Which of the following best describes when a claims file is considered closed?

• A. When all benefits that are due and payable have been paid.
• B. When the last payment of PD has been made.
• C. When the employee has returned to work.
• D. When TD has ended.

Answer: (A)

A claims file is closed when there are no remaining liabilities—no benefits due or payable left to the claimant. In a California SIP claim, that means all indemnity payments (like temporary disability and any permanent disability) and all medical benefits connected to the claim have been resolved and paid, and there’s no ongoing obligation or pending action. Once everything the law allows has been paid, the insurer can archive the file because there’s nothing more the claimant can draw from that claim.

Returning to work can happen even if medical care or disability benefits continue, so it doesn’t by itself mean the file is closed. Similarly, the end of temporary disability or the ending of permanent disability payments can occur while there are still unresolved medical needs or other benefits, so those milestones don’t define closure on their own.