Nevada Free Printable Workers Compensation Law Posters Nevada Brief Description of Your Rights and Benefits If You Are Injured on the Job or have an Occupational Disease Poster

The Brief Description of Your Rights and Benefits If You Are Injured on the Job or have an Occupational Disease is a workers compensation law poster by the Nevada Department Of Business and Industry. This is an optional poster, so while it is recommended that you post this if it is relevant to your employees, you are not required to by the Department Of Business and Industry.

This poster is optional to post and describes what to do if injured on the job or get a disease from working and what compensation or medical treatment you can receive. This poster describes how to file for compensation as well as how to file for an appeal should a claim be denied for compensation.


NV All-In-One Labor Poster: Instead of printing out dozens of posters, employers can also purchase an all-in-one poster that covers both Nevada and Federal poster requirements by clicking here .

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State of Nevada       
 DEPARTMENT OF BUSINESS & INDUSTRY 
  DIVISION OF INDUSTRIAL RELATIONS  Workers’ Compensation Section      
 A T T E N T I O N 
 Brief Description of Your Rights and Benefits 
  If You Are Injured on the Job or have an Occupational Disease 
 
Notice of Injury or Occupational Disease (Incident Report Form C-1)
If an injury or occupational disease (OD) arises out of and in the course ofemployment, you must provide written notice to your employer as soon as
practicable, but no later than 7 days after the accident or OD.  Youremployer shall maintain a sufficient supply of the forms. 
 
Claim for Compensation (Form C-4):  If medical treatment is sought, the
form C-4 is available at the place of initial treatment.  A completed "Clai
mfor Compensation" (Form C-4) must be filed within 90 days after an
accident or OD.  The treating physician or chiropractor must, within 3
working days after treatment, complete and mail to the employer, the
employer's insurer and third-party administrator, the Claim fo
rCompensation.   
 
Medical Treatment:  If you require medical treatment for your on-the-job 
injury or OD, you may be required to select a physician or chiropracto
rfrom a list provided by your workers’ compensation insurer, if it has
contracted with an Organization for Managed Care (MCO) or Preferred
Provider Organization (PPO) or providers of health care.  If your employe
rhas not entered into a contract with an MCO or PPO, you may select a
physician or chiropractor from the Panel of Physicians and Chiropractors.
Any medical costs related to your industrial injury or OD will be paid by
your insurer. 
 
Temporary Total Disability (TTD):  If your doctor has certified that you
are unable to work for a period of at least 5 consecutive days, or 5
cumulative days in a 20-day period, or places restrictions on you that you
remployer does not accommodate, you may be entitled to TTD
compensation.  
 
Temporary Partial Disability (TPD): If the wage you receive upon
reemployment is less than the compensation for TTD to which you are
entitled, the insurer may be required to pay you TPD compensation to
make up the difference.  TPD can only be paid for a maximum of 24
months. 
 
Permanent Partial Disability (PPD):  When your medical condition is
stable and there is an indication of a PPD as a result of your injury or OD,
within 30 days, your insurer must arrange for an evaluation by a rating
physician or chiropractor to determine the degree of your PPD.   The
amount of your PPD award depends on the date of injury, the results of the
PPD evaluation and your age and wage. 
 
Permanent Total Disability (PTD):  If you are medically certified by a
treating physician or chiropractor as permanently and totally disabled and
have been granted a PTD status by your insurer, you are entitled to receive
monthly benefits not to exceed 66 2/3% of your average monthly wage.
The amount of your PTD payments is subject to reduction if you previously
received a PPD award. 
 
 
  Vocational Rehabilitation Services:  You may be eligible for vocational 
rehabilitation services if you are unable to return to the job due to a 
permanent physical impairment or permanent restrictions as a result of 
your injury or occupational disease.   
 
Transportation and Per Diem Reimbursement: You may be eligible 
for travel expenses and per diem associated with medical treatment. 
 
Reopening: You may be able to reopen your claim if your condition 
worsens after claim closure. 
 
Appeal Process:If you disagree with a written determination issued by 
the insurer or the insurer does not respond to your request, you may 
appeal to the Department of Administration, Hearing Officer, 
by 
following the instructions contained in your determination letter. You 
must appeal the determination within 70 days from the date of the 
determination letter at 1050 E. William Street, Suite 400, Carson City, 
Nevada 89701, or 2200 S. Rancho Drive, Suite 210, Las Vegas, Nevada 
89102. If you disagree with the Hearing Officer decision, you may appeal 
to the Department of Administration, Appeals Officer.  You must file 
your appeal within 30 days from the date of the Hearing Officer decision 
letter at 1050 E. William Street, Suite 450, Carson City, Nevada 89701, o
r 
2200 S. Rancho Drive, Suite 220, Las Vegas, Nevada 89102.  If you 
disagree with a decision of an Appeals Officer, you may file a petition 
for judicial review with the District Court.  You must do so within 30 
days of the Appeal Officer’s decision.  You may be represented by an 
attorney at your own expense or you may contact the NAIW for possible 
representation. 
 
Nevada Attorney for Injured Workers (NAIW):If you disagree with 
a 
hearing officer decision, you may request that NAIW represent you 
without charge at an Appeals Officer hearing.  NAIW is an independen
t 
state agency and is not affiliated with any insurer.  For information
regarding denial of benefits, you may contact the NAIW at:  1000 E. 
William Street, Suite 208, Carson City, NV 89701, (775) 684-7555, o
r 
2200 S. Rancho Drive, Suite 230, Las Vegas, NV 89102, (702) 486-2830.
 
To File a Complaint with the Division:  If you wish to file a complain
t 
with the Administrator of the Division of Industrial Relations (DIR), 
please contact Workers’ Compensation Section,  400 West King Street, 
Suite 400, Carson City, Nevada 89703, telephone (775)684-7270, or 1301 
North Green Valley Parkway, Suite 200, Henderson, Nevada 89074, 
telephone (702) 486-9080. 
 
For Assistance with Workers’ Compensation Issues: You may contac
t 
the Office of the Governor Consumer Health Assistance, 555 E. 
Washington Avenue, Suite 4800, Las Vegas, Nevada 89101, Toll Free
 1-
888-333-1597, Web site: http:/govcha.state.nv.us, [email protected] 
 
The information in this publication is derived from Chapters 616A and 617 of the Nevada Revised Statutes and is provided for 
informational purposes only.  If you have any questions, regarding your injury or workers' compensation claim, please call the 
following:
  
Insurer/Administrator:                
   Contact Person:         
Address:        
  Telephone Number:          City            State            Zip 
MCO/Health Care Provider:          
  Contact Person:         
Address:        
  Telephone Number:          City      State    Zip D-1 (rev. 10/07)

Other Nevada Labor Law Posters 5 PDFS

There are an additional eight optional and mandatory Nevada labor law posters that may be relevant to your business. Be sure to also print all relevant state labor law posters, as well as all mandatory federal labor law posters.

Poster Name Poster Type
Mandatory State of Nevada Daily Overtime 2016 Annual Bulletin Overtime Law
Mandatory Notice of Limitations affecting the Application of Lie Detector Tests Miscellaneous Law
Mandatory State of Nevada Minimum Wage 2016 Minimum Wage Law
Mandatory Emergency Phone Numbers Job Safety Law
Mandatory Nevada Safety and Health Protection on the Job Job Safety Law

View all 9 Nevada labor law posters


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** This Document Provided By LaborPosters.org **
Source: http://www.laborposters.org/nevada/219-your-rights-and-benefits-if-injured-on-the-job-poster.htm