D.C. Mun. Regs. r. 7-153
A claimant wh o believes that the Program has incorrectly calculated his or her medical compensation, wage-loss compensation, or death benefit may request an audit of the Program's calculation by completing Form A- 1 and submitting it to the Chief Risk Officer, provided that the claimant's medical compensation,wage-loss compensation or death benefits were not terminated more than three (3) years before the date of the Form A- 1 submission.
The Chief Risk Officer shall affirm the Program's calculations, if it is supported by substantial evidence in the record. Otherwise, at the discretion of the Chief Risk Officer, the Program's decision may be modified, revised or remanded to the Program with instructions.
The Chief Risk Officer shall notify the claimant in writing of his or her decision on the audit request within thirty (30) days of the Program's receipt of the request, unless the Chief Risk Officer provides notice in writing that extenuating circumstances preclude him or her from making a decision within this period.
If no decision or notice of extenuating circumstances is issued within thirty (30) days, the calculation which forms the basis of the claimant's request for an audit shall be deemed the final decision of the agency in response to the claimant's request and the claimant may seek review of the calculations before the Superior Court of the District of Columbia on timely petition for review by the claimant.
Any retroactive benefits due to the claimant as result of a request made under this chapter are subject to the limitations of D.C. Official Code § 12 -301(8).
D.C. Mun. Regs. r. 7-153