Tulalip Gaming Commission New YorkTulalip Tribal Codes: 9. WORKERS’ COMPENSATIONSkip Chapter Digest. Sections: Article I. General Provisions. Purpose. 9. 1. 5. Scope. 9. 1. 5. 0. Sovereign immunity. ![]() Reporting obligations. Exclusive remedy. Administration. 9. Definitions. Article II. Coverage. 9. 1. 5. Persons covered. 9. Persons not covered. Employees with preexisting medical conditions. Acts outside course or scope of employment. Incarcerated employees. Article III. Compensation and Medical Benefits. Medical services and supplies. Artificial substitutes and mechanical aids. Modifications to residence or vehicle.
Employer liability for medical services and supplies. Time loss. 9. 1. 5. Utilizing sick leave. Limitation on payment. Temporary partial disability. Payments on behalf of children. Temporary total disability. Return to work provisions. Determination of permanent disability. ![]() The Pacific Northwest Gaming Law Summit, now in its thirteenth year, has become the most important gaming legal education event in the country. The Washington Indian Gaming Association (WIGA) is a non-profit organization of tribal government leaders of federally recognized Tribes in the state of Washington. The Tulalip Tribes of Washington / t uː ˈ l eɪ l ɪ p /, formerly known as the Tulalip Tribes of the Tulalip Reservation, is a federally recognized tribe of. Permanent partial disability. Permanent total disability. Death during permanent total disability. Reduction of awards. Compensation for additional accident. Death benefits. 9. Accelerating or converting awards. Protection of awards. Article IV. Claims Procedures. Notice of injury or occupational disease. Employee’s application for compensation. Employee’s duty to report claim activity. Statute of limitations. Tulalip Gaming Commission Scams![]() Burden of proof. 9. Presumptions. 9. 1. Proof of dependency. Compromise and release. Claim closure. 9. Recovery of payments made due to error, mistake, erroneous adjudication, or fraud. Medical examinations. Testimony of physicians not privileged. Confidentiality. 9. Actions against third persons. Article V. Protests and Appeals. Protests. 9. 1. 5. Appeals. 9. 1. 5. Attorneys fees. Article VI. Funding. 9. 1. 5. Purpose of fund. 9. Administration of fund. Article VII. Severability. Severability. Prior legislation: Res. Article I. General Provisions Purpose. This chapter is intended to establish procedures to administer and define the Tribes’ self- administered workers’ compensation program, in a manner that is fair to both employees and the Tribes. All work- related injuries and deaths sustained by employees of the Tulalip Tribes and its enterprises are withdrawn from private controversy. To guarantee relief for employees killed or injured on the job and their families, regardless of questions of fault and to the exclusion of every other remedy, proceeding, or compensation, the following plan is adopted, which shall be known as the Tulalip Tribes workers’ compensation plan. The plan shall serve as the exclusive remedy for the injured employee, except as otherwise provided herein, and to that end all civil causes of action for such personal injuries or deaths and all jurisdictions of the Courts are hereby abolished. Ord. 1. 08 § 1. 08. Res. 2. 00. 6- 3. Scope. This chapter shall apply to the Tulalip Tribes, every entity of the Tribes that is an employer, and to all employees of the Tribes and its entities. For purposes of this chapter, “every entity of the Tribes” includes every political subdivision, subordinate organization, economic enterprise, commission, and authority organized under Tribal law, including but not limited to the Tulalip Utility Authority and the Tulalip Gaming Organization. Ord. 1. 08 § 1. 08. Res. 2. 00. 6- 3. Sovereign immunity. Except as expressly provided in this chapter, the Tulalip Tribes shall be immune from all liability for compensation for injuries sustained by Tribal employees arising out of and in the course of their employment.(1) Limited Waiver for Claims Under This Chapter. For those claims outlined herein, this chapter contains a strictly limited waiver for suit only and solely in Tribal Court. This limited waiver shall extend only to Tribal employees and other persons specifically entitled to benefits under this chapter, and shall not be construed to apply or extend to actions by any other party or actions beyond the scope of this chapter.(2) No Modification to Existing Law. Except as specifically provided in this chapter, the provisions herein shall not be construed as modifying or restricting the immunity of the Tribes from tort liability as it existed on the date of enactment. Except as to claims that are wholly covered by the Tulalip Tribes workers’ compensation plan, nothing in this chapter, or in any State law incorporated herein by reference, shall in any way waive or diminish the sovereign immunity of the Tulalip Tribes. Ord. 1. 08 § 1. 08. Res. 2. 00. 6- 3. Reporting obligations. Any employee who has sustained an injury in the course of their employment shall immediately report the injury to the employer in accordance with TTC 9. In the case of an occupational disease, the employee shall report the condition to the employer immediately after the employee learns of, or reasonably should have been aware of, the connection between their employment and the occupational disease. All reports of injury and occupational disease shall be made in writing, in accordance with TTC 9. Exclusive remedy. The right to receive compensation pursuant to this chapter for injuries sustained by a covered worker shall be the exclusive remedy against the Tribes and employees thereof, except as otherwise provided herein, and to that end, all civil causes of action against the Tribes and its employees for such personal injuries or death, all jurisdictions of the Courts, and all claims for contribution or indemnity asserted by third persons from whom damages are sought on account of such injuries, are hereby abolished. Ord. 1. 08 § 1. 08. Res. 2. 00. 6- 3. Administration.(1) Workers’ Compensation Committee.(a) Membership. There is hereby established a Tulalip Workers’ Compensation Committee, whose responsibility it shall be to administer the plan and to act as the first level of review in the case of a disputed claim. The Committee shall be composed of six members, one of which shall serve as Chairperson of the Committee. The Committee shall include one representative from the Tribal government, one representative from Quil Ceda Village, one representative from the Legal Department, one representative from the Finance Department, and two representatives from the Tulalip Gaming and Hospitality Organization. The Committee Chairperson and members shall be appointed by the Tulalip Board of Directors for terms of three years. Vacancies occurring due to resignation, removal, or death shall also be filled by this method of appointment. The Board of Directors may remove any member of the Committee for cause. A majority of the Committee members shall constitute a quorum, and a majority of those members present and constituting a quorum must concur in order for any decision of the Committee to be valid.(b) Functions, Duties, and Authority. The Workers’ Compensation Committee shall: (i) Contract with a professional claims administration firm to handle the duties of the Claims Administrator, as provided in subsection (2) of this section. The Committee may review and approve key actions taken by the Claims Administrator to ensure compliance with this chapter.(ii) Establish and promulgate rules governing the administration of this chapter.(iii) Purchase stop loss insurance covering all claims arising under this chapter in excess of those covered by the Tribal fund.(iv) Hear protests from decisions of the Claims Administrator as provided in Article V of this chapter.(v) Consult with outside physicians having medical expertise related to the injury, when necessary.(vi) Manage the Tribal fund as provided in Article VI of this chapter.(vii) Submit annual reports to the Board of Directors as provided in Article VI of this chapter.(2) Claims Administrator.(a) Appointment. The Workers’ Compensation Committee shall contract with a third party administrator to serve as the Claims Administrator.(b) Functions, Duties, and Authority. The Claims Administrator shall: (i) Supervise medical, surgical, and hospital treatment for injured employees to ensure that it meets the required standards of modern medicine at the lowest possible cost.(ii) Open claims, verify time loss and other aspects of disability, handle disbursement of funds for employees and beneficiaries on Tribal checks drawn on the Tribal fund, make claim evaluations and determinations with respect to each claim made.(iii) Compile statistics as will afford the Workers’ Compensation Committee reliable information upon which to base its decisions.(iv) Make, and from time to time update, a fee chart of maximum charges to be made by any physician, surgeon, hospital, druggist, or other agency or person rendering services to the injured employee.(v) Make a record of the commencement of every disability and termination thereof, and when bills are rendered for the care and treatment of injured employees, approve and pay those which conform to the promulgated rules, regulations, and practices of the Workers’ Compensation Committee, and reject any bill or item thereof incurred in violation of the provisions of this chapter or the rules and regulations promulgated under it. Res. 2. 01. 0- 4. Ord. 1. 08 § 1. 08. Res. 2. 00. 6- 3. Definitions.(1) “Accident” means a specific occurrence, neither expected nor intended, which causes bodily injury to an employee.(2) “Accredited school” means a school approved by the Tribes or the State, or a school regulated, licensed, or recognized by the Tribes as having approved course content.(3) “Average monthly wage” means the average wage in the State of Washington, calculated by determining the total amount of wages paid by all employers in the State and dividing by 1. RCW 5. 1. 0. 8. 0. RCW 5. 0. 0. 4. 3.
0 Comments
Leave a Reply. |
AuthorWrite something about yourself. No need to be fancy, just an overview. Archives
September 2016
Categories |