007-1 Wyo. Code R. §§ 1-7 - Determination of Claims

(a) While serving in state active duty, the adjutant general may pay or reimburse reasonable medical expenses incurred by an officer or enlisted man as a direct consequence of state active duty. Medical expenses paid or reasonably eligible for payment by any third party on behalf of the officer or enlisted man shall not be eligible for payment or reimbursement.

(b) Medical expenses are the direct consequence of state active duty if the medical expense is for the treatment of a medical condition that arises out of and in the course of the member's service in state active duty, except that it shall not include medical expenses resulting from medical conditions due to gross negligence, intoxication, or culpable misconduct of the member receiving medical treatment.

(c) Only reasonable medical expenses paid or payable by the officer or enlisted man as a direct consequence of state active duty will be allowed for direct payment to a provider or reimbursement.

(d) Following its investigation, the Human Resources Office shall promptly make its written decision. If the Human Resources Office denies any claim, it shall serve by mail or personal delivery a copy of its written findings and decision to the member and a copy to the Adjutant General, advising the member that he/she has fifteen (15) calendar days from the date the decision was mailed or personally delivered to the member to request a hearing, in writing, before the Adjutant General. The request shall state the reason and basis for the request and disagreement with the Human Resources Office's decision. If a member fails to request a hearing within fifteen (15) calendar days from service of the Human Resources Office's decision, the Human Resources Office's decision shall become final.

(e) If the member timely requests a hearing, the Adjutant General shall forward the matter to the Office of Administrative Hearings (OAH) to conduct a hearing and provide a recommended decision. Following receipt of the OAH's recommended decision, the Adjutant General shall make the final decision.

(f) The Adjutant General's final decision shall be sent to the member by mail or personal delivery.

Notes

007-1 Wyo. Code R. §§ 1-7

Amended, Eff. 3/21/2018.