Reeves v. Bally's Grand Hotel & Casino

• Court: Nevada Supreme Court
• Decided: January 15, 2015
• Docket: 63950
• Status: Unpublished

Opinion

and her hearing request form all indicate that appellant was challenging the insurer's refusal to send a certificate of disability form to her physician. Thus, substantial evidence supports the appeals officer's determination that appellant was raising a complaint about the insurer's conduct, rather than contesting a benefits determination.' See

Vredenburg v. Sedgtvick CMS, 124 Nev. 553, 557 & n.4, 188 P.3d 1084, 1087 & n.4 (2008) (explaining that this court will not disturb the appeals officer's factual findings on judicial review if they are supported by substantial evidence). The DIR administrator has the duty to regulate any forms used for workers' compensation claims and conduct any investigations into whether an insurer has violated the statutory provisions. NRS 616A.100 (defining "Division"); NRS 616A.040 (defining "Administrator"); NRS 616A.400(2), (7) (setting forth the administrator's duties); NRS 616D.130 (explaining the investigation process). The DIR administrator also determines whether to impose a fine on an insurer for failing to comply with the statutory or regulatory provisions of NRS Chapters 616A-616D. NRS 616D.120. In contrast, the appeals officer considers matters relating

'Although appellant also asserts that the insurer used the lack of a certificate of disability form as a means to deny temporary total disability benefits, close her claim, and deny reopening of her claim, those actions are not at issue in this appeal and have been the subject of other appeals to this court. See Reeves v. Bally's Grand Hotel & Casino, Docket No. 56776 (addressing temporary total disability benefits); Reeves v. Bally's Grand Hotel & Casino, Docket No. 57823 (addressing claim closure and the scope of appellant's claim); Reeves v. Bally's Grand Hotel & Casino, Docket No. 62981 (addressing claim reopening). Therefore, we do not address that contention here. See Five Star Capital Corp. v. Ruby, 124 Nev. 1048, 1054-55, 194 P.3d 709, 713 (2008) (explaining claim and issue preclusion).

SUPREME COURT OF NEVADA 2 (0) 19474 Mt. to claims for workers' compensation or benefits. See NRS 616C.345. Because appellant was challenging the insurer's conduct, which is within the DIR's jurisdiction, the appeals officer did not err when she concluded that she lacked jurisdiction over appellant's administrative appeal. Accordingly, because the appeals officer did not err or abuse her discretion in dismissing appellant's claim for lack of jurisdiction, we affirm the district court's order denying judicial review. See Vredenburg, 124 Nev. at 557, 188 P.3d at 1087 (noting that this court reviews an appeals officer's decision in a workers' compensation matter for clear error or an abuse of discretion). It is so ORDERED.

Parraguirre

Douglas

J.

cc: Hon. Stefany Miley, District Judge Susan Reeves Lewis Brisbois Bisgaard & Smith, LLP/Las Vegas Eighth District Court Clerk

SUPREME COURT OF NEVADA 3 (0) I94Th