Each day, thousands of Reno workers show up at their place of employment and work hard to keep tourism and other industries alive. However, sometimes these workers become injured on the job. When this happens, they turn to the Nevada Workers’ Compensation program. If you’re suffering from a workplace injury and need compensation for your medical expenses and lost wages, a Reno Workers’ Compensation Lawyer can help you understand the process.
What Is Workers’ Compensation?
As explained by the Nevada Department of Industrial Relations, workers’ compensation is a no-fault insurance program that provides benefits to employers who are injured on the job and protection to employers who have provided coverage at the time of the injury. With some exceptions, anyone in Nevada who hires at least one employee must provide workers’ compensation insurance with coverage in place from the moment the employee is hired. Workers’ compensation benefits that the employee is entitled to receive include:
Compensation for lost time at work due to the injury
Permanent partial or permanent total disability compensation
Vocational rehabilitation for workers who are unable to return to the same position they held before the injury
Dependent benefits for employees who die as a result of their workplace injuries
Mileage associated with travel to obtain medical treatment
Employers who have provided coverage at the time of their employee’s injury are protected from any other damages claimed by the employee in relation to their work-related injury.
Nevada’s Workers’ Compensation Process
If you’re injured in a workplace accident, you should seek medical treatment immediately. After that, the process for obtaining workers’ compensation benefits includes the following steps:
Within three days of medical treatment for a workplace injury, a physician or chiropractor must file a Report of Initial Treatment (C-4) form with the employer and the employer’s insurer.
Within seven days of the injury, the injured employee must complete the Notice of Injury or Occupational Disease (C-1) form to be submitted to the employer and the employer’s insurer.
Within six days of receiving the C-4 form from the physician who provided treatment to the injured worker, employers must complete an Employer’s Report of Industrial Injury or Occupational Disease form to be submitted to the insurer.
Insurers have 30 days after being notified of the workplace injury to either accept the claim, notify the claimant and begin paying on the claim; or deny the claim and notify the claimant.
Within six days of receiving the C-4 form, the employer must also complete the Employer’s Wage Verification (D-8) form and submit it to the insurer if the C-4 indicates that injured worker will miss more than 5 consecutive days of work or 5 days within the next 20 days.
The employee has 90 days after an accident to file a claim with the insurer if the employee has sought medical treatment for an injury arising during the course of employment or the employee was off work as the result of an injury arising during the course of employment. In the event of the death of an employee, a family member has one year after the death of the employee to file a claim with the insurer. If the employee is unsure as to who the employer’s insurer is, he or she should ask the employer or look at the workers’ compensation poster posted at his or her workplace.
Employees must obtain medical treatment for their workplace injury from an authorized medical provider who is a member of the Panel of Treating Physicians and Chiropractors.
State law prohibits employers from inducing or coercing an employee to avoid seeking treatment for a workplace injury or from filing a claim. Employers also cannot fire an employee solely for filing a workers’ compensation claim. However, Nevada is an employment at-will state, meaning that employers can fire workers at any time, with or without reason.
Employees whose claims are denied will be notified of the appeals process.
If all of that sounds complicated, it is—and that’s the simplified version. That’s why you want a Reno workers’ comp attorney to help you through the process and make sure you don’t suffer any unnecessary delays or denials in obtaining your benefits.
Why Would Workers’ Compensation Deny Your Claim?
While the workers’ compensation program is a no-fault system designed to provide benefits to workers injured on the job regardless of how or why the injury took place, there are some reasons why a claim would be denied. The most common reasons for a denial include:
Untimely filing: The worker failed to meet the seven day deadline for notifying their employer or the 90 day deadline for filing a claim with the insurer.
Drug or alcohol use: If the employee is found to have drugs or alcohol in his or her system at the time of the injury, then the drugs or alcohol will be considered the proximate cause of the injury and the claim will be denied.
Intentional injury: If it is discovered that the employee’s injury occurred due to an intentional attempt to hurt himself or herself or anyone else, the claim may be denied.
Fraud: If it can be proven that the worker made an intentional misrepresentation of his or her injuries to gain workers’ compensation benefits, the claim will be denied and the employee may be prosecuted.
Workplace Injury Statistics
The United States Department of Labor’s Bureau of Labor Statistics reported the following information based on 2017 figures:
There were 2,811,500 total reportable cases of workplace injuries, illnesses, and fatalities in the U.S. Of those cases, more than 882,000 resulted in missed days of work.
The median number of missed workdays due to a workplace injury in 2017 was eight.
5,147 people in the nation lost their lives due to workplace injuries.
Road incidents rank among the highest causes for workplace fatalities in all private sectors. About 1,300 workers died during work-related travel.
Slips, trips, and falls are a common cause of both workplace injuries and fatalities. More than 227,000 workers were injured and 887 died due to falling, slipping, or tripping. Fatal falls were at their highest level of incidence in 26 years of Census of Fatal Occupational Injuries reporting.
Reno Workers’ Compensation FAQ
Most full-time employees spend at least one-third of their day at work, often more. This explains the common occurrence of workplace injuries and illnesses. At least 30,000 Nevada workers per year sustain injuries or suffer illness in the workplace, according to the Nevada Department of Business and Industry.
If you work in Reno and sustained an injury or developed an illness on the job, you most likely have rights under Nevada law to receive substantial workers’ compensation benefits. Unfortunately, having those rights and receiving the benefits you deserve do not always go hand-in-hand.
Here are answers to some of the most frequently asked questions we receive from Reno workers about workers’ comp claims. For answers to questions about your rights after sustaining a work-related injury or illness in Reno, contact the experienced Reno workers’ compensation lawyers at Benson & Bingham Accident Injury Lawyers, LLC, today, for a free case consultation.
What is workers’ comp?
Workers’ compensation (or comp) is insurance purchased by your employer to cover you against the costs of work-related injuries or illnesses. Your employer purchases workers’ comp insurance for you, and cannot ask you to pay for it yourself. The insurance covers you against the costs of all job-related injuries and illnesses, no matter how they happened or who caused them.
Do workers’ compensation benefits only cover medical expenses?
No. Although workers’ compensation benefits pay for necessary medical treatment related to a workplace injury or occupational illness, that is not all. Workers’ compensation insurance also pays disability-related benefits. The amount of benefits a worker might receive depends on the severity and nature of the worker’s injury or illness and long-term prognosis.
Temporary disability benefits replace some of a worker’s lost wages during recovery from a workplace illness or injury. Permanent disability benefits provide compensation for workers who have reached maximum medical improvement but still have a permanent injury or condition that limits their ability to work.
Spouses of workers who die because of a job-related injury or illness can also receive death benefits and reimbursement for funeral expenses.
My workers’ compensation claim was denied. Now what?
Under Nevada law, a workers’ compensation insurance company must send written correspondence within 30 days of receiving a claim for benefits notifying the worker of acceptance or denial of a claim. If the carrier denies the worker’s claim for benefits, then the worker has the right to appeal that decision.
Appealing a claim denial involves a somewhat-complicated process that resembles, in many ways, filing a lawsuit. We urge Reno workers who want to appeal the denial of a workers’ comp claim to seek experienced legal representation from our Reno workers’ compensation attorneys. Attempting to pursue an appeal on your own can easily result in mistakes that cost you important rights to workers’ comp benefits.
What should I expect at an appeal hearing?
A workers’ compensation appeal hearing resembles an informal court trial. Instead of a judge, a hearing officer presides. No court reporter takes a transcript. The person appealing the claim denial typically gets about 10 to 15 minutes to present a case for overturning the claim decision.
Workers (or, better, their attorneys) can use that time to present evidence and witness testimony, and to make arguments in their favor. Workers who live too far outside of Reno or cannot attend a hearing in person may arrange to attend via telephone. The worker should receive the hearing officer’s decision via mail approximately 10 days after the hearing. If the hearing officer denies the workers’ comp claim again, the worker can pursue another round of appeals.
Again, we urge any Reno worker who has received a workers’ comp claim denial to seek the help of our experienced attorneys.
My employer has a light duty role available. Do I have to go to work?
The short answer is yes. One way employers avoid large claims against their workers’ compensation insurance coverage is by offering injured workers a light-duty position that the worker can do even with medical restrictions. If your employer offers you a light duty role, in almost all circumstances you must take the position, even though that may result in you no longer qualifying for wage replacement (i.e., disability) benefits.
Nevada law does not require your employer to offer you a light duty position. If you give your employer the physical restrictions set by your doctor, and your employer does not give you a light duty role, then you can seek wage replacement benefits totaling two-thirds of your average monthly wages before the injury or illness (in most cases).
I filed my claim after the seven-day deadline. Can I still get benefits?
In Nevada, injured employees must notify their supervisor/employer of a workplace injury or occupational disease within seven days of injury or discovering the health condition. However, if you did not notify your employer until after the seven-day cutoff, you should still file a workers’ compensation claim.
Injured workers have valid reasons for not immediately notifying their employer of an injury or illness. Examples include working out of town, your supervisor was on vacation, or you were hospitalized and couldn’t talk. Speak with the experienced Reno workers’ compensation insurance attorneys at Benson & Bingham Accident Injury Lawyers, LLC, to learn about your rights.
Do I need legal representation to file a workers’ compensation claim?
Every claim is different, but our general advice is that it is better to be safe than sorry, and you should call us for help with your claim. Having an experienced lawyer on your team can make a world of difference in whether you obtain the benefits you deserve. Some instances where having legal representation may help include:
You filled out a workers’ compensation claim after a workplace injury, and the carrier denied the claim.
Your employer threatened to retaliate or actively retaliated against you after you filed a workers’ compensation claim.
You contracted an illness because of harmful chemicals or you were injured because of defective machinery.
You sustained an on-the-job injury because of an unsafe condition on someone else’s property.
Your employer did not purchase workers’ compensation insurance for you and your co-workers as required by law.
You were driving a company vehicle and got into a traffic crash.
Your benefits have been reduced.
You need medical care but your employer’s workers’ compensation carrier will not approve the recommended treatment.
Contact our experienced Reno workers’ compensation attorneys today to learn more.
Call Benson & Bingham Accident Injury Lawyers, LLC for Help With Filing or Appealing Your Reno Worker’s Comp Claim
If you have questions about the workers’ compensation process or your claim has been denied, we would be happy to provide guidance. We also serve clients in Lake Tahoe, Sparks, and Carson City. Contact us online or by calling (775) 600-6000 to schedule your free consultation and case review.
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