Current through December 31, 2024
1. For purposes of
determining whether an injured employee is stable and ratable and entitled to
an evaluation to determine the extent of any permanent impairment pursuant to
this section and NRS
616C.490, the Division interprets the term:
(a) "Stable" to include, without limitation,
a written indication from a physician or chiropractic physician that the
industrial injury or occupational disease of the injured employee:
(1) Is stationary, permanent or static;
or
(2) Has reached maximum medical
improvement.
(b)
"Ratable" to include, without limitation, a written indication from a physician
or chiropractic physician that the medical condition of the injured employee
may have:
(1) Resulted in a loss of motion,
sensation or strength in a body part of the injured employee;
(2) Resulted in a loss of or abnormality to a
physiological or anatomical structure or bodily function of the injured
employee; or
(3) Resulted in a
mental or behavioral disorder as the result of a claim that has been accepted
pursuant to NRS
616C.180.
2. If an insurer proposes that an injured
employee agree to a rating physician or chiropractic physician chosen by the
insurer, the insurer shall inform the injured employee in writing that the
injured employee:
(a) Is not required to agree
with the selection of that physician or chiropractic physician; and
(b) May request that the rating physician or
chiropractic physician be selected in accordance with subsection 3 and
NRS
616C.490, as amended by section 17 of Senate
Bill No. 274, chapter 535, Statutes of Nevada 2023, at page 3630.
3. An insurer shall comply with
subsection 2 of NRS
616C.490, as amended by section 17 of Senate
Bill No. 274, chapter 535, Statutes of Nevada 2023, at page 3630, within the
time prescribed in that subsection for the scheduling of an appointment, by:
(a) Selecting a rating physician or
chiropractic physician in accordance with the procedures for the random
selection of a rating physician or chiropractic physician set forth in section
7 and requesting that the selected rating physician or chiropractic physician
evaluate the injured employee and determine the extent of any permanent
impairment or, if the injured employee and insurer have agreed to a rating
physician or chiropractic physician pursuant to subsection 2 of
NRS
616C.490, as amended by section 17 of Senate
Bill No. 274, chapter 535, Statutes of Nevada 2023, at page 3630, by submitting
a completed form designated in NAC
616A.480 as D-35, Request for
Assignment of Rating Physician or Chiropractic Physician, which identifies the
rating physician or chiropractic physician to the Administrator within 30 days
after the insurer has received the statement from a physician or chiropractic
physician that the injured employee is ratable and stable; and
(b) Mailing written notice to the injured
employee of the date, time and place of the appointment for the rating
evaluation.
4. At least
3 working days before a rating evaluation, the party that requested the rating
evaluation must provide to the assigned rating physician or chiropractic
physician:
(a) All reports or other written
information concerning the injured employee's claim produced by a physician,
chiropractic physician, hospital or other provider of health care, including
the statement from the treating physician or chiropractic physician that the
injured employee is stable and ratable, surgical reports, diagnostic,
laboratory and radiography reports and information concerning any preexisting
condition relating to the injured employee's claim;
(b) Any evidence or documentation of any
previous evaluations performed to determine the extent of any of the injured
employee's disabilities and any previous injury, disease or condition of the
injured employee that is relevant to the evaluation being performed;
(c) The form designated in NAC
616A.480 as C-4, Employee's
Claim for Compensation/Report of Initial Treatment;
(d) The form designated in NAC
616A.480 as D-35, Request for
Assignment of Rating Physician or Chiropractic Physician; and
(e) The form designated in NAC
616A.480 as D-36, Request for
Additional Medical Information and Medical Release.
5. An insurer shall pay for the cost of
travel for an injured employee to attend a rating evaluation as required by NAC
616C.105.
6. Except as otherwise provided in subsection
7, if the rating physician or chiropractic physician finds that the injured
employee has a ratable impairment, the insurer shall, within the time
prescribed by NRS
616C.490, offer the injured employee the
award to which he or she is entitled. The insurer shall make payment to the
injured employee:
(b) If there is any child
support obligation affecting the injured employee, within 35 days, after the
later of the date on which the insurer offers the award or the date on which it
receives the properly executed lump-sum award papers from the injured employee
or his or her representative.
7. If the insurer disagrees in good faith
with the result of the rating evaluation, the insurer shall, within the time
prescribed in NRS
616C.490:
(a) Offer and pay the injured employee the
portion of the award, in installments, which it does not dispute;
(b) Provide the injured employee with a copy
of each rating evaluation performed of the injured employee; and
(c) Notify the injured employee of the
specific reasons for the disagreement and the right of the injured employee to
appeal. The notice must also set forth a detailed proposal for resolving the
dispute that can be executed in 75 days, unless the insurer demonstrates good
cause for why the proposed resolution will require more than 75 days.
8. The injured employee must
receive a copy of the results of each rating evaluation performed of the
injured employee before accepting an award for a permanent partial
disability.
9. As used in this
section, "lump-sum award papers" means the following forms designated in NAC
616A.480, as appropriate:
(a) D-10a, Election of Lump Sum Payment of
Compensation.
(b) D-10b, Election
of Lump Sum Payment of Compensation for Disability Greater than 30
Percent.
(c) D-11,
Reaffirmation/Retraction of Lump Sum Request.
Added to NAC
by Div. of Industrial Insurance Regulation, eff. 10-26-83; A 2-22-88; 9-7-88;
8-30-91; A by Div. of Industrial Relations by R009-97, 10-27-97; R006-97,
12-9-97; R090-99, 10-28-99; R090-99, 10-28-99, eff. 1-1-2000; R105-00,
1-18-2001, eff. 3-1-2001; R118-02, 9-7-2005; R108-09, 6-30-2010; A by
R134-20A,
eff. 9/20/2022;
Added to NAC by Div. of Industrial Relations by
R134-20RA,
eff. 12/19/2022; A
by
R032-21A,
eff. 8/1/2023; A by
R076-23A,
eff. 10/9/2024
NRS 616A.400,
616C.490, as amended by section
17 of Senate Bill No. 274, chapter 535, Statutes of Nevada 2023, at page
3630
