Despite its purpose as a resource for injured employees, the Nevada workers’ compensation system does not always produce the right outcome. Oftentimes, insurers and claim administrators look to deny claims for any reason they can. However, these decisions are not always error-free, and injured workers have the right to challenge unfair claim denials. A Henderson workers’ compensation appeals lawyer could guide you through the appeals process, ensuring your case is thoroughly reviewed and fought for. With the support of a skilled Henderson workers’ compensation attorney, you can pursue the benefits you rightfully deserve.
Learn more about the appeal process below and schedule a meeting with one of our English- or Spanish-speaking case managers to review your case further.
Workers’ compensation benefits are available to employees who suffer an injury while in the course of their employment. An employer’s insurer or claim administrator may deny a claim for one of two reasons. These issues can be complex and highly dependent on the unique facts or applicable workers’ compensation law. Seeking an independent review of a claim denial from a Workers’ compensation appeals lawyer in Henderson is an important first step for evaluating rights and available remedies on appeal.
The first potential reason for a denied claim is a belief that the worker’s injury does not meet the eligibility requirements for Nevada workers’ compensation. An employer could base this decision on many different arguments, such as:
A common example is employee misclassification. Workers’ compensation is generally only available to employees and not independent contractors. However, employers are known for misclassifying their workers to avoid the high costs of paying employee benefits like workers’ compensation.
Insurers may also deny a claim on ineligibility grounds if they believe the employee’s injury did not occur within the course of employment. Claim denials are common on this basis for injuries that either happened outside of work or that occurred at work but through reasons unrelated to employment. Examples may include cases of self-harm, injury from consuming drugs or alcohol at work, and fighting on the job.
Even if an insurer accepts an injured employee’s claim for benefits, an appeal may be necessary to challenge disputes over the extent of those benefits. Disagreements are possible at this stage for medical conditions that are difficult to classify for disability benefit purposes.
The two classification issues usually center on whether an injury results in temporary versus permanent disability and, in cases of permanent disability—partial or full. These issues can greatly impact the value of paid benefits over time, which is why insurers are quick to dispute them based on medical evidence.
Injured workers only have 70 days to appeal a letter denying a claim for benefits through the Hearings Division. Failing to timely submit an appeal will typically result in a forfeiture of the right to challenge an insurer’s decision.
Consider engaging the help of a Henderson workers’ compensation appeals lawyer after receiving notice to avoid an unintentional lapse in your appeal rights and to limit unnecessary delay in recovering benefits under a claim. Our attorneys are here to fight for your rights as an injured worker. Schedule a free consultation today.
