R20-5-117. Effective Date of Notices of Claim Status and Other Determinations; Attachments to Notices of Claim Status; Form of Notices of Claim Status

A. If a notice of claim status accepting a claim for benefits is final, any subsequent notice of claim status that changes a claimant’s amount of, or entitlement to, compensation or medical, surgical, or hospital benefits shall not have a retroactive effect for more than 30 days from the date a carrier or self-insured employer issues the subsequent notice of claim status. This subsection does not apply to a subsequent notice that affects the entitlement to or amount of death benefits. The Commission may for good cause relieve a carrier or self-insured employer of the effect of this subsection. B. If a notice of claim status or other determination issued by a carrier, self-insured employer, or special fund division, is based upon a physician’s report: 1. The carrier, self-insured employer, or special fund division shall attach a copy of the physician’s complete report to the notice of claim status or other determination sent to the Commission; and 2. The carrier, self-insured employer, or special fund division shall attach a copy of the physician’s complete report to the notice of claim status or other determination served on a party, except as provided in R20-5-113(C). C. If a carrier, self-insured employer, or special fund division pays compensation to a claimant: 1. The carrier or self-insured employer shall close the claim by issuing a notice of claim status; and 2. The special fund division shall close the claim by issuing a notice of determination. D. The inadvertent failure of a carrier, self-insured employer, or special fund division to comply with subsection (B) shall not affect the validity of a notice or determination if the carrier, self-insured employer, or special fund division issuing the notice or determination had in its possession at the time the notice or determination is issued a medical report consistent with the notice or determination. TITLE 20. COMMERCE, FINANCIAL INSTITUTIONS, AND INSURANCE