Workers' Compensation Hearings
Shook & Stone - Nevada Workers' Compensation Lawyers
What you need to know
For employees injured on the job, workers’ compensation is designed to provide benefits for their medical care and lost wages. But there are certain deadlines that must be met or an injured worker can lose his or her right to these benefits. This article discusses the types of deadlines that apply in workers’ compensation cases, what will happen if you miss them, and what you can do if your workers’ compensation benefits are denied.
Deadlines for Filing a Workers' Compensation Claim in Nevada
The first deadline that applies to all workers’ compensation claims in Nevada is the “date of injury.” This is either the date when an employee’s condition began or, if there was no clear start date, the date when an employee’s condition was diagnosed. It is important to act quickly if you are injured on the job because you only have two years from this date to file for benefits. There are some exceptions to this general rule (click here to learn more).
If your employer denies your claim after it has been filed, you must request a hearing within 45 days. During this hearing, an administrative law judge (ALJ) will review the evidence and make a decision on whether you are entitled to workers’ compensation benefits or not. You may appeal your case to a higher court if the ALJ denies your claim.
If your employer denies your initial claim before it is filed with the Board, you will not be required to request a hearing. Instead, your only option is to file a lawsuit in a state or federal court. You must do this within one year from the date that your claim was denied.
Deadlines for Filing an Appeal of a Workers' Compensation Decision
If you have filed a claim with the Board of Industrial Appeals (BIA) or the Division of Workers’ Compensation (DWC), you will be required to request a hearing within 45 days. During this hearing, an ALJ will review the evidence and make a decision on whether your claim should be approved or denied.
If you disagree with the ALJ’s decision, you may file an appeal with the Workers’ Compensation Appeals Board (WCB) within 30 days of the ALJ’s decision.
If you disagree with the WCB’s decision, you may file an appeal with a higher court within 60 days of receiving the WCB’s decision.
What Happens if I Miss a Deadline?
As discussed above, failing to meet a deadline can be disastrous. This is true for both initial claims and appeals. If you fail to meet a filing requirement, your claim or appeal will not be reviewed by the administrative law judge (ALJ) or Workers’ Compensation Appeals Board (WCB) until you complete any necessary steps.
For example, if you file an initial claim within six months of your date of injury, but you do not request a hearing within the required 45 days, you will be required to wait until six months after your claim is filed before it will be considered by an ALJ. And if you miss the deadline for filing an appeal with WCB, then they will dismiss your case without reviewing it.
Can I Request a Hearing?
If your employer denies your claim and you miss the deadline for requesting a hearing, you may still be able to ask for one. First, if you filed an appeal within 45 days of receiving your employer’s answer (or 30 days if it was mailed), you can request a hearing. Second, after those 45 or 30 days have passed, but within one year from the date your claim was denied, you can request a review of your case at any WCB hearing.
Are There Any Other Options?
If you have missed a deadline and cannot ask for a new hearing or any other type of review, then you may wish to contact an attorney who specializes in workers’ compensation law. Your claim or appeal may still be reviewed by a state court if your employer had some type of wrongdoing that resulted in the denial of benefits.
What Happens During a Work Comp Hearing?
In a workers’ compensation hearing, an administrative law judge (ALJ) hears evidence from the two parties involved in order to make a decision about whether an injured worker is entitled to benefits.
When you file for benefits or when your employer denies them, you will receive information about how and where to request a hearing. You can request this at the same time that you file for benefits or within 45 days of receiving either an employer’s denial, your claim status letter, or an order from the Appeals Board.
If you miss this deadline, your claim will be denied unless there is good cause for missing it (you were in the hospital after surgery, had a death in the family) and you can show that you tried to request a hearing within one year of the denial.
An ALJ will hear your case, but it may be assigned to an administrative law judge with special education or expertise in workers’ compensation claims . For example, if your claim is denied because you were not actually injured at work, then it will likely go before an ALJ who has expertise in this type of claim.
If you disagree with the decision made by the ALJ during your workers’ compensation hearing, then you can appeal it. You have 30 days to file an appeal notice, and this must be sent directly to the Appeals Board . If you miss this filing deadline, your case will be considered closed.
The Appeals Board will either review your case or refer it to an ALJ if they need additional information. If your appeal is successfully reviewed by the Appeals Board, they will either reverse the decision made by the ALJ or ask for further review .
If you disagree with the Appeals Board’s final decision, then it can be appealed in a court of law.
What Is a Request for Review?
During this type of workers’ compensation hearing, either an ALJ or an Appeals Board judge will listen to any new evidence and argument that you would like to submit . They may then make a decision without even holding a hearing.
Reviews are usually requested because the injured worker has new evidence such as medical records, witness statements, or another source of proof they did not present at their workers’ compensation hearing .
If you would like to request a review, then you must file this within 30 days of your previous hearing or within 45 days of receiving either an order from the Appeals Board or ALJ.
You cannot appeal the decision made by a judge during a review. You also cannot request another review during the same time period that you requested the first review unless your claim status changes .
What Is an Appeal?
Anyone involved in a workers’ compensation case has the right to appeal if they disagree with something that was decided during their hearing. This means that you also have the right to appeal if you won your case, but you are not happy with the amount of benefits offered or the way some aspect of your claim was handled. The only exception to this is if the Appeals Board upheld a decision made by an ALJ.
If you would like to appeal, then you must submit a notice within 30 days of receiving one of the following:
- A written order from the Appeals Board
- An oral ruling by an Appeals Board judge during your hearing
If your claim was approved, you will not be able to appeal unless the acceptance involved a decision other than your eligibility. For example, if your employer accepted the claim but argued that you were unfit for employment due to other reasons , then you can appeal this ruling. You must file within 30 days of receiving the order or ruling from the Appeals Board.
You are not required to request a review before filing an appeal . It is important to note that you cannot file both.
What If You Miss the 30-Day or 45-Day Deadline?
Your workers’ compensation case is once again closed, and you have no further right of appeal. This does not mean that your case is final, but you will have to reopen the case . This means that you will need to start from scratch and file a new claim.
What Happens During an Appeal?
f your appeal is accepted, then the Appeals Board will conduct another hearing . They may also remand your case back to the ALJ if they thought there was not enough evidence presented during your hearing.
Both will look at the same evidence as before, including new submissions. If you would like to submit new evidence or argument, then you must do it within 30 days of receiving an order from the Appeals Board informing you that they are remanding.
An Appeals Board may grant a motion for appropriate relief. This means that they may grant a new hearing or review if they believe you need more time to submit evidence or your circumstances have changed. It does not apply if the Appeals Board has already held a second hearing.
What If You Do Not Appear at Your Appeal?
If you miss your appeal, then the Appeals Board will automatically grant an order remanding your case back to the ALJ.
This means that you will need to file a new claim and go through the whole process again. This also includes paying all of your future medical costs if they were covered during your initial hearing.
What Will Happen During Remand?
The Appeals Board may send your case back with instructions to hold another hearing.
If it is remand, they will send the case back to the ALJ with written instructions for an additional hearing at a later date. The Appeals Board may or may not be present during this new hearing.
If the Appeals Board does not provide any instructions, then your claim will remain before the same ALJ who conducted your initial hearing.
What Happens After the Remand Hearing?
If your case is remanded, then you will receive a letter from the Appeals Board within 30 days telling you the date and time of your new hearing . You must give your attorney or representative adequate notice if you want them to participate in this new hearing. If you do not, then you must go to the hearing by yourself.
If your case was remanded three or more times , then your attorney or representative may have the right to request that it be removed from this ALJ. If that happens, then a new judge will review your entire claim.
If the Appeals Board did not send your case back for further review after your remand hearing, then the Appeals Board will issue its order on or before 40 days.
If you do not receive this order within 40 days of the remand hearing, then you may contact the Appeals Board. The Appeals Board staff should provide you with an update regarding your case status.
What is a Hearings Officer?
As part of the Appeals Board’s mission to provide more timely hearings, some cases are assigned to a Hearings Officer. This is not an ALJ but instead someone without any previous involvement with your case.
The Hearings Officer will review all new evidence submitted, as well as the evidence presented during your hearing. They may also ask you or your attorney or representative follow-up questions to clarify evidence they believe is important.
The Hearings Officer’s decision must be sent within 30 days.
What Are the Benefits of Appealing?
If you win your appeal, then you will receive all of the benefits that you were originally denied. This may include medical treatment, lost wages, and permanent disability benefits.
The Appeals Board does not provide monetary damages beyond the benefits that you were originally denied . This means that if your claim is remanded and you lose at a later hearing, then you will not receive any money for expenses such as lost wages and therapy costs.
What If I Need Help After an Appeal?
When people try to appeal a case on their own, they often find the process to be extremely difficult and confusing. The Appeals Board does not provide free legal representation , but you may qualify for an attorney through another program.
If you do not qualify for this type of assistance, then you should contact your local bar association or other available legal services providers. You can also contact the Nevada Division of Industrial Relations for assistance .
What Should I Do if I Win an Appeal?
If you win your appeal, then you will need to update all of your information with the Appeals Board so that the agency knows about your victory. Your claim cannot be closed until this happens.
You can do this online using a computer or by filling out the appropriate form and mailing it to the Appeals Board.
How Long Will I Receive Benefits?
If you were injured on or after January 1, 2008, then your benefits will end 10 years from the date of your injury. If your claim was pending before January 1, 2008, then you may receive benefits for an indefinite amount of time.
If you were injured on or before December 31, 2007, then your benefits will end whenever the Appeals Board determines that your injuries no longer qualify for compensation. In this situation, any future medical condition caused by a previous injury can make you eligible for additional benefits.
What Should I Do If My Benefits Are Terminated?
If your benefits were terminated and you believe that it was done in error, then you should send a written notice to the Appeals Board.
The Administrative Judge will review your claim to determine if there are any legal reasons why your benefits were terminated. If there are none, then the judge may order that benefits be reinstated if certain conditions are met.
If your benefits were terminated because you failed to attend a medical treatment meeting or submit requested paperwork, then you may be able to regain eligibility.
To learn more about this process, contact the Appeals Board.