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Protecting Your Interests: Understanding Worker’s Compensation Employee and Employer Perspectives

Understanding Workers Compensation

Apart from salaries, employee benefits are the largest employee-related expense most businesses pay. The important thing to understand is that worker’s compensation isn’t a benefit. Under Nevada law, it’s a requirement for all companies with 1 or more employees. More importantly, it was designed to protect the interests of employees and employers equally.

Under the worker’s compensation system, employers are required to purchase insurance that provides benefits to employees who suffer work-related injuries and illnesses. The system creates an equitable compromise between employers and employees. Workers get benefits regardless of who is at fault. In return, employers are largely indemnified from lawsuits by injured or sick employees seeking financial awards for pain and suffering, mental anguish, or other non-direct or immediate conditions.

Benefits to employees in exchange for their forfeiture of rights to sue his or her employer for negligence is the basis of worker’s compensation. The compromise between guaranteed coverage, and the lack of litigious recourse is often referred to as the ‘compensation bargain’. And generally, it’s thought to be a very fair bargain for both sides.

Remunerative damages for pain and suffering, and employer negligence are generally not available in workers’ compensation plans. Negligence is therefore generally a non-issue in such cases. The denial of recourse to abuse claims is an opportunity all employers should be happy about. Monthly premiums for worker’s compensation pale in comparison to upheld claims of employer negligence.

What to Do: The Truly Important Things

Employees injured at work must notify their employers and seek medical treatment immediately. Failure to do so adversely affects the dispensation of benefits. Written notice to employers must be furnished within7 days of an accident or injury. For occupational disease or chronic conditions, the clock starts ticking as soon as it’s realized that the condition was caused by work. Employers will provide their employees with the necessary form to report claims (Form C-1). Delay in giving notice, or failing to report entirely can often lead to the denial of a worker’s compensation claim.

Permanent vs Partial Disability

Workers who are totally disabled will receive two-thirds of their average monthly wages for as long as the disability lasts. Certain injuries, such as total blindness or amputation of both legs, are so severe that they are considered total permanent disabilities. For permanent disability to apply, the injury must be sufficiently extreme as to prevent a worker form obtaining gainful employment ever again.

Temporary Disability

Temporarily disabled workers will be eligible to receive temporary total disability benefits. Temporary total disability payments are two-thirds of average monthly wages with a ceiling maximum. Beneficiaries can continue to receive temporary disability benefits until a doctor declares maximum medical improvement (MMI), meaning that recovery has plateaued and the condition is not likely to improve.

In partial disability situations, an employee’s doctor will make assess a percentage of overall impairment, from 1% to 100%. In such cases, 6% of a worker’s average monthly wage for every 1% of impairment is provided. Accordingly, a disability rating of 50%, will award 30% of an average monthly wage.

What About Denied Claims?

If a workers’ comp claim is denied, or the insurance company is disputing any portion of a claim, an employee has the right to appeal under Nevada law. A Hearing Officer will hear from both sides and issue a decision in the case. If that decision is disagreeable to either party, another appeal may be filed with an Appeals Officer within 30 days.

At the End of the Day

Worker’s compensation insurance is beyond reasonable given the potential claims it obviates. Perhaps the most intangible of its benefits is the sense of security it affords covered team members. Workers evaluate their employers in the same way employers evaluate them – what are they getting in exchange for their time or money. Knowing they and their families are safe, regardless of what happens on the job, is an incalculable booster to their morale, productivity and retention – all of which save employers great sums of money in the long run.