Appealing a Nevada Workers’ Compensation Denial

Appealing the Decision

Workers’ compensation claims do not always go smoothly. Fortunately, if your claim has been denied, you’re not out of options. In Nevada, as in many other states, injured workers have the right to appeal the decision. This article will guide you through the steps you can take to appeal a workers’ compensation denial, including the option of hiring a lawyer to help you through the process.

Understanding the Denial

Before proceeding with an appeal, it’s essential to understand why your workers’ compensation claim was denied. In Nevada, common reasons for denial may include:

  • Lack of evidence: If medical evidence or the connection to your job isn’t strong enough to support your claim, it may be denied.
  • Missed deadlines: If you miss the deadline to file or fail to report your injury on time, your claim can be denied.
  • You have a preexisting condition: A common argument by the insurance company, a lawyer can help you prove that this was a new injury at work.
  • Injury was not work-related: Disputes sometimes arise over whether your injury was caused by your duties at work.
  • Inaccuracies or incomplete documentation: These arguments can also result in a workers’ compensation denial of your claim.

Appealing the Decision

Injured workers may appeal the decision to a Hearing Officer at the Nevada State Hearings Division within 70 days.  Alternatively, if an injured worker fails to receive a response from the insurer within 30 days after writing a request, he or she may appeal to a Hearing Officer. When the claim is not responded to within a 70-day period from the stamped postal date on the written request from the worker, the injured employee may appeal (NRS 616C.315).

Other Considerations

  • The requirement that you appeal a denial of a benefit must be met as soon as possible, even if you require more evidence.
  • Whenever you appeal the decision, include the notice of determination and the “request for hearing” form from the insurer/administrator.
  • You will only hear about issues related to the benefit you requested during your hearing.
  • You should bring extra copies of your evidence documents for the Hearing Officer and the opposing party.
  • To avoid attending your hearing in person if you are a long distance away or are housebound, call the Hearing Office early to arrange for filing documents or giving telephone testimony.

Hiring a Workers’ Compensation Lawyer

It can be challenging to navigate Nevada’s workers’ compensation appeals process. If you wish to appeal your workers’ compensation denial case, hiring an experienced attorney can give you a greater chance of success. A lawyer can help you in the following ways:

  • Experience: The laws and regulations governing workers’ compensation denial claims are well-understood by attorneys specializing in this field. You can benefit from their expertise in understanding the nuances of the system.
  • Evidence: Your lawyer can assist you with collecting and presenting evidence, including medical records, witness statements, and expert opinions.
  • Negotiation: During mediation or other settlement discussions, your lawyer can negotiate a fair settlement for you with the insurance company.
  • Representation: A lawyer represents your interests in court, presents evidence, and argues your case.
  • Benefits: Your attorney will ensure you receive all possible benefits, including medical costs and your lost wages.

You have options for appealing a denial of workers’ compensation, so keep this in mind when you face a denial. An experienced lawyer can help.

Attorney Jay Short: Workers’ Compensation Lawyer in Nevada

The law firm of Jay Short – Attorney at Law can help you if you have been injured on the job or have been ill due to your employment. It’s all we do to assist people in recovering benefits. By calling (775) 786-2006, you can obtain a free consultation at any time. If you would like to contact us online, feel free to do so.