This comprehensive Nevada workers’ comp guide will give you the details you need when preparing a workers’ compensation claim in this state. You’ll learn more about the benefits you may receive in a settlement, the kinds of injuries that Nevada law covers, how to report a work-related injury, and what to expect throughout the claims process.
After reading this guide, you should have a better idea about what a workers’ comp claim will entail as you build a potential case.
Workers’ Compensation in Nevada
Nevada workers’ compensation is a form of exclusive remedy that enables injured or ill workers to recover compensation through an insurance claim. This type of compensation protects employees and employers alike. While employees can recover compensation for various expenses resulting from a work injury, employers can avoid lawsuits following workplace incidents.
Employers in Nevada with one or more employees must carry a certain amount of workers’ comp insurance to remain protected and provide workers with a means of compensation. Exceptions include companies or individuals hiring independent contractors or others who don’t qualify as actual employees.
If your employer must carry workers’ comp insurance but doesn’t have any, you may still recover compensation through the State Uninsured Fund. In these cases, employers would need to pay back the compensation that the State Uninsured Fund pays out in a settlement, and they may face fines under the Division of Industrial Relations.
Benefits for Injured Workers in Nevada
Before filing a workers’ comp claim, you might wonder, “How much are Nevada workers’ comp settlements?” These settlements could pay out as much as 66% of the state’s average monthly wage. However, the specific amount of compensation you’re able to recover will depend on the damages involved in your case and the total financial losses you sustain.
An injured worker can recover multiple types of compensation in these cases, including:
- Medical expenses, including emergency care, ambulance rides, diagnostic costs, ongoing and future care, and the cost of assistive devices like wheelchairs
- Lost income resulting from time taken off from work to recover, along with lost earning capacity if you are unable to return to work in the same job
- Disability benefits, including partial or total permanent or temporary disability, depending on the extent of your injuries and ability to return to work in any capacity
- Death benefits for the families of workers who die on the job
Types of Injuries and Conditions Covered Under Nevada Workers’ Comp
Nevada law covers many types of one-time injuries, occupational illnesses, and conditions through workers’ compensation. For coverage to apply, these injuries must develop on the job.
Workers’ comp law in this state only covers injuries that occur within the scope of the worker’s employment. In other words, injuries must occur while the employee is actively working and can’t occur before work or during a break when the worker is off the clock.
While a one-time injury under Nevada law involves a single injury that occurs on the job, such as a fall from a high surface, occupational diseases or illnesses develop over time. An example of an occupational disease could include an illness that an employee develops following long-term exposure to toxic chemicals in the workplace.
Reporting a Workplace Injury
After sustaining a work-related injury, you must report the injury to your employer as soon as possible to begin a workers’ compensation case. Waiting too long to report to your employer could compromise your case and limit your ability to seek compensation.
Once you report your work injury, your employer can then provide you with the necessary paperwork to begin a workers’ compensation claim. Your employer would also be responsible for designating a specific doctor for you to visit when seeking a medical exam and treatment.
Report Injuries Before the Deadline
In Nevada, like other states, you have a limited amount of time to report work injuries to an employer before you’re unable to begin a workers’ comp case. In this state, the time limit is only seven days following the date of the injury.
If you sustain a serious injury that requires immediate care, and you’re unable to report the injury on your own, you may have someone else report for you if possible. You can then report to your employer once you’re capable of doing so.
Reporting shortly after your injury offers a couple of key benefits beyond exceeding the state’s time limit for reporting. The sooner you report, the more accurate the details of the accident are likely to be in your mind. You’ll have a better recollection of events and know what transpired, which means you’re likely to give better details to the employer. Reporting early also allows you to get a quick start on your workers’ compensation case, which can help you recover financially to cover all costs resulting from your condition.
Medical Treatment and Care
As mentioned, your employer will specify which doctor to see for examination and treatment for your injury or illness. However, you may be able to see another physician if you feel that your current physician isn’t giving you the right treatment. A workers’ comp lawyer could help you find the right physician based on your unique care requirements.
You may also ask, “What medical treatment is covered by workers’ compensation?” Workers’ comp in Nevada covers all medical costs deemed medically necessary by your healthcare provider.
Steps in a Workers’ Comp Claim
When you decide to file a workers’ comp claim, there are some key steps to keep in mind. After reporting your injury and filing your claim, the following are the main processes involved that will affect the outcome of your case.
Investigation and Decision
The first step after filing will involve an investigation into your claim. The workers’ comp insurance company behind your employer will assign investigators to review your claim and initiate an investigation to determine whether your injury was work-related.
During the investigation, your employer and investigators will request statements from witnesses and colleagues. Some job sites may also have security camera footage or other means of surveillance that could provide additional evidence.
Following this investigation, the insurance company will make a decision about the claim. If you are able to prove the legitimacy of your claim, the insurer will likely agree to a settlement and pay compensation for your medical expenses, lost income, and other financial losses resulting from your work injury.
Conversely, if the insurance company decides that your claim is invalid or potentially fraudulent, the company may reject the claim. Workers can also face criminal charges if investigators determine that a claim is fraudulent in any way.
Appeals and Disputes
If the insurer denies your claim, you may be able to appeal the decision. For example, you may be able to obtain more evidence proving the nature and extent of your injury, including that it was work-related, in which case you may decide to file an appeal.
In the event of a denial, you have 70 days under Nevada law to file an appeal with the Nevada Department of Administrations (DOA). This step would involve completing and filing a request for hearing form in addition to your denial letter.
You have the option of attending your scheduled hearing in person, by phone, or via a position statement. If a hearing officer still denies your claim, you could appeal the decision again within 30 days to an appeals officer.
If the appeals officer denies your claim, you have one last option of appealing to a district court appeals officer within 30 days of the denial.
The Benefits of Hiring a Workers’ Comp Lawyer in Nevada
When planning on building a workers’ compensation case in Nevada, you may benefit from hiring a workers’ compensation attorney to determine the options available to you.
While it’s possible to file a workers’ comp claim on your own, your case may be complex and be a lot more involved than simpler cases. Without experience navigating the workers’ compensation claims process, you could inadvertently hurt your claim by making mistakes at any point.
To make the process go smoother and increase your chances of succeeding with your case, consider the specific advantages of hiring an attorney, such as:
The Ability to Collect and Organize Evidence to Support Your Claim
While you don’t need to prove liability in workers’ compensation cases, you must prove that your injury resulted while completing work-related tasks or from performing your job in a hazardous work environment. In short, you need to show that the injury happened on the job in your scope of employment.
You must also prove that your injuries are legitimate, often through detailed medical records you will receive during treatment and future care.
An attorney can help you obtain and develop all critical pieces of evidence that might help your claim. For example, an attorney can collect evidence like:
- Medical records, bills, and receipts
- Surveillance footage of the job site or another location where the accident occurred
- Statements from witnesses at the accident scene, including co-workers
- Proof of lost income
If you have any difficulty collecting this evidence on your own, an attorney can help track it down as needed.
More Efficient Negotiations With Insurers
When filing a claim with insurers, you’ll need to begin negotiating a settlement based on the damages you sustained from your work injury. Insurers aren’t on your side in these cases and want to minimize the potential compensation they’ll need to pay. As a result, they may attempt to get you to settle for less than your case is worth.
An attorney can identify and calculate all damages involved in your case, including current and future medical expenses, lost income and lost earning capacity, disability, and other costs related to your injury. He or she can then negotiate for the best possible settlement you’re eligible to receive.
If an insurer makes an offer that’s far lower than your case’s actual value, the attorney will be able to make counteroffers to increase your chances of getting total compensation.
The Chance to Successfully Appeal a Denial
Another benefit of working with an attorney to handle a workers’ comp case is the ability to file an appeal if the insurer denies your claim. If your attorney believes you still have a chance to recover compensation and that your claim is valid, he or she can appeal the decision and schedule a hearing to review your case.
If the hearing results in a denial, the attorney may then decide to continue pursuing the case through additional appeals. Ultimately, this process could result in a favorable outcome for your case even after one or more denials.
The Potential to Reopen a Closed Claim
Injured workers may be able to reopen a closed claim if they stand to recover additional compensation for medical expenses exceeding $800, receive permanent partial disability benefits, or are unable to work because of their injuries for longer than five days.
If you want to reopen your case and seek additional compensation, an attorney may be able to help you do so. You’ll need sufficient documentation to reopen your case, including a detailed doctor’s report.
Knowing What to Expect With Nevada Workers’ Compensation
This Nevada workers’ comp guide should help you determine what to expect with a workers’ compensation case in this state. By gathering evidence proving the nature of your injuries and reporting and filing on time, you may recover full compensation for damages resulting from your condition.
An experienced lawyer can provide you with more information and assess your case to determine how to proceed with a claim. Additional research into Nevada workers’ comp law will also indicate what actions you can take if you sustain a work injury.