Nev. Rev. Stat. § 616C.145

Current through 82nd (2023) Legislative Session Chapter 535 and 34th (2023) Special Session Chapter 1 and 35th (2023) Special Session Chapter 1
Section 616C.145 - Independent medical examination of claimant; limitations; payment by insurer; rates of reimbursement; recovery of cost by insurer; applicability
1. An injured employee may obtain an independent medical examination:
(a) Except as otherwise provided in subsections 2 and 3, whenever a dispute arises from a determination issued by the insurer regarding the approval of care, the direction of a treatment plan or the scope of the claim;
(b) Within 30 days after an injured employee receives any report generated pursuant to a medical examination requested by the insurer pursuant to NRS 616C.140; or
(c) At any time by leave of a hearing officer or appeals officer after the denial of any therapy or treatment.
2. An injured employee is entitled to an independent medical examination pursuant to paragraph (a) of subsection 1 only:
(a) For a claim for compensation that is open;
(b) When the closure of a claim for compensation is under dispute pursuant to NRS 616C.235; or
(c) When a hearing or appeal is pending pursuant to NRS 616C.330 or 616C.360.
3. An injured employee is entitled to only one independent medical examination per calendar year pursuant to paragraph (a) of subsection 1.
4. Except as otherwise provided in subsection 5, an independent medical examination must not involve treatment and must be conducted by a physician or chiropractic physician selected by the injured employee from the panel of physicians and chiropractic physicians established pursuant to subsection 1 of NRS 616C.090.
5. An injured employee is entitled to request an independent medical examination pursuant to paragraph (a) of subsection 1 for a permanent partial disability to determine if the injured employee has a ratable impairment or, if the injured employee is seeking to dispute an initial rating determination, to obtain a second rating. The injured employee must select the rating physician or chiropractic physician at random from the list of qualified physicians and chiropractic physicians maintained by the Administrator pursuant to subsection 2 of NRS 616C.490, unless the insurer and the injured employee otherwise agree to a rating physician or chiropractic physician. Nothing in this subsection shall be construed to prohibit an injured employee from obtaining a determination for a permanent partial disability pursuant to NRS 616C.100.
6. The insurer shall:
(a) Pay the costs of any independent medical examination conducted pursuant to this section in accordance with subsection 7; and
(b) Upon request, receive a copy of any report or other document that is generated as a result of the independent medical examination.
7. The rates of reimbursement for an independent medical examination conducted pursuant to this section must be:
(a) For an independent medical examination other than an independent medical examination conducted pursuant to subsection 5, the rates applicable to independent medical examinations, as set forth in the schedule of fees established by the Administrator pursuant to NRS 616C.260.
(b) For an independent medical examination conducted pursuant to subsection 5, the rates applicable to a permanent partial disability, as set forth in the schedule of fees established by the Administrator pursuant to NRS 616C.260.
8. If an injured employee requests an independent medical examination pursuant to subsection 5 to obtain a second rating and the second rating does not result in a higher percentage of disability than the initial rating determination, the insurer may recover the cost of the independent medical examination, determined in accordance with the rates of reimbursement specified in paragraph (b) of subsection 7, from the amount of the award for permanent partial disability that the injured employee is entitled to be paid for that claim pursuant to NRS 616C.490.
9. The provisions of this section do not apply to an independent medical examination ordered by a hearing officer pursuant to subsection 3 of NRS 616C.330 or by an appeals officer pursuant to subsection 3 of NRS 616C.360.

NRS 616C.145

Added to NRS by 2017, 1160; A 2023, 3623
Amended by 2023, Ch. 535,§12, eff. 1/1/2024.
Added to NRS by 2017, Ch. 216, § 3