What Do I Do if the Insurance Company Tries to Close My Workers’ Compensation Claim?
When applying for workers’ compensation insurance benefits in the State of Nevada, there are 3 potential reasons that the insurer may decide to close the claim. An insurer may close the case due to no rating evaluation being necessary, can be closed with specific rating evaluations, or due to those cases that have accrued less than $300 in medical expenses. If you are ever in disagreement with the decision of the insurer involved in your case, the State of Nevada allows for the filing of a timely appeal at many stages during the process.
Some of the letters and notices that are provided in your case can be confusing, which may result in a halt of necessary benefits. Hiring an experienced and qualified attorney can help you to understand the often-complicated process and assist you with filing the proper paperwork and appeals procedures.
Nevada Workers’ Compensation Insurance Closure Due to No Rating Evaluation
If the insurer in your case determines that they will no longer cover any additional medical treatments or provide you with any more workers’ compensation insurance benefits, they will send you a letter that is called the “Notice of Intention to Close Claim”. In addition to this notice, you will also receive information regarding your right to appeal along with the necessary paperwork for you to file the appeal. If you are not in agreement with any part of this determination, you have 70 days to file such an appeal. You may disagree with part or all of the determination.
If you agree that you would no longer benefit from receiving continued medial treatments but feel you should receive more compensation due to time off work, you should still file an appeal. You should definitely appeal the decision if you feel that you will benefit from additional medical treatment. You will need to see another doctor, potentially at your own expense, to provide a written report contesting the current physician’s claims and stating that you need additional medical care for your work-related injuries or illness.
If you agree that you no longer need medical treatment but feel that you should be rated for some type of permanent disability or impairment, it is important to file an appeal in this situation as well. You will need to follow the procedures provided by Nevada state law, on how to receive a rating and how to provide it to your hearing officer at your appeal.
Nevada Workers’ Compensation Insurance Closing with a Scheduled Rating Evaluation
If your treating physician determines that you will no longer need any medical treatments but that you may have an impairment or disability that is likely to be permanent, the insurer will not send you the basic notice that they intend to close your case. Instead, the notice provided to you will state that you will no longer be eligible to receive benefits, unless you qualify for vocational rehabilitation benefits. This notice will, however, schedule you for a rating evaluation in order to determine the percentage of benefits you are eligible to receive due to a permanent partial disability.
If you feel you still need more medical treatments regarding your illness or injury, it is important to appeal this decision within 70 days. In addition, you will need to see a private doctor, at your own expense, to provide written documentation to prove that you need to continue with medical care or treatments.
While waiting for your appeal hearing date, it is important that you still attend the scheduled rating evaluation. If you miss this rating evaluation and you still need it, you may have to schedule one at your own expense at a later date. Also, the physician who examines you in order to determine your rating may determine that you actually do need additional medical treatment for your illness or injury, which will help to provide you with the necessary documentation necessary to prevent the insurer from closing your claim.
Nevada Workers’ Compensation Insurance Closure Due to Claims with Medical Expenses Less than $300
The insurer may close your case if you have accrued less than $300 in medical expenses since the date the claim was opened. If you disagree with this determination, it is important that you file a timely appeal. You should also provide written documentation from your doctor that you need additional medical care in order to keep receiving benefits. If you do not file an appeal and the insurer closes the case, you will be unable to reopen the claim or receive any additional benefits in regards to this injury or illness in the future.
Legal Assistance for Closure of Workers’ Compensation Claim
If you receive a notice of closure for your workers’ compensation insurance benefits in the State of Nevada, you may benefit from the assistance of a qualified lawyer. The attorneys at the Morris / Anderson law firm are experienced in dealing with all phases of the compensation benefits process, including appeals involving case closures. The attorneys can help you file the necessary paperwork in a timely manner as well as let you know of any additional documentation you may need to help in preparation for your appeal hearing. Once a claim has been closed, it is often difficult and even sometimes impossible to have the claim reopened at a later date in the future. It is better not to take any chances when it comes to your health and your future, and the Morris Anderson law firm can help.Go to the Next Article