Section 7-105. PROGRAM NOTICES OF INITIAL DETERMINATIONS AND ELIGIBILITY DETERMINATIONS

 

105.1The Program shall issue a notice of determination (NOD) regarding each ID and ED pursuant to this section. An NOD of an ID or ED shall be issued using a standard form developed by the Program that informs the claimant of the right to request reconsideration or a hearing before the OHA, whichever is applicable. Sample NODs shall be published on ORM’s website.

 

105.2An NOD shall be issued:

 

(a) When accepting a claim for benefits or when modifying, suspending, or terminating benefits;

 

(b) When changing the type of benefits a claimant receives;

 

(c) When amending an NOD pursuant to § 111 of this chapter;

 

(d) When accepting or denying a claim for recurrence of injury pursuant to § 120 of this chapter; or

 

(e) When issuing a schedule award pursuant to section 2307 of the Act.

 

105.3An NOD shall contain a narrative description of the rationale for the decision, cite relevant portions of the supporting documentation or claim file, and attach supporting documentation.

 

105.4An NOD shall be sent to the claimant's last known address by first-class mail, postage prepaid. A certificate of service shall be executed by the Program at the time of mailing.  If the claimant is represented by an attorney, a copy of the NOD shall be sent to the claimant’s attorney.  Failure to send a copy of the NOD to the claimant’s attorney shall not constitute a failure to provide notice to the claimant, nor shall it toll any deadlines under this chapter, unless failure to do so unduly prejudices the claimant.

 

authority

Chief Risk Officer of the Office of Risk Management (ORM), Executive Office of the Mayor, pursuant to the authority set forth in section 2344 of the District of Columbia Government Merit Personnel Act of 1978 (CMPA), effective March 3, 1979 (D.C. Law 2-139; D.C. Official Code § 1-623.44 (2012 Supp.)); section 7 of Reorganization Plan No. 1 of 2003 for the Office of Risk Management, effective December 15, 2003; and Mayor’s Order 2004-198, effective December 14, 2004

source

Notice of Final Rulemaking published at 28 DCR 2307 (May 22, 1981); as amended by Notice of Emergency and Proposed Rulemaking published at 57 DCR 9540 (October 8, 2010)[EXPIRED]; as amended by a Notice of Final Rulemaking published at 57 DCR 12224, 12227 (December 24, 2010); repealed and replaced by Final Rulemaking published at 59 DCR 8766, 8769 (July 27, 2012).