If you have a medical emergency, call 911 and go to an ER or the nearest medical facility as soon as possible.
If your injury or condition is not an emergency, report the incident to your employer and ask for the list of authorized medical providers who treat first responder injuries. See one of the listed providers as soon as you can. Even if you think it’s not a serious problem, don’t try to “tough it out” on your own. If you put off necessary reporting or treatment, the insurance carrier will question whether your injury is truly work-related or may even deny your claim.
Report your injury to your employer as soon as possible. If you don’t notify your employer within 7 days, you could lose your Nevada Workers’ Compensation benefits. Complete a “Notice of Injury or Occupational Disease-Incident Report” (a C-1 form) and give it to your employer within seven days of your injury or the start of your condition. Keep a copy! The C-1 form is how you report the incident in which you may have been injured, it does not start the worker’s compensation claim process.
Be accurate and thorough in your reports. The information you provide to everyone involved in the workers’ compensation process must be consistent. The insurance carrier will look for any reason to deny your claim if the details vary.
During your first medical appointment for a work-related injury or condition, you and your doctor must complete an “Employee’s Claim for Compensation/Report of Initial Treatment” (a C-4 form). Keep a completed copy for yourself. You must submit a copy to your employer, usually giving it to your supervisor is sufficient. Your employer will notify the workers’ compensation insurance carrier who will handle your claim. Make sure the C-4 is submitted within 90 days from your injury or when you first noticed your work-related condition.
If you miss the deadline, you may have a qualifying excuse but it’s best to process the form as soon as possible and definitely within 90 days. The insurer must accept or deny your claim, in writing, within the next 30 days. If your claim is denied, you will receive information about how to appeal the decision. If your claim is accepted, you continue treatment and gain the right to many other benefits. Workers’ compensation claims are often complicated, and you should consider retaining a lawyer to protect your rights.
In an emergency situation, go directly to the nearest ER or another medical provider. However, for workers’ compensation treatment you must follow state requirements. In Nevada, you must be treated by an authorized doctor or medical provider listed on the Panel of Treating Physicians and Chiropractors established by your employer and insurer.
If your doctor is not on the insurer’s approved provider list, you probably cannot see him or her, but you still have some rights about who treats you. During the first 90 days of your claim, you can request a different medical provider from the approved list and the insurer must comply with your request. After the first 90 days of your claim it becomes difficult to change doctors.
Keep in mind, if you see a doctor who is not on the insurer’s provider list, your medical bills may not be covered by workers’ compensation insurance. Your health insurance may not cover it either, potentially leaving you with the whole bill.
After you notify your employer about your injury using the C-1 form, you need to begin medical treatment. At your first meeting with an approved medical provider, you will both complete an Employee’s Claim for Compensation/Report of Initial Treatment form (a C-4 form). The C-4 form must be filed with your employer within 90 days from the date of your injury or the date you first noticed your work-related condition.
Don’t miss this 90-day deadline. While there are a few acceptable excuses for missing the filing requirement it’s best to meet all legal deadlines from the start. An experienced Nevada workers’ compensation attorney can explain the legal exceptions and whether you can still file for benefits if you already missed the deadline.
Since every injury or illness claim is different, some workers’ compensation rules may not apply to your claim.
Many first responders may be inclined to rely on their employer or the insurance carrier throughout their claim, but keep in mind, they don’t have the same goals and priorities that you probably have. In Nevada you can get some help through your local Police Union or Protective Association. You can also turn to a Nevada workers’ compensation lawyer.
For First Responders maintains a list of qualified and experienced workers’ compensation lawyers who will fight to protect your rights, and to get you maximum benefits and compensation for your work-related injury or condition. A tenacious workers’ compensation attorney will:
- Deal with the workers’ compensation insurance company for you,
- Help you get the best medical care available,
- Gather the medical evidence needed to support your claim,
- Negotiate the best settlement possible to protect your future rights, for example if you need to reopen your claim or apply for Social Security benefits down the road, and
- Represent you at worker’s compensation hearings or trial if necessary.
Most workers’ compensation lawyers will handle your case on a contingency basis, so they don’t get paid unless they win and you receive benefits. Also, you shouldn’t have to pay for an initial consultation to understand your rights and have your questions answered.
Absolutely. Many excellent Nevada resources exist and For First Responders maintains a vetted list of qualified and experienced workers’ compensation attorneys who will handle your claim with the most outstanding care and compassion. You can contact us directly for a recommendation that is best suited to your situation.
In some cases, the doctor may recommend light-duty work while you recover. If you try to resume full duties as a first responder too quickly you may further injure yourself or place your fellow officers in harm’s way. Until you are fully capable to act as a first responder again, you should consider light-duty work as an important part of your healing process and accept it if offered.
Light duty is different than being “placed off work.” While on light duty you may be assigned to work a different schedule than before, and you may not qualify for overtime pay. Light-duty work may not pay as much as your former position, if that is the case, you may qualify for Temporary Partial Disability (TPD) benefits that could make up the difference in pay.
If you are “placed off work” by a doctor, or your employer is unable to offer you light duty, you may be eligible for Temporary Total Disability (TTD) payments. TTD is 66 2/3 % of your average monthly pre-tax wage, up to the state maximum. Many first responders have collective bargaining agreements which allow them to get paid their full wages.
Be warned, if you do not accept a light-duty assignment when offered, the insurer is not obligated to pay you TTD. Another reason to accept a light duty offer is to reduce the risk of aggravation or further injury.
For a variety of reasons, many first responders are reluctant to accept light duty, and sometimes request full duty. This can be dangerous because the main purpose of light duty is to allow your injured body parts to rest, recover and avoid further strain or injury. Another reason to accept a light duty offer is to reduce the risk of aggravation or further injury. Think about it this way… it’s better to accept three months of light-duty work now and make a full recovery rather than spending nine months on light duty after re-injuring yourself because you tried to returned to full- duty work too soon.
If you ever experience chest pain, you should seek immediate medical treatment regardless of if you have a history of heart problems or not, or if you have a pending heart-related workers’ compensation claim.
Nevada workers’ compensation law allows a first responder who has already filed a workers’ comp claim for heart disease to be able to use additional medical reports to bolster their claim. Alternatively, seeking immediate medical treatment may establish a new heart claim.
If you have chest pain, don’t hesitate. Go to an emergency room and get checked out. You may get a workers’ compensation heart claim out of it, but more importantly, you may save your own life.
If you suffer a work-related injury or illness, you may not be able to work while you recover. Depending on your circumstances, and the form of benefits you receive, your Public Employees’ Retirement System (PERS) retirement benefits may be affected.
During the time you are receiving workers’ compensation payments and not working as a police officer, your employer may not be contributing to your PERS retirement plan. Also, the official date when you are eligible to receive full retirement benefits may be extended for the amount of time you were paid TTD during your workers’ compensation claim.
If you are concerned about a WC claim affecting your PERS you may want to speak with your union representative or a workers’ compensation attorney who is experienced in these types of issues.
Every officer’s situation is different and many variables affect the outcome. To understand how your workers’ compensation claim may affect your retirement, ask an experienced Nevada workers’ compensation attorney to explain the law.
You have seven days to report an on-duty incident to your employer. You should report any incident that has the potential of resulting injury, regardless of if you feel hurt at the time. This should protect your right to open a claim if you feel you need treatment within the next 90 days.
Reporting an injury is usually done by completing a C-1 form and submitting it. However, other written documentation that a supervisor or manager was aware of the incident can sometimes be sufficient.
Under Nevada Law, an injured worker has a lifetime right to reopen their claim in certain circumstances. In order to have lifetime reopening rights a Nevada workers’ compensation claim must:
- have closed with a Permanent Partial Disability (PPD) rating of 1% or higher (which usually means the injured worker received compensation), or
- the injured worker must have missed more than 5 days of work directly related to the injury.
Workers’ compensation claims that do not meet either of these requirements have a 1-year window to reopen and must show objective worsening of their condition.