How to file a workers’ compensation claim in Nevada

In Nevada, workers' compensation is generally the only way to receive benefits for an injury at work. When an employee has an accident at work, he or she needs to file a workers' compensation claim.

The injured worker only has to show that it is more likely than not that the injury or condition was caused by work and not some other cause for him or her to receive benefits.

Filing a claim for workers' compensation benefits in Nevada is a two-step process:

  1. When the injury occurs, the injured workers should notify the employer and fill out an Incident Report
  2. If the injured worker requires medical treatment or misses work, he or she should fill out an Employee's Claim for Compensation

The Employees Claim for Compensation is filled out by both the injured worker and an examining workers' compensation doctor.

A workers' compensation claim is filed when the doctor sends the form to the insurance company after examining the injured worker.

If the insurance company accepts the claim, it will provide one or more of the following benefits:

The insurance company may decide to deny the claim or not provide one of the benefits above. If the injured worker disagrees with that decision, he or she can appeal any denial of Nevada workers compensation benefits.

If an injured worker's claim has ended, but his or her condition has gotten worse, the claim can be reopened. This requires a doctor to state that:

  • the condition has gotten worse
  • a work injury is the cause

In this article, our Las Vegas Nevada workplace injury attorneys will explain:

nevada workers' compensation legal help
When an employee has an accident at work, he or she needs to file a workers' compensation claim.

1. What is a work injury?

A work injury is an accident or injury that is due to or related to work. A workers' compensation claim is how an injured worker gets benefits such as treatment for his or her injury.

The injury can be a specific incident or an accident. This is an unexpected or unforeseen event that happens suddenly and violently, with or without fault, that produces an injury.1

It can also be an occupational injury and a catastrophic injury.2 This includes any disease that is the result of exposure at work,3 likely over a period of time.

2. Who is an employee?

An employee covered by workers' compensation is any person who works for another, whether lawfully or not, with or without a written agreement.4

A contractor's subcontractors may be considered employees.5

However, an independent contractor is not considered an employee and is therefore not covered in an employer's workers' compensation policy.6

3. Where to file a work injury claim

The workers' compensation laws of Nevada are the only way for injured workers to receive benefits for a work injury.7 An injured employee files a claim with his or her insurance company under the direction of the Nevada Department of Industrial Relations.

A worker cannot generally sue an employer in civil court. He or she must use the workers' compensation laws.8

However, Nevada workers' compensation laws are interpreted to ensure the quick and efficient payment of compensation to an injured worker who is injured or disabled but at a reasonable cost to his or her employer.9

All employers are required to have workers' compensation insurance to pay for the cost of work injuries.10 There are special provisions when an employer does not have workers' compensation insurance.

4. How to prove a work injury

An employee does not have to show that the employer did anything wrong to claim a work injury. He or she only has to prove the injury occurred at work.

For an occupational injury, the injured worker has the burden of showing that the condition was caused by or was contributed to by the job and was not merely the result of the natural progression of a preexisting disease or condition.11

The burden of proof is a preponderance of the evidence.12 This means that it is more likely than not, or a 51% chance, that the injury or condition is work-related.

nevada workers' compensation claim
There are specific procedures to filing a workers' compensation claim in Nevada.

5. How to file a claim

Benefits for injured workers are set by Nevada statutes. There are specific procedures to filing a workers' compensation claim in Nevada.

5.1. Initial incident

When an injured worker has an injury, he or she should report it to a supervisor.13 The supervisor should provide a form called a Notice of Injury or Occupational Disease. It is an incident report that records:

  • the date of the accident
  • the time of the accident
  • what was the injury that resulted
  • the parts of the body injured
  • how the injury occurred
  • where the injury happened
  • confirmation that it occurred while working
  • witnesses
  • if the employee left work
  • if first aid was provided
  • if there was anyone else involved

The form should be filled out within seven days of the injury.14

Filing the form does not mean that the injured worker requires medical treatment. It only means that there was an incident at work

Example: Thomas is a blackjack dealer and injures his back from at work. He tells his supervisor.

Thomas is given an Incident Report form. He fills it out and signs it.

The report only notes the incident, it does not mean Thomas necessarily needs medical treatment or that he filed a workers' compensation claim.

5.2. The claim of work injury

A Nevada injured worker should file a workers' compensation claim by going to the doctor and completing the Employee's Claim for Compensation/Report of Initial Treatment within 90 days of the injury15 if he or she has:

  • sought medical treatment for a work injury
  • been off work due to a work injury

The injured worker fills out the first half of the form, and the examining doctor fills out the second half.

Injured worker's portion

The form requires the same information as the Notice of Injury or Occupational Disease form above, but requires more detail, as well as the:

  • name of the insurance company
  • injured worker's occupation

The injured worker should bring the form to the medical appointment to treat and/or assess the injury.

An injured worker can view the required worker's compensation poster16 at the employer's office or ask his or her employer for the name and contact information of the workers' compensation insurance company.

The information is also available online by searching for the Nevada employer. There is also a list for self-insured Nevada employers

Doctor's portion

The second half of the form is for the doctor who evaluates the injured worker. It includes:

  • diagnosis
  • description of injury
  • if the injury is work-related
  • treatment provided
  • further care needed
  • if the injured worker was under the influence
  • if the injured worker should remain off work for more than five days
  • any previous injury or disease contributing to the injury

The doctor must complete and mail the form within three days of treatment. Copies of the form are is sent to the insurance company, employer, and employee.

When the form is sent in a workers' compensation claim is filed.

Example: Janet is a retail manager. She injures her shoulder at work. She already filled out an Incident Report.

Janet went to the doctor and requires treatment for the injury. Janet fills out the top part of the Claim for Compensation and gives it to her doctor.

The doctor fills out the bottom portion of the form and sends it in to the insurance company. Janet's workers' compensation claim has now been filed.

nevada workers' compensation claim insurance company form
The insurance company has 30 days to accept or deny the claim after getting the Claim for Compensation.

6. Insurance company response to claim filing

The insurance company has 30 days to accept or deny the claim after getting the Claim for Compensation. The insurance company will also review the Employer's Report of the injury.

The Employer's Report has to be submitted by the employer to the insurance company within six working days of getting the Employee's Claim for Compensation.

The insurance company will:

  • accept the claim, notify the injured worker, and begin paying benefits; or
  • deny the claim and notify the injured worker and the Nevada Department of Industrial Relations of its denial17

Example: Dean is a Nevada firefighter who suffers a burn injury at work. The insurance company receives the Claim for Compensation. It also reviews the Employer's Report.

The insurance company accepts the injury. It will send Dean a notice in the mail and pay for any benefits he may require.

7. Nevada workers' compensation benefits

An injured worker is entitled to certain benefits to compensate him or her for the work injury and to pay for the cost of treatment.

The benefits are to limit the burden on the injured worker while he or she is being treated for the injury, compensate him or her for any permanent damage because of the injury, and ensure the employee has the opportunity to return to work if he or she is able.

There are special benefits available to some Nevada employees, such as police officers and firefighters. Employers may also place an injured worker on light duty.

7.1. Medical treatment

An injured worker is entitled to medical treatment for his or her injury, however, he or she must use an authorized medical provider.18 Treatment includes:

  • medical treatment
  • surgery
  • hospital stays
  • nursing
  • medicine
  • assistive devices19

7.2. Payment for lost wages

If the employee is off work for more than five consecutive days or five days in a 20-day period, he or she will receive temporary disability, benefits amounting to two-thirds of his or her monthly wage.20

The employer will submit a wage verification form.21

7.3. Payment for permanent loss of function

If an injured worker has a permanent loss of function, he or she is entitled to permanent disability benefits.22 An injured worker can be permanently partially disabled (PPD) or permanently totally disabled (PTD).

Permanent disability is based on a percentage determined by a doctor. The greater the percentage, the greater the disability.

The insurance company will request and schedule an appointment with a special rating doctor or chiropractor within 30 days of receipt of a ratable report.23

The doctor will rate the disability level based on the American Medical Association Guides to the Evaluation of Permanent Impairment.24

Payments are made over time, but the injured worker can elect to receive the payments in a lump sum.

nevada deceased workers' compensation family casket
Spouses and dependents of deceased Nevada workers are entitled to death benefits.

7.4. Death Benefits

Spouses and dependents of deceased Nevada workers are entitled to death benefits.25 Death benefits include:

  • burial expenses not to exceed $10,000
  • payment of two-thirds of the average monthly wage earned by the deceased worker to the surviving spouse and children26

If there are no children, the spouse receives the payment for the rest of his or her life. If there are children, the spouse gets 50% of the total amount for the rest of his or her life. The children split the remaining 50% until each reaches 18 years old.27

The death claim must be filed within one year of the worker's date of death.28

7.5. Retraining benefits

Every effort is made to return an injured worker to his or her prior job after an injury has stabilized. However, an injured worker is entitled to vocational rehabilitation benefits if he or she cannot return to work.29

The employee will work with a vocational rehabilitation counselor to find a new trade or profession.30

The employee can also settle the rehabilitation with a lump sum payment along with an agreement with the insurance company after signing that he or she understands the consequences.

7.6. Mileage reimbursement

An injured worker should fill out an Application for Reimbursement of Claim Related Travel Expenses to claim mileage reimbursement.31

An injured worker can also request reimbursement for attendance at hearings. This includes food, lodging, and lost wages.32

8. Insurance company decision to end the claim

The insurance company will decide based on medical evidence how long the injured worker's claim will remain open and any permanent disability benefits that will be paid. It will also decide if there is vocational rehabilitation necessary.

The insurance company will send a notice when the claim is closed.33

9. Appeal of the insurance company decision

If an injured worker disagrees with the decision or actions of the insurance company, he or she can appeal to the Department of Administration, Hearings Division by filing a Request for Hearing – Contested Claim within 70 days of the decision.34

The injured worker also had the opportunity to settle his or her Nevada workers compensation claim.

10. Reopening a Nevada workers' compensation claim

If a work injury gets worse after a claim has been closed, the workers compensation claim can be reopened.35

Reopening a claim requires a letter from a doctor that states that:

  • the injured worker's condition has changed
  • the change is the result of the original injury.36

The injured worker sends the letter to the insurance company and asks it to reopen the claim.

Example: Jerry is a Nevada police officer injured in the line of duty. His claim for his back injury has been closed for three years. But Jerry's back condition is worse. He believes it is from his work injury.

Jerry goes to the doctor and gets his doctor to write a letter that agrees with Jerry's opinion.

Jerry sends the letter to the insurance company and requests that his claim be reopened.

11. Understanding the basics of filing a workers' compensation claim in Nevada

An injured worker should not necessarily believe or trust the information provided by his or her employer or the insurance company.

Injured workers can obtain detailed information and forms at the Nevada workers' compensation website.

An injured worker can retain an attorney to navigate the Nevada workers' compensation system and obtain the benefits he or she deserves.

Injured at work in Nevada? Call us for help...

nevada legal defense attorneys workers' compensation
Call us for help at 702-DEFENSE

If you or someone you care about was injured at work in Nevada, our Las Vegas workers' compensation attorneys may be able to get you compensation. (For cases in California, please visit our page on how to bring a workers compensation claim in California.)

For a free consultation to discuss your case simply fill out the form below or call us at 702-DEFENSE(702-333-3673).

Legal References:

  1. Nev. Rev. Stat. § 616A.030

  2. Nev. Rev. Stat. § 617.440 & 617.450 & See 617 et. al.

  3. http://www.who.int/occupational_health/activities/occupational_work_diseases/en/

  4. Nev. Rev. Stat. § 616A.105

  5. Nev. Rev. Stat. § 616A.210 & 616A.285

  6. Nev. Rev. Stat. § 616B.603

  7. Nev. Rev. Stat. § 616A.020

  8. Nev. Rev. Stat. § 616A.020

  9. Nev. Rev. Stat. § 616A.010(1)

  10. Nev. Rev. Stat. § 616A.230

  11. State Industrial Insurance System v. Kelly (1986) 99 Nev. 774, 775-76, 671 P.2d 29, 30.

  12. Nev. Rev. Stat. § 616C.150(1)

  13. Nev. Rev. Stat. § 616C.010

  14. Nev. Rev. Stat. § 616C.015

  15. Nev. Rev. Stat. § 616C.020

  16. Nev. Admin. Code § 616A.460

  17. Nev. Rev. Stat. § 616C.065

  18. Nev. Rev. Stat. § 616C.090

  19. Nev. Rev. Stat § 616A.035

  20. Nev. Rev. Stat § 616C.475

  21. Nev. Rev. Stat. § 616C.045

  22. Nev. Rev. Stat. § 616C.490

  23. Nev. Rev. Stat. § 616C.490

  24. Nev. Rev. Stat. § 616C.110

  25. Nev. Rev. Stat. § 616C.505(1)

  26. Nev. Rev. Stat. § 616C.505

  27. Nev. Rev. Stat. § 616C.505(3)

  28. Nev. Rev. Stat. § 616C.020

  29. Nev. Rev. Stat. § 616C.530

  30. Nev. Rev. Stat. § 616C.555

  31. Nev. Admin. Code. § 616C.150

  32. Nev. Rev. Stat § 616C.365 & 616C.477

  33. Nev. Rev. Stat. § 616C.235

  34. Nev. Admin. Code § 616C.274

  35. Nev. Rev. Stat. § 616C.390

  36. Nev. Rev. Stat. § 616C.390

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