Current through 81st (2021) Legislative Session Chapters 1-557 and 33rd (2021) Legislative Special Session Chapters 1 and 2
Section 616C.390 - Reopening claim: General requirements and procedure; limitations; applicability
Except as otherwise provided in NRS 616C.392:1. If an application to reopen a claim to increase or rearrange compensation is made in writing more than 1 year after the date on which the claim was closed, the insurer shall reopen the claim if: (a) A change of circumstances warrants an increase or rearrangement of compensation during the life of the claimant;(b) The primary cause of the change of circumstances is the injury for which the claim was originally made; and(c) The application is accompanied by the certificate of a physician or a chiropractor showing a change of circumstances which would warrant an increase or rearrangement of compensation.2. After a claim has been closed, the insurer, upon receiving an application and for good cause shown, may authorize the reopening of the claim for medical investigation only. The application must be accompanied by a written request for treatment from the physician or chiropractor treating the claimant, certifying that the treatment is indicated by a change in circumstances and is related to the industrial injury sustained by the claimant.3. If a claimant applies for a claim to be reopened pursuant to subsection 1 or 2 and a final determination denying the reopening is issued, the claimant shall not reapply to reopen the claim until at least 1 year after the date on which the final determination is issued.4. Except as otherwise provided in subsection 5, if an application to reopen a claim is made in writing within 1 year after the date on which the claim was closed, the insurer shall reopen the claim only if:(a) The application is supported by medical evidence demonstrating an objective change in the medical condition of the claimant; and(b) There is clear and convincing evidence that the primary cause of the change of circumstances is the injury for which the claim was originally made.5. An application to reopen a claim must be made in writing within 1 year after the date on which the claim was closed if: (a) The claimant did not meet the minimum duration of incapacity as set forth in NRS 616C.400 as a result of the injury; and(b) The claimant did not receive benefits for a permanent partial disability.
If an application to reopen a claim to increase or rearrange compensation is made pursuant to this subsection, the insurer shall reopen the claim if the requirements set forth in paragraphs (a), (b) and (c) of subsection 1 are met.6. If an employee's claim is reopened pursuant to this section, the employee is not entitled to vocational rehabilitation services or benefits for a temporary total disability if, before the claim was reopened, the employee:(b) Otherwise voluntarily removed himself or herself from the workforce, for reasons unrelated to the injury for which the claim was originally made.7. One year after the date on which the claim was closed, an insurer may dispose of the file of a claim authorized to be reopened pursuant to subsection 5, unless an application to reopen the claim has been filed pursuant to that subsection.8. An increase or rearrangement of compensation is not effective before an application for reopening a claim is made unless good cause is shown. The insurer shall, upon good cause shown, allow the cost of emergency treatment the necessity for which has been certified by a physician or a chiropractor.9. A claim that closes pursuant to subsection 2 of NRS 616C.235 and is not appealed or is unsuccessfully appealed pursuant to the provisions of NRS 616C.305 and 616C.315 to 616C.385, inclusive, may not be reopened pursuant to this section.10. The provisions of this section apply to any claim for which an application to reopen the claim or to increase or rearrange compensation is made pursuant to this section, regardless of the date of the injury or accident to the claimant. If a claim is reopened pursuant to this section, the amount of any compensation or benefits provided must be determined in accordance with the provisions of NRS 616C.425.11. As used in this section: (a) "Governmental program" means any program or plan under which a person receives payments from a public form of retirement. Such payments from a public form of retirement include, without limitation:(1) Social security received as a result of the Social Security Act, as defined in NRS 287.120;(2) Payments from the Public Employees' Retirement System, as established by NRS 286.110;(3) Payments from the Retirees' Fund, as defined in NRS 287.04064;(4) A disability retirement allowance, as defined in NRS 1A.040 and 286.031;(5) A retirement allowance, as defined in NRS 218C.080; and(6) A service retirement allowance, as defined in NRS 1A.080 and 286.080.(b) "Retired" means a person who, on the date he or she filed for reopening a claim pursuant to this section: (1) Is not employed or earning wages; and(2) Receives benefits or payments for retirement from a:(I) Pension or retirement plan;(II) Governmental program; or(III) Plan authorized by 26 U.S.C. § 401(a), 401(k), 403(b), 457 or 3121.(c) "Wages" means any remuneration paid by an employer to an employee for the personal services of the employee, including, without limitation: (1) Commissions and bonuses; and(2) Remuneration payable in any medium other than cash.[56:168:1947; 1943 NCL § 2680.56] + [57:168:1947; 1943 NCL § 2680.57] - (NRS A 1971, 770 [Ch. 392]; 1981, 1198 [Ch. 560], 1831 [Ch. 735]; 1983, 285 [Ch. 108], 1294 [Ch. 483]; 1985, 1547 [Ch. 500]; 1993, 741 [Ch. 265], 2441 [Ch. 587]; 1995, 2152[Ch. 587]; 1999, 1787 [Ch. 388]; 2005, 1491 [Ch. 386]; 2015, 1140 [Ch. 240]; 2017, 1163 [Ch. 216] )Amended by 2015, Ch. 240,§2, eff. 1/1/2016.[56:168:1947; 1943 NCL § 2680.56 ] + [57:168:1947; 1943 NCL § 2680.57 ] - (NRS A 1971, 770; 1981, 1198, 1831; 1983, 285, 1294; 1985, 1547; 1993, 741, 2441; 1995, 2152; 1999, 1787; 2005, 1491)