This page provides answers to the following questions:
- I had an accident at work. How do I file a workers compensation claim in my state?
- Should my employer have workers compensation insurance? How do I know I am covered?
- What are the conditions that enable me or prevent me from claiming benefits under my state's law?
- What benefits might I be eligible to receive?
- How much time do I have to file my claim? What are the stages of the claim process? What should I expect?
- If I'm not happy with the determination, how do I appeal?
1. I had an accident at work. How do I file a workers compensation claim in my state?
If you are injured as a result of an accident in your workplace, do not hesitate and seek any emergency treatment if the injury calls for medical attention. Next, notify your employer about the injury and fill out a Form C-1, Notice of Injury or Occupational Disease-Incident Report. You have seven (7) days from the time of your injury to complete Form C-1. The form can be filled out whether or not you do seek medical treatment.
During your workers' compensation claims process, make sure that you fill out any requisite forms with as accurately as possible. Any inaccuracies could potentially delay the claims process.
Should my employer have workers compensation insurance? How do I know if I am covered?
Workers' compensation in Nevada is a no-fault insurance program that provides benefits to working individuals who are injured while on the job. From the moment you are hired at a job with your employer, you are covered under applicable workers' compensation laws and your employer's insurance coverage plan. Your employer is expected to participate in a workers' compensation insurance scheme. You may contact the Coverage Verification Service to verify what kind of coverage if available to you through your employer.
If you are uncertain about whether your employer has workers' compensation coverage, it is important that you the medical care professional providing you treatment that your injury occurred while at work and that you are uncertain as to whether your employer has coverage. Depending on the circumstances of your case, you may be entitled to receive benefits from the Nevada Uninsured Employer Account. However, this is case specific determination.
3. What are the conditions that enable me or prevent me from claiming benefits under my state's law?
The best way to ensure that you file a successful workers' compensation claim is to accurately complete all requisite forms and applications and also to timely file those forms or timely submit them.
4. What benefits might I be eligible to receive?
In Nevada, an injured employee may be entitled to the following benefits:
- Medical benefits
- Lost time compensation: wage benefits that compensate you for time lost or differentials in your pre-injury wage and your post-injury wage.
- Permanent Partial Disability: after your injury or illness has been stabilized through treatment, as assessment is made regarding a potential permanent partial disability award which considers the date of your injury, the extent of your injury, your age, and your wage.
- Permanent Total Disability: upon the determination of your doctor, if you are classified as PTD, you will receive monthly benefits equal to no more than two- thirds (66.67%) of your average monthly wages.
- Vocational Rehabilitation
- Dependent's payments in the event of death and
- Other claims-related benefits or expenses
5. How much time do I have to file my claim? What are the stages of the claims process? What should I expect?
Your workers' compensation claims begin upon filling out a Form C-4, Employee's Claim for Compensation/Report of Initial Treatment. Your medical care provider will give your this form at the time of your treatment. There is a portion of the form you are to complete and a portion of the form your medical provider is to complete- both portions must be completed. After the form is complete, your medical provider has three days from the date of your treatment to forward the C-4 to both your employer and your employer's insurance provider. Your claim is contingent upon completing the C-4, so make sure this is done if you plan to pursue a workers' compensation claim.
You have ninety (90) days from the date of your injury or the date you first learned of your occupational disease to file a workers' compensation claim.
Your employer's insurance provider has thirty (30) days from the receipt of the C-4 to accept or deny your claim. Your insurance provider should notify you concerning its determination. If the determination results in a claim denial, petition or appeal rights will apply.
To petition or appeal any dispute regarding your claim, you may request a hearing with a hearing officer within seventy (70) days from the date of the insurer's determination or to an appeal's officer within thirty (30) days. Your employer's insurance provider will provide all requisite forms to proceed with such a petition. Most appeals concern a person who is aggrieved by the written determination of their employer's insurance provider or whose employer's insurance provider has failed to provide a written determination within thirty days of receipt of information concerning the employee's injury. The hearing process before the hearing officer is conducted as informally as possible. Beyond the hearing process, you and/or your attorney may choose to submit a contested claim directly to an appeals officer.
6. If I am not happy with the determination, how do I appeal?
You may be entitled to some recourse through your state court system. Your next step would be to potentially file a claim with the state district court, where a judge will review your claim history.