Employers in Nevada have a number of obligations related to injured employees. One way to break down the obligations is to look at each of them according to when they arise. Some obligations arise as soon as the employee starts work. Others arise in the immediate response to an injury. And still others apply in the aftermath of the injury, when the employer’s assistance with the employee’s workers’ compensation claim can be the difference between an accepted or denied claim.
- Pre-injury obligations.
Most Nevada employers must carry workers’ compensation insurance that protects their employees in the event they are injured on the job. Not carrying insurance is a significant violation of law, subjecting the company to potential criminal prosecution, regulatory actions, and fines. Few employers want to risk losing their business over a failure to obtain workers’ compensation insurance. But from time to time an employer operates without it in hopes of saving some money, putting employees at risk.
Under state and federal workplace safety laws (commonly known as OSHA) employers over a certain size have a general duty to provide a safe working environment for their employees, as well as specific obligations relating to particular hazards such as electrical or chemical work. Although OSHA rules do not provide for a private cause of action, they do provide an important baseline of safety that protects employees from working in substandard conditions.
- Obligations in the immediate aftermath of an injury.
When an employee suffers an injury in Nevada the employer has an obligation to assist the injured employee with obtaining emergency medical treatment. That might include calling 911, and might also include administering emergency care such as CPR, performing triage on a wound, and so forth. Many employers are taking steps to train their staff in emergency first aid, in part because such programs can help them lower workers’ compensation costs.
- Obligations as the employee recovers.
The recovery phase of a serious injury is where things can get quite complex. There are a range of obligations that employers have with respect to employees who have been injured on the job:
- They may not take adverse employment actions against them based solely on their having suffered or reported an injury.
- They must keep good records of the incident and report it to the state.
- They are required to cooperate with any investigation that arises due to the employee’s workers’ compensation claim, such as if the insurance adjuster has questions about whether the injury was work-related.
- They must comply with laws governing an injured employee’s options for returning to work, including offering light duty where appropriate.
- They must make reasonable accommodations for an employee who has suffered a disability.
As one might expect, the above list only glosses over the surface of what might be involved in a given case. Quite often the injured employee can benefit from the assistance of an attorney with experience handling workers’ compensation cases. For over 45 years the law firm of Greenman Goldberg Raby Martinez has helped clients in the Las Vegas area pursue workers’ compensation claims. If you have been injured at work and you have questions about how to get the coverage you deserve, call us today for a free attorney consultation at 702-388-4476 or send us a request through our site
Having a workers’ compensation claim denied can be a shocking and frustrating experience. For many working people, workers’ comp is the best or only available resource for getting care for an injury or illness that happened on the job. When someone can’t keep working or needs long-term care, denied coverage can have profound personal consequences. Here are some of the common reasons why an insurer will deny a claim.
- The injury or illness is not eligible for benefits.
To be eligible for workers’ compensation coverage, an individual must have been injured or contracted a disease in the course and scope of employment. Workers’ comp is a no-fault form of insurance, which means that an insurer cannot base decisions about whether to approve a claim on the degree to which the employee or someone else is responsible for the injury or disease. But insurers do look closely at the circumstances of the claim to verify that the individual who makes it was in fact working at the time of the injury. Cases involving denied claims have included employees who are injured while commuting, on a lunch break, or between shifts. But the dividing line between work and not-work is not always clear, and sometimes a dispute can arise when, for example, an employee is injured on the way to an employer-provided break room
- Missed deadlines and incomplete paperwork.
The insurance adjusters who evaluate the merits of claims are paid to review every detail for breaches of legal requirements. When claim paperwork is submitted late, or required pieces are missing, an insurer may have an excuse for denying an otherwise valid claim. For example, an accident at work needs to be reported to the employer within seven days.
- Suspicious discrepancies.
Insurers are passionate about guarding against fraud. If they think that a claim is based on misinformation, they will be quick to deny it. Workers can find themselves facing a denied claim if information they provide in their paperwork doesn’t match third-party records, such as those provided by the employer or the physician who conducts the initial evaluation. Injured workers are also getting into trouble by posting contradictory information to social media accounts.
- Evidence of drugs or alcohol use.
A workers’ compensation insurer can deny an employee’s claims if it finds evidence that the employee was drunk or under the influence of a controlled substance at the time of the workplace injury. This includes recreational marijuana
use. An employee can only overcome the denial of a claim on the basis of drugs or alcohol use by showing through clear and convincing evidence that the substance was not a factor in the employee’s injury. Although the facts of an injury may support the employee’s argument, the process will be significantly more complicated as a consequence of drug or alcohol use at work.
For over 45 years the law firm of Greenman Goldberg Raby Martinez has represented Las Vegas clients in workers’ compensation claims disputes. We can help you resolve your questions about workers’ compensation coverage and fight back against an insurer that refuses to give you the coverage you deserve. Call us today for a free attorney consultation at 702-388-4476 or send us a request through our site
Work-related depression is a problem that is hiding in plain sight. Whether resulting from the stress of the job, loneliness
, or alienation, depression is an authentic and serious problem for working people. Evidence that employers are aware of this problem can be seen in the rise of employer-provided “help lines” that provide employees with no-cost, anonymous counseling services to address depression and other issues. When an employee suffers from depression that is linked to work, the employer’s workers’ compensation program may offer a source of financial assistance for treatment and recovery.
Despite the well-understood link between the stresses of work and clinical depression, the employee who makes a workers’ compensation claim likely will need help making an effective case for coverage. Workers’ compensation programs often are designed to address relatively easily understood workplace injuries, like broken bones and strained ligaments. Mental health issues pose special challenges for insurers, who will look for ways to avoid financial responsibility for an employee’s treatment.
The most likely argument that an insurer will make to deny coverage is that the illness was not work related. To be covered by workers’ compensation a disease must have arisen out of or in the course of employment. If the disease can be traced to a cause that is not work-related, coverage will not apply. A conventional injury, like carpal tunnel from a non-ergonomic desk layout, tends to have a clear causal link to the employee’s job. The claimant must be ready to show that depression was caused by the job.
Proving the link between depression and work can involve several sources of evidence. An important one will be the employee’s mental health professional, such as a psychiatrist or counselor. An expert’s evaluation of the underlying sources of depression can be vitally important in cases where causes beyond work can have played a secondary role. Other sources of evidence might include other employees as well as confirmation from family and friends who have observed the ways that the employee’s work have affected his or her mood.
Depression can result from ongoing stresses, but it can also be the consequence of a specific event. Here the case for workers’ compensation can be clearer. A worker who has seen a number of long-time colleagues laid off may experience specific emotional responses to those events. A worker who has suffered a physical injury at work may experience depression caused by medication or simply by a loss of mobility or career prospects.
A workers’ compensation attorney works with clients to improve claims outcomes. For more than 45 years the law firm of Greenman Goldberg Raby Martinez has helped injured workers get the coverage they need to get back to full health after suffering an injury on the job. For a free attorney consultation, contact us at 702-388-4476 or through our contact page
Pregnant women have unique concerns when they are injured. Protecting the health of a developing fetus can limit treatment options, like antibiotics, that might otherwise be available. And some injuries can pose serious risks to the fetus itself. For a pregnant woman who is injured at work and is receiving benefits under a workers’ compensation program, such challenges can raise questions about coverage and employment rights.
Nevada law protects pregnant women in the workplace
The Nevada Pregnant Workers’ Fairness Act
(NPWFA), NRS 613.335, limits the ways that employers can restrict a pregnant employee’s job responsibilities. Among other things, the law requires covered Nevada employers to provide pregnant employees with reasonable accommodations to allow them to continue to work during pregnancy and after childbirth. For employees who do manual work, the employer may lawfully offer light duty or a less risky role to protect the health of the employee and her fetus, and to manage the employer’s risk with respect to potential workplace injuries.
Although the NPWFA isn’t expressly a workers’ compensation law, it provides an important context for women who are injured at work while they are pregnant. A pregnant woman does not need to accept an employer’s unreasonable job restrictions that are only intended to limit the employer’s potential liability and create an unnecessary burden upon the employee.
Workers’ comp applies to all job-related injuries
Nevada’s workers’ compensation law requires all employers to insure their employees against all injuries and illnesses that arise out of or in the course of employment. The fact that an employee was pregnant at the time of an injury has no bearing on coverage. So long as the injury happened during working hours, or while the employee was performing work-related duties, coverage will apply. This is true regardless of the specific cause of the injury.
A pregnant employee whose injuries also cause pregnancy-related complications should expect those complications to be included as a component of coverage. It’s important to bear in mind that coverage may not be approved for conditions that cannot be traced to the job-related injury. Records of the employee’s obstetric treatment will be important to show that a condition did not exist prior to the work injury.
GGRM represents clients in complex workers’ compensation cases
For over 45 years the law firm of Greenman Goldberg Raby Martinez has represented Las Vegas clients in workers’ compensation claims disputes. We are happy to help women who are facing challenges involving pregnancy and workers’ comp claims to seek better outcomes for themselves and their children. For a free attorney consultation call us at 702-388-4476 or send us a request through our site
As employers have moved toward a more casual work environment, some have begun to allow employees to bring their dogs to work. When such a policy works, everyone in the office enjoys having a dog or two around, the dogs are friendly and unobtrusive, and the dog owners get to avoid paying for dog care or worrying about a dog left at home all day. But if a dog causes significant injuries to an employee, whether from biting or knocking the employee down, what options does the injured employee have to recover compensation? There are two potential avenues to consider: workers’ compensation and personal injury litigation.
Dogs and workers’ compensation
With respect to an employer’s liability, workers’ compensation rules apply to most injuries that arise out of or in the course of employment. Workers’ compensation is an exclusive remedy, which means that if an injury falls within the scope of workers’ compensation, the injured employee usually can’t sue the employer for personal injury. Instead, the employee files a workers’ comp claim to cover the costs associated with the injury. Because workers’ compensation is also a form of no-fault insurance, the insurer will not investigate whether the employee’s own negligence contributed to the injury. A workers’ compensation claim typically will cover medical bills, lost wages for someone who must take time off work, and potentially the cost of healing scars and other issues.
An employer that allows dogs at work should have incorporated the presence of dogs into its workers’ compensation policy. If the employer did not, and the insurer refuses to cover the employee’s injuries, the employee will need to consult with an attorney to determine the best next steps with respect to the employer’s liability.
What about the dog’s owner?
The workers’ comp exclusive remedy rule only protects the employer. It does not apply to the coworker who owns the dog. Whether a lawsuit against the dog’s owner is appropriate depends on a number of factors, including: Is workers’ compensation insufficient to cover the expenses related to the injury? Did the dog’s owner behave in an especially negligent or intentional manner to cause or contribute to the injury? Did the owner knowingly bring a dangerous dog to work?
In some cases, the answer to the question of whether to pursue workers’ compensation or a lawsuit may be “both.” Someone who receives workers’ comp benefits cannot pursue the same types of compensation from a defendant but may be able to pursue other forms of compensation. Workers’ comp doesn’t provide compensation for cases of gross negligence, or for pain, suffering, or other forms of noneconomic damages.
GGRM handles dog bite litigation in Las Vegas
For more than 45 years the law firm of Greenman Goldberg Raby Martinez has represented clients in personal injury and workers’ compensation cases. We can help you sort through your legal options if you have been injured by a dog at work. Reach out to us today for a free attorney consultation. Call us at 702-388-4476, or ask us to call you through our contact page
Workplace equipment can endure a lot of heavy abuse, especially in industries like construction or transportation. That equipment can break down and become a danger to employees is one reason that responsible employers incorporate routine maintenance checks into their risk management programs. But broken or badly maintained equipment can still end up in use, and workers can be injured as a consequence.
Equipment maintenance and the law
Nevada employers have an affirmative duty to maintain their work environments in a condition that is safe for employees. Under the standards set by Nevada’s Occupational Safety and Health Act (OSHA), NRS 618 et seq., and its related regulations, employers with at least eleven employees are required to adopt formal safety programs, which among other things should address potential hazards like wear and tear on dangerous equipment.
OSHA is a regulatory program enforced by the Nevada Division of Industrial Relations
(DIR). Although employees can make complaints to the DIR about safety problems at work, they are not able to take direct legal action themselves against their employers for safety violations. The DIR may respond to complaints by pursuing investigations into safety violations, which may result in fines and, in extreme cases, litigation.
Bad equipment and workers’ compensation
Workers who are injured by inadequately maintained equipment can be surprised to learn that their only recourse for recovery may be workers’ compensation. Nevada’s workers’ compensation system has several features that come into play. First, it is an exclusive remedy, which bars most personal injury lawsuits against employers who comply with their workers’ comp obligations. Second, it is no-fault insurance, which means that an injured employee will be covered for any injury arising in the course of employment, regardless of who is to blame.
An exception to the exclusive remedy exists for an employer’s intentional acts that are intended to cause harm to an employee. If, for example, an agent of the employer (a manager, for example) deliberately sabotages a piece of equipment knowing that it creates a hazard for employees, an injured employee can pursue direct litigation against the employer and the employee who caused the injury. Note that even if an employer has behaved irresponsibly, for example by requiring workers to use equipment that hasn’t been properly maintained, the most likely recourse remains workers’ compensation.
For over 45 years the law firm of Greenman Goldberg Raby Martinez has represented Las Vegas clients in workers’ compensation and personal injury cases. If you have been injured on the job, please reach out to us today for a free attorney consultation about your situation. Call us at 702-388-4476 or send us a request through our site
A workers’ compensation claims advocate is a professional who specializes in helping employers manage their relationships with their workers’ comp insurance providers. Their most important role is to help the employer manage claims. For many employers, developing in-house expertise on claims processing is difficult or impractical, so they hire outside firms, often an insurance brokerage, to provide claims advocacy services. For the injured worker, a claims advocate can be a good resource and a significant help in the event that a claim is denied. At the same time, however, the employee needs to understand that the claims advocate’s job is to represent the employer, not the employee.
A claims advocate works with his or her clients to help them manage the costs of their workers’ compensation program. The idea behind the role is to help employers avoid expensive litigation arising from denied or mishandled insurance claims. An advocate may provide a wide range of services, from training employees on risk management to helping resolve conflicts with insurers. A claims advocate typically has an insider’s perspective on how insurers operate, and can sometimes resolve issues in a way that avoids more costly forms of intervention.
Employers often work with claims advocates as part of a broader investment in the welfare of their employees. As such, a claims advocate’s role is partly to help ensure that an injured employee gets the coverage they need. Employees can benefit from an advocate’s assistance in a number of distinct ways:
- Ensuring that a claim satisfies legal and technical requirements.
- Mediating between the injured employee, the employer, and the insurer to resolve disagreements.
- Assisting the employer and employee to find solutions in the event that workers’ compensation won’t cover an injury.
On balance, services like these are of great benefit to an employee. But the employee always needs to remember that the advocate’s obligation is to the employer, not the employee. The advocate is there to help the employer save money by, among other things, reducing the risk of litigation. This motivation can result in a conflict of interest that may discourage the employee from pursuing the course that is in the employee’s best interest.
Working with an experienced workers’ compensation law firm is a good way for an injured employee to ensure that the claims process is handled with the employee’s interests in mind. The law firm of Greenman Goldberg Raby Martinez has represented clients in workers’ compensation cases for over 45 years. For a free attorney consultation about your case call us at 702-388-4476 or through our contacts page
Someone who gets injured at work and needs to file a workers’ compensation claim hopefully can rely on the system working smoothly to provide complete care and other benefits. One hopes that injured workers have access to good advice through their employers or a third-party claims administrator, and that everyone involved will try hard to ensure that the worker receives all the benefits that are owed under state law. Unfortunately, this isn’t always how things go. Like every kind of insurance, workers’ compensation often raises conflicts of interest, disputes about medical diagnoses or treatment plans, and other problems that a worker who isn’t represented by an attorney may struggle to overcome.
How an attorney facilitates workers’ comp claims
The role of a workers’ compensation attorney is to protect the client’s interests and ensure that all the benefits to which the worker is entitled are properly paid. Within the scope of that work there are a number of important things an attorney can do for the client:
- Ensure that claims paperwork is completed correctly and on time.
- Monitor the medical evaluation process to verify that the client isn’t railroaded into accepting an incorrect or incomplete diagnosis.
- Raise and resolve concerns with how coverage is being provided.
- Keep track of important records that may be vital if the claims process needs to be taken into a dispute resolution proceeding or litigation.
- Advise the client on when and how to dispute insurer decisions.
When should you hire an attorney?
Whether an individual needs the help of an attorney is really a question that needs to be answered after taking stock of all the facts of the individual’s case. It never hurts to reach out to an attorney who offers free consultations to determine if representation is necessary. Broadly speaking, the help of an attorney is more important if complicating factors are present. Some examples of these include:
- Severe injuries. An attorney’s help can make a huge difference for someone who has suffered a serious injury that will involve significant health care expenses, long periods off work, or some form of disability. Such injuries cost workers a lot of time, money, and stress. Ensuring that workers’ compensation benefits cover everything the worker needs takes planning and close oversight. In part this is because high-cost claims often end up in disputes as insurers look for ways to limit their financial exposure.
- Wrongfully denied claims. Someone who feels they’ve had their claim wrongfully turned down may need to file an appeal. Although an attorney isn’t necessarily required to make an appeal, the chances of an appeal succeeding gets significantly better if an attorney is involved, especially if the attorney has been involved from early in the process.
- Medical disputes. Many types of injury are subject to a wide variety of medical diagnoses. A strained back could be diagnosed as a muscular problem or as a slipped disc. A headache might be diagnosed as a concussion or as a more severe type of head trauma. Insurers know this and will use the medical examination process to find ways to restrict their exposure. An attorney can make sure the client knows how to exercise important rights like the option for seeking a second opinion.
The law firm of Greenman Goldberg Raby Martinez has represented clients in workers’ compensation cases for over 45 years. We provide personal, caring service to each and every client. For a free attorney consultation about your case call us at 702-388-4476 or through our contacts page
The number of temporary staffing firms is constantly growing as businesses look for ways to manage employee costs by outsourcing work to temporary staff. Temporary workers are found in virtually every industry, including dangerous professions like construction, transportation, and health care. Like other employers in Nevada, a temporary staffing firm is required to carry workers’ compensation insurance that protects its staff members in the event that they are injured while working at a client site.
Understanding when workers’ compensation applies
Nevada’s workers’ compensation system provides that employees are insured against injuries that arise out of or in the course of employment. Generally speaking “the course of employment” captures any time for which an employee is compensated. A worker often is also covered during times when they are doing something that the employer has asked them to do. Personal time is not within the scope of workers’ compensation. Critically, a normal commute usually is not covered. However, because a temporary worker is often asked to commute to a location other than their firm’s office, those trips may be covered for some workers.
Workers’ compensation is a kind of no-fault insurance. This means that the insurer is not allowed to base its coverage decisions on who was responsible for causing the worker’s injury. It’s important to remember that a temporary worker is employed by the staffing firm, not the client at whose site the work is done. The temp worker therefore falls under the staffing firm’s workers’ compensation coverage.
Staffing firms often face workers’ compensation challenges
The inherent complexity of a staffing firm’s risk profile means they can have a hard time finding insurance. Many firms get insured through a professional employer organization, or PEO. A PEO is essentially a service company that takes on components of an employer’s human resources functions, such as payroll and insurance administration. A PEO may offer temporary staffing firms with a way to secure workers’ compensation coverage under a plan that groups together all of the PEO’s clients.
The presence of a PEO in the chain of authority can add a layer of administrative challenges to a worker who is injured on the job. Ideally a claim process goes smoothly and with adequate support from the insurer to resolve technical hiccups without interrupting the injured worker’s treatment. But if administration of the claim is handled by a PEO, the worker may have no relationship with the individuals handling the claim and may need additional help to resolve problems.
The law firm of Greenman Goldberg Raby Martinez has represented clients in workers compensation cases for over 45 years. We can help temporary workers get the workers’ compensation coverage to which they are entitled. For a free attorney consultation about your claim, call us today at 702-388-4476 or through our contacts page
Nevada’s workers’ compensation insurance system is designed to ensure that everyone who works for an employer in the state is protected in the event of an injury on the job. Benefits are provided to qualified workers without regard to fault: an injury is covered regardless of whether the worker, the employer, or someone else can be blamed for causing it. The lack of a fault analysis doesn’t stop insurers from looking for ways to deny or limit an injured worker’s coverage. One way they may try to do that is by arguing that the injury existed prior to the work-related event that gave rise to the claim.
To be covered by workers’ compensation insurance an injury must “arise out of or in the course of employment.” Generally speaking this means that if a worker is injured while doing work-related activities, especially if the worker is “on the clock” and getting paid for the time that covers the injury event, the injury will be covered. In some types of injury, the cause may have arisen at work, but the scope of the injury only became clear later. Cancer arising after exposure to carcinogens at the workplace is a good example of a work-related illness that may be slow to develop and that would require the worker to establish a causal link to the employer in order to receive coverage.
Causation can become a barrier to coverage if the source of a particular injury can be traced to something that is not work-related. If a claim is for an injury that could be described as a “pre-existing condition” the insurer may refuse to cover it. For example, a worker who hurt his knee while skiing may have a more difficult time getting coverage for an injury to the same knee while on the job. The insurer’s argument will be that the injury did not “arise out of or in the course of employment” but was in fact the personal problem of the worker.
For a worker in such a circumstance the important thing is to document the ways in which an existing condition was made worse by the accident at work. Being clear with doctors about the details of the injury is important at every stage. So is keeping a record. In the case of the skier, if a doctor was consulted after the skiing accident the doctor will have records related to the scope and severity of the injury at that time. The accident at work may have worsened the condition in ways that can be medically measured, and to that extent the worker may be entitled to coverage.
If an insurer denies a claim that has a legitimate basis in a work-related injury the worker may need to consult with an attorney to make a successful appeal. An attorney can help the client organize facts, complete paperwork, and anticipate common insurer arguments. The attorney can also help the client navigate the medical examination process that will be used to determine the scope of coverage.
The law firm of Greenman Goldberg Raby Martinez has represented clients in workers’ compensation cases for over 45 years. We can help you understand how your preexisting conditions may affect your coverage for a work-related injury. For a free attorney consultation about your case call us at 702-388-4476 or through our contacts page