Kevin Kampschror, Esq.
Step 1: Are you eligible?
Nevada has lifetime reopening rights if you either 1) are off work due
to the injury; or 2) received a permanent partial disability (“PPD”).
Generally, you must wait one year before reopening if you have received a PPD.
See NRS 616C.390. If you were not off work or did not receive a PPD, you must
reopen your case within one year.
Id. If your work injury was minor and you accrued medical expenses less than
$300, you may not reopen your claim.
Step 2: If you are eligible, obtain a doctor’s report.
You will need to obtain a report from a doctor indicating that your original
workplace injury has now gotten worse and requires more care. Get this
on your own at your own expense (this can typically be reimbursed if the
claim is reopened).
Step 3: What should the report say?
It is very important that the report specifically states the new recommended
treatment is 100% due to the work injury and not due to anything else
such as pre-existing conditions. Keep in mind many claims for reopening
are denied because the medical report does not state that the recommended
treatment is 100% connected to the original workplace injury.
Step 4: Send the report into the insurance company, or have your attorney
send in for you.
Once you have the report and it fulfills the legal requirements of NRS
616C.390, attach the report to a letter to the insurer requesting reopening.
Also, it is a good idea to put the original claim number on the letter
you send. If you hire an attorney, which is highly recommended, your attorney
will take care of all of this for you.
Step 5: Was your request approved or denied?
If your request was approved, the insurer will reopen your claim. If not,
you will need to file a notice of hearing and begin to litigate the case
See NRS 616C.315. This happens all too frequently.
There are some common scenarios that are typically denied. For example,
things such as pain are generally not enough to reopen claims. However,
a new surgery is. Claims are also denied if a doctor says you have increased
pain and recommends an MRI. You would likely have to obtain the MRI on
your own prior to requesting reopening. You also do not want to reopen
your case until you have the applicable imaging and medical reporting.
The reason is if your reopening request is denied and you do not win on
appeal, you will have to wait another year to attempt again. Lastly, reopening
does not happen overnight and it can take time, especially if you have
to go to court to fight the insurance company.
This is not an area of law you should tackle yourself, nor is any part
of workers’ compensation. Therefore, it is advised you seek an experienced
attorney who is able to assist in obtaining all benefits that you are
entitled to under Nevada law.