Did the insurance company deny part or all of your claim for workers’ compensation benefits? Did you receive a determination letter that you would like to dispute? Did the insurer fail to respond to your claim by the 30-day deadline? Call our office right away so we can get started with an appeal.
If you filed your workers’ compensation claim for benefits without the assistance of a work comp lawyer and you’ve received one or more determination letters from the insurance company, it’s time for us to talk about getting you your money.
When you disagree with the decision the workers’ compensation insurer makes, you have the right to file an appeal. If you miss the deadline, fail to follow the guidelines, or your request for appeal is incomplete, however, you could lose your right to recover money for your injuries. Your medical bills will likely continue to pile up. You’ll continue to go without the income you’ve lost. And your medical treatment could even be delayed.
Don’t take any chances when it comes to your work comp appeal. Let us help make sure you get paid.
When you file a workers’ compensation claim for benefits, you will likely receive a number of determination letters from the insurer. These are typically sent out throughout the claims process. When you receive letters with which you don’t agree, each one must be appealed individually. In essence, your case may have multiple appeals and numerous hearings.
For each determination letter you receive, you have 70 days to file an appeal. If you fail to file an appeal by the deadline for even one of the letters you receive, you could lose your right to recover money for your medical bills and lost wages.
The first step in filing an appeal is to request a hearing with the Hearings Division of the Nevada Department of Administration.
We’ll help you get things in order for your hearing. We will need to review any portion of your case that you would like to have reviewed during your hearing. We’ll gather evidence, records, and statements, and we’ll make sure the necessary documents are sent to the Hearing Officer so he or she can see the big picture instead of just a glimpse of your situation. These informal hearings are usually scheduled to be held within 30 days of the division receiving your request.
If you win your appeal at this level, you will be entitled to receive interest of 9%, calculated from when the initial payment was due.
Appealing with the Appeals Officer
If you receive an unfavorable decision from the Hearing Officer, you still have options to recover money. You can appeal the decision of the Hearing Officer to the Appeals Officer at the Department of Administration. The Appeals Officer would then be tasked with addressing your appeal at another hearing.
While the Appeals Officer will review the decision made by the Hearing Officer, he or she will also conduct an additional review of the case. The Appeals Officer will base the hearing only off of evidence that is submitted for the hearing at hand. Any evidence that was previously submitted will not be reviewed unless it is resubmitted.
After consideration of all evidence, the Appeals Officer will decide:
The Appeals Officer can also decide to enter other orders as allowed by law. Decisions will be made within 15 days of the hearing. If you receive an answer from the Appeals Officer and you still don’t agree, you have the right to appeal further. This time, your appeal would be filed with the District Court.
Appealing the Appeals Officer’s Decision
If you choose to appeal the decision made by the appeals officer, you have 30 days to file a Petition for Judicial Review with the appropriate District Court. This review is limited to the information that was provided to the Appeals Officer. Once the petition is filed, we can prepare a brief on your behalf to explain to the Judge why you should prevail.
If you are considering filing a workers’ compensation appeal at any level, it is highly recommended that you work with a work comp lawyer. Our knowledge of the workers’ compensation laws in Nevada, familiarity with how appeals work, and resources to handle your case with no out of pocket expenses can help ensure that your bills are covered, you get the medical help you need, and you are paid for the time you’ve been unable to work.
March 18, 2020 Udpate.
We have just been given notice that all Hearings and Appeals have been vacated and are off calendar by order the Senior Appeals Officer from the Nevada Department of Administration. It is unknown when the reset dates will occur.
March 17, 2020 Update.
As efforts concerning the containment of COVID-19 (Coronavirus) continue to evolve here in the U.S. and around the world, we want to assure you that Jason D. Mills & Associates remains committed to three important priorities:
Our offices remain open for business; however, we encourage all existing clients to help us limit exposure and the potential spread of COVID-19 by avoiding in-office meetings. We remain open for business virtually during normally scheduled work hours (9:00 am to 5:00pm, Monday through Friday). All email, fax, telephone, and other electronic communication will continue without interruption. If you have a scanner please scan documents and send to us in .PDF format. If you do not have a scanner, there are smart phone apps available such as: CamScanner, Adobe Scan and Genius Scan (and many others), that will turn your smart phone into a document scanner at zero or little cost.
Our local courts continue to update and modify their policies and procedures in response to the current COVID-19 situation as well, and we are monitoring those procedures to navigate the impact on your claims. So far, the Hearing and Appeals Office has halted all in-person hearings and is in the process of converting future hearings into telephonic hearings. As we learn more, we will provide updated information.
We also know that many of you have been personally impacted in a number of ways, and we apologize for any inconvenience these modifications may cause you but of course we are all experiencing this disruption together and will get through it together. We will resume normal operations as soon as the local, state and national governments give instructions that it is reasonable to do so. We appreciate your flexibility as we do our part to help bring this unprecedented situation under control.
Again, we are fully operational and are actively working on your claims. If there is anything you need, please feel free to contact our office (telephonically or electronically) during office hours so that we can direct your call and follow up accordingly.