Nev. Admin. Code § 617.Sec. 33

Current through November 8, 2024

Section 617.Sec. 33 - NEW

For the purposes of this section, subsection 11 of NRS 617.455 and subsection 16 of NRS 617.457:

1. In calculating the number of days from the date on which an appeal of a determination regarding the denial of a claim is made until the date on which the claimant ultimately prevails, all of the following periods of time must be excluded:

(a) The day on which the determination was made; and

(b) If an appeal is pending before a hearing officer, appeals officer, district court judge or any other appellate proceeding:

(1) If the claimant or his or her representative requests a continuance of any hearing and the request is granted, from the date on which the request was filed or requested to the date of the next scheduled hearing.

(2) If the claimant or his or her representative agrees to a continuance of any hearing and the continuance is granted, from the earliest of:

(I) The date on the electronic mail or the initial communication which requests a continuance of the hearing; or

(II) The earliest date of a signature on the stipulation for the continuance of the hearing, to the date of the next scheduled hearing.

2. The amount of the benefit penalty for each day which is not excluded pursuant to subsection 1 must be imposed as follows:

(a) There must be no benefit penalty imposed if:

(1) An appeal is ordered to be remanded to the insurer for a new determination; or

(2) The insurer denies the claim pending medical investigation and, in a timely manner, conducts such an investigation, which results in the insurer issuing a determination of claim acceptance.

(b) A benefit penalty of $200 may be imposed for each day from the date on which an appeal is filed until the date on which the claimant ultimately prevails.

3. As used in this section, the term "ultimately prevails" means that the matter was litigated to conclusion and the final outcome was determined by a hearing officer, appeals officer, district court judge or appellate court judge.

Nev. Admin. Code § 617.Sec. 33

Added to NAC by Div. of Industrial Relations by R134-20A, eff. 9/20/2022; Added to NAC by Div. of Industrial Relations by R134-20A, eff. 9/20/2022

NRS 616A.400, 617.455 and 617.457