6.10.690 Initiation of a claim.
(A) Claim Initiation. A claim shall be initiated by immediate reporting of a work injury to a supervisor, the Gaming Enterprise, and the Administrator pursuant to the reporting obligations set forth in this section.
(B) Written Notice of Injury. An employee must report any work injury, no matter how slight, to his/her supervisor in writing within twenty-four (24) hours of the incident that caused the work injury. Failure to promptly report a work injury within the required time frame may lead to denial of a claim.
(C) Supervisor Reporting Obligations. A supervisor, upon receiving written notification of the work injury from the employee, must either promptly submit the written notice of injury or promptly complete a claim form (provided by the Administrator) and transmit either document to the Gaming Enterprise, who shall then report the claim to the Administrator. Failure of a supervisor to promptly submit the claim form or submit the written notice of injury may result in disciplinary action against the supervisor and shall toll the statute of limitations for the claim as set forth in KTC 6.10.700(B)(2).
(D) Presumption of Compensability. If the employee or dependent properly files a claim pursuant to the terms of this article, and the Administrator fails to reject liability within ninety (90) days after the claim is filed, the injury will be presumed compensable. The presumption is rebuttable only by evidence discovered after the ninety (90) day period.
(E) Conditional Denial. If, after exercising due diligence, the necessary information to accept or deny a claim is not available to the Administrator by the ninetieth day, the Administrator may issue a “conditional denial” which permits the Administrator to continue to investigate the claim for an additional ninety (90) days. [Res. 19-R-083 § 7, 7/18/2019.]