When your job leads to an injury, illness, or health condition that requires medical treatment and keeps you from working, you are entitled to Workers’ Compensation benefits. All Nevada employers with at least one employee must participate in the program, and you are covered from your first day at work, even if you are a seasonal or part-time worker.
Most employers contract with Workers’ Comp insurance companies in Summerlin to administer the program. Like all insurance companies, they exist to make profits for their shareholders, and they do not work in your best interests. Some employers self-insure, but they are also more concerned with limiting your benefits than ensuring you get the care you need and sufficient time to recover.
When you have a work-related injury or condition and need to access your Workers’ Compensation benefits, contact Shook & Stone. Our dependable workers’ comp attorneys have years of experience managing these claims and ensuring injured workers get the benefits they have earned.
You Must Adhere to Program Guidelines
If you want Workers’ Compensation benefits in Summerlin, you must adhere to all the insurance program’s rules and timelines. Our attorneys are limited in the help they can provide if you miss deadlines or do not follow the rules regarding medical treatment.
One critical requirement appears in Nevada Revised Statute § 616C.015, which mandates that you report your workplace accident to your employer within seven calendar days of the incident. For occupational diseases or conditions that develop gradually, such as repetitive strain injuries, hearing loss, or respiratory conditions, the seven-day reporting period begins when the employee has knowledge of both the disability and its relationship to their employment. Failure to meet this deadline can result in claim denial under NRS 616C.025, though exceptions may apply in cases where the injury or another cause beyond the employee’s control prevented filing, the failure was caused by physical or mental inability, or other circumstances specified in the statute.
Employers must maintain a list of healthcare providers authorized to provide services under the Workers’ Comp program. If you are hurt in an accident, you can seek emergency treatment from any healthcare provider. However, you must get your follow-up care from a provider on the list.
Appealing a Denial
A Workers’ Comp insurer in Summerlin, Rhodes Ranch, Sovana, or Sun City may deny your claim. If they do, the insurer must send you a determination letter describing the reason for the denial. You have 70 days from the date of the determination letter to file an appeal.
When you receive a determination letter denying your claim or a part of your claim, contact Shook & Stone immediately. Our attorneys will file a request for a hearing before an administrative judge. In many cases, it is possible to prove that the insurer’s decision was unjustified given the circumstances of your injury, the extent of your injuries, or the pace of your recovery.
It is essential to have legal representation at an appeal hearing. Your employer and its insurance company will be represented by lawyers who are very familiar with the hearing process. You will be at a distinct disadvantage if you appear without representation.
Contesting Medical Decisions
Your Summerlin doctor will periodically report to the Workers’ Compensation insurer as your recovery continues. The reports might explain whether you:
- Are fit to return to work
- Can return to work with restrictions
- Have reached a point that further treatment will not produce noticeable results
- Have sustained a permanent partial or total disability as a result of your condition
Your doctor’s opinion on these issues is valuable, but it is not the last word. You can request a second opinion from another doctor. Depending on the situation, the employer or their insurance company might request an Independent Medical Exam (IME), which is a review by another physician the insurance company selects.
Our Workers’ Compensation attorneys at Shook & Stone have extensive experience helping injured workers navigate these issues. We can recommend healthcare providers for a second opinion, help you prepare for an IME, and argue vigorously to ensure you receive all the care and benefits you deserve.
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Contact Our Summerlin Attorneys for Help With Workers’ Comp Insurance Issues
When you are hurt and cannot work, the last thing you need is an argument from your employer’s insurance company. Unfortunately, that is the situation many workers face.
At Shook & Stone, our attorneys are adept at contesting the decisions of Workers’ Comp insurance companies in Summerlin. Get in touch as soon as possible for a free case review if you are unhappy with the way your employer’s insurer is handling your claim.
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