Timelines Flashcards
of days insurer has to pay accepted claims disposition agreement CDA
14 Days
of days IW has to appeal a Notice of Closure
60 Days
Days insurer has to close a claim once all information has been obtained
14 Days
Timeline for attorney asking for discovery of documents
14 Days, every 30 days for 180 days
days an insurer has to reclassify a nondisabling claim to disabling
14 days
days an IW has to appeal a denial
60 days
of days an IW has to report an OD to their employer
1 year
of days an IW has to report an injury to their employer
90 days or 1 year with good cause
of days insurer has to send the cover letter to the IME physician
7 days
Timeframe for an IME with multiple exams to count as 1 visit
Within 72 hours
of days to provide IW with notice of scheduled IME
10 days
Timeline for request for reimbursment
2 years
of days to pay a reimbursement request
30 days
of days to pay medical bills received prior to acceptance of claim
14 days from date of acceptance
of days to pay medical bills on accepted claims
45 days
of days a NP or ANP can provide medical services or authorize TL
180 days
of days a medical provider has to send records to the insurer
14 days
of days insurer has to respond for diagnostic pre authorization
14 days
of days to report a change of AP on an 827
5 days from first treatment of new AP
of days an ER Dr can authorize TL
14 days
of days for Type B provide Med Services and TL
60 days of treatment / 30 days of TL
Timeline for Voc Training eligibility
5 days when likely eligible/ 30 days for decision
of days insurer has to pay PPD award by closure
30 days from notice of closure
Timeline for Time Loss TL
By law 14 days from EDOK - SAIF is 13 days and paid every 14 days thereon
of days to report an injury on an 801 by employer
5 days from EDOK
of days to report an injury on an 827 by Dr.
72 hours from visit
of days to send form 1502 to WCD on claim decision
14 days from decision date
