Filing a Workers Comp Claim in Nevada

Filing a worker compensation claim in Nevada can be complex.

Every illness, injury and accident will have their own set of circumstances.

Most employees are required to carry work comp insurance.

Having a smart attorney that knows the process is often needed in these situations to get the benefits that you deserve.

Filing out the forms and paperwork alone can be daunting for those not familiar with the legalities of the claim.

There will be deadlines and other matters that will need expert attention.

Medical care and financial help are benefits that workers are entitled to under the state’s law.

When there are disputes over claims, having a work comp attorney will be valuable.

The system is designed to provide medical treatment to employees injured on the job.

Illness is also covered, as is providing replacement of wages that were lost.

The employer’s insurance will cover this in most cases.

There are several steps that the worker must take in order to secure their benefits.

Here are some of them below.

how to file work comp claim in nevada

How to File a Work Comp Claim in Nevada

Report the Injury: If injured on the job, an employee must report it to the employer within 7 days. A “Notice of Injury or Occupational Disease” should be provided by the employee. This is called a C-1 Form, which is used to provide documentation of the injury or occupational illness. Information of the employee, like name and job title, will be provided on this form. The date, time, and location of the injury or illness will also be included. Detailed descriptions of how the event occurred will be included. If there were witnesses, their information will also be part of the form. If there is medical treatment needed, then a C-4 form will need to be filled out next.
Seek Medical Treatment: The C-4 Form is where the claim begins. This form must be sent to the employers’ insurance company that they use for workers’ compensation coverage. The C-4 will need to be filled out by you in the specified part when you first go to the medical provider. Not filing the form out properly will delay the claim. “Employee’s Claim for Compensation/Report of Initial Treatment” is the title of the form. The physician must also fill out the form. Once he does this, he must send a copy to your employer and their insurance company. Once the C-4 is properly completed, then your claim is official and begins. It is vital that you get a copy and save it for your records. There is a time limit on when to fill out this form. All of this must be done within 90 days from the date of the occupational illness or injury.
Insurance Review Process: There is a 30-day period for the insurance company to accept or deny the claim. If accepted the benefits to the employee will include medical treatment and care. These include permanent total disability (PTD) or permanent partial disability (PPD). Temporary partial disability (TPD) or Temporary total disability (TTD).

Vocational Rehabilitation in Work Compensation Cases

This can be helpful in the recovery process of an injured employee.

Vocational rehabilitation can assist injured workers in returning to the workforce.

A worker that can no longer do the tasks of their previous job can get training and new job skills.

Job placement is also available through this program.

Career Counseling: This gives an employee a chance to look at new career paths that are suited to their abilities.
Job Training and Skill Development: An employee looking to get back in the workforce can get training for jobs that align with their medical limitations.
Job Placement: This will help to find employment for those medically ready to get back to work.
Educational Support: Furthering your training and education can be valuable to getting hired. This will allow access to courses and certifications that can make it easier to get employed.
Accommodations in the Workplace: This will make sure that the worker can safely perform their tasks in the workplace.

Vocational rehabilitation is valuable to the employee in many ways.

Coming back to work from injury or illness can be difficult.

This can help with sense of purpose and self-esteem.

It can also restore earning potential and ease the financial burdens from an injury.

Potential conflicts with insurers are reduced if the worker is actively participating and seeking to return to the workplace.

It’s always smart to speak to a top Vegas personal injury lawyer before you do anything else.

What Reasons for Claim Denials?

There are a multiple reasons why workers’ compensation claims are denied.

Documentation, eligibility, and other disputes can cause a claim not to be accepted by the insurance company.

Late Reporting: It is critical to the claim that employees in Nevada report the injury within 7 days. This is cause for denial if the 7 days pass beyond this time without reporting.
Evidence: There will need to be proof of the injury. The injury must have taken place at the workplace in order to have a valid claim. If there were no witnesses or medical reports to support the claim it can be denied.
Inconsistencies in Reports: If there are discrepancies in medical records and witness statements this can cause reason for denial. Employee reports must be consistent with the evidence. If the details of the claim are in question the insurer can deny it.
Pre- Existing Conditions: In some cases, an injury may have taken place before the injury on the job. If there was a prior medical condition the insurance company can dispute the claim. They may argue that the injury was caused on the job.
Failing to Seek Medical Care: There must be medical records to support the claim. If these are not. It is vital to get medical attention immediately after the injury. If the employee waits too long the claim can be challenged by the insurance company.
Employer Disputes: An employer can contest the claim if they believe that the injury did not occur on the job. It may be believed that the injury occurred during non-work activities or after work hours. In this case the claim can be denied. There are also some injuries that may not be covered.
Missed Deadlines: C-4 Forms must be filled out properly and completed within the 90-day period after medical treatment. A failure to do so will result in a claim denial.
Lack of Coverage: If an employer is not covered adequately or at all with workers’ compensation insurance, the claim will have issues. Employers are legally obligated to cover employees in most cases.
Insurer’s Error: Some claims are denied due to insurance companies mistakes. This could be a procedural error or misinterpretation of the claim. Errors do happen and workers can appeal the decision. This will take time and effort.

Appealing a Denied Work Comp Claim

It is possible to file an appeal for a denied worker compensation claim in Nevada.

There are certain steps that will need to be taken in order to challenge the decision and seek the benefits that you feel you deserve.

Here are some steps to take when doing so.

Review of Denial Letter: If your claim is denied a Notice of Claim Denial letter will be sent from the insurer to you. It is important to carefully analyze the letter and understand the reason for the denial. It is important to maintain accurate and detailed records of the claim. This will include medical records, witness statements, accident reports, and other documents that support your claim.
File a Hearing Request: Within 70 days of receiving the denial you must submit a request for a hearing. This will be given to the Nevada Department of Administration Hearings Division. This will be the legal way to challenge the insurer’s decision before an administration hearing officer.
Preparation: Evidence and arguments must be prepared. Witnesses statements, medical records, and expert opinions are some of the ways of providing evidence that supports your case. This is recommended to do with a workers’ compensation attorney. This will give you your best chance of having a successful outcome.
Attend the Hearing: A hearing officer will be provided with all documentation and evidence of the claim. Having an attorney representing you at the hearing is highly recommended. An argument for why the claim should be accepted will be given. The hearing officer will analyze all the evidence and issue a decision.
Higher Level Appeal if Necessary: If the first hearing officer denies your appeal you can request a second review. An appeals officer can take a look at the claim. In the cases where claims are still denied it is possible to appeal to the District Court or even to the Nevada Supreme Court.

As you see a work comp claim can get complicated.

The Law Offices of Richard Harris are well aware of this.

We have been working on these types of cases in Nevada since 1980.

Our record speaks for itself. We have won $ billions for our clients over the years.

We are here to protect your rights and fight to get you the compensation you deserve.

common workplace injuries

Most Common Workplace Injuries

All types of industries are affected by workplace injuries.

Work comp claims are filed for various reasons.

Accidents on the job can be devastating.

It is important to understand how these injuries occur so that they can be prevented in the future.

Safety of the employee should always come first.

Overexertion Injuries: This type of injury occurs when a worker pushes, pulls, or lifts something. Carrying objects can also lead to this type of injury. Strained muscles, sprains, strains, and torn ligaments can be the result. These are most common in manufacturing and construction jobs.
Slips, Trips, and Falls: This is one of the leading causes of injuries in the workplace. Wet floors, cluttered spaces, cracked tiles, uneven floors, grease, and inadequate lighting are the main contributors. Fractures, traumatic brain injury, and spinal injuries can do serious harm. Falling off a ladder, scaffolding or rooftop can be catastrophic. Recovery can be long-lasting and ongoing in the most severe injuries.
Machinery Accidents: Workers that work with heavy machinery are at risk of accidents. These accidents can cause severe injuries. Some of these include crushed limbs, amputations, and lacerations. This can be fatal. Employers must give employees proper training, equipment, and safety protocols when working with machinery.
Harmful Substance Exposure: Chemicals and toxic fumes can cause serious harm to workers. Long-term health issues can occur from this type of exposure. Respiratory problems and other complications can cause an employee to file a workers’ compensation claim. Proper safety equipment must be used in order to prevent these types of injuries. Goggles, masks, gloves, and protective clothing are just some of these.
Repetitive Strain Injuries: RSI can occur from repeating the same motion over and over again on the job. Typing and assembly line work can seem harmless but can cause serious damage to nerves and tendons. Carpal tunnel syndrome, tendonitis, and chronic pain can result from repetitive strain injuries.
Burns and Electrocutions: Workers can get injured by burns from hot surfaces, chemicals, and fires. Faulty wiring, and jobs that deal with electrical equipment injuries are common. Immediate medical attention is needed when these types of injuries occur on the job.