Although free food is a nice benefit for employees, providing food invites the relatively rare but potentially significant risk that an employee could suffer an allergic reaction. This is especially so if the allergen is not disclosed on the food’s packaging. Food provided in the workplace raises potential challenges for the employee who is injured and requires medical care. There are several dimensions that must be taken into account, such as whether the food was provided during working hours or was given to the employee to eat on personal time. These questions are important because they can determine if the employee’s illness or injury is covered by workers’ compensation insurance. Workers’ compensation law requires employers to insure their employees against injuries or illnesses that arise out of or in the course of employment. If food is provided to an employee during working hours or in connection with a work-related event, such as a meeting, the question of the injury’s work-relatedness likely will be answered in favor of coverage by workers’ compensation. Workers’ compensation coverage has good and bad elements for an employee. On the one hand, it is a form of no-fault insurance that will cover medical costs, replace wages, and provide other benefits that vary according to the nature of the employee’s illness and other factors. On the other hand, an employee is barred from filing a personal injury lawsuit against an employer for most injuries that are covered by workers’ compensation. This is true even if the employer was negligent—for example, if another employee switched the warning labels on food so the injured employee did not know about the presence of an allergen. Workers’ compensation law may not restrict an employee’s ability to sue the service or restaurant that provided the food. If in the above example the negligent act that led to a mislabeling of food was committed by the outside service, the employee may have a good case that they have failed to take reasonable precautions to notify customers about the presence of potential allergens in their food. Restaurants take pains to track common allergens, like nuts, so when they fail to do so it is often a sign of negligence and actionable by someone who gets injured as a consequence. Cases involving businesses and employment are always more complicated than they might seem. Someone who is faced with complications from an allergic reaction to workplace food should consult with an attorney to better understand how the law can help them. For more than 45 years the law firm of Greenman Goldberg Raby Martinez has represented clients in the Las Vegas area in personal injury and workers’ compensation cases. For a free attorney consultation about your case, contact us at 702-388-4476 or through our contact page.
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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.
- Obligations in the immediate aftermath of an injury.
- Obligations as the employee recovers.
- 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.
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.
- Missed deadlines and incomplete paperwork.
- Suspicious discrepancies.
- Evidence of drugs or alcohol use.
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 workplaceThe 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 injuriesNevada’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 casesFor 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.
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 claimsThe 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 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 appliesNevada’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 challengesThe 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.
Getting injured while on the job in Nevada entitles workers to insurance coverage under their insurers’ workers’ compensation program. Once a valid claim is started, the insurer will pay for a range of important expenses associated with the worker’s medical care. In some cases, though, an injured worker may need to pay some costs. Nevada’s workers’ compensation system provides a broad basket of benefits to covered workers:
- Medical bills for treatment that is reasonable, necessary, and authorized.
- Wage replacement (up to defined maximums).
- Mileage reimbursement for travel to and from doctors’ appointments.
- Vocational rehabilitation for workers who can no longer continue their prior profession.
- Benefits such as funeral expenses and special payments to heirs in the event that the worker dies as a result of work-related injuries.
Cancer affects much more than just a patient’s physical health. It also can have profound consequences for the sufferer’s financial wellbeing. One hopes that cancer victims always have the benefit of thorough insurance coverage, but that isn’t always the case. When cancer can be traced to a cause that was work-related, a patient can sometimes seek benefits under the workers’ compensation insurance policy of the employer responsible. For cancer to be covered by an employer’s workers’ compensation insurance the patient must be ready to prove that the disease arose “out of or in the course of employment.” For most types of injury the link between an injury and employment is established early in the process, usually at the first visit to a doctor. But unlike a broken arm suffered at a work site, cancer can be slow to develop and its cause may be difficult to trace. There are three threshold matters that the patient must establish (or be prepared to establish) to ensure that coverage will not be denied:
- Exposure to a carcinogen at work. Proving exposure to a carcinogenic material at work can be easier in some situations than in others. If the patient worked at a chemical plant and was routinely exposed to substances that are well known to cause cancer, the case will be relatively easy to build. But if the patient’s exposure was in an isolated event, where the presence of carcinogens wasn’t known, proving the link may be more difficult. The passage of time can complicate proof as well.
- A causal relationship between the carcinogen and the patient’s specific cancer type. The patient’s doctor can help draw a connection between the work-related exposure to a carcinogen and the patient’s cancer. If a dispute arises with the workers’ compensation insurance provider, additional expert testimony and other scientific evidence might be required to prove causation.
- No intervening cause. Although a patient doesn’t need to prove that his or her cancer didn’t come from a source other than work, the insurer will almost certainly argue that it might have. This has been the insurer’s argument in cases involving secondhand smoke exposure at casinos. Because casino workers can be exposed to cigarette smoke other than at work, insurers have successfully denied coverage for their lung cancers.
In an ideal world every injury would have a predictable, consistent path to recovery, or at the very least a clearly defined range of potential harms. Of course, we don’t live in a perfect world. An injury can be misdiagnosed or underdiagnosed at preliminary medical appointments, or its treatment can lead to unexpected complications that require additional medical care or expensive drugs that weren’t part of the original plan. For someone who is receiving care under a workers’ compensation claim, these kinds of complications can require a claim to be reopened. “Reopening” a workers’ compensation claim can be necessary if an insurer has formally indicated that its financial obligations with respect to it have been fulfilled—that is, the claim has been closed. Closing claims is one of the ways insurers manage the predictability of their costs: by closing a claim, the insurer knows with certainty how much it had to pay, and how much it needs to pass on to the employer. Reopening a claim therefore necessarily involves a degree of paperwork. Nevada law sets out specific procedures for when and how a workers’ compensation claim may be reopened. The specific procedure depends on how long the claim has been closed. For claims that have been closed less than one year, the insurer is only required to reopen the claim if:
- Medical evidence demonstrates that an objective change in the claimant’s medical condition has taken place.
- There is clear and convincing evidence that the claimant’s change in circumstances was primarily caused by the injury covered by the original claim.
- A change of circumstances (complications during recovery, discovery of previously undiagnosed problems, and so on) warrants an increase or rearrangement of compensation.
- The primary cause of the change of circumstances was the injury covered by the original claim.
- The claimant’s doctor has provided a certificate attesting to the change of circumstances.