“Administrator” means the agency, entity, or person responsible for managing the Gaming Enterprise’s workers’ compensation program. Responsibilities include, but are not limited to, determining the compensability of claims, making payments to injured employees, medical providers, and others entitled to compensation under this article. Responsibilities may also include, managing a trust account for administering the Tribe’s workers’ compensation liabilities, and, making reports to the Tribe regarding its program and individual claims. The Administrator’s duties are more fully described in KTC 6.10.730.
“Appeal Board” means the independent tribunal established to hear all disputes arising out of this article, as required by the Compact, Section 12.6(a)(2).
“Child or children” means the child or children of an employee, under the age of eighteen (18), including an unborn child, a child legally adopted prior to the injury, a child for whom the employee is a legal guardian, and a stepchild, if such stepchild was, at the time of the injury, a member of the employee’s family and substantially dependent upon the employee for support. A child does not include any married children unless they are dependents. A person might also qualify as a child according to Tribal custom and tradition as determined by applicable Tribal Law.
“Claimant” for the purposes of this article shall mean any employee of the Gaming Enterprise, except for independent contractors, who suffers an injury, either specific or cumulative, or death, arising out of and in the course and scope of that employment, or dependent thereof, who files a claim pursuant to this article.
“Compact” means the Class III Tribal-State Gaming Compact between the Tribe and the state of California executed on or about December 4, 2013, with an effective date of November 19, 2014 (“Compact”), as amended by the First Amendment to the Compact executed on or before August 1, 2018, with an effective date of December 27, 2018.
“Compensable work injury” means an injury to an employee when that injury arises during a period of employment, and while performing the duties of the employment in or on the premises of the Gaming Enterprise, or wherever the Gaming Enterprise requires the employee to perform the employment activities as more fully described in this article.
“Compensation” means compensation under this article and includes every benefit or payment conferred by this article upon an injured employee.
“Days” means calendar days unless otherwise provided.
“Dependency” means dependent or dependence on another (see definition of “dependent”).
“Dependent” means the father, mother, grandfather, grandmother, stepfather, stepmother, grandson, granddaughter, brother, sister, half-sister, half-brother, niece, nephew, or any other extended family member as approved by the Administrator, who at the time of the compensable work injury that causes the employee’s death is actually and necessarily dependent in whole or in part upon the earnings of the employee.
“Gaming Enterprise” means the Karuk Tribe’s gaming operation and gaming facility authorized under the Compact and Tribal Law to carry out gaming activities on the Indian lands of the Tribe.
“Karuk Tribal Gaming Authority” means the instrumentality of the Karuk Tribe pursuant to the Tribal Gaming Authority Ordinance, adopted by the Tribal Council for purposes of overseeing the operation, management, and promotion of the Gaming Enterprise.
“Permanent partial disability” means a level of permanent disability at the time a permanent and stationary status and/or maximum medical improvement is achieved, as established by the assigned treating physician or from an independent medical examination (by an independent medical reviewer on the state’s approved list, a qualified medical evaluator on the state’s approved list, or an agreed medical examiner upon mutual agreement of the employee and Tribe), which results in an impairment rating of less than seventy (70) percent and is the result of a compensable work injury.
“Permanent total disability” means a level of permanent disability at the time a permanent and stationary status and/or maximum medical improvement is achieved, as established by the assigned treating physician or from an independent medical examination (by an independent medical reviewer on the state’s approved list, a qualified medical evaluator on the state’s approved list, or an agreed medical examiner upon mutual agreement of the employee and Tribe), which results in an impairment rating of seventy (70) percent or higher and is the result of a compensable work injury.
“Physician” means physicians and surgeons holding an M.D. or D.O. degree, psychologists, acupuncturists, optometrists, dentists, podiatrists, and chiropractic practitioners licensed by California state law and practicing within the scope of their licensure as defined by California state law.
“Referral physician” means a physician to whom an employee is referred because of an action under this article.
“Spouse” means a husband, wife, or registered domestic partner of the employee.
“State” means the state of California.
“Supplemental job displacement benefits” means the amount payable to an injured employee who sustains a permanent partial disability caused by a compensable work injury and who does not receive a bona fide offer of permanent modified or alternative work from the Gaming Enterprise. Such amount shall help compensate such employee for the anticipated costs of vocational retraining or rehabilitation to permit the employee to return to gainful employment.
“Temporary disability” means a physical incapacity caused by a compensable work injury that is expected to be completely cured or improved with proper medical attention. This term includes both a temporary partial disability and a temporary total disability.
“Temporary partial disability” means a nonpermanent medical status caused by a compensable work injury that results in the employee being able to perform modified or light duty work assignments or reduced hours at the direction of a physician approved by the Administrator, which results in diminished earnings as compared to the pre-injury average weekly wage.
“Temporary total disability” means a nonpermanent medical status caused by a compensable work injury that results in the employee being physically unable to perform any work in the judgment of a physician approved by the Administrator, which results in a complete loss of earnings.
“Tribal lands” means all land occupied or owned by the Tribe, whether in fee or held in trust by the United States of America.
“Tribal law” means the statutory and common law of the Karuk Tribe, including ordinances, rules and regulations adopted by the governing authority of the Tribe; and the traditions and customs of the Tribe, whether or not codified.
“Tribe” means the Karuk Tribe, a federally recognized Indian tribe.
“Work injury” shall include any physical injury or disease arising out of and in the course and scope of employment, including injuries to artificial limbs, dentures, hearing aids, eyeglasses, and medical braces of all types; provided, however, that eyeglasses and hearing aids will not be replaced, repaired, or otherwise compensated for, unless injury to them is incident to a compensable injury covered by this article.
Work injuries under this section shall be either:
(1) Specific occurring, which means that the injury is a result of one (1) incident or exposure which causes disability or need for medical treatment; or
(2) Cumulative occurring, which means that the injury is a result of repetitive mental or physical activities extending over a period of time, the combined effect of which causes any disability or need for medical treatment. The date of a cumulative injury is the date upon which the employee first suffered disability and knew, or in the exercise of reasonable diligence should have known, that the disability was caused by his present or prior employment.
“Written decision” means the following:
(1) The finding(s) and decision(s) of the Administrator to accept in full or in part, or deny in full or in part, any claim submitted by a claimant regarding a work injury; or
(2) The finding(s) and decision(s) of the Administrator to close a claim, determine whether an employee is entitled to a benefit, or determine the scope of a benefit level to which an employee may be entitled;
(3) Any finding, decision, or award reduced to written form by the Appeal Board.