Rule 3.2200 of the Vermont Workers’ Compensation and
Occupational Disease Rules states that “[t]he employer or insurance carrier
shall have 21 days (measured from the date on which the employer received
notice or knowledge of a claimed work-related injury) within which to determine
whether any compensation is due. If it determines that no compensation is due, within
21 days after receiving notice or knowledge of the injury, it shall
file a Denial of Workers’ Compensation Benefits (Form 2) with the Commissioner
and the injured worker.” Rule 3.2200 (emphasis added).
A question has been raised at the Department of Labor
regarding the phrase “within 21 days” and whether that means that the Form 2
denial must be received by the Department of Labor within the 21 day
period or whether the Form 2 denial must be postmarked by the 21st
day. With the tight time frames that apply to employers and carriers, it
is very important to understand the Department of Labor’s understanding of the
Rules to which employers and carriers will be held accountable. We have
been advised by the Department of Labor that the Department considers Rule
3.2200 to mean that the Form 2 denial is timely if it is received by the
Department of Labor on or before the 21st day. A Form 2
denial, therefore, is not timely if it is postmarked on the 21st
day. For many employers and carriers, this may mean a significant shift
in how denials are handled.
When asked whether filing the Form 2 denial itself via email
on the 21st day is sufficient to meet the Department’s standards,
the response was that it should be sufficient to email the Form 2 denial to the
Specialist assigned to the file, even if there are additional medical records
and documentation that have to be sent via regular mail due to size (Rule
3.3000 states that attachments greater than 20 pages in length must be sent
either via disc or hard copy by regular mail).
If you are sending out a Form 2 denial either shortly before
or on the 21st day after notice or knowledge of the claim, it is
advisable to send the Form 2 denial and up to 20 pages of supporting
documentation via email to the Specialist handling the file. If you have
larger attachments that must be sent by regular mail, let the Specialist know
that there are additional documents coming by regular mail. It is unclear
at this point whether this will be sufficient to meet the “within 21 days”
standard, but it is necessary to cover your bases to make sure that the denial
is timely.
Please see below the current assignment of files at the
Department of Labor:
The new schedule for assigned claims is as follows and shall
remain in effect until further notice. Any State File Numbers ending in
-0 or -9 (e.g.: HH-67250 or HH-67259) will be assigned to staff based on
the next number immediately preceding the -0 or -9 (e.g.:
HH-67250 or HH-67259 would go to Julie
Mercier as a -5 claim).
Assigned Specialist
II Assigned
Specialist
I
-1 Anne
Coutermarsh
Shirley Houghton
-2 Anne
Coutermarsh
Shirley Houghton
-6 Anne
Coutermarsh
Wendell Sargent
-3 Mary
Sarazin
Muriel Landis
-4 Mary
Sarazin
Muriel Landis
-5 Julie
Mercier
Muriel Landis
-7 Julie
Charonko
Wendell Sargent
-8 Julie
Charonko
Wendell Sargent
