two thousand nine hundred seventy dollars ($2,970) per
degree; for each degree of permanent impairment above fifty
(50), three thousand eight hundred fifty dollars ($3,850) 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 disablements occurring on or after
July 1, 2001, and before July 1, 2002, eight hundred twenty-two
dollars ($822).
(10) With respect to injuries disablements occurring on or after
July 1, 2002, and before July 1, 2006, eight hundred eighty-two
dollars ($882).
(11) With respect to injuries disablements occurring on or after
July 1, 2006, and before July 1, 2007, nine hundred dollars
($900).
(12) With respect to injuries disablements occurring on or after
July 1, 2007, and before July 1, 2008, nine hundred thirty dollars
($930).
(13) With respect to injuries disablements occurring on or after
July 1, 2008, and before July 1, 2009, nine hundred fifty-four
dollars ($954).
(14) With respect to injuries disablements occurring on or after
July 1, 2009, and before July 2, 2011, nine hundred seventy-five
dollars ($975).
(15) With respect to disablements occurring on or after July
1, 2011, one thousand seventy-five dollars ($1,075).
(n) If any employee, only partially disabled, refuses employment
suitable to the employee's capacity procured for the employee, the
employee shall not be entitled to any compensation at any time during
the continuance of such refusal unless, in the opinion of the worker's
compensation board, such refusal was justifiable. The employee 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.
(o) If an employee has sustained a permanent impairment or
disability from an accidental injury other than an occupational disease
in another employment than that in which the employee suffered a
subsequent disability from an occupational disease, such as herein
specified, the employee shall be entitled to compensation for the
subsequent disability in the same amount as if the previous impairment
or disability had not occurred. However, if the permanent impairment
or disability resulting from an occupational disease for which
compensation is claimed results only in the aggravation or increase of
a previously sustained permanent impairment from an occupational
disease or physical condition regardless of the source or cause of such
previously sustained impairment from an occupational disease or
physical condition, the board shall determine the extent of the
previously sustained permanent impairment from an occupational
disease or physical condition as well as the extent of the aggravation or
increase resulting from the subsequent permanent impairment or
disability, and shall award compensation only for that part of said
occupational disease or physical condition resulting from the
subsequent permanent impairment. An amputation of any part of the
body or loss of any or all of the vision of one (1) or both eyes caused by
an occupational disease shall be considered as a permanent impairment
or physical condition.
(p) If an employee suffers a disablement from an occupational
disease for which compensation is payable while the employee is still
receiving or entitled to compensation for a previous injury by accident
or disability by occupational disease in the same employment, the
employee shall not at the same time be entitled to compensation for
both, unless it be for a permanent injury, such as specified in
subsection (k)(1), (k)(4), (k)(5), (k)(8), or (k)(9), but the employee shall
be entitled to compensation for that disability and from the time of that
disability which will cover the longest period and the largest amount
payable under this chapter.
(q) If an employee receives a permanent disability from an
occupational disease such as specified in subsection (k)(1), (k)(4),
(k)(5), (k)(8), or (k)(9) after having sustained another such permanent
disability in the same employment the employee shall be entitled to
compensation for both such disabilities, but the total compensation
shall be paid by extending the period and not by increasing the amount
of weekly compensation and, when such previous and subsequent
permanent disabilities, in combination 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.
(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 the employee's 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 the employee's 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) An employer or employer's insurance carrier may not delay the provision of emergency medical care whenever emergency medical care is considered necessary in the professional judgment of the attending health care facility physician.
(f) 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.
(g) 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. A health care provider must file a claim for payment with the board not later than two (2) years after the last date the provider provided services to an employee having a disablement. A medical services facility may request the adjustment of a claim paid under a Medicare fee schedule that is superseded not later than thirty (30) days after the payment date by a Medicare fee schedule adopted by the worker's compensation board under section 17.2(b) of 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.
(b) This subsection applies to charges for medical services, treatment, or supplies provided after June 30, 2011, by a medical services facility to an employee. The pecuniary liability of an employer or an employer's insurance carrier for a specific service, treatment, or supply covered under this chapter is equal to two hundred percent (200%) of the amount determined using the Medicare program reimbursement methodologies, models, and values or weights, including the coding, billing, and reporting payment policies, approved by the worker's compensation board and in effect on the date a service, treatment, or supply is provided. The worker's compensation board shall adopt annually, not later than December 31 each year, the most recent Medicare fee schedule. A medical services facility may request the adjustment of a claim paid under a Medicare fee schedule that is superseded not later than thirty (30) days after the payment date by a Medicare fee schedule adopted by the worker's compensation board under this subsection.
reduced as a result of application of the eightieth percentile or of a
Current Procedural Terminology (CPT) or Medicare 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 or Medicare coding change, the basis
upon which the change was made;
not later than thirty (30) days after the date of the request.
(c) (d) 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) (a)(3) or subsection (b)
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).
(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);
(7) with respect to disablements occurring on and after July 1, 2006, and before July 1, 2007:
(A) not more than nine hundred dollars ($900); and
(B) not less than seventy-five dollars ($75);
(8) with respect to disablements occurring on and after July 1, 2007, and before July 1, 2008:
(A) not more than nine hundred thirty dollars ($930); and
(B) not less than seventy-five dollars ($75);
(9) with respect to disablements occurring on and after July 1, 2008, and before July 1, 2009:
(A) not more than nine hundred fifty-four dollars ($954); and
(B) not less than seventy-five dollars ($75);
(10) with respect to disablements occurring on and after July 1, 2009, and before July 1, 2011:
(A) not more than nine hundred seventy-five dollars ($975); and
(B) not less than seventy-five dollars ($75).
(11) with respect to disablements occurring on and after July 1, 2011:
(A) not more than one thousand seventy-five dollars ($1,075); and
(B) not less than seventy-five dollars ($75).
(k) The maximum compensation with respect to disability or death occurring on and after July 1, 1985, and before July 1, 1986, which shall be paid for occupational disease and the results thereof under the provisions of this chapter or under any combination of its provisions may not exceed eighty-nine thousand dollars ($89,000) in any case.
(l) The maximum compensation with respect to disability or death occurring on and after July 1, 1986, and before July 1, 1988, which shall be paid for occupational disease and the results thereof under the provisions of this chapter or under any combination of its provisions may not exceed ninety-five thousand dollars ($95,000) in any case.
(m) The maximum compensation with respect to disability or death occurring on and after July 1, 1988, and before July 1, 1989, that shall be paid for occupational disease and the results thereof under this chapter or under any combination of its provisions may not exceed one hundred twenty-eight thousand dollars ($128,000) in any case.
(n) The maximum compensation with respect to disability or death occurring on and after July 1, 1989, and before July 1, 1990, that shall be paid for occupational disease and the results thereof under this chapter or under any combination of its provisions may not exceed one hundred thirty-seven thousand dollars ($137,000) in any case.
(o) The maximum compensation with respect to disability or death occurring on and after July 1, 1990, and before July 1, 1991, that shall be paid for occupational disease and the results thereof under this chapter or under any combination of its provisions may not exceed one hundred forty-seven thousand dollars ($147,000) in any case.
(p) The maximum compensation with respect to disability or death occurring on and after July 1, 1991, and before July 1, 1992, 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).
(9) With respect to disability or death occurring on and after July
1, 2008, and before July 1, 2009, three hundred eighteen thousand
dollars ($318,000).
(10) With respect to disability or death occurring on or after July 1, 2009, and before July 1, 2011, three hundred twenty-five thousand dollars ($325,000).
(11) With respect to a disability or death occurring on and after July 1, 2011, three hundred sixty thousand dollars ($360,000).
(u) For all disabilities occurring on and after July 1, 1985, "average weekly wages" means the earnings of the injured employee during the period of fifty-two (52) weeks immediately preceding the disability divided by fifty-two (52). If the employee lost seven (7) or more calendar days during the period, although not in the same week, then the earnings for the remainder of the fifty-two (52) weeks shall be divided by the number of weeks and parts of weeks remaining after the time lost has been deducted. If employment before the date of disability extended over a period of less than fifty-two (52) weeks, the method of dividing the earnings during that period by the number of weeks and parts of weeks during which the employee earned wages shall be followed if results just and fair to both parties will be obtained. If by reason of the shortness of the time during which the employee has been in the employment of the employer or of the casual nature or terms of the employment it is impracticable to compute the average weekly wages for the employee, the employee's average weekly wages shall be considered to be the average weekly amount that, during the fifty-two (52) weeks before the date of disability, was being earned by a person in the same grade employed at the same work by the same employer or, if there is no person so employed, by a person in the same grade employed in that same class of employment in the same district. Whenever allowances of any character are made to an employee instead of wages or a specified part of the wage contract, they shall be considered a part of the employee's earnings.
(v) The provisions of this article may not be construed to result in an award of benefits in which the number of weeks paid or to be paid for temporary total disability, temporary partial disability, or permanent total disability benefits combined exceeds five hundred (500) weeks. This section shall not be construed to prevent a person from applying for an award under IC 22-3-3-13. However, in case of permanent total disability resulting from a disablement occurring on or after January 1, 1998, the minimum total benefit shall not be less than seventy-five thousand dollars ($75,000).
