When Premiums Go Up, Will Reported Injuries Go Down?

 The Las Vegas Chamber of Commerce magazine "Business Voice"  reported in the June 2012 edition that Nevada employers with a history of claims should expect to pay higher premiums beginning on March 1, 2013.   Premiums are set by the National Council on Compensation Insurance. The number and severity of work injuries are compared with the claims histories of similar employers.  Employers with expensive lost time claims will pay much higher premiums than employers  with fewer claims.

This magazine article advises employers to make sure that every claim is accurate and closed in the next three months before new policy premiums take effect.  It also encourages employers to prevent future claims by making the workplace safe.   It discusses that employers with temporary light duty work programs can save thousands of dollars in premiums by keeping the claim as a medical only claim.  ( A medical only claim is a claim where only medical bills are paid, and no lost time compensation benefits are paid.)

These are good suggestion for employers to save on workers' compensation premiums. However, I'm concerned about the statement  that employers can lower the number of claims filed  by rewarding employees who don't have claims..   While such reward programs undoubtedly  result in fewer claims,   However, some employers go too far and use so-called safety  incentive programs as a way to intimidate and discourage employees with job injuries from filing legitimate claims.  

Employers should not be offering to pay injured employees cash for not filing a claim after an employee is injured. Sometimes a person does not know how seriously they are injured in the first days or weeks after a work accident.  For example, the sudden onset of low back pain  at work after lifting a heavy truss could be just a bad sprain.   Not wanting to be the one to ruin his employer's claim-free record this year,  this injured worker might not report the injury as work-related when he first gets medical treatment.  Only after the injury does not improve, and a MRI shows a herniated disc , does the injured worker file a claim.   That claim may be denied by the insurer however, because it \was not reported  and filed right away.

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Occupational Illnesses: When to File a Claim

The Nevada Supreme Court just published a decision favorable to Nevada employees who have illnesses that are caused from their employment.  In City of Las Vegas v. Lawson,  a City of Las Vegas fire fighter filed a workers' compensation claim after her breast cancer recurred, several years after she was initially diagnosed and treated for cancer. The city denied the claim as being untimely,  because it wasn't filed when Lawson was first treated and off work due to breast cancer.  The court found that the claim was timely, stating that an employee must first have knowledge of her disability and its relationship to her employment before being required to give notice and file a claim. In Lawson's case, her doctor did not know or tell her until after her recurrence of cancer, that her exposure to known carcinogens when fighting fires was related to breast cancer. 

Nevada law requires an employee to provide written notice of an occupational disease within  7 days after the employee has knowledge of the disability and its relationship to the employee's employment.   In addition, the employee must file a claim for compensation ( the C-4 Claim for Compensation form),  within 90 days after the employee has knowledge of the disability and its relationship to his or her employment.  NRS 617.342(1), and NRS 617.344(1).  In Lawson's case, the appeals officer believed her when she testified that she did not know of the relationship between her breast cancer and her work as a fire fighter when she was first diagnosed and first off work. 

Please note that the laws pertaining to occupational diseases, including cancer, lung disease, and heart disease are  different,  depending on whether the employee is a fire fighter or police officer, or employed in some other occupation.  Nevada employees in other occupations can rarely  establish a  Nevada workers' compensation claim for cancer. While this case discusses laws applicable only to fire fighters, it has useful application  to all Nevada employees regarding the time limits  for  filing a written notice of injury or /illness and when to  fiile a claim.