Code of Massachusetts Regulations
452 CMR - DEPARTMENT OF INDUSTRIAL ACCIDENTS
Title 452 CMR 1.00 - Adjudicatory Rules of the Industrial Accident Board
Section 1.09 - Assignment to Division of Dispute Resolution

Universal Citation: 452 MA Code of Regs 452.1

Current through Register 1531, September 27, 2024

(1) An insurer who is aggrieved by the assessment of a referral fee of 130% of the average weekly wage in the Commonwealth pursuant to M.G.L. c. 152 § 10(5) may seek an administrative review by the conciliation manager within 30 days of the issuance of the bill and shall include any relevant documentation with such request.

(a) A conciliator's assertion that an insurer was absent for a scheduled conciliation shall be final, and the review shall be limited to the issues of whether the higher assessment was a mistake and, if not a mistake, whether the absence of the insurer was beyond such insurer's control. Said manager shall make a finding within 30 days of receipt of a documented request for review.

(b) An insurer who is aggrieved by the finding of said manager shall have 14 days from receipt of said finding to request a hearing before the Director or the Director's designee, who shall schedule such hearing in Boston within 30 days of receipt of such request. The issues at such hearing shall be limited to those that may be considered in the administrative review. The hearing shall not be subject to rules of evidence.

(c) No insurer shall be granted more than one administrative review for any referral of a case to the Division of Dispute Resolution.

(d) An insurer's obligation to pay a referral fee shall not delay the forwarding of the claim and the case to the Industrial Accident Board.

(2) At any time after the case has been assigned to the Industrial Accident Board, any party may petition the Director for a stay of the proceedings for documented reasons beyond the control of such party or his or her attorney. On any such request, the Director may grant a stay for no more than 60 calendar days. A list of all stays shall be compiled quarterly and shall be submitted to the advisory council.

(3) At any proceeding within the Division of Dispute Resolution, the burden of going forward shall be on the party seeking benefits or on the insurer seeking modification or discontinuance of benefits.

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