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A. Pronouns of the masculine gender used in this Act shall apply to both sexes. Unless stated otherwise in specific sections of the Act, time limits shall be calculated using calendar days.

B. Unless the context otherwise requires, the definitions which follow govern the construction and meaning of the terms used in this Act:

1. Administrator” or “workers’ compensation benefits system claim administrator” shall mean either the insurance company providing coverage hereunder or any subcontractor appointed by said insurance company; or, if self-insured, the employee or third-party administrator retained by the employer to carry out the policies established by the employer for processing of claims and settlements.

2. Attending physician” shall mean the physician, or other medical care provider, who is responsible for the planning, provision and oversight of medical treatment to a worker who sustains a covered injury.

3. Average weekly wage” shall be as follows:

For workers hired to a regular full- or part-time, temporary, emergency or special projects position expected to last at least fourteen (14) weeks, the average weekly wage shall be calculated based on the preceding fourteen (14) weeks of the worker’s actual wage earnings from an employer. In the case of a worker who has not worked for an employer within the immediate preceding fourteen (14) weeks, the average weekly wage shall be calculated based on the salary level the worker was hired at or is currently receiving.

For purposes of this definition, the work week shall be as defined by the personnel manual or policy applicable to the worker at the time of injury.

4. Benefits” shall mean payments and services, which include medical payments, payment of lost wages due to disability, impairment payments, vocational rehabilitation and death benefits as provided by this Act.

5. Child” includes dependent natural legitimate children, dependent stepchildren, adopted children and recognized illegitimate children; but does not include married children unless they are shown to be dependents.

6. Claim” means a claim filed with the Administrator by or on behalf of a worker for benefits provided under this Act.

7. Claimant” means the injured worker or, in the event of death of the worker, dependents of the deceased.

8. Consulting physician” shall mean the physician, other health care provider or other health care expert who is retained by the Administrator to assist the Administrator in carrying out the duties and responsibilities under this Act. Such activities may include, but are not limited to, determination of the validity of a claim; review of an attending physician’s diagnosis and treatment plans; determination of maximum medical improvement (MMI); determination of impairment rating. At the discretion and expense of the Administrator, an injured worker may be required to be seen by the consulting physician to assist in making any required recommendations to the Administrator.

9. Course and scope of employment” shall mean an act or action within a worker’s job duties or assignments, as set forth in the worker’s job description or otherwise, which acts or actions are in the furtherance of the employer’s interest. Course and scope excludes injuries sustained while a worker is at home or preparing for work.

10. Cumulative trauma” means an injury resulting from employment activities which are repetitive in nature and engaged in over a period of at least six months of continuous exposure and which is supported by objective medical evidence. Ordinary, gradual deterioration or progressive degeneration caused by the aging process is not considered compensable.

11. Death” is any fatality of the worker proximately and directly caused by work injury or occupational disease.

12. Dependents” means the following persons:

a. The widow or widower if married and living with the deceased at the time of deceased’s death and legally entitled to be supported by the deceased as a dependent;

b. A child under eighteen (18) years of age, or incapable of self-support, unmarried and dependent upon the deceased; or a child under twenty-five (25) years of age enrolled as a full-time student in an accredited education institution at the time of the worker’s injury;

c. A grandchild, brother or sister, niece or nephew of the worker under eighteen (18) years of age, who were wholly dependent on the earnings of a deceased worker for support at the time of his on-the-job injury; or

d. A member of the injured worker’s family or next of kin who was wholly dependent upon the earnings of the worker at the time of the injury.

13. Disability” means the inability of the worker to obtain and/or retain wages equivalent to the pre-injury wage rate as a result of a direct loss of functional capacity compromising that individual’s ability to perform the necessary duties of the job. This functional loss must be directly and materially attributable to a compensable work-related injury and/or occupational disease and must be supported by the worker’s attending physician and, if requested by the Administrator, the consulting physician. “Partial disability” is distinguished as any incapacity less than one hundred percent (100%) inability as defined above.

14. Disability income” means the total and partial disability income benefits set forth in Section 4-504 of this Title.

15. Employer” shall mean the Osage Nation, its agencies, commissions, subsidiaries and any business entity wholly owned by the Osage Nation.

16. Idiopathic injury” means an injury which is either peculiar to the individual or arising spontaneously from an obscure or unknown cause. This includes epileptic attacks, diabetic seizures, heart disease, cardiovascular or respiratory conditions, heart attack, the failure or occlusion of any coronary blood vessels, stroke, thrombosis, allergic disorders, auto-immune diseases, etc.

17. Impairment” means any anatomic or functional abnormality or loss existing after maximum medical improvement (MMI) as defined herein that results from a compensable injury and/or occupational disease and is reasonably presumed to be permanent based on reasonable medical probability.

18. Injury” shall mean, in addition to accidental injury which may be definitely located as to the time when and the place where the accident occurred, any injury to a worker which is causally connected with his employment and is the direct result of repetitive trauma or repetitive acts incident to such employment and occupational disease. Injury shall not be construed to include (a) an injury to a worker which results from his voluntary participation in any activity the major purpose of which is social or recreational, including, but not limited to, athletic events, parties and picnics, whether or not the employer pays some or all of the cost of such activity; (b) a mental or emotional impairment, unless such impairment arises from a physical injury or occupational disease; or (c) a mental or emotional impairment which results from a personnel action, including, but not limited to, a transfer, promotion, demotion, or termination.

19. Intoxication” or “intoxicated” means blood alcohol content of 0.08 percent or greater or conviction of the offense of driving while intoxicated or impaired by any jurisdiction, or loss of the normal use of one’s mental and/or physical faculties resulting from the voluntary introduction into the body of (a) an alcoholic beverage; (b) a controlled substance (a controlled substance for the purpose of this Act has the same definition of that term that appears in the Controlled Substances Act); (c) a mind-altering drug and/or hallucinogenic; (d) an abusable glue or aerosol paint; (e) the intentional use of prescribed drugs in excess of the prescribed therapeutic amounts; or (f) any other similar substance.

20. Maximum medical improvement” (MMI) means the point after which further material recovery from or last improvement to an injury can no longer reasonably be anticipated, based on the reasonable medical probability.

MMI can be determined without regard to subjective complaints of pain by the worker. Once the date of MMI has been determined (except cases in which a worker is medically unable to continue working) no further determinations of other dates of MMI for that personal injury are permitted. A determination of MMI is not rendered ineffective by the worsening of the worker’s medical condition and recovery thereafter.

21. Occupational disease” shall be only those diseases which arise out of and in the course and scope of the worker’s employment. Such diseases shall have a direct causal connection with the employment and must have followed as a natural incident thereto from injurious exposure occasioned by the nature of the employment. Such disease must be incidental to the character of the business, occupation, or process in which the worker was employed and not independent of the employment. Such disease need not 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 resulted from that source as an incident and rational consequence. A disease which follows from a hazard to which a worker has or would have been equally exposed outside of said occupation is not compensable as an occupational disease.

A disease is not bodily injury by accident unless it results directly from bodily injury by accident.

22. Parent or grandparent” shall mean the natural or adoptive father or mother or the natural grandfather or grandmother of the worker.

23. Policy” shall mean any workers’ compensation benefits policy of insurance issued to the Nation, or other employer.

24. Preexisting condition” is defined as an injury, disease, congenital abnormality, personality disorder, or similar condition that precedes the onset of an initial claim for an injury, or occupational disease or that precedes a claim for a worsened condition resulting from the original injury.

25. Scheduled weeks” means one hundred fifty-six (156) weeks and is the maximum number of weeks that a worker shall be entitled to functional impairment benefits under this Act.

26. Settlement” shall mean full release and waiver of any and all claims and benefits associated with this Act.

27. Spouse” shall mean the person married to the worker at the time of the death or injury to the worker.

28. Nation” means or refers to the Osage Nation as a federally recognized American Indian tribe.

29. Workers’ compensation benefits system” shall mean this Act, any and all rules and regulations promulgated hereunder, as well as the functions of the Administrator and the arbitrator selected to adjudicate disputes under Subchapter 8 of this chapter.

30. Worker” means every person who has entered into the employment of or performs work for the employer, works under contract of service, express or implied, or apprenticeship, for an employer, every executive officer elected or appointed and empowered under and in accordance with the charter and bylaws of a corporation, including a person holding an official position, or standing in a representative capacity of the employer, including officials elected or appointed by the Nation, compensated monetarily or otherwise, except as hereinafter specified. Workers shall include all persons employed by the employer regardless of where they work, whether it be inside or outside of Osage Nation jurisdictional boundaries. The term worker shall not include an independent contractor working under contract for an employer, whether that contract be express or implied. ONCA 12-76, eff. Oct. 1, 2012; ONCA 15-52, eff. Nov. 6, 2015.