When you suffer an injury at work, you have a right to seek and apply for workers compensation benefits under the Nevada Workers Compensation laws. The laws are complex, however, and filing an injury claim on your own can be daunting. If you have a work-related injury in Nevada, you need a Nevada workers compensation lawyer to ensure that you get the financial compensation you deserve.
At the Law Office of Kathleen A. Sigurdson, Esq., in Reno, Nevada, we have experience representing individuals with workers compensation (also known as “workman’s compensation” or “work comp”) claims that you need. Our clients include persons filing initial claims as well as individuals whose benefits have been wrongfully denied. We advise workers’ compensation claimants throughout Northern Nevada.
Typically, the nature and severity of an injury, combined with the level of interference with an employee’s ability to work, will determine the extent of workers’ compensation benefits. However, disputes may arise over the extent of injuries, how they were incurred, appropriate medical care and how much they interfere with work. Often, many people who desperately need workers’ compensation benefits are delayed, mistakenly denied, or have their benefits cut-off. We can help.
When you have been injured on the job, you MUST do the following things:
- Report your injury to your employer. The law states you have SEVEN (7) days to report your injury. Please, do not wait. Report your injury to your employer immediately. Make the report in writing and keep a copy of the report yourself.
- You must obtain medical attention from a physician. Do this right away. The law gives you 90 days to go to the doctor, but do not wait. The longer you wait, the harder it will be to show the insurance company your medical problems were caused by your work.
- The insurance company has 30 days to tell you if they are accepting your injury or denying your claim. When you get the letter accepting your claim, make sure they have listed all the body parts that were injured at work. If they are not on this acceptance letter, they are not part of your claim.
- If the insurance company has denied your claim, you MUST file a Request for Hearing within 70 days of the date of the letter. If you miss this deadline, your claim is lost and you cannot seek medical care or compensation under this claim. Of course, there are a few exceptions, but, always do your best to comply. The exceptions are extremely hard to prove.
- Anytime you get a determination letter from the insurance company on any issue in your claim/case and you disagree with their determination, you only have 70 days to file a Request for Hearing.
- There are two levels of appeals in the Workers Compensation arena.
- a. First, there is a Hearing’s Officer hearing. Each party has the opportunity to tell the Hearing’s Officer why they should get what they are asking for. If you lose or if the insurance company loses, there is another administrative level of appeal available.
- b. Second level is the Appeal’s Officer hearing. This is a more formal proceeding. The Appeal’s Officer is a Judge who renders a final decision. You will get sworn in and anything you say will be under oath. Everything anyone says will be recorded. The Appeal’s Officer will hear the testimony, review the evidence and will render a Decision.
- c. You do have appeal rights to the District Court or Nevada Supreme Court, but you must decide this after a length discussion with your attorney to decide if it is worth taking to the next level. There are very specific legal standards that would apply and these need to be carefully reviewed.
- It is important to remember, Nevada is a no fault state when it comes to injuries on the job. This means, it doesn’t matter if you were negligent or if your employer was negligent and the result was your injury. So long as you were not using illegal drugs or under the influence of alcohol at the time of the injury, your claim should be accepted. Of course, there are exceptions, but these can be discussed with Kathleen.
- Remember, each case is different and there is no guarantee. The facts and circumstances of your case will determine the outcome and the amount of you recovery. Often, people talk to friends and neighbors who will tell them how to go about their worker’s compensation case. If this is happening to you, you should consult with a qualified attorney to help you with your claim.
- If you think you need help with your case, please call an experienced and reputable attorney, such as Kathleen A. Sigurdson, Esq., to assist you with your case.
- If you were injured due to faulty machinery, call an attorney IMMEDIATELY. The piece of machinery that caused the injury will need to be examined promptly after the accident by your representative.
Contact Us for a personal consultation.
The workers compensation system provides benefits if you become injured on the job or ill from your job. Generally, you do not have to prove that the accident or illness was your employer’s fault or that it was not your fault (exceptions – see NRS 616C.230).
- Pays for reasonably necessary medical services related to the injury;
- Pays compensation for part of your wage loss or inability to earn a full income;
- Pays compensation for permanent loss of use of or loss of body function;
- Pays benefits to dependents for a work related death;
- Pays for vocational rehabilitation services if you cannot return to the job or to the employer you had before your injury, or other gainful employment (see NRS 616C.555);
- Helps you return to work as soon as reasonably possible;
- Attempts to return you, as close as possible, to the income you had before the injury.
Who pays the workers compensation benefits?
Employers purchase workers compensation policies from insurance companies; some employers are approved to be self-insured; they pay the benefits themselves. Most self-insured employers hire third party administrators to administer claims.
Either insurance companies or approved self-insured employers pay benefits to injured workers for wage-loss and permanent loss of use of body functions. Insurers pay the medical and vocational rehabilitation costs directly to the service providers. Insurers reimburse employees for some expenses such as mileage under certain circumstances.
What about the injured worker’s rights?
Under state law you have the right to file for workers’ compensation benefits. You do not have to pay for any workers compensation benefits. State law requires employers to have workers’ compensation insurance to pay for all workers compensation benefits.
What should I do when I am injured?
- Report your injury to your supervisor as soon as possible and complete a written report on the form provided by your employer (C-1 form).
- Get prompt medical care, and complete a C-4 form – Employees Claim for Compensation/Report of Initial Treatment. This form is completed by the injured worker and the physician or chiropractor and submitted to the insurer by the medical provider to initiate an injured worker’s claim.
- Inform your employer about your medical condition and when you can return to work; this information should be provided to you by your medical provider at each visit. Call your insurer / administrator if you have questions or problems with your claim.
What does my employer do?
Your employer completes a C-3 form – Employer’s Report of Injury form and sends it to the insurance company; or the plan administrator, if self-insured.
What does the insurance company/administrator do?
After you have reported the injury, the insurer/administrator investigates the injury report and makes an initial decision about whether to accept or deny your claim based on the circumstances surrounding your injury and the laws governing workers compensation insurance in this State.
What benefits do I receive?
If your Doctor states in writing that you are temporarily unable to work because of your injury, or places physical restrictions on you that your employer cannot accommodate, you will receive Temporary Total Disability (TTD) benefits.
What if I need help returning to work?
Talk with your employer and your treating physician about going back to work. Your employer may provide accommodations to help you return to work. If you cannot return to your employer because of your injury, vocational rehabilitation services may help you find work with a new employer.
Problems with my claim
Most workers’ compensation claims are paid without any problems, however if you think the insurance company/administrator is not paying you correctly, or not paying your medical bills, you may want to do the following:
- Contact the claims adjuster – write down the date, time, and adjuster’s name for your records. Explain the problem and attempt to work it out; many times problems are fixed with a simple telephone call. If not, put your request in writing and send it to the insurer/administrator.
- Be sure the insurance company really must pay for what you want. Determine if the law allows the benefit you believe you should have.
- If you continue to have difficulty with your workers compensation claim (benefit or medical management issues), you may call the Office of the Governor, Consumer Health Assistance at 702-486-3587 or toll free at 888-333-1597.
- If you believe your insurer has violated a law or regulation, you may contact the Division of Industrial Relations (DIR), Workers Compensation Section (WCS) to report the suspected violation. You may reach them in Southern Nevada at 702-486-9080 or in Northern Nevada at 775-684-7260.
- If you think you are in need of legal assistance, the Nevada Attorney for Injured Workers (NAIW) may be available to represent you without fee. You may reach the NAIW in Southern Nevada at 702-486-2830 or in Northern Nevada at 775-684-7555.
- Helpful Hints for Injured Workers Attend and participate in all scheduled physician appointments and other provider appointments (such as physical therapy);
- Inform your employer about your medical progress and plans to return to work;
- Keep in frequent touch with your claims adjuster, medical personnel, and vocational rehabilitation counselor;
- Put your name, Social Security number and date of injury on all papers and forms sent to the insurance company to help process them quickly. Clearly identify your employer and its insurer;
- Save copies of all case documents, letters, forms, compensation checks and medical bills (generally injured workers should not receive any medical bills);
- Save notes of telephone conversations;
- Keep track of your mileage for vocational rehabilitation and medical visits to possibly qualify for reimbursements.
- Keep on top of your claim – assist with the management, and know where to turn if you have problems.