HB 1456 Summary

• Defines "compensable injury" as accident-related injuries arising from hazardous employment, requiring medical evidence supported by objective medical findings, with expanded coverage for heart conditions, strokes, and mental stimulus injuries if employment is at least 50% of the cause.

• Establishes presumption that a treating physician's opinion or medical determination is correct unless rebutted by clear and convincing evidence based on objective medical findings in administrative appeals.

• Creates presumption of compensability for volunteer firefighters, emergency volunteers, and health practitioners who experience heart attacks, strokes, or mental stimulus injuries within 24 hours of performing volunteer services.

• Allows injured employees to appeal denials of benefits, including treatment or testing methods recommended by their treating physician, and permits request for insurance commissioner review before filing formal appeal.

• Requires the organization to pay judicial appeal costs and attorney's fees if injured employee prevails, with maximum fees set at the average rate paid for the organization's attorney in the three most recent appeals.

• Allows health insurance companies to dispute claim denials when the organization deems injuries did not occur during employment, with insurance commissioner authority to hear appeals.