D.C. Mun. Regs. tit. 7, r. 7-151

Current through Register 71, No. 45, November 7, 2024
Rule 7-151 - THIRD PARTY RECOVERY
151.1

If the Program determines that an injury or death for which indemnity compensation is payable under this chapter is caused under circumstances creating a legal liability on the part of a third party to pay the District or the employee damages, the employee (or authorized representative if the employee is deceased) shall prosecute the action within sixty (60) days of the incident.

151.2

If the employee (or authorized representative if the employee is deceased) does not prosecute the action within sixty (60) days of the incident, the employee (or authorized representative, as applicable) shall assign to the District of Columbia government:

(a) Any right of action the employee or employee's estate may have to enforce the liability; or
(b) Any right that the employee or employee's estate may have to share in money or other property received in satisfaction of that liability.
151.3

If an employee or authorized representative refuses to assign or prosecute an action in his or her own name when required to do so by the Program pursuant to §§ 151.1 and 151.2, the Program shall suspend the employee's current or prospective benefits, unless the employee provides the Program with evidence of extenuating circumstances that prevents the employee from prosecuting the action at the time required by the Program. A claimant's continual refusal to assign or prosecute an action for more than twelve (12) months from the date of the incident without an accepted excuse from the Program shall result in termination of the claimant's indemnity compensation.

151.4

The Program may refer to the Office of the Attorney General (OAG) for civil prosecution a cause of action assigned to the District of Columbia government under § 151.2.

151.5

Recoveries by the Program following an assignment shall be distributed pursuant to Section 2331(c) of the Act.

(a) If there are any funds remaining after the deductions and payments made pursuant to § 151.6, the Program shall deposit the remaining funds into the Employees' Compensation Fund and the funds shall be used to pay the employee's future compensation payable for the same injury.
151.6

If an employee claimant prosecutes a third party for an injury or death for which compensation is payable under this chapter and recovers money or other property in satisfaction of the third party's liability, the employee, after deducting the costs of the prosecution, reasonable attorneys' fees, and one-fifth (1/5) of the net amount of money or property remaining after payment of expenses and attorneys' fees, shall pay to the Program the amount of compensation already paid by the Program to the employee under this chapter. The payment shall be credited to the Employees' Compensation Fund. If there are any funds remaining after the employee's payment to the Program, the remaining sum shall be a credit for the same amount of future payments of compensation by the Program for which the employee is eligible. The Program shall not pay the employee the number of future payments that totals the amount of the credit.

(a) The amount due to the District pursuant to this section shall be calculated as of the date of the settlement. Any indemnity or medical compensation received by the employee after the date of the settlement shall be treated as "future payments of compensation" within the meaning Section 2332 of the Act. If the Program has already paid the employee "future payments of compensation" at the time the settlement is reported, "future payments of compensation" that total the amount of the credit or surplus shall be treated as debt to the District of Columbia.
(b) "Costs of suit" under Section 2332 if the Act means court filing, nonexpert witness fees, deposition transcript, subpoena and photocopying fees, excluding transportation fees.
151.7

If an employee or claimant successfully prosecutes a claim against a third party pursuant to § 151.1 of this chapter and fails to remit payment to the Program, the amount owed shall be:

(a) Withheld from the claimant's indemnity compensation payments.
(b) If the employee or claimant is not receiving indemnity compensation payments, the amount due shall be treated as an employee debt to the District pursuant to Section 2902 and 2904 of the Act and subject to civil prosecution in the Superior Court for the District of Columbia. Pursuant to Section 2901(g) of the Act, Sections 2901(a) through (f) of the Act shall not apply to limit the Program's ability to collect on overpayments.
(c) Recovery of the amounts owed pursuant to 2904 of the Act includes an offset against claimant's indemnity compensation payments.
151.8

No court, insurer, attorney, defendant, or other person shall pay or distribute to the claimant or his or her designee the proceeds of such suit or settlement without first satisfying or assuring satisfaction of the interest of the District of Columbia government pursuant to § 151.6.

151.9

The employee or claimant, insurer, attorney, or other person, shall notify the District of any settlement or judgment entered within fourteen (14) days of the settlement of or entry of judgment in any third-party claim filed pursuant to § 151.1.

151.10

An attorney, who represents a District employee, who was injured during the course of his or her employment, against a third-party tort-feasor shall not be excused of his or her obligation to satisfy the District's interest in the proceeds of such suit or settlement, unless, the attorney has received written confirmation from the District that it does not have a lien against any such recovery.

151.11

Any employee or claimant, insurer, defendant, or other person who fails to comply with §§ 151.6 through 151.9 of this chapter shall be held jointly and severally liable to the District of Columbia government for the amount due as calculated pursuant to § 151.6 of this chapter, plus pre-judgment interest, reasonable attorney's fees and costs incurred by the District.

(a) Pre-judgment interest shall be calculated pursuant to D.C. Official Code § 28-3302(c) starting on the fifteenth (15th) day after settlement or entry of judgment.
151.12

If an employee returns to work and is then required to appear as a party or witness in the prosecution of an action under this section, the employee shall be considered to be in an active duty status while so engaged.

151.13

The Program may treat any payment due to the District under Section 2332 of the Act as an employee debt to the District pursuant to Section 2902 and 2904 of the Act. Pursuant to Section 2901(g) of the Act, Sections 2901(a) through (f) of the Act shall not apply to limit the Program's ability to collect on debt due under this section.

D.C. Mun. Regs. tit. 7, r. 7-151

Final Rulemaking published at 64 DCR 6325 (7/7/2017)