Notice Of Intention To Close Claim No Evaluation {D-31c}

D-31c - NOTICE OF INTENTION TO CLOSE CLAIM OF LESS THAN $800 IN MEDICAL BENEFITS IN 12 MONTHS- NO PERMANENT PARTIAL DISABILITY EVALUATION (Pursuant to NRS 616C.235(2) and (3)). This is a formal notice issued by a workers’ compensation insurer in Nevada. This notice informs the injured worker that their workers’ compensation claim will be closed because the medical benefits paid for the claim were less than $800 in the first 12 months. The closure is in accordance with NRS 616C.235(2). In this case, the insurer has determined that there is no permanent impairment related to the injury, meaning no Permanent Partial Disability (PPD) evaluation will be conducted. This determination is based on the available medical information. The notice also outlines the appeal process for the worker if they disagree with the insurer's decision. The worker can appeal the closure of the claim under NRS 616C.305 and related statutes, but the appeal must be filed within 70 days from the date the notice was mailed. The notice explains the right to reopen the claim under NRS 616C.390. To reopen, the worker must submit a written request and provide a doctor’s report indicating that their condition has worsened since the claim closure and now requires additional medical care. Reopening is not effective prior to the request date unless good cause is shown. www.FormsWorkflow.com