reglab/statecodes huggingface dataset:
2023 Nevada Revised Statutes › Chapter 616C - Industrial Insurance: Benefits for Injuries or Death › NRS 616C.160 - Newly developed injury or disease: Inclusion in original claim for compensation; limitation.

If, after a claim for compensation is filed pursuant to NRS 616C.020:
1. The injured employee seeks treatment from a physician or chiropractic physician for a newly developed injury or disease; and
2. The employee’s medical records for the injury reported do not include a reference to the injury or disease for which treatment is being sought, or there is no documentation indicating that there was possible exposure to an injury described in paragraph (b), (c) or (d) of subsection 2 of NRS 616A.265,
the injury or disease for which treatment is being sought must not be considered part of the employee’s original claim for compensation unless the physician or chiropractic physician establishes by medical evidence a causal relationship between the injury or disease for which treatment is being sought and the original accident.
(Added to NRS by 1993, 663; A 1999, 2447; 2001, 1016)
2023 Nevada Revised Statutes › Chapter 616C - Industrial Insurance: Benefits for Injuries or Death › NRS 616C.165 - Determination of responsibility of insurer for undisputed claim for compensation; reimbursement of insurer initially providing compensation to injured employee.

If responsibility for an undisputed claim for compensation by an injured employee is contested, the insurer to which the employee first submits the claim is responsible for providing the required compensation to the employee pending final resolution of the issue regarding which insurer is responsible for the claim. If the insurer that initially provides compensation to the injured employee is not held responsible for payment of the claim, the insurer that is held responsible shall reimburse that insurer within 30 days after final resolution of the issue of responsibility for payment of the claim.
(Added to NRS by 1995, 2122)
2023 Nevada Revised Statutes › Chapter 616C - Industrial Insurance: Benefits for Injuries or Death › NRS 616C.170 - Resolution of disputes between insurers if benefits are claimed against more than one insurer; adoption of regulations by Administrator; appeal of decision of Administrator; payment of benefits until determination of responsibility by Administrator.

1. The Administrator shall resolve any disputes between insurers if an injured employee claims benefits against more than one insurer.
2. The Administrator shall adopt regulations concerning the resolution of disputes between insurers regarding benefits to be paid to any injured employee.
3. If the insurer or the employee is dissatisfied with the decision of the Administrator, the dissatisfied party may request a hearing before an appeals officer.
4. Until the Administrator has determined which insurer is responsible for a claim, the current insurer of the employer shall pay benefits to the claimant pursuant to chapters 616A to 617, inclusive, of NRS. Payments made by an insurer pursuant to this subsection are not an admission of liability for the claim or any portion of the claim.
(Added to NRS by 1995, 2002)
2023 Nevada Revised Statutes › Chapter 616C - Industrial Insurance: Benefits for Injuries or Death › NRS 616C.175 - Employment-related aggravation of preexisting condition which is not employment related; aggravation of employment-related injury by incident which is not employment related.

1. The resulting condition of an employee who:
(a) Has a preexisting condition from a cause or origin that did not arise out of or in the course of the employee’s current or past employment; and
(b) Subsequently sustains an injury by accident arising out of and in the course of his or her employment which aggravates, precipitates or accelerates the preexisting condition,
shall be deemed to be an injury by accident that is compensable pursuant to the provisions of chapters 616A to 616D, inclusive, of NRS, unless the insurer can prove by a preponderance of the evidence that the subsequent injury is not a substantial contributing cause of the resulting condition.
2. The resulting condition of an employee who:
(a) Sustains an injury by accident arising out of and in the course of his or her employment; and
(b) Subsequently aggravates, precipitates or accelerates the injury in a manner that does not arise out of and in the course of his or her employment,
shall be deemed to be an injury by accident that is compensable pursuant to the provisions of chapters 616A to 616D, inclusive, of NRS, unless the insurer can prove by a preponderance of the evidence that the injury described in paragraph (a) is not a substantial contributing cause of the resulting condition.
(Added to NRS by 1993, 663; A 1995, 2147; 1999, 1777)
2023 Nevada Revised Statutes › Chapter 616C - Industrial Insurance: Benefits for Injuries or Death › NRS 616C.177 - Medical records concerning preexisting condition: Authority of insurer to request records; injured employee required to release records under certain circumstances.

1. An insurer may inquire about and request medical records of an injured employee that concern a preexisting medical condition that is reasonably related to the industrial injury of that injured employee.
2. An injured employee must sign all medical releases necessary for the insurer of his or her employer to obtain information and records about a preexisting medical condition that is reasonably related to the industrial injury of the employee and that will assist the insurer to determine the nature and amount of workers’ compensation to which the employee is entitled.
(Added to NRS by 1999, 1775)
2023 Nevada Revised Statutes › Chapter 616C - Industrial Insurance: Benefits for Injuries or Death › NRS 616C.185 - Compensation for mastectomy and reconstructive surgery.

1. If compensation is paid to an employee under chapters 616A to 616D, inclusive, of NRS for the surgical procedure known as a mastectomy, the employee is also entitled to receive commensurate compensation for at least two prosthetic devices and for reconstructive surgery incident to the mastectomy. Except as otherwise provided in subsection 2, this compensation is subject to the same requirements and conditions that apply to the compensation for the mastectomy.
2. If reconstructive surgery is begun within 3 years after a mastectomy, the amount of the compensation provided for that surgery must equal those amounts provided for in chapters 616A to 616D, inclusive, of NRS at the time of the mastectomy. If the surgery is begun more than 3 years after the mastectomy, the compensation provided is subject to the requirements and conditions that apply at the time of the reconstructive surgery.
3. For the purposes of this section, "reconstructive surgery" means a surgical procedure performed following a mastectomy on one breast or both breasts to re-establish symmetry between the two breasts. The term includes, but is not limited to, augmentation mammoplasty, reduction mammoplasty and mastopexy.
(Added to NRS by 1983, 617; A 1989, 1892)—(Substituted in revision for NRS 616.503)
2023 Nevada Revised Statutes › Chapter 616C - Industrial Insurance: Benefits for Injuries or Death › NRS 616C.190 - Compensation of employee injured out of State.

1. Except as otherwise provided in subsection 4 of NRS 616B.600, if an employee who has been hired or is regularly employed in this State receives a personal injury by an accident arising out of and in the course of such employment outside of this State, the employee, or the dependents of the employee in case of the death of the employee, are entitled to receive compensation according to the law of this State, and such compensation is the exclusive remedy of the employee or dependents.
2. The provisions of this section apply only to those injuries received by the employee within 6 months after leaving this State, unless before the expiration of the 6-month period the employer has filed with the private carrier or, in the case of a self-insured employer or an association of self-insured public or private employers, with the Administrator notice that he or she has elected to extend the coverage for a greater period.
[Part 74:168:1947; A 1955, 187]—(NRS A 1981, 1168, 1488; 1989, 579; 1995, 2031; 1999, 1778)
2023 Nevada Revised Statutes › Chapter 616C - Industrial Insurance: Benefits for Injuries or Death › NRS 616C.195 - Acceptance of compensation or benefits by employee injured out of State constitutes release of employer and waiver of remedy at common law or statutory remedy provided in another state.

1. Anything to the contrary in chapters 616A to 616D, inclusive, of NRS notwithstanding, if an employee who has been hired or is regularly employed in this State receives personal injury by accident arising out of and in the course of such employment outside this State, and the employee, or the dependents of the employee in case of his or her death, accepts any compensation or benefits under the provisions of chapters 616A to 616D, inclusive, of NRS, the acceptance of such compensation shall constitute a waiver by such employee or dependents of all rights and remedies against the employer at common law or given under the laws of any other state, and shall further constitute a full and complete release of such employer from any and all liability arising from such injury or death.
2. No compensation shall be paid to any such employee, or his or her dependents in case of death, until such employee, the employee’s personal or legal representatives, dependents or next of kin shall have executed and delivered to the employer a full and complete release of such employer from any and all liability arising from or growing out of such injury or death.
[74.1:168:1947; added 1955, 187]—(Substituted in revision for NRS 616.525)
2023 Nevada Revised Statutes › Chapter 616C - Industrial Insurance: Benefits for Injuries or Death › NRS 616C.200 - Commencement of action in another state to recover damages or compensation by employee injured out of State constitutes irrevocable waiver of compensation due under Nevada law; satisfaction of foreign judgment against Nevada employer.

1. If an employee who has been hired or is regularly employed in this State receives a personal injury by an accident arising out of and in the course of such employment outside this State, and the employee, or the employee’s personal or legal representatives, dependents or next of kin commence any action or proceeding in any other state to recover any damages or compensation from his or her employer for the injury or death, the act of commencing such an action or proceeding constitutes an irrevocable waiver of all compensation for the injury or death to which persons would otherwise have been entitled under the laws of this State.
2. If the injured employee or the employee’s personal or legal representatives, dependents or next of kin recover a final judgment against the employer for damages arising out of the injury or death in any court of competent jurisdiction in any other state, the compensation which would otherwise have been payable under the laws of this State, up to the full amount thereof, but less any sums previously paid for the injury or death, must be applied in satisfaction of the judgment as follows:
(a) Upon receipt of an authenticated copy of the final judgment and writ of execution or other process issued in aid thereof, the insurer shall immediately determine the total amount of compensation which would have been payable under the laws of this State if a claim therefor had been made to the insurer. In the case of compensation payable in installments, the insurer shall convert it into a lump sum by such a system of computation as the Administrator deems proper.
(b) The insurer shall thereupon order to be paid in full or partial satisfaction of the judgment a sum not to exceed the total amount of compensation computed as provided in this section or the amount of the judgment, whichever is less.
(c) Except for a self-insured employer or an employer who is a member of an association of self-insured public or private employers, if the judgment is satisfied fully by the employer before any payment by the private carrier pursuant to paragraph (b), the amount payable thereunder must be paid to the employer.
[74.2:168:1947; added 1955, 187]—(NRS A 1979, 1054; 1981, 1169, 1489; 1995, 2031; 1999, 1778)
2023 Nevada Revised Statutes › Chapter 616C - Industrial Insurance: Benefits for Injuries or Death › NRS 616C.205 - Compensation not assignable; exempt from attachment, garnishment and execution; accrued compensation payable to dependents.

Except as otherwise provided in this section and NRS 18.015, 31A.150 and 31A.330, compensation payable or paid under chapters 616A to 616D, inclusive, or chapter 617 of NRS, whether determined or due, or not:
1. Is not assignable before the issuance and delivery of the check or the deposit of any payment for compensation pursuant to NRS 616C.409;
2. Is exempt from attachment, garnishment and execution; and
3. Does not pass to any other person by operation of law.
In the case of the death of an injured employee covered by chapters 616A to 616D, inclusive, or chapter 617 of NRS from causes independent from the injury for which compensation is payable, any compensation due the employee which was awarded or accrued but for which a check was not issued or delivered or for which payment was not made pursuant to NRS 616C.409 at the date of death of the employee is payable to the dependents of the employee as defined in NRS 616C.505.
[Part 66:168:1947; A 1955, 71]—(NRS A 1979, 1055; 1983, 1880; 1985, 1434; 1993, 543; 1999, 221, 3285; 2007, 400; 2021, 1184)
2023 Nevada Revised Statutes › Chapter 616C - Industrial Insurance: Benefits for Injuries or Death › NRS 616C.210 - Compensation of nonresident alien dependents; notification of dependent required.

1. The insurer shall notify a dependent of a deceased employee who is residing outside of the United States by certified mail at the last known address of the dependent if compensation is due the decedent or beneficiary pursuant to chapters 616A to 616D, inclusive, or chapter 617 of NRS. The dependent may request that payment be made directly to him or her within 90 calendar days after the notice was mailed. The insurer shall pay compensation which is due a beneficiary directly to the beneficiary if the beneficiary requests payment within 90 calendar days after the notice was mailed.
2. If the insurer does not receive a request that payment be made directly to a beneficiary within 90 days after the notice required by subsection 1 is mailed, payments to the consul general, vice consul general, consul or vice consul of the nation of which any dependent of a deceased employee is a resident or subject, or a representative of such consul general, vice consul general, consul or vice consul, of any compensation due under chapters 616A to 616D, inclusive, or chapter 617 of NRS to any dependent residing outside of the United States, any power of attorney to receive or receipt for the same to the contrary notwithstanding, are as full a discharge of the benefits or compensation payable under those chapters as if payments were made directly to the beneficiary.
[Part 66:168:1947; A 1955, 71]—(NRS A 1991, 804; 1999, 221)
2023 Nevada Revised Statutes › Chapter 616C - Industrial Insurance: Benefits for Injuries or Death › NRS 616C.225 - Misrepresentation or concealment of fact to obtain benefits: Insurer entitled to reimbursement or deduction from benefits; appeal of determination; alternative remedies.

1. Except as otherwise provided in this section, if an insurer determines that an employee has knowingly misrepresented or concealed a material fact to obtain any benefit or payment under the provisions of chapters 616A to 616D, inclusive, of NRS, the insurer may deduct from any benefits or payments due to the employee, the amount obtained by the employee because of the misrepresentation or concealment of a material fact. The employee shall reimburse the insurer for all benefits or payments received because of the willful misrepresentation or concealment of a material fact.
2. An employee who is aggrieved by a determination of an insurer made pursuant to subsection 1 may appeal that determination pursuant to NRS 616C.315 to 616C.385, inclusive. If the final decision by an appeals officer is favorable to the employee, the Administrator shall order the insurer to pay $2,000 to that employee, in addition to any benefits or payments the employee is entitled to receive, if the Administrator determines that the insurer had no reasonable basis for believing that the employee knowingly misrepresented or concealed a material fact to obtain any benefit or payment.
3. If an employee elects to receive an award for a permanent partial disability in a lump sum pursuant to NRS 616C.495 and a criminal action is brought against the employee for an alleged violation of NRS 616D.300, the insurer shall, upon receiving notice of the action and until a judgment is entered in the action, pay reasonable portions of the lump-sum award in monthly installments. If the employee is not convicted of the alleged violation, the insurer shall pay the employee the balance of the award in a lump sum. The provisions of subsection 2 do not apply to require any additional payment at the conclusion of a criminal action.
4. This section does not preclude an insurer from making an investigation pursuant to, or pursuing the remedies provided by, NRS 616D.300.
(Added to NRS by 1989, 1993; A 1993, 745; 1995, 1873)—(Substituted in revision for NRS 616.563)
2023 Nevada Revised Statutes › Chapter 616C - Industrial Insurance: Benefits for Injuries or Death › NRS 616C.232 - Denial of compensation for temporary total disability because of discharge for misconduct.

1. If an injured employee is discharged from his or her employment as a result of misconduct, an insurer may deny compensation for temporary total disability to the injured employee because of that discharge for misconduct only if the insurer proves by a preponderance of the evidence that:
(a) The injured employee was discharged from his or her employment solely for the employee’s misconduct and not for any reason relating to the employee’s claim for compensation; and
(b) It is the injured employee’s discharge from his or her employment for misconduct, and not the injury, that is the sole cause for the injured employee’s inability to return to work with the preinjury employer.
2. An insurer waives its rights under subsection 1 if the insurer does not make a determination to deny or suspend compensation to the injured employee within 70 days after the date on which the insurer learns that the injured employee has been discharged for misconduct.
3. An insurer may not deny any compensation pursuant to this section except for compensation for temporary total disability pursuant to subsection 1.
4. Discharge from employment for reasons other than gross misconduct does not limit an injured employee’s entitlement to receive benefits for temporary total disability.
(Added to NRS by 2007, 3343; A 2009, 1281, 3033)
2023 Nevada Revised Statutes › Chapter 616C - Industrial Insurance: Benefits for Injuries or Death › NRS 616C.245 - Injured employee entitled to accident benefits; limitation on receipt of modified motor vehicle as accident benefit; regulations establishing maximum benefit.

1. Every injured employee within the provisions of chapters 616A to 616D, inclusive, of NRS is entitled to receive promptly such accident benefits as may reasonably be required at the time of the injury and within 6 months thereafter. Such benefits may be further extended for additional periods as may be required.
2. An injured employee is entitled to receive as an accident benefit a motor vehicle that is modified to allow the employee to operate the vehicle safely if:
(a) As a result of an injury arising out of and in the course of his or her employment, the injured employee is quadriplegic, paraplegic or has had a part of his or her body amputated; and
(b) The injured employee cannot be fitted with a prosthetic device which allows the employee to operate a motor vehicle safely.
3. If an injured employee is entitled to receive a motor vehicle pursuant to subsection 2, a motor vehicle must be modified to allow the employee to operate it safely in the following order of preference:
(a) A motor vehicle owned by the injured employee must be so modified if the insurer or employer providing accident benefits determines that it is reasonably feasible to do so.
(b) A used motor vehicle must be so modified if the insurer or employer providing accident benefits determines that it is reasonably feasible to do so.
(c) A new motor vehicle must be so modified.
4. The Administrator shall adopt regulations establishing a maximum benefit to be paid under the provisions of this section.
[Part 58:168:1947; 1943 NCL § 2680.58]—(NRS A 1957, 28; 1973, 605; 1993, 733; 2003, 2332)
2023 Nevada Revised Statutes › Chapter 616C - Industrial Insurance: Benefits for Injuries or Death › NRS 616C.250 - Establishment, revision and compliance with standards of care for provision of accident benefits.

1. The Division shall, after consulting with and considering the advice of persons representative of organized labor groups, employers, insurers and providers of health care, adopt regulations establishing standards of care for the provision of accident benefits to employees who have suffered industrial injuries or occupational diseases. The standards must include, but are not limited to criteria and protocols to be used as minimal guides for evaluating and ensuring the quality of programs of treatment and for reviewing the:
(a) Utilization of diagnostic procedures and the provision of other medical services;
(b) Treatment and expected durations of industrial injuries and occupational diseases;
(c) Utilization of narcotic drugs and other forms of medication;
(d) Referral of patients to obtain a second opinion; and
(e) Provision of care by more than one provider of health care.
The standards must be consistent with national or regional guidelines and must be specific to medicine for industrial injuries and occupational diseases.
2. The Division shall, after consulting with and considering the advice of persons representative of organized labor groups, employers, insurers and providers of health care, periodically review and revise as necessary the standards established pursuant to subsection 1.
3. An insurer and each person who provides any accident benefit to an employee who has suffered an industrial injury or occupational disease shall comply with the regulations adopted pursuant to this section.
(Added to NRS by 1991, 389; A 1993, 1858)—(Substituted in revision for NRS 616.188)
2023 Nevada Revised Statutes › Chapter 616C - Industrial Insurance: Benefits for Injuries or Death › NRS 616C.255 - Premium for accident benefits paid by employer; accident benefits provided by private carrier; separate account for accident benefits.

1. Each private carrier shall collect a premium upon the total payroll of every employer insured by the private carrier at the rate filed with the Commissioner pursuant to chapter 686B of NRS.
2. Every employer paying this premium is relieved from furnishing accident benefits, and the accident benefits must be provided by the private carrier.
3. The private carrier is liable for any accident benefits provided in this section. The account provided for accident benefits must be kept as a separate account on the records of the private carrier.
[Part 58:168:1947; 1943 NCL § 2680.58]—(NRS A 1973, 601; 1981, 1475; 1995, 2027; 1997, 1438; 1999, 444, 1784)
2023 Nevada Revised Statutes › Chapter 616C - Industrial Insurance: Benefits for Injuries or Death › NRS 616C.270 - Employers to notify Administrator when injured employee receives medical services.

1. Every employer who has elected to provide accident benefits for his or her injured employees shall prepare and submit a written report to the Administrator:
(a) Within 6 days after any accident if an injured employee is examined or treated by a physician, chiropractic physician, physician assistant or advanced practice registered nurse; and
(b) If the injured employee receives additional medical services.
2. The Administrator shall review each report to determine whether the employer is furnishing the accident benefits required by chapters 616A to 616D, inclusive, of NRS.
3. The content and form of the written reports must be prescribed by the Administrator.
4. References to a physician assistant and an advanced practice registered nurse in this section are for the purposes of the examination and treatment of an injured employee which are authorized to be provided by a physician assistant or advanced practice registered nurse in the exclusive context of an initial examination and treatment pursuant to NRS 616C.010.
(Added to NRS by 1977, 393; A 1981, 1476; 1985, 1545; 2021, 1185)
2023 Nevada Revised Statutes › Chapter 616C - Industrial Insurance: Benefits for Injuries or Death › NRS 616C.275 - Change of physicians, chiropractic physicians or other requirements; cost of change borne by insurer; cause of action of injured employee assigned to private carrier.

1. If the Administrator finds that the employer is furnishing the requirements of accident benefits in such a manner that there are reasonable grounds for believing that the health, life or recovery of the employee is being endangered or impaired thereby, or that an employer has failed to provide benefits pursuant to NRS 616C.265 for which he or she has made arrangements, the Administrator may, upon application of the employee, or upon the Administrator’s own motion, order a change of physicians or chiropractic physicians or of any other requirements of accident benefits.
2. If the Administrator orders a change of physicians or chiropractic physicians or of any other accident benefits, the cost of the change must be borne by the insurer.
3. The cause of action of an injured employee against an employer insured by a private carrier must be assigned to the private carrier.
[Part 58:168:1947; 1943 NCL § 2680.58]—(NRS A 1973, 602; 1975, 797; 1981, 1168, 1476; 1985, 308, 1545; 1993, 724; 1995, 2027; 1999, 1785)
2023 Nevada Revised Statutes › Chapter 616C - Industrial Insurance: Benefits for Injuries or Death › NRS 616C.280 - Withdrawal of approval for employer to provide accident benefits: Grounds supporting withdrawal.

The Administrator may withdraw his or her approval of an employer’s providing accident benefits for his or her employees and require the employer to pay the premium collected pursuant to NRS 616C.255 if the employer intentionally:
1. Determines incorrectly that a claimed injury did not arise out of and in the course of the employee’s employment;
2. Fails to advise an injured employee of the employee’s rights under chapters 616A to 616D, inclusive, or chapter 617 of NRS;
3. Impedes the determination of disability or benefits by delaying a needed change of an injured employee’s physician or chiropractic physician;
4. Causes an injured employee to file a legal action to recover any compensation or other medical benefits due the employee from the employer;
5. Violates any of the Administrator’s or the Division’s regulations regarding the provision of accident benefits by employers; or
6. Discriminates against an employee who claims benefits under chapters 616A to 616D, inclusive, or chapter 617 of NRS.
(Added to NRS by 1983, 426; A 1985, 1545; 1997, 1438; 1999, 225)
2023 Nevada Revised Statutes › Chapter 616C - Industrial Insurance: Benefits for Injuries or Death › NRS 616C.285 - Withdrawal of approval for employer to provide accident benefits: Request for hearing; notice of decision.

1. If an employer requests a hearing concerning the withdrawal of approval pursuant to NRS 616C.280, the Administrator shall set a date for a hearing within 20 days after receiving the request, and shall give the employer at least 10 business days’ notice of the time and place of the hearing.
2. A record of the hearing must be kept, but it need not be transcribed unless it is requested by the employer and the employer pays the cost of transcription.
3. Within 5 business days after the hearing, the Administrator shall either affirm or disaffirm the withdrawal of approval and give the employer written notice thereof by certified mail or electronic transmission.
(Added to NRS by 1983, 427; A 1997, 1438)
2023 Nevada Revised Statutes › Chapter 616C - Industrial Insurance: Benefits for Injuries or Death › NRS 616C.295 - Duties of Chief of Hearings Division: Adoption of regulations establishing codes of conduct for hearing officers and appeals officers, standards for initial training and continuing education and qualifications for hearing officers; expediting of certain cases; annual report.

1. The Chief of the Hearings Division shall adopt regulations establishing:
(a) A code of conduct for hearing officers who conduct hearings in contested cases for compensation under chapters 616A to 617, inclusive, of NRS; and
(b) A code of conduct for appeals officers who conduct hearings and appeals as required pursuant to chapters 616A to 617, inclusive, of NRS.
2. The codes of conduct established pursuant to subsection 1 must be designed to ensure fairness and impartiality, and to avoid the appearance of impropriety.
3. The Chief of the Hearings Division shall adopt regulations establishing:
(a) Standards for the initial training and continuing education of hearing officers who conduct hearings in contested cases for compensation under chapters 616A to 617, inclusive, of NRS; and
(b) Standards for the initial training and continuing education of appeals officers who conduct hearings and appeals as required pursuant to chapters 616A to 617, inclusive, of NRS.
4. The standards established pursuant to subsection 3 must, without limitation, include training and continuing education in:
(a) The provisions of chapters 616A to 617, inclusive, of NRS;
(b) Dispute resolution; and
(c) Mediation.
5. The Chief of the Hearings Division shall:
(a) Prescribe by regulation the qualifications required before a person may, pursuant to chapters 616A to 617, inclusive, of NRS, serve as a hearing officer.
(b) Provide for the expediting of the hearing of cases that involve the termination or denial of compensation.
6. From the cases heard each year by hearing officers and appeals officers regarding claims for benefits by injured employees, the Chief of the Hearings Division shall prepare an annual report which itemizes, on the basis of each insurer and third-party administrator, the number of cases affirmed, reversed, remanded and resolved by other disposition involving that insurer or third-party administrator, including a breakdown of that information by the type of benefits denied by the insurer or third-party administrator.
7. As used in this section, "Chief of the Hearings Division" means the Chief of the Hearings Division of the Department of Administration.
(Added to NRS by 1991, 2396; A 2005, 101; 2007, 3350)
2023 Nevada Revised Statutes › Chapter 616C - Industrial Insurance: Benefits for Injuries or Death › NRS 616C.300 - Hearing officers: Appointment; salary; disqualification from particular case.

1. The Director of the Department of Administration shall appoint one or more hearing officers to conduct hearings in contested cases for compensation under chapters 616A to 617, inclusive, of NRS. Each hearing officer shall serve at the pleasure of the Director of the Department of Administration. Each hearing officer is entitled to receive an annual salary in an amount provided by law and is in the unclassified service of the State.
2. If a hearing officer determines that he or she has a personal interest or a conflict of interest, directly or indirectly, in any case which is before him or her, the hearing officer shall disqualify himself or herself from hearing the case and the case must be assigned to another hearing officer.
(Added to NRS by 1993, 669)—(Substituted in revision for NRS 616.184)
2023 Nevada Revised Statutes › Chapter 616C - Industrial Insurance: Benefits for Injuries or Death › NRS 616C.305 - Procedure for appeal of final determination of organization for managed care which has contracted with insurer.

1. Except as otherwise provided in subsection 3, any person who is aggrieved by a final determination concerning accident benefits made by an organization for managed care which has contracted with an insurer must, within 14 days of the determination and before requesting a resolution of the dispute pursuant to NRS 616C.345 to 616C.385, inclusive, appeal that determination in accordance with the procedure for resolving complaints established by the organization for managed care.
2. The procedure for resolving complaints established by the organization for managed care must be informal and must include, but is not limited to, a review of the appeal by a qualified physician or chiropractic physician who did not make or otherwise participate in making the determination.
3. If a person appeals a final determination pursuant to a procedure for resolving complaints established by an organization for managed care and the dispute is not resolved within 14 days after it is submitted, the person may request a resolution of the dispute pursuant to NRS 616C.345 to 616C.385, inclusive.
(Added to NRS by 1993, 691; A 1993, 2452; 1995, 2149; 1999, 2216)
2023 Nevada Revised Statutes › Chapter 616C - Industrial Insurance: Benefits for Injuries or Death › NRS 616C.310 - Contested cases: Procedures; format; redaction of personal identifying information; representation of insurer or employer by legal counsel or other agent.

1. The Chief of the Hearings Division of the Department of Administration:
(a) May by regulation provide for specific procedures for the determination of contested cases.
(b) Shall develop a format to be used by hearing officers to indicate their findings in contested cases.
(c) Shall adopt regulations to provide for the redaction of personal identifying information of a person filing a claim for compensation from a document relating to the contested case of the person, unless the identity of the person is at issue. As used in this paragraph, "personal identifying information" means any information which would identify a person, including, without limitation, an address, a birth date or a social security number.
2. An insurer or employer may be represented in a contested case by private legal counsel or by any other agent.
(Added to NRS by 1973, 1596; A 1975, 761; 1977, 1389; 1979, 1042; 1985, 50; 1991, 2417; 2005, 2511; 2005, 22nd Special Session, 97)
2023 Nevada Revised Statutes › Chapter 616C - Industrial Insurance: Benefits for Injuries or Death › NRS 616C.320 - Resolution of disputed decision of self-insured employer or employer who is member of association of self-insured public or private employers or insured by private carrier.

If an employee of a self-insured employer, an employer who is a member of an association of self-insured public or private employers or an employer insured by a private carrier is dissatisfied with a decision of his or her employer, the association or the private carrier, the employee may seek to resolve the dispute pursuant to NRS 616C.305 and 616C.315 to 616C.385, inclusive.
(Added to NRS by 1979, 1039; A 1993, 737; 1995, 2032)
2023 Nevada Revised Statutes › Chapter 616C - Industrial Insurance: Benefits for Injuries or Death › NRS 616C.325 - Representation of employee and employer before hearings officer or appeals officer or in negotiations with insurer; licensure of employer’s representative; employer liable for representative’s violations; compensation of employer’s representative must not be contingent on outcome.

1. It is unlawful for any person to represent an employee before a hearing officer, or in any negotiations, settlements, hearings or other meetings with an insurer concerning the employee’s claim or possible claim, unless the person is:
(a) Employed by the employee’s labor organization and is not an independent contractor;
(b) Admitted to practice law in this State;
(c) Employed full-time by and under the supervision of an attorney admitted to practice law in this State; or
(d) Appearing without compensation on behalf of the employee.
It is unlawful for any person who is not admitted to practice law in this State to represent the employee before an appeals officer.
2. It is unlawful for any person to represent an employer at hearings of contested cases unless that person is:
(a) Employed full-time by the employer or a trade association to which the employer belongs that is not formed solely to provide representation at hearings of contested cases;
(b) An employer’s representative licensed pursuant to subsection 3 who is not licensed as a third-party administrator;
(c) Admitted to practice law in this State; or
(d) A licensed third-party administrator.
3. The Director of the Department of Administration shall adopt regulations which include the:
(a) Requirements for licensure of employers’ representatives, including:
(1) The registration of each representative; and
(2) The filing of a copy of each written agreement for the compensation of a representative;
(b) Procedure for such licensure; and
(c) Causes for revocation of such a license, including any applicable action listed in NRS 616D.120 or a violation of this section.
4. Any person who is employed by or contracts with an employer to represent the employer at hearings regarding contested claims is an agent of the employer. If the employer’s representative violates any provision of this chapter or chapter 616A, 616B, 616D or 617 of NRS, the employer is liable for any penalty assessed because of that violation.
5. An employer shall not make the compensation of any person representing the employer contingent in any manner upon the outcome of any contested claim.
6. The Director of the Department of Administration shall collect in advance and deposit with the State Treasurer for credit to the State General Fund the following fees for licensure as an employer’s representative:
(a) Application and license........................................................................................ $78
(b) Triennial renewal of each license......................................................................... 78
(Added to NRS by 1987, 2140; A 1989, 527; 1993, 737, 2453, 2458; 1995, 2149; 1999, 225; 2013, 420)
2023 Nevada Revised Statutes › Chapter 616C - Industrial Insurance: Benefits for Injuries or Death › NRS 616C.350 - Testimony of physician, chiropractic physician, physician assistant or advanced practice registered nurse before appeals officer; privileged communications.

1. Any physician, chiropractic physician, physician assistant or advanced practice registered nurse who attends an employee within the provisions of chapters 616A to 616D, inclusive, or chapter 617 of NRS in a professional capacity, may be required to testify before an appeals officer. A physician, chiropractic physician, physician assistant or advanced practice registered nurse who testifies is entitled to receive the same fees as witnesses in civil cases and, if the appeals officer so orders at his or her own discretion, a fee equal to that authorized for a consultation by the appropriate schedule of fees for physicians, chiropractic physicians, physician assistants or advanced practice registered nurses, if any. These fees must be paid by the insurer.
2. Information gained by the attending physician, chiropractic physician, physician assistant or advanced practice registered nurse while in attendance on the injured employee is not a privileged communication if:
(a) Required by an appeals officer for a proper understanding of the case and a determination of the rights involved; or
(b) The information is related to any fraud that has been or is alleged to have been committed in violation of the provisions of this chapter or chapter 616A, 616B, 616D or 617 of NRS.
3. References to a physician assistant and an advanced practice registered nurse in this section are for the purposes of the examination and treatment of an injured employee which are authorized to be provided by a physician assistant or advanced practice registered nurse in the exclusive context of an initial examination and treatment pursuant to NRS 616C.010.
[Part 52:168:1947; 1943 NCL § 2680.52]—(NRS A 1975, 763; 1977, 314; 1981, 1197, 1471; 1985, 1543; 1993, 715; 1995, 1872, 2023; 1997, 583; 1999, 226; 2021, 1192)
2023 Nevada Revised Statutes › Chapter 616C - Industrial Insurance: Benefits for Injuries or Death › NRS 616C.355 - Use of affidavits or declarations as evidence at hearing; notice to opposing party; waiver of right to cross-examine affiant or declarant; effect of waiver.

At any time 10 or more days before a scheduled hearing before an appeals officer, the Administrator or the Administrator’s designee, a party shall mail or deliver to the opposing party any affidavit or declaration which the party proposes to introduce into evidence and notice to the effect that unless the opposing party, within 7 days after the mailing or delivery of such affidavit or declaration, mails or delivers to the proponent a request to cross-examine the affiant or declarant, the opposing party’s right to cross-examine the affiant or declarant is waived and the affidavit or declaration, if introduced into evidence, will have the same effect as if the affiant or declarant had given sworn testimony before the appeals officer, the Administrator or the Administrator’s designee.
(Added to NRS by 1975, 761; A 1977, 84; 1981, 1490; 1983, 358; 1993, 740; 1997, 1422; 1999, 1728)
2023 Nevada Revised Statutes › Chapter 616C - Industrial Insurance: Benefits for Injuries or Death › NRS 616C.363 - External review: Duties of independent review organization; contents and submission of decision by organization; costs; regulations.

1. Not later than 5 business days after the date that an independent review organization receives a request for an external review, the independent review organization shall:
(a) Review the documents and materials submitted for the external review; and
(b) Notify the injured employee, his or her employer and the insurer whether the independent review organization needs any additional information to conduct the external review.
2. The independent review organization shall render a decision on the matter not later than 15 business days after the date that it receives all information that is necessary to conduct the external review.
3. In conducting the external review, the independent review organization shall consider, without limitation:
(a) The medical records of the insured;
(b) Any recommendations of the physician of the insured; and
(c) Any other information approved by the Commissioner for consideration by an independent review organization.
4. In its decision, the independent review organization shall specify the reasons for its decision. The independent review organization shall submit a copy of its decision to:
(a) The injured employee;
(b) The employer;
(c) The insurer; and
(d) The appeals officer, if any.
5. The insurer shall pay the costs of the services provided by the independent review organization.
6. The Commissioner may adopt regulations to govern the process of external review and to carry out the provisions of this section. Any regulations adopted pursuant to this section must provide that:
(a) All parties must agree to the submission of a matter to an independent review organization before a request for external review may be submitted;
(b) A party may not be ordered to submit a matter to an independent review organization; and
(c) The findings and decisions of an independent review organization are not binding.
(Added to NRS by 2003, 2332; A 2011, 3423)
2023 Nevada Revised Statutes › Chapter 616C - Industrial Insurance: Benefits for Injuries or Death › NRS 616C.365 - Reimbursement of employee’s expenses incurred and wages lost as result of hearing requested by employer or insurer; regulations.

1. If an employer or insurer requests a hearing before a hearing officer or appeals officer relating to a claim for compensation, and the hearing results in a decision favorable to the employee, the employee is entitled to receive reimbursement from the insurer for:
(a) The employee’s actual expenses necessarily incurred for travel to and from the hearing, if the employee is required to travel more than 20 miles one way from his or her residence or place of employment to the hearing; and
(b) Any regular wages lost as a result of his or her attending the hearing.
2. The Division shall adopt regulations governing the procedure and forms to be used for the reimbursement provided by subsection 1.
(Added to NRS by 1985, 1575; A 1993, 1870)—(Substituted in revision for NRS 616.5428)
2023 Nevada Revised Statutes › Chapter 616C - Industrial Insurance: Benefits for Injuries or Death › NRS 616C.370 - Judicial review.

1. No judicial proceedings may be instituted for compensation for an injury or death under chapters 616A to 616D, inclusive, of NRS unless:
(a) A claim for compensation is filed as provided in NRS 616C.020; and
(b) A final decision of an appeals officer has been rendered on such claim.
2. Judicial proceedings instituted for compensation for an injury or death, under chapters 616A to 616D, inclusive, of NRS are limited to judicial review of the decision of an appeals officer.
(Added to NRS by 1973, 1596; A 1977, 84, 315, 317; 1993, 740)—(Substituted in revision for NRS 616.543)
2023 Nevada Revised Statutes › Chapter 616C - Industrial Insurance: Benefits for Injuries or Death › NRS 616C.375 - Stay of decision of appeals officer.

If an insurer, employer or claimant, or the representative of an insurer, employer or claimant, appeals the decision of an appeals officer, that decision is not stayed unless a stay is granted by the appeals officer or the district court within 30 days after the date on which the decision was rendered.
(Added to NRS by 1991, 2394)—(Substituted in revision for NRS 616.5433)
2023 Nevada Revised Statutes › Chapter 616C - Industrial Insurance: Benefits for Injuries or Death › NRS 616C.380 - Payment pending appeal when decision not stayed; effect of final resolution of claim.

1. If a hearing officer, appeals officer or district court renders a decision on a claim for compensation and the insurer or employer appeals that decision, but is unable to obtain a stay of the decision:
(a) Payment of that portion of an award for a permanent partial disability which is contested must be made in installment payments until the claim reaches final resolution.
(b) Payment of the award must be made in monthly installments of 66 2/3 percent of the average wage of the claimant until the claim reaches final resolution if the claim is for more than 3 months of past benefits for a temporary total disability or rehabilitation, or for a payment in lump sum related to past benefits for rehabilitation, such as costs for purchasing a business or equipment.
2. If the final resolution of the claim is in favor of the claimant, the remaining amount of compensation to which the claimant is entitled may be paid in a lump sum if the claimant is otherwise eligible for such a payment pursuant to NRS 616C.495 and any regulations adopted pursuant thereto. If the final resolution of the claim is in favor of the insurer or employer, any amount paid to the claimant in excess of the uncontested amount must be deducted from any future benefits related to that claim, other than medical benefits, to which the claimant is entitled. The deductions must be made in a reasonable manner so as not to create an undue hardship to the claimant.
(Added to NRS by 1989, 687; A 1995, 2152)—(Substituted in revision for NRS 616.5435)
2023 Nevada Revised Statutes › Chapter 616C - Industrial Insurance: Benefits for Injuries or Death › NRS 616C.385 - Costs and attorney’s fees for frivolous petitions for judicial review.

If a party petitions the district court for judicial review of a final decision of an appeals officer, the Administrator or the Administrator’s designee, and the petition is found by the district court to be frivolous or brought without reasonable grounds, the district court may order costs and a reasonable attorney’s fee to be paid by the petitioner.
(Added to NRS by 1975, 761; A 1977, 316; 1983, 358; 1993, 741; 1999, 1728)