Many people have questions about workers’ compensation when they’ve been injured on the job. If you have experienced a workplace injury, then you can find answers to most of your questions about workers’ compensation right here. Following is a comprehensive list of frequently asked questions and basic answers that should get you started with understanding workers’ compensation laws in Nevada. To get specific answers related to your case or a thorough analysis of what your claim might be worth, contact a Las Vegas workers’ compensation attorney.
How does workers’ compensation work in Nevada?
Workers’ compensation works in Nevada much the same way is works in other states, as a no-fault insurance program, with some differences in the laws and guidelines that vary from state to state. The goal of workers’ compensation is to provide benefits to injured employees who sustained their injuries during the course of employment while protecting the employer with adequate coverage to address workplace injuries and occupational illnesses.
What is the waiting period for workers’ compensation coverage after being hired?
There is no waiting period for workers’ compensation coverage after being hired by an employer in Nevada. According to the Nevada Revised Statutes and Nevada Administrative Code 616 and 617, you are covered by workers’ compensation insurance from the moment that you are hired.
How do I go about filing a claim for workers’ compensation?
You will begin the process of filing a claim for workers’ compensation by filing the Employee’s Claim for Compensation/Report of Initial Treatment (Form C-4). Your medical care provider will give you this form when he or she treats your injury or illness for the first time. You will fill out the top portion of the form, the treating physician will fill out the rest of the information, and you will both sign and date the form.
What is the deadline for filing a workers’ compensation claim in Nevada?
From the date of your accident, injury, or diagnosis of occupational disease, you have 90 days to file a claim for workers’ compensation. If there is a delay in discovery of the injury or cause of illness, then you have 90 days from the day of discovery to file your claim.
What steps should I take after getting injured at work?
If your injury is serious and urgent, then the first step to take is to call 911 and/or seek medical care from the nearest emergency room. However, notifying your employer of your injury as soon as possible is just as important on the list of first steps following an injury. Notify the employer in writing and keep a copy for your records. You will also fill out the employer provided Notice of Injury or Occupational Disease – Incident Report (Form C-1) and the treating physician provided Employee’s Claim for Compensation/Report of Initial Treatment (Form C-4).
Can I choose any healthcare providers that I prefer?
You cannot choose any healthcare provider (doctor, chiropractor, therapist, etc.) that you want to. You actually have to go to an authorized medical provider and member of the Panel of Treating Physicians and Chiropractors. You will be choosing from the insurers list of approved providers that may be included in a MCO (managed care organization), HMO (health maintenance organization), PPO (preferred provider organization), or an internal managed care unit with the insurance company. Of course, if you are in need of urgent care, you should always dial 911 and/or seek care from the nearest emergency room. You will then receive guidance from medical care staff as to how to proceed.
Can I use the MCO (managed care organization) for workers’ compensation?
If your employer works with an MCO, then you can receive the list of providers that are authorized by the insurer. There should be a workers’ compensation poster (Form D-1) on display at your place of employment which will provide further information. You can also get the contact information of the MCO from your employer for further direction and answers to your questions.
As an injured employee, what benefits am I entitled to?
Nevada’s workers’ compensation laws entitled injured employees to the following benefits:
- Medical treatment expenses
- Temporary/Permanent partial/total disability payments
- Vocational rehabilitation
- Death benefits to your dependents if you die from your injuries/illness
- Lost wages and future earning potential
- Various other related expenses (like mileage)
What injuries will be covered by workers’ compensation?
Any work related injuries and illnesses will be covered by workers’ compensation for employees who are eligible for coverage. Exceptions would include intentional injuries or injuries that occur while the employee is under the influence of drugs or alcohol.
Can I reopen my claim in the future if necessary?
In some situations, you may be able to reopen your workers’ compensation claim in the future. You can find information about the requirements, limitations, procedure, and general tips from a Nevada workers’ compensation attorney and from NRS 616C.390.
If my employer offers light duty work, do I have to accept it?
If your employer offers light duty work, you are obligated to accept it as long as it is within the restrictions outlined by your medical health care provider. If you reject light duty work, then you can lose your compensation and benefits (NRS 616C.475 and NAC 616C.583).
How will my average monthly wage be calculated?
You can learn all about how the average monthly wage of an employee is defined and calculated from NAC 616C.420 through 616C.447.
If employees are related to the employer, do they have to be covered?
Generally, the answer is yes, though you can find more information on this subject and the specific answer that applies to your situation in the Nevada Employer’s Guide to Workers’ Compensation (http://dirweb.state.nv.us/wcs/Brochures/employer.pdf).
If the company I work for is out-of state, do they have to provide Nevada workers’ compensation?
This question is complicated by different factors and conditions that may apply to the company that you work for. To get an idea of the requirements and exemptions that relate to out-of-state employers in Nevada, see NRS 616B.600.
If my employer is a sole proprietor, does he or she have to provide workers’ compensation coverage?
If you work for a sole proprietor employer, then he or she does have to maintain workers’ compensation coverage for all employees. The only time where a sole proprietor does not have to maintain coverage is if he or she has no employees. Even then, the sole proprietor does have the option of seeking workers’ compensation coverage for him or herself. If the sole proprietor is a contractor (according to NRS 624.020), and is operating within the scope of a contractor’s license, then coverage is required.
What do I do if I suspect workers’ compensation fraud?
If you suspect workers’ compensation fraud, you should contact the Attorney General’s Workers’ Compensation Fraud Unit at (800) 266-8688. This unit will investigate any allegations of fraud (related to employer, claimant, and provider) on behalf of the state of Nevada and self-insured employers. You can get more information from the AG Fraud website at http://ag.state.nv.us/org/bcj/spd/wcfu/wcfu.html.
Is there any way for me to verify that my employer has workers’ compensation coverage?
You can verify that your employer has workers’ compensation coverage by using the DIR/WCS’s Coverage Verification Service (CVS) at http://dirweb.state.nv.us/WCS/cvs.htm. You can search your employer by name and view policy coverage on any past or present date. This service will not display the information of self-insured employers, but you can find a list of self-insured employers on the website for Division of Insurance at http://www.doi.state.nv.us.
What if no insurance company will issue a policy to a high risk employer?
Even high risk/difficult to insure companies can find a workers’ compensation insurance policy. To find a list of residual market insurers who will provide this, visit the National Council on Compensation Insurance, Inc. website at https://www.ncci.com/pages/default.aspx.
What are the maximum and minimum disability compensation limits?
There is no minimum payment for disability, though NRS616A.120 through NRS 616A.205 specify wages of certain job trainees, board members and volunteers. When it comes to the maximum level of disability compensation in Nevada, NRS 616A.065 and NRS 616C.475 set this at 66% of the employee’s average monthly wage. If the injury occurred between July 1, 2011 and June 30, 2012, then the maximum wage that can be considered for calculation is $5,151.57. According to the 66% rule, this equates to a maximum monthly disability compensation amount of $3,434.38.
How can I find out if my claim has been accepted?
You will receive notice of whatever decision is reached by the workers’ compensation insurance provider or claims administrator that receives your claim. They have 30 days to come to a decision and let you know if your claim has been accepted or denied. If you have not received notification within this time frame, you should contact a Nevada workers’ compensation attorney to investigate.
Can I dispute the decision of the workers’ compensation insurance provider?
You can dispute the decision of the workers’ compensation insurer or self-insured employer. See NRS 616C.305 and 616C.315 through 616C.385 for more information.
How do I respond to a dispute or denial of my claim?
If the workers’ compensation insurer has denied or is disputing your claim, you can respond by requesting a hearing to resolve the dispute or appealing to the Hearing Officer. The Hearing Officer will come to a decision based on the details of your case.
If I disagree with the decision of the Hearings Officer, what can I do?
You can always file an appeal with the Appeals Officer if you disagree with the decision of the Hearings Officer. The Appeals Officer may reverse, remand, or uphold the decision of the Hearings Officer.
If an employee is an illegal immigrant, is he or she still covered by workers’ compensation statutes in Nevada?
Any employee, whether employment is lawful or unlawful (including illegal immigrants), is covered by Nevada’s statutes for workers’ compensation. The only thing that illegal immigrants are not entitled to is vocational rehabilitation (NRS 616A.105).
Who can provide workers’ compensation coverage in Nevada?
Employers may purchase insurance from a private carrier licensed in Nevada or be certified by the Division of Insurance (DOI) as a self-insured employer or a member of an association of self-insured public or private employers. Private carriers currently utilize competitive premium rates which allow them to deviate on the expense portion of the premiums. This rate must be filed with the DOI 15 days before if is effective and can be disapproved. Contact DOI for more information: Carson City (775) 687-4270; Las Vegas (702) 486-4009.
Where can employers purchase workers’ compensation coverage in Nevada?
Employers have options when it comes to purchasing workers’ compensation coverage in Nevada. They can purchase the insurance with a private Nevada licensed insurance carrier or they can become a self-insured employer and/or member of an association of self-insured public and private employers by getting certified by the Division of Insurance (DOI). Typically the most competitive rates come from private workers’ compensation insurance carriers and they are able to deviate on premium expenses. To ensure that an insurance rate is effective and can be disproved, the rate must be filed 15 days prior with the DOI. You can learn more by contacting the DOI at:
- (702) 486-4009 – Las Vegas
- (775) 687-4270 – Carson City
If my employer does not have workers’ compensation, what will happen?
If your employer does not have workers’ compensation insurance, then he or she will face legal consequences according to the Division of Industrial Relations, Workers’ Compensation Section (DIR/WCS), which ensures that employers comply with workers’ compensation laws in Nevada. Consequences can include the following:
- Fine up to $15,000
- Premium penalties
- Order to close business until workers’ compensation requirements are met
- Financial responsibility for all work-related injuries
- Criminal penalties for substantial work related injuries or death
For more information, see NRS 616D.200 and NAC 616D.345.
How are Nevada employers protected by workers’ compensation?
Nevada’s workers’ compensation statutes set forth the benefits of injured workers and Nevada has exclusive remedy. This means that employers are protected from additional claimed damages as long as they provide workers’ compensation coverage at the time of injury.
Should employers have Subsequent Injury Accounts?
Employers can choose to have Subsequent Injury Accounts which will cover the costs of any qualified subsequent injury (NRS 616B.545 through NRS 616B.590). This also encourages employers to hire workers who have physical disabilities and impairments. Learn more by contacting a Nevada workers’ compensation attorney and asking about the benefit of Subsequent Injury Accounts.
Are all employers required to provide worker’s compensation coverage?
Any employer who has one or more employee in Nevada is required to provide workers’ compensation coverage, unless a specific statute excludes the employer from this requirement. For example, NRS 616A.110 will exclude some employees from workers’ compensation coverage for meeting certain criteria in the course of their employment. Following are circumstances where this applies:
- If the employment is related to interstate commerce entities that are not subject to Nevada’s legislative power, then the employer may not have to provide coverage.
- If the employment is covered by private disability and death benefit plans which include compensation payments/benefits that are equal to or greater than what is provided by NRS 616 (and have been effective since July 1, 1946), then workers’ compensation is not required.
- If employees are insured in another state, extraterritorial coverage provisions are in effect, and the employee is only temporarily working in Nevada, then Nevada workers’ compensation coverage is not required (except in construction trades).
- If the employment is casual (meaning that it does not last more than 20 days or include $500+ in labor cost), then the employer is exempt from providing workers’ compensation coverage unless that employment is in the course of the particular trade or profession of the employer. The primary exception to this is that all construction trades are required to have workers’ compensation insurance, no matter what.
I have questions about my claim; who can I talk to?
You can contact the insurance company, claims adjuster, or your employer to get answers to your questions about workers’ compensation claims. You can also learn more from viewing Form D-1, the workers’ compensation poster displayed at your place of employment.
Who can I talk to if my claim is not being properly handled?
If you have questions or feel like your claim is not being properly handled, then you can discuss this with your supervisor, with the insurance claims adjuster, and/or with the DIR/WCS. Your insurer should also provide information about your right to appeal to the Department of Administration, Hearings Division to resolve any claim disputes. You can appeal any decisions to the Hearings Officer within 70 days of the insurer’s decision or to the Appeals Office within 30 days of a decision made by an MCO. Contact a Nevada workers’ compensation attorney for more information about procedures, protecting your rights, and ensuring that your claim is handled appropriately.
My employer changed insurance companies; what will happen to my claim?
What happens to your claim after your employer changes insurance companies will depend on a few factors. The contract that your employer had with the old insurance company will dictate whether your claim remains with the old company or transfers to the new one. If your injury occurred after the change of insurance, then your case will be handled by the new insurance. Ask your employer for more information about how the change in insurance companies affects your claim.
What if my employer won’t let me file a workers’ compensation claim?
Your employer cannot legally stop you from filing a workers’ compensation claim. If your employer tries to stop you from filing a claim or threatens to fire you for doing so, you should contact a Nevada workers’ compensation attorney to ensure that your rights are protected.
What if my employer fires me for filing a workers’ compensation claim?
Your employer cannot legally fire you for filing a workers’ compensation claim. However, the employer can fire you for any other reason, and it may be up to you to prove that you were wrongfully terminated for filing a claim. Contact a Nevada workers’ compensation attorney to learn more.
My question isn’t here; where can I find more information?
If you do not see the answer to your question here, your best bet is to contact a workers’ compensation attorney to discuss your case, Nevada laws, and any specific questions you have about your claim.