Calculation of my Workers Compensation Benefits
Workers who have been approved with a successful claim for Nevada workers compensation benefits are eligible to receive financial compensation under certain conditions. Workers who miss a certain amount of work in a time period due to an approved injury or illness may receive payment for temporary total disability. Documentation including the most recent wages and earnings must be submitted in order for the insurer to properly calculate the potential financial compensation that the injured worker is eligible to receive.
Workers must be eligible to make a claim for financial compensation
In order to be eligible for a worker to receive financial payment for temporary total disability for workers compensation benefits in Nevada, the worker must have missed five days or more of work in a row or five days or more total within a time period of twenty days. This time off of work must be as a direct result of the approved injury or illness in order for the insurer to calculate financial compensation for work missed. Once a Nevada workers compensation claim has been accepted, an employee who has missed work may provide the necessary information to receive temporary total disability. The insurer will use the employee’s most recent pay information to calculate the amount of financial compensation benefits.
The employer must provide wage verification to the insurer in order for the employee to receive temporary total disability benefits through Nevada workers compensation. Typically, wage information for the 12-week period prior to the injury or illness is used to provide the average wages of the employee. This wage amount includes all earnings, including reported tips and any overtime. If the prior 12-week period is not representative of the employee’s average pay, a period of one-year may be requested to increase the rate of financial compensation. Additionally, if the worker is employed through more than one employer, all concurrent employment wages are included to calculate the claim. When claiming concurrent employment, it is up to the injured employee to notify the insurer of multiple employers and employment information.
Temporary total disability calculation
Once the average monthly wage has been calculated, the amount of financial compensation per month of work missed is calculated to 66 2/3 percent of this average. For example, a worker who averages about $2,000.00 per month can receive $1,333.00 in financial compensation. There is, however, a maximum income limit to such benefits under Nevada workers compensation law. The maximum income limit is calculated by taking 150 percent of the average state weekly wage, and multiplying that number by 4.33 to determine the maximum earnings used to calculate financial compensation. In 2012, the maximum monthly income allowed was 5,151.57, so workers who earned above this amount had their benefits calculated from this maximum amount.
Nevada Regulations for Benefits Calculation
Regulations concerning financial compensation for a workers compensation claim are covered under the Nevada Administrative Code and Nevada Revised Statutes. There are special regulations concerning special conditions and circumstances involving income and employment involving workers with less than 12 weeks of employment, piece meal employment, and union workers.
Workers employed less than 12 weeks
For workers who were employed less than 12 weeks, the average of time worked is used as long as the time of employment was at least 4 weeks. If information for less than 4 weeks is available, projected earnings may be used by calculating the employee’s pay rate with his or her projected work schedule.
Injured workers who do not have 4 consecutive weeks of employment history will have their earnings calculated by using monthly wage information from employees that do the same work.
Members of labor organizations who receive their employment through referrals from the organization’s office may use employment information for 1 year prior to the injury or illness to gain a fair representation of monthly average.
Exclusion of days
If the injured worker missed a number of days from work for a variety of reasons, these days may be excluded from the average monthly wage calculations. Days eligible for exclusion may include those for:
- • Certified illness
- • Disability
- • Admittance into a hospital or institution
- • Days of full-time education not scheduled for work
- • Military service, excluding weekend training
- • Approved strike days
- • Approved leave through the Family and Medical Leave Act of 1993
To include these days in the time period for average monthly wage might unfairly reduce the amount of financial compensation available to the injured worker, so these days may be excluded when making such calculations. Days that are not listed in these exceptions will be counted in average monthly pay, including any time off for vacations or personal time off.
Reopening a workers compensation claim
It is important that the employer use complete and accurate information when providing wage verification to the third party administrator. The determined average monthly wage is used not only to provide financial compensation for temporary total disability while the injured employee is off of work due to the injury or illness, but this amount is also used in determining how much financial compensation is available if an injured worker is entitled to a permanent partial disability award. Additionally, if the case must ever be re-opened in the future, this same amount will be used to calculate benefits if the employee is entitled.
Legal assistance for calculating workers compensation benefits
Because of the importance of using the correct average monthly income to determine current and future financial compensation from a work injury, it is often helpful to have a qualified attorney double-check the calculations to be sure nothing is missed in the process. Bighorn Law can help with wage information, verification, and calculations that will be used to determine the amount of compensation that you may be entitled to receive. In addition to assistance in calculation of potential compensation, Bighorn Law can help with all aspects of your Nevada workers compensation claim, from assistance with the appropriate paperwork and forms. Legal assistance can help increase your chances of success for approval of benefits.Go to the Next Article