Nevada Workers' Compensation Law Blog : Nevada Workers' Compensation Lawyer & Attorney : Virginia Hunt Law Firm : Las Vegas Job Injuries & Worker Accidents

Injured workers should be aware that if their insurer denies their request to reopen their claim, they may not request reopening again for at least a year.  For example, if you send a letter to the insurer asking to reopen your claim, but you do not attach any supporting medical reports, your request will be denied.  If you don't appeal that denial, then you must wait a year after the date of the insurer's denial to ask for reopening again. If you appeal the denial, but your lose your appeal,  you must wait a year after the final decision on your appeal before you may ask to reopen again.

You want to make sure that you first understand what your reopening rights are on your particular claim underNRS 616C.390.  Then, you want to make sure that you attach a medical report that is likely to get your claim reopened.  Finally, if your request is denied, you should pursue the appeals process to get your claim reopened if you don't want to have to wait a year to request reopening again. 

If you had a lawyer represent you previously on your claim, your lawyer should be willing to help you reopen your claim.  If you decide not to bother with your lawyer, then it may be very difficult for your lawyer to help you later if your request is denied because you didn't follow the proper reopening procedure.   Please read my blog posts about the reopening process before  you attempt to reopen.

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I just saw a TV ad that asks injured workers whether they know that they have a right to choose their own doctor.   Enough wasn't said in this ad in my opinion.  The actual law,  NRS 616C.090, gives injured workers just a limited right to choose a different doctor. 

An employer can require that  their injured employees first go to specific clinics to report a claim and to get initial treatment.   Concentra, Fremont Medical, Harmon Medical Center, and Industrial Medical Group are  examples of  clinics that many insurers and self-insured employers use for that purpose.  If you don't want problems in getting your claim accepted, you should go where your employer tells you to go to file your claim and to get evaluated by a physician.  Then, you can change doctors after your claim is accepted.

Injured workers who want to change doctors have the right to request a different treating doctor, but they must request the name of one who is already on their  particular employer or insurer's provider list.  Injured workers  cannot just make an appointment with a doctor of their choosing to treat their job injury or occupational illness.   If it isn't an emergency, an employee with with an accepted claim must  go through his or her adjuster to first ask which doctors are on the provider list, and to then ask for a change of doctors.

Most injured employees simply don't k now to ask for a copy of the employer or insurer's provider list.  If you ask for it writing, they must give it to you.  First get this, then request a change of doctors so that you aren't wasting your time asking for a doctor who isn't on the provider list.

Also,  if the injured worker asks to change doctors after 90 days following the date of the accident, the adjuster may refuse to grant the change.  This is a very important right that  injured workers have, but one that few use.  If you are dissatisfied with your initial treating doctor, and many injured workers aren't happy with the quality of care, get immediate legal  help in transferring your care if you don't feel capable of doing it yourself. This is the single most important decision you will make on your claim-  who will be your doctor?  And ideally,  this decision should be made within the first 90 days of your claim with the help of someone who is knowledgeable about each of the doctors on the provider list.    For more information on the law on choice of physicians, and to read what the Nevada Supreme Court said about this choice, read my earlier blog post when they changed this law in 2009. 

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The most recent edition of the local magazineNevada Business has incorrect information from a local insurance agency on how permanent partial disability awards (PPD) are determined under Nevada law.  The sidebar in the article states that  Nevada has workers' compensation laws that are pro business and that favor the employer, and I agree with that overall observation.  However,  this sidebar also  states that in Nevada the "PPD is based on work restrictions."  That is incorrect.  The PPD is not based on an injured workers' work restrictions.

Under Nevada law, the rating physician is required to use the criteria in the AMA Guides to Evaluation of Permanent Impairment, 5th edition.  The Guides determine impairment, defined as "a loss, loss of use, or derangement of any body part, organ system, or organ function."  Guides, 1.2a.  Ratings reflect the impact on an individuals performance of activities of daily living, excluding work, which is not considered to be an ADL in the Fifth Edition.  Guides 1.5.

An injured worker may have a PPD percentage  under the Guides, such as a 1% whole body PPD for a partial meniscectomy to the knee,  but may be fully capable of returning to his preaccident job without any work restrictions.  Many employers, and apparently insurers also, are under the misconception that injured workers who are released full duty by their treating physicians are not entitled to a PPD award.  Whether or not an injured worker has work restrictions does not govern whether the employee is entitled to a PPD award.

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