If you were injured on the job and filed a workers’ compensation claim, only to receive a less than favorable outcome, you have options in disputing this result. If you received notice of a decision on your claim that you do not agree with, the first step is to request a hearing. This hearing, overseen by a Hearing Officer who is an employee of the Nevada Department of Administration Hearings Division, will provide you with the opportunity to present your case and seek an advantageous result.
Though you are not required to have an attorney represent you at this initial hearing, you may find it extremely beneficial to have your case presented in a clear and compelling manner. A knowledgeable attorney will also know precisely what information is needed and how to present this to the Hearing Officer in such a manner as to help you seek the best possible outcome. While you focus on healing and taking care of yourself and your family, your attorney can prepare for the hearing.
If your claim was denied or there has been no timely response, and you wish to request a hearing, you must do so in writing. Your request must include a copy of the letter or notice that is being appealed. If you do not properly file your request for a hearing, you may experience unnecessary delays and may even have your request for a hearing denied.
There is also a time limit by which you must act. Failure to do so may result in the loss of right to appeal. You must file your request within 70 days of receiving the workers’ compensation insurance provider’s decision. You may also request a hearing if the insurance provider or your self-insured employer has failed to respond to your written request within 30 days. In this second scenario, you have 70 days from the date that you mailed your request.
One you have properly filed your request, an initial hearing will be scheduled within 5 days of the date that your request is received by the Hearings Division. This hearing will be set to take place within 30 days, and you will be given at least 15 days’ notice of this.
A workers’ compensation hearing is held to address whatever issue or issues you decided to appeal based off the insurance provider’s determination or a failure to respond to a written request. It will be your responsibility to prove your case, so be sure you fully understand what issues you wish to address and gather the documentation that will be necessary to prove your point. You will need to provide copies of any documents that will be provided to the Hearing Officer to the other side as well (the workers’ compensation insurance provider or your self-insured employer).
Hearing Officers are trained in mediation and are required to conduct hearings in a fair and impartial manner. At your hearing, the Hearing Officer will attempt to help you and the insurer or your employer resolve whatever issues you have contested. The Hearing Officer will have you present your evidence and case at the hearing and will consider this and any evidence or information presented by the other side. Using this information, the Hearing Officer will then come to a decision on the matter.
If you disagree with the decision of a Hearing Officer, you can file an appeal to the Appeals Officer. This is the next step in contesting a denied workers’ compensation claim in Nevada.
Ready to learn more? Contact a Las Vegas workers’ comp lawyer at Shook & Stone.