Current through February 27, 2024
For the purposes of this section, subsection 11 of NRS 617.455 and subsection 16 of NRS 617.457:
1.
In calculating the number of days from the date on which an appeal of a
determination regarding the denial of a claim is made until the date on which
the claimant ultimately prevails, all of the following periods of time must be
excluded:
(a) The day on which the
determination was made; and
(b) If
an appeal is pending before a hearing officer, appeals officer, district court
judge or any other appellate proceeding:
(1)
If the claimant or his or her representative requests a continuance of any
hearing and the request is granted, from the date on which the request was
filed or requested to the date of the next scheduled hearing.
(2) If the claimant or his or her
representative agrees to a continuance of any hearing and the continuance is
granted, from the earliest of:
(I) The date on
the electronic mail or the initial communication which requests a continuance
of the hearing; or
(II) The
earliest date of a signature on the stipulation for the continuance of the
hearing, to the date of the next scheduled hearing.
2. The amount of the
benefit penalty for each day which is not excluded pursuant to subsection 1
must be imposed as follows:
(a) There must be
no benefit penalty imposed if:
(1) An appeal
is ordered to be remanded to the insurer for a new determination; or
(2) The insurer denies the claim pending
medical investigation and, in a timely manner, conducts such an investigation,
which results in the insurer issuing a determination of claim
acceptance.
(b) A
benefit penalty of $200 may be imposed for each day from the date on which an
appeal is filed until the date on which the claimant ultimately
prevails.
3. As used in
this section, the term "ultimately prevails" means that the matter was
litigated to conclusion and the final outcome was determined by a hearing
officer, appeals officer, district court judge or appellate court
judge.
Added
to NAC by Div. of Industrial Relations by
R134-20A,
eff. 9/20/2022; Added
to NAC by Div. of Industrial Relations by
R134-20A,
eff. 9/20/2022
NRS 616A.400, 617.455 and
617.457
