Benson & Bingham

Workers’ Compensation Common Claim Questions

What do I do when I get injured?

Answer:

Providing your employer with notice of an injury is extremely important. Nevada law requires that you put your employer on notice of an injury within 7 days of your injury pursuant to NRS 616C.015. Your employer should provide you with a C-1 Form (Notice of Injury or Occupational Disease – Incident Report).

In order to actually open a claim for workers’ compensation, you must complete the C-4 Form (Employee’s Claim for Compensation/Report of Initial Treatment). The injured worker completes the top portion of the C-4 Form and a medical provider will complete the bottom half of the C-4 Form. Of importance, is you only have 90 days from the date of injury or knowledge of the onset of an occupational disease to file the C-4 Form.

Why is it taking a long time to determine if my claim has been accepted?

Answer: By law, the insurance company has 30 days after receiving the C-4 Form to make a determination as to accept or deny a claim. A claim determination letter will be sent to you in the mail with appeal rights. However, many times the claim determination letter does not include all of the body parts injured as accepted body parts. This can be an issue in the future when it comes to medical treatment authorization, which is why it is important to hire an attorney immediately so that all of the injured workers’ rights can be preserved.

If I am off of work due to a work injury, will I be paid?

Answer:

When an injured worker is taken off of work for work related injuries, often times this puts a financial strain on the injured worker. If an injured worker is completely taken off of work and the claim has been accepted, temporary total disability benefits (TTD) will be paid to the injured worker. However, the TTD rate is only 66 2/3 of the injured worker’s average monthly wage.

When an injured worker is taken off of work with modified/light duty restrictions and the employer is not able to accommodate the work restrictions, then TTD benefits will be issued. However, if the employer is able to accommodate the work restrictions, then the injured worker will be returned to work.

Sometimes when an injured worker is accommodated, the rate of pay of the job offered is lower than the TTD rate. If this is the case, the injured worker would be entitled to temporary partial disability (TPD) benefits.

Why can’t I go to my own doctor for treatment?

Answer: Often times injured workers are sent to a quick care for medical treatment and do not receive the care and attention that is needed. Unfortunately, an injured worker cannot treat with any physician that s/he wants to. The injured worker must treat with a physician from a list of approved network providers from the insurance company. However, knowing which physician to choose is crucial to the medical treatment of the injured worker. An experienced attorney is knowledgeable when it comes to selecting a physician that is focused on patient care.

Why do I need an attorney?

Answer:

The purpose of the workers’ compensation system is to get the injured worker back to where s/he was at before the injury. However, more often than not, injured workers are faced with roadblocks by the insurance company when medical treatment or benefits are not being properly provided to the injured worker. Understand that it is not the insurance adjuster’s responsibility to advise an injured worker as to when to file an appeal. Many of the insurance companies just want to hurry up and close a claim even when the injured worker needs continued medical treatment in order to save costs.

It is important to hire an attorney immediately because an injured workers’ rights can be affected within the first few days of an injury. Hiring an experienced attorney will allow the injured worker to focus on his/her medical treatment and move forward in the recovery process while the attorney advocates for the rights of the injured worker. Call Benson & Bingham Accident Injury Lawyers, LLC now to preserve your rights!

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