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As used in this chapter, these terms have the following meaning:

“Accident” means an event that causes or is believed to cause a work injury.

“Administrator” means the agency (which may be a department of the casino) responsible for managing the casino’s workers’ compensation program. The administrator’s responsibilities include, but are not limited to, determining the compensability of claims; making payments to injured employees, medical providers and others; managing a trust account for the purpose of dispensing the Tribe’s workers’ compensation liabilities; and reporting to the Tribe or casino regarding the program and individual claims. The administrator’s duties are more fully described in YTC 5.65.070.

“Casino” means the Redwood Casino owned and operated by the Tribe.

“Child” or “children” means a child of an employee under the age of 18, including an unborn child, a posthumous child, a child legally adopted prior to the work injury, a child toward whom the employee stands in loco parentis, an illegitimate child, and a stepchild, if such stepchild was, at the time of the work 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 as determined by the applicable Tribal law.

“Claimant” means an employee who suffers a work injury, either specific or cumulative, arising from that employment or occurring in the course and scope of that employment, and seeks compensation for that injury.

“Compensable injury” means a work injury to an employee when the injury arises while the employee is acting within the course and scope of employment and while performing the duties of employment in, on or off the premises of the casino or whenever the Tribe requires the employee to perform the employment activities as more fully described in this chapter.

“Days” means calendar days unless otherwise expressly provided.

“Dependent” means the spouse or children, or any other family member approved by the administrator, of the employee who, at the time of the work injury that causes the employee’s death, is actually and necessarily dependent in whole or in part upon the employee’s earnings.

“Disability” means the employee’s incapacity to earn wages in the same or any other employment caused by a work injury. Incapacity to earn wages includes an inability to continue in a modified or alternate position with the Tribe, and/or a diminished capacity to compete in an open market.

“Employee” means a person employed by the casino or in the service of the casino under any contract of hire, express or implied, oral or written, where the Tribe has the power or right to control and direct such individual in return for which such individual receives a salary or wages. For purposes of this chapter, employee does not include independent contractors, contractors, and outside consultants.

“Independent medical examination” means a medical examination and/or evaluation of the employee, scheduled by the casino or administrator, at the casino’s expense, for the purpose of obtaining medical information or an opinion.

“Reservation” means all lands within the exterior boundaries of the Yurok Reservation.

“Spouse” means the employee’s husband or wife.

“Tribal Council” or “Council” means the Yurok Tribal Council, the governing body of the Tribe pursuant to Article IV, Section 5 of the Constitution of the Yurok Tribe, or its duly authorized representatives.

“Tribe” means the Yurok Tribe, including any Tribal agency, subdivision, instrumentality, officer, and employee, acting at the direction of the Council.

“Work injury” or “work injuries” means any physical or psychiatric injury, illness, or disease arising out of and in the course and scope of employment with the casino. In determining proximate causation to employment, evaluation of an injury must be determined to be both arising out of and occurring within the course and scope of such employment. Work injury includes any damage to artificial members, dentures, hearing aids, eyeglasses and medical braces of any types. However, eyeglasses and hearing aids will not be replaced or repaired unless damage to them results from an injury causing disability.

“Work injuries” under this section shall be either:

(1) “Specific,” occurring as a result of one incident or exposure which causes disability or need for medical treatment; or

(2) “Cumulative,” occurring as a result of repetitive trauma extending over a period of time in the workplace, the combined effect of which causes disability or need for medical treatment. The date of a cumulative trauma injury is the date upon which the employee first knew or should have known that the present employment caused such injury.

“Written decision” means the administrator’s written determination to accept in full or in part or deny in full or in part any claims submitted by the claimant regarding the work injury. [Ord. 47 § 1010, adopted, 11/10/2016.]