Section 8 AAC 45.510 - Request for reemployment benefits eligibility evaluation(a) For injuries occurring on or after November 7, 2005, if the employee has been totally unable to return to the employee's employment at time of injury for at least 60 consecutive days, but less than 90 consecutive days, as a result of the injury, the employee or employer may request an eligibility evaluation for reemployment benefits. The requesting party must file with the administrator and serve all other parties with(1) a written request for the evaluation;(2) a physician's prediction the injury may permanently preclude the employee from returning to the employee's job at the time of the injury; and(3) documentation the employee has been totally unable to return to the employee's employment at the time of the injury for at least 60 consecutive days, but less than 90 consecutive days, as a result of the injury.(b) The administrator shall consider a written request for an eligibility evaluation for reemployment benefits, unless the employer controverts on grounds the employee's injury did not arise out of and in the course of employment, on grounds the employee's total inability to return to the employee's employment at the time of injury is not a result of the injury, or on grounds identified under AS 23.30.022, 23.30.100, 23.30.105, or 23.30.250. If reemployment benefits have been controverted on any of these grounds, the administrator shall forward the matter to the board to conduct a prehearing conference regarding the controversion no later than 30 days after the board receives the matter. If a claim is filed and if requested by the employee, the board will conduct a hearing no later than 90 days after the prehearing conference in accordance with 8 AAC 45.060(e) and 8 AAC 45.070(b) (3), limited to the grounds set out in this subsection.(c) If the request for an eligibility evaluation is incomplete, the administrator shall, no later than five working days after receipt of the request, send a letter to the employee and the employer requesting additional medical documentation regarding the employee's total inability to return to the employee's employment at the time of the injury for at least 60 consecutive days as a result of the injury. The employer and employee shall submit additional medical documentation no later than 10 working days after the administrator's request. After the prescribed period for submitting additional medical documentation expires, the administrator shall rely on the division's record, including any documents submitted by the parties, to determine the employee's total inability to return to the employee's employment at the time of the injury for at least 60 consecutive days.(d) No later than 14 days after receiving a complete request under (a) of this section, the administrator shall send a letter to the employee and the employer stating whether the employee is entitled to an eligibility evaluation. If the employee is found entitled to an eligibility evaluation, the administrator shall include in the letter the name and address of the rehabilitation specialist selected in accordance with AS 23.30.041(c) to evaluate the employee.(e) If the rehabilitation specialist selected to complete an eligibility evaluation is performing any other work on the same workers' compensation claim involving the injured employee, or if the person that employs a selected rehabilitation specialist is performing any other work on the same workers' compensation claim involving the injured employee, the rehabilitation specialist shall notify, in writing, the administrator and the parties no later than five working days after receiving the referral letter. The administrator shall select a different rehabilitation specialist in accordance with AS 23.30.041(c) to evaluate the employee.(f) No later than 10 working days after receipt of the administrator's letter selecting a rehabilitation specialist, the employer at the time of injury or the employer's adjuster shall forward a copy of the employee's resume and job application, and a job description or summary of the employee's job duties, if available, to the rehabilitation specialist, the employee, and the administrator. The employer or employer's adjuster shall also forward a copy of the report of injury and all medical reports, compensation reports, and controversions to the rehabilitation specialist, the employee, and the administrator.(g) If a party disputes the administrator's decision rendered under this section, the party must petition the board, no later than 10 days after the filing of that decision for review of the administrator's decision.Eff. 7/2/98, Register 146; am 7/9/2011, Register 199Authority:AS 23.30.005
AS 23.30.010
AS 23.30.041