616C.345 - Notice of appeal; notice of contested claim; prerequisites to scheduling of hearing on appeal; effect of appeal on enforcement of decision of hearing officer; setting of date, time and plac
616C.345 Notice of appeal; notice of contested claim; prerequisites to scheduling of hearing on appeal; effect of appeal on enforcement of decision of hearing officer; setting of date, time and place for hearing on appeal; continuances.
1. Any party aggrieved by a decision of the hearing officer relating to a claim for compensation may appeal from the decision by, except as otherwise provided in subsections 9 and 10, filing a notice of appeal with an appeals officer within 30 days after the date of the decision.
2. A claimant aggrieved by a written determination of the denial of a claim, in whole or in part, by an insurer, or the failure of an insurer to respond in writing within 30 days to a written request of the claimant mailed to the insurer, concerning a claim arising from the provisions of NRS 617.453, 617.455, 617.457, 617.485 or 617.487 may file a notice of a contested claim with an appeals officer. The notice must include the information required pursuant to subsection 3 and, except as otherwise provided in subsections 9 and 11, must be filed within 70 days after the date on which the notice of the insurer’s determination was mailed by the insurer or the unanswered written request was mailed to the insurer, as applicable. The failure of an insurer to respond in writing to a written request for a determination within 30 days after receipt of such a request shall be deemed by the appeals officer to be a denial of the request. The insurer shall provide, without cost, the forms necessary to file a notice of a contested claim to any person who requests them.
3. A hearing must not be scheduled until the following information is provided to the appeals officer:
(a) The name of:
(1) The claimant;
(2) The employer; and
(3) The insurer or third-party administrator;
(b) The number of the claim; and
(c) If applicable, a copy of the letter of determination being appealed or, if such a copy is unavailable, the date of the determination and the issues stated in the determination.
4. If a dispute is required to be submitted to a procedure for resolving complaints pursuant to NRS 616C.305 and:
(a) A final determination was rendered pursuant to that procedure; or
(b) The dispute was not resolved pursuant to that procedure within 14 days after it was submitted,
Ê any party to the dispute may, except as otherwise provided in subsections 9 and 10, file a notice of appeal within 70 days after the date on which the final determination was mailed to the employee, or the dependent of the employee, or the unanswered request for resolution was submitted. Failure to render a written determination within 30 days after receipt of such a request shall be deemed by the appeals officer to be a denial of the request.
5. Except as otherwise provided in NRS 616C.380, the filing of a notice of appeal does not automatically stay the enforcement of the decision of a hearing officer or a determination rendered pursuant to NRS 616C.305. The appeals officer may order a stay, when appropriate, upon the application of a party. If such an application is submitted, the decision is automatically stayed until a determination is made concerning the application. A determination on the application must be made within 30 days after the filing of the application. If a stay is not granted by the officer after reviewing the application, the decision must be complied with within 10 days after the date of the refusal to grant a stay.
6. Except as otherwise provided in subsections 3 and 7, within 10 days after receiving a notice of appeal pursuant to this section or NRS 616C.220, 616D.140 or 617.401, or within 10 days after receiving a notice of a contested claim pursuant to subsection 7 of NRS 616C.315, the appeals officer shall:
(a) Schedule a hearing on the merits of the appeal or contested claim for a date and time within 90 days after receipt of the notice at a place in Carson City, Nevada, or Las Vegas, Nevada, or upon agreement of one or more of the parties to pay all additional costs directly related to an alternative location, at any other place of convenience to the parties, at the discretion of the appeals officer; and
(b) Give notice by mail or by personal service to all parties to the matter and their attorneys or agents at least 30 days before the date and time scheduled.
7. Except as otherwise provided in subsection 12, a request to schedule the hearing for a date and time which is:
(a) Within 60 days after the receipt of the notice of appeal or contested claim; or
(b) More than 90 days after the receipt of the notice or claim,
Ê may be submitted to the appeals officer only if all parties to the appeal or contested claim agree to the request.
8. An appeal or contested claim may be continued upon written stipulation of all parties, or upon good cause shown.
9. The period specified in subsection 1, 2 or 4 within which a notice of appeal or a notice of a contested claim must be filed may be extended for an additional 90 days if the person aggrieved shows by a preponderance of the evidence that the person was diagnosed with a terminal illness or was informed of the death or diagnosis of a terminal illness of the person’s spouse, parent or child.
10. Failure to file a notice of appeal within the period specified in subsection 1 or 4 may be excused if the party aggrieved shows by a preponderance of the evidence that he or she did not receive the notice of the determination and the forms necessary to appeal the determination. The claimant, employer or insurer shall notify the hearing officer of a change of address.
11. Failure to file a notice of a contested claim within the period specified in subsection 2 may be excused if the claimant shows by a preponderance of the evidence that he or she did not receive the notice of the determination and the forms necessary to file the notice. The claimant or employer shall notify the insurer of a change of address.
12. Within 10 days after receiving a notice of a contested claim pursuant to subsection 2, the appeals officer shall:
(a) Schedule a hearing on the merits of the contested claim for a date and time within 60 days after his or her receipt of the notice at a place in Carson City, Nevada, or Las Vegas, Nevada, or upon agreement of one or more of the parties to pay all additional costs directly related to an alternative location, at any other place of convenience to the parties, at the discretion of the appeals officer; and
(b) Give notice by mail or by personal service to all parties to the matter and their attorneys or agents within 10 days after scheduling the hearing.
Ê The scheduled date must allow sufficient time for full disclosure, exchange and examination of medical and other relevant information. A party may not introduce information at the hearing which was not previously disclosed to the other parties unless all parties agree to the introduction.
(Added to NRS by 1979, 1040; A 1981, 1198; 1983, 358; 1985, 50, 669; 1991, 2418; 1993, 739, 2441; 1995, 2151; 1997, 3235; 1999, 2218; 2003, 1672, 2308, 2335, 2810; 2007, 3354; 2009, 1284)