Division of Longshore and Harbor Workers' Compensation (DLHWC)
CHAPTER 3-301 DISABILITY
- Purpose and Scope. This Chapter describes the procedures for the review of secondary disability case files by the Claims Examiner (CE) or Claims Examiner Clerk (CEC) after completing the initial primary case review. Secondary cases are jacketed cases which a CE/CEC has reviewed initially and in which at least one action has been taken. The second review of the file is made after additional information is received by the DO or when a call-up becomes due. These procedures augment those for primary case review in PM 2-201.
Routine Cases Review.
a. Review for Additional Information at Call-Up Date. As soon as new information is received, the CE shall review each document for adequacy. All medical reports should be evaluated with respect to adequacy (check to see whether a diagnosis has been made, the severity of the injury, the type of treatment rendered, prognosis, etc.). Form LS-1, Request for Examination and/or Treatment (Exhibit 1, PM 10-200) should be reviewed to see whether the medical report was timely filed (within ten days) by the physician, and whether it indicates the claimant was afforded free choice of a physician.
b. Follow-Up Action for Additional Information. If the review of the case file is based on an expired call-up because the CE is awaiting additional information and the information has not been received, there should be a follow-up. If more than sixty days have elapsed without the receipt of a Form LS-204, Attending Physician's Supplementary Report (Exhibit 18, PM 10-200), or narrative report, the CE should request a medical report.
c. Closure of Case. Cases are closed when conditions exist as explained in PM 2-200.4 or when all payments have been made in accordance with a compensation order and Form LS-208, Notice of Final Payment or Suspension of Compensation Payments (Exhibit 21, PM 10-200) showing termination of payments is received and is verified by the CE. If Form LS-208 is correct, the CE sends copies of the form to the claimant or claimant's representative. The case is closed by changing the status in the LCMS. (For details on closing cases, see paragraph 12 below.)
In-Depth Case Review. Cases involving serious injuries, occupational diseases (see PM 2-203), or other complications require in-depth review as secondary cases. All the issues listed below must be considered. The balance of the Chapter (paragraphs 4 through 10) addresses situations which may or may not occur and must be treated accordingly.
a. Determine Eligibility. The CE/CEC considers the criteria set forth in PM 0-300 and continues the evaluation begun in the primary review, PM 2-201.
b. Verify Compensation Rate (Wage Rates, AWW). The DD or CE shall review Form LS-206, Payment of Compensation Without Award (Exhibit 19, PM 10-200) to insure the correctness of payments to the injured employee. The employee's average weekly wage (AWW) shall be determined in accordance with section 10(a) through (d) of the Act (see PM 3-201). If Form LS-206 indicates that compensation payments are being paid at a tentative rate, and the EC reports that they have been unable to obtain data as to the employee's earnings through their usual channels to establish the exact amount of earnings, the CE/CEC shall send Form LS-426, Request to Employee for Wage Earnings Information (Exhibit 39, PM 10-200). When the information is received, the CE will determine the employee's correct AWW, and if it differs from the wage used by the employer/carrier, the CE shall advise the EC, using Form Ltr. LS-537, (Exhibit 46, PM 10-200), to adjust compensation payments accordingly. The CE should verify that the correct AWW is entered into the LCMS. The CE should also check for the applicability of minimum/maximum rates payable pursuant to section 6(b) (Exhibit 26, PM 10-300).
c. Consider Third Party Involvement. The CE/CEC reviews the case and takes action, as required, in accordance with PM 3-600.
d. Check for Controversion of Entitlement. When the EC controverts the employee's entitlement to compensation as indicated in PM 2-201.3d and Form LS-207, Notice of Controversion of Right to Compensation (Exhibit 20, PM 10-200) is received in the DO, the CE shall send a Form LS-209, Request for Employee's Reply to Employer's Objections (Exhibit 22, PM 10-200) to the claimant within ten days. The claimant should be allowed thirty to sixty days to respond before taking action (e.g., schedule of informal conference). Where any installment of compensation is not paid within fourteen days of date due (unless controversion is filed within fourteen days of the knowledge of injury), a 10% penalty must be applied under section 14(e) of the Act unless such nonpayment is excused by the DD after a showing by the EC that owing to conditions over which it had no control, such payment could not be made within the period prescribed for the payment. If the controversion notice is filed more than fourteen days after knowledge of the injury, the 10% penalty shall apply to all compensation due up to the date of the untimely filing or the date of an informal conference held to discuss the contested issue(s), whichever occurs first. (See PM 8-202.) Furthermore, interest should be applied to each delayed installment of compensation in accordance with 28 U.S.C. section 1961. (See PM 8-201.)
e. Consider Medical Evidence. Each case file should include sufficient medical data so that the DD/CE can monitor the medical care received and to make the necessary determinations regarding compensation.
(1) Initial Medical Reports. Within ten days following the initial examination or treatment, the physician shall furnish a medical report on Form LS-1, Request for Examination and/or Treatment (Exhibit 1, PM 10-200) to the DD, with copies to the EC.
(2) Medical Questions. In those cases where the DD/CE determines that there is a question regarding the necessity, character, or sufficiency of medical care being furnished the injured employee, the question shall be resolved as promptly as possible. Maximum use shall be made of available OWCP District Medical Advisors, or consultation with the attending physician. For further responsibilities of the DD/CE regarding the management of medical care for the injured employee, see PM 5-200.
(3) Obtaining Medical Reports. If no initial medical report is received within thirty days, a request on Form LS-216, Request for Additional Reports (Exhibit 25, PM 10-200) shall be sent to the EC. If the EC fails to respond within thirty days, the CE shall make a follow-up request. If the attending physician fails to comply within an additional thirty days or continually fails to submit reports, the CE shall refer the case to the DD, stating the facts of the case along with a recommendation for further handling of the case. (See PM 5-300.)
(4) Medical Reports in Long-Term Disabilities. Generally, medical reports should be required every thirty to sixty days. In cases of obvious long term disability (i.e., disabilities permanent in nature or permanent impairment), reports may be requested at ninety day intervals or longer, based on the circumstances.
(5) Final Medical Reports. Such reports are required for all extended disability cases at the time maximum medical improvement is achieved. Where the potential for PPD exists, a report shall be requested indicating the percentage of PPD (impairment) using the AMA Guides where possible. Sections 7(e) and 14(h) procedures may be utilized to obtain medical information on permanent impairments resulting from injuries when disputes arise in such cases. (See PM 5-300, PM 5-400 and LHWCA Program Memorandum No. 50, May 20, 1974, regarding applicability of section 7(e).) A copy of the Program Memorandum can be obtained from the National Office, if needed.
(6) Hearing Loss. In special evaluations for hearing loss cases, the claimant shall be referred to an impartial otologist for examination and determination as to the amount of hearing loss. This referral will be made after the CE insures that the case file contains as much information or evidence as is readily available or considered pertinent. Upon receipt of the otologist's report and contingent upon the findings, the DD/CE shall calculate the percentage of hearing impairment and render a recommendation for payment of a schedule award, notifying the interested parties of recommended payment of benefits. (See PM 3-401.)
f. Consider Late Report (Employer).
(1) Form LS-202, Employer's First Report of Accident or Occupational Illness. (Exhibit 16, PM 10-200). Section 30(a) requires an employer to furnish a report of the injury which causes loss of one or more shifts of work or death. For procedures regarding the assessment of penalty for late reporting, see PM 8-302.
(2) Form LS-208, Notice of Final Payment or Suspension of Compensation Payment. (Exhibit 21, PM 10-200). Under section 14(g), an EC is given sixteen days after final payment of compensation to make a report (Form LS-208) of the payment to the DD, or is subject to a penalty in accordance with the procedures in PM 8-301.
g. Consider Rehabilitation Potential.
(1) CE Referral Responsibility. The CE's responsibility for the development of rehabilitation referrals is the foundation for a successful rehabilitation program.
(a) "R" System Referrals (LS-222). The EC may, but is not required to, file Form LS-222, Carrier's or Self Insurer's Report of Rehabilitation (Exhibit 26, PM 10-200) whenever (i) the need for rehabilitation services is indicated or (ii) the injured individual receiving compensation has not returned to work within two months from the date of injury.
(b) Rehabilitation Follow-up System. To assist in the identification of cases with possible rehabilitation potential, LCMS automatically places a rehabilitation call-up on a case for "Initial Rehab Review" 120 days after the Pay Indicator is turned on for the first time. Running the "Rehabilitation Call-Up Schedules" under the Reports tab of LCMS will produce a list of those open cases with a rehab call-up falling within the period specified by the user.
(i) "R" Form (LS-222) Received. The mail clerk attaches the yellow copy of the Form LS-222 to the case file. The CE/CEC notes any significant details. The white copy of the Form LS-222 is routed to the Rehabilitation Specialist (RS).
(ii) "R" Form (LS-222) Not Received. The claims examiner is responsible for the medical monitoring of cases in a TTD status for early indications of the need for rehabilitation. The claims examiner should refer the case to the Rehabilitation Specialist using Form OWCP-14 where the medical evidence indicates that the claimant cannot return to the job held when injured and is in need of rehabilitation services. If the claimant remains in TTD status for more than 120 days and the medical evidence is not sufficient to make a determination regarding referral, the claims examiner should then contact the employer/carrier to determine whether any rehabilitation effort has been initiated.
(c) Other Referrals (OWCP 14). Occasionally, the CE will encounter a case that warrants consideration for rehabilitation and is not being monitored by the RS. For example, the employee was previously referred to the RS but was terminated from monitoring by the RS and now has a change in medical or vocational condition. The CE should refer the case to the RS using Form OWCP 14, Referral to OWCP Rehabilitation (Exhibit 4, PM 10-200).
(2) Medical Rehabilitation. The CE's identification of subsequent cases for rehabilitation begins with the receipt of Form LS-204, Attending Physician's Supplementary Report (Exhibit 18, PM 10-200) or other medical report. For further procedures regarding medical rehabilitation, see OWCP Rehabilitation Procedure Manual. The RS, after referral by the CE, initiates an evaluation for medical rehabilitation services when the employee's early return to work would be facilitated. The RS will coordinate with the CE as needed.
(3) CE Involvement in Rehabilitation Planning.
(a) TTD During Rehabilitation. Injured workers have additional anxiety in planning for and undergoing rehabilitation programs when the length and amount of compensation payments are uncertain. The CE can eliminate this uncertainty by encouraging the EC to continue TTD payments during a vocational rehabilitation effort. See Abbott v. Louisiana Ins. Guaranty Ass'n. 27 BRBS 192(1993), aff'd, 40 F.3d 122,29 BRBS 22 (CRT)(5th Cir. 1994).
(b) Settlements During Rehabilitation. Injured workers settling their claim during rehabilitation rarely effectively rehabilitate themselves. The CE should support and encourage workers to complete rehabilitation programs, once started. The CE should also advise the RS whenever a case in rehabilitation is settled. (See Olsen v. General Engineering & Machine Works, 25 BRBS (1991).)
h. Consider Adequacy of Report Forms. By this time in the case review process, the voids in the essential reports for the development of a case should be identified and pursued by the CE/CEC.
(1) Required Additional Information. No more than thirty days elapse before a Form LS-216 (Exhibit 25, PM 10-200) or similar request is released for missing information. Such request shall receive a follow-up within thirty days.
(2) Required Information for Rehabilitation Cases. Submission of Form LS-222 (Exhibit 26, PM 10-200) or "R" Form is voluntary and may be submitted within two months of injury when compensation is continued and the injured worker has not returned to work. If the claimant remains in TTD status for more than 120 days and the medical evidence is not sufficient to make a determination regarding referral, the claims examiner should then contact the employer/carrier to determine whether any rehabilitation effort has been initiated.
Failure To Pay Installment of Compensation.
a. Policy. If any installment of compensation payable without an award is not paid within fourteen days after it becomes due, there shall be added to such unpaid installment an amount equal to 10% of the amount due. This additional amount shall be paid at the same time as, but in addition to, such installment. Such nonpayment may be excused by the DD after considering evidence by the EC, owing to conditions over which the EC had no control, the installment could not be paid within the period prescribed for the payment. (See PM 8-202.)
b. Assessment. The DD shall take steps to insure payment of the compensation due, plus an additional 10% in any case in which:
(1) More than twenty-eight days have passed without an initial payment of compensation from the date the EC had knowledge of the injury or death, or
(2) Any subsequent installment of compensation payable without an award is not paid within fourteen days after it becomes due, and the DD does not excuse the nonpayment. A subsequent installment of compensation as defined by section 14(b) of the Act is due as of the end of the installment period.
Compensation Payments Without Award.
a. Compensation benefits, under the Act, shall be paid by the EC periodically, promptly, and directly to the person entitled thereto without an award, except where the liability to pay compensation is controverted by the employer (see subparagraph 3d, above). For TTD, an employee is entitled to two-thirds of his/her AWW at the time of injury, subject to the maximum compensation rate (established under section 6 of the Act) which is in effect at the time of injury.
b. The first installment of compensation becomes due on the fourteenth day after the EC has knowledge of the employee's injury or death. In addition, the Act states that all compensation then due must be paid. The EC, making compensation payments must immediately notify the DD by submitting Form LS-206, Payment of Compensation Without Award (Exhibit 19, PM 10-200), which indicates that compensation is being paid. If the entire period of compensable disability for work is covered by a single payment, Form LS-208, Notice of Final Payment or Suspension of Payments (Exhibit 21, PM 10-200) may be submitted in lieu of Form LS-206. If the employee's disability for work did not exceed fourteen days, he/she is not entitled to compensation for the first three days of disability. After the first payment, compensation should be paid at intervals of two weeks, or otherwise as the DD directs. Upon receipt of Form LS-206, or other indication that payments are ongoing, the CE should insure that the payment status is properly entered into the LCMS.
c. Where the claimant is entitled to compensation, the CE should check the file in accordance with this paragraph, to insure that compensation payments without an award have been made.
Compensation Status. Check to determine if the employee has returned to duty or if he/she is actually being compensated. If the EC's first report of injury indicates that the claimant lost time from work, but does not give the date of the employee's return to duty or notice of commencement of payment, the CE to whom the case is assigned shall request a report from the EC as to the claimant's status with respect to compensation. Form LS-216, (Exhibit 25, PM 10-200), should be used for this purpose. After the compensation status of the claimant has been established, the CE should update the LCMS to reflect the information.
a. Applicability. Cases in which long term disability has been established, either by the issuance of compensation orders or when the EC voluntarily continues compensation payments, must be reviewed on a regular basis. If a compensation order is entered, the CE verifies that the EC is making or continuing payments. If the compensation is not for PTD or a death case, a call-up for twelve months may be placed on the case. At the end of the period, the CE requests a summary of payments made by the EC, and extends the call-up. A determination regarding the onset of permanency should be made at the earliest possible date in extended disability cases to insure that claimants receive all annual adjustments to which they are due.
b. PTD and Death Cases. All PTD and death case files are pulled annually (October) for the purpose of having an adjustment made under section 10(f) of the Act by either the EC or NO, DLHWC. (See PM 3-202.) The LCMS can provide a listing of these cases.
Computation of Compensation for Loss of Wage-Earning
Capacity. Sections 8(c)(21) concerning permanent partial disability and 8(e) concerning temporary partial disability both basically provide that compensation for these classes of disability shall be two-thirds of the difference between the employee's average weekly wages (AWW) at the time of injury and the employee's wage-earning capacity (WEC) after the injury. Since the employee's post-injury earning capacity may be established several years after the injury and given the possible intervening times of rapid economic inflation or depression, it is necessary to adjust the post-injury WEC back to the time of injury before making a comparison to the employee's AWW (see Bethard v. Sun Shipbuilding and Dry Dock Company, 12 BRBS 691).
If the wages for the post-injury job at the time of injury are known, a direct comparison can be made. In some instances, they can be readily determined. For example, if the employee's post-injury job pays the minimum wage, then the claimant's WEC for comparison purposes would be the minimum wage at the time of injury.
If, however, the post-injury wages at the time of injury cannot be so easily determined, adjustment should be made based on the change in the national average weekly wage (NAWW). In Richardson v. General Dynamics Corporation, 23 BRBS 327, the BRB held that where there was no evidence of the actual wages paid by the claimant's post-injury job at the time of injury, the percent increase in the yearly national average weekly wage (NAWW), due to its more accurate reflection of the increase in wages over time than the Consumer Price Index (CPI), should be applied to adjust the claimant's post-injury wages downward.
For example, an employee was injured in July 1996 and had an AWW of $500.00 per week. In February 2000, the employee establishes a wage-earning capacity of $300.00 per week. Comparing the NAWW at the time of injury ($391.22) with the NAWW in February 2000 ($450.64) produces an adjustment factor of .86814 ($391.22/$450.64 = .86814). Applying this adjustment factor to the current WEC of $300.00 results in a WEC at the time of injury of $260.44 ($300.00 x .86814 = $260.44). This adjusted WEC can then be compared to the employee's AWW to determine the compensation entitlement.
$500.00 - AWW
less 260.44 - Adjusted WEC
$239.56 - Loss of WEC x 2/3 = $159.71 per week
Suspension of Payments. In a non-controverted disability case in which the EC has been paying compensation without an award under sections 14(a) and (b), the EC should not stop or suspend the payment of compensation without notification to the DD. When a further medical examination shows some improvement in the injury-related condition, but there is continued disability for work, the EC should ask the DD for an informal conference in order to determine any future liability as contemplated by section 14(h). Suspension of payments unilaterally under the foregoing circumstance is not authorized or justified by the Act and a unilateral suspension of compensation is done at the risk of incurring liability for an additional assessment under Section 14(e) if it is eventually found that the suspension was not warranted.
Suspension Of Compensation Contested By Claimant.
a. Actions to Resolve Contested Compensation. The claimant may contest the stoppage of compensation, and submit medical evidence of his/her continuing disability, or otherwise advise the CE either in writing, by phone, or by a personal visit to the DO, that he/she is not able to return to work. If the EC upon notification refuses to resume compensation, the CE may schedule an impartial medical examination or schedule an informal conference, whichever is appropriate, to attempt to resolve the differences in medical opinion or the extent of continuing disability. The CE should request the EC to pay for the examination. The Special Fund will pay only for those examinations involving Special Fund beneficiaries or examinations requested by the Director, DLHWC. (For EC liability and insolvency, see LHWCA MEMO 56, March 31, 1977, LHWCA Bulletin No. 82-2, and PM 6-202. Contact the National Office if a copy of these issuances is needed.)
b. Informal Written Recommendation. Upon receipt of the impartial examining physician's report, the CE reviews the case to determine whether an informal written recommendation is possible. Copies of the recommendation letter or memorandum and the impartial examiner's report are sent to all interested parties. At this time, a three week call-up requirement shall be placed on the file awaiting a response to the informal recommendation.
c. Acceptance of Additional Compensation to Claimant. If the informal recommendation is for payment of additional benefits to the claimant, and EC accepts it and submits Form LS-206 or LS-208 (Exhibits 19, and 21, PM 10-200) in compliance, the CE should check the form for accuracy of the payment(s). If Form LS-208 was required, after verification, the CE should send the appropriate copies of the form to the claimant and claimant's representative. If the recommended payment constitutes a final payment under section 14(g), the CE should also determine whether Form LS-208 was submitted within sixteen days after final payment was made. (See PM 8-301.) If the compensation status of the claimant changes, an entry must be made in the LCMS to reflect the new status.
d. Controversion by EC of Informal Recommendation. The EC is required to submit Form LS-207 (Exhibit 20, PM 10-200) or equivalent within fourteen days of the date of injury. If not, the EC may be subject to payment of additional compensation under section 14(e). The CE should immediately determine whether the Notice of Controversion was timely submitted. If Form LS-207 is received, copies, with Form Ltr. LS-209 (Exhibit 22, PM 10-200), or by a cover letter prepared by the district office, are sent to the claimant and his/her representative within ten days of receipt of Form LS-207 or equivalent.
e. Adjudication by Informal Conferences or Formal Hearing. A period of thirty to sixty days is allowed for a response to controversion by claimant or attorney/representative before taking further action. Procedures have been established for handling disputed cases by informal conferences (PM 4-200), and if the differences cannot be resolved by this method, a case is to be referred for formal hearing by the Office of Administrative Law Judges (OALJ). (See PM 4-600.)
Suspension Or Termination.
a. Requirements for EC. Section 14(g) of the Act requires that within sixteen days after suspending or terminating payments of compensation, the EC shall send to the DD a Form LS-208 (Exhibit 21, PM 10-200) stating that such payments have been suspended or terminated, the total amount of compensation paid, the name of the employee and of any other person to whom compensation has been paid, the date of the injury or death, and the date (inclusive) to which compensation has been paid. For instructions regarding the assessment of a penalty for failure to submit report of final payment of the compensation, see PM 8-301.
b. Review of Form LS-208 by CE. The guidelines and procedures are set forth below:
(1) Review and Disposition of Compensation Status. On receipt of Form LS-208 (Exhibit 21, PM 10-200), the CE checks the period and amount of compensation for correctness, and releases copies to the claimant and his/her attorney or representative. The action is noted on the file copy of the form by initials and date of release of the form. Also, at this time the compensation status should be changed in the LCMS to show that the case is no longer in compensation status. If the information on the form is incorrect (i.e., wrong dates, incorrect number of days, or wrong compensation), the CE notes correction on copy four (employee's) and returns it to the EC with instructions to correct the error and return a corrected Form LS-208.
(2) Call-Up of Non-Controverted Case Files. In non-controverted claims, a call-up ranging from three to six months may be placed on the case file for later review; however, the length of the call-up is at the discretion of the claims examiner, provided that:
(a) Call-ups are being reviewed as cases become due.
(b) All initial data is available at the time the Form LS-208 is received.
(c) No immediate action is indicated, notwithstanding the need for further development or consideration of the case in the future (e.g., evaluation of PPD, disposition of a third party action, etc.).
c. Verification and Notification of Suspension to Claimant. Form LS-208 will be reviewed and verified by the CE/CEC having responsibility for the case. If the payments reported are incorrect, the EC should be advised. If the payments reported are correct as to the period, weekly compensation, and total amount, the CE should send a copy of the approved form to the claimant, and note on the original copy in the file the date that the form was sent to the claimant. If the claimant may be entitled to further compensation (schedule award), a call-up should be placed on the file pending receipt of further information.
Call-Up After Second Review. After a second review of the case file, the CE determines when the file should be reviewed again, and places a call-up on the file. The periods between reviews are based on the CE's experience and judgement as to what further action is required.
Closing Compensation Cases.
a. Conditions and Forms Required for Closure. In order to close a case file, Form LS-204, Final Medical Report (Exhibit 18, PM 10-200) or an optional narrative report and Form LS-208 (Exhibit 21, PM 10-200) should be available for consideration. However, a case may be closed without obtaining a final medical report where all of the following conditions are satisfied:
(1) The case is not controverted,
(2) The disability is short-term (i.e., less than 15 days of disability),
(3) There is no indication of permanent disability (including a scheduled loss),
(4) No further adjudicatory action appears necessary, and,
(5) Form LS-208 has been received, where appropriate.
b. CE's Analysis and Actions in Closing Case. The CE shall examine the Forms LS-204 and LS-208 to verify that they are complete. If no errors or omissions are discovered, and the CE believes that the claimant's injury could result in PPD, the CE shall prepare and release a Form Ltr. LS-403, Employee's Right to File Claim for Disability Compensation (Exhibit 38, PM 10-200) to the claimant, with a copy of Form LS-203. The Form LS-403 instructs the claimant to contact the DO if the claimant has a claim for compensation or permanency. This serves as a final check for the propriety of closing a case. The case file is returned to central file with a thirty to sixty day call-up, pending a reply. If no reply is received, the CE closes the case at the end of the thirty day period by changing the case status code in the LCMS.
c. Exceptions to Closing Procedures. There are exceptions to these closing procedures under the following circumstances:
(1) Cases where the claim is rejected or where the claimant is determined ineligible to receive compensation payments. This would include cases where it was determined by the DO or some higher adjudicative body that the claim was not under LHWCA jurisdiction. Under these circumstances, the case would be closed when an order to that effect is received by the DO. The DO has no requirement to issue an order covering such a decision, unless requested by any of the parties involved.
(2) Cases where the injured party makes no claim. The injured party usually will not have to file a claim to receive benefits under the LHWCA. In other rare circumstances, payments will not be forthcoming without specific initiatives on the part of the injured party.
(a) Occasionally, an injury report is jacketed with less than three days disability in instances where the injury is such that the CE/CEC expects some claim for partial disability. However, the injured party may fail to respond to the dispatched Form Ltr. LS-504, Letter to Employee Explaining Rights (Exhibit 40, PM 10-200) and make no such claim. After a specified period of time to allow for such a response, the case file will be called up and closed by the CE.
(b) A claimant may agree with an EC's reasons for denying the right to compensation, via Form Ltr. LS-209, Request for Employee's Reply to Employer's Objections, (Exhibit 22, PM 10-200). If so, and the CE cannot dispute the EC's contention, the case file will be closed.