September 11, 2017 | Category: Employment

Despite a general belief to the contrary, workers’ compensation in Nevada is not all that complicated. Like any field, workers’ compensation has it’s own unique terms, phrases, and abbreviations, but once you get past that, it’s fairly straight forward.

To dispel some of the confusion, the Nevada Association of Employers has developed the following as a guide to give employers an understanding of the workers’ compensation system in Nevada.

What is Workers’ Compensation

Nevada requires all private employers with one or more employees to get and maintain  workers’ compensation insurance. Workers’ compensation insurance provides benefits to employees who are injured on the job and protection to employers who have provided coverage at the time of injury. These benefits and protections are provided regardless of fault; making workers’ compensation no-fault insurance. Further, because workers’ compensation is an exclusive remedy in Nevada, employers who provide coverage for their employees at the time of injury are protected from any additional damages claimed by their employees as a result of an injury on the job. This protection is established when the injured employee opts to receive workers’ compensation benefits.

Procedure

An on-the-job injury or illness has occurred, now what? There are several forms you should become familiar with to ensure the claim process runs as smoothly as possible.

Notice of Injury or Occupational Disease – Incident Report (C-1 Form)
This form is completed by the injured worker following a workplace injury. The form should be completed within seven (7) days after the accident. Once completed, the injured worker provides it to the employer. The employer must maintain the form for a period of three (3) years.

Employers should always keep an adequate supply of blank C-1 forms for employees to use when an accident occurs.

Employer’s Report of Industrial Injury or Occupational Disease (C-3 Form)
This form is completed by the employer. This form must be completed and filed with the employer’s insurer within six (6) working days after receiving a copy of the C-4 form from the treating physician (details on the C-4 form below). Failure to file this form timely may result in a fine of up to $1,000 for each occurrence.

One of the main purposes of this form is to establish wage history for benefit purposes, so it is important to ensure the date of hire  and wage history is reported accurately. Additionally, this is the first opportunity that an employer will have to comment on the validity of the claim.

Employer’s Wage Verification Form (D-8 Form)
This form is completed by the employer. This form must be completed and filed with the employer’s insurer within six (6) working days after receipt of the C-4 form (if the C-4 indicates that the injured worker will be off for 5 consecutive days or more or 5 days in a 20 day period) or when requested by the insurer.

Employee’s Claim for Compensation / Report of Initial Treatment (C-4 Form)
This form is completed by the injured worker and his/her treating physician. The form must be completed and filed with the employer and the employer’s workers’ compensation insurance carrier within three (3) working days of treatment. Failure to file this form timely may result in a fine of up to $1,000 per occurrence for the treating physician.

Within 30 days after notification (or 30 working days after receipt of the claim for occupational disease), the insurer must accept the claim and notify the injured worker or his/her representative of acceptance and begin payment on the claim or deny the claim and notify the injured worker, his/her representative and the Division of Industrial Relations of the denial. In either case, the insurer must document the notification with a certificate of mailing.

Available Benefits

There are many benefits available to injured workers in Nevada. Do not confuse the following with other benefits available through unemployment or social security — they are different.

Temporary Total Disability (TTD)
Money an injured worker received when completely disabled or when the injured worker has physical restrictions the employer cannot meet. It is intended to provide economic support to an injured worker when he or she is unable to work. TTD requires a doctor’s certification.

The amount of the TTD payment is 66.66% of the injured worker’s wage and paid bi-weekly.

Temporary Partial Disability (TPD)
Money an injured worker, who is back to work, but earning less than his or her pre-injury wages, receives to supplement wages earned. The amount of the TPD is 66.66% of the difference between what the injured worker earned at the time of the injury and his or her current earnings.

Permanent Partial Disability (PPD)
Money an injured worker receives, usually in a lump sum settlement, to compensate for permanent impairment as a result of a work-related injury. The amount is based upon the percentage of disability, the injured worker’s age, and his or her wage.

Vocational Rehabilitation Maintenance
Money an injured worker receives to provide support while he or she receives training for a different occupation. Although it has a different name, this benefit is the exact same in amount as TTD.

Vocational Rehabilitation Training
Training available to an eligible injured worker to train in another occupational field, which is consistent with his or her physical limitations and educational level. The length of the training program will depend on the percentage of PPD.

Permanent Total Disability (PTD)
Money an injured worker receives when he or she is no longer able to work at all due to the work-related injury. This amount is usually paid to the injured worker for the remainder of their life.

Lifetime Re-Opening
Nevada allows an injured worker to reopen their workers’ compensation claim at any point, for life. An injured worker can petition to have his or her claim reopened if he or she can prove, by certification from a doctor, that his or her injury or condition has worsened. Once reopened, generally speaking, an injured worker is entitled to all of the available benefits noted above.

Defenses

While the workers’ compensation system is a no-fault system, there is an element of fault when it comes to available defenses.

Untimely Filing
Generally speaking, the injured worker has a deadline defined in statute to provide notice of his or her injury (7 days) and to file a claim for compensation (90 days). Failure to meet these deadlines may (and we must emphasize may) preclude the claim for progressing.

Drug and Alcohol Use
The presence of drugs and/or alcohol in the system of an injured worker following a work-related injury usually spells doom for the claim. If drugs and/or alcohol are present, it is presumed that drugs and/or alcohol were the proximate cause of the injury and the claim can be denied.

Intentional Injury
If the injury is caused by the injured worker’s willful intent to injure himself/herself or someone else, the claim may be denied.

Fraud
If it is proven that the injured worker made an intentional misrepresentation in order to receive workers’ compensation benefits, the claim will be denied and the injured worker may face prosecution by the Attorney General’s Office.

We know these areas of the law can be confusing. That is why we are here. As an employer, please consider the Nevada Association of Employers your one-stop resource for all those problems facing employers in Nevada. Our goal is to make sure your business is abiding to Nevada standards. For more information, contact the Nevada Association of Employers at (775) 329-4241 or visit our contact page today.