2005 Nevada Revised Statutes - Chapter 616C — Industrial Insurance: Benefits for Injuries or Death
CHAPTER 616C - INDUSTRIAL INSURANCE:BENEFITS FOR INJURIES OR DEATH
REPORTS OF INJURIES AND CLAIMS FOR COMPENSATION
NRS 616C.005 Formsfor reporting injuries: Insurer to distribute revised forms to employersperiodically; Administrator to make revised forms available to physicians andchiropractors.
NRS 616C.010 Employeeto report accident and injury to employer; examination of employee.
NRS 616C.015 Noticeof injury or death: Requirements; availability of form; retention.
NRS 616C.020 Claimfor compensation: Requirements for injured employee, his dependent or hisrepresentative to file claim; form.
NRS 616C.025 Recoveryof compensation barred if notice of injury or claim for compensation is notfiled; exceptions.
NRS 616C.030 Dependentof injured employee barred from filing claim for compensation if untimely orpreviously denied.
NRS 616C.035 Applicationfor death benefit.
NRS 616C.040 Claimfor compensation: Duty of treating physician or chiropractor to file ordelegate duty to medical facility; electronic filing; form and contents;maintenance of forms; penalty.
NRS 616C.045 Reportof industrial injury or occupational disease: Duty of employer to file; electronicfiling; form and contents; penalty.
NRS 616C.050 Informationrequired to be provided by insurer to claimant.
NRS 616C.052 Exposureof police officer or firefighter to contagious disease: Reporting and testingrequirements; eligibility for compensation.
NRS 616C.055 Useof fee schedules which unfairly discriminate among physicians and chiropractorsprohibited; payment for services rendered by physician or chiropractor afterremoval from panel prohibited.
NRS 616C.065 Insurerto commence payment of claim or deny claim within certain time after insurernotified of industrial accident; notification of claimant and Administrator ofdenial of claim; penalty for unreasonable delay or refusal to pay claim.
NRS 616C.070 Personswho are conclusively presumed to be totally dependent on injured or deceasedemployee; exception.
NRS 616C.075 Effectof employees refusal to submit to physical examination after accident.
TREATMENT AND RATING OF INJURED EMPLOYEES
NRS 616C.085 Dutiesof employer when employee injured: First aid; reimbursement.
NRS 616C.090 Selectionof physician or chiropractor: Powers and duties of Administrator; selection andalternate selection from established panel or pursuant to contract;responsibility for charges.
NRS 616C.095 Dutyof physician or chiropractor to advise injured employee of rights.
NRS 616C.100 Additionaldetermination of percentage of disability permitted if cost paid by injuredemployee; authority of injured employee to seek reimbursement of cost; resultsof determination may be offered at hearing or conference.
NRS 616C.105 Requirementsfor designation of chiropractor to rate permanent partial disabilities.
NRS 616C.110 AmericanMedical Associations Guides to the Evaluation of Permanent Impairment:Duty of Division to adopt Guides by regulation; determination ofappropriate version of Guides to apply.
NRS 616C.115 Prescriptionof generic drugs required; exceptions.
NRS 616C.120 Employeemay elect treatment through prayer in lieu of medical treatment.
NRS 616C.125 Insurermay contract with suppliers for provision of services and goods to injuredemployees.
NRS 616C.130 Insurerspayment to physician or chiropractor attending injured employee conditionedupon receipt of itemized statement and certificate.
NRS 616C.135 Liabilityof insurer for payment of charges for treatment related to industrial injury oroccupational disease; acceptance of payment by provider of health care frominjured employee or health or casualty insurer for treatment that was erroneouslydenied.
NRS 616C.136 Actionby insurer on bill from provider of health care; payment of interest; requestfor additional information; compliance with requirements.
NRS 616C.137 Denialof payment for unrelated services: Requirements for notification; liability ofinjured employee; appeal.
NRS 616C.138 Paymentof provider of health care upon insurers denial of authorization orresponsibility for treatment or other services provided; reimbursement of injuredemployee or health or casualty insurer; recovery of excess amount paid toprovider of health care.
NRS 616C.140 Medicalexamination of claimant; effect of refusal to submit to examination;communications not privileged.
DETERMINATION AND PAYMENT OF BENEFITS
NRS 616C.150 Compensationprohibited unless preponderance of evidence establishes that injury arose outof and in course of employment; rebuttable presumption if notice of injury isfiled after termination of employment.
NRS 616C.155 Paymentof compensation by insurer prohibited before required; recovery of overpaymentby insurer.
NRS 616C.157 Requestfor prior authorization: Time to respond; effect of failure to respond intimely manner.
NRS 616C.160 Newlydeveloped injury or disease: Inclusion in original claim for compensation;limitation.
NRS 616C.165 Determinationof responsibility of insurer for undisputed claim for compensation;reimbursement of insurer initially providing compensation to injured employee.
NRS 616C.170 Resolutionof disputes between insurers if benefits are claimed against more than oneinsurer; adoption of regulations by Administrator; appeal of decision ofAdministrator; payment of benefits until determination of responsibility byAdministrator.
NRS 616C.175 Employment-relatedaggravation of preexisting condition which is not employment related;aggravation of employment-related injury by incident which is not employmentrelated.
NRS 616C.177 Medicalrecords concerning preexisting condition: Authority of insurer to requestrecords; injured employee required to release records under certaincircumstances.
NRS 616C.180 Injuryor disease caused by stress.
NRS 616C.185 Compensationfor mastectomy and reconstructive surgery.
NRS 616C.190 Compensationof employee injured out of State.
NRS 616C.195 Acceptanceof compensation or benefits by employee injured out of State constitutesrelease of employer and waiver of remedy at common law or statutory remedyprovided in another state.
NRS 616C.200 Commencementof action in another state to recover damages or compensation by employeeinjured out of State constitutes irrevocable waiver of compensation due under Nevada law; satisfaction of foreign judgment against Nevada employer.
NRS 616C.205 Compensationnot assignable; exempt from attachment, garnishment and execution; accruedcompensation payable to dependents.
NRS 616C.210 Compensationof nonresident alien dependents; notification of dependent required.
NRS 616C.215 Actionsand proceedings to recover damages in tort or from proceeds of vehicleinsurance: Reduction of compensation by amount of recovery; rights of injuredemployee or his dependents and of insurer or Administrator; notification andpayment of insurer or Administrator; instructions to jury; calculation ofemployers premium.
NRS 616C.220 Compensationfrom uninsured employers claim account: Administration and payment of claims;eligibility of employee; liability of employer; powers and duties of Division;appeals; penalty.
NRS 616C.225 Misrepresentationor concealment of fact to obtain benefits: Insurer entitled to reimbursement ordeduction from benefits; appeal of determination; alternative remedies.
NRS 616C.230 Groundsfor denial, reduction or suspension of compensation; evidence of andexamination for use of alcohol or controlled substance.
NRS 616C.235 Closureof claim by insurer: Procedure; notice; special procedure if medical benefitsless than $300.
ACCIDENT BENEFITS
NRS 616C.245 Injuredemployee entitled to accident benefits; limitation on receipt of modified motorvehicle as accident benefit; regulations establishing maximum benefit.
NRS 616C.250 Establishment,revision and compliance with standards of care for provision of accidentbenefits.
NRS 616C.255 Premiumfor accident benefits paid by employer; accident benefits provided by privatecarrier; separate account for accident benefits.
NRS 616C.260 Feesand charges for accident benefits: Restrictions; establishment and revision ofschedule; powers and duties of Administrator; penalty for refusal to provideinformation; regulations.
NRS 616C.265 Electionby employer to provide accident benefits; reporting requirements; payment ofassessments.
NRS 616C.270 Employersto notify Administrator when injured employee receives medical services.
NRS 616C.275 Changeof physicians, chiropractors or other requirements; cost of change borne byinsurer; cause of action of injured employee assigned to private carrier.
NRS 616C.280 Withdrawalof approval for employer to provide accident benefits: Grounds supportingwithdrawal.
NRS 616C.285 Withdrawalof approval for employer to provide accident benefits: Request for hearing;notice of decision.
CONTESTED CLAIMS
NRS 616C.295 Dutiesof Chief of Hearings Division of Department of Administration.
NRS 616C.300 Hearingofficers: Appointment; salary; disqualification from particular case.
NRS 616C.305 Procedurefor appeal of final determination of organization for managed care which hascontracted with insurer.
NRS 616C.310 Proceduresto be adopted by Chief of Hearings Division; representation of insurer oremployer. [Effective through December 31, 2006.]
NRS 616C.310 Contestedcases: Procedures; format; redaction of personal identifying information;representation of insurer or employer by legal counsel or other agent.[Effective January 1, 2007.]
NRS 616C.315 Requestfor hearing; forms for request to be provided by insurer; prerequisites toscheduling of hearing; expeditious and informal hearing required; directsubmission to appeals officer.
NRS 616C.320 Resolutionof disputed decision of self-insured employer or employer who is member of associationof self-insured public or private employers or insured by private carrier.
NRS 616C.325 Representationof employee and employer before hearings officer or appeals officer or innegotiations with insurer; licensure of employers representative; employerliable for representatives violations; compensation of employersrepresentative must not be contingent on outcome.
NRS 616C.330 Date,time and place for hearing; evaluation of injured employee; powers and dutiesof hearing officer; issuance of decision; procedure for obtaining stay ofdecision.
NRS 616C.335 Awardof interest.
NRS 616C.340 Appointment,term, qualifications and salary of appeals officers and special appealsofficers; conflicts of interest; finality of decision by appeals officer.
NRS 616C.345 Noticeof appeal to appeals officer; prerequisites to scheduling of hearing on appeal;effect of appeal on enforcement of decision of hearing officer; setting ofdate, time and place for hearing on appeal; continuances.
NRS 616C.350 Testimonyof physician or chiropractor before appeals officer; privileged communications.
NRS 616C.355 Useof affidavits or declarations as evidence at hearing; notice to opposing party;waiver of right to cross-examine affiant or declarant; effect of waiver.
NRS 616C.360 Recordof hearing before appeals officer; rules of evidence; evaluation of injuredemployee; submission to external review organization; powers and duties ofappeals officer; transcripts; issuance of decision.
NRS 616C.363 Externalreview: Duties of external review organization; contents and submission ofdecision by organization; costs; regulations.
NRS 616C.365 Reimbursementof employees expenses incurred and wages lost as result of hearing requestedby employer or insurer; regulations.
NRS 616C.370 Judicialreview.
NRS 616C.375 Stayof decision of appeals officer.
NRS 616C.380 Paymentpending appeal when decision not stayed; effect of final resolution of claim.
NRS 616C.385 Costsand attorneys fees for frivolous petitions for judicial review.
NRS 616C.390 Reopeningclaim: General requirements and procedure; limitations; applicability.
NRS 616C.392 Reopeningclaim: Circumstances under which insurer is required to reopen claim for permanentpartial disability.
COMPENSATION FOR INJURIES AND DEATH
General Provisions
NRS 616C.400 Minimumduration of incapacity.
NRS 616C.405 Limitationson benefits received by employee.
NRS 616C.408 Restrictiveendorsements on checks issued by insurers.
NRS 616C.410 Prohibitionof settlements paid in lump sum; exceptions.
NRS 616C.412 Purchaseof annuity by insurer to ensure payment of claim; adoption of regulations byCommissioner.
NRS 616C.415 Writtenexplanation of alternative settlements to be given to employee or dependents.
NRS 616C.420 Methodof determining average monthly wage.
NRS 616C.425 Dateof determination of amount of compensation and benefits.
NRS 616C.430 Reductionof compensation by amount of federal disability insurance benefits received byemployee.
Permanent Total Disability
NRS 616C.435 Injuriesdeemed total and permanent.
NRS 616C.440 Amountand duration of compensation; limitations; effect of previous award ofcompensation.
NRS 616C.445 Recipientof compensation to report annual earnings; payments suspended if report notmade.
NRS 616C.447 Insurerrequired to make certain accountings to injured employee who is entitled to compensationfor permanent total disability; additional accountings may be requested byinjured employee.
NRS 616C.450 Compensationto injured employee or dependents of injured employee for permanent totaldisability or death benefit if injury or occupational disease occurred beforeJuly 1, 1980.
NRS 616C.453 Additionalannual payment to certain claimants and dependents of claimants who areentitled to receive compensation for permanent total disability; adoption ofregulations to determine amount of payment.
NRS 616C.455 Increasein benefits for permanent total disability incurred before April 9, 1971.
NRS 616C.460 Additionalincrease in benefits for permanent total disability incurred before July 1,1973.
NRS 616C.465 Increasein benefits for permanent total disability incurred on or after April 9, 1971,or for claimant or dependent not entitled to benefits for disability fromfederal social security system.
NRS 616C.470 Increasein benefits for permanent total disability if claimant is entitled to benefitsfor disability from federal social security system.
NRS 616C.473 Annualincrease in benefits for permanent total disability incurred on or afterJanuary 1, 2004.
Temporary Total Disability
NRS 616C.475 Amountand duration of compensation; limitations; requirements for certification ofdisability; offer of light-duty employment.
NRS 616C.477 Compensationfor lost wages incurred by employee who receives medical treatment afterreturning to work; prohibition against employer requiring employee to usepersonal leave for such treatment.
NRS 616C.480 Reductionof benefits for previous injury causing permanent partial disabilityprohibited.
Permanent and Temporary Partial Disabilities
NRS 616C.485 Permanentpartial disability: Loss of or permanent damage to teeth.
NRS 616C.490 Permanentpartial disability: Compensation.
NRS 616C.495 Permanentpartial disability: Payments in lump sum.
NRS 616C.500 Temporarypartial disability: Compensation.
Death Benefits
NRS 616C.505 Amountand duration of compensation.
NRS 616C.510 Increaseddeath benefits if injury or disablement occurred before July 1, 1973.
NRS 616C.515 Additionalincrease in death benefits if injury or disablement occurred before July 1,1973.
NRS 616C.520 Increaseddeath benefits if injury or disablement occurred on or after July 1, 1973.
VOCATIONAL REHABILITATION
NRS 616C.530 Prioritiesfor returning injured employee to work.
NRS 616C.540 Supervision,ratio and review of uncertified counselors; knowledge of labor market required.
NRS 616C.542 Prohibitingvocational rehabilitation counselor employed by entity administering injuredemployees case from providing services to injured employee without provisionof certain written disclosures; right of injured employee to be assignedalternate counselor.
NRS 616C.545 Dutyof insurer to determine physical limitations on injured employees ability towork.
NRS 616C.547 Generalduties of vocational rehabilitation counselor.
NRS 616C.550 Writtenassessment of injured employee.
NRS 616C.555 Planfor program of vocational rehabilitation.
NRS 616C.560 Extensionof program for vocational rehabilitation.
NRS 616C.570 On-the-jobtraining as component of plan for program of vocational rehabilitation.
NRS 616C.575 Paymentof vocational rehabilitation maintenance.
NRS 616C.580 Provisionof services outside of State; limited lump-sum payment in lieu of services.
NRS 616C.585 Limiton goods and services which may be provided; exceptions.
NRS 616C.590 Eligibilityfor services; effect of incarceration; effect of refusing services offered byinsurer; effect of inability of insurer to locate injured employee.
NRS 616C.595 Agreementsfor payment of compensation in lump sum in lieu of provision of vocationalrehabilitation services.
NRS 616C.600 Ordersfor self-employment or payment of compensation in lump sum for vocationalrehabilitation prohibited; agreements concerning self-employment authorized.
_________
REPORTS OF INJURIES AND CLAIMS FOR COMPENSATION
NRS
1. An insurer shall distribute to each employer thatit insures any form for reporting injuries that has been revised within theprevious 12 months.
2. The Administrator shall make available tophysicians and chiropractors any form for reporting injuries that has beenrevised within the previous 12 months.
(Added to NRS by 1991, 2395; A 1997, 1434)
NRS
1. Whenever any accident occurs to any employee, heshall forthwith report the accident and the injury resulting therefrom to hisemployer.
2. When an employer learns of an accident, whether ornot it is reported, the employer may direct the employee to submit to, or theemployee may request, an examination by a physician or chiropractor, in orderto ascertain the character and extent of the injury and render medicalattention which is required immediately. The employer may furnish the names,addresses and telephone numbers of one or more physicians or chiropractors, butmay not require the employee to select any particular physician orchiropractor. Thereupon, the examining physician or chiropractor shall reportforthwith to the employer and to the insurer the character and extent of theinjury. The employer shall not require the employee to disclose or permit thedisclosure of any other information concerning his physical condition.
3. Further medical attention, except as otherwiseprovided in NRS 616C.265, must beauthorized by the insurer.
4. This section does not prohibit an employer fromrequiring the employee to submit to an examination by a physician orchiropractor specified by the employer at any convenient time after medicalattention which is required immediately has been completed.
[Part 52:168:1947; 1943 NCL 2680.52](NRS A 1981,1167, 1471; 1983, 478; 1985, 1543)(Substituted in revision for NRS 616.360)
NRS
1. An employee or, in the event of the employeesdeath, one of his dependents, shall provide written notice of an injury thatarose out of and in the course of employment to the employer of the employee assoon as practicable, but within 7 days after the accident.
2. The notice required by subsection 1 must:
(a) Be on a form prescribed by the Administrator. Theform must allow the injured employee or his dependent to describe briefly theaccident that caused the injury or death.
(b) Be signed by the injured employee or by a person onhis behalf, or in the event of the employees death, by one of his dependentsor by a person acting on behalf of the dependent.
(c) Include an explanation of the procedure for filinga claim for compensation.
(d) Be prepared in duplicate so that the injuredemployee or his dependent and the employer can retain a copy of the notice.
3. Upon receipt of the notice required by subsection1, the employer, the injured employees supervisor or the agent of the employerwho was in charge of the type of work or the area where the accident occurredshall sign the notice. The signature of the employer, the supervisor or theemployers agent is an acknowledgment of the receipt of the notice and shallnot be deemed to be a waiver of any of the employers defenses or rights.
4. An employer shall maintain a sufficient supply ofthe forms required to file the notice required by subsection 1 for use by hisemployees.
5. An employer shall retain any notice providedpursuant to subsection 1 for 3 years after the date of the accident. Anemployer insured by a private carrier shall not file a notice of injury withthe private carrier.
[55:168:1947; 1943 NCL 2680.55](NRS A 1969, 95;1973, 604; 1979, 1052, 1053; 1981, 1487; 1989, 332; 1991, 2415, 2416; 1993,731; 1995, 2031, 2146; 1997, 585;
NRS
1. Except as otherwise provided in subsection 2, aninjured employee, or a person acting on his behalf, shall file a claim for compensationwith the insurer within 90 days after an accident if:
(a) The employee has sought medical treatment for aninjury arising out of and in the course of his employment; or
(b) The employee was off work as a result of an injuryarising out of and in the course of his employment.
2. In the event of the death of the injured employeeresulting from the injury, a dependent of the employee, or a person acting onhis behalf, shall file a claim for compensation with the insurer within 1 yearafter the death of the injured employee.
3. The claim for compensation must be filed on a formprescribed by the Administrator.
(Added to NRS by 1993, 661)(Substituted in revisionfor NRS 616.501)
NRS
1. Except as otherwise provided in subsection 2, anemployee or, in the event of the death of the employee, his dependent, isbarred from recovering compensation pursuant to the provisions of
2. An insurer may excuse the failure to file a noticeof injury or a claim for compensation pursuant to the provisions of thissection if:
(a) The injury to the employee or another cause beyondhis control prevented him from providing the notice or claim;
(b) The failure was caused by the employees ordependents mistake or ignorance of fact or of law;
(c) The failure was caused by the physical or mentalinability of the employee or the dependent; or
(d) The failure was caused by fraud, misrepresentationor deceit.
(Added to NRS by 1993, 661)(Substituted in revisionfor NRS 616.5011)
NRS
1. The time for filing the claim has expired pursuantto NRS 616C.020 and the failure tofile the claim is not excused pursuant to NRS616C.025; or
2. The injured employee or another dependent filed aclaim for compensation for that industrial injury, the claim was denied and,upon final resolution of the claim, it was denied.
(Added to NRS by 1993, 663)(Substituted in revisionfor NRS 616.50115)
NRS
1. Proof of death;
2. Proof of relationship showing the parties to beentitled to compensation under chapters 616Ato 616D, inclusive, of NRS;
3. Certificates of the attending physician, if any;and
4. Such other proof as required by the regulations ofthe Division.
[54:168:1947; 1943 NCL 2680.54](NRS A 1979, 1053;1981, 1488; 1993, 1869)(Substituted in revision for NRS 616.505)
NRS
1. Except as otherwise provided in this section, atreating physician or chiropractor shall, within 3 working days after firstproviding treatment to an injured employee for a particular injury, completeand file a claim for compensation with the employer of the injured employee andthe employers insurer. If the employer is a self-insured employer, thetreating physician or chiropractor shall file the claim for compensation withthe employers third-party administrator. If the physician or chiropractorfiles the claim for compensation by electronic transmission, the physician orchiropractor shall, upon request, mail to the insurer or third-party administratorthe form that contains the original signatures of the injured employee and thephysician or chiropractor. The form must be mailed within 7 days afterreceiving such a request.
2. A physician or chiropractor who has a duty to filea claim for compensation pursuant to subsection 1 may delegate the duty to amedical facility. If the physician or chiropractor delegates the duty to amedical facility:
(a) The medical facility must comply with the filingrequirements set forth in this section; and
(b) The delegation must be in writing and signed by:
(1) The physician or chiropractor; and
(2) An authorized representative of the medicalfacility.
3. A claim for compensation required by subsection 1must be filed on a form prescribed by the Administrator.
4. If a claim for compensation is accompanied by acertificate of disability, the certificate must include a description of anylimitation or restrictions on the injured employees ability to work.
5. Each physician, chiropractor and medical facilitythat treats injured employees, each insurer, third-party administrator andemployer, and the Division shall maintain at their offices a sufficient supplyof the forms prescribed by the Administrator for filing a claim forcompensation.
6. The Administrator may impose an administrative fineof not more than $1,000 for each violation of subsection 1 on:
(a) A physician or chiropractor; or
(b) A medical facility if the duty to file the claimfor compensation has been delegated to the medical facility pursuant to thissection.
(Added to NRS by 1993, 661; A 1995, 649; 1997, 1434;
NRS
1. Except as otherwise provided in
2. The report must:
(a) Be filed on a form prescribed by the Administrator;
(b) Be signed by the employer or his designee;
(c) Contain specific answers to all questions requiredby the regulations of the Administrator; and
(d) Be accompanied by a statement of the wages of theemployee if the claim for compensation received from the treating physician orchiropractor, or a medical facility if the duty to file the claim forcompensation has been delegated to the medical facility pursuant to
3. An employer who files the report required bysubsection 1 by electronic transmission shall, upon request, mail to theinsurer or third-party administrator the form that contains the originalsignature of the employer or his designee. The form must be mailed within 7days after receiving such a request.
4. The Administrator shall impose an administrativefine of not more than $1,000 on an employer for each violation of this section.
(Added to NRS by 1993, 661; A 1995, 649; 1997, 1435;
NRS
1. An insurer shall provide to each claimant:
(a) Upon written request, one copy of any medicalinformation concerning his injury or illness.
(b) A statement which contains information concerningthe claimants right to:
(1) Receive the information and forms necessaryto file a claim;
(2) Select a treating physician or chiropractorand an alternative treating physician or chiropractor in accordance with theprovisions of NRS 616C.090;
(3) Request the appointment of the NevadaAttorney for Injured Workers to represent him before the appeals officer;
(4) File a complaint with the Administrator;
(5) When applicable, receive compensation for:
(I) Permanent total disability;
(II) Temporary total disability;
(III) Permanent partial disability;
(IV) Temporary partial disability;
(V) All medical costs related to hisinjury or disease; or
(VI) The hours he is absent from the placeof employment to receive medical treatment pursuant to
(6) Receive services for rehabilitation if hisinjury prevents him from returning to gainful employment;
(7) Review by a hearing officer of anydetermination or rejection of a claim by the insurer within the time specifiedby statute; and
(8) Judicial review of any final decision withinthe time specified by statute.
2. The insurers statement must include a copy of theform designed by the Administrator pursuant to subsection 7 of
(Added to NRS by 1995, 2003; A
NRS
1. Except as otherwise provided in
(a) Upon battery by an offender; or
(b) While performing the duties of a police officer orfirefighter,
the employerof the police officer or firefighter shall create and maintain a reportconcerning the exposure that includes, without limitation, the name of eachpolice officer or firefighter, as applicable, who was exposed to the contagiousdisease and the name of each person, if any, to whom the police officer orfirefighter was exposed.
2. Except as otherwise provided in paragraph (d) ofsubsection 2 of NRS 616A.265, if theresults of a physical examination administered pursuant to
3. Except as otherwise provided in
(a) At the time of termination and at 3 months afterthe date of termination, provide to the police officer or firefighter apurified protein derivative skin test to screen for exposure to tuberculosis,unless the police officer or firefighter previously submitted to such a testand tested positive for exposure to tuberculosis. Except as otherwise providedin paragraph (d) of subsection 2 of NRS616A.265, if a skin test administered pursuant to this paragraph andprovided to the employer reveals that the police officer or firefighter testedpositive for exposure to tuberculosis, the police officer or firefighter iseligible, during his lifetime, to receive compensation pursuant to
(b) Within 30 days after the date of termination and at6 and 12 months after the date of termination, provide to the police officer orfirefighter a blood test or other appropriate test to screen for othercontagious diseases, including, without limitation, hepatitis A, hepatitis B,hepatitis C and human immunodeficiency virus, unless the police officer orfirefighter previously submitted to such a test for a contagious disease andtested positive for exposure to that contagious disease. Except as otherwise providedin paragraph (d) of subsection 2 of NRS616A.265, if a blood test or other appropriate test administered pursuantto this paragraph and provided to the employer reveals that the police officeror firefighter has any other contagious disease or the antibodies associatedwith a contagious disease, the police officer or firefighter is eligible,during his lifetime, to receive compensation pursuant to
4. The former employer of a police officer or asalaried or volunteer firefighter shall pay all the costs associated withproviding skin and blood tests and other appropriate tests required pursuant tosubsection 3.
5. As used in this section, the term batteryincludes, without limitation, the intentional propelling or placing, or thecausing to be propelled or placed, of any human excrement or bodily fluid uponthe person of an employee.
(Added to NRS by
NRS
1. The insurer may not, in accepting responsibilityfor any charges, use fee schedules which unfairly discriminate among physiciansand chiropractors.
2. If a physician or chiropractor is removed from thepanel established pursuant to NRS 616C.090or from participation in a plan for managed care established pursuant to
(Added to NRS by 1979, 651; A 1981, 1168, 1488; 1983,325; 1985, 1546; 1991, 2417; 1993, 733;
NRS
1. Except as otherwise provided in
(a) Commence payment of a claim for compensation; or
(b) Deny the claim and notify the claimant andAdministrator that the claim has been denied.
Paymentsmade by an insurer pursuant to this section are not an admission of liabilityfor the claim or any portion of the claim.
2. Except as otherwise provided in this subsection, ifan insurer unreasonably delays or refuses to pay the claim within 30 days afterthe insurer has been notified of an industrial accident, the insurer shall payupon order of the Administrator an additional amount equal to three times theamount specified in the order as refused or unreasonably delayed. This paymentis for the benefit of the claimant and must be paid to him with thecompensation assessed pursuant to chapters 616Ato 617, inclusive, of NRS. The provisions ofthis section do not apply to the payment of a bill for accident benefits thatis governed by the provisions of NRS616C.136.
(Added to NRS by 1995, 2001; A
NRS
1. A person is conclusively presumed to be totallydependent upon an injured or deceased employee if the person is a natural,posthumous or adopted child, whether legitimate or illegitimate, under the ageof 18 years, or over that age if physically or mentally incapacitated from wageearning, and there is no surviving parent. Stepparents may be regarded in
2. Except as otherwise provided in subsection 13 of
3. The presumptions of this section do not apply infavor of aliens who are nonresidents of the United States at the time of theaccident, injury to, or death of the employee.
[24:168:1947; 1943 NCL 2680.24](NRS A 1971, 321;1975, 598; 1985, 1460; 1993, 733;
NRS
[Part 52:168:1947; 1943 NCL 2680.52](NRS A 1973,599; 1981, 1167, 1471; 1985, 1544; 1993, 715)(Substituted in revision for NRS616.365)
TREATMENT AND RATING OF INJURED EMPLOYEES
NRS
1. Every employer within the provisions of
2. An employer who is not self-insured or a member ofan association of self-insured public or private employers is entitled toreceive reimbursement from his insurer for the costs incurred in rendering thenecessary first aid and transportation of an injured employee to the nearestplace of proper treatment.
[Part 58:168:1947; 1943 NCL 2680.58](NRS A 1975,252, 826; 1979, 1489; 1981, 1165, 1469; 1985, 664; 1991, 2404; 1993, 713,1862)(Substituted in revision for NRS 616.340)
NRS
1. The Administrator shall establish a panel ofphysicians and chiropractors who have demonstrated special competence andinterest in industrial health to treat injured employees under
2. An injured employee whose employers insurer hasnot entered into a contract with an organization for managed care or withproviders of health care services pursuant to
3. An injured employee whose employers insurer hasentered into a contract with an organization for managed care or with providersof health care services pursuant to NRS616B.527 must choose his treating physician or chiropractor pursuant to theterms of that contract. If the injured employee is not satisfied with the firstphysician or chiropractor he so chooses, he may make an alternative choice ofphysician or chiropractor pursuant to the terms of the contract if the choiceis made within 90 days after his injury. If the injured employee, afterchoosing his treating physician or chiropractor, moves to a county which is notserved by the organization for managed care or providers of health careservices named in the contract and the insurer determines that it isimpractical for the injured employee to continue treatment with the physicianor chiropractor, the injured employee must choose a treating physician orchiropractor who has agreed to the terms of that contract unless the insurerauthorizes the injured employee to choose another physician or chiropractor. Ifthe treating physician or chiropractor refers the injured employee to aspecialist for treatment, the treating physician or chiropractor shall provideto the injured employee a list that includes the name of each physician orchiropractor with that specialization who is available pursuant to the terms ofthe contract with the organization for managed care or with providers of healthcare services pursuant to NRS 616B.527,as appropriate. After receiving the list, the injured employee shall, at thetime the referral is made, select a physician or chiropractor from the list. Ifthe employee fails to select a physician or chiropractor, the insurer mayselect a physician or chiropractor with that specialization. If a physician orchiropractor with that specialization is not available pursuant to the terms ofthe contract, the organization for managed care or the provider of health careservices may select a physician or chiropractor with that specialization.
4. Except when emergency medical care is required andexcept as otherwise provided in NRS616C.055, the insurer is not responsible for any charges for medicaltreatment or other accident benefits furnished or ordered by any physician,chiropractor or other person selected by the injured employee in disregard ofthe provisions of this section or for any compensation for any aggravation ofthe injured employees injury attributable to improper treatments by suchphysician, chiropractor or other person.
5. The Administrator may order necessary changes in apanel of physicians and chiropractors and shall suspend or remove any physicianor chiropractor from a panel for good cause shown.
6. An injured employee may receive treatment by morethan one physician or chiropractor if the insurer provides writtenauthorization for such treatment.
7. The Administrator shall design a form that notifiesinjured employees of their right pursuant to subsections 2 and 3 to select analternative treating physician or chiropractor and make the form available toinsurers for distribution pursuant to subsection 2 of
(Added to NRS by 1973, 1595; A 1979, 651, 1045, 1046;1981, 1166, 1196, 1470, 1829; 1985, 1542; 1991, 2405, 2406; 1993, 713; 1995,2137; 1999, 219,
NRS
[53:168:1947; 1943 NCL 2680.53](NRS A 1981, 1470;1985, 1543; 1993, 1863; 1999,220)
NRS
1. If an injured employee disagrees with thepercentage of disability determined by a physician or chiropractor, the injuredemployee may obtain a second determination of the percentage of disability. Ifthe employee wishes to obtain such a determination, he must select the nextphysician or chiropractor in rotation from the list of qualified physicians orchiropractors maintained by the Administrator pursuant to subsection 2 of
2. The results of a second determination made pursuantto subsection 1 may be offered at any hearing or settlement conference.
(Added to NRS by 1991, 2398; A 1993, 736; 1995, 2148;1999, 1777)
NRS
(Added to NRS by 1991, 2392)(Substituted in revisionfor NRS 616.5417)
NRS
1. For the purposes of
(a) Not later than August 1, 2003, the Division shalladopt regulations incorporating the American Medical Associations Guides tothe Evaluation of Permanent Impairment, 5th edition, by reference.The regulations:
(1) Mustbecome effective on October 1, 2003; and
(2) Mustbe applied to all examinations for a permanent partial disability that areconducted on or after October 1, 2003, regardless of the date of the injury,until regulations incorporating the 6th edition by reference have becomeeffective pursuant to paragraph (b).
(b) Beginning with the 6th edition and continuing foreach edition thereafter, the Division shall adopt regulations incorporating themost recent edition of the American Medical Associations Guides to theEvaluation of Permanent Impairment by reference. The regulations:
(1) Must become effective not later than 18months after the most recent edition is published by the American MedicalAssociation; and
(2) Mustbe applied to all examinations for a permanent partial disability that areconducted on or after the effective date of the regulations, regardless of thedate of injury, until regulations incorporating the next edition by referencehave become effective pursuant to this paragraph.
2. Afteradopting the regulations required pursuant to subsection 1, the Division mayamend those regulations as it deems necessary, except that the amendments tothose regulations:
(a) Must beconsistent with the edition of the American Medical Associations Guides tothe Evaluation of Permanent Impairment most recently adopted by theDivision;
(b) Must notincorporate any contradictory matter from any other edition of the AmericanMedical Associations Guides to the Evaluation of Permanent Impairment;and
(c) Must notconsider any factors other than the degree of physical impairment of the wholeman in calculating the entitlement to compensation.
3. If the edition of the American MedicalAssociations Guides to the Evaluation of Permanent Impairment mostrecently adopted by the Division contains more than one method of determiningthe rating of an impairment, the Administrator shall designate by regulationthe method from that edition which must be used to rate an impairment pursuantto NRS 616C.490.
(Added to NRS by 1995, 2128; A
NRS
1. Except as otherwise provided in subsection 2, aphysician or advanced practitioner of nursing shall prescribe for an injuredemployee a generic drug in lieu of a drug with a brand name if the generic drugis biologically equivalent and has the same active ingredient or ingredients ofthe same strength, quantity and form of dosage as the drug with a brand name.
2. A physician or advanced practitioner of nursing isnot required to comply with the provisions of subsection 1 if:
(a) He determines that the generic drug would not bebeneficial to the health of the injured employee; or
(b) The generic drug is higher in cost than the drugwith a brand name.
(Added to NRS by 1993, 669)(Substituted in revisionfor NRS 616.5023)
NRS
(Added to NRS by 1973, 1595; A
NRS
(Added to NRS by 1987, 2148; A 1989, 1429; 1993,714)(Substituted in revision for NRS 616.344)
NRS
(Added to NRS by 1957, 232; A 1981, 1167, 1471; 1985,1543; 1997, 1435)
NRS
1. A provider of health care who accepts a patient asa referral for the treatment of an industrial injury or an occupational diseasemay not charge the patient for any treatment related to the industrial injuryor occupational disease, but must charge the insurer. The provider of healthcare may charge the patient for any services that are not related to theemployees industrial injury or occupational disease.
2. The insurer is liable for the charges for approvedservices related to the industrial injury or occupational disease if thecharges do not exceed:
(a) The fees established in accordance with
(b) The charges provided for by the contract betweenthe provider of health care and the insurer or the contract between theprovider of health care and the organization for managed care.
3. A provider of health care may accept payment froman injured employee or from a health or casualty insurer paying on behalf ofthe injured employee pursuant to NRS616C.138 for treatment or other services that the injured employee allegesare related to the industrial injury or occupational disease.
4. If a provider of health care, an organization formanaged care, an insurer or an employer violates the provisions of thissection, the Administrator shall impose an administrative fine of not more than$250 for each violation.
(Added to NRS by 1983, 1291; A 1985, 574; 1991, 2407;1993, 715; 2001, 1894,2738,
NRS
1. Except as otherwise provided in this section, aninsurer shall approve or deny a bill for accident benefits received from aprovider of health care within 30 calendar days after the insurer receives thebill. If the bill for accident benefits is approved, the insurer shall pay thebill within 30 calendar days after it is approved. Except as otherwise providedin this section, if the approved bill for accident benefits is not paid withinthat period, the insurer shall pay interest to the provider of health care at arate of interest equal to the prime rate at the largest bank in Nevada, asascertained by the Commissioner of Financial Institutions, on January 1 or July1, as the case may be, immediately preceding the date on which the payment wasdue, plus 6 percent. The interest must be calculated from 30 calendar daysafter the date on which the bill is approved until the date on which the billis paid.
2. If an insurer needs additional information todetermine whether to approve or deny a bill for accident benefits received froma provider of health care, he shall notify the provider of health care of hisrequest for the additional information within 20 calendar days after hereceives the bill. The insurer shall notify the provider of health care of allthe specific reasons for the delay in approving or denying the bill for accidentbenefits. Upon the receipt of such a request, the provider of health care shallfurnish the additional information to the insurer within 20 calendar days afterreceiving the request. If the provider of health care fails to furnish theadditional information within that period, the provider of health care is notentitled to the payment of interest to which he would otherwise be entitled forthe late payment of the bill for accident benefits. The insurer shall approveor deny the bill for accident benefits within 20 calendar days after hereceives the additional information. If the bill for accident benefits isapproved, the insurer shall pay the bill within 20 calendar days after hereceives the additional information. Except as otherwise provided in thissubsection, if the approved bill for accident benefits is not paid within thatperiod, the insurer shall pay interest to the provider of health care at therate set forth in subsection 1. The interest must be calculated from 20calendar days after the date on which the insurer receives the additionalinformation until the date on which the bill is paid.
3. An insurer shall not request a provider of healthcare to resubmit information that the provider of health care has previouslyprovided to the insurer, unless the insurer provides a legitimate reason forthe request and the purpose of the request is not to delay the payment of theaccident benefits, harass the provider of health care or discourage the filingof claims.
4. An insurer shall not pay only a portion of a billfor accident benefits that has been approved and is fully payable.
5. The Administrator may require an insurer to provideevidence which demonstrates that the insurer has substantially complied withthe requirements of this section, including, without limitation, payment withinthe time required of at least 95 percent of approved accident benefits or atleast 90 percent of the total dollar amount of approved accident benefits. Ifthe Administrator determines that an insurer is not in substantial compliancewith the requirements of this section, the Administrator may require the insurerto pay an administrative fine in an amount to be determined by theAdministrator.
6. The payment of interest provided for in thissection for the late payment of an approved claim may be waived only if thepayment was delayed because of an act of God or another cause beyond thecontrol of the insurer.
7. Payments made by an insurer pursuant to thissection are not an admission of liability for the accident benefits or anyportion of the accident benefits.
(Added to NRS by
NRS
1. If an insurer, organization for managed care oremployer who provides accident benefits for injured employees pursuant to
(a) State the relevant amount requested as payment inthe statement, that the reason for denying payment is that the services werenot related to the industrial injury or occupational disease and that, pursuantto subsection 2, the injured employee will be responsible for payment of therelevant amount if he does not, in a timely manner, appeal the denial pursuantto NRS 616C.305 and
(b) Include an explanation of the injured employeesright to request a hearing to appeal the denial pursuant to
2. An injured employee who does not, in a timelymanner, appeal the denial of payment for the services rendered or who appealsthe denial but is not successful is responsible for payment of the relevantcharges on the itemized statement.
3. To succeed on appeal, the injured employee mustshow that the:
(a) Services provided were related to the employeesindustrial injury or occupational disease; or
(b) Insurer, organization for managed care or employerwho provides accident benefits for injured employees pursuant to
(Added to NRS by
NRS
1. Except as otherwise provided in this section, if aprovider of health care provides treatment or other services that an injuredemployee alleges are related to an industrial injury or occupational diseaseand an insurer, an organization for managed care, a third-party administratoror an employer who provides accident benefits for injured employees pursuant toNRS 616C.265 denies authorization orresponsibility for payment for the treatment or other services, the provider ofhealth care is entitled to be paid for the treatment or other services asfollows:
(a) If the treatment or other services will be paid bya health insurer which has a contract with the provider of health care under ahealth benefit plan that covers the injured employee, the provider of healthcare is entitled to be paid the amount that is allowed for the treatment orother services under that contract.
(b) If the treatment or other services will be paid bya health insurer which does not have a contract with the provider of healthcare as set forth in paragraph (a) or by a casualty insurer or the injuredemployee, the provider of health care is entitled to be paid not more than:
(1) The amount which is allowed for thetreatment or other services set forth in the schedule of fees and chargesestablished pursuant to NRS 616C.260;or
(2) If the insurer which denied authorization orresponsibility for the payment has contracted with an organization for managedcare or with providers of health care pursuant to
2. The provisions of subsection 1:
(a) Apply only to treatment or other services providedby the provider of health care before the date on which the insurer,organization for managed care, third-party administrator or employer whoprovides accident benefits first denies authorization or responsibility forpayments for the alleged industrial injury or occupational disease.
(b) Do not apply to a provider of health care that is ahospital as defined in NRS 439B.110.The provisions of this paragraph do not exempt the provider of health care fromcomplying with the provisions of subsections 3 and 4.
3. If:
(a) The injured employee pays for the treatment orother services or a health or casualty insurer pays for the treatment or otherservices on behalf of the injured employee;
(b) The injured employee requests a hearing before ahearing officer or appeals officer regarding the denial of coverage; and
(c) The hearing officer or appeals officer ultimatelydetermines that the treatment or other services should have been covered, orthe insurer, organization for managed care, third-party administrator oremployer who provides accident benefits subsequently accepts responsibility forpayment,
the hearingofficer or appeals officer shall order the insurer, organization for managedcare, third-party administrator or employer who provides accident benefits topay to the injured employee or the health or casualty insurer the amount whichthe injured employee or the health or casualty insurer paid that is allowed forthe treatment or other services set forth in the schedule of fees and chargesestablished pursuant to NRS 616C.260or, if the insurer has contracted with an organization for managed care or withproviders of health care pursuant to NRS616B.527, the amount that is allowed for the treatment or other servicesunder that contract.
4. If the injured employee or the health or casualtyinsurer paid the provider of health care any amount in excess of the amountthat the provider would have been entitled to be paid pursuant to this section,the injured employee or the health or casualty insurer is entitled to recoverthe excess amount from the provider. Within 30 days after receiving notice ofsuch an excess amount, the provider of health care shall reimburse the injuredemployee or the health or casualty insurer for the excess amount.
5. As used in this section:
(a) Casualty insurer means any insurer or otherorganization providing coverage or benefits under a policy or contract ofcasualty insurance in the manner described in subsection 2 of
(b) Health benefit plan means any type of policy,contract, agreement or plan providing health coverage or benefits in accordancewith state or federal law.
(c) Health insurer means any insurer or other organizationproviding health coverage or benefits in accordance with state or federal law.
(Added to NRS by
NRS
1. Any employee who is entitled to receivecompensation under chapters 616A to
(a) Requested by the insurer or employer; or
(b) Ordered by an appeals officer or a hearing officer,
submithimself for medical examination at a time and from time to time at a placereasonably convenient for the employee, and as may be provided by theregulations of the Division.
2. If the insurer has reasonable cause to believe thatan injured employee who is receiving compensation for a permanent totaldisability is no longer disabled, the insurer may request the employee tosubmit to an annual medical examination to determine whether the disabilitystill exists. The insurer shall pay the costs of the examination.
3. The request or order for an examination must fix atime and place therefor, with due regard for the nature of the medicalexamination, the convenience of the employee, his physical condition and hisability to attend at the time and place fixed.
4. The employee is entitled to have a physician orchiropractor, provided and paid for by him, present at any such examination.
5. If the employee refuses to submit to an examinationordered or requested pursuant to subsection 1 or 2 or obstructs theexamination, his right to compensation is suspended until the examination hastaken place, and no compensation is payable during or for the period ofsuspension.
6. Any physician or chiropractor who makes or ispresent at any such examination may be required to testify as to the resultthereof.
[67:168:1947; 1943 NCL 2680.67] + [68:168:1947;1943 NCL 2680.68](NRS A 1975, 763; 1977, 314; 1979, 1054; 1981, 1169, 1197,1489, 1830; 1985, 1546; 1993, 735, 1869; 1995, 579; 1997, 1394)
DETERMINATION AND PAYMENT OF BENEFITS
NRS
1. An injured employee or his dependents are not entitledto receive compensation pursuant to the provisions of
2. For the purposes of chapters616A to 616D, inclusive, of NRS, if theemployee files a notice of an injury pursuant to
(Added to NRS by 1993, 662)(Substituted in revisionfor NRS 616.5015)
NRS
1. An insurer shall not provide compensation to or foran employee or his dependents before the compensation is required to be paidpursuant to the provisions of chapters 616Ato 616D, inclusive, of NRS.
2. If, within 30 days after a payment is made to aninjured employee pursuant to the provisions of chapters616A to 616D, inclusive, of NRS, theinsurer determines that it has overpaid the injured employee as a result of aclerical error in its calculation of the amount of payment, or as a result ofusing improper or incorrect information to determine the injured employeeseligibility for payment or to calculate the amount of payment, the insurer maydeduct the amount of the overpayment from future benefits related to that claimto which the injured employee is entitled, other than accident benefits, if:
(a) The insurer notifies the injured employee inwriting of its determination;
(b) The insurer informs the injured employee of hisright to contest the deduction; and
(c) The injured employee fails to contest the deductionor does so and upon final resolution of the contested deduction, it isdetermined that such an overpayment was made.
3. Any deductions made pursuant to subsection 2 mustbe made in a reasonable manner which does not cause undue hardship to theinjured employee.
(Added to NRS by 1993, 662)(Substituted in revisionfor NRS 616.5017)
NRS
1. An insurer, organization for managed care orthird-party administrator shall respond to a written request for priorauthorization for:
(a) Treatment;
(b) Diagnostic testing; or
(c) Consultation,
within 5working days after receiving the written request.
2. If the insurer, organization for managed care orthird-party administrator fails to respond to such a request within 5 workingdays, authorization shall be deemed to be given. The insurer, organization formanaged care or third-party administrator may subsequently deny authorization.
3. If the insurer, organization for managed care orthird-party administrator subsequently denies a request for authorizationsubmitted by a provider of health care for additional visits or treatments, itshall pay for the additional visits or treatments actually provided to theinjured employee, up to the number of treatments for which payment is requestedby the provider of health care before the denial of authorization is receivedby the provider.
(Added to NRS by
NRS
1. The injured employee seeks treatment from aphysician or chiropractor for a newly developed injury or disease; and
2. The employees medical records for the injuryreported do not include a reference to the injury or disease for whichtreatment is being sought, or there is no documentation indicating that therewas possible exposure to an injury described in paragraph (b), (c) or (d) ofsubsection 2 of NRS 616A.265,
the injuryor disease for which treatment is being sought must not be considered part ofthe employees original claim for compensation unless the physician or chiropractorestablishes by medical evidence a causal relationship between the injury ordisease for which treatment is being sought and the original accident.
(Added to NRS by 1993, 663; A
NRS
(Added to NRS by 1995, 2122)
NRS
1. The Administrator shall resolve any disputesbetween insurers if an injured employee claims benefits against more than oneinsurer.
2. The Administrator shall adopt regulationsconcerning the resolution of disputes between insurers regarding benefits to bepaid to any injured employee.
3. If the insurer or the employee is dissatisfied withthe decision of the Administrator, the dissatisfied party may request a hearingbefore an appeals officer.
4. Until the Administrator has determined whichinsurer is responsible for a claim, the current insurer of the employer shallpay benefits to the claimant pursuant to chapters616A to 617, inclusive, of NRS. Paymentsmade by an insurer pursuant to this subsection are not an admission ofliability for the claim or any portion of the claim.
(Added to NRS by 1995, 2002)
NRS
1. The resulting condition of an employee who:
(a) Has a preexisting condition from a cause or originthat did not arise out of or in the course of his current or past employment;and
(b) Subsequently sustains an injury by accident arisingout of and in the course of his employment which aggravates, precipitates oraccelerates his preexisting condition,
shall bedeemed to be an injury by accident that is compensable pursuant to theprovisions of chapters 616A to
2. The resulting condition of an employee who:
(a) Sustains an injury by accident arising out of andin the course of his employment; and
(b) Subsequently aggravates, precipitates oraccelerates the injury in a manner that does not arise out of and in the courseof his employment,
shall bedeemed to be an injury by accident that is compensable pursuant to theprovisions of chapters 616A to
(Added to NRS by 1993, 663; A 1995, 2147;
NRS
1. An insurer may inquire about and request medicalrecords of an injured employee that concern a preexisting medical conditionthat is reasonably related to the industrial injury of that injured employee.
2. An injured employee must sign all medical releasesnecessary for the insurer of his employer to obtain information and recordsabout a preexisting medical condition that is reasonably related to theindustrial injury of the employee and that will assist the insurer to determinethe nature and amount of workers compensation to which the employee isentitled.
(Added to NRS by
NRS
1. Except as otherwise provided in this section, aninjury or disease sustained by an employee that is caused by stress iscompensable pursuant to the provisions of chapters616A to 616D, inclusive, or
2. Any ailment or disorder caused by any gradualmental stimulus, and any death or disability ensuing therefrom, shall be deemednot to be an injury or disease arising out of and in the course of employment.
3. An injury or disease caused by stress shall bedeemed to arise out of and in the course of employment only if the employeeproves by clear and convincing medical or psychiatric evidence that:
(a) He has a mental injury caused by extreme stress intime of danger;
(b) The primary cause of the injury was an event thatarose out of and during the course of his employment; and
(c) The stress was not caused by his layoff, thetermination of his employment or any disciplinary action taken against him.
4. The provisions of this section do not apply to aperson who is claiming compensation pursuant to
(Added to NRS by 1993, 663; A 1993,2445)(Substituted in revision for NRS 616.5019)
NRS
1. If compensation is paid to an employee under
2. If reconstructive surgery is begun within 3 yearsafter a mastectomy, the amount of the compensation provided for that surgerymust equal those amounts provided for in chapters616A to 616D, inclusive, of NRS at thetime of the mastectomy. If the surgery is begun more than 3 years after themastectomy, the compensation provided is subject to the requirements andconditions that apply at the time of the reconstructive surgery.
3. For the purposes of this section, reconstructivesurgery means a surgical procedure performed following a mastectomy on onebreast or both breasts to reestablish symmetry between the two breasts. Theterm includes, but is not limited to, augmentation mammoplasty, reductionmammoplasty and mastopexy.
(Added to NRS by 1983, 617; A 1989,1892)(Substituted in revision for NRS 616.503)
NRS
1. Except as otherwise provided in subsection 4 of
2. The provisions of this section apply only to thoseinjuries received by the employee within 6 months after leaving this State,unless before the expiration of the 6-month period the employer has filed withthe private carrier or, in the case of a self-insured employer or anassociation of self-insured public or private employers, with the Administratornotice that he has elected to extend the coverage for a greater period.
[Part 74:168:1947; A 1955, 187](NRS A 1981, 1168,1488; 1989, 579; 1995, 2031;
NRS
1. Anything to the contrary in
2. No compensation shall be paid to any such employee,or his dependents in case of death, until such employee, his personal or legalrepresentatives, dependents or next of kin shall have executed and delivered tothe employer a full and complete release of such employer from any and allliability arising from or growing out of such injury or death.
[74.1:168:1947; added 1955, 187](Substituted inrevision for NRS 616.525)
NRS
1. If an employee who has been hired or is regularlyemployed in this State receives a personal injury by an accident arising out ofand in the course of such employment outside this State, and he, or hispersonal or legal representatives, dependents or next of kin commence anyaction or proceeding in any other state to recover any damages or compensationfrom his employer for the injury or death, the act of commencing such an actionor proceeding constitutes an irrevocable waiver of all compensation for theinjury or death to which persons would otherwise have been entitled under thelaws of this State.
2. If the injured employee or his personal or legalrepresentatives, dependents or next of kin recover a final judgment against theemployer for damages arising out of the injury or death in any court ofcompetent jurisdiction in any other state, the compensation which wouldotherwise have been payable under the laws of this State, up to the full amountthereof, but less any sums previously paid for the injury or death, must beapplied in satisfaction of the judgment as follows:
(a) Upon receipt of an authenticated copy of the finaljudgment and writ of execution or other process issued in aid thereof, theinsurer shall immediately determine the total amount of compensation whichwould have been payable under the laws of this State if a claim therefor hadbeen made to the insurer. In the case of compensation payable in installments,the insurer shall convert it into a lump sum by such a system of computation asthe Administrator deems proper.
(b) The insurer shall thereupon order to be paid infull or partial satisfaction of the judgment a sum not to exceed the totalamount of compensation computed as provided in this section or the amount ofthe judgment, whichever is less.
(c) Except for a self-insured employer or an employerwho is a member of an association of self-insured public or private employers,if the judgment is satisfied fully by the employer before any payment by theprivate carrier pursuant to paragraph (b), the amount payable thereunder mustbe paid to the employer.
[74.2:168:1947; added 1955, 187](NRS A 1979, 1054;1981, 1169, 1489; 1995, 2031;
NRS
[Part 66:168:1947; A 1955, 71](NRS A 1979, 1055;1983, 1880; 1985, 1434; 1993, 543;
NRS
1. The insurer shall notify a dependent of a deceasedemployee who is residing outside of the United States by certified mail at hislast known address if compensation is due the decedent or beneficiary pursuantto chapters 616A to
2. If the insurer does not receive a request thatpayment be made directly to a beneficiary within 90 days after the noticerequired by subsection 1 is mailed, payments to the consul general, vice consulgeneral, consul or vice consul of the nation of which any dependent of adeceased employee is a resident or subject, or a representative of such consulgeneral, vice consul general, consul or vice consul, of any compensation dueunder chapters 616A to
[Part 66:168:1947; A 1955, 71](NRS A 1991, 804;
NRS
1. If an injured employee or, in the event of hisdeath, his dependents, bring an action in tort against his employer to recoverpayment for an injury which is compensable pursuant to the provisions of
(a) The amount of compensation the injured employee orhis dependents are entitled to receive pursuant to the provisions of
(b) The insurer, or in the case of claims involving theuninsured employers claim account or a subsequent injury account theAdministrator, has a lien upon the total amount paid by the employer if theinjured employee or his dependents receive compensation pursuant to theprovisions of chapters 616A to
Thissubsection is applicable whether the money paid to the employee or his dependentsby the employer is classified as a gift, a settlement or otherwise. The provisionsof this subsection do not grant to an injured employee any right of action intort to recover damages from his employer for his injury.
2. When an employee receives an injury for whichcompensation is payable pursuant to the provisions of
(a) The injured employee, or in case of death hisdependents, may take proceedings against that person to recover damages, butthe amount of the compensation the injured employee or his dependents areentitled to receive pursuant to the provisions of chapters616A to 616D, inclusive, or
(b) If the injured employee, or in case of death hisdependents, receive compensation pursuant to the provisions of
3. When an injured employee incurs an injury for whichcompensation is payable pursuant to the provisions of
(a) The injured employee, or in the case of death hisdependents, may take proceedings to recover those proceeds, but the amount ofcompensation the injured employee or his dependents are entitled to receivepursuant to the provisions of chapters 616Ato 616D, inclusive, or
(b) If an injured employee, or in the case of death hisdependents, receive compensation pursuant to the provisions of
4. In any action or proceedings taken by the insureror the Administrator pursuant to this section, evidence of the amount ofcompensation, accident benefits and other expenditures which the insurer, theuninsured employers claim account or a subsequent injury account have paid orbecome obligated to pay by reason of the injury or death of the employee isadmissible. If in such action or proceedings the insurer or the Administratorrecovers more than those amounts, the excess must be paid to the injuredemployee or his dependents.
5. In any case where the insurer or the Administratoris subrogated to the rights of the injured employee or of his dependents asprovided in subsection 2 or 3, the insurer or the Administrator has a lien uponthe total proceeds of any recovery from some person other than the employer,whether the proceeds of such recovery are by way of judgment, settlement orotherwise. The injured employee, or in the case of his death his dependents,are not entitled to double recovery for the same injury, notwithstanding anyact or omission of the employer or a person in the same employ which was adirect or proximate cause of the employees injury.
6. The lien provided for pursuant to subsection 1 or 5includes the total compensation expenditure incurred by the insurer, theuninsured employers claim account or a subsequent injury account for theinjured employee and his dependents.
7. An injured employee, or in the case of death hisdependents, or the attorney or representative of the injured employee or hisdependents, shall notify the insurer, or in the case of claims involving theuninsured employers claim account or a subsequent injury account theAdministrator, in writing before initiating a proceeding or action pursuant tothis section.
8. Within 15 days after the date of recovery by way ofactual receipt of the proceeds of the judgment, settlement or otherwise:
(a) The injured employee or his dependents, or theattorney or representative of the injured employee or his dependents; and
(b) The third-party insurer,
shall notifythe insurer, or in the case of claims involving the uninsured employers claimaccount or a subsequent injury account the Administrator, of the recovery andpay to the insurer or the Administrator, respectively, the amount due pursuantto this section together with an itemized statement showing the distribution ofthe total recovery. The attorney or representative of the injured employee orhis dependents and the third-party insurer are jointly and severally liable forany amount to which an insurer is entitled pursuant to this section if theattorney, representative or third-party insurer has knowledge of the lienprovided for in this section.
9. An insurer shall not sell its lien to a third-partyinsurer unless the injured employee or his dependents, or the attorney orrepresentative of the injured employee or his dependents, refuses to provide tothe insurer information concerning the action against the third party.
10. In any trial of an action by the injured employee,or in the case of his death by his dependents, against a person other than theemployer or a person in the same employ, the jury must receive proof of theamount of all payments made or to be made by the insurer or the Administrator.The court shall instruct the jury substantially as follows:
Payment of workmenscompensation benefits by the insurer, or in the case of claims involving theuninsured employers claim account or a subsequent injury account theAdministrator, is based upon the fact that a compensable industrial accidentoccurred, and does not depend upon blame or fault. If the plaintiff does notobtain a judgment in his favor in this case, he is not required to repay hisemployer, the insurer or the Administrator any amount paid to him or paid onhis behalf by his employer, the insurer or the Administrator.
If you decide that theplaintiff is entitled to judgment against the defendant, you shall find hisdamages in accordance with the courts instructions on damages and return yourverdict in the plaintiffs favor in the amount so found without deducting theamount of any compensation benefits paid to or for the plaintiff. The lawprovides a means by which any compensation benefits will be repaid from youraward.
11. To calculate an employers premium, the employersaccount with the private carrier must be credited with an amount equal to thatrecovered by the private carrier from a third party pursuant to this section,less the private carriers share of the expenses of litigation incurred inobtaining the recovery, except that the total credit must not exceed the amountof compensation actually paid or reserved by the private carrier on the injuredemployees claim.
12. As used in this section, third-party insurermeans an insurer that issued to a third party who is liable for damagespursuant to subsection 2, a policy of liability insurance the proceeds of whichare recoverable pursuant to this section. The term includes an insurer thatissued to an employer a policy of uninsured or underinsured vehicle coverage.
[75:168:1947; A 1949, 659; 1943 NCL 2680.75](NRS A1957, 519; 1973, 498; 1977, 216, 424; 1979, 1055; 1981, 1491; 1991, 2419; 1993,621, 742; 1997, 599; 1999,221, 763,
NRS
1. The Division shall designate one:
(a) Third-party administrator who has a validcertificate issued by the Commissioner pursuant to
(b) Insurer, other than a self-insured employer orassociation of self-insured public or private employers,
toadminister claims against the uninsured employers claim account. The designationmust be made pursuant to reasonable competitive bidding procedures establishedby the Administrator.
2. Except as otherwise provided in this subsection, anemployee may receive compensation from the uninsured employers claim accountif:
(a) He was hired in this State or he is regularlyemployed in this State;
(b) He suffers an accident or injury which arises outof and in the course of his employment:
(1) In this State; or
(2) While on temporary assignment outside theState for not more than 12 months;
(c) He files a claim for compensation with theDivision; and
(d) He makes an irrevocable assignment to the Divisionof a right to be subrogated to the rights of the injured employee pursuant to
An employeewho suffers an accident or injury while on temporary assignment outside theState is not eligible to receive compensation from the uninsured employersclaim account unless he has been denied workers compensation in the state inwhich the accident or injury occurred.
3. If the Division receives a claim pursuant tosubsection 2, the Division shall immediately notify the employer of the claim.
4. For the purposes of this section, the employer hasthe burden of proving that he provided mandatory industrial insurance coveragefor the employee or that he was not required to maintain industrial insurancefor the employee.
5. Any employer who has failed to provide mandatorycoverage required by the provisions of chapters616A to 616D, inclusive, of NRS isliable for all payments made on his behalf, including any benefits,administrative costs or attorneys fees paid from the uninsured employersclaim account or incurred by the Division.
6. The Division:
(a) May recover from the employer the payments made bythe Division that are described in subsection 5 and any accrued interest bybringing a civil action in a court of competent jurisdiction.
(b) In any civil action brought against the employer,is not required to prove that negligent conduct by the employer was the causeof the employees injury.
(c) May enter into a contract with any person to assistin the collection of any liability of an uninsured employer.
(d) In lieu of a civil action, may enter into anagreement or settlement regarding the collection of any liability of anuninsured employer.
7. The Division shall:
(a) Determine whether the employer was insured within30 days after receiving notice of the claim from the employee.
(b) Assign the claim to the third-party administratoror insurer designated pursuant to subsection 1 for administration and paymentof compensation.
Upondetermining whether the claim is accepted or denied, the designated third-partyadministrator or insurer shall notify the injured employee, the named employerand the Division of its determination.
8. Upon demonstration of the:
(a) Costs incurred by the designated third-partyadministrator or insurer to administer the claim or pay compensation to theinjured employee; or
(b) Amount that the designated third-partyadministrator or insurer will pay for administrative expenses or compensationto the injured employee and that such amounts are justified by thecircumstances of the claim,
the Divisionshall authorize payment from the uninsured employers claim account.
9. Any partyaggrieved by a determination made by the Division regarding the assignment ofany claim made pursuant to this section may appeal that determination by filinga notice of appeal with an appeals officer within 30 days after the determinationis rendered. The provisions of NRS616C.345 to 616C.385, inclusive,apply to an appeal filed pursuant to this subsection.
10. Any party aggrieved by a determination to acceptor to deny any claim made pursuant to this section or by a determination to payor to deny the payment of compensation regarding any claim made pursuant tothis section may appeal that determination, within 70 days after thedetermination is rendered, to the Hearings Division of the Department ofAdministration in the manner provided by NRS616C.305 and 616C.315.
11. All insurers shall bear a proportionate amount ofa claim made pursuant to chapters 616A to
12. An uninsured employer is liable for the intereston any amount paid on his claims from the Uninsured Employers Claim Account.The interest must be calculated at a rate equal to the prime rate at thelargest bank in Nevada, as ascertained by the Commissioner of FinancialInstitutions, on January 1 or July 1, as the case may be, immediately precedingthe date of the claim, plus 3 percent, compounded monthly, from the date theclaim is paid from the account until payment is received by the Division fromthe employer.
13. Attorneys fees recoverable by the Divisionpursuant to this section must be:
(a) If a private attorney is retained by the Division,paid at the usual and customary rate for that attorney.
(b) If the attorney is an employee of the Division,paid at the rate established by regulations adopted by the Division.
Any moneycollected must be deposited to the Uninsured Employers Claim Account.
14. In addition to any other liabilities provided forin this section, the Administrator may impose an administrative fine of notmore than $10,000 against an employer if the employer fails to providemandatory coverage required by the provisions of chapters616A to 616D, inclusive, of NRS.
(Added to NRS by 1975, 599; A 1981, 1197, 1830; 1991,2408; 1993, 716, 1863; 1995, 579; 1997, 1436;
NRS
1. Except as otherwise provided in this section, if aninsurer determines that an employee has knowingly misrepresented or concealed amaterial fact to obtain any benefit or payment under the provisions of
2. An employee who is aggrieved by a determination ofan insurer made pursuant to subsection 1 may appeal that determination pursuantto NRS 616C.315 to
3. If an employee elects to receive his award for apermanent partial disability in a lump sum pursuant to
4. This section does not preclude an insurer frommaking an investigation pursuant to, or pursuing the remedies provided by,
(Added to NRS by 1989, 1993; A 1993, 745; 1995,1873)(Substituted in revision for NRS 616.563)
NRS
1. Compensation is not payable pursuant to theprovisions of chapters 616A to
(a) Caused by the employees willful intention toinjure himself.
(b) Caused by the employees willful intention toinjure another.
(c) Proximately caused by the employees intoxication.If the employee was intoxicated at the time of his injury, intoxication must bepresumed to be a proximate cause unless rebutted by evidence to the contrary.
(d) Proximately caused by the employees use of acontrolled substance. If the employee had any amount of a controlled substancein his system at the time of his injury for which the employee did not have acurrent and lawful prescription issued in his name or that he was not using inaccordance with the provisions of chapter 453Aof NRS, the controlled substance must be presumed to be a proximate causeunless rebutted by evidence to the contrary.
2. For the purposes of paragraphs (c) and (d) ofsubsection 1:
(a) The affidavit or declaration of an expert or otherperson described in NRS 50.315 isadmissible to prove the existence of any alcohol or the existence, quantity oridentity of a controlled substance in an employees system. If the affidavit ordeclaration is to be so used, it must be submitted in the manner prescribed in
(b) When an examination requested or ordered includestesting for the use of alcohol or a controlled substance, the laboratory thatconducts the testing must be licensed pursuant to the provisions of
3. No compensation is payable for the death,disability or treatment of an employee if his death is caused by, or insofar ashis disability is aggravated, caused or continued by, an unreasonable refusalor neglect to submit to or to follow any competent and reasonable surgicaltreatment or medical aid.
4. If any employee persists in an unsanitary orinjurious practice that imperils or retards his recovery, or refuses to submitto such medical or surgical treatment as is necessary to promote his recovery,his compensation may be reduced or suspended.
5. An injured employees compensation, other thanaccident benefits, must be suspended if:
(a) A physician or chiropractor determines that theemployee is unable to undergo treatment, testing or examination for theindustrial injury solely because of a condition or injury that did not ariseout of and in the course of his employment; and
(b) It is within the ability of the employee to correctthe nonindustrial condition or injury.
Thecompensation must be suspended until the injured employee is able to resumetreatment, testing or examination for the industrial injury. The insurer mayelect to pay for the treatment of the nonindustrial condition or injury.
[70:168:1947; 1943 NCL 2680.70] + [71:168:1947;1943 NCL 2680.71] + [72:168:1947; 1943 NCL 2680.72](NRS A 1979, 1057;1981, 1198; 1991, 2421; 1993, 745; 1995, 2153; 1997, 1394, 1421;
NRS
1. Except as otherwise provided in subsections 2, 3and 4:
(a) When the insurer determines that a claim should beclosed before all benefits to which the claimant may be entitled have beenpaid, the insurer shall send a written notice of its intention to close theclaim to the claimant by first-class mail addressed to the last known addressof the claimant. The notice must include a statement that if the claimant doesnot agree with the determination, he has a right to request a resolution of thedispute pursuant to NRS 616C.305 and
(b) If the insurer does not receive a request for theresolution of the dispute, it may close the claim.
(c) Notwithstanding the provisions of
2. If, during the first 12 months after a claim isopened, the medical benefits required to be paid for a claim are less than$300, the insurer may close the claim at any time after he sends, byfirst-class mail addressed to the last known address of the claimant, writtennotice that:
(a) The claim is being closed pursuant to thissubsection;
(b) The injured employee may appeal the closure of theclaim pursuant to the provisions of NRS 616C. 305 and 616C.315 to 616C.385,inclusive; and
(c) If the injured employee does not appeal the closureof the claim or appeals the closure of the claim but is not successful, theclaim cannot be reopened.
3. In addition to the notice described in subsection2, an insurer shall send to each claimant who receives less than $300 inmedical benefits within 6 months after the claim is opened a written noticethat explains the circumstances under which a claim may be closed pursuant to subsection2. The written notice provided pursuant to this subsection does not create anyright to appeal the contents of that notice. The written notice must be:
(a) Sent by first-class mail addressed to the lastknown address of the claimant; and
(b) A document that is separate from any other documentor form that is used by the insurer.
4. The closure of a claim pursuant to subsection 2 isnot effective unless notice is given as required by subsections 2 and 3.
(Added to NRS by 1979, 707; A 1981, 1140, 1492; 1989,333; 1991, 2421; 1993, 746; 1997, 1437;
ACCIDENT BENEFITS
NRS
1. Every injured employee within the provisions of
2. An injured employee is entitled to receive as anaccident benefit a motor vehicle that is modified to allow the employee tooperate the vehicle safely if:
(a) As a result of an injury arising out of and in thecourse of his employment, he is quadriplegic, paraplegic or has had a part ofhis body amputated; and
(b) He cannot be fitted with a prosthetic device whichallows him to operate a motor vehicle safely.
3. If an injured employee is entitled to receive amotor vehicle pursuant to subsection 2, a motor vehicle must be modified toallow the employee to operate it safely in the following order of preference:
(a) A motor vehicle owned by the injured employee mustbe so modified if the insurer or employer providing accident benefitsdetermines that it is reasonably feasible to do so.
(b) A used motor vehicle must be so modified if theinsurer or employer providing accident benefits determines that it isreasonably feasible to do so.
(c) A new motor vehicle must be so modified.
4. The Administrator shall adopt regulationsestablishing a maximum benefit to be paid under the provisions of this section.
[Part 58:168:1947; 1943 NCL 2680.58](NRS A 1957,28; 1973, 605; 1993, 733;
NRS
1. The Division shall, after consulting with andconsidering the advice of persons representative of organized labor groups,employers, insurers and providers of health care, adopt regulationsestablishing standards of care for the provision of accident benefits toemployees who have suffered industrial injuries or occupational diseases. Thestandards must include, but are not limited to criteria and protocols to beused as minimal guides for evaluating and ensuring the quality of programs oftreatment and for reviewing the:
(a) Utilization of diagnostic procedures and theprovision of other medical services;
(b) Treatment and expected durations of industrialinjuries and occupational diseases;
(c) Utilization of narcotic drugs and other forms ofmedication;
(d) Referral of patients to obtain a second opinion;and
(e) Provision of care by more than one provider ofhealth care.
Thestandards must be consistent with national or regional guidelines and must bespecific to medicine for industrial injuries and occupational diseases.
2. The Division shall, after consulting with andconsidering the advice of persons representative of organized labor groups,employers, insurers and providers of health care, periodically review andrevise as necessary the standards established pursuant to subsection 1.
3. An insurer and each person who provides anyaccident benefit to an employee who has suffered an industrial injury oroccupational disease shall comply with the regulations adopted pursuant to thissection.
(Added to NRS by 1991, 389; A 1993,1858)(Substituted in revision for NRS 616.188)
NRS
1. Each private carrier shall collect a premium uponthe total payroll of every employer insured by the private carrier at the ratefiled with the Commissioner pursuant to chapter686B of NRS.
2. Every employer paying this premium is relieved fromfurnishing accident benefits, and the accident benefits must be provided by theprivate carrier.
3. The private carrier is liable for any accidentbenefits provided in this section. The account provided for accident benefitsmust be kept as a separate account on the records of the private carrier.
[Part 58:168:1947; 1943 NCL 2680.58](NRS A 1973,601; 1981, 1475; 1995, 2027; 1997, 1438;
NRS
1. All fees and charges for accident benefits mustnot:
(a) Exceed the amounts usually billed and paid in theState for similar treatment.
(b) Be unfairly discriminatory as between personslegally qualified to provide the particular service for which the fees orcharges are asked.
2. The Administrator shall, giving consideration tothe fees and charges being billed and paid in the State, establish a scheduleof reasonable fees and charges allowable for accident benefits provided toinjured employees whose insurers have not contracted with an organization formanaged care or with providers of health care services pursuant to
3. The Administrator shall designate a vendor whocompiles data on a national basis concerning fees and charges that are billedand paid for treatment or services similar to the treatment and services thatqualify as accident benefits in this State to provide him with such informationas he deems necessary to carry out the provisions of subsection 2. Thedesignation must be made pursuant to reasonable competitive bidding proceduresestablished by the Administrator. In addition, the Administrator may request ahealth insurer, health maintenance organization or provider of accidentbenefits, an agent or employee of such a person, or an agency of the State toprovide the Administrator with information concerning fees and charges that arebilled and paid in this State for similar services as he deems necessary tocarry out the provisions of subsection 2. The Administrator shall require ahealth insurer, health maintenance organization or provider of accidentbenefits, an agent or employee of such a person, or an agency of the State thatprovides records or reports of fees and charges billed and paid pursuant tothis section to provide interpretation and identification concerning theinformation delivered. The Administrator may impose an administrative fine of$500 on a health insurer, health maintenance organization or provider ofaccident benefits, or an agent or employee of such a person for each refusal toprovide the information requested pursuant to this subsection.
4. The Division may adopt reasonable regulationsnecessary to carry out the provisions of this section. The regulations mustinclude provisions concerning:
(a) Standards for the development of the schedule offees and charges that are billed and paid; and
(b) The monitoring of compliance by providers ofbenefits with the schedule of fees and charges.
5. The Division shall adopt regulations requiring theuse of a system of billing codes as recommended by the American MedicalAssociation.
(Added to NRS by 1981, 1454; A 1983, 325, 1294; 1985,574; 1987, 2148; 1991, 2412; 1993, 723, 1865; 1995, 579;
NRS
1. Except as otherwise provided in
2. Employers electing to make such arrangements shallnotify the Administrator of the election and render a detailed statement of thearrangements made, which arrangements do not become effective until approved bythe Administrator.
3. Every employer who maintains a hospital of any kindfor his employees, or who contracts for the hospital care of injured employees,shall, on or before January 30 of each year, make a written report to theAdministrator for the preceding year, which must contain a statement showing:
(a) The total amount of hospital fees collected,showing separately the amount contributed by the employees and the amountcontributed by the employers;
(b) An itemized account of the expenditures,investments or other disposition of such fees; and
(c) What balance, if any, remains.
4. Every employer who provides accident benefitspursuant to this section:
(a) Shall, in accordance with regulations adopted bythe Administrator, make a written report to the Division of his actual andexpected annual expenditures for claims and such other information as theDivision deems necessary to calculate an estimated or final annual assessmentand shall, to the extent that the regulations refer to the responsibility ofinsurers to make such reports, be deemed to be an insurer.
(b) Shall pay the assessments collected pursuant to
5. The reports required by the provisions of subsections3 and 4 must be verified:
(a) If the employer is a natural person, by theemployer;
(b) If the employer is a partnership, by one of thepartners;
(c) If the employer is a corporation, by the secretary,president, general manager or other executive officer of the corporation; or
(d) If the employer has contracted with a physician orchiropractor for the hospital care of injured employees, by the physician orchiropractor.
6. No employee is required to accept the services of aphysician or chiropractor provided by his employer, but may seek professionalmedical services of his choice as provided in
7. Every employer who fails to notify theAdministrator of such election and arrangements, or who fails to render thefinancial reports required, is liable for accident benefits as provided by
[Part 58:168:1947; 1943 NCL 2680.58](NRS A 1973,602; 1975, 796; 1981, 1475; 1983, 427; 1985, 1544; 1991, 2413; 1993, 1866;
NRS
1. Every employer who has elected to provide accidentbenefits for his injured employees shall prepare and submit a written report tothe Administrator:
(a) Within 6 days after any accident if an injuredemployee is examined or treated by a physician or chiropractor; and
(b) If the injured employee receives additional medicalservices.
2. The Administrator shall review each report todetermine whether the employer is furnishing the accident benefits required by
3. The content and form of the written reports must beprescribed by the Administrator.
(Added to NRS by 1977, 393; A 1981, 1476; 1985,1545)(Substituted in revision for NRS 616.417)
NRS
1. If the Administrator finds that the employer isfurnishing the requirements of accident benefits in such a manner that thereare reasonable grounds for believing that the health, life or recovery of theemployee is being endangered or impaired thereby, or that an employer hasfailed to provide benefits pursuant to NRS616C.265 for which he has made arrangements, the Administrator may, uponapplication of the employee, or upon his own motion, order a change ofphysicians or chiropractors or of any other requirements of accident benefits.
2. If the Administrator orders a change of physiciansor chiropractors or of any other accident benefits, the cost of the change mustbe borne by the insurer.
3. The cause of action of an injured employee againstan employer insured by a private carrier must be assigned to the privatecarrier.
[Part 58:168:1947; 1943 NCL 2680.58](NRS A 1973,602; 1975, 797; 1981, 1168, 1476; 1985, 308, 1545; 1993, 724; 1995, 2027;
NRS
1. Determines incorrectly that a claimed injury didnot arise out of and in the course of the employees employment;
2. Fails to advise an injured employee of his rightsunder chapters 616A to
3. Impedes the determination of disability or benefitsby delaying a needed change of an injured employees physician or chiropractor;
4. Causes an injured employee to file a legal actionto recover any compensation or other medical benefits due him from theemployer;
5. Violates any of his or the Divisions regulationsregarding the provision of accident benefits by employers; or
6. Discriminates against an employee who claimsbenefits under chapters 616A to
(Added to NRS by 1983, 426; A 1985, 1545; 1997, 1438;1999, 225)
NRS
1. If an employer requests a hearing concerning thewithdrawal of approval pursuant to NRS616C.280, the Administrator shall set a date for a hearing within 20 daysafter receiving the request, and shall give the employer at least 10 businessdays notice of the time and place of the hearing.
2. A record of the hearing must be kept, but it neednot be transcribed unless it is requested by the employer and he pays the costof transcription.
3. Within 5 business days after the hearing, theAdministrator shall either affirm or disaffirm the withdrawal of approval andgive the employer written notice thereof by certified mail or electronictransmission.
(Added to NRS by 1983, 427; A 1997, 1438)
CONTESTED CLAIMS
NRS
1. The Chief of the HearingsDivision shall:
(a) Prescribe by regulation the qualifications andtraining required before a person may, pursuant to
(b) Provide for the expediting of the hearing of casesthat involve the termination or denial of compensation.
2. From the cases heard each year by hearing officersand appeals officers regarding claims for benefits by injured employees, theChief of the Hearings Division shall prepare an annual report which itemizes,on the basis of each insurer and third-party administrator, the number of casesaffirmed, reversed, remanded and resolved by other disposition involving thatinsurer or third-party administrator, including a breakdown of that informationby the type of benefits denied by the insurer or third-party administrator.
3. As used in this section, Chief of the HearingsDivision means the Chief of the Hearings Division of the Department ofAdministration.
(Added to NRS by 1991, 2396; A
NRS
1. The Director of the Department of Administrationshall appoint one or more hearing officers to conduct hearings in contestedcases for compensation under chapters 616Ato 617, inclusive, of NRS. Each hearingofficer shall serve at the pleasure of the Director of the Department of Administration.Each hearing officer is entitled to receive an annual salary in an amountprovided by law and is in the unclassified service of the State.
2. If a hearing officer determines that he has apersonal interest or a conflict of interest, directly or indirectly, in anycase which is before him, he shall disqualify himself from hearing the case andthe case must be assigned to another hearing officer.
(Added to NRS by 1993, 669)(Substituted in revisionfor NRS 616.184)
NRS
1. Except as otherwise provided in subsection 3, any personwho is aggrieved by a final determination concerning accident benefits made byan organization for managed care which has contracted with an insurer must,within 14 days of the determination and before requesting a resolution of thedispute pursuant to NRS 616C.345 to
2. The procedure for resolving complaints establishedby the organization for managed care must be informal and must include, but isnot limited to, a review of the appeal by a qualified physician or chiropractorwho did not make or otherwise participate in making the determination.
3. If a person appeals a final determination pursuantto a procedure for resolving complaints established by an organization formanaged care and the dispute is not resolved within 14 days after it issubmitted, he may request a resolution of the dispute pursuant to
(Added to NRS by 1993, 691; A 1993, 2452; 1995, 2149;1999, 2216)
NRS
1. The Chief of the Hearings Division of theDepartment of Administration:
(a) May by regulation provide for specific proceduresfor the determination of contested cases.
(b) Shall develop a format to be used by hearingofficers to indicate their findings in contested cases.
2. An insurer or employer may be represented in acontested case by private legal counsel or by any other agent.
(Added to NRS by 1973, 1596; A 1975, 761; 1977, 1389;1979, 1042; 1985, 50; 1991, 2417)(Substituted in revision for NRS 616.541)
NRS 616C.310
1. The Chief of the Hearings Division of theDepartment of Administration:
(a) May by regulation provide for specific proceduresfor the determination of contested cases.
(b) Shall develop a format to be used by hearingofficers to indicate their findings in contested cases.
(c) Shall adopt regulations to provide for theredaction of personal identifying information of a person filing a claim forcompensation from a document relating to the contested case of the person,unless the identity of the person is at issue. As used in this paragraph,personal identifying information means any information which would identify aperson, including, without limitation, an address, a birth date or a socialsecurity number.
2. An insurer or employer may be represented in acontested case by private legal counsel or by any other agent.
(Added to NRS by 1973, 1596; A 1975, 761; 1977, 1389;1979, 1042; 1985, 50; 1991, 2417;
NRS
1. Any person who is subject to the jurisdiction ofthe hearing officers pursuant to chapters 616Ato 616D, inclusive, or
2. A hearingmust not be scheduled until the following information is provided to thehearing officer:
(a) The nameof:
(1) Theclaimant;
(2) Theemployer; and
(3) Theinsurer or third-party administrator;
(b) The numberof the claim; and
(c) If applicable,a copy of the letter of determination being appealed or, if such a copy isunavailable, the date of the determination and the issues stated in the determination.
3. Except as otherwise provided in
(a) A written determination of an insurer; or
(b) The failure of an insurer to respond within 30 daysto a written request mailed to the insurer by the person who is aggrieved,
may appealfrom the determination or failure to respond by filing a request for a hearingbefore a hearing officer. Such a request must include the information requiredpursuant to subsection 2 and must be filed within 70 days after the date onwhich the notice of the insurers determination was mailed by the insurer orthe unanswered written request was mailed to the insurer, as applicable. Thefailure of an insurer to respond to a written request for a determinationwithin 30 days after receipt of such a request shall be deemed by the hearingofficer to be a denial of the request.
4. Failure to file a request for a hearing within theperiod specified in subsection 3 may be excused if the person aggrieved showsby a preponderance of the evidence that he did not receive the notice of thedetermination and the forms necessary to request a hearing. The claimant oremployer shall notify the insurer of a change of address.
5. The hearing before the hearing officer must beconducted as expeditiously and informally as is practicable.
6. The parties to a contested claim may, if the claimantis represented by legal counsel, agree to forego a hearing before a hearingofficer and submit the contested claim directly to an appeals officer.
(Added to NRS by 1979, 1040; A 1981, 1490; 1983,1294; 1985, 668; 1991, 834, 2417; 1993, 736;
NRS
(Added to NRS by 1979, 1039; A 1993, 737; 1995, 2032)
NRS
1. It is unlawful for any person to represent anemployee before a hearings officer, or in any negotiations, settlements,hearings or other meetings with an insurer concerning the employees claim orpossible claim, unless he is:
(a) Employed full-time by the employees labororganization;
(b) Admitted to practice law in this State;
(c) Employed full-time by and under the supervision ofan attorney admitted to practice law in this State; or
(d) Appearing without compensation on behalf of theemployee.
It isunlawful for any person who is not admitted to practice law in this State torepresent the employee before an appeals officer.
2. It is unlawful for any person to represent anemployer at hearings of contested cases unless that person is:
(a) Employed full-time by the employer or a tradeassociation to which the employer belongs that is not formed solely to providerepresentation at hearings of contested cases;
(b) An employers representative licensed pursuant tosubsection 3 who is not licensed as a third-party administrator;
(c) Admitted to practice law in this State; or
(d) A licensed third-party administrator.
3. The Director of the Department of Administrationshall adopt regulations which include the:
(a) Requirements for licensure of employersrepresentatives, including:
(1) The registration of each representative; and
(2) The filing of a copy of each writtenagreement for the compensation of a representative;
(b) Procedure for such licensure; and
(c) Causes for revocation of such a license, includingany applicable action listed in NRS616D.120 or a violation of this section.
4. Any person who is employed by or contracts with anemployer to represent the employer at hearings regarding contested claims is anagent of the employer. If the employers representative violates any provisionof this chapter or chapter 616A,
5. An employer shall not make the compensation of anyperson representing him contingent in any manner upon the outcome of anycontested claim.
6. The Director of the Department of Administrationshall collect in advance and deposit with the State Treasurer for credit to theState General Fund the following fees for licensure as an employersrepresentative:
(a) Application and license........................................................................................... $78
(b) Triennial renewal of each license............................................................................. 78
(Added to NRS by 1987, 2140; A 1989, 527; 1993, 737,2453, 2458; 1995, 2149; 1999,225)
NRS
1. The hearing officer shall:
(a) Except as otherwise provided in subsection 2 of
(b) Give notice by mail or by personal service to allinterested parties to the hearing at least 15 days before the date and timescheduled; and
(c) Conduct hearings expeditiously and informally.
2. The notice must include a statement that theinjured employee may be represented by a private attorney or seek assistanceand advice from the Nevada Attorney for Injured Workers.
3. If necessary to resolve a medical questionconcerning an injured employees condition or to determine the necessity oftreatment for which authorization for payment has been denied, the hearingofficer may refer the employee to a physician or chiropractor of his choice whohas demonstrated special competence to treat the particular medical conditionof the employee. If the medical question concerns the rating of a permanentdisability, the hearing officer may refer the employee to a rating physician orchiropractor. The rating physician or chiropractor must be selected in rotationfrom the list of qualified physicians and chiropractors maintained by theAdministrator pursuant to subsection 2 of NRS616C.490, unless the insurer and injured employee otherwise agree to arating physician or chiropractor. The insurer shall pay the costs of anymedical examination requested by the hearing officer.
4. If an injured employee has requested payment forthe cost of obtaining a second determination of his percentage of disabilitypursuant to NRS 616C.100, the hearingofficer shall decide whether the determination of the higher percentage ofdisability made pursuant to NRS 616C.100is appropriate and, if so, may order the insurer to pay to the employee anamount equal to the maximum allowable fee established by the Administratorpursuant to NRS 616C.260 for the typeof service performed, or the usual fee of that physician or chiropractor forsuch service, whichever is less.
5. The hearing officer shall order an insurer,organization for managed care or employer who provides accident benefits forinjured employees pursuant to NRS 616C.265to pay to the appropriate person the charges of a provider of health care ifthe conditions of NRS 616C.138 aresatisfied.
6. The hearing officer may allow or forbid thepresence of a court reporter and the use of a tape recorder in a hearing.
7. The hearing officer shall render his decisionwithin 15 days after:
(a) The hearing; or
(b) He receives a copy of the report from the medicalexamination he requested.
8. The hearing officer shall render his decision inthe most efficient format developed by the Chief of the Hearings Division ofthe Department of Administration.
9. The hearing officer shall give notice of hisdecision to each party by mail. He shall include with the notice of hisdecision the necessary forms for appealing from the decision.
10. Except as otherwise provided in
(Added to NRS by 1979, 1040; A 1983, 645; 1985, 669,864, 1547; 1991, 835, 2418; 1993, 738; 1995, 2150;
NRS
(Added to NRS by 1989, 687; A 1989,2002)(Substituted in revision for NRS 616.5418)
NRS
1. The Governor shall appoint one or more appealsofficers to conduct hearings and appeals as required pursuant to
2. Each appeals officer must be an attorney who hasbeen licensed to practice law before all the courts of this State for at least2 years. Except as otherwise provided in NRS7.065, an appeals officer shall not engage in the private practice of law.
3. If an appeals officer determines that he has apersonal interest or a conflict of interest, directly or indirectly, in anycase which is before him, he shall disqualify himself from hearing the case.
4. The Governor may appoint one or more specialappeals officers to conduct hearings and appeals as required pursuant to
5. A special appeals officer appointed pursuant tosubsection 4 is vested with the same powers as a regular appeals officer. Aspecial appeals officer may hear any case in which a regular appeals officerhas a conflict, or any case assigned to him by the senior appeals officer toassist with a backlog of cases. A special appeals officer is entitled to bepaid at an hourly rate, as determined by the Department of Administration.
6. The decision of an appeals officer is the final andbinding administrative determination of a claim for compensation under
(Added to NRS by 1973, 1595; A 1975, 764; 1977, 84,315, 316; 1979, 1055; 1981, 409; 1983, 357, 1010; 1989, 204; 1993, 738; 1997,3234; 2003, 1672,2308)
NRS
1. Any party aggrieved by a decision of the hearingofficer relating to a claim for compensation may appeal from the decision byfiling a notice of appeal with an appeals officer within 30 days after the dateof the decision.
2. A hearing must not be scheduled until the followinginformation is provided to the appeals officer:
(a) The name of:
(1) The claimant;
(2) The employer; and
(3) The insurer or third-party administrator;
(b) The number of the claim; and
(c) If applicable, a copy of the letter ofdetermination being appealed or, if such a copy is unavailable, the date of thedetermination and the issues stated in the determination.
3. If a dispute is required to be submitted to a procedurefor resolving complaints pursuant to NRS616C.305 and:
(a) A final determination was rendered pursuant to thatprocedure; or
(b) The dispute was not resolved pursuant to thatprocedure within 14 days after it was submitted,
any party tothe dispute may file a notice of appeal within 70 days after the date on whichthe final determination was mailed to the employee, or his dependent, or theunanswered request for resolution was submitted. Failure to render a written determinationwithin 30 days after receipt of such a request shall be deemed by the appealsofficer to be a denial of the request.
4. Except as otherwise provided in
5. Except as otherwise provided in subsections 2 and6, within 10 days after receiving a notice of appeal pursuant to this sectionor NRS 616C.220,
(a) Schedule a hearing on the merits of the appeal orcontested claim for a date and time within 90 days after his receipt of thenotice at a place in Carson City, Nevada, or Las Vegas, Nevada, or uponagreement of one or more of the parties to pay all additional costs directlyrelated to an alternative location, at any other place of convenience to theparties, at the discretion of the appeals officer; and
(b) Give notice by mail or by personal service to allparties to the matter and their attorneys or agents at least 30 days before thedate and time scheduled.
6. A request to schedule the hearing for a date andtime which is:
(a) Within 60 days after the receipt of the notice ofappeal or contested claim; or
(b) More than 90 days after the receipt of the noticeor claim,
may besubmitted to the appeals officer only if all parties to the appeal or contestedclaim agree to the request.
7. An appeal or contested claim may be continued uponwritten stipulation of all parties, or upon good cause shown.
8. Failure to file a notice of appeal within theperiod specified in subsection 1 or 3 may be excused if the party aggrievedshows by a preponderance of the evidence that he did not receive the notice ofthe determination and the forms necessary to appeal the determination. Theclaimant, employer or insurer shall notify the hearing officer of a change ofaddress.
(Added to NRS by 1979, 1040; A 1981, 1198; 1983, 358;1985, 50, 669; 1991, 2418; 1993, 739, 2441; 1995, 2151; 1997, 3235;
NRS
1. Any physician or chiropractor who attends anemployee within the provisions of chapters 616Ato 616D, inclusive, or
2. Information gained by the attending physician orchiropractor while in attendance on the injured employee is not a privilegedcommunication if:
(a) Required by an appeals officer for a properunderstanding of the case and a determination of the rights involved; or
(b) The information is related to any fraud that hasbeen or is alleged to have been committed in violation of the provisions ofthis chapter or chapter 616A,
[Part 52:168:1947; 1943 NCL 2680.52](NRS A 1975,763; 1977, 314; 1981, 1197, 1471; 1985, 1543; 1993, 715; 1995, 1872, 2023;1997, 583; 1999, 226)
NRS
(Added to NRS by 1975, 761; A 1977, 84; 1981, 1490;1983, 358; 1993, 740; 1997, 1422;
NRS
1. A stenographic or electronic record must be kept ofthe hearing before the appeals officer and the rules of evidence applicable tocontested cases under chapter 233B of NRSapply to the hearing.
2. The appeals officer must hear any matter raisedbefore him on its merits, including new evidence bearing on the matter.
3. If there is a medical question or disputeconcerning an injured employees condition or concerning the necessity oftreatment for which authorization for payment has been denied, the appealsofficer may:
(a) Refer the employee to a physician or chiropractorof his choice who has demonstrated special competence to treat the particularmedical condition of the employee. If the medical question concerns the ratingof a permanent disability, the appeals officer may refer the employee to arating physician or chiropractor. The rating physician or chiropractor must beselected in rotation from the list of qualified physicians or chiropractorsmaintained by the Administrator pursuant to subsection 2 of
(b) If the medical question or dispute is relevant toan issue involved in the matter before the appeals officer and all partiesagree to the submission of the matter to an external review organization, submitthe matter to an external review organization in accordance with
4. If an injured employee has requested payment forthe cost of obtaining a second determination of his percentage of disabilitypursuant to NRS 616C.100, the appealsofficer shall decide whether the determination of the higher percentage of disabilitymade pursuant to NRS 616C.100 isappropriate and, if so, may order the insurer to pay to the employee an amountequal to the maximum allowable fee established by the Administrator pursuant toNRS 616C.260 for the type of serviceperformed, or the usual fee of that physician or chiropractor for such service,whichever is less.
5. The appeals officer shall order an insurer,organization for managed care or employer who provides accident benefits forinjured employees pursuant to NRS 616C.265to pay to the appropriate person the charges of a provider of health care ifthe conditions of NRS 616C.138 aresatisfied.
6. Any party to the appeal or the appeals officer mayorder a transcript of the record of the hearing at any time before the seventhday after the hearing. The transcript must be filed within 30 days after thedate of the order unless the appeals officer otherwise orders.
7. The appeals officer shall render his decision:
(a) If a transcript is ordered within 7 days after thehearing, within 30 days after the transcript is filed; or
(b) If a transcript has not been ordered, within 30days after the date of the hearing.
8. The appeals officer may affirm, modify or reverseany decision made by the hearing officer and issue any necessary and properorder to give effect to his decision.
(Added to NRS by 1979, 1040; A 1987, 92; 1991, 2419;1993, 740; 1999, 1786,2219;
NRS
1. Not later than 5 business days after the date thatan external review organization receives a request for an external review, theexternal review organization shall:
(a) Review the documents and materials submitted forthe external review; and
(b) Notify the injured employee, his employer and theinsurer whether the external review organization needs any additionalinformation to conduct the external review.
2. The external review organization shall render adecision on the matter not later than 15 business days after the date that itreceives all information that is necessary to conduct the external review.
3. In conducting the external review, the externalreview organization shall consider, without limitation:
(a) The medical records of the insured;
(b) Any recommendations of the physician of theinsured; and
(c) Any other information approved by the Commissionerfor consideration by an external review organization.
4. In its decision, the external review organizationshall specify the reasons for its decision. The external review organizationshall submit a copy of its decision to:
(a) The injured employee;
(b) The employer;
(c) The insurer; and
(d) The appeals officer, if any.
5. The insurer shall pay the costs of the services providedby the external review organization.
6. The Commissioner may adopt regulations to governthe process of external review and to carry out the provisions of this section.Any regulations adopted pursuant to this section must provide that:
(a) All parties must agree to the submission of amatter to an external review organization before a request for external reviewmay be submitted;
(b) A party may not be ordered to submit a matter to anexternal review organization; and
(c) The findings and decisions of an external revieworganization are not binding.
(Added to NRS by
NRS
1. If an employer or insurer requests a hearing beforea hearing officer or appeals officer relating to a claim for compensation, andthe hearing results in a decision favorable to the employee, the employee isentitled to receive reimbursement from the insurer for:
(a) His actual expenses necessarily incurred for travelto and from the hearing, if he is required to travel more than 20 miles one wayfrom his residence or place of employment to the hearing; and
(b) Any regular wages lost as a result of his attendingthe hearing.
2. The Division shall adopt regulations governing theprocedure and forms to be used for the reimbursement provided by subsection 1.
(Added to NRS by 1985, 1575; A 1993,1870)(Substituted in revision for NRS 616.5428)
1. No judicial proceedings may be instituted forcompensation for an injury or death under chapters616A to 616D, inclusive, of NRS unless:
(a) A claim for compensation is filed as provided in
(b) A final decision of an appeals officer has beenrendered on such claim.
2. Judicial proceedings instituted for compensationfor an injury or death, under chapters 616Ato 616D, inclusive, of NRS are limited tojudicial review of the decision of an appeals officer.
(Added to NRS by 1973, 1596; A 1977, 84, 315, 317;1993, 740)(Substituted in revision for NRS 616.543)
NRS
(Added to NRS by 1991, 2394)(Substituted in revisionfor NRS 616.5433)
NRS
1. If a hearing officer, appeals officer or districtcourt renders a decision on a claim for compensation and the insurer oremployer appeals that decision, but is unable to obtain a stay of the decision:
(a) Payment of that portion of an award for a permanentpartial disability which is contested must be made in installment paymentsuntil the claim reaches final resolution.
(b) Payment of the award must be made in monthlyinstallments of 66 2/3 percent of the average wage of the claimant until theclaim reaches final resolution if the claim is for more than 3 months of pastbenefits for a temporary total disability or rehabilitation, or for a paymentin lump sum related to past benefits for rehabilitation, such as costs forpurchasing a business or equipment.
2. If the final resolution of the claim is in favor ofthe claimant, the remaining amount of compensation to which the claimant isentitled may be paid in a lump sum if the claimant is otherwise eligible forsuch a payment pursuant to NRS 616C.495and any regulations adopted pursuant thereto. If the final resolution of theclaim is in favor of the insurer or employer, any amount paid to the claimantin excess of the uncontested amount must be deducted from any future benefitsrelated to that claim, other than medical benefits, to which the claimant isentitled. The deductions must be made in a reasonable manner so as not tocreate an undue hardship to the claimant.
(Added to NRS by 1989, 687; A 1995,2152)(Substituted in revision for NRS 616.5435)
NRS
(Added to NRS by 1975, 761; A 1977, 316; 1983, 358;1993, 741; 1999, 1728)
NRS
1. If an application to reopen a claim to increase orrearrange compensation is made in writing more than 1 year after the date onwhich the claim was closed, the insurer shall reopen the claim if:
(a) A change of circumstances warrants an increase orrearrangement of compensation during the life of the claimant;
(b) The primary cause of the change of circumstances isthe injury for which the claim was originally made; and
(c) The application is accompanied by the certificateof a physician or a chiropractor showing a change of circumstances which wouldwarrant an increase or rearrangement of compensation.
2. After a claim has been closed, the insurer, uponreceiving an application and for good cause shown, may authorize the reopeningof the claim for medical investigation only. The application must beaccompanied by a written request for treatment from the physician orchiropractor treating the claimant, certifying that the treatment is indicatedby a change in circumstances and is related to the industrial injury sustainedby the claimant.
3. If a claimant applies for a claim to be reopenedpursuant to subsection 1 or 2 and a final determination denying the reopeningis issued, the claimant shall not reapply to reopen the claim until at least 1year after the date on which the final determination is issued.
4. Except as otherwise provided in subsection 5, if anapplication to reopen a claim is made in writing within 1 year after the dateon which the claim was closed, the insurer shall reopen the claim only if:
(a) The application is supported by medical evidencedemonstrating an objective change in the medical condition of the claimant; and
(b) There is clear and convincing evidence that theprimary cause of the change of circumstances is the injury for which the claimwas originally made.
5. An application to reopen a claim must be made inwriting within 1 year after the date on which the claim was closed if:
(a) The claimant was not off work as a result of theinjury; and
(b) The claimant did not receive benefits for apermanent partial disability.
If anapplication to reopen a claim to increase or rearrange compensation is madepursuant to this subsection, the insurer shall reopen the claim if therequirements set forth in paragraphs (a), (b) and (c) of subsection 1 are met.
6. If an employees claim is reopened pursuant to thissection, he is not entitled to vocational rehabilitation services or benefitsfor a temporary total disability if, before his claim was reopened, he:
(a) Retired; or
(b) Otherwise voluntarily removed himself from theworkforce,
for reasonsunrelated to the injury for which the claim was originally made.
7. One year after the date on which the claim wasclosed, an insurer may dispose of the file of a claim authorized to be reopenedpursuant to subsection 5, unless an application to reopen the claim has beenfiled pursuant to that subsection.
8. An increase or rearrangement of compensation is noteffective before an application for reopening a claim is made unless good causeis shown. The insurer shall, upon good cause shown, allow the cost of emergencytreatment the necessity for which has been certified by a physician or achiropractor.
9. A claim that closes pursuant to subsection 2 of
10. The provisions of this section apply to any claimfor which an application to reopen the claim or to increase or rearrangecompensation is made pursuant to this section, regardless of the date of theinjury or accident to the claimant. If a claim is reopened pursuant to thissection, the amount of any compensation or benefits provided must be determinedin accordance with the provisions of NRS616C.425.
[56:168:1947; 1943 NCL 2680.56] + [57:168:1947;1943 NCL 2680.57](NRS A 1971, 770; 1981, 1198, 1831; 1983, 285, 1294; 1985,1547; 1993, 741, 2441; 1995, 2152;
NRS
1. An insurer shall reopen a claim to consider thepayment of compensation for a permanent partial disability if:
(a) The claim was closed and the claimant was notscheduled for an evaluation of the injury in accordance with
(b) The claimant demonstrates by a preponderance of theevidence that, at the time that the case was closed, the claimant was, becauseof the injury, qualified to be scheduled for an evaluation for a permanentpartial disability; and
(c) The insurer has violated a provision of
2. The demonstration required pursuant toparagraph (b) of subsection 1 must be made with documentation that existed atthe time that the case was closed.
3. Notwithstanding any specific statutory provision tothe contrary, the consideration of whether a claimant is entitled to payment ofcompensation for a permanent partial disability for a claim that is reopenedpursuant to this section must be made in accordance with the provisions of theapplicable statutory and regulatory provisions that existed on the date onwhich the claim was closed, including, without limitation, using the edition ofthe American Medical Associations Guides to the Evaluation of PermanentImpairment as adopted by the Division pursuant to
(Added to NRS by
COMPENSATION FOR INJURIES AND DEATH
General Provisions
NRS
1. Temporary compensation benefits must not be paid underchapters 616A to
2. The period prescribed in this section does notapply to:
(a) Accident benefits, whether they are furnishedpursuant to NRS 616C.255 or
(b) Compensation paid to the injured employee pursuantto subsection 1 of NRS 616C.477.
[69:168:1947; 1943 NCL 2680.69](NRS A 1975, 254;1987, 922; 2005, 101)
NRS
1. A permanent total disability is not entitled tocompensation for permanent partial disability during the period when he isreceiving compensation for the permanent total disability.
2. A temporary total disability is not entitled tocompensation for a permanent partial disability during the period of temporarytotal disability.
3. A temporary partial disability is not entitled tocompensation for a permanent partial disability during the period of temporarypartial disability.
(Added to NRS by 1983, 431; A 1995,2159)(Substituted in revision for NRS 616.613)
NRS
1. An insurer shall not issue a check pursuant to theprovisions of chapters 616A to
2. An insurer may issue a check pursuant to theprovisions of chapters 616A to
3. If an insurer issues a check that includes arestrictive endorsement pursuant to subsection 2, the restrictive endorsementmust:
(a) Clearly and accurately state the restrictiveconditions; and
(b) Not provide for any condition or restriction notauthorized under the provisions of chapters 616Ato 616D, inclusive, or
(Added to NRS by
NRS
[65:168:1947; A 1949, 659; 1943 NCL 2680.65](NRS A1959, 204; 1966, 48; 1967, 691; 1971, 320; 1973, 535; 1975, 607; 1981, 1172,1497; 1983, 430, 646; 1987, 1466; 1989, 688; 1991, 2426; 1993,754)(Substituted in revision for NRS 616.620)
NRS
1. An insurer may purchase an annuity to ensure thepayment of a claim filed with the insurer pursuant to
2. The Commissioner shall adopt such regulations asare necessary to carry out the provisions of this section.
(Added to NRS by 1997, 1425)
NRS
1. Every injured employee, widow, widower ordependent, within the provisions of chapters616A to 616D, inclusive, of NRS, isentitled to receive from a qualified employee of the insurer an explanation ofthe various alternatives implicit in lump-sum compensation or other settlementpursuant to those chapters and the long-range effects of a determination madeas to one or the other kind of settlement.
2. The insurer shall provide a written explanation ofthe alternatives pursuant to subsection 1.
3. Upon selecting an alternative, the injuredemployee, widow, widower or dependent shall provide his selection in writing tothe insurer.
(Added to NRS by 1971, 770; A 1981, 1497; 1991,2426)(Substituted in revision for NRS 616.623)
NRS
(Added to NRS by 1981, 1196; A 1981, 1829; 1983,1296)(Substituted in revision for NRS 616.624)
NRS
1. The amount of compensation and benefits and theperson or persons entitled thereto must be determined as of the date of theaccident or injury to the employee, and their rights thereto become fixed as ofthat date.
2. If the employee incurs a subsequent injury ordisability that primarily arises from a previous accident or injury that aroseout of and in the course of his employment, the date of the previous accidentor injury must be used to determine the amount of compensation and benefits towhich the claimant is entitled.
[Part 59:168:1947; A 1949, 659; 1951, 485; 1953, 292;1955, 901](NRS A 1961, 278; 1963, 1146; 1971, 321; 1981, 1226; 1985, 1461;1993, 754; 1995, 2160)(Substituted in revision for NRS 616.625)
NRS
1. If an employee who is entitled to compensationunder chapters 616A to
2. This section must not be applied to reduce theemployees compensation under chapters 616Ato 616D, inclusive, of NRS to any greaterextent than his federal benefits would have otherwise been reduced by theSocial Security Administration under section 224 of the Social Security Act, asamended (42 U.S.C. 424a). After any reduction pursuant to this section, thecombination of his state compensation and federal benefits must be at least asmuch as the greater of:
(a) The benefits payable pursuant to
(b) The benefits payable under the Social Security Act(without any reduction).
3. After a reduced amount of compensation for anemployee has been established pursuant to this section, no further reduction inhis compensation may be made because he receives an increase in his benefitsunder the Social Security Act as the result of an adjustment based on anincrease in the cost of living.
4. No compensation may be reduced pursuant to thissection until the Social Security Administration has determined the amount of benefitspayable to the employee under section 202 or 223 of the Social Security Act andhe has begun to receive those benefits.
5. If an employee:
(a) Fails to report the amount of benefits which he isreceiving under section 202 or 223 of the Social Security Act, within 30 daysafter he is requested in writing by the insurer to make that report; or
(b) Fails to provide the insurer with a writtenauthorization for the Social Security Administration to release information onthe employees average current earnings and the amount of benefits to which heis entitled, within 30 days after he is requested to provide thatauthorization,
the insurermay reduce by 50 percent the compensation which the employee would otherwisereceive pursuant to chapters 616A to
6. If the provisions of section 224 of the SocialSecurity Act are amended:
(a) To allow an employee to receive more compensationunder chapters 616A to
(b) To lower the maximum sum of compensation payableunder chapters 616A to
the reductionimposed by this section must be increased or decreased correspondingly.
7. No reduction in compensation may be made under thissection for any period of entitlement which:
(a) Occurs before January 1, 1982;
(b) Occurs before the employee has been given a writtennotice by mail of the intended reduction; or
(c) Includes any week after the week in which theemployee becomes 62 years of age.
(Added to NRS by 1981, 1224; A 1981,1538)(Substituted in revision for NRS 616.6285)
Permanent Total Disability
NRS
1. In cases of the following specified injuries, inthe absence of proof to the contrary, the disability caused thereby shall bedeemed total and permanent:
(a) The total and permanent loss of sight of both eyes.
(b) The loss by separation of both legs at or above theknee.
(c) The loss by separation of both arms at or above theelbow.
(d) An injury to the spine resulting in permanent andcomplete paralysis of both legs or both arms, or one leg and one arm.
(e) An injury to the skull resulting in incurableimbecility or insanity.
(f) The loss by separation of one arm at or above theelbow, and one leg by separation at or above the knee.
2. The enumeration in subsection 1 is not exclusive,and in all other cases permanent total disability must be determined by theinsurer in accordance with the facts presented.
[60:168:1947; 1943 NCL 2680.60](NRS A 1981,1492)(Substituted in revision for NRS 616.575)
NRS
1. Except as otherwise provided in this section and
(a) In cases of total disability adjudged to bepermanent, compensation per month of 66 2/3 percent of the average monthlywage.
(b) If there is a previous disability, as the loss ofone eye, one hand, one foot or any other previous permanent disability, thepercentage of disability for a subsequent injury must be determined bycomputing the percentage of the entire disability and deducting therefrom thepercentage of the previous disability as it existed at the time of the subsequentinjury, but such a deduction for a previous award for permanent partialdisability must be made in a reasonable manner and must not be more than thetotal amount which was paid for the previous award for permanent partialdisability. The total amount of the allowable deduction includes, withoutlimitation, compensation for a permanent partial disability that was deductedfrom:
(1) Any compensation the employee received for atemporary total disability; or
(2) Any other compensation received by the employee.
(c) If the character of the injury is such as to renderthe employee so physically helpless as to require the service of a constantattendant, an additional allowance may be made so long as such requirementscontinue, but the allowance may not be made while the employee is receivingbenefits for care in a hospital or facility for intermediate care pursuant tothe provisions of NRS 616C.265.
2. Except as otherwise provided in
3. An employee is entitled to receive compensation fora permanent total disability only so long as the permanent total disabilitycontinues to exist. The insurer has the burden of proving that the permanenttotal disability no longer exists.
4. If an employee who has received compensation in alump sum for a permanent partial disability pursuant to
(a) Unless the employee submits a request described inparagraph (b), deduct from the compensation for the permanent total disabilityan amount that is not more than 10 percent of the rate of compensation for apermanent total disability until the actual amount of the lump sum paid to theemployee for the permanent partial disability is recovered; or
(b) Upon the request of the employee, accept in asingle payment from the employee an amount that is equal to the actual amountof the lump sum paid to the employee for the permanent partial disability, lessthe actual amount of all deductions made to date by the insurer from theemployee for repayment of the lump sum.
[Part 59:168:1947; A 1949, 659; 1951, 485; 1953, 292;1955, 901](NRS A 1959, 614; 1961, 278; 1965, 319; 1966, 42; 1969, 472; 1971,322; 1973, 530; 1985, 1765; 1993, 746; 1995, 2154; 1997, 3347;
NRS
(Added to NRS by 1973, 598; A 1979, 1057; 1981, 1170,1493)(Substituted in revision for NRS 616.583)
NRS
1. An insurer that makes payments of compensation toan injured employee for a permanent total disability shall provide to theinjured employee an annual accounting in the form of a letter that sets forthwith respect to the payments:
(a) The total amount of the compensation for thepermanent total disability that the injured employee is entitled to receive,before any deductions are made;
(b) The net amount of the current payment for thecompensation;
(c) The amount of any deduction that is made againstthe total amount of the compensation, if any; and
(d) If a deduction is being made against the totalamount of the compensation to repay any previous awards of compensation for apermanent partial disability:
(1) The amount of the deduction;
(2) The claim number for each of those awards;and
(3) The balance of each of those awards.
2. An injured employee may request in writingfrom the insurer an accounting described in subsection 1. The accounting mustcover the period from the date on which the most recent annual accounting wasprovided to the injured employee pursuant to subsection 1 to the date on whichthe written request is made. The insurer shall provide the accounting to theinjured employee not later than 30 days after receiving the written request forthe accounting from the injured employee. Any accounting provided by an insurerto an injured employee pursuant to this subsection must be provided in additionto, and not in lieu of, the annual accountings required pursuant to subsection1.
(Added to NRS by
NRS
1. An injured employee or the dependents of an injuredemployee who are entitled to receive compensation for a permanent totaldisability pursuant to NRS 616C.440 ora death benefit pursuant to NRS 616C.505for an industrial injury or occupational disease which occurred before July 1,1980, are entitled to receive compensation of not less than $600 each month. Ifthe compensation is to be received by the dependents of an injured employee, itmust be divided amongst them as provided in chapters616A to 616D, inclusive, of NRS.
2. A self-insured employer or an association ofself-insured public or private employers shall provide for the increase inmonthly compensation required by subsection 1 for each person who would beentitled to receive the increase if the provisions of this section were applicableto the employer or association.
3. A person who is entitled to receive an increase inhis monthly compensation pursuant to subsection 1 is not required to acceptthat increase.
4. The Administrator shall adopt regulations to carryout the provisions of this section.
(Added to NRS by 1991, 1946; A 1993, 754, 2444, 2454;1995, 2160)(Substituted in revision for NRS 616.6283)
NRS
1. If a claimant or a dependent of a claimant isentitled to receive compensation pursuant to chapters616A to 617, inclusive, of NRS for apermanent total disability and the claimant or dependent is not entitled to anannual increase in that compensation pursuant to
2. Each year, the Administrator shall withdraw fromthe Uninsured Employers Claim Account established pursuant to
3. The Administrator shall adopt regulationsestablishing a method for the equitable distribution of the money withdrawnfrom the Account pursuant to subsection 2. The regulations must provide forpayments that result in the largest proportional share of the money being paidto claimants and dependents who receive the lowest amount of compensationpursuant to chapters 616A to
4. The Administrator shall make the payment requiredby this section to each claimant and dependent of the claimant who is entitledto the payment not later than October 1 of each year. Any payment received bythe claimant or dependent of the claimant pursuant to this section is inaddition to any compensation to which the claimant or dependent of the claimantis otherwise entitled by law.
(Added to NRS by
NRS
1. Any claimant or dependent of a claimant who residesin this State and receives compensation for a permanent total disability causedby an industrial injury or a disablement from an occupational disease whichoccurred before April 9, 1971, is entitled to a 65 percent increase in thatcompensation, without regard to any limitation on wages imposed by
2. The increase must be paid from the account forpensions for silicosis, diseases related to asbestos and other disabilities.
(Added to NRS by 1973, 538; A 1975, 823; 1979, 1520;1981, 1226; 1985, 723; 1987, 589; 1991, 1802)(Substituted in revision for NRS616.626)
NRS
(Added to NRS by 1985, 1460)(Substituted in revisionfor NRS 616.6261)
NRS
1. Any claimant or dependent of a claimant who isreceiving compensation pursuant to chapters 616Ato 616D, inclusive, of NRS for a permanenttotal disability but is not entitled:
(a) To an increase in that compensation pursuant to
(b) To any disability income benefits from the federalsocial security system,
is entitledto an increase in that compensation by the same percentage as the increase inthe state average monthly wage from the date of the claimants disablingaccident or disease or from July 1, 1973, whichever is later, to July 1, 1980.
2. The increase provided by this section must not bepaid for any period before July 1, 1981.
(Added to NRS by 1981, 1224)(Substituted in revisionfor NRS 616.6262)
NRS
1. Any claimant who is not entitled to an increasepursuant to NRS 616C.465 and whoreceives less in disability benefits from the federal social security systemand pursuant to chapters 616A to
(a) The increase provided pursuant to
(b) The difference between the amount of benefits he isreceiving and 80 percent of the average current earnings,
whichever isless.
2. The increase provided by this section must not bepaid for any period before July 1, 1981.
(Added to NRS by 1981, 1224)(Substituted in revisionfor NRS 616.6264)
NRS
1. If a claimant or a dependent of a claimant isentitled to receive compensation pursuant to chapters616A to 617, inclusive, of NRS for apermanent total disability caused by an industrial injury or a disablement froman occupational disease that occurs on or after January 1, 2004, the claimantor dependent is entitled to an annual increase in that compensation in theamount of 2.3 percent. The compensation must be increased pursuant to thissection:
(a) On January 1 of the year immediately after the yearin which the claimant or dependent becomes entitled to receive thatcompensation; and
(b) On January 1 of each successive year after the yearspecified in paragraph (a) in which the claimant or dependent is entitled toreceive that compensation.
2. Any increase in compensation provided pursuant tothis section is in addition to any increase in compensation to which a claimantor a dependent of a claimant is otherwise entitled by law.
(Added to NRS by
Temporary Total Disability
NRS
1. Except as otherwise provided in this section,
2. Except as otherwise provided in
3. If a claim for the period of temporary totaldisability is allowed, the first payment pursuant to this section must beissued by the insurer within 14 working days after receipt of the initialcertification of disability and regularly thereafter.
4. Any increase in compensation and benefits effectedby the amendment of subsection 1 is not retroactive.
5. Payments for a temporary total disability mustcease when:
(a) A physician or chiropractor determines that theemployee is physically capable of any gainful employment for which the employeeis suited, after giving consideration to the employees education, training andexperience;
(b) The employer offers the employee light-dutyemployment or employment that is modified according to the limitations orrestrictions imposed by a physician or chiropractor pursuant to subsection 7;or
(c) Except as otherwise provided in
6. Each insurer may, with each check that it issues toan injured employee for a temporary total disability, include a form approvedby the Division for the injured employee to request continued compensation forthe temporary total disability.
7. A certification of disability issued by a physicianor chiropractor must:
(a) Include the period of disability and a descriptionof any physical limitations or restrictions imposed upon the work of theemployee;
(b) Specify whether the limitations or restrictions arepermanent or temporary; and
(c) Be signed by the treating physician or chiropractorauthorized pursuant to NRS 616B.527 orappropriately chosen pursuant to subsection 3 of
8. If the certification of disability specifies thatthe physical limitations or restrictions are temporary, the employer of theemployee at the time of his accident may offer temporary, light-duty employmentto the employee. If the employer makes such an offer, the employer shallconfirm the offer in writing within 10 days after making the offer. The making,acceptance or rejection of an offer of temporary, light-duty employmentpursuant to this subsection does not affect the eligibility of the employee toreceive vocational rehabilitation services, including compensation, and doesnot exempt the employer from complying with NRS616C.545 to 616C.575, inclusive,and 616C.590 or the regulationsadopted by the Division governing vocational rehabilitation services. Any offerof temporary, light-duty employment made by the employer must specify aposition that:
(a) Is substantially similar to the employees positionat the time of his injury in relation to the location of the employment and thehours he is required to work;
(b) Provides a gross wage that is:
(1) If the position is in the sameclassification of employment, equal to the gross wage the employee was earningat the time of his injury; or
(2) If the position is not in the sameclassification of employment, substantially similar to the gross wage theemployee was earning at the time of his injury; and
(c) Has the same employment benefits as the position ofthe employee at the time of his injury.
[Part 59:168:1947; A 1949, 659; 1951, 485; 1953, 292;1955, 901](NRS A 1957, 72; 1959, 201; 1963, 837; 1965, 226; 1966, 43; 1969,472; 1971, 322; 1973, 531; 1975, 253; 1983, 1295; 1985, 1548; 1991, 2422; 1993,747, 1870, 2442; 1995, 579, 2155; 1997, 3348;
NRS
1. Except as otherwise provided in subsection 2, inaddition to any other benefits an injured employee is entitled to receivepursuant to chapters 616A to
2. The provisions of subsection 1 do not apply to aninjured employee who is paid his regular hourly rate of pay by his employer foreach hour he is absent from the place of employment to receive such medicaltreatment.
3. An employer may not require an injured employee touse sick leave, annual leave, compensatory leave or any other personal leavefor his absence from the place of employment to receive medical treatment forhis injury after he returns to work. The provisions of this subsection applywhether the injured employee is being paid compensation pursuant to subsection1 or his regular hourly rate of pay pursuant to subsection 2.
4. TheAdministrator shall adopt regulations to carry out the provisions of thissection, including, without limitation, regulations which establish:
(a) The documentation which an injured employee oremployer is required to submit for the payment of compensation to the injuredemployee pursuant to subsection 1;
(b) The method for determining the amount ofcompensation to be paid to the injured employee pursuant to subsection 1; and
(c) A definition of place of employment as that termis used in this section.
(Added to NRS by
NRS
(Added to NRS by 1983, 647)(Substituted in revisionfor NRS 616.587)
Permanent and Temporary Partial Disabilities
NRS
[Part 64:168:1947; A 1951, 485](NRS A 1989,333)(Substituted in revision for NRS 616.595)
NRS
1. Except as otherwise provided in
2. Within 30 days after receiving from a physician orchiropractor a report indicating that the injured employee may have suffered apermanent disability and is stable and ratable, the insurer shall schedule anappointment with the rating physician or chiropractor selected pursuant to thissubsection to determine the extent of the employees disability. Unless theinsurer and the injured employee otherwise agree to a rating physician or chiropractor:
(a) The insurer shall select the rating physician orchiropractor from the list of qualified rating physicians and chiropractorsdesignated by the Administrator, to determine the percentage of disability inaccordance with the American Medical Associations Guides to the Evaluationof Permanent Impairment as adopted and supplemented by the Divisionpursuant to NRS 616C.110.
(b) Rating physicians and chiropractors must be selectedin rotation from the list of qualified physicians and chiropractors designatedby the Administrator, according to their area of specialization and the orderin which their names appear on the list unless the next physician orchiropractor is currently an employee of the insurer making the selection, inwhich case the insurer must select the physician or chiropractor who is next onthe list and who is not currently an employee of the insurer.
3. If an insurer contacts the treating physician orchiropractor to determine whether an injured employee has suffered a permanentdisability, the insurer shall deliver to the treating physician or chiropractorthat portion or a summary of that portion of the American Medical AssociationsGuides to the Evaluation of Permanent Impairment as adopted by theDivision pursuant to NRS 616C.110 thatis relevant to the type of injury incurred by the employee.
4. At the request of the insurer, the injured employeeshall, before an evaluation by a rating physician or chiropractor is performed,notify the insurer of:
(a) Any previous evaluations performed to determine theextent of any of the employees disabilities; and
(b) Any previous injury, disease or condition sustainedby the employee which is relevant to the evaluation performed pursuant to thissection.
The noticemust be on a form approved by the Administrator and provided to the injuredemployee by the insurer at the time of the insurers request.
5. Unless the regulations adopted pursuant to
6. The rating physician or chiropractor shall providethe insurer with his evaluation of the injured employee. After receiving theevaluation, the insurer shall, within 14 days, provide the employee with a copyof the evaluation and notify the employee:
(a) Of the compensation to which he is entitledpursuant to this section; or
(b) That he is not entitled to benefits for permanentpartial disability.
7. Each 1 percent of impairment of the whole man mustbe compensated by a monthly payment:
(a) Of 0.5 percent of the claimants average monthlywage for injuries sustained before July 1, 1981;
(b) Of 0.6 percent of the claimants average monthlywage for injuries sustained on or after July 1, 1981, and before June 18, 1993;
(c) Of 0.54 percent of the claimants average monthlywage for injuries sustained on or after June 18, 1993, and before January 1,2000; and
(d) Of 0.6 percent of the claimants average monthlywage for injuries sustained on or after January 1, 2000.
Compensationmust commence on the date of the injury or the day following the termination oftemporary disability compensation, if any, whichever is later, and mustcontinue on a monthly basis for 5 years or until the claimant is 70 years ofage, whichever is later.
8. Compensation benefits may be paid annually toclaimants who will be receiving less than $100 a month.
9. Where there is a previous disability, as the lossof one eye, one hand, one foot, or any other previous permanent disability, thepercentage of disability for a subsequent injury must be determined bycomputing the percentage of the entire disability and deducting therefrom thepercentage of the previous disability as it existed at the time of thesubsequent injury.
10. The Division may adopt schedules for rating permanentdisabilities resulting from injuries sustained before July 1, 1973, andreasonable regulations to carry out the provisions of this section.
11. The increase in compensation and benefits effectedby the amendment of this section is not retroactive for accidents whichoccurred before July 1, 1973.
12. This section does not entitle any person to doublepayments for the death of an employee and a continuation of payments for apermanent partial disability, or to a greater sum in the aggregate than if theinjury had been fatal.
[63:168:1947; A 1949, 659; 1953, 292](NRS A 1959,204; 1966, 46; 1967, 691; 1969, 475; 1971, 326; 1973, 531; 1975, 605; 1977,1006; 1979, 1057; 1981, 1170, 1493, 1653; 1983, 428, 1295; 1985, 308, 374;1987, 78; 1991, 493, 2423, 2424; 1993, 748, 1871; 1995, 579, 2156;
NRS
1. Except as otherwise provided in
(a) A claimant injured on or after July 1, 1973, andbefore July 1, 1981, who incurs a disability that does not exceed 12 percentmay elect to receive his compensation in a lump sum. A claimant injured on orafter July 1, 1981, and before July 1, 1995, who incurs a disability that doesnot exceed 25 percent may elect to receive his compensation in a lump sum.
(b) The spouse, or in the absence of a spouse, anydependent child of a deceased claimant injured on or after July 1, 1973, who isnot entitled to compensation in accordance with
(c) Any claimant injured on or after July 1, 1981, andbefore July 1, 1995, who incurs a disability that exceeds 25 percent may electto receive his compensation in a lump sum equal to the present value of anaward for a disability of 25 percent. If the claimant elects to receivecompensation pursuant to this paragraph, the insurer shall pay in installmentsto the claimant that portion of the claimants disability in excess of 25percent.
(d) Any claimant injured on or after July 1, 1995, mayelect to receive his compensation in a lump sum in accordance with regulationsadopted by the Administrator and approved by the Governor. The Administratorshall adopt regulations for determining the eligibility of such a claimant toreceive all or any portion of his compensation in a lump sum. Such regulationsmay include the manner in which an award for a permanent partial disability maybe paid to such a claimant in installments. Notwithstanding the provisions of
2. If the claimant elects to receive his payment for apermanent partial disability in a lump sum pursuant to subsection 1, all of hisbenefits for compensation terminate. His acceptance of that payment constitutesa final settlement of all factual and legal issues in the case. By so acceptinghe waives all of his rights regarding the claim, including the right to appealfrom the closure of the case or the percentage of his disability, except:
(a) His right to:
(1) Reopen his claim in accordance with theprovisions of NRS 616C.390; or
(2) Have his claim considered by his insurerpursuant to NRS 616C.392;
(b) Any counseling, training or other rehabilitativeservices provided by the insurer; and
(c) His right to receive a benefit penalty inaccordance with NRS 616D.120.
The claimantmust be advised in writing of the provisions of this subsection when he demandshis payment in a lump sum, and has 20 days after the mailing or personaldelivery of the notice within which to retract or reaffirm his demand, beforepayment may be made and his election becomes final.
3. Any lump-sum payment which has been paid on a claimincurred on or after July 1, 1973, must be supplemented if necessary to conformto the provisions of this section.
4. Except as otherwise provided in this subsection,the total lump-sum payment for disablement must not be less than one-half theproduct of the average monthly wage multiplied by the percentage of disability.If the claimant received compensation in installment payments for his permanentpartial disability before electing to receive his payment for that disabilityin a lump sum, the lump-sum payment must be calculated for the remainingpayment of compensation.
5. The lump sum payable must be equal to the presentvalue of the compensation awarded, less any advance payment or lump sumpreviously paid. The present value must be calculated using monthly payments inthe amounts prescribed in subsection 7 of NRS616C.490 and actuarial annuity tables adopted by the Division. The tablesmust be reviewed annually by a consulting actuary.
6. If a claimant would receive more money by electingto receive compensation in a lump sum than he would if he receives installmentpayments, he may elect to receive the lump-sum payment.
(Added to NRS by 1983, 430; A 1983, 646, 1296; 1987,1465; 1989, 687, 1162, 2001,2002; 1991, 493, 2425; 1993, 749, 1872; 1995, 579, 2157;
NRS
1. Except as otherwise provided in subsection 2 and
2. Except as otherwise provided in
[61:168:1947; A 1953, 292](NRS A 1967, 878; 1973,533; 1993, 751; 1997, 3349)
Death Benefits
NRS
1. In addition to any other compensation payablepursuant to chapters 616A to
2. To the surviving spouse of the deceased employee,66 2/3 percent of the average monthly wage is payable until his death orremarriage, with 2 years compensation payable in one lump sum upon remarriage.
3. In the event of the subsequent death of thesurviving spouse:
(a) Each surviving child of the deceased employee mustshare equally the compensation theretofore paid to the surviving spouse but notin excess thereof, and it is payable until the youngest child reaches the ageof 18 years.
(b) Except as otherwise provided in subsection 11, ifthe children have a guardian, the compensation they are entitled to receive maybe paid to the guardian.
4. Upon the remarriage of a surviving spouse withchildren:
(a) The surviving spouse must be paid 2 yearscompensation in one lump sum and further benefits must cease; and
(b) Each child must be paid 15 percent of the averagemonthly wage, up to a maximum family benefit of 66 2/3 percent of the averagemonthly wage.
5. If there are any surviving children of the deceasedemployee under the age of 18 years, but no surviving spouse, then each suchchild is entitled to his proportionate share of 66 2/3 percent of the averagemonthly wage for his support.
6. Except as otherwise provided in subsection 7, ifthere is no surviving spouse or child under the age of 18 years, there must bepaid:
(a) To a parent, if wholly dependent for support uponthe deceased employee at the time of the injury causing his death, 33 1/3percent of the average monthly wage.
(b) To both parents, if wholly dependent for supportupon the deceased employee at the time of the injury causing his death, 66 2/3percent of the average monthly wage.
(c) To each brother or sister until he or she reachesthe age of 18 years, if wholly dependent for support upon the deceased employeeat the time of the injury causing his death, his proportionate share of 66 2/3percent of the average monthly wage.
7. The aggregate compensation payable pursuant tosubsection 6 must not exceed 66 2/3 percent of the average monthly wage.
8. In all other cases involving a question of total orpartial dependency:
(a) The extent of the dependency must be determined inaccordance with the facts existing at the time of the injury.
(b) If the deceased employee leaves dependents onlypartially dependent upon his earnings for support at the time of the injurycausing his death, the monthly compensation to be paid must be equal to thesame proportion of the monthly payments for the benefit of persons totallydependent as the amount contributed by the deceased employee to the partialdependents bears to the average monthly wage of the deceased employee at thetime of the injury resulting in his death.
(c) The duration of compensation to partial dependentsmust be fixed in accordance with the facts shown, but may not exceedcompensation for 100 months.
9. Compensation payable to a surviving spouse is forthe use and benefit of the surviving spouse and the dependent children, and theinsurer may, from time to time, apportion such compensation between them insuch a way as it deems best for the interest of all dependents.
10. In the event of the death of any dependentspecified in this section before the expiration of the time during whichcompensation is payable to him, funeral expenses are payable in an amount notto exceed $5,000.
11. If a dependent is entitled to receive a deathbenefit pursuant to this section and is less than 18 years of age orincompetent, the legal representative of the dependent shall petition for aguardian to be appointed for that dependent pursuant to
12. Except as otherwise provided in paragraphs (a) and(b), the entitlement of any child to receive his proportionate share ofcompensation pursuant to this section ceases when he dies, marries or reachesthe age of 18 years. A child is entitled to continue to receive compensationpursuant to this section if he is:
(a) Over 18 years of age and incapable of supportinghimself, until such time as he becomes capable of supporting himself; or
(b) Over 18 years of age and enrolled as a full-timestudent in an accredited vocational or educational institution, until hereaches the age of 22 years.
13. As used in this section, surviving spouse meansa surviving husband or wife who was married to the employee at the time of theemployees death.
[Part 59:168:1947; A 1949, 659; 1951, 485; 1953, 292;1955, 901](NRS A 1957, 732; 1959, 614; 1963, 1144; 1965, 264; 1966, 46; 1967,686; 1969, 476; 1973, 533; 1975, 600; 1979, 764, 1059; 1981, 1495; 1989, 333;1991, 804; 1993, 751; 1999,1224)
NRS
1. Any widow, widower, surviving child or survivingdependent parent who resides in this State and who receives death benefits onaccount of an industrial injury or a disablement from an occupational diseasewhich occurred before July 1, 1973, is entitled to a 65 percent increase inthose benefits without regard to any limitation on wages imposed by
2. The increase must be paid from the Account forPensions for Silicosis, Diseases Related to Asbestos and Other Disabilities.
(Added to NRS by 1973, 538; A 1975, 823; 1979, 1520;1981, 1227; 1985, 723; 1987, 589; 1991, 1802)(Substituted in revision for NRS616.628)
NRS
(Added to NRS by 1985, 1460)(Substituted in revisionfor NRS 616.6281)
NRS
1. Any widow, widower, surviving child or survivingdependent parent who is receiving death benefits pursuant to
2. The increase provided by this section must not bepaid for any period before July 1, 1981.
(Added to NRS by 1981, 1224)(Substituted in revisionfor NRS 616.6282)
VOCATIONAL REHABILITATION
NRS
1. Return the injured employee to the job he hadbefore his injury.
2. Return the injured employee to a job with theemployer he worked for before his accident that accommodates any limitationimposed by his injury.
3. Return the injured employee to employment withanother employer in a job that uses his existing skills.
4. Provide training for the injured employee while heis working in another vocation.
5. Provide formal training or education for theinjured employee in another vocation.
(Added to NRS by 1991, 2396)(Substituted in revisionfor NRS 616.378)
NRS
1. Ensure that the work of a vocational rehabilitationcounselor who is not certified is supervised and reviewed by a certifiedvocational rehabilitation counselor.
2. Employ at least one certified vocationalrehabilitation counselor for every four vocational rehabilitation counselorsthat it employs who are not certified.
3. Employ vocational rehabilitation counselors whohave knowledge of the labor market within the geographical area where theinjured employee resides.
(Added to NRS by 1993, 664; A 1993, 797;
NRS
1. If the employer of a vocational rehabilitationcounselor is also the entity administering an injured employees case, the vocationalrehabilitation counselor shall not provide services as a vocationalrehabilitation counselor to the injured employee, including, withoutlimitation, completing a written assessment pursuant to
(a) Discloses the relationship between the vocationalrehabilitation counselor and the entity administering the injured employeescase; and
(b) Informs the injured employee of his right to beassigned an alternate vocational rehabilitation counselor who is not affiliatedwith the entity administering the injured employees case.
2. After receiving the written disclosure requiredpursuant to subsection 1, the injured employee has a right to be assigned analternate vocational rehabilitation counselor who is not affiliated with theentity administering the injured employees case. To be assigned an alternatevocational rehabilitation counselor, the injured employee must submit a writtenrequest to the entity administering the injured employees case before thecommencement of vocational rehabilitation services. Not later than 10 daysafter receiving such a request, the entity administering the injured employeescase shall assign the injured employee an alternate vocational rehabilitationcounselor who is not affiliated with the entity administering the injured employeescase.
(Added to NRS by
NRS
1. There are physical limitations on the injuredemployees ability to work; and
2. The limitations, if any, are permanent ortemporary.
(Added to NRS by 1993, 664)(Substituted in revisionfor NRS 616.51715)
NRS
1. The primary obligation of a vocational rehabilitationcounselor is to the injured employee.
2. A vocational rehabilitation counselor shall notprovide services as a vocational rehabilitation counselor, including, withoutlimitation, completing a written assessment pursuant to
(Added to NRS by
NRS
1. If benefits for a temporary total disability willbe paid to an injured employee for more than 90 days, the insurer or theinjured employee may request a vocational rehabilitation counselor to prepare awritten assessment of the injured employees ability or potential to return to:
(a) The position he held at the time that he wasinjured; or
(b) Any other gainful employment.
2. Before completing the written assessment, thecounselor shall:
(a) Contact the injured employee and:
(1) Identify the injured employees educationalbackground, work experience and career interests; and
(2) Determine whether the injured employee hasany existing marketable skills.
(b) Contact the injured employees treating physicianor chiropractor and determine:
(1) Whether the employee has any temporary orpermanent physical limitations;
(2) The estimated duration of the limitations;
(3) Whether there is a plan for continuedmedical treatment; and
(4) When the employee may return to the positionthat he held at the time of his injury or to any other position. The treatingphysician or chiropractor shall determine whether an employee may return to theposition that he held at the time of his injury.
3. Except as otherwise provided in
4. The Division may, by regulation, require a writtenassessment to include additional information.
5. If an insurer determines that a written assessmentrequested pursuant to subsection 1 is impractical because of the expectedduration of the injured employees total temporary disability, the insurershall:
(a) Complete a written report which specifies hisreasons for the decision; and
(b) Review the claim at least once every 60 days.
6. The insurer shall deliver a copy of the writtenassessment or the report completed pursuant to subsection 5 to the injuredemployee, his employer, the treating physician or chiropractor and the injuredemployees attorney or representative, if applicable.
7. For the purposes of this section, existingmarketable skills include, but are not limited to:
(a) Completion of:
(1) A program at a trade school;
(2) A program which resulted in an associatesdegree; or
(3) A course of study for certification,
if theprogram or course of study provided the skills and training necessary for theinjured employee to be gainfully employed on a reasonably continuous basis inan occupation that is reasonably available in this State.
(b) Completion of a 2-year or 4-year program at acollege or university which resulted in a degree.
(c) Completion of any portion of a program for agraduates degree at a college or university.
(d) Skills acquired in previous employment, includingthose acquired during an apprenticeship or a program for on-the-job training.
The skillsset forth in paragraphs (a) to (d), inclusive, must have been acquired withinthe preceding 7 years and be compatible with the physical limitations of theinjured employee to be considered existing marketable skills.
8. Each written assessment of an injuredemployee must be signed by a certified vocational rehabilitation counselor.
(Added to NRS by 1993, 664; A 1993, 2445; 1997, 1438;2005, 811,
NRS
1. A vocational rehabilitation counselor shall developa plan for a program of vocational rehabilitation for each injured employee whois eligible for vocational rehabilitation services pursuant to
2. If the counselor determines in a written assessmentrequested pursuant to NRS 616C.550that the injured employee has existing marketable skills, the plan must consistof job placement assistance only. When practicable, the goal of job placementassistance must be to aid the employee in finding a position which pays a grosswage that is equal to or greater than 80 percent of the gross wage that he wasearning at the time of his injury. An injured employee must not receive jobplacement assistance for more than 6 months after the date on which he wasnotified that he is eligible only for job placement assistance because:
(a) He was physically capable of returning to work; or
(b) It was determined that he had existing marketableskills.
3. If the counselor determines in a written assessmentrequested pursuant to NRS 616C.550that the injured employee does not have existing marketable skills, the planmust consist of a program which trains or educates the injured employee andprovides job placement assistance. Except as otherwise provided in
(a) If the injured employee has incurred a permanentdisability as a result of which permanent restrictions on his ability to workhave been imposed but no permanent physical impairment rating has been issued,or a permanent disability with a permanent physical impairment of 1 percent ormore but less than 6 percent, 9 months.
(b) If the injured employee has incurred a permanentphysical impairment of 6 percent or more, but less than 11 percent, 1 year.
(c) If the injured employee has incurred a permanentphysical impairment of 11 percent or more, 18 months.
Thepercentage of the injured employees permanent physical impairment must bedetermined pursuant to NRS 616C.490.
4. A plan for a program of vocational rehabilitationmust comply with the requirements set forth in
5. A plan created pursuant to subsection 2 or 3 mustassist the employee in finding a job or train or educate the employee andassist him in finding a job that is a part of an employers regular businessoperations and from which the employee will gain skills that would generally betransferable to a job with another employer.
6. A program of vocational rehabilitation must notcommence before the treating physician or chiropractor, or an examiningphysician or chiropractor determines that the injured employee is capable ofsafely participating in the program.
7. If, based upon the opinion of a treating or an examiningphysician or chiropractor, the counselor determines that an injured employee isnot eligible for vocational rehabilitation services, the counselor shallprovide a copy of the opinion to the injured employee, the injured employeesemployer and the insurer.
8. A plan for a program of vocational rehabilitationmust be signed by a certified vocational rehabilitation counselor.
9. If an initial program of vocational rehabilitationpursuant to this section is unsuccessful, an injured employee may submit awritten request for the development of a second program of vocationalrehabilitation which relates to the same injury. An insurer shall authorize asecond program for an injured employee upon good cause shown.
10. If a second program of vocational rehabilitationpursuant to subsection 9 is unsuccessful, an injured employee may submit awritten request for the development of a third program of vocationalrehabilitation which relates to the same injury. The insurer, with the approvalof the employer who was the injured employees employer at the time of hisinjury, may authorize a third program for the injured employee. If such anemployer has terminated operations, his approval is not required for authorizationof a third program. An insurers determination to authorize or deny a thirdprogram of vocational rehabilitation may not be appealed.
11. The Division shall adopt regulations to carry outthe provisions of this section. The regulations must specify the contents of aplan for a program of vocational rehabilitation.
(Added to NRS by 1993, 665; A 1993, 797, 2447, 2456;1995, 2147; 1999,1793; 2001, 1901;2005, 1495)
NRS
1. A program for vocational rehabilitation developedpursuant to subsection 3 of NRS 616C.555may be extended:
(a) Without condition or limitation, by the insurer athis sole discretion; or
(b) In accordance with this section if:
(1) The injured employee makes a written requestto extend the program within 30 days after he receives written notificationthat he is eligible for vocational rehabilitation services; and
(2) There are exceptional circumstances whichmake it unlikely that the injured employee will obtain suitable gainfulemployment as a result of vocational rehabilitation which is limited to theperiod for which he is eligible.
An insurersdetermination to grant or deny an extension pursuant to paragraph (a) may notbe appealed.
2. If an injured employee has incurred a permanentphysical impairment of less than 11 percent:
(a) The total length of the program, including anyextension, must not exceed 2 years.
(b) Exceptional circumstances shall be deemed toexist for the purposes of paragraph (b) of subsection 1, if:
(1) The injured employee lacks work experience,training, education or other transferable skills for an occupation which he isphysically capable of performing; or
(2) Severe physical restrictions as a result ofthe industrial injury have been imposed by a physician which significantlylimit the employees occupational opportunities.
3. If an injured employee has incurred a permanentphysical impairment of 11 percent or more:
(a) The total length of the program, including anyextension, must not exceed 2 1/2 years.
(b) Exceptional circumstances shall be deemed toexist for the purposes of paragraph (b) of subsection 1, if the injuredemployee has suffered:
(1) The total and permanent loss of sight ofboth eyes;
(2) The loss by separation of a leg at or abovethe knee;
(3) The loss by separation of a hand at or abovethe wrist;
(4) An injury to the head or spine which resultsin permanent and complete paralysis of both legs, both arms or a leg and anarm;
(5) An injury to the head which results in asevere cognitive functional impairment which may be established by a nationallyrecognized form of objective psychological testing;
(6) The loss by separation of an arm at or abovethe elbow and the loss by separation of a leg at or above the knee;
(7) An injury consisting of second or thirddegree burns on 50 percent or more of the body, both hands or the face;
(8) A total bilateral loss of hearing;
(9) The total loss or significant and permanentimpairment of speech; or
(10) A permanent physical impairment of 50percent or more determined pursuant to NRS616C.490, if the severity of the impairment limits the injured employeesgainful employment to vocations that are primarily intellectual and require alonger program of education.
4. The insurer shall deliver a copy of its decisiongranting or denying an extension to the injured employee and the employer.Except as otherwise provided in this section, the decision shall be deemed tobe a final determination of the insurer for the purposes of
(Added to NRS by 1993, 666; A 1993, 2448; 1997, 1440;1999, 1794)
NRS
1. A plan for a program of vocational rehabilitationdeveloped pursuant to NRS 616C.555 mayinclude a program for on-the-job training, if the training is suitable for theinjured employee.
2. Before an injured employee may participate in aprogram for on-the-job training, the insurer and the employer must execute awritten agreement which contains an explanation of the training and a schedulefor that training.
3. Except as otherwise provided in subsection 4, theinsurer may pay not more than 50 percent of the wages of an injured employeewho is participating in a program for on-the-job training. An insurercontributing toward the wages of an injured employee shall pay the employeewithin 10 days after the employee submits documentation of his payroll to theinsurer. The insurer shall not contribute to the wages of the injured employeefor more than the period authorized for the particular employee pursuant tosubsection 3 of NRS 616C.555 or
4. The insurer shall, within 30 days after receipt ofa request for payment, reimburse the training employer for the wages paid bythe training employer to the injured employee pursuant to this section if:
(a) After the successful completion of the training,the training employer continues to employ the injured employee for at least 90days in a position which requires the training so obtained; or
(b) The injured employee:
(1) Within 30 days after his successfulcompletion of the training, obtains employment which requires the skillsobtained by him as a direct result of the training provided by the trainingemployer; and
(2) Retains that or similar employment for atleast 6 months after the completion of the training.
(Added to NRS by 1993, 667; A 1993,2449)(Substituted in revision for NRS 616.51745)
NRS
1. The Division shall, by regulation, prescribe when:
(a) Vocational rehabilitation maintenance must be paidto an injured employee; and
(b) Vocational rehabilitation maintenance must cease tobe paid to an injured employee.
An injuredemployee must not receive vocational rehabilitation maintenance after his programof vocational rehabilitation ends pursuant to
2. As used in this section, vocational rehabilitationmaintenance means the amount of compensation paid to an injured employee whilehe is participating in a program of vocational rehabilitation developedpursuant to NRS 616C.555.
(Added to NRS by 1993, 668)(Substituted in revisionfor NRS 616.5175)
NRS
1. Except as otherwise provided in this section,vocational rehabilitation services must not be provided outside of this State.
2. An injured employee who:
(a) Resides outside of this State, within 50 miles fromany border of this State, on the date of injury; or
(b) Was injured while temporarily employed in thisState by an employer subject to the provisions of chapters616A to 617, inclusive, of NRS who candemonstrate that, on the date of injury, his permanent residence was outside ofthis State,
may receivevocational rehabilitation services at a location within 50 miles from hisresidence if such services are available at such a location.
3. An injured employee who:
(a) Is eligible for vocational rehabilitation servicespursuant to NRS 616C.590; and
(b) Resides outside of this State but does not qualifyto receive vocational rehabilitation services outside of this State pursuant tosubsection 2,
may executea written agreement with the insurer which provides for the payment ofcompensation in a lump sum in lieu of the provision of vocationalrehabilitation services pursuant to NRS616C.595. The amount of the lump sum must not exceed $20,000.
4. An injured employee who resides outside of thisState but does not qualify to receive vocational rehabilitation servicesoutside of this State pursuant to subsection 2 may receive the vocationalrehabilitation services to which he is entitled pursuant to
(a) This State; or
(b) A location within 50 miles from any border of thisState,
at his ownexpense, if such services are available at such a location.
5. An injured employee who resides in this State mayreceive vocational rehabilitation services outside of this State at a locationwithin 50 miles from his residence if such services are available at such alocation. An insurer may not unreasonably deny a request made by an injuredemployee pursuant to this subsection to receive vocational rehabilitationservices outside of this State.
(Added to NRS by 1993, 668; A
NRS
1. Except as otherwise provided in subsection 2,vocational rehabilitation services ordered by an insurer, a hearing officer oran appeals officer must not include the following goods and services:
(a) A motor vehicle.
(b) Repairs to an injured employees motor vehicle.
(c) Tools and equipment normally provided to theinjured employee by his employer during the course of his employment.
(d) Care for the injured employees children.
2. An injured employee is entitled to receive thegoods and services set forth in subsection 1 only if his insurer determinesthat such goods and services are reasonably necessary.
3. Vocational rehabilitation services ordered by aninsurer may include the formal education of the injured employee only if:
(a) The priorities set forth in
(b) The education is recommended by a plan for aprogram of vocational rehabilitation developed pursuant to
(c) A written proposal concerning the probable economicbenefits to the employee and the necessity of the education is submitted to theinsurer.
(Added to NRS by 1993, 668; A 1997, 1441)
NRS
1. Except as otherwise provided in this section, aninjured employee is not eligible for vocational rehabilitation services,unless:
(a) The treating physician or chiropractor approves thereturn of the injured employee to work but imposes permanent restrictions thatprevent the injured employee from returning to the position that he held at thetime of his injury;
(b) The injured employees employer does not offeremployment that:
(1) The employee is eligible for considering therestrictions imposed pursuant to paragraph (a);
(2) Provides a gross wage that is equal to orgreater than 80 percent of the gross wage that the employee was earning at thetime of his injury; and
(3) Has the same employment benefits as theposition of the employee at the time of his injury; and
(c) The injured employee is unable to return to gainfulemployment with any other employer at a gross wage that is equal to or greaterthan 80 percent of the gross wage that the employee was earning at the time ofhis injury.
2. If the treating physician or chiropractor imposespermanent restrictions on the injured employee for the purposes of paragraph(a) of subsection 1, he shall specify in writing:
(a) The medically objective findings upon which hisdetermination is based; and
(b) A detailed description of the restrictions.
The treatingphysician or chiropractor shall deliver a copy of the findings and thedescription of the restrictions to the insurer.
3. If there is a question as to whether therestrictions imposed upon the injured employee are permanent, the employee mayreceive vocational rehabilitation services until a final determinationconcerning the duration of the restrictions is made.
4. Vocational rehabilitation services must cease assoon as the injured employee is no longer eligible for the services pursuant tosubsection 1.
5. An injured employee is not entitled to vocationalrehabilitation services solely because the position that he held at the time ofhis injury is no longer available.
6. An injured employee or his dependents are notentitled to accrue or be paid any money for vocational rehabilitation servicesduring the time the injured employee is incarcerated.
7. Any injured employee eligible for compensationother than accident benefits may not be paid those benefits if he refusescounseling, training or other vocational rehabilitation services offered by theinsurer. Except as otherwise provided in NRS616B.028 and 616B.029, an injuredemployee shall be deemed to have refused counseling, training and othervocational rehabilitation services while he is incarcerated.
8. If an insurer cannot locate an injured employee forwhom it has ordered vocational rehabilitation services, the insurer may closehis claim 21 days after the insurer determines that the employee cannot belocated. The insurer shall make a reasonable effort to locate the employee.
9. The reappearance of the injured employee after hisclaim has been closed does not automatically reinstate his eligibility forvocational rehabilitation benefits. If the employee wishes to reestablish hiseligibility for those benefits, he must file a written application with theinsurer to reinstate his claim. The insurer shall reinstate the employeesclaim if good cause is shown for the employees absence.
(Added to NRS by 1973, 362; A 1979, 1042; 1981, 1459;1985, 1541; 1991, 491, 2401; 1993, 703; 1997, 1441, 3350;
NRS
1. If an injured employee is eligible for vocationalrehabilitation services pursuant to NRS616C.590, the insurer and the injured employee may, at any time during theemployees eligibility for such services, execute a written agreement providingfor the payment of compensation in a lump sum in lieu of the provision ofvocational rehabilitation services. An insurers refusal to execute such anagreement may not be appealed.
2. If the insurer and the injured employee execute anagreement pursuant to subsection 1, the acceptance of the payment ofcompensation in a lump sum by the injured employee extinguishes his right toreceive vocational rehabilitation services under his claim. Except as otherwiserequired by federal law, an injured employee shall not receive vocationalrehabilitation services from any state agency after he accepts payment ofcompensation in a lump sum pursuant to this section.
3. Before executing an agreement pursuant tosubsection 1, an insurer shall:
(a) Order an assessment of and counseling concerningthe vocational skills of the injured employee, unless the provisions ofsubsection 3 of NRS 616C.580 are applicable;
(b) Consult with the employer of the injured employee;and
(c) Provide a written notice to the injured employeethat contains the following statements:
(1) That the injured employee is urged to seekassistance and advice from the Nevada Attorney for Injured Workers or toconsult with a private attorney before signing the agreement.
(2) That the injured employee may rescind theagreement within 20 days after he signs it.
(3) That the 20-day period pursuant tosubparagraph (2) may not be waived.
(4) That acceptance by the injured employee ofpayment of compensation in a lump sum in lieu of the provision of vocationalrehabilitation services extinguishes his right to receive such services.
4. No payment of compensation in a lump sum may bemade pursuant to this section until the 20-day period provided for therescission of the agreement has expired.
(Added to NRS by 1991, 2396; A 1993, 753; 1995, 2159;2005, 210)
NRS
1. A hearing officer or appeals officer shall notorder self-employment for an injured employee or the payment of compensation ina lump sum for vocational rehabilitation.
2. An insurer, an employer and an injured employee mayexecute an agreement concerning self-employment.
(Added to NRS by 1991, 2394)(Substituted in revisionfor NRS 616.573)
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