How does workers’ compensation work?
Workers’ compensation works as a no-fault insurance plan for workers in the state of Nevada. It provide benefits to any employee who is injured at work and protects employers who provide coverage.
What is the waiting period for workers’ compensation coverage?
There is no waiting period. You are covered under applicable statutes and regulations in the Nevada Revised Statues and Nevada Administrative Code 616 and 617.
If the employee is a family member, does he or she have to be insured too?
Get the answer that relates to your case in the Nevada Employer’s Guide to Workers’ Compensation: http://dirweb.state.nv.us/wcs/Brochures/employer.pdf. Typically, the answer will be yes.
If you work for an out-of-state company, do they have to offer Nevada workers’ compensation coverage?
This will depend on the situation and certain conditions as described in NRS 616B.600.
Does a sole proprietor have to have workers’ compensation coverage?
If a sole proprietor has no employees, he or she does not need to maintain workers’ compensation coverage. A sole proprietor does have the option of getting workers’ compensation coverage for personal security. If there are any employees who work for the sole proprietor, then workers’ compensation coverage will be required. A sole proprietor who is a contractor (according to NRS 624.020) and is operating within the scope of their license must have coverage.
What do I do if I become aware of Workers’ Compensation fraud?
If you become aware of workers’ compensation fraud, then you need to contact the Attorney General’s Workers’ Compensation Fraud Unit to investigate the allegations. This unit will investigate any kind of fraud related to workers’ compensation. You can call the AG Fraud Hotline (800-266-8688) or visit their website for more information at http://ag.state.nv.us/org/bcj/spd/wcfu/wcfu.html
Can I verify that my employer has workers’ compensation coverage?
DIR/WCS’s Coverage Verification Service (CVS) can help users verify workers’ compensation coverage of employers who have policies with private carriers. CVS searches can indicate policy coverage status on current and past dates. http:dirweb.state.nv.us/WCS/cvs.htm
You can verify that your employer has workers’ compensation coverage by using the DIR/WCS Coverage Verification Service (CVS). This system will not show self-insured employers. You can do a search for your employer for information on past and present coverage. Visit http:dirweb.state.nv.us/WCS/cvs.htm. You can also view a listing of self-insured employers at the Division of Insurance website: http://www.doi.state.nv.us/
What if no insurance company will issue a policy to a particular employer?
Some businesses are difficult to insure, so there is a National Council on Compensation Insurance where employers can find residual market insurers who will provide coverage.
What if I want to reopen my claim sometime in the future?
It is sometimes possible to reopen a claim. You can view the requirements, limitations, and procedures for this in NRS 616C.390. You can also get more information from http://naiw.nv.gov/
If my employer offers light duty work after my injury, do I have to accept it?
According to NAC 616C.583 and NRS 616C.475, an injured worker must accept light duty work offers from his or her employer or he or she may lose all compensation and benefits.
How will they determine my average monthly wage if I’m injured?
There are specific methods of calculating your average monthly wage after an injury. You can learn about the details of these methods in NAC 616C.420 through NAC 616.447.
What are the maximum and minimum compensation levels?
The maximum disability compensation is 66% of average monthly wage. The maximum considered wage for calculating this for FY 2013 (6/1/11 to 6/30/12) is $5,151.57. 66% of this is a maximum compensation amount of $3,434.38 per month. Though NRS 616A. 120 specifies deemed wages for volunteers, trainees, etc., there is no minimum payment for disability.
What if I want to start a dispute?
You can always dispute the decision of the insurer or self-insured employer, as per NRS 616C.305 and NRS 616C.315 through 616C.385 provisions.
Do Nevada’s workers’ compensation statutes cover illegal immigrants?
Illegal aliens are covered by Nevada’s workers’ compensation statutes, in accordance with NRS 616A.105. They are not eligible for vocational rehabilitation, however.
Is my employer breaking the law by not maintaining workers’ compensation insurance?
To be in compliance with Nevada laws, employers must maintain workers’ compensation insurance. The Division of Industrial Relations, Workers’ Compensation Section (DIR, WCS) is responsible for ensuring that employers follow this law. If they do not, they can face fines up to $15,000, premium penalties, and potentially having to close down their business until they can comply with the workers’ compensation laws. If any employee injuries occur, the employer will be financially responsible. The employer can even face a criminal penalty if serious injury or death occur (NRS 616D.200, NAC 616D.345).
Where can my employer get workers’ compensation coverage in Nevada?
Private carriers who are licensed in Nevada or who are certified by the Division of Insurance (DOI) as self-insured/member of public or private self-insured association can provide workers’ compensation coverage to your employer. A private carrier will have competitive rates which must be filed 15 days before being effective with the DOI. You can reach the DOI for more info: (775) 687-4270 (Carson City) or (702) 486-4009 (Las Vegas).
Does the employer receive any kind of protection?
‘Exclusive remedy’ is applicable in Nevada, meaning that the statutes set forth the benefits of injured workers, and employers are protected from additional damages that may be claimed by injured workers. As soon as an injured worker decides to receive workers’ compensation benefits, this protection applies to his or her employer.
What are Subsequent Injury Accounts?
Subsequent Injury Accounts cover the costs of subsequent injuries when workers have permanent disabilities (NRS 616B.545 through 590).
Are there any employers who don’t have to provide workers’ compensation?
There are certain state exclusions and exceptions, but most employers have to provide workers’ compensation insurance. The employees who are excluded because of unique criteria according to NRS 616A.110 include the following.
- Employees of any interstate commerce entities not subject to Nevada’s legislative power.
- Employees covered by private disability and death benefit plans, if compensation payments have been in effect for one year before July 1, 1947 and are equal to or greater than NRS 616 amounts.
- Employees insured in another state who are only in Nevada temporarily, except for construction trades, which are all required to have workers’ compensation.
- Employees who are “casually” employed, where employment lasts no more than 20 days with less than $500 in labor costs, as long as employment is not in the trade of the employer.
If I get hurt on the job, what steps should I take?
The first thing that you need to do if you are hurt on the job is to inform your supervisor. In an emergency, seeking medical care will the first step, but you must notify your employer as soon as possible and fill out the associated forms that your employer will provide. These include the Incident Report (Form C-1 – Notice of Injury or Occupational Disease) and the Report of Initial Treatment/Claim for Compensation (Form C-4).
Can I choose my own health care professionals?
You cannot choose any health care professional you prefer. Rather, you have to see an authorized medical provider and member of the Panel of Treating Physicians and Chiropractors. Your employer may have a Managed Care Organization (MCO) insurer, a Preferred Provider Organization (PPO) insurer, a Health Maintenance Organization (HMO) insurer , or an internal managed care unit insurer. If you have a serious injury, go to the neared emergency room.
Can workers’ compensation come through Managed Care Organizations (MCOs)?
You can get workers’ compensation through MCOs. Ask your employer/insurer for the authorized provider list of the insurer. View Form D-1 (the workers’ compensation poster) that should be displayed at your place of employment. You can also get more information from your employer.
Which kinds of benefits might I be entitled to if I am injured at work?
There are many benefits that injured workers may be entitled to including:
- Medical treatment/expenses
- Lost wages and future earning potential
- Permanent partial or total disability
- Vocational rehabilitation
- Payments to dependents in event of death
- Other related expenses (like mileage)
Who can I ask about my claim if I am injured at work?
You can ask questions about your claim with your insurer, employer, or claims adjuster. You can also learn more by viewing the workers’ compensation poster at your place of employment.
If my claim is not being handled correctly, who do I talk to?
The first step is to discuss your claim with your supervisor. Next, you can contact the claims adjuster.
Finally, the DIR/WCS can be contacted if your concerns are not appropriately addressed. State law ensures that all insurers provide a right to appeal to the Department of Administration, Hearings Division, which resolves disputes. Whenever an employee disagrees with the determination in a claim, he or she can appeal that decision within 70 days of the determination. You can also appeal to the Appeals Office within 30 days of an MCO determination. Contact a Nevada attorney to learn more.
My employer changed insurance companies, so what happens to my claim/benefits?
Your open claim might stay with the old insurer or it may transfer to the new one. It all depends on your employer’s contract, and you’ll want to ask your employer about this. If the injury occurred after the switch to a new insurer, then the new insurer will handle the claim.