146 P.3d 801, 805 (2006) ("[T]his court affords no deference to the district 

court's ruling in judicial review matters."). 

We conclude that the appeals officer erred in his 

interpretation of NRS 616C.495. See City of N. Las Vegas v. Warburton, 

127 Nev. 682, 686, 262 P.3d 715, 718 (2011) (stating this court reviews 

questions of law, like statutory interpretation, arising out of 

administrative appeals de novo). When a person seeks to reopen his or her 

workers' compensation claim after accepting a permanent partial 

disability (PPD) lump sum payment, NRS 616C.495 controls. Under NRS 

616C.495(2)(a)(1)'s plain terms, a person can reopen his or her workers' 

compensation claim after accepting a PPD lump sum payment if he or she 

satisfies the requirements of NRS 616C.390.' 

Here, Vela accepted a PPD lump sum payment, and then 

sought to reopen her workers' compensation claim. However, instead of 

looking only towards the requirements of NRS 616C.390, as instructed by 

NRS 616C.495, the appeals officer relied on NRS 616C.495(2)'s language 

that "Mlle claimant's acceptance of [the PPD lump sum payment] 

constitutes a final settlement of all factual and legal issues in the case," 

and other appeal dates and waiver language which arose over the course 

of Vela's workers' compensation claim. As a result, the appeals officer 

precluded Vela from reopening her claim. This was error. In assessing 

whether Vela could reopen her claim, the appeals officer should have 

focused entirely on NRS 616C.390. See Day v. Washoe Cnty. School Dist., 

'All of the paperwork signed by Vela in accepting her PPD lump 

sum payment mirrored the language of NRS 616C.495, and thus, aligns 

with the statutory interpretation of NRS 616C.495 as set forth. 

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121 Nev. 387, 390, 116 P.3d 68, 70 (2005) (explaining in a case featuring 

similar facts that when an injured employee seeks to reopen his or her 

workers' compensation claim, the pertinent analysis falls under NRS 

616 C .390). 

Under NRS 616C.390, an insurer must reopen a claim if (1) 

"[the] application to reopen a claim is made in writing within 1 year after 

the date on which the claim was closed," (2) "[t]he application is supported 

by medical evidence demonstrating an objective change in the medical 

condition of the claimant," and (3) "[t]here is clear and convincing evidence 

that the primary cause of the change of circumstances is the injury for 

which the clam was originally made." NRS 616C.390(4). 

Vela satisfied NRS 616C.390's first requirement because she 

filed her application to reopen her claim only 15 days after her claim had 

closed. The appeals officer's factual findings support this, as he found that 

Vela "requested reopening only two weeks after the closure of her claim." 

While it is not clear what the appeals officer precisely found in regards to 

the second element, his findings generally, along with evidence in the 

record, support the conclusion that Vela's application to reopen was 

supported by medical evidence demonstrating an objective change in her 

medical condition. 2 

Finally, as to NRS 616C.390's third requirement, the appeals 

officer found that Vela had "not shown that her worsening of condition is 

primarily related to the industrial strain of her lumbosacral spine." We 

conclude, based on the record as a whole, that this finding by the appeals 

2This conclusion is supported by Dr. Lynch's diagnosis and reliance 

on an X-Ray and an MRI, and Dr. Hall's affirmation of that diagnosis. 

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officer was clearly erroneous. See Day, 121 Nev. at 389, 116 P.3d at 69 

("While this court will not substitute its judgment for that of the agency as 

to the weight of the evidence, this court will reverse an agency decision 

that is clearly erroneous in light of reliable, probative, and substantial 

evidence on the whole record." (internal quotations omitted)). In making 

his decision, the appeals officer gave more weight to office paperwork and 

Dr. Hall's expert opinion (who only spent 30 minutes in total on the case), 

over Dr. Lynch's expert opinion (a board-certified spinal neurosurgeon who 

treated Vela), Dr. Rappaport's expert opinion (who treated Vela), and Dr. 

Nagy's expert opinion (a board certified neurosurgeon). 3Thus, we 

conclude that Vela satisfied all the requirements necessary to reopen her 

workers' compensation claim after the awardS of her lump sum payment. 

We further conclude that CCMSI is equitably estopped from 

limiting Vela to treatment for a lumbar strain because (1) CCMSI covered 

her treatment by Dr. DeMordaunt even when he treated her for more than 

a strain, (2) CCMSI's claim manager Hickson told Vela over the phone she 

could reopen her claim for surgery, and (3) CCMSI never issued a letter to 

Vela pursuant to NRS 616C.065(7) denying coverage of her spinal 

conditions beyond a strain. See Dickinson v. American Medical Response, 

124 Nev. 460, 467, 186 P.3d 878, 883 (2008) ("Equitable estoppel may be 

invoked against a party who claims a statutory right in administrative 

3We have considered the parties remaining arguments and conclude 

that they are without merit. Specifically, the argument CCMSI raised in 

its answering brief that it cannot be held responsible for payment to Dr. 

Lynch because Dr. Lynch was not on the insurer's panel of treating 

physicians, as well as the argument that Vela never requested a change of 

physician pursuant to NRS 616C.090, are not appropriate for this appeal. 

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workers' compensation proceedings, when the invoking party has 

reasonably relied on the other party's words or conduct to her detriment.") 

Accordingly, we 

ORDER the judgment of the district court REVERSED AND 

REMAND this matter to the district court for proceedings consistent with 

this order, and instruct the district court to enter an order reversing the 

appeals officer's decision. 

Gibbons 

, J. 

cc: Hon. James E. Wilson, District Judge 

James Georgeson, Settlement Judge 

Nevada Attorney for Injured Workers/Carson City 

Attorney General/Carson City 

Beckett, Yott, McCarty & Spann/Reno 

Carson City Clerk 

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