(1)
What Can Be Protested. Any order, decision, or award made by the Claims Administrator can be protested to the Workers’ Compensation Committee after exhaustion of administrative appeals to the Claims Administrator. Whenever such an order, decision, or award is made, the employee, beneficiary, employer, and any other person affected by the decision shall be sent a copy of the decision by mail.
(a)
Exhaustion of Administrative Appeals. Decisions of the Claims Administrator must be appealed within 15 days. If the administrative appeals process extends beyond 90 days from the time of filing, any benefits suspended during the pendency of the administrative appeals shall be reinstated from that date forward until the Claims Administrator issues a final decision.
(2)
Procedure for Protest.
(a)
Notice of Protest. Any employee, beneficiary, employer, or other person aggrieved by an order, decision, or award as initially made by the Claims Administrator must file a notice of protest with the Workers’ Compensation Committee within 15 days after receipt of the Claims Administrator’s final decision following exhaustion of administrative appeals. Such notice of protest need be in no particular form, but must be in writing. Any additional evidence, proof, or claim shall be submitted along with the notice of protest. A notice of protest is barred if it is not timely filed.
(b)
Workers’ Compensation Committee Decision. The protest shall be considered by the Workers’ Compensation Committee, and a decision shall be rendered within 30 days of receipt of the notice of protest and additional evidence. The Workers’ Compensation Committee shall hold no hearing, but shall review the matter on the basis of the claim files and records. The Committee may also seek opinions from outside physicians, if necessary, and consider any supplementary materials submitted by the protestor. The written decision shall be sent to the protestor by mail.
(c)
Scope of Decision. The Workers’ Compensation Committee has the power to approve, deny, or modify any order, decision, or award of the Claims Administrator upon protest.
(Ord. 108 § 108.5.1, 10-6-2006 (Res. 2006-312))