Private employers in Las Vegas must provide workers’ compensation insurance for their employees. If you were injured while working, you might be wondering how long it will take to receive your benefits and how long you will keep receiving them.
The length of a Las Vegas workers’ compensation claim depends on multiple factors, including your conduct. If you do not follow all the procedures exactly or miss a deadline, your benefits could be delayed or your claim denied. Seeking counsel from an experienced workers’ comp attorney at Shook & Stone can ensure you receive the payments you deserve in a timely fashion.
Making the Initial Claim
Securing workers’ compensation benefits requires injured employees to abide by certain rules, including meeting deadlines. The first relevant deadline requires a worker to inform their employer of a work-related injury within seven days. If the condition or disease is work-related but not the result of an accident—such as a repetitive stress injury or cancer related to toxic exposure—the worker must inform the employer within seven days of diagnosis.
The employer will have a list of approved healthcare providers. The employee must see an approved medical professional for initial treatment after an accident or to confirm a diagnosis of a work-related injury or illness. The healthcare provider must complete and sign a form the employer will provide.
A worker must submit a claim form and the signed form from the healthcare provider within 90 days of the original accident or diagnosis, or they lose their rights to claim benefits. The sooner they submit the completed claim, the sooner they can begin collecting benefits. A diligent Las Vegas workers’ comp attorney could manage the initial claim to ensure it is complete, accurate, and submitted on time.
Insurer’s Response to the Initial Claim
Once a worker submits their claim, the employer’s workers’ compensation insurance company can accept or deny it. The insurance company has 30 days to examine the claim. If it accepts the claim, a worker is entitled to receive indemnity benefits of up to two-thirds of their average weekly wage starting from the eighth day after the accident. Therefore, if the insurer took the entire 30 days to review the claim before accepting it, the worker’s first check might cover several weeks of benefits.
The insurer could deny the claim if it is incomplete. Other grounds a workers’ compensation insurer might cite for denying a claim include:
- The injury was not work-related
- The injury resulted from an employee’s intentional act to harm themself
- The employee was intoxicated or under the influence of drugs when the injury occurred
If the insurance company denies the claim or does not provide all the benefits the worker believes they should receive, the worker should consult a Las Vegas attorney about contesting the claim. A worker has 70 days from the date of the denial to appeal the decision.
The worker is entitled to receive indemnity benefits until their condition has improved enough that they can resume their duties, or they reach the point of maximum medical improvement (MMI). MMI means that the treating doctor certifies the worker is not fully healed, cannot resume their former employment, and their condition is unlikely to improve with further medical care. A worker or employer can seek another opinion after an MMI determination.
Timeframes for Appealing Workers’ Compensation Decisions
A workers’ compensation case can go on for years when an employee has an injury that takes significant time to heal or never resolves completely. There are points throughout the process when a worker must act within a given timeline.
For example, if a worker disagrees with a determination the workers’ compensation insurer makes, they must contest the decision and request a hearing within 70 days of the date of the notice of determination. However, if the worker has a hearing and disagrees with the result, Nevada Revised Statutes § 616C.345 allows them only 30 days to appeal the decision.
Keeping track of the various time limits is critical because a failure to respond timely to a workers’ compensation decision means the decision stands. Seeking help from a seasoned Las Vegas workers’ comp lawyer could preserve injured workers’ rights by ensuring they do not miss any deadlines.
Discuss the Potential Length of Your Workers’ Compensation Claim With a Las Vegas Attorney
The workers’ compensation program offers valuable benefits, but accessing them is not always simple. There are a lot of rules you must follow every step of the way.
Although the length of a Las Vegas workers’ compensation claim depends primarily on the severity of your injury, the help of an experienced lawyer could streamline the process and relieve your stress. Reach out to Shook & Stone today to discuss your situation with a knowledgeable legal professional.