MINUTES OF THE SENATE COMMITTEE ON COMMERCE AND LABOR Sixty-eighth Session May 3, 1995 The Senate Committee on Commerce and Labor was called to order by Chairman Randolph J. Townsend, at 8:15 a.m., on Wednesday, May 3, 1995, in Room 227 of the Legislative Building, Carson City, Nevada. Exhibit A is the Agenda. Exhibit B is the Attendance Roster. COMMITTEE MEMBERS PRESENT: Senator Randolph J. Townsend, Chairman Senator Ann O'Connell, Vice Chairman Senator Sue Lowden Senator Kathy M. Augustine Senator Raymond C. Shaffer Senator John B. (Jack) Regan Senator Joseph M. Neal, Jr. STAFF MEMBERS PRESENT: Beverly Willis, Committee Secretary Scott Young, Senior Research Analyst Vance Hughey, Senior Research Analyst OTHERS PRESENT: Lenard Ormsby, General Counsel, State Industrial Insurance System (SIIS) Jan Myers, Northern District Manager, Division of Industrial Relations (DIR) Ron Swirczek, Administrator, Division of Industrial Relations (DIR) Jan Needham, Principal Deputy Legislative Counsel, Legal Division, Legislative Counsel Bureau Nancyann Leeder, Attorney, Nevada Attorney for Injured Workers Referring to Exhibit C, (Exhibit C of May 1, 1995, The Original is in the Research Library.), Senator Townsend announced the first order of business will be proposed language (Exhibit D), presented by Lenard Ormsby, General Counsel, State Industrial Insurance System (SIIS). Mr. Ormsby proceeded to give an explanation. Next to testify, Scott Young, Senior Research Analyst, introduced Exhibit E. Mr. Young proceeded with an explanation, addressing issues surrounding the use of the American Medical Association Guides to the Evaluation of Permanent Impairment (AMA Guides). Exhibit E also includes detailed information indicating how various surrounding states use these guides and how they calculate their actual Permanent Partial Disability (PPD) and what limits are placed on them. At Senator Townsend's request, Jan Myers, Northern District Manager, Division of Industrial Relations (DIR), came forward to testify. Senator Townsend noted each state seems to adopt its own conclusion. Ms. Myers concurred. Ms. Myers, Senator Townsend and Senator Neal proceeded with discussion considering regulations for future ratings when the fourth edition of the AMA Guide might be adopted. Senator O'Connell posed questions concerning the adoption of a new AMA Guide. Ms. Myers stated, "We do have the authority [to adopt] and make modifications as deemed necessary." Senator O'Connell inquired what flexibility DIR will have to determine any new modifications. Ms. Myers replied, "The way the law is currently written, we do have flexibility; however, from a practical standpoint, we need to be very careful mixing the different guides." Ron Swirczek, Administrator, Division of Industrial Relations (DIR), noted if AMA guides are mixed, the issue of training may become a factor. He went on to state he feels consistency is a key point. Mr. Swirczek noted training may be based on the fourth edition of the AMA Guide, so trying to mix the different editions might not be advisable. Mr. Swirczek asserted it might be possible to have Dr. Christopher Brigham testify to answer questions regarding the fourth edition. Dr. Brigham conducts training using the fourth edition and is a recognized authority as far as determining percentage of impairment. Mr. Swirczek, Senator Shaffer and Senator Townsend continued with a detailed discussion on the training process and concurred that it would be helpful to have objective guidance. Senator Townsend declared he has no problem with Ms. Myers reporting to an interim committee regarding determination of schedules and training progress. Ms. Myers noted with hearings and training this process will take a good 6 months. Senator O'Connell stated: I think it is to our benefit to try and mirror as closely as we can to similar situations [work and daily living] so for our comfort level we know we are comparing apples to apples. ........If we have any references where we have a level of comfort as far as workers are concerned so we are not taking an industry that does not have an impact. Senator Townsend reiterated various concerns voiced by Senators Shaffer, Neal and Lowden. Senator Townsend and Mr. Swirczek continued their discussion. Senator Townsend stated: I guess what I am trying to say in a specific instance relative to the language of this bill is I'd like you to continue what you are doing, using the second guide, holding hearings on the fourth [guide], till July 1, 1996, at which time you could utilize this language to adopt what you wanted, but it wouldn't prohibit you from using a schedule of injury that you agree Nevada would work better under. Senator Neal stated: If we should happen to look at any other kind of rating, the underlying purpose of that should be to arrive as close as possible at the actual condition of the injured worker and what that person should be rated on. That should be the underlying purpose of any type of rating scheme we go into. ......I would think that you in formulating the scheme, whether it be the fourth edition of the AMA Guide, the underlying purpose is to arrive at the best indicator of the conditions of the injured worker. Whatever mechanism will give you that, I think that's the one that you should adopt. Senator Townsend stated, "that should be one of the intents of the interim committee as they look at the mechanisms of ratings." Jan Needham, Principal Deputy Legislative Counsel, Legal Division, Legislative Counsel Bureau, and Senator Townsend deliberated the question of an effective date for the adoption of regulations incorporated into the AMA Guide. Ms. Myers and Senator O'Connell discussed training schedules and the length of time required for training. Senator Townsend, Ms. Needham and Mr. Swirczek again discussed interim hearings and training times. Ms. Needham offered clarification noting "there will be a prohibition against using any other edition except the second edition [AMA Guide], the one they use now." Senator Townsend added, "till December 31, 1995 and then if you weren't ready you could still hold off; you would not have to do it at that time. That's what that language says you shall adopt regulations incorporating this and may amend those from time to time. I think that gives you the flexibility, or do you need a word change there?" Mr. Swirczek indicated he feels this direction will be fine. SENATOR NEAL MOVED TO UTILIZE THE SECOND EDITION OF THE AMERICAN MEDICAL ASSOCIATION'S GUIDE TILL JANUARY 1, 1996. ON OR AFTER JANUARY 1, 1996, THE DIVISION OF INDUSTRIAL RELATIONS MAY ADOPT ANY RATING SYSTEM. SENATOR SHAFFER SECONDED THE MOTION. THE MOTION CARRIED. (SENATOR AUGUSTINE WAS ABSENT FOR THE VOTE.) * * * * * Again referring to Exhibit C, Senator Townsend opened a discussion with Ms. Needham on sections 83 and 89. Citing Exhibit D, Senator Townsend then initiated review of section 91, noting this language was presented by Mr. Ormsby. SENATOR NEAL MOVED TO INCLUDE PROPOSED LANGUAGE AS SUBMITTED BY LENARD ORMSBY IN SECTION 91 AND SECTION 92. SENATOR O'CONNELL SECONDED THE MOTION. THE MOTION CARRIED. (SENATOR LOWDEN WAS ABSENT FOR THE VOTE.) * * * * * Nancyann Leeder, Attorney, Nevada Attorney for Injured Workers, came forward to testify. Ms. Leeder and Ms. Needham conversed, regarding language changes that may be needed in section 98. At this time, Mr. Ormsby entered the discussion along with Senator Townsend providing an explanation. SENATOR NEAL MOVED TO ACCEPT LANGUAGE PROPOSED BY MR. ORMSBY AND MS. LEEDER FOR SECTION 98. SENATOR O'CONNELL SECONDED THE MOTION. THE MOTION CARRIED UNANIMOUSLY. * * * * * Next to be addressed were sections 117, 118, 119 and 120 of Exhibit C. After discussion, Senator Neal proposed a motion. SENATOR NEAL MOVED TO ADD SUBSECTION C TO SECTION 119 TO INCLUDE THE RATING OF INJURED WORKERS. SENATOR O'CONNELL SECONDED THE MOTION. THE MOTION CARRIED UNANIMOUSLY. * * * * * SENATOR O'CONNELL MOVED TO DELETE THE PREFERRED WORKERS SECTIONS 12 THROUGH 23. SENATOR NEAL SECONDED THE MOTION. THE MOTION CARRIED UNANIMOUSLY. * * * * * Senator Townsend noted: I will, tomorrow, bring up the issue. I would like to have that included as part the responsibilities of the interim committee to develop that program during the interim. There being no further business, the meeting was adjourned at 10:25 a.m. RESPECTFULLY SUBMITTED: Beverly Willis, Committee Secretary APPROVED BY: Senator Randolph J. Townsend, Chairman DATE: Senate Committee on Commerce and Labor May 3, 1995 Page