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How to File a Workers’ Compensation Claim

How to File a Workers’ Compensation Claim Benson and BinghamIn days gone by, workers who sustained injuries or got sick on the job had little to protect them from financial ruin. Fortunately, times have changed.

Today, Nevada workers who suffer a work-related injury or illness have a right to receive workers’ compensation benefits to help them pay for medical and disability-related costs.

In this blog post, we walk you through the process of filing a workers’ compensation claim.

To learn more about your rights after a workplace injury or illness, contact an experienced workers’ compensation attorney.

First Steps After Suffering a Work-Related Injury or Illness

In an Emergency

Get medical help immediately. If need be, go to the nearest hospital emergency room to treat any serious, life-threatening injury. Your health and well-being are your top priority. In this situation, worrying about workers’ compensation can wait. Get help now.

In a Non-Emergency/After an Emergency Has Passed

Notify your employer of your injury or illness as soon as possible. This is critical for protecting your rights to receive workers’ comp benefits.

Next, seek appropriate medical care. (See below.)

Then, request and fill out a Form C-1 Notice of Injury of Occupational Disease – Incident Report within 7 days of the incident. Your employer can give you the form to fill out, if need be. Form C-1 is an incident report which will begin the process of documenting the injury or illness and establishes working conditions, injuries, and a date and time of the incident. Make sure all information you provide on the form is your current information such as address, name, contact information, and other information. Incorrect information will result in delays and possibly the rejection of your claim.

Give the completed form to your employer to file.

Getting Non-Emergency Medical Care

Workers’ comp insurance pays for the medical care you need to treat a work-related injury or illness, but there is a catch. Workers’ comp will only pay for care you receive from a medical provider who is on the official, state-approved, Panel of Treating Physicians and Chiropractors.

In seeking non-emergency medical treatment, make sure the doctor you choose to see is approved by the Panel and by your employer’s workers’ compensation insurance carrier. This information can be provided to you by your employer.

Next Step: Filing the Form C-4 Workers’ Comp Claim

Perhaps the most tricky part of the process of obtaining workers’ compensation benefits is making sure the claim paperwork gets properly completed and filed on time. When you are injured, you probably don’t want to dwell too much on the details or deadlines of filing forms and follow-ups. If the tasks below seem overwhelming, seek the help of an experienced Nevada workers’ compensation attorney right away. Failing to file the proper paperwork can lead to denial of your claim and loss of benefits.

In seeking medical care for a work-related injury or illness, you will be asked to fill out the top portion of a Form C-4 Employee’s Claim for Compensation/Report of Initial Treatment. Do not leave your initial visit with a doctor without filling out the top portion of this form.

Your doctor or medical provider fills out the rest of the Form C-4 and then, within three days, sends it to your employer and the employer’s workers’ compensation insurer. This is, officially, the “filing” of your workers’ compensation claim. Follow up with your doctor, your employer, and the workers’ compensation insurance company to make sure the form has been sent and received.

You must file a Form C-4 within 90 days from the date of your work-related injury or illness to receive workers’ compensation benefits. In the case of a serious injury, especially if your mobility or cognitive response is limited, your personal representative or attorney (if you have one) can fill out the portions you need to complete for you.

Next: Wait for a Decision (and Appeal if Necessary)

The workers’ compensation insurance company has 30 days to accept or deny your claim for workers’ comp benefits. You will be notified of the claim decision by letter sent to you or your representative.

If the claim is accepted, then you should begin receiving benefits shortly. Depending upon the nature of your injury or illness, benefits you may receive can include:

  • Medical treatment
  • Lost time compensation
  • Permanent Partial Disability payments
  • Permanent Total Disability payments
  • Vocational Rehabilitation services
  • Dependents payments in case of death
  • Other claims-related expenses (such as mileage, medical equipment, physical therapy)

If the claim is denied, then the letter you receive from the workers’ compensation insurance company must tell you the reasons for the denial, and explain your rights to “appeal” the claim decision. An appeal is a process by which you ask the state to review the claim decision. Nevada law provides for several successive levels of review of a disputed claim decision. Generally speaking, each level of review becomes more-and-more legally technical.

How a Workers’ Compensation Attorney Can Help

Ben J. Bingham, Esq.
Workers’ Compensation Attorney, Ben J. Bingham, Esq.

Filing a workers’ compensation claim and receiving the benefits you deserve should feel like a straightforward and fair process. Unfortunately, many injured and ill Nevada workers find the process of applying for workers’ comp anything but easy, and discover the hard way that workers’ compensation insurance companies would prefer not to pay claims.

To ensure fair and reasonable treatment throughout the workers’ compensation claim process, injured and ill Nevada workers can benefit from seeking the advice and counsel of an experienced workers’ compensation attorney. An attorney can help workers complete paperwork accurately and completely, follow-up with parties to make sure they meet filing deadlines and, perhaps most critically, fight for their rights when an insurance company partially or totally denies a claim. Oftentimes, working with an attorney can help workers’ avoid making mistakes in the process that can cost them benefits, and can convince workers’ compensation insurance companies that it will cost them less to pay maximum benefits than to fight.

If you have sustained a work-related injury or illness, contact an experienced workers’ compensation attorney for a free consultation.

 


Benson & Bingham
626 S 10th St
Las Vegas, NV 89101
702-382-9797

Benson and Bingham