S1932.02I

To repeal sections 287.020, 287.030, 287.040, 287.061, 287.067, 287.120, 287.128, 287.129, 287.135, 287.140, 287.150, 287.160, 287.170, 287.190, 287.200, 287.203, 287.210, 287.215, 287.220, 287.240, 287.250, 287.260, 287.266, 287.380, 287.390, 287.420, 287.430, 287.460, 287.480, 287.550, 287.655, and 287.800, RSMo 1994, and section 287.650, RSMo Supp. 1995, relating to workers' compensation and to enact in lieu thereof thirty-seven new sections relating to the same subject, with an expiration date for certain sections.

BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF MISSOURI,

AS FOLLOWS:

Section A. Sections 287.020, 287.030, 287.040, 287.061, 287.067, 287.120, 287.128, 287.129, 287.135, 287.140, 287.150, 287.160, 287.170, 287.190, 287.200, 287.203, 287.210, 287.215, 287.220, 287.240, 287.250, 287.260, 287.266, 287.380, 287.390, 287.420, 287.430, 287.460, 287.480, 287.550, 287.655, and 287.800, RSMo 1994, and section 287.650, RSMo Supp. 1995, are repealed and thirty-seven new sections enacted in lieu thereof to be known as sections 287.020, 287.030, 287.040, 287.061, 287.067, 287.120, 287.128, 287.129, 287.135, 287.140, 287.150, 287.160, 287.170, 287.190, 287.200, 287.203, 287.210, 287.215, 287.220, 287.240, 287.250, 287.260, 287.263, 287.266, 287.380, 287.390, 287.420, 287.430, 287.460, 287.480, 287.550, 287.650, 287.655, 287.735, 287.800, 287.805 and 287.806, to read as follows:

287.020. 1. The word "employee" as used in this chapter shall be construed to mean every person in the service of any employer, as defined in this chapter, under any contract of hire, express or implied, oral or written, or under any appointment or election, including executive officers of corporations. Any reference to any employee who has been injured shall, when the employee is dead, also include his dependents, and other persons to whom compensation may be payable. The word "employee" shall also include all minors who work for an employer, whether or not such minors are employed in violation of law, and all such minors are hereby made of full age for all purposes under, in connection with, or arising out of this chapter. The word "employee" shall not include an individual who is the owner and operator of a motor vehicle which is leased or contracted with a driver to a for-hire common or contract motor vehicle carrier operating within a commercial zone as defined in section 390.020 or 390.041, RSMo, or operating under a certificate issued by the transportation division of the department of economic development or by the interstate commerce commission.

2. The word "accident" as used in this chapter shall, unless a different meaning is clearly indicated by the context, be construed to mean an unexpected or unforeseen identifiable event or series of events happening suddenly and violently, with or without human fault, and producing at the time objective symptoms of an injury. An injury is compensable if it is clearly work related. An injury is clearly work related if the work was a substantial factor in the cause of the resulting medical condition or disability. Work as a substantial factor shall mean that factor that is the leading factor of all the other factors combined to cause the resulting medical condition or disability. The medical condition or disability must be supported by objective medical findings. This chapter shall not apply to personal health conditions of an employee which manifest themselves in the employment in which the work played no substantial factor in the resulting need for medical treatment or disability. An injury, including injuries resulting directly or indirectly from idiopathic causes, is not compensable merely because work was a triggering or precipitating factor.

3. (1) In this chapter the term "injury" is hereby defined to be an injury which has arisen out of and in the course of employment. The injury must be incidental to and not independent of the relation of employer and employee. An injury shall not be deemed to have been directly caused by the employment where it is shown that the employee suffers disability as a result of ordinary, gradual deterioration or progressive degeneration of the body caused by aging [shall not be compensable, except where the deterioration or degeneration follows as an incident of employment] or by the normal activities of day-to-day living.

(2) The employee shall not be entitled to recover for the aggravation of a pre-existing condition, except to the extent that the work-related injury causes increased disability. Any award of compensation shall be reduced by the amount of permanent partial disability determined to be pre-existing. If a compensable injury combines with a pre-existing disease or condition to cause or prolong disability or need for treatment, the resultant condition is compensable only to the extent that the compensable injury is and remains a substantial factor in the cause of the disability or need for treatment. If the substantial cause of a worsened condition is an injury not arising out of and in the course of the employment, the worsening is not compensable.

[(2)] (3) An injury shall be deemed to arise out of and in the course of the employment only if:

(a) It is reasonably apparent, upon consideration of all the circumstances, that the employment is a substantial factor in causing the injury; and

(b) It can be seen to have followed as a natural incident of the work; and

(c) It can be fairly traced to the employment as a proximate cause; and

(d) It does not come from a hazard or risk unrelated to the employment to which workers would have been equally exposed outside of and unrelated to the employment in normal nonemployment life;

[(3)] (4) The terms "injury" and "personal injuries" shall mean violence to the physical structure of the body and to the personal property which is used to make up the physical structure of the body, such as artificial dentures, artificial limbs, glass eyes, eyeglasses, and other prostheses which are placed in or on the body to replace the physical structure and such disease or infection as naturally results therefrom. These terms shall in no case except as specifically provided in this chapter be construed to include occupational disease in any form, nor shall they be construed to include any contagious or infectious disease contracted during the course of the employment, nor shall they include death due to natural causes occurring while the worker is at work.

4. "Death" when mentioned as a basis for the right to compensation means only death resulting from such violence and its resultant effects occurring within three hundred weeks after the accident; except that in cases of occupational disease, the limitation of three hundred weeks shall not be applicable.

5. Without otherwise affecting either the meaning or interpretation of the abridged clause, "personal injuries arising out of and in the course of such employment", it is hereby declared not to cover workers except while engaged in or about the premises where their duties are being performed, or where their services require their presence as a part of such service.

6. A person who is employed by the same employer for more than five and one-half consecutive work days shall for the purpose of this chapter be considered an "employee".

7. The term "total disability" as used in this chapter shall mean inability to return to any employment and not merely mean inability to return to the employment in which the employee was engaged at the time of the accident.

8. As used in this chapter and all acts amendatory thereof, the term "commission" shall hereafter be construed as meaning and referring exclusively to the labor and industrial relations commission of Missouri, and the term "director" shall hereafter be construed as meaning the director of the department of insurance of the state of Missouri or such agency of government as shall exercise the powers and duties now conferred and imposed upon the department of insurance of the state of Missouri.

9. The term "division" as used in this chapter means the division of workers' compensation of the department of labor and industrial relations of the state of Missouri.

10. For the purposes of this chapter, the term "minor" means a person who has not attained the age of eighteen years; except that, for the purpose of computing the compensation provided for in this chapter, the provisions of section 287.250 shall control.

287.030. 1. The word "employer" as used in this chapter shall be construed to mean:

(1) Every person, partnership, association, corporation, trustee, receiver, the legal representatives of a deceased employer, and every other person, including any person or corporation operating a railroad and any public service corporation, using the service of another for pay;

(2) The state, county, municipal corporation, township, school or road, drainage, swamp and levee districts, or school boards, board of education, regents, curators, managers or control commission, board or any other political subdivision, corporation, or quasi-corporation, or cities under special charter, or under the commission form of government;

(3) Any of the above defined employers must have five or more employees to be deemed an employer for the purposes of this chapter unless election is made to become subject to the provisions of this chapter as provided in subsection 2 of section 287.090, except that construction industry employers who erect, demolish, alter or repair improvements shall be deemed an employer for the purposes of this chapter if they have one or more employees.

2. Any reference to the employer shall also include his insurer or group self-insurer.

287.040. 1. Any person who has work done under contract on or about his premises which is an operation of the usual business which he there carries on shall be deemed an employer for the purposes of section 287.030, and shall require a current, valid certificate of insurance or self-insurance for workers' compensation for each contractor, his subcontractor and their employees if they are otherwise required to cover their liability under this chapter and shall be liable under this chapter to the

qualified employees of such contractor[,] and his subcontractors, [and their employees, when] a qualified employee being an employee other than an employee who is the owner, as the sole proprietor, partner, officer, or its designated agent, of any such subcontractor or contractor, when any such qualified employee is injured or killed on or about the premises of the employer while doing work which is in the usual course of his business.

2. The provisions of this section shall apply to the relationship of landlord and tenant, and lessor [or] and lessee, when created for the fraudulent purpose of avoiding liability, but not otherwise. In such cases the landlord or lessor shall be deemed the employer of the employees of the tenant or lessee.

3. The provisions of this section shall not apply to the owner of premises upon which improvements are being erected, demolished, altered or repaired by an independent contractor but such independent contractor shall be deemed to be the employer of the employees of his subcontractors and their subcontractors when employed on or about the premises where the principal contractor is doing work.

4. In all cases mentioned in the preceding subsections, the immediate contractor or subcontractor shall be liable as an employer of the employees of his subcontractors. All persons so liable may be made parties to the proceedings on the application of any party. The liability of the immediate employer shall be primary, and that of the others secondary in their order, and any compensation paid by those secondarily liable may be recovered from those primarily liable, with attorney's fees and expenses of the suit. Such recovery may be had on motion in the original proceedings. No such employer shall be liable as in this section provided, if the employee was insured by his immediate or any intermediate employer or if the secondary employer received and maintained on file a copy of a current certificate of insurance from each of his subcontractors documenting that such subcontractor had workers' compensation coverage in effect at the time the work was being conducted. Any fraudulent certification of coverage by the secondary employer for the purpose of avoiding liability shall void this exception.

5. Any person liable under the provisions of subsections 1, 3, or 4 of this section for the injury or death of any employee of a contractor or subcontractor may require a current, valid certificate of insurance or self-insurance for workers' compensation for such contractor or subcontractor, and their respective employees, if the same are required to insure their liability under this chapter, and the insurer of such a contractor or subcontractor shall provide such a certificate thereof to any person liable under the provisions of subsections 1, 3, or 4 of this section. Such certificate of insurance shall state that the insurer, or in the case of self-insurance, the division shall provide to the certificate holder ten days prior written notice of cancellation of insurance or the revocation of self-insurance status for the contractor or subcontractor.

6. The insurer of a contractor or subcontractor shall remain liable for the injury or death of any employee of that contractor or subcontractor until the notice required by subsection 5 of this section is given to each certificate holder and to the division.

7. It is unlawful, pursuant to section 287.128 for any contractor or his subcontractor, as referred to in this section, to provide fraudulent information pursuant to this section.

287.061. 1. Any city or county which issues an occupational or business license for a contractor in the construction industry shall require a certificate of insurance for workers' compensation coverage [if the applicant for the license is required to cover his liability under this chapter].

2. Any [applicant] contractor who fails to comply with the provisions of subsection 1 of this section shall be denied such a license until [he] such person furnishes a certificate of insurance.

3. It is unlawful, pursuant to section 287.128, for any [applicant] contractor to provide fraudulent information pursuant to this section.

4. Nothing in this section shall be construed to create or constitute a liability to or a cause of action against a city or county in regard to the issuance of any license pursuant to this section.

287.067. 1. In this chapter the term "occupational disease" is hereby defined to mean, unless a different meaning is clearly indicated by the context, an identifiable disease arising with or without human fault out of and in the course of the employment. Ordinary diseases of life to which the general public is exposed outside of the employment shall not be compensable, except where the diseases follow as an incident of an occupational disease as defined in this section. The disease need not to have been foreseen or expected but after its contraction it must appear to have had its origin in a risk connected with the employment and to have flowed from that source as a rational consequence.

2. An occupational disease is compensable if it is clearly work related and meets the requirements of an injury which is compensable as provided in subsections 2 and 3 of section 287.020. An occupational disease is not compensable merely because work was a triggering or precipitating factor.

3. "Loss of hearing due to industrial noise" is recognized as an occupational disease for purposes of this chapter and is hereby defined to be a loss of hearing in one or both ears due to prolonged exposure to harmful noise in employment. "Harmful noise" means sound capable of producing occupational deafness.

4. "Radiation disability" is recognized as an occupational disease for purposes of this chapter and is hereby defined to be that disability due to radioactive properties or substances or to Roentgen rays (X rays) or exposure to ionizing radiation caused by any process involving the use of or direct contact with radium or radioactive properties or substances or the use of or direct exposure to Roentgen rays (X rays) or ionizing radiation.

5. Disease of the lungs or respiratory tract, hypotension, hypertension, or disease of the heart or cardiovascular system, including carcinoma, may be recognized as occupational diseases for the purposes of this chapter and are defined to be disability due to exposure to smoke, gases, carcinogens, inadequate oxygen, or psychological stress of firefighters of a paid fire department if a direct causal relationship is established.

6. Any employee who is exposed to and contracts any contagious or communicable disease arising out of and in the course of his or her employment shall be eligible for benefits under this chapter as an occupational disease.

7. With regard to occupational disease due to repetitive motion, if the exposure to the repetitive motion which is found to be the cause of the injury is for a period of less than three months and the clear and convincing evidence demonstrates that the exposure to the repetitive motion with a prior employer was the substantial contributing factor to the injury, the prior employer shall be liable for such occupational disease.

8. In any proceeding under subsection 7 of this section, the employee, the last employer and any prior employer shall have the right to join any prior employer in the principal case as an alleged employer for the purpose of determining whether or not there was repetitive motion exposure which was the major contributing factor to the injury during the employment of such employee, all of such matters to be tried in one hearing in which the division shall have exclusive jurisdiction of the parties and the subject matter to determine the issues. Upon a hearing, the administrative law judge, or the parties, as they may otherwise agree, shall determine which of the employers was the last employer with which there was an occupational disease which was the major contributing factor to the injury the employee sustained and, in the event of a voluntary payment, shall order reimbursement by such employer or its insurer. The employee shall cooperate in all phases of such hearing, giving testimony as is necessary to determine the issues. Should the employee fail to cooperate in being willing to testify to the essential facts, the administrative law judge shall suspend all rights to benefits under this chapter unless and until the employee so cooperates. If the employee fails to cooperate within a period of six months after being ordered to do so by the administrative law judge, his case shall be automatically dismissed with prejudice as to any rights under this chapter. Any employer who has paid benefits to the employee can sue the employee pursuant to any civil remedy available upon the property, both real and personal, of the employee, to satisfy any payments made by such employer to said employee under such circumstances, notwithstanding the provisions of section 287.260.1.

287.120. 1. Every employer subject to the provisions of this chapter shall be liable, irrespective of negligence, to furnish compensation under the provisions of this chapter for personal injury or death of the employee by accident arising out of and in the course of his employment, and shall be released from all other liability [therefor] whatsoever, including any unintentional acts of the employer, under any theory of liability, whether to the employee or any other person. The term "accident" as used in this section shall include, but not be limited to, injury or death of the employee caused by the unprovoked violence or assault against the employee by any person.

2. The rights and remedies herein granted to an employee shall exclude all other rights and remedies of the employee, his wife, her husband, parents, personal representatives, dependents, heirs or next kin, at common law or otherwise, on account of such [accidental] injury or death, against the municipality or any co-employee of a municipality acting in the scope of their employment pertaining to fire, police, ambulance or other public safety employment of the municipality, except such rights and remedies as are not provided for by this chapter.

3. No compensation shall be allowed under this chapter for the injury or death due to the employee's intentional self-inflicted injury, but the burden of proof of intentional self-inflicted injury shall be on the employer or the person contesting the claim for allowance.

4. Where the injury is caused by the failure of the employer to comply with any statute in this state or any lawful order of the division or the commission, the compensation and death benefit provided for under this chapter shall be increased fifteen percent.

5. Where the injury is caused by the [willful] failure of the employee to use safety devices where provided by the employer, or from the employee's failure to obey any reasonable rule adopted by the employer for the safety of employees, including safety measures adopted by the employer in compliance with subsection 2 of section 287.123 for insured employers, and standards set by the division as a requirement to become self-insured for self-insured employers, which rule has been kept posted in a conspicuous place on the employer's premises, or that the employee has read the rule or which rule the employee has read and signed his or her signature to same, acknowledging actual knowledge of same, on a bi- annual basis, reading and signing of same to take place within the year of the anniversary date of employment by the employee the compensation and death benefit provided for herein shall be reduced fifteen percent; [provided, that it is shown that the employee had actual knowledge of the rule so adopted by the employer;] and provided[, further,] that the employer had, prior to the injury, made a diligent effort to cause his employees to use the safety device or devices and to obey or follow the rule so adopted for the safety of the employees.

6. (1) Where the employee fails to obey any rule or policy adopted by the employer relating to the use of alcohol or nonprescribed controlled drugs in the workplace, which rule or policy has been kept posted in a conspicuous place on the employer's premises, the compensation and death benefit provided for herein shall be reduced fifteen percent if the injury was sustained in conjunction with the use of alcohol or nonprescribed controlled drugs; provided, that it is shown that the employee had actual knowledge of the rules or policy so adopted by the employer and, provided further that the employer had, prior to the injury, made a diligent effort to inform the employee of the requirement to obey any reasonable rule or policy adopted by the employer.

(2) If, however, the use of alcohol or nonprescribed controlled drugs in violation of the employer's rule or policy which is posted and publicized as set forth in subdivision (1) is the proximate cause of the injury, then the benefits or compensation otherwise payable under this chapter for death or disability shall be forfeited. The forfeiture of benefits or compensation shall not apply when:

(a) The employer has actual knowledge of the employee's use of the alcohol or nonprescribed controlled drugs and in the face thereof fails to take any recuperative or disciplinary action; or

(b) As part of the employee's employment, he is authorized by the employer to use such alcohol or nonprescribed controlled drugs.

7. Where the employee's participation in a voluntary recreational or exercise activity,[or] program, or social event, referred to in this section as "such voluntary activity", whether on or off the employer's premises at the time of the injury, under circumstances where the employee voluntarily attends or where the injury did not result from the performance of tasks related to the employee's job duties or as specifically instructed to be performed by the employer, is the proximate cause of the injury, benefits or compensation otherwise payable under this chapter for death or disability shall be forfeited regardless that the employer may have promoted, sponsored or supported the recreational activity or program, expressly or impliedly, in whole or in part. The forfeiture of benefits or compensation shall not apply when:

(a) The employee was directly ordered by the employer to participate in such [recreational] voluntary activity [or program];

(b) The employee was paid wages or travel expenses while participating in such [recreational] voluntary activity [or program]; or

(c) The injury from such [recreational] voluntary activity [or program] occurs on the employer's premises due to an unsafe condition and the employer had actual knowledge of the employee's participation in [the recreational] such voluntary activity [or program] and of the unsafe condition of the premises and failed to either curtail the [recreational] voluntary activity [or program] or cure the unsafe condition.

8. Mental injury resulting from work related stress does not arise out of and in the course of the employment, unless it is demonstrated that the stress is work related and was extraordinary and unusual. The amount of work stress shall be measured by objective standards and actual events.

9. A mental injury is not considered to arise out of and in the course of the employment if it resulted from any disciplinary action, work evaluation, job transfer, layoff, demotion, termination or any similar action taken in good faith by the employer.

10. The ability of a firefighter to receive benefits for psychological stress under section 287.067 shall not be diminished by the provisions of subsections 8 and 9 of this section.

11. No compensation shall be allowed under this chapter for the injury or death due to an employee's or supervisor's instigation of or participation in horseplay that results in harm or injury to the participating employee or supervisor. The forfeiture of benefits or compensation shall not apply when:

(1) The employer has actual knowledge of the employee's or supervisor's instigation of or participation in horseplay and in the face thereof fails to take any recuperative or disciplinary action; or

(2) As part of the employee's employment, the employer condones the employee's or supervisor's instigation of or participation in horseplay.

287.128. 1. It shall be unlawful for any person to:

(1) Knowingly present or cause to be presented any false or fraudulent claim for the payment of benefits pursuant to a workers' compensation claim;

(2) Knowingly present multiple claims for the same occurrence with intent to defraud;

(3) Purposefully prepare, make or subscribe to any writing with intent to present or use the same, or to allow it to be presented in support of any false or fraudulent claim;

(4) Knowingly assist, abet, solicit or conspire with:

(a) Any person who knowingly presents any false or fraudulent claim for the payment of benefits;

(b) Any person who knowingly presents multiple claims for the same occurrence with an intent to defraud; or

(c) Any person who purposefully prepares, makes or subscribes to any writing with the intent to present or use the same, or to allow it to be presented in support of any such claim;

(5) Knowingly make or cause to be made any false or fraudulent claim for payment of a health care benefit;

(6) Knowingly submit a claim for a health care benefit which was not used by, or on behalf of, the claimant;

(7) Knowingly present multiple claims for payment of the same health care benefit with an intent to defraud;

(8) Knowingly make or cause to be made any false or fraudulent material statement or material representation for the purpose of obtaining or denying any benefit;

(9) Knowingly make or cause to be made any false or fraudulent statements with regard to entitlement to benefits with the intent to discourage an injured worker from making a legitimate claim. For the purposes of subdivisions (8) and (9) of this subsection, the term "statement" includes any notice, proof of injury, bill for services, payment for services, hospital or doctor records, X-ray or test results.

2. It shall be unlawful for any insurance company or self-insurer in this state to:

(1) Intentionally refuse to comply with known and legally indisputable compensation obligations;

(2) Discharge or administer compensation obligations in a dishonest manner; and

(3) Discharge or administer compensation obligations in such a manner as to cause injury to the public or those persons dealing with the employer or insurer.

3. Any person violating any of the provisions of subsections 1 and 2 of this section shall be guilty of a class A misdemeanor and, in addition, shall be liable to the state of Missouri for a fine not to exceed ten thousand dollars or double the value of the fraud whichever is greater.

4. Any person who knowingly misrepresents any fact in order to obtain workers' compensation insurance at less than the proper rate for that insurance shall be guilty of a class A misdemeanor.

5. Any employer failing to insure his liability pursuant to this chapter shall be guilty of a class A misdemeanor and, in addition, shall be liable to the state of Missouri for a penalty in an amount equal to twice the annual premium the employer would have paid had such employer been insured or twenty-five thousand dollars, whichever amount is greater.

6. Any person may file a complaint alleging fraud or noncompliance with this chapter with a legal advisor in the division of workers' compensation. The legal advisor shall refer the complaint to the fraud and noncompliance unit within the division. The unit shall investigate all complaints and present any finding of fraud or noncompliance to the director, who may refer the file to the attorney general. The attorney general may

prosecute any fraud or noncompliance associated with this chapter. All costs incurred by the attorney general associated with any investigation and prosecution pursuant to [this subsection] sections 287.128 or 287.129 shall be paid out of the workers' compensation fund. Any fines or penalties levied and received as a result of any prosecution under [this section] sections 287.128 or 287.129 shall be paid to the workers' compensation fund. Any restitution ordered as a part of the judgment shall be paid to the person or persons who were defrauded.

7. There is hereby established in the division of workers' compensation a fraud and noncompliance administrative unit responsible for investigating incidences of fraud and failure to comply with the provisions of this chapter.

8. The division and the attorney general shall report to the general assembly, on an annual basis, on all investigations and prosecutions made under this section. Copies of the reports shall be delivered to all members of the general assembly no later than January 15, 1994. Copies shall also be made available to the public after that date. This subsection shall expire January 1, 1997.

287.129. 1. A health care provider commits a fraudulent workers' compensation insurance act if he knowingly and with intent to defraud presents, causes to be presented, or prepares with knowledge or belief that it will be presented, to or by an insurer, purported insurer, broker, or any agent thereof, any claim for payment or other benefit which involves any one or more of the following false billing practices:

(1) "Unbundling" an insurance claim by claiming a number of medical procedures were performed instead of a single comprehensive procedure;

(2) "Upcoding" a medical, hospital or rehabilitative insurance claim by claiming that a more serious or extensive procedure was performed than was actually performed;

(3) "Exploding" a medical, hospital or rehabilitative insurance claim by claiming a series of tests were performed on a single sample of blood, urine, or other bodily fluid, when actually the series of tests were part of one battery of tests; or

(4) "Duplicating" a medical, hospital or rehabilitative insurance claim made by a health care provider by resubmitting the claim through another health care provider in which the original health care provider has an ownership interest. Nothing in this section shall prohibit providers from making good faith efforts to ensure that claims for reimbursement are coded to reflect the proper diagnosis and treatment.

2. If, by its own inquiries or as a result of complaints, the department of insurance has reason to believe that a person has engaged in, or is engaging in, any fraudulent workers' compensation insurance act contained in this section, it may administer oaths and affirmations, serve subpoenas ordering the attendance of witnesses or proffering of matter, and collect evidence.

3. If the matter that the department of insurance seeks to obtain by request is located outside the state, the person so requested may make it available to the division or its representative to examine the matter at the place where it is located. The department may designate representatives, including officials of the state in which the matter is located, to inspect the matter on its behalf, and it may respond to similar requests from officials of other states.

4. Any person violating any of the provisions of this section shall be guilty of a class A misdemeanor and, in addition, shall be liable to the state of Missouri for a fine not to exceed ten thousand dollars or double the value of the fraud whichever is greater.

287.135. 1. The department of insurance shall establish a program whereby managed care organizations in this state shall be certified by the department for the provision of managed care services to employers who voluntarily choose to use such organizations. The department shall report to the division of workers' compensation all managed care organizations certified pursuant to the provisions of this section. The division shall maintain a registry of certified managed care organizations that can be readily accessed by employers for the provision of managed care services. For the purposes of this section, the term "managed care organizations" shall mean organizations such as preferred provider organizations, health maintenance organizations and other direct employer/provider arrangements which have been certified by the department designed to provide incentives to medical care providers to manage the cost and use of care associated with claims covered by workers' compensation insurance.

2. No preferred provider organization, health maintenance organization or other entity may provide managed care services to employees, on behalf of employers or insurers, in this state unless certified by the department of insurance pursuant to the criteria set forth in this section.

[2.] 3. The director of the department of insurance shall promulgate rules which set out the approval criteria for certification of a managed care organization. Approval criteria shall take into consideration the adequacy of services that the organization will be able to offer the employer, the geographic area to be served, staff size and makeup of the organization in

relation to both services offered and geographic location, access to health care providers, the adequacy of internal management and oversight, the adequacy of procedures for peer review, utilization review, and internal dispute resolution, including a method to resolve complaints by injured employees, medical providers, and insurers over the cost, necessity and appropriateness of medical services, the availability of case management services, and any other criteria as determined by the director. Thirty days prior to the annual anniversary of any current certification granted by the director, any managed care organization seeking continued certification shall file an application for recertification with the director, on a form approved by the director, accompanied by a filing fee established by the director by rule and any other materials specified by the director. No recertification shall be issued by the director unless the managed care organization seeking continued certification meets:

(1) All criteria required for initial certification then in effect; and

(2) Performance evaluation criteria established by the director.

[3.] 4. The director of the department of insurance shall promulgate rules which set out the criteria under which the fees charged by a managed care organization shall be reimbursed by an employer's workers' compensation insurer and which establish criteria providing for the coordination and integration between the managed care organization and the insurer of their respective internal operational systems relating to such matters as claim reporting and handling, medical case management procedures and

billing. Such criteria shall require any such reimbursable fees to be reasonable in relation both to the managed care services provided and to the savings which result from those services. Such criteria shall discourage the use of fee arrangements which result in unjustified costs being billed for either medical services or managed care services. Insurers and managed care organizations shall be permitted to voluntarily negotiate and utilize alternative fee arrangements. Notwithstanding any provision of this subsection to the contrary, if an insurer and a managed care organization enter into a voluntary agreement that accomplishes the same purposes as this subsection, that insurer and that managed care organization with respect to that agreement shall not be required to meet the requirements of this subsection or regulations promulgated by the department pursuant to this subsection.

[4. Any managed care organization, including any managed care organization that has been established or selected by or has contracted with a workers' compensation insurance carrier to provide managed care services to insured employers, that has previously been certified prior to August 28, 1993, by the director of the department of insurance shall be deemed to have met the criteria set forth in this section.]

5. The necessity and appropriateness of medical care services recommended or provided by providers shall be subject to review by the division of workers' compensation, upon application, following a decision by the managed care organization's utilization review and dispute resolution review and appeal procedure. The decision of the managed care organization relating to payment for such medical care services shall be subject to modification by the division of workers' compensation, after mediation conference or hearing, only upon showing that it was unreasonable, arbitrary or capricious.

287.140. 1. In addition to all other compensation, the employee shall receive and the employer shall provide such medical, surgical, chiropractic, and hospital treatment, including nursing, custodial, ambulance and medicines, as may reasonably be required after the injury or disability, to cure and relieve from the effects of the injury. If the employee desires, he shall have the right to select his own physician, surgeon, or other such requirement at his own expense. Where the requirements are furnished by a public hospital or other institution, payment therefor shall be made to the proper authorities. Regardless of whether the health care provider is selected by the employer or is selected by the employee at the employee's expense, the health care provider shall have the affirmative duty to communicate fully with the employee regarding the nature of the employee's injury and recommended treatment exclusive of any evaluation for a permanent disability rating. Failure to perform such duty to communicate shall constitute a disciplinary violation by the provider subject to the provisions of chapter 620, RSMo. When an employee is required to submit to medical examinations or necessary medical treatment at a place outside of the local or metropolitan area from the place of injury or the place of his residence, the employer or its insurer shall advance or reimburse the employee for all necessary and reasonable expenses; except that an injured employee who resides outside the state of Missouri and who is employed by an employer located in Missouri shall have the option of selecting the location of services provided in this section either at a location within one hundred miles of the injured employee's residence, place of injury or place of hire by the employer. The choice of provider within the location selected shall continue to be made by the employer. In case of a medical examination if a dispute arises as to what expenses shall be paid by the employer, the matter shall be presented to the legal advisor, the administrative law judge or the commission, who shall set the sum to be paid and same shall be paid by the employer prior to the medical examination. In no event, however, shall the employer or its insurer be required to pay transportation costs for a greater distance than two hundred fifty miles each way from place of treatment. In addition to all other payments authorized or mandated under this subsection, when an employee who has returned to full-time employment is required to submit to a medical examination for the purpose of evaluating permanent disability, or to undergo physical rehabilitation, the employer or its insurer shall pay a proportionate weekly compensation benefit based on the provisions of section 287.180 for such wages that are lost due to time spent undergoing such medical examinations or physical rehabilitation, except that where the employee is undergoing physical rehabilitation, such proportionate weekly compensation benefit payment shall be limited to a time period of no more than twenty weeks. For purposes of this subsection only, "physical rehabilitation" shall mean the restoration of the seriously injured person as soon as possible and as nearly as possible to a condition of self-support and maintenance as an able-bodied worker. Determination as to what care and restoration constitutes physical rehabilitation shall be the sole province of the treating physician. Should the employer or its insurer contest the determination of the treating physician, then the director shall review the case at question and issue his determination. Such determination by the director shall be appealable like any other finding of the director or the division. Serious injury includes, but is not limited to, quadriplegia, paraplegia, amputations of hand, arm, foot or leg, atrophy due to nerve injury or nonuse, and back injuries not amenable alone to recognized medical and surgical procedures.

2. If it be shown to the division or the commission that the requirements are being furnished in such manner that there is reasonable ground for believing that the life, health, or recovery of the employee is endangered thereby, the division or the commission may order a change in the physician, surgeon, hospital or other requirement.

3. All fees and charges under this chapter shall be fair and reasonable, shall be subject to regulation by the division or the commission, or the board of rehabilitation in rehabilitation cases. A health care provider shall not charge a fee for treatment and care which is governed by the provisions of this chapter greater than the usual and customary fee the provider receives for the same treatment or service when the payor for such treatment or service is a private individual or a private health insurance carrier. The division or the commission, or the board of rehabilitation in rehabilitation cases, shall also have jurisdiction to hear and determine all disputes as to such charges. A health care provider is bound by the determination upon the reasonableness of health care bills.

4. The division shall, by regulation, establish methods to resolve disputes concerning the reasonableness of medical charges, services, or aids. This regulation shall govern resolution of disputes between employers and medical providers over fees charged, whether or not paid, and shall be in lieu of any other administrative procedure under this chapter. The employee shall not be a party to a dispute over medical charges, nor shall the employee's recovery in any way be jeopardized because of such dispute.

5. No compensation shall be payable for the death or disability of an employee, if and insofar as the death or disability may be caused, continued or aggravated by any unreasonable refusal to submit to any medical or surgical treatment or operation, the risk of which is, in the opinion of the division or the commission, inconsiderable in view of the seriousness of the injury. If the employee dies as a result of an operation made necessary by the injury, the death shall be deemed to be caused by the injury.

6. The testimony of any physician or chiropractic physician who treated the employee shall be admissible in evidence in any proceedings for compensation under this chapter, subject to all of the provisions of section 287.210.

7. Every hospital or other person furnishing the employee with medical aid at any time rendered, before and after the employee's injury, shall permit all of its record pertaining to any relevant parts of the body alleged to have been injured in any pending claim filed against the employer and against the second injury fund to be copied by and shall furnish full information to the division or the commission, the employer, the second injury fund, the employee or his dependents and any other party to any proceedings for compensation under this chapter, and certified copies of the records shall be admissible in evidence in any such proceedings.

8. The employer may be required by the division or the commission to furnish an injured employee with artificial legs, arms, hands, surgical orthopedic joints, or eyes, or braces, as needed, for life whenever the division or the commission shall find that the injured employee may be partially or wholly relieved of the effects of a permanent injury by the use thereof. Nothing in this chapter shall prevent the employer from settling his liability for the rendition of prosthetic devices, as needed, for life, at any time.

9. Nothing in this chapter shall prevent an employee being provided treatment for his injuries by prayer or spiritual means if the employer does not object to the treatment.

10. The employer shall have the right to select the licensed treating physician, surgeon, chiropractic physician, or other health care provider; provided, however, that such physicians, surgeons or other health care providers shall offer only those services authorized within the scope of their licenses. For the purpose of this subsection, subsection 2 of section 287.030 shall not apply.

11. Any physician or other health care provider who orders, directs or refers a patient for treatment, testing, therapy or rehabilitation at any institution or facility shall, at or prior to the time of the referral, disclose in writing if such health care provider, any of his partners or his employer has a financial interest in the institution or facility to which the patient is being referred, to the employer and the payer of the health services. [following:

(1) The patient;

(2) The employer of the patient with workers' compensation liability for the injury or disease being treated;

(3) The workers' compensation insurer of such employer; and

(4) The workers' compensation adjusting company for such insurer.]

12. Violation of subsection 11 of this section is a class A misdemeanor.

13. (1) No hospital, physician or other health care provider, other than a hospital, physician or health care provider selected by the employee at his own expense pursuant to subsection 1 of this section, shall bill or attempt to collect any fee or any portion of a fee for services rendered to an employee due to a work-related injury or report to any credit reporting agency any failure of the employee to make such payment, when an injury covered by this chapter has occurred and such hospital, physician or health care provider has received actual notice given in writing by the employee, the employer or the employer's insurer. Actual notice shall be deemed received by the hospital, physician or health care provider five days after mailing by certified mail by the employer or insurer to the hospital, physician or health care provider.

(2) The notice shall include:

(a) The name of the employer;

(b) The name of the insurer, if known;

(c) The name of the employee receiving the services;

(d) The general nature of the injury, if known; and

(e) Where a claim has been filed, the claim number, if known.

(3) When an injury is found to be noncompensable under this chapter, the hospital, physician or other health care provider

shall be entitled to pursue the employee for any unpaid portion of the fee or other charges for authorized services provided to the employee. Any applicable statute of limitations for an action for such fees or other charges shall be tolled from the time notice is given to the division by a hospital, physician or other health care provider pursuant to subdivision (6) of this subsection, until a determination of noncompensability in regard to the injury which is the basis of such services is made, or in the event there is an appeal to the labor and industrial relations commission, until a decision is rendered by that commission.

(4) If a hospital, physician or other health care provider or a debt collector on behalf of such hospital, physician or other health care provider pursues any action to collect from an employee after such notice is properly given, the employee shall have a cause of action against the hospital, physician or other health care provider for actual damages sustained plus up to one thousand dollars in additional damages, costs and reasonable attorney's fees.

(5) If an employer or insurer fails to make payment for authorized services provided to the employee by a hospital, physician or other health care provider pursuant to this chapter, the hospital, physician or other health care provider may proceed pursuant to subsection 4 of this section with a dispute against the employer or insurer for any fees or other charges for services provided.

(6) A hospital, physician or other health care provider whose services have been authorized in advance by the employer or insurer may give notice to the division of any claim for fees or other charges for services provided for a work-related injury that is covered by this chapter, with copies of the notice to the employee, employer and the employer's insurer. Where such notice has been filed, the administrative law judge may order direct payment from the proceeds of any settlement or award to the hospital, physician or other health care provider for such fees as are determined by the division. The notice shall be on a form prescribed by the division.

14. In any determination of permanent disability, the administrative law judge or appellate judge hearing a case shall consider all medical evidence. Primary consideration shall be given to objective medical findings, that is, those medical findings which cannot come under the voluntary control of the patient. The complaint of pain, or the complaint of chronic pain, and any range of motion tests, individually, or considered together, shall be defined as subjective complaints and not be considered to be an objective medical finding.

15. Maximum medical improvement means a point in time when an injury under an objective medical finding, as defined in subsection 14 of this section, has become stable and when no further treatment is reasonably expected to improve the condition.

287.150. 1. Where a third person is liable to the employee or to the dependents, for the injury or death, the employer shall be subrogated to the right of the employee or to the dependents against such third person, and the recovery by such employer shall not be limited to the amount payable as compensation to such employee or dependents, but such employer may recover any amount which such employee or his dependents would have been entitled to recover. Any recovery by the employer against such third person [shall be apportioned between the employer and employee or his dependents using the provisions of subsections 2 and 3 of this section], in excess of the compensation paid by the employer, after deducting the expenses of making such recovery shall be paid forthwith to the employee or to the dependents, and shall be treated as an advance payment by the employer, on account of any future payments of compensation.

2. When a third person is liable for the death of an employee and compensation is paid or payable under this chapter, and recovery is had [by a dependent under this chapter] either by judgment or settlement for the wrongful death of the employee, subject to subsection 3 of this section, the employer shall receive or have credit for all sums paid or payable under this chapter to any one or all of the dependents of the deceased employee to the extent of the settlement or recovery [by such dependents] for the wrongful death, whether or not one or all of the dependents are entitled to share in the proceeds of the settlement or recovery and whether or not one or all of the dependents could have maintained the action or claim for wrongful death. [Recovery by the employer and credit for future installments shall be computed using the provisions of subsection 3 of this section relating to comparative fault of the employee.]

3. Whenever recovery against the third person is effected by the employee or his dependents, the employer shall pay from his share of the recovery a proportionate share of the expenses of the recovery, including a reasonable attorney fee. After the expenses and attorney fee have been paid, the balance of the recovery shall be apportioned between the employer and the employee or his dependents in the same ratio that the amount due the employer bears to [the total amount recovered if there is no finding of comparative fault on the part of the employee, or the total damages determined by the trier of fact if there is a finding of comparative fault on the part of the employee. Notwithstanding the foregoing provision,] the total amount recovered, or the balance of the recovery may be divided between the employer and the employee or his dependents as they may [otherwise] agree. Any part of the recovery found to be due to the employer, the employee or his dependents shall be paid forthwith and any part of the recovery paid to the employee or his dependents under this section shall be treated by them as an advance payment by the employer on account of any future installments of compensation [in the following manner:

(1) The total amount paid to the employee or his dependents shall be treated as an advance payment if there is no finding of comparative fault on the part of the employee; or

(2) A percentage of the amount paid to the employee or his dependents equal to the percentage of fault assessed to the third person from whom recovery is made shall be treated as an advance payment if there is a finding of comparative fault on the part of the employee].

4. In any case in which an injured employee has been paid benefits from the second injury fund as provided in subsection 3 of section 287.141, and recovery is had against the third party liable to the employee for the injury, the second injury fund shall be subrogated to the rights of the employee against said third party to the extent of the payments made to him from such fund, subject to provisions of subsection[s 2 and] 3 of this section.

5. No construction design professional who is retained to perform professional services on a construction project or any employee of a construction design professional who is assisting or representing the construction design professional in the performance of professional services on the site of the construction project shall be liable for any injury resulting from the employer's failure to comply with safety standards on a construction project for which compensation is recoverable under the workers' compensation law, unless responsibility for safety practices is specifically assumed by contract. The immunity provided by this subsection to any construction design professional shall not apply to the negligent preparation of design plans or specifications.

6. Any provision in any contract or subcontract, where one party is an employer in the construction group of code classifications, which purports to waive subrogation rights provided under this section in anticipation of a future injury or death is hereby declared against public policy and void. Each contract of insurance for workers' compensation shall require the insurer to diligently pursue all subrogation rights of the employer and shall require the employer to fully cooperate with the insurer in pursuing such recoveries, except that the employer may enter into compromise agreements with an insurer in lieu of the insurer pursuing subrogation against another party. The amount of any subrogation recovery by an insurer shall be credited against the amount of the actual paid losses in the determination of such employer's experience modification factor within forty-five days of the collection of such amount.

287.160. 1. Except as provided in section 287.140, no compensation shall be payable for the first three regularly scheduled work days or less [of] for disability unless the disability shall last longer than fourteen days. If the disability lasts longer than fourteen days, payment for the first three days shall be made retroactively to the claimant.

2. Compensation shall be payable as the wages were paid prior to the injury, but in any event at least once every two weeks. [If an injured employee claims benefits pursuant to this section, an employer may, if the employee agrees in writing, pay directly to the employee any benefits due pursuant to section 287.170. The employer shall continue such payments until the insurer starts making the payments or the claim is contested by any party.] The employer or its insurer, if the employer has insured its liability under this chapter, may in its respective discretion initiate the payments of benefits under section 287.170 for any injury by alleged accident or by alleged occupational disease at any time following the injury, such payments to continue in its respective discretion until such time as the claim is contested, or the employee is released from employment and would no longer be entitled to such benefits or such time as compensation pursuant to an award is due. The voluntary payment of compensation under this section shall not constitute an admission by the employer or its insurer of the compensability of the claim, or for any other purpose, nor shall any such payments be subject to the provisions of subsection 3 of this section. The termination of compensation under this section shall not constitute the termination of compensation for the purposes of section 287.203. Where the claim is found to be compensable and the employer only has made such payments, with the prior approval of the insurer, the employer's workers' compensation insurer shall indemnify the employer for any payments made pursuant to this subsection. If the employee's claim is found to be fraudulent or noncompensable, after a hearing, the employee shall reimburse the employer, or the insurer if the insurer has itself made the payment or has indemnified the employer, for any benefits received either by a:

(1) Lump sum payment;

(2) Refund of the compensation equivalent of any accumulated sick or disability leave;

(3) Payroll deduction; or

(4) Secured installment plan. If the employee is no longer employed by such employer, the employer [may garnish the employee's wages or execute] can sue the employee pursuant to any civil remedy available upon any property, [except] both real [estate] or personal, of the employee, notwithstanding the provisions of subsection 1 of section 287.260. Nothing in this subsection shall be construed to require any employer to make payments directly to the employee.

3. Where weekly benefit payments that are not being contested by the employer or his insurer are due, and if such weekly benefit payments are made more than thirty days after becoming due, the weekly benefit payments that are late shall be increased by ten percent simple interest per annum. Provided, however, that if such claim for weekly compensation is contested by the employee, and the employer or his insurer have not paid the disputed weekly benefit payments or lump sum within thirty days of when the administrative law judge's order becomes final, or from the date of a decision by the labor and industrial relations commission, or from the date of the last judicial review, whichever is later, interest on such disputed weekly benefit payments or lump sum so ordered, shall be increased by ten percent simple interest per annum beginning thirty days from the date of such order. Provided, however, that if such claims for weekly compensation are contested solely by the employer or insurer, no interest shall be payable until after thirty days after the award of the administrative law judge. The state of Missouri or any of its political subdivisions, as an employer, is liable for any such interest assessed against it for failure to promptly pay on any award issued against it under this chapter.

4. Insurers, self-insured employers and self-insured groups of employers shall submit regularly to the division a "Timeliness of Payment Report" for all injuries that result in four or more lost work days, and the division shall publish annually a "Report of Payment Performance" which shall include the payment performance of all insurers and self-insurers. The report shall also include, but not be limited to, information on the number of injuries, by insurer or self-insurer, that result in a claim being filed by an injured worker. The provisions of this subsection shall expire on August 28, 1996.

5. Compensation shall be payable in accordance with the rules given in sections 287.170, 287.180, 287.190, 287.200, 287.240, and 287.250.

6. The employer shall [not] be entitled to credit for wages or such pay benefits paid to the employee or his dependents on account of the injury or death, from any source, in excess of the amounts otherwise due for compensation under this chapter, except as is further provided in section 287.270.

7. If any nonoccupational benefits, including medical, have been paid to the employee including but not limited to employees with multiple employments under subsection 8 of section 287.250 by any employer or any insurer of any employer for the same period of time for which any compensation benefits are due under this chapter, whether or not such payments have been made pursuant to an insurance policy or self-insured program of any employer, to the extent to which any employer contributed to such payment or the premium for such payment, the employee including but not limited to employees with multiple employments shall be paid under this chapter only to the extent by which the workers' compensation benefits due exceed the amount of the nonoccupational benefits paid or to be paid, up to the after tax salary of the employee at the time of the injury, provided this section shall not apply to union negotiated compensation benefit packages negotiated as a portion of a union contract which specifically provides that benefits are in addition to the statutory workers' compensation benefit allowed by the state.

8. Notwithstanding the provisions of section 287.100, if an employee is receiving retirement benefits under the federal social security act or retirement or pension benefits from any retirement systems, program or plan which is provided by the employer against whom the workers' compensation claim is being made, any compensation benefit payments for temporary total, temporary partial, or permanent total disability which the employee is eligible to receive under the workers' compensation act shall be reduced by the weekly equivalent amount of the total amount of all such retirement benefits, less any portion of any such retirement benefit, other than retirement benefits under the federal social security act, that is attributable to payments or contributions made by the employee.

287.170. 1. For temporary total disability the employer shall pay compensation for not more than four hundred weeks during the continuance of such disability at the weekly rate of compensation in effect under this section on the date of the injury for which compensation is being made. The amount of such compensation shall be computed as follows:

(1) For all injuries occurring on or after September 28, 1983, but before September 28, 1986, the weekly compensation shall be an amount equal to sixty-six and two-thirds percent of the injured employee's average weekly earnings as of the date of the injury; provided that the weekly compensation paid under this subdivision shall not exceed an amount equal to seventy percent of the state average weekly wage, as such wage is determined by the division of employment security, as of the July first immediately preceding the date of injury;

(2) For all injuries occurring on or after September 28, 1986, but before August 28, 1990, the weekly compensation shall be an amount equal to sixty-six and two-thirds percent of the injured employee's average weekly earnings as of the date of the injury; provided that the weekly compensation paid under this subdivision shall not exceed an amount equal to seventy-five percent of the state average weekly wage, as such wage is determined by the division of employment security, as of the July first immediately preceding the date of injury;

(3) For all injuries occurring on or after August 28, 1990, but before August 28, 1991, the weekly compensation shall be an amount equal to sixty-six and two-thirds percent of the injured employee's average weekly earnings as of the date of the injury; provided that the weekly compensation paid under this subdivision shall not exceed an amount equal to one hundred percent of the state average weekly wage;

(4) For all injuries occurring on or after August 28, 1991, the weekly compensation shall be an amount equal to sixty-six and two-thirds percent of the injured employee's average weekly earnings as of the date of the injury; provided that the weekly compensation paid under this subdivision shall not exceed an amount equal to one hundred five percent of the state average weekly wage;

(5) For all injuries occurring on or after September 28, 1981, the weekly compensation shall in no event be less than forty dollars per week.

2. Temporary total disability payments shall be made to the claimant by check or other negotiable instruments approved by the director which will not result in delay in payment and shall be forwarded subject to the provisions of section 287.260, directly to the claimant without intervention, or, when requested, to claimant's attorney if represented, except as provided in section 454.517, RSMo, by any other party except by order of the division of workers' compensation.

3. No compensation shall be payable for temporary total, temporary partial or permanent total disability under the workers' compensation law for any week that an employee has received or is receiving unemployment compensation benefits under the employment security law of Missouri, under the law of another state or a similar federal law.

287.190. 1. For permanent partial disability, which shall be in addition to compensation for temporary total disability or temporary partial disability paid in accordance with sections 287.170 and 287.180, respectively, the employer shall pay to the employee compensation computed at the weekly rate of compensation in effect under subsection 5 of this section on the date of the injury for which compensation is being made, which compensation shall be allowed for loss by severance, total loss of use, or proportionate loss of use of one or more of the members mentioned in the schedule of losses.

SCHEDULE OF LOSSES

Weeks

(1) Loss of arm at shoulder . . . . . . . . . . . . . 232

(2) Loss of arm between shoulder and elbow . . . . . 222

(3) Loss of arm at elbow joint . . . . . . . . . . . 210

(4) Loss of arm between elbow and wrist . . . . . . . 200

(5) Loss of hand at the wrist joint . . . . . . . . . 175

(6) Loss of thumb at proximal joint . . . . . . . . . 60

(7) Loss of thumb at distal joint . . . . . . . . . . . 45

(8) Loss of index finger at proximal joint. . . . . . . 45

(9) Loss of index finger at second joint . . . . . . . 35

(10) Loss of index finger at distal joint . . . . . . . 30

(11) Loss of either the middle or ring finger at the

proximal joint . . . . . . . . . . . . . . . . . . 35

(12) Loss of either the middle or ring finger at second

joint . . . . . . . . . . . . . . . . . . . . . . 30

(13) Loss of either the middle or ring finger at the distal

joint . . . . . . . . . . . . . . . . . . . . . . . 26

(14) Loss of little finger at proximal joint . . . . . . 22

(15) Loss of little finger at second joint . . . . . . . 20

(16) Loss of little finger at distal joint . . . . . . . 16

(17) Loss of one leg at the hip joint or so near thereto

as to preclude the use of artificial limb . . . . 207

(18) Loss of one leg at or above the knee, where the

stump remains sufficient to permit the use of

artificial limb . . . . . . . . . . . . . . . . . 160

(19) Loss of one leg at or above ankle and below knee

joint . . . . . . . . . . . . . . . . . . . . . . 155

(20) Loss of one foot in tarsus . . . . . . . . . . . . 150

(21) Loss of one foot in metatarsus . . . . . . . . . 110

(22) Loss of great toe of one foot at proximal joint . . 40

(23) Loss of great toe of one foot at distal joint . . . 22

(24) Loss of any other toe at proximal joint . . . . . 14

(25) Loss of any other toe at second joint . . . . . . 10

(26) Loss of any other toe at distal joint. . . . . . 8

(27) Complete deafness of both ears . . . . . . . . . 168

(28) Complete deafness of one ear, the other being

normal . . . . . . . . . . . . . . . . . . . . . . 44

(29) Complete loss of the sight of one eye . . . . . . 140

2. If the disability suffered in any of items (1) through (29) of the schedule of losses is total by reason of severance or complete loss of use thereof the number of weeks of compensation allowed in the schedule for such disability shall be increased by ten percent.

3. For permanent injuries other than those specified in the schedule of losses, the compensation shall be paid for such periods as are proportionate to the relation which the other injury bears to the injuries above specified, but no period shall exceed four hundred weeks, at the rates fixed in subsection 1. The other injuries shall include permanent injuries causing a loss of earning power. 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 the arm, hand, thumb, finger, leg, foot, toe or phalange, as provided in the schedule of losses.

4. If an employee is seriously and permanently disfigured about the head, neck, hands or arms, the division or commission may allow such additional sum for the compensation on account thereof as it may deem just, but the sum shall not exceed forty weeks of compensation. If both the employer and employee agree, the administrative law judge may utilize a photograph of the disfigurement in determining the amount of such additional sum.

5. The amount of compensation to be paid under subsection 1 of this section shall be computed as follows:

(1) For all injuries occurring on or after September 28, 1983, but before August 28, 1990, the weekly compensation shall be an amount equal to sixty-six and two-thirds percent of the employee's average weekly earnings as of the date of the injury; provided that the weekly compensation paid under this subdivision shall not exceed an amount equal to forty-five percent of the state average weekly wage, as such wage is determined by the division of employment security, as of the July first immediately preceding the date of injury;

(2) For all injuries occurring on or after September 28, 1981, the weekly compensation shall in no event be less than forty dollars per week;

(3) For all injuries occurring on or after August 28, 1990, but before August 28, 1991, the weekly compensation shall be an amount equal to sixty-six and two-thirds percent of the employee's average weekly earnings as of the date of the injury; provided that the weekly compensation paid under this subdivision shall not exceed an amount equal to fifty percent of the state average weekly wage;

(4) For all injuries occurring on or after August 28, 1991, but before August 28, 1992, the weekly compensation shall be an amount equal to sixty-six and two-thirds percent of the employee's average weekly earnings as of the date of the injury; provided that the weekly compensation paid under this subdivision shall not exceed an amount equal to fifty-two percent of the state average weekly wage;

(5) For all injuries occurring on or after August 28, 1992, the weekly compensation shall be an amount equal to sixty-six and two-thirds percent of the employee's average weekly earnings as of the date of the injury; provided that the weekly compensation paid under this subdivision shall not exceed an amount equal to fifty-five percent of the state average weekly wage.

6. "Permanent partial disability" means a disability that is permanent in nature and partial in degree, that is based upon the objective medical findings set forth under section 287.140, and when payment therefor has been made in accordance with a settlement approved either by an administrative law judge or by the labor and industrial relations commission, a rating approved by an administrative law judge or legal adviser, or an award by an administrative law judge or the commission, the percentage of disability shall be conclusively presumed to continue undiminished whenever a subsequent injury to the same member or same part of the body also results in permanent partial disability for which compensation under this chapter may be due; provided, however, the presumption shall apply only to compensable injuries which may occur after the passage of this section.

287.200. 1. Compensation for permanent total disability shall be paid [during the continuance of such disability] for the period of time the employee is unable to return to any employment after an injury in accordance with the provisions of section 287.140 for the lifetime of the employee at the weekly rate of compensation in effect under this subsection on the date of the injury for which compensation is being made. The amount of such compensation shall be computed as follows:

(1) For all injuries occurring on or after September 28, 1983, but before September 28, 1986, the weekly compensation shall be an amount equal to sixty-six and two-thirds percent of the injured employee's average weekly earnings during the year immediately preceding the injury, as of the date of the injury; provided that the weekly compensation paid under this subdivision shall not exceed an amount equal to seventy percent of the state average weekly wage, as such wage is determined by the division of employment security, as of the July first immediately preceding the date of injury;

(2) For all injuries occurring on or after September 28, 1986, but before August 28, 1990, the weekly compensation shall be an amount equal to sixty-six and two-thirds percent of the injured employee's average weekly earnings during the year immediately preceding the injury, as of the date of the injury; provided that the weekly compensation paid under this subdivision shall not exceed an amount equal to seventy-five percent of the state average weekly wage, as such wage is determined by the division of employment security, as of the July first immediately preceding the date of injury;

(3) For all injuries occurring on or after August 28, 1990, but before August 28, 1991, the weekly compensation shall be an amount equal to sixty-six and two-thirds percent of the injured employee's average weekly earnings as of the date of the injury; provided that the weekly compensation paid under this subdivision shall not exceed an amount equal to one hundred percent of the state average weekly wage;

(4) For all injuries occurring on or after August 28, 1991, the weekly compensation shall be an amount equal to sixty-six and two-thirds percent of the injured employee's average weekly earnings as of the date of the injury; provided that the weekly compensation paid under this subdivision shall not exceed an amount equal to one hundred five percent of the state average weekly wage;

(5) For all injuries occurring on or after September 28, 1981, the weekly compensation shall in no event be less than forty dollars per week.

2. All claims for permanent total disability shall be determined in accordance with the facts. When an injured employee receives an award for permanent total disability but by the use of glasses, prosthetic appliances, or physical rehabilitation the employee is restored to his regular work or its equivalent, the life payment mentioned in subsection 1 of this section shall be suspended during the time in which the employee is restored to his regular work or its equivalent. The employer and the division shall keep the file open in the case during the lifetime of any injured employee who has received an award of permanent total disability. In any case where the life payment is suspended under this subsection, the commission may at reasonable times review the case and either the employee or the employer may request an informal conference with the commission relative to the resumption of the employee's weekly life payment in the case.

287.203. Whenever the employer has provided compensation under section 287.170, 287.180 or 287.200, and terminates such compensation, the employer [shall] may notify the employee of such termination and shall advise the employee of the reason for such termination. If the employee disputes the termination of such benefits, the employee may request a hearing before the division and the division [shall] may set the matter for hearing within sixty days of such request and the division [shall] may hear the matter on the date of hearing and [no] continuances or delays may be granted [except] upon a showing of good cause or by consent of the parties. Due consideration shall be given if the case is set on dockets other than St. Louis and Kansas City, Missouri, dependent upon the availability of judges to hear the case. The division shall render a decision within thirty days of the date of hearing. [Reasonable cost of recovery shall be awarded to the prevailing party.]

287.210. 1. After an employee has received an injury he shall from time to time thereafter during disability submit to reasonable medical examination and examination by a nonphysician vocational expert for the limited purpose of determining the employee's work capacity and whether the employee can be vocationally rehabilitated for employment within the meaning of this act at the request of the employer, his insurer, the state treasurer as custodian of the second injury fund, created under section 287.220, the commission, the division or an administrative law judge, subject to the provisions of subsection 2 of this section, the time and place of which shall be fixed with due regard to the convenience of the employee and his physical condition and ability to attend. The employee may have his own physician or vocational rehabilitation expert present, and if the employee refuses to submit to the examination, or in any way obstructs it, his right to compensation shall be forfeited during such period unless in the opinion of the commission the circumstances justify the refusal or obstruction.

2. The commission, the division or administrative law judge shall, when deemed necessary, appoint a duly qualified impartial physician or qualified vocational expert to examine the injured employee, and any physician so chosen, if he accepts the appointment, shall promptly make the examination requested and make a complete medical report to the commission or the division in such duplication as to provide all parties with copies thereof. The physician's or qualified vocational expert's fee shall be fair and reasonable, as provided in subsection 3 of section 287.140, and the fee and other reasonable costs of the impartial examination may be paid as other costs under this chapter. If all the parties shall have had reasonable access thereto, the report of the physician shall be admissible in evidence.

3. The testimony of any qualified physician or qualified vocational expert who treated, counseled or examined the injured employee shall be admissible in evidence in any proceedings for compensation under this chapter, but only if the medical or vocational rehabilitation report of the physician or vocational expert has been made available to all parties as in this section provided. The procedure for admitting the testimony of any qualified physician or qualified vocational expert will be the same as in civil cases, provided the party offering the physician's or vocational expert's records and reports may have them marked as an exhibit, and admitted into evidence, without the necessity of the physician or vocational expert having to read the contents of same. Thereafter, the opposing party shall have full right of cross-examination. Each party shall bear his respective share of the costs on a page by page basis on each such deposition, depending upon the number of pages respectively used by each of the parties for direct examination, cross-examination, re- examination and recross-examination of any physician. Any cost for fees of the physician or vocational expert and for the bill for any court reporter involved in conducting such deposition shall be the respective individual liability of the party incurring such cost and, in addition, shall act as a lien against the employee and as a lien against the employer, or its insurer, if the employer's liability is insured under this chapter, with such payments to be made by and on behalf of the employee or the employer or its insurer as soon as possible after such services are rendered. Such costs shall act as a lien of the highest priority against the proceeds of any settlement between the parties or the proceeds of any award rendered in favor of the employee against the employer. In the event there is an award of no compensation, and there is no settlement, such costs may be collected in the same manner as any other costs that are due and owing under this chapter. Immediately upon receipt of notice from the division or the commission setting a date for hearing of a case in which the nature and extent of an employee's disability is to be determined, the parties or their attorneys shall arrange, without charge or costs, each to the other, for an exchange of all medical and vocational expert's reports, including those made both by treating and examining physician or physicians, to the end that the parties may be commonly informed of all medical findings and opinions. The exchange of medical or vocational expert's reports shall be made at least seven days before the date set for the hearing, or at least seven days before the date set for the evidence deposition of the qualified physician or vocational expert, and failure of any party to comply may be grounds for asking for and receiving a continuance, upon proper showing by the party to whom the medical reports or vocational experts were not furnished. If any party fails or refuses to furnish the opposing party with the medical or vocational expert's report of the treating or examining physician or the counseling or examining vocational expert at least seven days before such physician's or vocational expert's deposition or personal testimony at the hearing, as in this section provided, upon the objection of the party who was not provided with the medical or vocational expert's report, the physician shall not be permitted to testify at that hearing or by medical or vocational expert's deposition.

4. Upon request, an administrative law judge, the division, or the commission shall be provided with a copy of any medical report.

5. As used in this chapter the terms "physician's report" and "medical report" mean the report of any physician made on any printed form authorized by the division or the commission or any complete medical report. As used in this chapter the term "complete medical report" means the report of a physician giving the physician's qualifications and the patient's history, complaints, details of the findings of any and all laboratory, X-ray and all other technical examinations, diagnosis, prognosis, nature of disability, if any, and an estimate of the percentage of permanent partial disability, if any. [An element or elements of a complete medical report may be met by the physician's records.]

[6. Upon the request of a party, the physician or physicians who treated or are treating the injured employee shall be required to furnish to the parties a rating and complete medical report on the injured employee, at the expense of the party selecting the physician, along with a complete copy of the physician's clinical record including copies of any records and reports received from other health care providers.

7. The testimony of a treating or examining physician may be submitted in evidence on the issues in controversy by a complete medical report and shall be admissible without other foundational evidence subject to compliance with the following procedures. The party intending to submit a complete medical report in evidence shall give notice at least sixty days prior to the hearing to all parties and shall provide reasonable opportunity to all parties to obtain cross-examination testimony of the physician by deposition. The notice shall include a copy of the report and all the clinical and treatment records of the physician including copies of all records and reports received by the physician from other health care providers. Without additional cost, a party may submit interrogatories to the opposing party's physician on the subject matter of the report and records submitted pursuant to this subsection, according to the rules of the supreme court of Missouri. The party offering the report must make the physician available for cross-examination testimony by deposition not later than seven days before the matter is set for hearing, and each cross-examiner shall compensate the physician for the portion of testimony obtained in an amount not to exceed a rate of reasonable compensation to be set by the commission by rule taking into consideration the specialty practiced by the physician. Cross-examination testimony shall not bind the cross-examining party. Any testimony obtained by the offering party shall be at that party's expense on a proportional basis, including the deposition fee of the physician. Upon request of any party, the party offering a complete medical report in evidence must also make available copies of X rays or other diagnostic studies obtained by or relied upon by the physician. Within ten days after receipt of such notice a party shall dispute whether a report meets the requirements of a complete medical report by providing written objections to the offering party stating the grounds for the dispute, and at the request of any party, the administrative law judge shall rule upon such objections upon pretrial hearing whether the report meets the requirements of a complete medical report and upon the admissibility of the report or portions thereof. If no objections are filed the report is admissible, and any objections thereto are deemed waived. Nothing herein shall prevent the parties from agreeing to admit medical reports or records by consent. The provisions of this subsection shall not apply to claims against the second injury fund.]

[8.] 6. Certified copies of the proceedings before any coroner holding an inquest over the body of any employee receiving an injury in the course of his employment resulting in death shall be admissible in evidence in any proceedings for compensation under this chapter, and it shall be the duty of the coroner to give notice of the inquest to the employer and the dependents of the deceased employee, who shall have the right to cross-examine the witness.

[9.] 7. The division or the commission may in its discretion in extraordinary cases order a postmortem examination and for that purpose may also order a body exhumed.

287.215. No statement in writing made or given by an injured employee, whether taken and transcribed by a stenographer, signed or unsigned by the injured employee, or any statement which is mechanically or electronically recorded, or taken in writing by another person, or otherwise preserved, other than a statement given by an employee to a physician, hospital or other health care provider, as part of the history of the injury, shall be admissible in evidence, used or referred to in any manner at any hearing or action to recover benefits under this law unless a copy thereof is given or furnished the employee, or his dependents in case of death, or their attorney, within fifteen days after written request for it by the injured employee, his dependents in case of death, or by their attorney. The request shall be [directed to the employer or its insurer by certified mail.] sent by certified mail to the workers' compensation insurer, if known at the time of the request, at its appropriate address based upon the venue of the case, or, if not known, or if the employer's liability is self-insured under this chapter, then to the employer at its appropriate address based on the venue of the case. Statements given by an employee to a physician, hospital or other health care provider as part of the history of the injury, although not included in this section, shall be served as part of the requirement of subsections 3 and 5 of section 287.210.

287.220. 1. All cases of permanent disability where there has been previous disability shall be compensated as herein provided. Compensation shall be computed on the basis of the average earnings at the time of the last injury. If any employee who has a preexisting permanent partial disability whether from compensable injury or otherwise, of such seriousness as to constitute a hindrance or obstacle to employment or to obtaining reemployment if the employee becomes unemployed, and the preexisting permanent partial disability, if a body as a whole injury, equals a minimum of fifty weeks of compensation or, if a major extremity injury only, equals a minimum of fifteen percent permanent partial disability, according to the medical standards that are used in determining such compensation, receives a subsequent compensable injury resulting in additional permanent partial disability so that the degree or percentage of disability, in an amount equal to a minimum of fifty weeks compensation, if a body as a whole injury or, if a major extremity injury only, equals a minimum of fifteen percent permanent partial disability, caused by the combined disabilities is substantially greater than that which would have resulted from the last injury, considered alone and of itself, and if the employee is entitled to receive compensation on the basis of the combined disabilities, the employer at the time of the last injury shall be liable only for the degree or percentage of disability which would have resulted from the last injury had there been no preexisting disability. After the compensation liability of the employer for the last injury, considered alone, has been determined by an administrative law judge or the commission, the degree or percentage of employee's disability that is attributable to all injuries or conditions existing at the time the last injury was sustained shall then be determined by that administrative law judge or by the commission and the degree or percentage of disability which existed prior to the last injury plus the disability resulting from the last injury, if any, considered alone, shall be deducted from the combined disability, and compensation for the balance, if any, shall be paid out of a special fund known as the second injury fund, hereinafter provided for. If the previous disability or disabilities, whether from compensable injury or otherwise, and the last injury together result in total and permanent disability, the minimum standards under this subsection for a body as a whole injury or a major extremity injury shall not apply and the employer at the time of the last injury shall be liable only for the disability resulting from the last injury considered alone and of itself; except that if the compensation for which the employer at the time of the last injury is liable is less than the compensation provided in this chapter for permanent total disability, then in addition to the compensation for which the employer is liable and after the completion of payment of the compensation by the employer, the employee shall be paid the remainder of the compensation that would be due for permanent total disability under section 287.200 out of a special fund known as the "Second Injury Fund" hereby created exclusively for the purposes as in this section provided and for special weekly benefits in rehabilitation cases as provided in section 287.141. Maintenance of the second injury fund shall be as provided by section 287.710. The state treasurer shall be the custodian of the second injury fund which shall be deposited the same as are state funds and any interest accruing thereon shall be added thereto. The fund shall be subject to audit the same as state funds and accounts and shall be protected by the general bond given by the state treasurer. Upon the requisition of the director of the division of workers' compensation, warrants on the state treasurer for the payment of all amounts payable for compensation and benefits out of the second injury fund shall be issued.

2. In all cases in which a recovery against the second injury fund is sought for permanent partial disability, permanent total disability, [or death,] the state treasurer as custodian thereof shall be named as a party, and shall be entitled to defend against the claim. The state treasurer, with the advice and consent of the attorney general of Missouri, may enter into compromise settlements as contemplated by section 287.390, or agreed statements of fact that would affect the second injury fund. All awards for permanent partial disability, permanent total disability, or death affecting the second injury fund shall be subject to the provisions of this chapter governing review and appeal. For all claims filed against the second injury fund on or after July 1, 1994, the attorney general shall use assistant attorneys general except in circumstances where an actual or potential conflict of interest exists, to provide legal services as may be required in all claims made for recovery against the fund. Any legal expenses incurred by the attorney general's office in the handling of such claims, including, but not limited to, medical examination fees, expert witness fees, court reporter expenses, travel costs, and related legal expenses shall be paid by the fund. Effective July 1, 1993, the payment of such legal expenses shall be contingent upon annual appropriations made by the general assembly, from the fund, to the attorney general's office for this specific purpose.

3. If more than one injury in the same employment causes concurrent temporary disabilities, compensation shall be payable only for the longest and largest paying disability.

4. If more than one injury in the same employment causes concurrent and consecutive permanent partial disability, compensation payments for each subsequent disability shall not begin until the end of the compensation period of the prior disability.

5. If an employer fails to insure or self-insure as required in section 287.280, funds from the second injury fund may be withdrawn to cover the fair, reasonable, and necessary medical expenses to cure and relieve the effects of the injury or disability of an injured employee in the employ of an uninsured employer, or in the case of death of an employee in the employ of an uninsured employer, funds from the second injury fund may be withdrawn to cover fair, reasonable, and necessary funeral expenses in the manner required in [sections] section 287.240 [and 287.241]. In defense of claims arising under this subsection, the treasurer of the state of Missouri, as custodian of the second injury fund, shall have the same defenses to such claims as would the uninsured employer. Any funds received by the employee or the employee's dependents, through civil or other action, must go towards reimbursement of the second injury fund, for all payments made to the employee, the employee's dependents, or paid on the employee's behalf, from the second injury fund pursuant to this subsection. The office of the attorney general of the state of Missouri shall bring suit in the circuit court of the county in which the accident occurred against any employer not covered by this chapter as required in section 287.280.

6. Every three years the second injury fund shall have an actuarial study made to determine the solvency of the fund, appropriate funding level of the fund, and forecasted expenditures from the fund. The first actuarial study shall be completed prior to July 1, 1988. The expenses of such actuarial studies shall be paid out of the fund for the support of the division of workers' compensation.

7. The director of the division of workers' compensation shall maintain the financial data and records concerning the fund for the support of the division of workers' compensation and the second injury fund. The division shall also compile and report data on claims made pursuant to subsection 9 of this section. The attorney general shall provide all necessary information to the division for this purpose.

8. All claims for fees and expenses filed against the second injury fund and all records pertaining thereto shall be open to the public.

9. Any employee who at the time a compensable work-related injury is sustained is employed by more than one employer, the employer for whom the employee was working when the injury was sustained shall be responsible for wage loss benefits applicable only to the earnings in that employer's employment and the injured employee shall be entitled to file a claim against the second injury fund for any additional wage loss benefits attributed to loss of earnings from the employment or employments where the injury did not occur, up to the maximum weekly benefit less those benefits paid by the employer in whose employment the employee sustained the injury. The employee shall be entitled to a total benefit based on the total average weekly wage of such employee computed according to subsection 8 of section 287.250. The employee shall not be entitled to a greater rate of compensation than allowed by law on the date of the injury. The employer for whom the employee was working where the injury was sustained shall be responsible for all medical costs incurred in regard to that injury. The provisions of this subsection shall expire on August 28, 1996.

287.240. If the injury causes death, either with or without disability, the compensation therefor shall be as provided in this section:

(1) In all cases the employer shall pay direct to the persons furnishing the same the reasonable expense of the burial of the deceased employee not exceeding five thousand dollars. But no person shall be entitled to compensation for the burial expenses of a deceased employee unless he has furnished the same by authority of the widow or widower, the nearest relative of the deceased employee in the county of his death, his personal representative, or the employer, who shall have the right to give the authority in the order named. All fees and charges under this section shall be fair and reasonable, shall be subject to regulation by the division or the commission and shall be limited to such as are fair and reasonable for similar service to persons of a like standard of living. The division or the commission shall also have jurisdiction to hear and determine all disputes as to the charges. If the deceased employee leaves no dependents, the death benefit in this subdivision provided shall be the limit of the liability of the employer under this chapter on account of the death, except as herein provided for burial expenses and except as provided in section 287.140; provided that in all cases when the employer admits or does not deny liability for the burial expense, it shall be paid within thirty days after written notice, that the service has been rendered, has been delivered to the employer. The notice may be sent by registered mail, return receipt requested, or may be made by personal delivery;

(2) The employer shall also pay to the total dependents of the employee a death benefit based on the employee's average weekly earnings during the year immediately preceding the injury that results in the death of the employee, as provided in section 287.250. The amount of compensation for death, which shall be paid in installments in the same manner that compensation is required to be paid under this chapter, shall be computed as follows:

(a) If the injury which caused the death occurred on or after September 28, 1983, but before September 28, 1986, the weekly compensation shall be an amount equal to sixty-six and two-thirds percent of the employee's average weekly earnings during the year immediately preceding the injury; provided that the weekly compensation paid under this paragraph shall not exceed an amount equal to seventy percent of the state average weekly wage, as such wage is determined by the division of employment security, as of the July first immediately preceding the date of injury. If there is a total dependent, no death benefits shall be payable to partial dependents or any other persons except as provided in subdivision (1) of this section;

(b) If the injury which caused the death occurred on or after September 28, 1986, but before August 28, 1990, the weekly compensation shall be an amount equal to sixty-six and two-thirds percent of the employee's average weekly earnings during the year immediately preceding the injury; provided that the weekly compensation paid under this paragraph shall not exceed an amount equal to seventy-five percent of the state average weekly wage, as such wage is determined by the division of employment security, as of the July first immediately preceding the date of injury. If there is a total dependent, no death benefit shall be payable to partial dependents or any other persons except as provided in subdivision (1) of this section;

(c) If the injury which caused the death occurred on or after August 28, 1990, but before August 28, 1991, the weekly compensation shall be an amount equal to sixty-six and two-thirds percent of the injured employee's average weekly earnings as of the date of the injury; provided that the weekly compensation paid under this paragraph shall not exceed an amount equal to one hundred percent of the state average weekly wage;

(d) If the injury which caused the death occurred on or after August 28, 1991, the weekly compensation shall be an amount equal to sixty-six and two-thirds percent of the injured employee's average weekly earnings as of the date of the injury; provided that the weekly compensation paid under this paragraph shall not exceed an amount equal to one hundred five percent of the state average weekly wage;

(e) If the injury which caused the death occurred on or after September 28, 1981, the weekly compensation shall in no event be less than forty dollars per week;

(3) If there are partial dependents, and no total dependents, a part of the death benefit herein provided in the case of total dependents, determined by the proportion of his contributions to all partial dependents by the employee at the time of the injury, shall be paid by the employer to each of the dependents proportionately;

(4) The word "dependent" as used in this chapter shall be construed to mean a relative by blood or marriage of a deceased employee, who is actually dependent for support, in whole or in part, upon his or her wages at the time of the injury. The following persons shall be conclusively presumed to be totally dependent for support upon a deceased employee, and any death benefit shall be payable to them to the exclusion of other total dependents:

(a) A wife upon a husband with whom she lives or who is legally liable for her support, and a husband upon a wife with whom he lives or who is legally liable for his support; provided that on the death or remarriage of a widow or widower, the death benefit shall cease unless there be other total dependents entitled to any death benefits under this chapter. In the event of remarriage, a lump sum payment equal in amount to the benefits due for a period of two years shall be paid to the widow or widower. Thereupon the periodic death benefits shall cease unless there are other total dependents entitled to any death benefit under this chapter, in which event the periodic benefits to which such widow or widower would have been entitled had he or she not died or remarried shall be divided among such other total dependents and paid to them during their period of entitlement under this chapter;

(b) A natural, posthumous, or adopted child or children, whether legitimate or illegitimate, under the age of eighteen years, or until marriage, whichever event is first to occur, or over that age if physically or mentally incapacitated from wage earning, upon the parent legally liable for the support or with whom he, she, or they are living at the time of the death of the parent. In case there is a wife or a husband mentally or physically incapacitated from wage earning, dependent upon a wife or husband, and a child or more than one child thus dependent, the death benefit shall be divided among them in such proportion as may be determined by the commission after considering their ages and other facts bearing on the dependency. In all other cases questions of total or partial dependency shall be determined in accordance with the facts at the time of the injury, and in such other cases if there is more than one person wholly dependent the death benefit shall be divided equally among them. The payment of death benefits to a child or other dependent as provided in this paragraph shall cease when the dependent dies, marries, attains the age of eighteen years, or becomes physically and mentally capable of wage earning over that age, or until twenty-two years of age if the child of the deceased is in attendance and remains as a full-time student in any accredited educational institution, or if at eighteen years of age the dependent child is a member of the armed forces of the United States on active duty; provided, however, that such unmarried dependent child shall be entitled to compensation during four years of full-time attendance at a fully accredited educational institution to commence prior to twenty-three years of age and immediately upon cessation of his active duty in the armed forces, unless there are other total dependents entitled to the death benefit under this chapter;

(5) The division or the commission may, in its discretion, order or award the share of compensation of any such child to be paid to the parent, grandparent, or other adult next of kin or conservator of the child for the latter's support, maintenance and education, which order or award upon notice to the parties may be modified from time to time by the commission in its discretion with respect to the person to whom shall be paid the amount of the order or award remaining unpaid at the time of the modification;

(6) The payments of compensation by the employer in accordance with the order or award of the division or the commission shall discharge the employer from all further obligations as to the compensation;

(7) All death benefits in this chapter shall be paid in installments in the same manner as provided for disability compensation;

(8) Every employer shall keep a record of the correct names and addresses of the dependents of each of his employees, and upon the death of an employee by accident arising out of and in the course of his employment shall so far as possible immediately furnish the division with such names and addresses;

(9) Dependents receiving death benefits under the provisions of this chapter shall annually report to the division as to marital status in the case of a widow or widower or age and physical or mental condition of a dependent child. The division shall provide forms for the making of such reports.

287.250. 1. Except as otherwise provided for in this chapter, the method of computing an injured employee's average weekly earnings which will serve as the basis for compensation provided for in this chapter shall be as follows:

(1) If the wages are fixed by the week, the amount so fixed shall be the average weekly wage;

(2) If the wages are fixed by the month, the average weekly wage shall be the monthly wage so fixed multiplied by twelve and divided by fifty-two;

(3) If the wages are fixed by the year, the average weekly wage shall be the yearly wage fixed divided by fifty-two;

(4) If the wages were fixed by the day, hour, or by the output of the employee, the average weekly wage shall be computed by dividing by thirteen the wages earned while actually employed by the employer in each of the last thirteen calendar weeks immediately preceding the week in which the employee was injured or if actually employed by the employer for less than thirteen weeks, by the number of calendar weeks, or any portion of a week, during which the employee was actually employed by the employer. For purposes of computing the average weekly wage pursuant to this subdivision, absence of five regular or scheduled work days, even if not in the same calendar week, shall be considered as absence for a calendar week. If the employee commenced employment on a day other than the beginning of a calendar week, such calendar week and the wages earned during such week shall be excluded in computing the average weekly wage pursuant to this subdivision;

(5) If the employee has been employed less than two calendar weeks immediately preceding the injury, the employee's weekly wage shall be considered to be equivalent to the average weekly wage prevailing in the same or similar employment at the time of the injury, except if the employer has agreed to a certain hourly wage, then the hourly wage agreed upon multiplied by the number of weekly hours scheduled shall be the employee's average weekly wage;

(6) If the hourly wage has not been fixed or cannot be ascertained, or the employee earned no wage, the wage for the purpose of calculating compensation shall be taken to be the usual wage for similar services where such services are rendered by paid employees of the employer or any other employer;

(7) In computing the average weekly wage pursuant to subdivisions (1) to (6) of this subsection, an employee shall be considered to have been actually employed for only those weeks in which labor is actually performed by the employee for the employer and wages are actually paid by the employer as compensation for such labor.

2. For purposes of this section, the term "gross wages" includes, in addition to money payments for services rendered, the reasonable value of board, rent, housing, lodging or similar advance received from the employer, except if such benefits continue to be provided during the period of the disability, then the value of such benefits shall not be considered in calculating the average weekly wage of the employee. The term "wages", as used in this section, includes the value of any gratuities received in the course of employment from persons other than the employer to the extent that such gratuities are reported for income tax purposes. "Wages", as used in this section, does not include fringe benefits such as retirement, pension, health and welfare, life insurance, training, social security or other employee or dependent benefit plan furnished by the employer for the benefit of the employee. Any wages paid to helpers or any money paid by the employer to the employee to cover any special expenses incurred by the employee because of the nature of his employment shall not be included in wages.

3. If an employee is hired by the employer for less than the number of hours per week needed to be classified as a full-time or regular employee, benefits computed for purposes of this chapter for permanent partial disability, permanent total disability and death benefits shall be based upon the average weekly wage of a full-time or regular employee engaged by the employer to perform work of the same or similar nature and at the number of hours per week required by the employer to classify the employee as a full-time or regular employee, but such computation shall not be based on less than thirty hours per week.

4. If pursuant to this section the average weekly wage cannot fairly and justly be determined by the formulas provided in subsections 1 to 3 of this section, the division or the commission may determine the average weekly wage in such manner and by such method as, in the opinion of the division or the commission, based upon the exceptional facts presented, fairly determine such employee's average weekly wage.

5. In computing the compensation to be paid to an employee, who, before the injury for which the employee claims compensation, was disabled and drawing compensation under the provisions of this chapter, the compensation for each subsequent injury shall be apportioned according to the proportion of incapacity and disability caused by the respective injuries which the employee may have suffered.

6. For purposes of establishing a rate of compensation applicable only to permanent partial disability, permanent total disability and death benefits, pursuant to this chapter, the average weekly wage for an employee who is under the age of twenty-one years shall be adjusted to take into consideration the increased earning power of such employee until she or he attains the age of twenty-one years and the average weekly wage for an employee who is an apprentice or a trainee, and whose earnings would reasonably be expected to increase, shall be adjusted to reflect a level of expected increase, based upon completion of apprenticeship or traineeship, provided that such adjustment of the average weekly wage shall not consider expected increase for a period occurring more than three years after the date of the injury.

7. In all cases in which it is found by the division or the commission that the employer knowingly employed a minor in violation of the child labor laws of this state, a fifty percent additional compensation shall be allowed.

8. For an employee with multiple employments, as to the employee's entitlement to any temporary total or temporary partial disability benefits only under this chapter, and for no other purposes, the employee's total average weekly wage shall be [equal to the sum of the total] the greater or greatest of the average weekly wage computed separately for each employment pursuant to the provisions of this section to which the employee is unable to return because of [the] this injury; provided that any non-workers' compensation accident or sickness indemnity benefit otherwise paid to the employee from any employer for whom the employee was working at the time of the injury because of the injury shall first be subtracted from any amount found to be due and owed. The employer for whom the employee was injured shall be liable for that compensation rate which the employee would otherwise have been entitled to receive had the employee been working for that employer only at the time of the injury. Any additional or deferential amount due to the employee shall be due and owing from the second injury fund of the state of Missouri under the provisions of subsections 3 and 9 of section 287.220.

287.260. 1. The compensation payable under this chapter, whether or not it has been awarded or is due, shall not be assignable, shall be exempt from attachment, garnishment, and execution, shall not be subject to setoff or counterclaim, or be in any way liable for any debt and in case of the insolvency of an employer or his insurer, or the levy of an attachment or an execution against an employer or insurer shall be entitled to the same preference and priority as claims for wages, without limit as to time or amount, except that if written notice is given to the division or the commission of the nature and extent thereof, the division or the commission may allow as lien on the compensation, reasonable attorney's fees for services in connection with the proceedings for compensation if the services are found to be necessary and may order the amount thereof paid to the attorney in a lump sum or in installments. All attorney's fees for services in connection with this chapter shall be subject to regulation by the division or the commission and shall be limited to such charges as are fair and reasonable and the division or the commission shall have jurisdiction to hear and determine all disputes concerning the same.

2. Notwithstanding subsection 1 of this section, the compensation payable under this chapter other than compensation for medical expenses and therapy under section 287.141, shall be assignable for the purpose of satisfying child support obligations or spousal maintenance, shall be subject to attachment, garnishment and execution for the purpose of collecting and satisfying unpaid and delinquent child support obligations, and shall be subject to the lien provided for in section 454.517, RSMo. Section 452.140, RSMo, shall apply to limit property exemptions available in an action to collect child support under this subsection.

3. Notwithstanding subsections 1 and 2 of this section, the compensation payable under this chapter shall be subject to any credits due to the employer under section 287.160 and section 287.170.

287.263. 1. With respect to any and all proceedings in connection with any claim for compensation, no claim of any attorney for services rendered in connection with the securing of compensation for an employee or the employee's dependents, whether secured by agreement, order, award or a judgment in any workers' compensation administrative hearing proceedings or court proceedings involving workers' compensation shall exceed a reasonable amount for such services or an amount equal to the total of twenty-five percent of that portion of total compensation recovered and paid which is less than ten thousand and one dollars, and an amount equal to the total of twenty percent of that portion of the total amount of the compensation recovered and paid which is equal to or greater than ten thousand and one dollars but less than twenty thousand and one dollars, and fifteen percent of that portion of the total amount of the compensation recovered and paid which is equal to or greater than twenty thousand and one dollars, whichever is less, in addition to actual expenses incurred, and subject to the other provisions of this section, except that in the case of permanent total disability, permanent partial disability or death cases, the maximum amount allowable, applying the above formula, shall not, in any event, exceed the sum of twenty-five thousand dollars.

2. All attorney fees in connection with any claim for compensation shall be fixed pursuant to a written contract between the attorney and the employee or the employee's dependents. All attorney fees in connection with any claim for compensation shall be subject to approval by the administrative law judge or the commission. Any claims for attorney fees not in excess of the limits provided in this section and approved by the administrative law judge or commission shall be enforceable as a lien on the compensation due or to become due. In reviewing the reasonableness of any claim for attorney fees, the administrative law judge or the commission shall consider the following factors:

(1) The written offers of settlement made prior to representation;

(2) The time and labor required, the novelty and difficulty of the questions involved and the skill requisite to perform the legal services properly;

(3) The fee customarily charged in the locality for similar legal services;

(4) The time limitations imposed by the employee, by the employee's dependents or by the circumstances.

3. No attorney fees shall be charged with respect to vocational rehabilitation benefits, except where allowance is made for proposed or future treatment as part of a compromise settlement.

4. No attorney fees shall be charged in connection with medical bills or temporary total disability compensation unless the payment of such compensation in the proper amount is refused, or unless such compensation is terminated by the employer and the payment of such compensation is obtained or reinstated by the efforts of the attorney, whether by agreement, settlement, award or judgment.

5. With regard to any claim where there is no dispute as to any of the material issues prior to representation of the claimant or claimants by an attorney, or where the amount to be paid for compensation does not exceed the offer made to the claimant or claimants by the employer prior to representation by an attorney, the fees to any such attorney shall not exceed a reasonable fee for the time actually spent by the attorney, as determined by the administrative law judge or commission, exclusive of reasonable attorney fees for any representation by such attorney in reference to any necessary probate proceedings.

6. All attorney fees for representation of an employee or the employee's dependents shall be only recoverable from compensation actually paid to such employee or dependents except as specifically provided otherwise in subsection 7 of this section.

7. In the event any attorney renders services to an employee or the employee's dependents, subsequent to the ultimate disposition of the original or the amended claim, in conjunction with an application for review and modification, upon a hearing for additional benefits, or otherwise, such attorney shall be entitled to a reasonable attorney fee for such services in addition to the attorney fees received or which the attorney is entitled to receive by contract in connection with the original or amended claim. Such attorney fees shall be awarded by the administrative law judge or commission on the basis of the reasonable and customary charges in the locality for such services and not on a contingent fee basis. If the services rendered under this subsection by an attorney results in an additional award of compensation, the attorney's fees shall be paid from such amounts of compensation.

8. Any and all disputes regarding attorney fees, whether such disputes relate to which of one or more attorneys represents the claimant or claimants or is entitled to the attorney fees, or a division of attorney fees where the claimants are or have been represented by more than one attorney, or any other disputes concerning attorney fees or contracts for attorney fees, shall be heard and determined by the administrative law judge or commission, after reasonable notice to all interested parties and attorneys.

9. After reasonable notice and hearing before the administrative law judge or commission, any attorney found to be in violation of any provision of this section shall be required to make restitution of any excess fees charged.

287.266. 1. As used in this section, the following terms mean:

(1) "Provider", any individual, corporation, public or private entity that has entered into an agreement with the state to provide any service set out in section 208.152, RSMo, and subsequent amendments;

(2) "Person eligible for public assistance", any individual who is or was eligible for medical assistance under the laws of this state.

2. Payments, other than temporary total disability and temporary partial disability, made to or on behalf of a person eligible for public assistance as the result of any compensable injury, occupational disease or disability as defined by this chapter shall be a debt due the state, and recovery of same shall be a recognized action pursuant to this chapter.

3. The state shall have a lien upon any funds owed by any employer that are or might be due under any insurance agreement or self-insurance authority in effect at the time the medical expense or any portion thereof was paid by the department of social services or its designated division.

4. The state shall have a right of subrogation to any funds owed to or received by the employee or any person, corporation, public agency or private agency acting on his behalf notwithstanding any other provisions of this chapter.

5. The department of social services or its designated division may maintain an appropriate action to recover funds due under this section pursuant to the workers' compensation law or the second injury fund, which includes the exercise of all appeal rights afforded by the laws of this state.

6. The department shall have a right to recover the full amount of its payments when payments are made to a provider under this chapter if the payments were made on behalf of a person eligible for public assistance for an injury, occupational disease, or disability which is compensable under this chapter.

7. This debt due the state shall be subordinate only to the fee rights of the injured employee's attorney pursuant to this chapter, and the state shall not be required to pay any portion of the fees or costs incurred by the employee or the employer.

8. Application for and acceptance of public assistance made to or on behalf of the injured employee shall constitute an assignment of rights to the department of social services for reimbursement of funds expended by the department of social services in the treatment of a compensable injury.

9. The attorney shall notify the department of social services upon representation of each client who was eligible for public assistance as provided by sections 208.151 to 208.159, RSMo, and section 208.162, RSMo, prior to, during or subsequent to the date of injury, that the attorney was retained to pursue the client's legal rights related to the compensable injury.

10. The administrative law judge, pursuant to authority granted under section 287.610, shall apportion the debt due the state between the injured worker and the injured worker's employer or their designated representatives when an agreement cannot be reached regarding the respective liability for money expended by the department of social services on behalf of the injured employee, but in no case shall the debt due the state be reduced.

287.380. 1. [Except as provided in subsection 2 of this section,] Every employer or his insurer in this state, whether he has accepted or rejected the provisions of this chapter, shall within ten days after knowledge of an accident resulting in personal injury to any employee notify the division thereof, and shall, within one month from the date of filing of the original notification of injury, file with the division under such rules and regulations and in such form and detail as the division may require, a full and complete report of every injury or death to any employee for which the employer would be liable to furnish medical aid, other than immediate first aid which does not result in further medical treatment or lost time from work, or compensation hereunder had he accepted this chapter, and every employer or insurer shall also furnish the division with such supplemental reports in regard thereto as the division shall require. All reports submitted under this subsection shall include the name, address, date of birth and wages of the deceased or injured employee, the time and cause of the accident, the nature and extent of the injury, the name and address of the employee's and the employer's or insurer's attorney of record, if any, the medical cost incurred in treating the injured employee, the amount of lost work time of the employee as a result of the injury and such other information as the director may reasonably require in order to maintain in the division, accurate and complete data on the impact of work-related injuries on the workers' compensation system. The division shall collect and maintain such data in such a form as to be readily retrieved and available for analysis by the division. Employers shall report all injuries to their insurance carrier, or third-party administrators, if applicable, within five days of the date of the injury or within five days of the date on which the injury was reported to the employer by the employee, whichever is later. Where an employer reports injuries covered pursuant to this chapter to his insurer or third-party administrator, the insurer or third-party administrator shall be responsible for filing the report prescribed in this section.

2. [The division shall provide by rule that for accidents involving less than five hundred dollars in total medical costs and no lost time from the employment, upon receipt of the notice required by section 287.420, the employer shall deliver a notice to the employee, on a form provided by the division, of the employee's rights under this chapter, giving the date and location of the accident, and the employer shall retain a copy of such notice signed by the employee. The employer shall forward a signed copy to the division accompanied by the report of injury.

3.] Every employer and his insurer, and every injured employee, his dependents and every person entitled to any rights hereunder, and every other person receiving from the division or the commission any blank reports with direction to fill out the same shall cause the same to be promptly returned to the division or the commission properly filled out and signed so as to answer fully and correctly to the best of his knowledge each question propounded therein, and a good and sufficient reason shall be given for failure to answer any question.

[4.] 3. No information obtained under the provisions of this section shall be disclosed to persons other than the parties to compensation proceedings and their attorneys, except by order of the division or the commission, or at a hearing of compensation proceeding, but such information may be used by the division or the commission for statistical purposes.

[5.] 4. Any person, including any employer, insurer or any employee, who violates any of the provisions of this section, including any employer or insurer who knowingly fails to report any accident under the provisions of subsection 1 of this section, or anyone who knowingly makes a false report or statement in writing to the division or the commission, shall be deemed guilty of a misdemeanor and on conviction thereof shall be punished by a fine of not less than fifty nor more than five hundred dollars, or by imprisonment in the county jail for not less than one week nor more than one year, or by both the fine and imprisonment.

287.390. 1. Nothing in this chapter shall be construed as preventing the parties to claims hereunder from entering into voluntary agreements in settlement thereof, but no agreement by an employee or his dependents to waive his rights under this chapter shall be valid, nor shall any agreement of settlement or compromise of any dispute or claim for compensation under this chapter be valid until approved by an administrative law judge or the commission, nor shall an administrative law judge or the commission approve any settlement for which [is] they have not [in accordance with] explained the rights of [the] any unrepresented parties as given in this chapter. No such agreement shall be valid unless made after seven days from the date of the injury or death.

2. If the employee or his dependents and the employer wish to agree to a settlement or cannot agree to a settlement, the administrative law judge, associate administrative law judge or legal advisor shall not refer, send, or otherwise direct either party to any specific attorney, physician or other provider of services, except as provided under subsection 2 of section 287.210. If it is proven to the director of the division that an administrative law judge, associate administrative law judge or legal advisor did refer, send, or otherwise direct either party to any specific attorney, physician or other provider of services, then the director of the division shall recommend to the governor that the administrative law judge, associate administrative law judge or legal advisor be terminated for violating this subsection pursuant to section 287.610.

3. It shall be the policy of the division that no employee of the division shall refer, send, or otherwise direct any party to any specific attorney or panel of attorneys, physician or other provider of services. If it is proven to the director of the division that an employee did refer, send, or otherwise direct a party to any specific attorney or panel of attorneys, physician or other provider of services, then such action shall constitute grounds for termination of employment with the division for violating this subsection.

4. In the case of compromise settlements in which the employer and the employee, with or without representation by attorney, agree to the settlement, the division shall not refuse to approve the compromise settlement agreement.

[2.] 5. A compromise settlement approved by an administrative law judge or the commission during the employee's lifetime shall extinguish and bar all claims for compensation for the employee's death if the settlement compromises a dispute on any question or issue other than the extent of disability or the rate of compensation.

[3.] 6. Notwithstanding the provisions of section 287.190, an employee shall be afforded the option of receiving a compromise settlement as a one-time lump sum payment. A compromise settlement approved by an administrative law judge or the commission shall indicate the manner of payment chosen by the employee.

[4.] 7. A minor dependent, by parent or conservator, may compromise disputes and may enter into a compromise settlement agreement, and upon approval by an administrative law judge or the commission the settlement agreement shall have the same force and effect as though the minor had been an adult. The payment of compensation by the employer in accordance with the settlement agreement shall discharge the employer from all further obligation.

287.420. No proceedings for compensation under this chapter shall be maintained unless actual or written notice of the time, place and nature of the work-related injury, and the name and address of the person injured, have been given to the employer, and not to a third party other than the employer, as soon as practicable after the happening thereof but not later than thirty days after the accident, or, in the case of an occupational disease, no later than thirty days after the date it becomes reasonably discoverable and apparent that a work related injury has been sustained, unless the division or the commission finds that there was good cause for failure to give the notice, or that the employer was not prejudiced by failure to receive the notice. No defect or inaccuracy in the notice shall invalidate it unless the commission finds that the employer was in fact misled and prejudiced thereby.

287.430. [1.] Except for a claim for recovery filed against the second injury fund, no proceedings for compensation under this chapter shall be maintained unless a claim therefor, setting forth in appropriate detail the date or dates of the accident or occupational disease, and setting forth in appropriate detail the nature and character of same, both against the employer and against the second injury fund, is filed with the division within two years after the date of injury or death, or the last payment made under this chapter on account of the injury or death, except that if the report of the injury or the death is not filed by the employer as required by section 287.380, the claim for compensation may be filed within three years after the date of injury, death, or last payment made under this chapter on account of the injury or death. The filing of any form, report, receipt, or agreement, other than a claim for compensation, shall not toll the running of the periods of limitation provided in this section. The filing of the report of injury or death three years or more after the date of injury, death, or last payment made under this chapter on account of the injury or death, shall not toll the running of the periods of limitation provided in this section, nor shall such filing reactivate or revive the period of time in which a claim may be filed. A claim against the second injury fund shall be filed within two years after the date of the injury or within one year after a claim is filed against an employer or insurer pursuant to this chapter, whichever is later. In all other respects the limitations shall be governed by the law of civil actions other than for the recovery of real property, but the appointment of a conservator shall be deemed the termination of the legal disability from minority or disability as defined in chapter 475, RSMo. The statute of limitations contained in this section is one of extinction and not of repose.

[2. The director of the division shall establish a procedure whereby a claim for compensation may be reactivated after settlement of such claim is completed. The claim shall be reactivated only after the claimant can show good cause for the reactivation of this claim and the claim shall be made only for the payment of medical procedures involving life threatening surgical procedures or if the claimant requires the use of a new or the modification, alteration or exchange of an existing prosthetic device. For the purpose of this subsection, "life threatening" shall mean a situation or condition which, if not treated immediately, will likely result in the death of the injured worker.]

287.460. 1. The division, through an administrative law judge, shall hear in a summary proceeding the parties at issue and their representatives and witnesses and shall determine the dispute by issuing the written award no later than thirty days after hearing the last of the evidence, which shall occur no later than thirty days from the date of commencement of the hearing, except in extraordinary circumstances where a lengthy trial or complex issues necessitate a longer time frame than thirty days. All evidence introduced at any such hearings shall be reported by a competent reporter appointed by the division or be recorded by electronic means. The award, together with a statement of the findings of fact, rulings of law and any other matters pertinent to the question at issue, shall be filed with the record of proceedings, and a copy of the award shall immediately be sent by United States mail to the parties in dispute and the employer's insurer.

2. The division of workers' compensation shall develop by rule procedures whereby mediation services are provided to the parties in a claim for workers' compensation benefits whereby claims may be mediated by the parties at a prehearing conference when the division determines that a claim may be settled or upon application for a mediation settlement conference filed by either party.

3. The division may require the parties to produce at the mediation conference all available medical records and reports. Such mediation conference shall be informal to ascertain the issues and attempt to resolve the claim or other pending issues. Such mediation conference may be set at any time prior to the commencement of the evidentiary hearing and nothing in this section shall be interpreted to delay the setting of the matter for hearing. Upon the request of any party, a person providing mediation settlement services shall be disqualified from conducting any evidentiary hearing relating to the claim without limiting the rights conferred by section 287.810.

287.480. If an application for review is made to the commission within twenty days from the date of the award, the full commission, if the first hearing was not held before the full commission, shall review the evidence, or, if considered advisable, as soon as practicable hear the parties at issue, their representatives and witnesses and shall make an award and file it in like manner as specified in section 287.470. Any notice of appeal, application or other paper required under this law to be filed with the division or the commission shall, when mailed to, or faxed by telephonic transmission, and received by the division or the commission, be deemed to be filed as of the date endorsed by the United States post office on the envelope or container in which such paper is received, or the date received if filed by facsimile. In instances where the last day for the filing of any such paper falls on a Sunday or legal holiday, the filing shall be deemed timely if accomplished on the next day subsequent which is neither a Sunday or a legal holiday. When filing is by fax transmission, the parties shall, on the same date as the fax transmission, place in the United States mail the original and the requisite number of copies, mailing same to the commission.

287.550. All proceedings before the director, administrative law judges, the commission or any commissioner and the appellate courts shall be [simple, informal and summary, and without regard to the technical] conducted in an impartial manner and according to rules of evidence, and [no defect or irregularity therein shall invalidate the same. Except as otherwise provided in this chapter, all such proceedings] shall be according to such rules and regulations as may be adopted by the commission.

287.650. 1. The division of workers' compensation shall have such powers as may be necessary to carry out all the provisions of this chapter, and it may make such rules and regulations as may be necessary for any such purpose, subject to the approval of the labor and industrial relations commission of Missouri. The division shall have power to strike pleadings and enter awards against any party or parties who fail or refuse to comply with its lawful orders.

2. (1) The division shall have the power upon the expiration of five years after their receipt to destroy reports of injuries on which no compensation (exclusive of medical costs) was due or paid, together with the papers attendant to the filing of such reports, and also to destroy records in compensable cases after the expiration of ten years from the date of the termination of compensation.

(2) Records in compensable cases shall include the originals or duplicate originals by electronic or other means, of the deposition of the employee, reports of examining physicians for both employee and employer containing ratings of disability, sufficient treatment records of the employee, including hospital diagnosis and operative summary sheets, to show nature and extent of the course of treatment, and copies of the compromise lump sum settlement papers in order that, if the employee has a later injury, or a second injury fund claim, these records shall be available for at least ten years to determine the nature and extent of the pre-existing disabilities in the earlier cases.

(3) Any party to a workers' compensation case or a personal injury case, or their duly authorized representatives, in any case involving injuries to the employee, shall have an absolute right to inspect and photocopy any records kept by the division under this section, at their individual expense, for the photocopying of same.

3. No rule or portion of a rule promulgated under the authority of this section shall become effective unless it has been promulgated pursuant to the provisions of section 536.024, RSMo.

287.655. 1. Any injury or claim for compensation before the division shall be dismissed by a written order of dismissal by the judge sent by certified mail, notice to the last known address reflected in the division's files by the filing of a written request for dismissal with an administrative law judge by an employee or by an employee and his attorney, if represented, without the necessity of the notice of hearing required by sections 287.450, 287.460 and 287.520, the following subject to the review and appeal set forth in subsection 2 of this section.

2. Any claim before the division may be dismissed for failure to prosecute in accordance with rules and regulations promulgated by the commission, except such notice need not be by certified or registered mail if the person or entity to whom notice is directed is represented by counsel and counsel is also given such notice at counsel's last known address. To dismiss a claim the administrative law judge shall enter an order of dismissal which shall be deemed an award and subject to review and appeal in the same manner as provided for other awards in this chapter.

3. On or after August 28, 1996, subject to the provisions in subsections 1 and 2 of this section, any claim for compensation filed with the division pursuant to this chapter for which no hearing has been conducted for a period of three years after the date of acknowledgement of the claim for compensation by the division shall be automatically dismissed, upon written notification by certified mail from the division to the employee, of a hearing date certain for the employee to appear and present his case, with prejudice to any further rights of the employee, provided, that in the event the employee can demonstrate that he is under the active medical care of a qualified physician on a regular basis within six months before the expiration of the three-year period, the three-year period shall not apply to him, but shall be extended for a period of three years from the last date of such medical care as the administrative law judge shall feel appropriate, provided the employee is under medical care and there is a good valid reason for keeping such case open. At such time as no such valid reason continues to exist, the case shall be dismissed by the division upon written notification by certified mail to the employee of the hearing, at which time his claim shall be automatically dismissed, with prejudice to any further rights the employee might have under this chapter. The written order of the administrative law judge shall set forth in detail the nature and character of the history of the case and the reason for dismissal.

4. Any employee upon failure to keep the second regularly scheduled medical appointment for treatment or evaluation purposes, the employee, upon having at least two weeks prior notice thereof shall, upon failure to keep such appointment, reimburse the physician an appropriate amount for the physician's time in scheduling the appointment at his reasonable charges for same. This charge may be assessed against the employee with respect to any such appointment. If the employer or its insurer pays the physician a reasonable amount for such appointment not kept, such employer or its insurer shall be directly reimbursed, in lieu of said lien, out of the settlement proceeds, or any award of compensation.

287.735. Effective September 30, 1996, any person who is defined as an employer or employing unit pursuant to chapter 287 and chapter 288, RSMo, but whose employees are not eligible for benefits under either or both chapters shall not be required to pay any taxes otherwise imposed under those chapters to the extent that the person's employees are not eligible for benefits.

287.800. 1. [All of the provisions of this chapter shall be liberally construed with a view to the public welfare, and a substantial compliance therewith shall be sufficient to give effect to rules, regulations, requirements, awards, orders or decisions of the division and the commission, and they shall not be declared inoperative, illegal or void for any omission of a technical nature in respect thereto.] All of the provisions of this chapter shall be impartially construed with a view to the public welfare. The facts in a workers' compensation case are not to be interpreted liberally in favor of either the rights of the injured worker or the rights of the employer. It is the specific intent of the legislature that workers' compensation cases shall be decided on their merits.

2. The director, administrative law judges, commissioners and appellate judges shall give all of the parties reasonable opportunity to be heard and to present evidence, to insure the employee, the employer and the insurer an equal, expeditious hearing, conforming to the rules of evidence as in civil cases, and shall act reasonably without partiality to anyone.

287.805. The division of workers' compensation shall establish an independent advisory panel consisting of two representatives from the business community and eight clinical experts licensed pursuant to chapter 334, RSMo. The independent advisory panel shall review on a quarterly basis the division of workers' compensation database. The purpose of such a panel is to assess current statewide trends or patterns in occupational injuries and illnesses, and their associated costs to the business community. Such a panel shall provide guidance and recommendations to the division of workers' compensation, business coalitions, the general assembly, and clinical community in order to reduce occupational injury and illness claims and costs. This panel shall establish specialty subgroups to develop statewide consensus in the statistical analysis, prevention and treatment of specific types of occupational injuries and illnesses. This panel shall be appointed by the director of the division by January 1, 1997, with each member of this panel serving one term of three years.

287.806. Based on the recommendations from the independent advisory panel and its specific specialty subgroups, the division of workers' compensation shall establish specific quality of care and utilization measures, with statistical thresholds, in order to identify aberrant patterns in individual employee medical care. If individual aberrant quality of care or utilization measures are identified, employee medical record case review shall be performed by a qualified, independent review organization consisting of four representatives of business, one representative from labor and two clinical experts licensed pursuant to chapter 334, RSMo. This review organization shall provide an independent written assessment to the division of workers' compensation and the independent advisory panel concerning the quality of care and utilization of medical services rendered to an employee. Such an independent assessment shall be incorporated in the claims adjudication process. This independent review organization shall be appointed by the director of the division by January 1, 1997, with each member of the organization serving one term of three years.

Section B. The provisions of sections 287.805 and 287.806 of this act shall terminate on January 1, 2000.