Stockbridge-Munsee Tribal Law Library
Stockbridge-Munsee Tribal Code.

Section EMP.04.08 — Claim Closure

(a) A worker's compensation claim shall be closed after payment of the worker's last medical treatment when the health care provider determines that the injured worker has reached the point where no further material improvement would reasonably be expected from medical treatment or the passage of time.

(1) If more than one (1) year has passed since a worker last received treatment for an injury, the worker's compensation claim shall be closed and the worker is barred from receiving additional treatment or benefits.

(b) When the insurer determines that a worker's claim for compensation will be denied by the insurer, the worker shall be informed about the availability of dispute resolution proceedings.

(c) If compensation was paid under this Ordinance; a claim may be re-opened within one year after the date of claim closure, based on an objective finding of a material worsening in the underlying condition. Furthermore, a claim may be re-opened during the period up to three years after claim closure, for the payment of medical benefits if a pathological worsening of the underlying condition is established by clear and convincing medical evidence.