(a) Based upon investigation and available information, the administrator will make a determination of the responsibility of the casino and will either accept or deny a claim. Within 90 days of receipt of receiving notice of a work injury, the administrator will advise the claimant and the casino of its decision in writing.

(b) In its sole discretion, the administrator will determine the reasonableness and necessity of medical care and charges and will determine amount payable under this chapter. The administrator will also approve or disapprove any change of primary physician, referral to referral physician, or surgical procedure.

(c) Based on information supplied by the casino and/or claimant, the administrator will determine compensation rates for temporary total, temporary partial, permanent partial disability and dependency and the length of time that such benefits shall be paid.

(d) The administrator will determine the length of time during which temporary total or temporary partial disability benefits are payable.

(e) The administrator will determine the amount of permanent partial disability benefits payable.

(f) The administrator will determine the eligibility of dependents and the term of any dependency benefits payable.

(g) In the event of the need to allocate dependency benefits between dependents living in different households, the administrator will make the necessary allocations, based on the obligations, legal or otherwise, of the decedent.

(h) The administrator will, on behalf of the casino, vigorously pursue any cause of action assigned to the casino under this chapter.

(i) If an employee’s claim is subject to the limitations of YTC 5.65.290, the administrator will advise the employee and casino in writing of the effect of this limitation in writing.

(j) Benefits payable to employees pursuant to this chapter shall be comparable to those mandated for comparable employees under state law. Notwithstanding this provision, nothing in this section or chapter shall mandate the Tribe to provide benefits where the administrator or Appeal Board or single arbitrator has deemed the claim noncompensable, or the available of particular benefit is inapplicable under this chapter. [Ord. 47 § 1101, adopted, 11/10/2016.]