Existing law establishes the Nevada Industrial Insurance Act, which provides for the payment of compensation to employees who are injured or disabled as the result of an occupational injury. (Chapters 616A-616D of NRS) Existing law requires certain insurers to maintain an office in this State that is operated by the insurer or its third-party administrator and to provide access to files relating to industrial insurance claims at that office. (NRS 616B.021, 616B.027) Section 1.5 of this bill requires the insurer to make such files available for inspection and reproduction by electronic means or at an office operated by the insurer or its third-party administrator located in this State. Section 1.5 also authorizes the insurer to keep physical records concerning a claim filed in this State at a location outside this State if those records are made available for inspection and reproduction in certain electronic forms or at offices located in this State. Section 2 of this bill permits an office operated by an insurer or its third-party administrator to keep reproductions of certain files rather than the original copies. Section 2 also removes the requirement that an insurer accept collect calls from injured employees. Existing law requires a person who acts as a third-party administrator pursuant to the Nevada Industrial Insurance Act or the Nevada Occupational Diseases Act to administer claims arising under each plan of insurance that the person administers from one or more offices located in this State and maintain in those offices all of the records concerning those claims. (NRS 616B.503) Section 2.3 of this bill removes that requirement. Instead, section 1 of this bill establishes certain authorizations and requirements concerning the administration of claims arising under the Nevada Industrial Insurance Act or the Nevada Occupational Diseases Act. Section 1: (1) authorizes an employee of a private carrier who is licensed as a company adjuster or a third-party administrator for a private carrier to administer such claims from a location in or outside this State; and (2) requires records concerning such claims to be maintained at offices located in this State or in certain electronic forms. Section 1 also: (1) authorizes an employee of a private carrier who is not licensed as a company adjuster or a third-party administrator for a self-insured employer or an association of self-insured public or private employers to administer such claims only from one or more offices located in this State; and (2) requires records concerning such claims to be maintained at those offices. Section 2 requires an employee of a private carrier or a third-party administrator who administers a claim from a location outside of this State to make himself or herself available to communicate in real time with a claimant or a representative of a claimant at certain times. Existing law requires the Commissioner to take certain disciplinary action against a third-party administrator for certain violations. (NRS 616B.506) Section 2.7 of this bill requires the Commissioner to also take such disciplinary action against a third-party administrator who violates the provisions of section 1. Existing law requires an insurer to keep a list of physicians and chiropractic physicians from which an injured employee may choose to receive treatment and include in that list a certain number of physicians or chiropractic physicians from a panel established and maintained by the Administrator of the Division of Industrial Relations of the Department of Business and Industry. Existing law also sets forth procedures and limitations governing the removal of a physician or chiropractic physician from an insurer's list. (NRS 616C.087, 616C.090) Section 4 of this bill expands the circumstances under which a physician or chiropractic physician may be involuntarily removed from an insurer's list and requires the Administrator to adopt regulations prescribing the format of the list which insurers must maintain. Section 5 of this bill revises the reasons for which the Administrator may remove a physician or chiropractic physician from a panel and authorizes certain persons to notify the Administrator if the person believes a physician or chiropractic physician satisfies certain criteria for removal from a panel. Section 5 also authorizes a physician or chiropractic physician who is removed from a panel to reapply under certain circumstances for inclusion on the panel. Existing law provides that an employee who is injured by an accident arising out of and in the course of employment is entitled to receive compensation under the Nevada Industrial Insurance Act for a permanent partial disability which is rated during an evaluation by certain physicians or chiropractic physicians. (NRS 616C.490) Section 7 of this bill revises the methodology by which those physicians or chiropractic physicians are selected to perform such an evaluation and authorizes such a physician or chiropractic physician to decline to perform an evaluation if the physician or chiropractic physician believes he or she is not qualified to rate the disability at issue. Sections 3 and 7 of this bill require the Administrator to prepare annual and quarterly reports containing certain information about those physicians and chiropractic physicians and the frequency with which they perform such evaluations and certain other examinations. Existing law authorizes an injured employee, subject to various requirements and restrictions, to obtain an independent medical examination concerning an injury that is the subject of a claim filed pursuant to the Nevada Industrial Insurance Act. (NRS 616C.145) Section 6 of this bill provides that such an injured employee is entitled to request such an independent examination for a permanent partial disability to determine if the employee has a ratable impairment or to dispute the initial rating determination of the employee's injury. Section 6 also identifies the method by which the rate of reimbursement relating to certain independent medical examinations must be determined and authorizes an insurer to recover the cost of a second examination to determine a rating of a permanent partial disability under certain circumstances. Existing law authorizes an injured employee who disagrees with the percentage of disability determined by a physician or chiropractic physician to obtain a second determination of the percentage of disability by selecting the next physician or chiropractic physician in rotation from the list of qualified physicians and chiropractic physicians maintained by the Administrator. (NRS 616C.100) Section 5.5 of this bill requires the physician or chiropractic physician to be selected at random from that list. Existing law authorizes certain persons to request a hearing before a hearing officer of matters relating to the Nevada Industrial Insurance Act or the Nevada Occupational Diseases Act. (NRS 616C.315) If necessary to resolve a medical question concerning the rating of an employee's permanent disability, existing law authorizes a hearing officer to refer the employee for examination by a rating physician or chiropractic physician who, with certain exceptions, must be selected in rotation from the list of physicians and chiropractic physicians maintained by the Administrator. (NRS 616C.330, 616C.360) Sections 6.8 and 6.9 of this bill instead require the physician or chiropractic physician to be selected at random from the list. Existing law provides that a claimant under the Nevada Industrial Insurance Act may elect to receive payment for a permanent partial disability in a lump sum under certain circumstances. (NRS 616C.495) Section 8 of this bill requires an insurer to use the actuarial annuity tables adopted by the Division that are in effect on the date on which the claimant demands payment in a lump sum to calculate the present value of the lump sum payable. Existing law authorizes the Administrator to order an insurer or certain other persons to pay to a claimant a benefit penalty if the Administrator determines the insurer or other person has refused to process a claim for compensation pursuant to the Nevada Industrial Insurance Act or committed certain other violations. (NRS 616D.120) Existing law authorizes a person to contest a decision of the Administrator to impose or refuse to impose a benefit penalty by filing a notice of appeal with an appeals officer. (NRS 616D.140) Section 9 of this bill revises certain procedural requirements relating to such an appeal and authorizes a claimant on whose behalf a benefit penalty is imposed to bring a civil action to recover the amount of the benefit penalty. Existing law authorizes an insurer or employer who pays an annual increase in compensation for permanent total disability to a claimant or dependent who is entitled to such compensation due to certain industrial injuries or disablements to obtain reimbursement from the Administrator and sets forth the procedure for obtaining such a reimbursement. (NRS 616C.266) Similarly, existing law entitles an insurer who pays an increase in certain death benefits to a widow, widower, surviving child or surviving dependent parent to be reimbursed annually for the amount of that increase and sets forth procedures for obtaining reimbursement. (NRS 616C.268) Sections 6.3 and 6.7 of this bill revise the procedures governing the issuance of such reimbursement to an insurer and impose various requirements on the Administrator with respect to such reimbursement.

Statutes affected:
As Introduced: 616B.021, 616B.027, 616C.087, 616C.090, 616C.145, 616C.490, 616C.495, 616D.140
Reprint 1: 616B.021, 616B.027, 616C.050, 616C.087, 616C.090, 616C.145, 616C.266, 616C.268, 616C.490, 616C.495, 616D.140, 616B.371
Reprint 2: 616B.021, 616B.027, 616B.503, 616B.506, 616C.050, 616C.087, 616C.090, 616C.100, 616C.145, 616C.266, 616C.268, 616C.330, 616C.360, 616C.490, 616C.495, 616D.140
BDR: 616B.021, 616B.027, 616C.087, 616C.090, 616C.145, 616C.490, 616C.495, 616D.140