Nevada Workers' Compensation Law

Nevada Workers'
Compensation Law

News & Updates on Workers' Compensation Laws & helpful Information on the Claims Process

Mileage reimbursement update

Posted in Mileage reimubursement, Uncategorized
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Effective January 1, 2015, the reimbursement rate for workers compensation related travel has been increased from $.56 per mile to $.575 per mile.

Injured workers are eligible for mileage allowance under NAC 616C.150. Mileage is eligible for reimbursement if the injured worker

  • is traveling to a doctor’s appointment related to his or her workers compensation claim (this includes physical therapy); and
  • is using a private vehicle; and
  • travels 20 miles or more one way; or
  • travels 40 miles or more within one week

In order to be reimbursed for eligible travel expenses, the injured worker must fill out a D-26 ‘Application for Reimbursement of Claim Related Travel Expenses’ and submit it to the adjuster. Mileage expenses must be submitted within 60 days of the travel date.

There are a couple of things you can do to make reimbursement as simple as possible for yourself, as well as your adjuster.

  • Fill out one reimbursement form for each month. Submitting multiple forms at separate times throughout the month makes it more difficult for your adjuster to calculate the expenses, and may delay your reimbursement check;
  • Use MapQuest or Google Maps to calculate the mileage. Your adjuster will double check the distance using one of these sites;
  • When following up with your adjuster for mileage reimbursement check, have a copy of the request on hand. Knowing the dates that the request covered will help your adjuster know exactly which expenses you are referring to. Keep in mind that the insurance company has 30 days to issue a mileage reimbursement check. Generally, the check goes out in the mail the day after it is issued.

 

Good News on Hearing Loss Treatment

Posted in Occupational Illnesses
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I’ve got good news and bad news about occupational hearing loss.

First the bad news about  occupational hearing loss claims:

  • It can be hard  to prove that the hearing loss was caused by a work accident or by an incident of loud noise at work as opposed to hearing loss from aging, particularly if there is no baseline audiogram when the employee begins the job,
  • Insurers fight these claims because hearing aids are expensive and need frequent replacement,
  • Claims for hearing loss that comes on gradually over time from noise exposure at work are often denied if the employee writes  a date of onset more than 90 days before a C-4 claim form is completed.  The insurer may argue that the claim should have been filed sooner.
  • Insurers change the rules as to how to compare hearing loss from one year to the next,
  • An employee can have a significant hearing loss and need hearing aids, but still may not have a ratable impairment under the AMA Guides and not be entitled to a permanent partial disability award.

Now the good news-  the N.Y. Times reports  on advances in treatment of hearing loss with medication   Medication may cost less than treatment with expensive hearing aids and may ultimately result in less resistance from insurers in accepting these claims.  Additionally, many people have a hard time adjusting to hearing aids.

Petitions for Judicial Review in Nevada

Posted in Appeals
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The most important hearing  on a contested workers’ compensation case in Nevada is the one before the  the appeals officer, because that  hearing is recorded, it is the last avenue for presenting witnesses or documentary evidence on the contested issue, and the appeals officer’s decision is difficult to attack.  However, any of the parties who lose at the appeals officer level, has the right to file an appeal to a district court judge, and that appeal is called a Petition for Judicial Review.

Continue Reading

Your Privacy and Medical Authorization Releases

Posted in Medical Care
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Some third-party administrators of Nevada workers’ compensation claims routinely send injured workers their own medical release forms which give the adjuster authorization to request any and all medical records from any medical providers.  I don’t have my clients sign those overly broad medical releases.  They are an invasion of the injured worker’s privacy, and injured workers are not required to sign those types of release forms.

NRS 616C.177 is the law that allows an insurer to ask about preexisting conditions and that requires the injured worker to sign a release.  However, this statute limits both the inquiry about preexisting medical conditions and the release form to “a preexisting medical condition that is reasonably related to the industrial injury of that injured employee.” [emphasis added] This law also states that the release is to assist the insurer to determine the nature and amount of workers’ compensation to which the employee is entitled.

NAC 616C.079, a regulation adopted by the DIR, says that the insurer may require the injured worker to sign a medical release for records “necessary for the insurer to obtain appropriate information and documents to determine the nature and amount of benefits.”  [emphasis added]  To the extent a regulation conflicts with a statute, the statute prevails, according to rules of statutory interpretation by the Nevada Supreme Court.

NRS 616A.400 gives authority to the DIR to regulate the forms used to process workers’ compensation claims.  DIR passed NAC616A.480(4) which requires insurers and third-party administrators to use the forms that DIR has written and listed in that regulation. One of those forms is the  D-36  used by insurers to ask about prior medical conditions that might affect the current claim.  This form has a medical release incorporated into the form.  It is a limited release form and only requests records pertinent to the injury. Insurers who want to use a different form are supposed to ask permission from DIR.

I doubt that DIR would authorize an insurer to use a very broad medical release form that can be used to obtain medical records for all past treatment, regardless of its relevancy to the current injury.  If DIR were to approve such a form, it is my opinion that it would be a violation of the first law I cited, NRS 616C.177, that limits inquiries and releases to records of preexisting conditions that are reasonably related to the claim.

Rather than just fail to return an overly broad release, I recommend that you print the D-36 form that is linked in this post, complete it as to any body parts that are at issue with this claim, and tell the adjuster that you will not sign other forms that are not authorized by DIR.

 

Federal Workers’ Compensation

Posted in Guest Blog Posts, Uncategorized
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I do not practice federal workers’ compensation law, but recently met an excellent attorney at a national work comp conference who does handle these cases.  As he explains in his guest post below, while you may live in Nevada, because federal law is the same in every state, it makes sense to hire the best federal work comp attorney even if he is physically located across the country.  I am referring all clients with federal work comp questions to Dan. His contact information is below. Virginia Hunt

The Federal Employees Compensation Act (FECA) covers traumatic injury claims and occupational disease or illness claims for most all civilian employees of the United States government, including temporary employees, contract employees and volunteers who are injured during the course of and as result of their employment. Benefits include wage loss compensation, medical benefits, vocational rehabilitation benefits, survivor benefits and payment for permanent partial disability to specified parts of the body. FECA is administered by the United States Department of Labor, Office of Worker’s Compensation Programs (OWCP), Division of Federal Employee Compensation which has 12 district offices serving various regions of the country (http://www.dol.gov/owcp/dfec/). OWCP plays a hybrid role as not only the adjudicator of the claim, but it is also designated to assist the employee in the development of the claim. All claims are submitted and initially determine by a paper filing. If an appeal is necessary, it is heard administratively in an informal manner with no courts or judges involved. FECA is a unique statutory scheme unlike any other worker compensation law in the country.

A lawyer may represent a government employee FECA claimant no matter where that employee resides or is employed as the law is uniform amongst all states and U.S. territories and all FECA practitioners have a national practice. Personal appearances at hearings or appeals are not required and often times they are conducted by video conference or telephonically. There are no more than approximately 20 lawyers in the country the majority of whose practice is FECA.

 

Daniel B. Shapiro, Esq., a graduate of Boston University and New England Law Boston, is a frequent lecturer on the Federal Employees Compensation Act and practice before the Office of Worker Compensation Programs of the United States Department of Labor. He has addressed and advised many local branches of federal employee unions and their individual members on their worker compensation rights for over thirty-eight years. He is the vice-president of the FECA Law and Advisory Group, a national organization of OWCP claimant representatives. Shapiro & Associates (http://www.shapirolaw.com/) is the single largest provider of FECA legal services in the country.

OSHA Regulations on Reporting Fatalities and Serious Injuries in Nevada

Posted in Uncategorized, Workplace safety
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New OSHA regulations go into effect the first of this year that increase the reporting requirements for employers of more than 10 employees of work-related  serious injuries.  The December 22, 2014 article in theLas Vegas  Business Press states that with increased funding and expanded enforcement Nevada employers have noticed increased OHSA investigations. Reportable serious injuries would include in-patient hospitalization, partial or complete amputations or loss of an eye. Those accidents should trigger immediate investigations, site inspections, witness interviews, and examination of an employer’s safety and training programs.  Violations of record-keeping rules can also result in fines and penalties, just like safety violations. Continue Reading

Chiropractors in Nevada Rule the Rating List for PPD Exams

Posted in Uncategorized
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The Division of Industrial Relations (DIR) is the Nevada sub-agency responsible for maintaining a list of doctors authorized to perform impairment evaluations, also known as ratings, on injured workers with Nevada workers’ compensation claims.  On December 14, 2014, the DIR updated its list of rating doctors to show which doctors have been added, or which ones are inactive, and the medical specialty for each doctor.  Several doctors are listed more than once to indicate that the doctor is available in multiple geographical areas in Nevada.  The total number of rating doctors who are currently active is 137, with chiropractors now numbering  100 of that total. Continue Reading

Rating for Sacroiliac Joint- Nevada PPD

Posted in Permanent partial disability awards
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I have had rating issues come up  in the past on how to rate injuries to the sacroiliac joint, and fortunately I had two experienced rating doctors reason that they should be rated under the DRE categories for a low back injury.  I say fortunately because  some rating doctors would have taken the position that because the AMA Guides 5th edition don’t specifically mention the sacroiliac joint, they would have found  no ratable impairment.   The November/December 2014 AMA Guides Newletter should settle any controversy over how to rate an injury to the SI joint.

This article notes that diagnosing an injury to the SI joint can be difficult because the injured worker’s pain complaints are similar to other causes of low back pain.  Imaging studies of both the low back and the SI joint may reveal degenerative changes which may or may not be pain contributors, and there doesn’t seem to be a consensus as to what tests will definitely distinguish between a disc  problem, facet joint , or the SI joint as the source of back pain.

But once the diagnosis has been made of a SI joint injury and appropriate treatment is finished, it should be easier to establish what the impairment should be now that this article sanctions the use of the low back DRE categories to rate under the 5th edition of the Guides.  If the SI joint injury presents the rating doctor with findings of “muscle guarding”, “muscle spasm”, asymmetric loss of motion”, and non-verifiable radicular complaints, it should be rated as a DRE Category II ( 5%-8% whole person, depending on impairment in activities of daily living).

Blog Honored Again for 2014 Posts

Posted in Uncategorized
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I am pleased that my blog has again been named as one of the top blogs on work injury law by Lexis Nexis.  I had my first ten-day vacation in years during November, so I haven’t had time to write lately, but will catch up over the holidays.  If you have suggestions for topics you would like me to write about, please let me know.  I am working on a post about recent developments in FMLA law and how they impact work injury claims, and more posts about temporary and permanent light duty.  Thanks for reading.  Virginia 

“Nevada Workers’ Compensation Law Blog, written by claimant’s attorney and former administrative appeals officer, Virginia Hunt, is a repository for information and opinion related to workplace injuries in the Silver State. Having worked inside the “system,” Hunt offers excellent advice to claimants and attorneys alike on such important issues as how to fight back when the “independent” medical exam physician isn’t independent [seehttp://www.nevadaworkerscompensationlaw.com/2014/11/articles/claims/independent-medical-exams-are-rarely-independent/], how to seek appropriate treatment for PTSD [seehttp://www.nevadaworkerscompensationlaw.com/2014/06/articles/psychological-injury/post-traumatic-stress-disorder-nevada-comp-law/], and how to obtain out-of-state medical care [seehttp://www.nevadaworkerscompensationlaw.com/2014/08/articles/benefits/out-of-state-care/out-of-state-medical-care-for-nevada-injured-workers/]. Hunt also engages others in her discussion of important issues. See, for example, a March 4 post in which she asked Nevada attorney, Gerald Welt, to share his expertise related to the interaction between Nevada Workers’ Comp law and Social Security disabilities [seehttp://www.nevadaworkerscompensationlaw.com/2014/03/articles/miscellaneous/nevada-workers-comp-and-social-security-disability/].”