SUMMARY
This chapter discusses requirements for closing a workers’ compensation claim as well reconsideration of a closed claim and claim-closure litigation. PDF Download - After purchase go to My Content to retrieve your digital file(s).
DESCRIPTION
Chapter 18
CLAIM CLOSURE
Melissa D. Douglas
Bin Chen
§ 18.1 CLAIM CLOSURE GENERALLY
§ 18.1-1 Applicable Statutes and Rules
§ 18.1-2 History
§ 18.1-3 Prerequisites for Closure
§ 18.1-3(a) Generally
§ 18.1-3(b) Substantive and Procedural Requirements
§ 18.1-3(c) Determining when an Injured Worker Is Medically Stationary
§ 18.1-3(d) When an Injured Worker Is Not Medically Stationary
§ 18.1-3(d)(1) Injury Is No Longer the Major Contributing Cause
§ 18.1-3(d)(2) Effect of Failure to Seek Medical Treatment or Failure to Attend Closing Examination
§ 18.1-3(e) Effect of Reexamination of Permanent Total Disability Award
§ 18.1-3(f) Effect of Being Enrolled and Actively Engaged in Training
§ 18.2 AWARD OF BENEFITS FOR TEMPORARY DISABILITY
§ 18.3 ACTUAL CLOSURE OF THE CLAIM
§ 18.3-1 Nondisabling Claim
§ 18.3-2 Fatality Claim
§ 18.3-3 When an Injured Worker Dies before Issuance of Notice of Closure
§ 18.3-4 Disabling Claim
§ 18.3-5 Worker Request to Close the Claim
§ 18.3-6 Required Elements of the Notice of Closure
§ 18.3-7 Required Documentation to Accompany Notice of Closure
§ 18.3-8 Adjustments and Offsets at Time of Closure
§ 18.3-8(a) Adjustments
§ 18.3-8(b) Offsets
§ 18.3-9 Correcting or Rescinding the Notice of Closure
§ 18.3-9(a) Requirements for Correcting the Notice of Closure
§ 18.3-9(b) Requirements for Rescinding the Notice of Closure
§ 18.4 PAYMENT OF BENEFITS AWARDED BY NOTICE OF CLOSURE
§ 18.4-1 Temporary Disability
§ 18.4-2 Permanent Disability
§ 18.4-3 Stay of Benefits when Denied Claim Is on Appeal
§ 18.5 RECONSIDERATION PROCESS
§ 18.5-1 When?
§ 18.5-2 Why?
§ 18.5-3 How?
§ 18.5-3(a) Format
§ 18.5-3(b) Procedure
§ 18.5-3(c) Medical Arbiter’s Examination Process
§ 18.5-3(d) Reconsideration Record
§ 18.5-4 Penalty within the Reconsideration Proceeding
§ 18.5-5 Attorney Fee in the Reconsideration Proceeding
§ 18.6 CLAIM-CLOSURE LITIGATION
§ 18.6-1 Issues and Evidentiary Record
§ 18.6-2 Premature-Closure Issues
§ 18.6-3 Substantive Time Loss Benefits and Permanent Partial Disability
§ 18.6-4 Unreasonable Claim Closure Penalty before the Board