STATE OF OKLAHOMA

1st Session of the 54th Legislature (2013)

HOUSE BILL 1362	By:	Hulbert

AS INTRODUCED

An Act relating to workers’ compensation; creating an administrative system for the Workers’ Compensation Code; designating the Insurance Department as the state agency designated to oversee the workers’ compensation system; creating the Division of Workers’ Compensation within the Department; providing duties and authority of the Division; providing authority of the Insurance Commissioner and the Commissioner of Workers’ Compensation; providing for investigations; providing duties of the Insurance Department; providing for the Commissioner of Workers’ Compensation; providing duties and authority of the Commissioner; providing for appointment of the Commissioner; providing immunity from certain liability; establishing the goals of the workers’ compensation system; providing for statutory references to prior Workers’ Compensation Court and Administrator of the Workers’ Compensation Court; providing procedures relating to complaints; providing for public participation; providing for Division staff; providing for promulgation of rules; providing for recommendations to the Legislature; providing for maintenance of Division records; authorizing inspection fee; requiring maintenance of certain information; providing that certain information is confidential; providing for record checks; providing for release of certain information; providing penalties for failure to maintain confidentiality; defining term; providing for investigation files; requiring cooperation between the Insurance Department and the Division of Workers’ Compensation and the Office of Injured Employee Counsel; establishing the Office of Injured Employee Counsel; providing for the General Counsel as chief administrative officer of the Office; providing for appointment of the General Counsel; providing relationship between the Office and the Insurance Department; providing duties of the Department in relation to the Office; requiring the Office to publish certain information; requiring the Office to develop and implement certain policy; providing procedures for complaints; providing qualifications of General Counsel; providing duties and authority of the Office of Injured Employee Counsel; authorizing the General Counsel to refuse or terminate services in certain circumstances; requiring the Office to inform appropriate authorities of workers’ compensation fraud; providing for an ombudsman program within the Office; providing authority of the Office to assist employees in administrative procedures; granting the General Counsel access to certain information; providing for adoption of a notice of injured employee rights and responsibilities; providing confidentiality requirements applicable to General Counsel and Office; providing for Office access to information; providing for ombudsman program for death benefits; providing duties of ombudsman; providing for codification; providing for recodification; and providing an effective date.

BE IT ENACTED BY THE PEOPLE OF THE STATE OF OKLAHOMA:
SECTION 1.     NEW LAW     A new section of law to be codified in the Oklahoma Statutes as Section 502 of Title 85, unless there is created a duplication in numbering, reads as follows:
A.  The Insurance Department is the state agency designated to oversee the workers' compensation system of this state.  
B.  The Division of Workers' Compensation is established as a division within the Insurance Department to administer and operate the workers' compensation system of this state. 
SECTION 2.     NEW LAW     A new section of law to be codified in the Oklahoma Statutes as Section 503 of Title 85, unless there is created a duplication in numbering, reads as follows:
A.  The Division of Workers’ Compensation is administered by the Commissioner of Workers' Compensation.  Except as otherwise provided by the Workers’ Compensation Code, the Commissioner of Workers' Compensation shall exercise all executive authority, including rulemaking authority, under the Workers’ Compensation Code.
B.  The Commissioner of Insurance may delegate to the Commissioner of Workers' Compensation or to that person's designee and may redact any delegation, and the Commissioner of Workers' Compensation may delegate to the Commissioner of Insurance or to that person's designee, any power or duty regarding workers' compensation imposed on the Commissioner of Insurance or the Commissioner of Workers' Compensation under the Workers’ Compensation Code, including the authority to make final orders or decisions.  A delegation made under this subsection must be made in writing.
C.  The Commissioner of Insurance shall develop and implement policies that clearly separate the respective responsibilities of the Insurance Department and the Division.
D.  The Commissioner of Insurance may provide advice, research, and comment regarding the adoption of rules by the Commissioner of Workers' Compensation.
SECTION 3.     NEW LAW     A new section of law to be codified in the Oklahoma Statutes as Section 504 of Title 85, unless there is created a duplication in numbering, reads as follows:
The Insurance Department shall investigate the conduct of the work of the Division of Workers’ Compensation.  For that purpose, the Department shall have access at any time to all Division books and records and may require an officer or employee of the Division to furnish written or oral information.
SECTION 4.     NEW LAW     A new section of law to be codified in the Oklahoma Statutes as Section 505 of Title 85, unless there is created a duplication in numbering, reads as follows:
A.  The Division of Workers' Compensation is administratively attached to the Insurance Department.
B.  The Department shall provide the staff and facilities necessary to enable the Division to perform the duties of the Division under the Workers’ Compensation Code, including:
1.  Administrative assistance and services to the Division, including budget planning and purchasing;
2.  Personnel and financial services; and
3.  Computer equipment and support.
C.  The Commissioner of Workers' Compensation and the Commissioner of Insurance may enter into agreements as necessary to implement the Workers’ Compensation Code.
SECTION 5.     NEW LAW     A new section of law to be codified in the Oklahoma Statutes as Section 506 of Title 85, unless there is created a duplication in numbering, reads as follows:
A.  In addition to other duties required under the Workers’ Compensation Code, the Division of Workers’ Compensation shall:
1.  Regulate and administer the business of workers' compensation in this state; and
2.  Ensure that the Workers’ Compensation Code and other laws regarding workers' compensation are executed.
B.  To the extent determined feasible by the Commissioner of Workers’ Compensation, the Division shall establish a single point of contact for injured employees receiving services from the Division.
SECTION 6.     NEW LAW     A new section of law to be codified in the Oklahoma Statutes as Section 507 of Title 85, unless there is created a duplication in numbering, reads as follows:
The Division of Workers’ Compensation is composed of the Commissioner of Workers' Compensation and other officers and employees as required to efficiently implement:
1.  The Workers’ Compensation Code; and
2.  Other laws granting jurisdiction or applicable to the Division or the Commissioner.
SECTION 7.     NEW LAW     A new section of law to be codified in the Oklahoma Statutes as Section 508 of Title 85, unless there is created a duplication in numbering, reads as follows:
A.  The Commissioner of Workers' Compensation is the chief executive and administrative officer of the Division of Workers’ Compensation.  The Commissioner shall administer and enforce the Workers’ Compensation Code and other laws granting jurisdiction to or applicable to the Division or the Commissioner.  Except as otherwise specifically provided by the Workers’ Compensation Code, a reference in Title 85 of the Oklahoma Statutes to the "Commissioner" means the Commissioner of Workers' Compensation.
B.  The Commissioner has the powers and duties vested in the Division by the Workers’ Compensation Code. 
SECTION 8.     NEW LAW     A new section of law to be codified in the Oklahoma Statutes as Section 509 of Title 85, unless there is created a duplication in numbering, reads as follows:
The Governor, subject to confirmation by the Senate, shall appoint the Commissioner of Workers’ Compensation.  The Commissioner shall serve at the pleasure of the Governor.
SECTION 9.     NEW LAW     A new section of law to be codified in the Oklahoma Statutes as Section 510 of Title 85, unless there is created a duplication in numbering, reads as follows:
The Commissioner of Workers’ Compensation shall:
1.  Be a competent and experienced administrator;
2.  Be well-informed and qualified in the field of workers' compensation; and
3.  Have at least five (5) years of experience as an executive in the administration of business or government or as a practicing attorney, physician, or certified public accountant.
SECTION 10.     NEW LAW     A new section of law to be codified in the Oklahoma Statutes as Section 511 of Title 85, unless there is created a duplication in numbering, reads as follows:
The Commissioner of Workers’ Compensation shall not be liable in a civil action for an act performed in good faith in the execution of duties as Commissioner.
SECTION 11.     NEW LAW     A new section of law to be codified in the Oklahoma Statutes as Section 512 of Title 85, unless there is created a duplication in numbering, reads as follows:
A.  The Commissioner of Workers’ Compensation shall conduct the daily operations of the Division and otherwise implement Division policy.
B.  The Commissioner or the Commissioner's designee may:
1.  Investigate misconduct;
2.  Hold hearings;
3.  Issue subpoenas to compel the attendance of witnesses and the production of documents;
4.  Administer oaths;
5.  Take testimony directly or by deposition or interrogatory;
6.  Assess and enforce penalties established under the Workers’ Compensation Code;
7.  Enter appropriate orders as authorized by the Workers’ Compensation Code;
8.  Institute an action in the Division's name to enjoin the violation of the Workers’ Compensation Code;
9.  Initiate an action to intervene in a judicial proceeding that relates to the administration of the Workers’ Compensation Code;
10.  Prescribe the form, manner, and procedure for the transmission of information to the Division;
11.  Correct clerical errors in the entry of orders; and
12.  Exercise other powers and perform other duties as necessary to implement and enforce the Workers’ Compensation Code.
C.  The Commissioner is the agent for service of process on out-of-state employers.
SECTION 12.     NEW LAW     A new section of law to be codified in the Oklahoma Statutes as Section 513 of Title 85 unless there is created a duplication in numbering, reads as follows:
A.  The basic goals of the workers' compensation system of this state are as follows:
1.  Each employee shall be treated with dignity and respect when injured on the job; 
2.  Each injured employee shall have access to a fair and accessible dispute resolution process; 
3.  Each injured employee shall have access to prompt, high-quality medical care within the framework established by the Workers’ Compensation Code; and 
4.  Each injured employee shall receive services to facilitate the employee's return to employment as soon as it is considered safe and appropriate by the employee's health care provider. 
B.  It is the intent of the Legislature that, in implementing the goals described by subsection A of this section, the workers' compensation system of this state shall:
1.  Promote safe and healthy workplaces through appropriate incentives, education, and other actions;
2.  Encourage the safe and timely return of injured employees to productive roles in the workplace;
3.  Provide appropriate income benefits and medical benefits in a manner that is timely and cost-effective;
4.  Provide timely, appropriate, and high-quality medical care supporting restoration of the injured employee's physical condition and earning capacity;
5.  Minimize the likelihood of disputes and resolve them promptly and fairly when identified;
6.  Promote compliance with the Workers’ Compensation Code and rules adopted under the Workers’ Compensation Code through performance-based incentives;
7.  Promptly detect and appropriately address acts or practices of noncompliance with the Workers’ Compensation Code and rules adopted under the Workers’ Compensation Code;
8.  Effectively educate and clearly inform each person who participates in the system as a claimant, employer, insurance carrier, health care provider, or other participant of the person's rights and responsibilities under the system and how to appropriately interact within the system; and
9.  Take maximum advantage of technological advances to provide the highest levels of service possible to system participants and to promote communication among system participants.
C.  This section shall not be construed as:
1.  Creating a cause of action; or
2.  Establishing an entitlement to benefits to which a claimant is not otherwise entitled by the Workers’ Compensation Code.
D.  As provided by the Workers’ Compensation Code, the Division of Workers’ Compensation shall work to promote and help ensure the safe and timely return of injured employees to productive roles in the workforce.
SECTION 13.     NEW LAW     A new section of law to be codified in the Oklahoma Statutes as Section 514 of Title 85, unless there is created a duplication in numbering, reads as follows:
A reference in the Workers’ Compensation Code or any other law to the Workers' Compensation Court means the Division of Workers' Compensation of the Insurance Department.  A reference to the Administrator of the Workers’ Compensation Court means the Commissioner of the Division of Workers’ Compensation.
SECTION 14.     NEW LAW     A new section of law to be codified in the Oklahoma Statutes as Section 515 of Title 85, unless there is created a duplication in numbering, reads as follows:
A.  The Commissioner of Workers’ Compensation shall prepare information of public interest describing the functions of the Division and the procedures by which complaints are filed with and resolved by the Division of Workers’ Compensation.
B.  The Commissioner shall make the information available to the public and appropriate state agencies.
C.  The Commissioner by rule shall ensure that each form, standard letter, and brochure of the Division:
1.  Is written in plain language;
2.  Is in a readable and understandable format; and
3.  Complies with all applicable requirements relating to minimum readability requirements.
SECTION 15.     NEW LAW     A new section of law to be codified in the Oklahoma Statutes as Section 516 of Title 85, unless there is created a duplication in numbering, reads as follows:
A.  The Commissioner of Workers’ Compensation shall:
1.  Adopt rules regarding the filing of a complaint under the Workers’ Compensation Code against an individual or entity subject to regulation under the Workers’ Compensation Code; and
2.  Ensure that information regarding the complaint process is available on the Internet website of the Division of Workers’ Compensation.
B.  The rules adopted under this section shall, at a minimum:
1.  Ensure that the Division clearly defines in rule the method for filing a complaint; and
2.  Define what constitutes a frivolous complaint.
C.  The Division shall develop and post on the Division's Internet website:
1.  A simple standardized form for filing complaints under the Workers’ Compensation Code; and
2.  Information regarding the complaint filing process.
D.  The Division shall adopt a policy outlining the Division's complaint process from receipt of the initial complaint to the complaint's disposition.
E.  The Division shall keep an information file about each written complaint filed with the Division that is unrelated to a specific workers' compensation claim, including a complaint regarding the administration of the workers' compensation system.  The information shall include:
1.  The date the complaint is received;
2.  The name of the complainant;
3.  The subject matter of the complaint;
4.  A record of all persons contacted in relation to the complaint;
5.  A summary of the results of the review or investigation of the complaint; and
6.  For complaints for which the Division took no action, an explanation of the reason the complaint was closed without action.
F.  For each written complaint that is unrelated to a specific workers' compensation claim that the Division has authority to resolve, the Division shall provide to the person filing the complaint and the person about whom the complaint is made information about the Division's policies and procedures relating to complaint investigation and resolution.  The Division, at least quarterly and until final disposition of the complaint, shall notify those persons about the status of the complaint unless the notice would jeopardize an undercover investigation.
SECTION 16.     NEW LAW     A new section of law to be codified in the Oklahoma Statutes as Section 517 of Title 85, unless there is created a duplication in numbering, reads as follows:
A.  The Division of Workers’ Compensation shall develop procedures to formally document and analyze complaints received by the Division.
B.  The Division shall compile detailed statistics on all complaints received and analyze complaint information trends, including:
1.  The number of complaints;
2.  The source of each complaint;
3.  The types of complaints;
4.  The length of time from the receipt of the complaint to its disposition; and
5.  The disposition of complaints.
C.  The Division shall report the information compiled and analyzed under subsection B of this section to the Commissioner of Workers’ Compensation at regular intervals.
SECTION 17.     NEW LAW     A new section of law to be codified in the Oklahoma Statutes as Section 518 of Title 85, unless there is created a duplication in numbering, reads as follows:
A.  The Division of Workers’ Compensation shall assign priorities to complaint investigations based on risk.  In developing priorities under this section, the Division shall develop a formal, risk-based complaint investigation system that considers:
1.  The severity of the alleged violation;
2.  Whether the alleged violator showed continued or wilful noncompliance; and
3.  Whether an order of the Commissioner of Workers’ Compensation has been violated.
B.  The Commissioner may develop additional risk-based criteria as determined necessary.
SECTION 18.     NEW LAW     A new section of law to be codified in the Oklahoma Statutes as Section 519 of Title 85, unless there is created a duplication in numbering, reads as follows:
A.  The Commissioner of Workers’ Compensation shall develop and implement policies that provide the public with a reasonable opportunity to appear before the Division of Workers’ Compensation and to speak on issues under the general jurisdiction of the Division.
B.  The Division shall comply with federal and state laws related to program and facility accessibility.
SECTION 19.     NEW LAW     A new section of law to be codified in the Oklahoma Statutes as Section 520 of Title 85, unless there is created a duplication in numbering, reads as follows:
The Commissioner of Workers’ Compensation shall appoint deputies, assistants, and other personnel as necessary to carry out the powers and duties of the Commissioner and the Division of Workers’ Compensation under the Workers’ Compensation Code and other laws granting jurisdiction or applicable to the Division or the Commissioner.
SECTION 20.     NEW LAW     A new section of law to be codified in the Oklahoma Statutes as Section 521 of Title 85, unless there is created a duplication in numbering, reads as follows:
The Commissioner of Workers’ Compensation shall promulgate rules as necessary for the implementation and enforcement of the Workers’ Compensation Code.
SECTION 21.     NEW LAW     A new section of law to be codified in the Oklahoma Statutes as Section 522 of Title 85, unless there is created a duplication in numbering, reads as follows:
A.  The Commissioner of Workers’ Compensation shall consider and recommend to the Legislature changes to the Workers’ Compensation Code.
B.  The Commissioner shall forward the recommended changes to the Legislature not later than December 1 of each even-numbered year.
SECTION 22.     NEW LAW     A new section of law to be codified in the Oklahoma Statutes as Section 523 of Title 85, unless there is created a duplication in numbering, reads as follows:
A.  The Commissioner of Workers’ Compensation is the custodian of the Division of Workers’ Compensation records and shall perform the duties of a custodian required by law, including providing copies and the certification of records.
B.  The Division shall comply with records retention schedules as provided by law.
C.  The Division may charge a reasonable fee for making available for inspection any of its information that contains confidential information that must be redacted before the information is made available.  However, when a request for information is for the inspection of ten or fewer pages, and a copy of the information is not requested, the Division may charge only the cost of making a copy of the page from which confidential information must be redacted.
SECTION 23.     NEW LAW     A new section of law to be codified in the Oklahoma Statutes as Section 524 of Title 85, unless there is created a duplication in numbering, reads as follows:
A.  The Division of Workers’ Compensation shall maintain demographic information on every compensable injury pursuant to rules promulgated by the Commission.
B.  On request from the Office of Injured Employee Counsel, the Division shall provide to the Office the identity, claim number, and contact information of claimants receiving assistance from the Office.
SECTION 24.     NEW LAW     A new section of law to be codified in the Oklahoma Statutes as Section 525 of Title 85, unless there is created a duplication in numbering, reads as follows:
A.  Information in or derived from a claim file regarding an employee is confidential and shall not be disclosed by the Division of Workers’ Compensation except as provided by the Workers’ Compensation Code.
B.  Information concerning an employee who has been finally adjudicated of wrongfully obtaining payment under the Workers’ Compensation Code is not confidential.
SECTION 25.     NEW LAW     A new section of law to be codified in the Oklahoma Statutes as Section 526 of Title 85, unless there is created a duplication in numbering, reads as follows:
A.  The Division of Workers’ Compensation shall perform and release a record check on an employee, including current or prior injury information, to the parties listed in subsection B of this section if:
1.  The claim is:
a.	open or pending before the Division,
b.	on appeal to a court of competent jurisdiction, or
c.	the subject of a subsequent suit in which the insurance carrier or the subsequent injury fund is subrogated to the rights of the named claimant; and
2.  The requesting party requests the release on a form prescribed by the Division for this purpose and provides all required information.
B.  Information on a claim may be released as provided by subsection A of this section to:
1.  The employee or the employee's legal beneficiary;
2.  The employee's or the legal beneficiary's representative;
3.  The employer at the time of injury;
4.  The insurance carrier;
5.  The Individual Self-Insured Guaranty Fund Board, if that Fund is liable to make payments on a claim;
6.  The Group Self-Insurance Association Guaranty Fund Board, if that Fund is liable to make payments on a claim; 
7.  The Workers’ Compensation Self-Insurance Guaranty Fund Board, if that Fund is liable to make payments on a claim; or
8.  A third-party litigant in a lawsuit in which the cause of action arises from the incident that gave rise to the injury.
C.  The requirements of paragraph 1 of subsection A of this section do not apply to a request from a third-party litigant described by paragraph 8 of subsection B of this section.
D.  For purposes of this section only, "insurance carrier" means:
1.  A certified self-insurer; or
2.  An entity authorized under the Insurance Code that provides health insurance coverage or health benefits in this state, including:
a.	an insurance company, including an insurance company that holds a certificate of authority issued by the Commissioner of Insurance to engage in the business of workers' compensation insurance in this state,
b.	a group hospital service corporation,
c.	a health maintenance organization,
d.	a fully self-insured plan, as described by the Employee Retirement Income Security Act of 1974 (29 U.S.C. Section 1001 et seq.),
e.	a governmental plan, as defined by Section 3(32), Employee Retirement Income Security Act of 1974 (29 U.S.C. Section 1002(32)),
f.	an employee welfare benefit plan, as defined by Section 3(1), Employee Retirement Income Security Act of 1974 (29 U.S.C. Section 1002(1)), or
g.	an insurer authorized by the Insurance Department to offer disability insurance in this state.
E.   The Commissioner of Workers’ Compensation by rule may establish a reasonable fee, not to exceed five cents ($0.05) for each claimant listed in an information request, in an electronic data format.  The Commissioner shall adopt rules to establish:
1.  Reasonable security parameters for all transfers of information requested under this section in electronic data format; and
2.  Requirements regarding the maintenance of electronic data in the possession of an insurance carrier.
F.  The insurance carrier or the carrier's authorized representative shall execute a written agreement with the Commissioner before submitting the carrier's first request.  The agreement shall contain a provision by which the carrier and the representative agree to comply with the Commissioner's rules governing security parameters applicable to the transfer of information and the maintenance of electronic data.
SECTION 26.     NEW LAW     A new section of law to be codified in the Oklahoma Statutes as Section 527 of Title 85, unless there is created a duplication in numbering, reads as follows:
A.  The Division of Workers’ Compensation shall release information on a claim to:
1.  The Insurance Department for any statutory or regulatory purpose;
2.  A legislative committee for legislative purposes;
3.  A state or federal elected official requested in writing to provide assistance by a constituent who qualifies to obtain injury information under the Workers’ Compensation Code, if the request for assistance is provided to the Division;
4.  The Attorney General or the Department of Human Services, relating to:
a.	establishing, modifying, or enforcing a child support or medical support obligation, or
b.	locating an absent parent; or
5.  The Office of Injured Employee Counsel for any statutory or regulatory purpose that relates to a duty of that Office.
B.  The Division may release information on a claim to a governmental agency, political subdivision, or regulatory body to use to:
1.  Investigate an allegation of a criminal offense or licensing or regulatory violation;
2.  Provide:
a.	unemployment compensation benefits,
b.	crime victims compensation benefits,
c.	vocational rehabilitation services, or
d.	health care benefits;
3.  Investigate occupational safety or health violations;
4.  Verify income on an application for benefits under an income-based state or federal assistance program; or
5.  Assess financial resources in an action, including an administrative action, to:
a.	establish, modify, or enforce a child support or medical support obligation,
b.	establish paternity,
c.	locate an absent parent, or
d.	cooperate with another state in an action authorized under Part D, Title IV, Social Security Act (42 U.S.C. Section 651 et seq.).
SECTION 27.     NEW LAW     A new section of law to be codified in the Oklahoma Statutes as Section 528 of Title 85, unless there is created a duplication in numbering, reads as follows:
A.  Information relating to a claim that is confidential under the Workers’ Compensation Code remains confidential when released to any person, except when used in court for the purposes of an appeal.
B.  This section does not prohibit an employer from releasing information about a former employee to another employer with whom the employee has applied for employment, if that information was lawfully acquired by the employer releasing the information.
SECTION 28.     NEW LAW     A new section of law to be codified in the Oklahoma Statutes as Section 529 of Title 85, unless there is created a duplication in numbering, reads as follows:
A.  A prospective employer who has workers' compensation insurance coverage and who complies with the Workers’ Compensation Code is entitled to obtain information on the prior injuries of an applicant for employment if the employer obtains written authorization from the applicant before making the request.
B.  The employer shall make the request by telephone or file the request in writing not later than the fourteenth day after the date on which the application for employment is made.
C.  The request shall include the applicant's name, address, and social security number.
D.  If the request is made in writing, the authorization shall be filed simultaneously.  If the request is made by telephone, the employer shall file the authorization not later than the tenth day after the date on which the request is made.
SECTION 29.     NEW LAW     A new section of law to be codified in the Oklahoma Statutes as Section 530 of Title 85, unless there is created a duplication in numbering, reads as follows:
A.  A person commits an offense if the person knowingly, intentionally, or recklessly publishes, discloses, or distributes information that is confidential under the Workers’ Compensation Code to a person not authorized to receive the information directly from the Division of Workers’ Compensation.
B.  A person commits an offense if the person knowingly, intentionally, or recklessly receives information that is confidential under the Workers’ Compensation Code and that the person is not authorized to receive.
C.  An offense under this section is a misdemeanor, subject to a fine of not more than One Thousand Dollars ($1,000.00) or imprisonment in the county jail for not more than one (1) year, or both such fine and imprisonment.
D.  An offense under this section may be prosecuted in a district court in the county where the information was unlawfully received, published, disclosed, or distributed.
E.  The court has jurisdiction to enjoin the use, publication, disclosure, or distribution of confidential information under this section.
SECTION 30.     NEW LAW     A new section of law to be codified in the Oklahoma Statutes as Section 531 of Title 85, unless there is created a duplication in numbering, reads as follows:
A.  In this section, "investigation file" means any information compiled or maintained by the Division with respect to a Division investigation authorized under the Workers' Compensation Code.  The term does not include information or material acquired by the Division that is relevant to an investigation by the Anti-fraud Unit of the Insurance Department, the Office of Attorney General Workers’ Compensation Fraud Unit or the Office of Attorney General Insurance Fraud Unit.
B.  Information maintained in the investigation files of the Division of Workers’ Compensation is confidential and shall not be disclosed except:
1.  In a criminal proceeding;
2.  In a hearing conducted by the Division;
3.  On a judicial determination of good cause;
4.  To a governmental agency, political subdivision, or regulatory body if the disclosure is necessary or proper for the enforcement of the laws of this or another state or of the United States; or
5.  To an insurance carrier if the investigation file relates directly to a felony regarding workers' compensation or to a claim in which restitution is required to be paid to the insurance carrier.
C.  Division investigation files are not open records.
D.  Information in an investigation file that is information in or derived from a claim file, or an employer injury report or occupational disease report, is governed by the confidentiality provisions relating to that information.
E.  The Division, upon request, shall disclose the identity of a complainant under this section if the Division finds:
1.  The complaint was groundless or made in bad faith;
2.  The complaint lacks any basis in fact or evidence;
3.  The complaint is frivolous; or
4.  The complaint is done specifically for competitive or economic advantage.
F.  Upon completion of an investigation in which the Division determines a complaint is described by subsection E of this section, the Division shall notify the person who was the subject of the complaint of its finding and the identity of the complainant.
SECTION 31.     NEW LAW     A new section of law to be codified in the Oklahoma Statutes as Section 532 of Title 85, unless there is created a duplication in numbering, reads as follows:
A.  The Insurance Department and the Division of Workers’ Compensation shall cooperate with the Office of Injured Employee Counsel in providing services to claimants under the Workers’ Compensation Code.
B.  The Department shall provide facilities to the Office of Injured Employee Counsel.
SECTION 32.     NEW LAW     A new section of law to be codified in the Oklahoma Statutes as Section 533 of Title 85, unless there is created a duplication in numbering, reads as follows:
A.  The Office of Injured Employee Counsel is established to represent the interests of workers' compensation claimants in this state.
B.  The chief administrative director of the Office shall be the General Counsel, who shall be appointed by the Governor, subject to confirmation by the Senate.  The General Counsel shall serve at the pleasure of the Governor.
C.  The Office is administratively attached to the Insurance Department but is independent of direction by the Insurance Commissioner or the Commissioner of Workers’ Compensation.
D.  The Insurance Department shall provide the staff and facilities necessary to enable the Office to perform the duties of the Office, including:
1.  Administrative assistance and services to the Office, including budget planning and purchasing;
2.  Personnel services; and
3.  Computer equipment and support.
E.  The Office shall prepare information of public interest describing the functions of the Office and make the information available to the public and appropriate state agencies.
SECTION 33.     NEW LAW     A new section of law to be codified in the Oklahoma Statutes as Section 534 of Title 85, unless there is created a duplication in numbering, reads as follows:
The Office of Injured Employee Counsel shall develop and implement a policy to encourage the use of appropriate alternative dispute resolution procedures under the Workers’ Compensation Code, to assist in the resolution of internal and external disputes under the Office's jurisdiction.
SECTION 34.     NEW LAW     A new section of law to be codified in the Oklahoma Statutes as Section 535 of Title 85, unless there is created a duplication in numbering, reads as follows:
A.  The Office of Injured Employee Counsel shall maintain a system to promptly and efficiently act on complaints filed with the Office.  The Office shall maintain information about parties to the complaint, the subject matter of the complaint, a summary of the results of the review or investigation of the complaint, and its disposition.
B.  The Office shall make information available describing its procedures for complaint investigation and resolution.
C.  The Office shall periodically notify the complaint parties of the status of the complaint until final disposition.
SECTION 35.     NEW LAW     A new section of law to be codified in the Oklahoma Statutes as Section 536 of Title 85, unless there is created a duplication in numbering, reads as follows:
To be eligible to serve as General Counsel of the Office of Injured Employee Counsel, a person shall:
1.  Be a resident of this state;
2.  Be licensed to practice law in this state;
3.  Have management experience;
4.  Possess knowledge and experience with the workers' compensation system; and
5.  Have experience with legislative procedures and administrative law.
SECTION 36.     NEW LAW     A new section of law to be codified in the Oklahoma Statutes as Section 537 of Title 85, unless there is created a duplication in numbering, reads as follows:
A.  The Office of Injured Employee Counsel shall:
1.  Provide assistance to workers' compensation claimants;
2.  Advocate on behalf of injured employees as a class regarding rulemaking by the Commissioner and Commissioner of Insurance relating to workers' compensation;
3.  Assist injured employees with contacting appropriate licensing boards for complaints against a health care provider; 
4.  Assist injured employees with referral to local, state, and federal financial assistance, rehabilitation, and work placement programs, as well as other social services that the Office considers appropriate;
5.  Assist injured employees, through the ombudsman program, with the resolution of complaints pending at the Division of Workers’ Compensation or the Insurance Department; and
6.  Assist injured employees, through the ombudsman program, in the administrative dispute resolution system of the Division.
B.  The Office shall not appear or intervene, as a party or otherwise, before the Commissioner of Workers’ Compensation, Commissioner of Insurance, Division of Workers’ Compensation, or Insurance Department on behalf of an individual injured employee, except through the ombudsman program.
SECTION 37.     NEW LAW     A new section of law to be codified in the Oklahoma Statutes as Section 538 of Title 85, unless there is created a duplication in numbering, reads as follows:
A.  The General Counsel of the Office of Injured Employee Counsel may refuse to provide or may terminate the services of the Office to any claimant who:
1.  Is abusive or violent to or who threatens any employee of the Office;
2.  Requests assistance in claiming benefits not provided by law; or
3.  Commits or threatens to commit a criminal act in pursuit of a workers' compensation claim.
B.  If the General Counsel determines that the services of the Office should be refused or terminated, the Office shall inform the affected claimant in writing and notify the Division of Workers’ Compensation.
C.  The Office shall notify and cooperate with the appropriate law enforcement authority and the Office of Attorney General Workers’ Compensation Fraud Unit, if the Office becomes aware that the claimant or a person acting on the claimant's behalf commits or threatens to commit a criminal act.
SECTION 38.     NEW LAW     A new section of law to be codified in the Oklahoma Statutes as Section 539 of Title 85, unless there is created a duplication in numbering, reads as follows:
A.  The Office of Injured Employee Counsel shall operate an ombudsman program.
B.  The General Counsel of the Office shall assign staff attorneys, as the general counsel considers appropriate, to supervise the work of the ombudsman program and advise ombudsmen in providing assistance to claimants and preparing for informal and formal hearings.
SECTION 39.     NEW LAW     A new section of law to be codified in the Oklahoma Statutes as Section 540 of Title 85, unless there is created a duplication in numbering, reads as follows:
A.  The Office of Injured Employee Counsel, through the ombudsman program, may appear before the Commissioner of Workers’ Compensation or the Division of Workers’ Compensation to provide assistance to an individual injured employee during:
1.  A workers' compensation administrative dispute resolution process; or
2.  An enforcement action by the Division against an employee for a violation of the Workers’ Compensation Code.
B.  This section shall not be construed as requiring or allowing legal representation for an individual injured employee by an Office attorney or ombudsman in any proceeding.
SECTION 40.     NEW LAW     A new section of law to be codified in the Oklahoma Statutes as Section 541 of Title 85, unless there is created a duplication in numbering, reads as follows:
A.  The ombudsman program of Office of Injured Employee Counsel shall maintain an ombudsman program to assist injured employees and persons claiming death benefits in obtaining benefits under the Workers’ Compensation Code.
B.  An ombudsman shall:
1.  Meet with or otherwise provide information to injured employees;
2.  Investigate complaints;
3.  Communicate with employers, insurance carriers, and health care providers on behalf of injured employees; and
4.  Assist unrepresented claimants to enable those persons to protect their rights in the workers' compensation system.
SECTION 41.     NEW LAW     A new section of law to be codified in the Oklahoma Statutes as Section 542 of Title 85, unless there is created a duplication in numbering, reads as follows:
The General Counsel of the Office of Injured Employee Counsel:
1.  Is entitled to the same access as a party to the records of the Division of Workers’ Compensation available in a proceeding before the Commissioner of Workers’ Compensation; and
2.  Is entitled to obtain discovery of any nonprivileged matter that is relevant to the subject matter involved in a proceeding or submission before the Commissioner or Division.
SECTION 42.     NEW LAW     A new section of law to be codified in the Oklahoma Statutes as Section 543 of Title 85, unless there is created a duplication in numbering, reads as follows:
The General Counsel of the Office of Injured Employee Counsel shall adopt, after consultation with the Commissioner of Workers' Compensation, a notice of injured employee rights and responsibilities to be distributed by the Division of Workers’ Compensation.  This section shall not be construed as establishing an entitlement to benefits to which the claimant is not otherwise entitled under the Workers’ Compensation Code.
SECTION 43.     NEW LAW     A new section of law to be codified in the Oklahoma Statutes as Section 544 of Title 85, unless there is created a duplication in numbering, reads as follows:
A.  Confidentiality requirements applicable to examination reports and to the Commissioner of Workers’ Compensation apply to the General Counsel of the Office of Injured Employee Counsel.
B.  An employee of the Office shall not be compelled to disclose information communicated to the employee by a claimant on any matter relating to the claimant's claim.  This subsection does not prohibit or alter the Office's duty to notify and cooperate with the Office of Attorney General Workers’ Compensation Fraud Unit.
SECTION 44.     NEW LAW     A new section of law to be codified in the Oklahoma Statutes as Section 545 of Title 85, unless there is created a duplication in numbering, reads as follows:
A.  When assisting an injured employee, the Office of Injured Employee Counsel is entitled to the same access to information related to the employee's injury and workers' compensation claim as the employee or any other party to the claim.
B.  The Office shall not access information under subsection A of this section that is an attorney-client communication or an attorney work product, or other information protected by a statutory privilege. 
SECTION 45.     RECODIFICATION     85 O.S. 2011, Section 301, shall be recodified as Section 501 of Title 85 of the Oklahoma Statutes, unless there is created a duplication in numbering.
SECTION 46.  This act shall become effective January 1, 2015.

54-1-5587	SD	01/16/13