Section 7-120. RECURRENCE OF INJURY

 

120.1An employee who received indemnity compensation for which payments have ceased who suffers a recurrence of the same compensable injury must notify the Program in writing of the recurrence.  The employee shall provide notice of the recurrence within thirty (30) days of the recurrence or within thirty (30) days of when the claimant first became aware or reasonably should have become aware of the recurrence and its relationship to the original claim.

 

120.2An employee who reports a recurrence of an injury shall provide the Program with medical evidence that the recurrence is the same injury for which the claim was originally accepted, and shall follow all requirements in this chapter relevant to receiving benefits, including the requirements of §§ 123 and 124 of this chapter. 

 

120.3The Program shall begin paying the employee indemnity payments again if:

 

(a) The employee’s notification to the Program of the recurrence meets the requirements of § 120.5; and

 

(b) The Program determines after considering all relevant factual evidence, including all relevant medical evidence received pursuant to §§ 123 and 124 of this chapter that:

 

(1) The injury is the same injury for which the claim was initially accepted; and

 

(2) The recurrence of the injury prevents the claimant from being able to work.

 

120.4The Program shall issue an NOD either awarding or denying the claim for a recurrence of injury within thirty (30) days of the Program’s receipt of the information required in § 120.2.  The Program may controvert a claim for a recurrence of injury pursuant to §§ 112.3 through 112.7 of this chapter.

 

120.5The Program shall not begin payment of indemnity compensation to the employee again if three hundred sixty-six (366) days or more has passed since:

 

(a) The employee received a payment of compensation; or

 

(b) A final order was issued by a judicial entity regarding the employee’s indemnity payments.   

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

Final Rulemaking at 43 DCR 1466 (March 22, 1996); as amended by Notice of Emergency and Proposed Rulemaking published at 57 DCR 9540 (October 8, 2010)[EXPIRED]; as amended by Notice of Final Rulemaking published at 57 DCR 12224, 12233 (December 24, 2010); repealed and replaced by Final Rulemaking published at 59 DCR 8766, 8786 (July 27, 2012).