If your claim for worker’s compensation in Las Vegas was denied, you need to know your rights and what you can do to appeal the decision. It is important that you follow the guidelines provided for filing an appeal, as failing to do so will result in your appeal being denied as well.
Request a Hearing
Upon receiving a letter of denial, your first step in the appeals process is to submit a Request for Hearing with the Nevada Department of Administration (DOA). You will need to include a copy of the denial letter. This request must be submitted no more than 70 days after the date shown on the denial letter. In most cases, your hearing will be scheduled within 30 days, and both you and the adjuster will be required to present your evidence for the hearing. If you don’t agree with the outcome of the hearing, you can move on to the next step.
Within 30 days of your initial appeal hearing, you will need to file a form with the Appeals Officer, also making sure to include a copy of the decision made by the hearing officer. This hearing will be considerably more formal, and it will be recorded. You will also have to submit all of your evidence in the case. If your appeal is still denied, you can always appeal that decision, as well, by contacting the Nevada court system.
If you decide to take your appeal to the District Court system, you must file the Petition for Judicial Review within 30 days. If you are taking your appeal to the courts, you need to contact a lawyer before you do so. The procedures for civil court cases can be complicated, and you have to keep in mind that your appeal has already been denied twice. A Las Vegas worker’s compensation attorney will be able to help you understand whether you have a strong case, and, if so, how to approach your court case so that you are in compliance with the rules and requirements.
In claims involving managed care organizations, you will have to follow different rules. First, you will need to contact the MCO with your dispute in writing within 14 days. You should receive the decision within 14 days – if not, or if you disagree, you will have 30 days to request that your appeal be heard by the Appeals Officer.
Dealing with a worker’s compensation claim denial in Las Vegas is difficult, but it can have a positive effect on your case. If you are unsure of your rights, or whether you should file an appeal, you can always contact an attorney to help you with the process. In Nevada, you can take advantage of the Nevada Attorneys for Injured Workers (NAIW), which provides representation for Appeals Officer hearings at no charge for those with worker’s compensation claims in Las Vegas and throughout Nevada. They can also assist you at the civil court level if you decide to take your appeal that far.