NAC616B.7702. Submission of claim.

     1. A claim against the Subsequent Injury Account for Self-Insured Employers established pursuant to NRS 616B.554 must be submitted in writing to the Administrator for evaluation by the Board.

     2. A self-insured employer who submits a claim pursuant to subsection 1 shall include with the claim:

     (a) The information necessary to establish that the claim should be paid from the Subsequent Injury Account for Self-Insured Employers, including the medical records of the employee who is the subject of the claim; and

     (b) A completed copy of the form entitled “D-37, Insurer’s Subsequent Injury Checklist” which is prescribed by the Administrator. A copy of the form may be obtained from the Administrator at no cost.

     3. A claim submitted to the Administrator pursuant to subsection 1 must be organized in the manner prescribed in part 5 of Form D-37, Insurer’s Subsequent Injury Checklist.

     4. A self-insured employer who submits a claim pursuant to subsection 1 shall, upon the request of the Administrator:

     (a) Allow the Administrator to inspect the records maintained by the self-insured employer concerning the claim; or

     (b) Provide copies of those records to the Administrator.

     (Added to NAC by Div. of Industrial Relations, eff. 2-18-97)