In this blog, you will find a series of posts with an on-going discussion of the worker?s compensation system in Nevada.? Each state has a different system because worker?s compensation is governed by state law unless you work for the federal government, which is governed by federal law.? If you have any questions, please do not hesitate to call my office and we will be happy to help you with your questions.
In Nevada Workers Compensation is mandatory by statute.? NRS 616D.200.? There must be a mechanism in place to provide for medical treatment and loss of wages for employees.? This is defined by the below link:
>>Nevada Industrial Insurance Act and Nevada Occupational Diseases Act<<
When an individual is injured in the course and scope of his or her employment, they are entitled to benefits under the Worker?s Compensation Act.? NRS 616C.150.?? In Nevada, Workers Compensation insurance provides cover for medical care and compensation for employees who are injured in the course of employment.? Workers Compensation provides for lost wages, reimbursement or payment of medical and like expenses (functioning as a form of health insurance), and benefits payable to the dependents of workers killed during employment (functioning as a form of life insurance).? General damages for pain and suffering, and punitive damages for employer negligence, are generally not available in worker compensation plans.?? NRS 616A.030 defines an accident as an unexpected or unforeseen event happening suddenly and violently, with or without human fault, and producing at the time objective symptoms of an injury.?
INITIATING A CLAIM
A Worker?s Compensation claim is triggered by the completion of a C-4 form.? Also, the injured employee needs to give his/her employer notice of the injury within seven days.? This is often done by completing a C-3 form or Notice of Injury form. Many employers have their own forms and are acceptable as notice.? There also is a concept called actual notice to the employer.? Sometimes, when there is a catastrophic injury, the employee cannot physically complete the needed forms.? Generally, the employer will have actual notice of such a catastrophic accident and resulting injuries.? As example of actual notice scenarios would be an employee driving a company vehicle who is involved in a car collision.? The employer will have actual notice because generally the police will be notified and they in turn will contact the employer if the employee cannot.?
An insurer has thirty days to accept or deny the claim.? NRS 616C.065. The Insurer has the right to investigate the claim.? This can take a long time in some instances.? There are some changes to the Insurer?s timeliness of investigation that are being presented to our legislative body in the upcoming session.
During a claim, both sides of the claim have responsibilities.? The employee or injured worker must participate in their medical care.? They must go to appointments and if they fail to do so, their benefits can be cancelled.? The Insurer must respond to any written request from the injured worker or his/her attorney within thirty days of a request.? The Insurer must respond to a physician?s request for authorization within five days, whether authorizing or denying.
Source: http://www.sigurdsonlaw.com/blog/481
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