As mentioned in SB 289 part 1, this year’s legislative session was a big one and SB 289 was a huge bill. SB 289 changed apportionment, who can sign C-4s, determinations send by fax, added attorney’s liens, amended rules about accepting PPD awards, clarified existing rules on vocational rehabilitation, and allows claimants to recover costs. While SB 289 part 1 was all about the new apportionment changes, this blog will briefly touch on the rest of SB 289.
Who can sign C-4s?
Previously, only chiropractors (DC) and physicians (MDs and DOs) could sign the initial claims forms and treat injured workers. This led to massive problems when injured workers would be seen by a physician assistant (PA) or an advanced practice registered nurse (APRN) at Concentra and that PA or APRN would sign their C-4 form. In this scenario, insurance companies and their attorneys were arguing that the forms are invalid and/or there was not MD, DO, or DC causally connecting the injury as being job incurred as required by the statute. This was a technicality, out of the injured workers’ control, that was allowing for claims to be wrongfully denied. NOW, PAs and APRNs can sign C-4s and treat injured workers.
Side note on C-4s… they can now be signed electronically, however, the injured worker must be provided a copy at the time of discharge.
Determinations can be sent by facsimile (fax)?
Yes! NRS 616C.065 has been amended to include that if requested by the claimant or the person acting on behalf of the claimant all determinations made by the insurer must be faxed and the insurer must then retain proof of a successful transmission. If the insurer fails to retain proof of the successful transmission it shall be deemed a failure of the insurer to send by fax.
Why is this important? Dead are the days of insurance company’s making a detrimental determination, saying they sent it, you never getting it, and them arguing too bad. Unless they can show the determination was sent your appeal rights have been tolled. This means you will no longer be hit with “I sent a letter saying it was denied and you never appealed,” if they cannot show it was sent. This new rule only applies if you have requested determinations be sent to you by fax. Be careful, this also effects your appeal rights. There is an argument that this will limit your appeal time to 70 days rather than 73 days (3 days for mailing).
How many vocational rehabilitation counselors can I pick from?
I believe it was 2017 when the statue was amended to require the workers’ compensation insurer to send an injured work three vocational rehabilitation counselors to pick from. The problem was insurers were sending the names of three counselors that work for the same company. Now, the list of counselors must be “employed by at least three different organizations or entities.”
I can accept my PPD award in a lump sum and continue to fight?
Regarding most issues, yes! It used to be once you accept the PPD award all issues of fact and law are deemed final. This is no longer the case for “contested matters which are pending at the time the claimant executes his or her election to receive his or her payment for a permanent partial disability in a lump sum.” There are three exceptions to this new rule… one cannot accept his/her PPD award and continue to argue: 1) the scope of the claim (that more body parts or diagnoses should be included), 2) the claimant’s stable and ratable status (that more treatment is needed), and 3) the claimant’s average monthly wage.
I can recover costs?
NRS 616C.335 now allows for an award of costs against the opposing party for: clerks’ fees, reporters’ fees for depositions, fees for witnesses and an appeals hearing and deposing witnesses, reasonable costs for photocopies, postage, travel, and other litigation related expenses. Costs awarded pursuant to this new rule are “limited to the costs incurred as a result of the litigation of those issues which were decided in favor of the claimant.”
This is a big win for claimants, as insurers and employers often have deep pockets and go to great lengths to prove their point. This rule will even the playing field and allow claimants to build their case, with the possibility of being reimbursed if successful.
A lien for attorney’s fees?
Attorney’s can now assert a lien for attorney’s fees pursuant to NRS 18.015 on workers’ compensation claims. This protects attorneys and their ability to get paid for work performed on a client’s file.