and 700 various sections & paragraphs Workers Compensation Claims Procedures and Managed Care In

"Carrier" means the duly licensed insurance company which, pursuant to RSA 281-A:5, I and RSA 281-A:6, secures the payment of compensation for an employer subject to the statute. Notes N.H. Admin. Code § Lab 502.02 (See Revision Note at part heading for Lab 502) #5235, eff 9-27-9…

"Carrier identification number" means a 3 digit number assigned to the carrier by the New Hampshire department of labor. Notes N.H. Admin. Code § Lab 502.03 (See Revision Note at part heading for Lab 502) #5235, eff 9-27-91, EXPIRED: 9-27-97 New. #6631, INTERIM, eff 11-16-97, EXP…

"Case" means a claim within an administrative or adjudicatory process. Notes N.H. Admin. Code § Lab 502.04 (See Revision Note at part heading for Lab 502) #5235, eff 9-27-91, EXPIRED: 9-27-97 New. #6631, INTERIM, eff 11-16-97, EXPIRED: 3-16-98 New. #6806, eff 7-18-98 (formerly La…

"Coverage" means workers' compensation insurance. Notes N.H. Admin. Code § Lab 502.05 (See Revision Note at part heading for Lab 502) #5235, eff 9-27-91, EXPIRED: 9-27-97 New. #6631, INTERIM, eff 11-16-97, EXPIRED: 3-16-98 New. #6806, eff 7-18-98 (formerly Lab 502.04); ss by #868…

"Days" means calendar days, unless otherwise specified. Notes N.H. Admin. Code § Lab 502.06 (See Revision Note at part heading for Lab 502) #5235, eff 9-27-91, EXPIRED: 9-27-97 New. #6631, INTERIM, eff 11-16-97, EXPIRED: 3-16-98 New. #6806, eff 7-18-98 (formerly Lab 502.05); ss b…

"Employee" means any person, in the service of an employer who is, or who has elected to be, subject to the workers' compensation law specifically RSA 281-A:2, VI, VII, VIII and RSA 281-A:3. Notes N.H. Admin. Code § Lab 502.07 (See Revision Note at part heading for Lab 502) #5235…

"Employer" means any subject private or public entity that has one or more employees, other than 3 executive officers of a corporation, pursuant to RSA 281-A:2, VIII, RSA 281-A:2, IX, and any other person who has elected to be subject to the workers' compensation law, RSA 281-A:3…

"Employer identification number" means the federal identification number assigned to an employer by the Internal Revenue Service. Notes N.H. Admin. Code § Lab 502.09 (See Revision Note at part heading for Lab 502) #5235, eff 9-27-91, EXPIRED: 9-27-97 New. #6631, INTERIM, eff 11-1…

"First aid treatment" means any one-time treatment that generates a bill less than $2,000. Notes N.H. Admin. Code § Lab 502.10 (See Revision Note at part heading for Lab 502) #5235, eff 9-27-91, EXPIRED: 9-27-97 New. #6631, INTERIM, eff 11-16-97, EXPIRED: 3-16-98 New. #6806, eff …

"Form" means a document for the collection of specific data, and except where the context specifically indicates otherwise includes both paper and electronic formats. Notes N.H. Admin. Code § Lab 502.11 (See Revision Note at part heading for Lab 502) #5235, eff 9-27-91, EXPIRED: …

"Poster" means the employer's notice of compliance with the insurance coverage provisions of the statute. Notes N.H. Admin. Code § Lab 502.12 (See Revision Note at part heading for Lab 502) #5235, eff 9-27-91, EXPIRED: 9-27-97 New. #6631, INTERIM, eff 11-16-97, EXPIRED: 3-16-98 N…

"Rehabilitation provider" means any person providing physical rehabilitation services and/or remedial or restorative care. Notes N.H. Admin. Code § Lab 502.13 #6806, eff 7-18-98 (formerly Lab 502.12); ss by #8682, INTERIM, eff 7-15-06, EXPIRED: 1-11-07 New. #9019, eff 11-1-07 Ame…

"Special Officer" means a person employed as a law enforcement officer by any political subdivision of the state for a temporary or specific purpose, or who was duly appointed by the appointing authority and works part-time. Notes N.H. Admin. Code § Lab 502.14 Derived From Volume…

"Statute" means the Workers' Compensation Law, RSA 281-A. Notes N.H. Admin. Code § Lab 502.15 Derived From Volume XXXVI Number 14, Filed April 7, 2016, Proposed by #11067, Effective 4/1/2016, Expires 4/1/2026.

"Vocational rehabilitation provider" means any person who provides vocational rehabilitation services, such as job placement, job analysis, aptitude testing, labor market surveys and vocational counseling. Notes N.H. Admin. Code § Lab 502.16 Derived From Volume XXXVI Number 14, F…

(a) No claimant's representative, carrier, employer, attorney, vocational consultant or any representative of any party shall send anything in writing, including electronic communication, to the department or any of its personnel concerning a case before the department without si…

(a) Any party in a claim may notify the commissioner in writing of any issue concerning health care provider referrals as described in RSA 281-A:23, IV. Copies of all notifications shall be provided to all parties in the claim and to the health care provider in question and shall…

(a) Employers shall familiarize themselves with the provisions of the statute and these rules. (b) Employers shall obtain from their carriers a sufficient quantity of "Workers' Compensation Law - Notice of Compliance" which shall indicate the current carrier's name. (c) Employers…

(a) Employers shall record work-connected injuries and diseases in sufficient detail and keep same for a period of 5 years from date of injury for future reference. The "Notice of Accidental Injury or Occupational Disease" form 8aWCA (7/2014), contained in Appendix II together wi…

(a) Employers who desire to invoke the reimbursement provisions of RSA 281-A: 54, IX, shall file proof of eligibility with the department. The reimbursement request shall be preceded by submission of the plan for modification to the commissioner. (b) In order for the plan to be a…

(a) All employers with 5 or more full time employees shall provide temporary alternative work programs to bring injured employees back to work. (b) Temporary alternative work shall be limited and transitional in nature. For the purpose of this provision, transitional means the du…

(a) An employer of 5 or more full time employees shall reinstate an employee with a compensable injury to their former position within 18 months if that position is available, as follows: (1) If the date of injury: a. Is clear, then the 18 months shall be determined from the date…

(a) An employer holding a self-insurance permit shall:(1) Perform all functions required of an employer and an insurance carrier by these rules and (2) Be subject to all civil and other penalties attaching to non-compliance with the statute and rules applicable to employers and c…

(a) Carriers shall familiarize themselves with the provisions of the statute and these rules. (b) Carriers shall obtain and maintain a supply of mandated state forms which they shall supply to their insured's and their own claims offices. (c) Carriers shall keep their insured inf…

(a) If upon investigation it is determined that the claim is compensable, the carrier or employer within 21 days of notification of claim or period of disability shall: (1) Pay compensation to the injured employee; (2) Complete and file a "Memo of Payment", form 9WCA (6/1994), co…

(a) An injured employee shall be entitled to an increase in his or her total disability benefits if he or she qualifies for such an increase pursuant to RSA 281-A:29 and this section. (b) Self-insured employers and insurance carriers shall acquaint themselves with the provisions …

(a) Self-insured employers and insurance carriers shall give notice to the department of possible claim against the second injury fund in writing not later than 100 weeks after the date of injury. The employer or carrier may complete and file "Application for the Use of the Secon…

(a) For the purposes of RSA 281-A:63, I, any licensed New Hampshire insurance adjuster or adjusting company handling workers' compensation claims within the state of New Hampshire shall: (1) Maintain a business office in the state of New Hampshire on a full time basis; (2) Be ope…

(a) An employee receiving workers' compensation benefits shall report to the carrier, self-insured employer, or third party administrator: (1) Any changes in his or her medical condition; and (2) Any changes in his or her employment status or earnings or both. (b) An employee eli…

An employee who becomes incarcerated shall notify the insurance carrier of the date, place of incarceration, and date of release. Notes N.H. Admin. Code § Lab 507.02 #5041, eff 1-9-91, ss by #5235, eff 9-27-91, EXPIRED: 9-27-97 New. #6631, INTERIM, eff 11-16-97, EXPIRED: 3-16-98 …

In the event of a claim pursuant to RSA 281-A:15, III, the employee shall request that the concurrent employer(s) complete a wage schedule and make it available to the carrier handling the claim. Notes N.H. Admin. Code § Lab 507.03 #6806, eff 7-18-98 (formerly Lab 514.02); ss by …

(a) Pursuant to RSA 281-A:39, the employee shall submit to an independent medical examination scheduled by the employer or his insurance carrier at a reasonable time and place. (b) Pursuant to RSA 281-A:38, II, the employee may have a witness present during such examination. The …

(a) When pre approval of medical, hospital or remedial care in accordance with RSA 281-A:23 is required, the injured employee shall obtain a written statement from the medical provider containing the following: (1) The nature of the proposed care; (2) How the proposed care is req…

(a) A "Workers' Compensation Initial Medical Report,", form 75WCA-1 (6/1994), contained in Appendix II, shall be completed in full and filed with the carrier within 10 days of the first examination. The health care provider shall keep a supply of the initial medical report form i…

(a) The commissioner shall assess a civil penalty between $0.00 and $2,500.00 against any health care provider who without sufficient cause, as determined by the commissioner, bills an injured employee or his or her employer for services covered by insurers or self-insurers under…

Vocational rehabilitation of occupationally disabled persons under RSA 281-A:25 truly represents not only the most humane approach, but also the most economical. Accordingly, the goal of vocational rehabilitation is to restore the employee to, or as close as possible to, his or h…

(a) Employees who are disabled from performing the work for which they have training or experience shall be referred by the carrier or self-insured employer or by the department after consultation with the carrier or self-insured employer, to an appropriate vocational rehabilitat…

(a) Carriers and self-insured employers shall complete and file with the department a Report of Extended Disability, form 74WCA (7/1989) , contained in Appendix II, with copies of the complete medical file and any vocational rehabilitation reports which are available at that time…

(a) Within 7 days of receiving a referral from a carrier or self-insured employer, the vocational rehabilitation provider shall report it to the department. This information shall be provided on the vocational rehabilitation provider's letterhead and shall reflect referrals for v…

All job placements shall be evaluated by the vocational rehabilitation provider 60 days after placement, and a status report of that evaluation shall be filed with the department immediately, with a copy sent to the carrier or self-insured employer. Notes N.H. Admin. Code § Lab 5…

(a) A vocational rehabilitation training agreement shall be developed and submitted to the department for prior approval on a case by case basis using the criteria listed in Lab 509.02(b). This shall be done for services which involve any expenditure of monies beyond those for th…

(a) The employee, carrier, or vocational rehabilitation provider may request in writing a hearing to decide any of the following issues: (1) Disputes regarding the employee's eligibility to receive vocational rehabilitation services; (2) Disputes regarding the level of services t…

A claimant, carrier, or employer may petition the commissioner under RSA 281-A:48 to review eligibility for compensation by reason of a change in condition, mistake as to the nature or extent of the injury or disability, fraud, undue influence, or coercion. Notes N.H. Admin. Code…

(a) No carrier shall reduce or terminate benefit payments for reasons other than provided by statute, Lab 506.02(p), or Lab 510.04 without obtaining prior approval of the commissioner pursuant to (b) through (d) below. (b) A carrier seeking approval to reduce or terminate benefit…

Pursuant to RSA 281-A:48, in the absence of work opportunity and on the basis of medical and other evidence, the earning capacity of a partially disabled person shall be 60% of the difference between 80% of the statutory minimum wage under RSA 279 in effect on the date of injury …

(a) Pursuant to RSA 281-A:3-a, a claimant who has become incarcerated pursuant to a conviction shall forfeit any right to workers' compensation indemnity benefits 30 days after incarceration for the remaining period of incarceration. (b) A carrier or employer who becomes aware of…

(a) Lump sum settlements of past, present and future weekly indemnity benefits under RSA 281-A:26, 28, 28-a, 31, 31-a, which may also include past, present or future scheduled permanent impairment awards to which the claimant may be entitled under RSA 281-A:32, shall be permitted…