Question 1

I just injured myself at work.  What should I do?

Accepted Answer

When an injured worker suffers an industrial injury, make sure that the accident is reported to the employer. Nevada law provides, under NRS 616C.015, an employee or, in the event of the employee's death, one of the dependents of the employee, shall provide written notice of an injury that arose out of and in the course of employment to the employer of the employee as soon as practicable, but within 7 days after the accident.  It is also very important that the injured worker seek medical attention immediately.

Question 2

What if I did not report my industrial injury within 7 days?

Accepted Answer

Nevada law provides, under NRS 616C.025, an employee or, in the event of the death of the employee, a dependent of the employee, is barred from recovering compensation if the employee or dependent, as applicable, fails to file a notice of injury pursuant to NRS 616C.015 or a claim for compensation pursuant to NRS 616C.020.  However, there is a possible exception to the rule.  The statute also provides that the late notice may be excused if:
    (a) The injury to the employee or another cause beyond the control of the employee prevented the employee from providing the notice or claim;
    (b) The failure was caused by the employee's or dependent's mistake or ignorance of fact or of law;
    (c) The failure was caused by the physical or mental inability of the employee or the dependent; or
    (d) The failure was caused by fraud, misrepresentation or deceit.
If the injured worker gives oral notice to the employer, that may help, but the problem can be if the supervisor later denies the conversation.  Even if a co-employee witnesses the reporting, the co-employee might get cold feet and not want to help out the injured worker for fear of losing his or her job.

Question 3

How do I file a worker’s compensation claim for my industrial injury?

Accepted Answer

When you are seen by the doctor, you will fill out the upper portion of a C-4 form.  The doctor will then fill out the bottom of the form with your diagnosis, your work status, and whether or not the doctor believes that your diagnosis was caused by your industrial injury.  The doctor will then forward the form to the industrial insurance company.  (Make sure that you have also filled out your notice of injury with your employer).

Question 4

How long will it take for the industrial insurance company to accept or deny my claim?

Accepted Answer

Within 30 days after the insurer has been notified of an industrial accident (i.e. receipt of the C-4 form), every insurer shall either:
    (a) Accept the industrial injury claim, notify the injured worker that the claim has been accepted, and commence payment of the claim; or
    (b) Deny the industrial injury claim and notify the injured worker that the claim has been denied.

Question 5

What if the industrial insurance company denies my claim?

Accepted Answer

The injured worker can appeal the denial to the Department of Administration.  The denial letter should contain a form to be filled out in order to appeal the denial.  It is very important that the injured worker timely file his/her appeal.  There should be instructions on the letter of determination on where to send the appeal.

Question 6

Do I need an attorney to represent me in my appeal to the Hearings Officer and/or the Appeals Officer?

Accepted Answer

No one is forced to have an attorney, but common sense should lead all injured workers to the only realistic conclusion; namely, every injured worker should have an experienced workers’ compensation attorney.  If the insurance company has an attorney representing them at the hearings, the injured worker should also.  Plus, an experienced workers’ compensation attorney who knows the law and the system is worth its weight in gold in properly helping the injured worker prepare for the upcoming hearing and proper presentation of their case before the Hearings Officer.

Question 7

What if my claim is accepted, do I still need an attorney?

Accepted Answer

That would be a smart decision.  Throughout a workers’ compensation claim, the insurer will issue letters of determination that approve or deny workers’ compensation benefits.  Having an attorney ready to fight for your right to benefits can be a valuable asset.

Question 8

I notice that some workers’ compensation attorneys advertise that they are experts and specialists.  Should I hire a regular attorney or one who is an expert/specialist in workers’ compensation law?

Accepted Answer

First, some attorneys advertise that they are experts/specialists but they are not.  Nevada law provides that only attorneys who successfully pass certain requirements, a written test and an oral test, are permitted to represent that they are experts and specialize in workers’ compensation law.  So if an attorney advertises that they are an expert and they are not, they are already misleading the potential client.  Starting an attorney/client relationship on a lie is always a bad idea.
In order to become a real Nevada expert and specialize in workers’ compensation law, the attorney must be officially declared an expert and specialist by the State Bar of Nevada and the Nevada Justice Association.  The rigorous requirements are listed on our Expert Qualifications page of this website.  You will see that it takes a lot to become a real expert and specialist.  Perhaps that is why there are not many that hold this distinction.
Attorney Joel Santos was one of the first Nevada attorneys to be declared an expert and specialist.

Question 9

When should I hire a workers’ compensation attorney?

Accepted Answer

As it is customary in workers’ compensation cases for an attorney to charge a contingency fee (in short, you are not required to pay a retainer fee - when you receive a settlement or decision, the attorney is then paid out of the funds recovered), it only makes sense to hire the attorney from the very beginning of the workers’ compensation claim. The injured worker can receive more work for the same amount of fees.
Also, a certified expert attorney can monitor the industrial claim and try to head off problems before they become a real problem.  If there is a problem, then the attorney can be prepared to litigate the issue to its conclusion.

Question 10

Do I get paid for being certified off of work due to my industrial injury?

Accepted Answer

Generally, yes.  Every employee who is injured by accident arising out of and in the course of employment, or his or her dependents, is entitled to receive for the period of temporary total disability, 66 2/3 percent of the average monthly wage.

Question 11

How do I know if the workers’ compensation insurance company is paying me the right amount of money for being off of work?

Accepted Answer

There are multiple ways to calculate an injured worker’s average monthly wage.  Insurers normally only use one method.  An injured worker may request that their average monthly wage be calculated using a different method, and the insurer is required to use the higher amount.  It is important to have the correct average monthly wage, because not only does it affect the amount an injured worker would receive for temporary total disability (money for being off of work), it also affects what they would receive for temporary partial disability, vocational rehabilitation maintenance, permanent total disability payments, and the amount of their permanent partial disability award (the settlement).  This is another reason why a certified expert attorney is very important.

Question 12

After I am done with all of my medical treatment, what if I cannot return to work because I have work limitations?

Accepted Answer

If the treating physician imposes permanent work restrictions and the injured worker cannot return to pre-injury employment, then the injured worker may be eligible for vocational rehabilitation services and benefits.  This could range from, for example, on-the-job training, to sending the injured worker to school to learn a new trade, or even negotiating a lump sum buyout so that the injured worker can follow a career choice that the insurer will not approve.

Question 13

If you have a question that is not covered on this page, check out our other pages or blogs, or simply contact Attorney Joel Santos for a free workers’ compensation consultation.

Accepted Answer

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Frequently Asked Workers' Compensation Questions

I just injured myself at work. What should I do?