Workers' Compensation Attorney

In Nevada, police officers and fire fighters have additional workers’ compensation coverage and benefits for some injuries and illnesses that Nevada employees of  other occupations do not have.  The laws that are unique to police officers and/or fire fighters are amended frequently when the Nevada legislature meets every two years.  It is therefore important to check for any recent amendments to the laws referenced in this blog post.  Please use this post as a starting point for discussion with an attorney about your particular circumstances if you are a police officer or fire fighter.  Look for upcoming posts on topics of special interest to police officers and fire fighters, such as heart disease, lung disease, hearing loss, psychological stress disorders, cancer, and contagious diseases.

The legal definition of who is a police officer for purposes of knowing whether the special laws and benefits apply is in NRS 617.135.  The listing in this statute of the various law enforecement employees of various public entities (state, city, and county) is reviewed for amendment almost every legislative session to consider whether additional positions should be included.     Whether a particular law enforcement group is added to the list by amendment depends on the political clout of the omitted group. 

NRS 617.135 is considered to be an exclusive list of who is a police officer.  Other employees with  law enforcement duties similar to those  positions included in the statute have not been successful arguing that the special laws for police officers should apply to them also. 

If you do want to attempt to do legal research on your own, here are links to look up the laws, regulations and cases that might address your particular issue.  Keep in mind that laws and regulations must be interpreted, and what lawyers do for a living, after three years of law school, is argue alternate interpretations of the law.  The DIR website also has basic information for injured workers.

Many of the laws in Chapter 616 (the Nevada Industrial Insurance Act) are poorly written.   Look at the law that discusses medical care on denied claims, NRS 616C.090.  Would you have any idea after reading that law how an injured worker can get reimbursed for deductibles or co-payments that he paid after his claim was denied once an appeals officer orders the claim accepted?   

It is important to know how local appeals officers interpret laws and how they might apply the  Nevada Supreme Court decisions that discuss workers’ compensation claims to your particular fact situation.  There isn’t any public repository of appeals officer decisions.  You must have experience arguing cases before the appeals officers before you can predict a likely outcome in your case.  Most cases are not decided on a question of law, but instead are decided on whether the appeals officer thinks that you or your witnesses appear to be telling the truth. 

The Nevada Attorney for Injured Workers is a free state agency created for the purpose of representing injured workers during the second level of the appeals process. 

Injuries by accident and Occupational Diseases

1. Notify immediate supervisor and complete written notice even if you don’t need medical care.  If there is any possibility of you needing medical care in the future, it is essential that you promptly notified your employer.  The law (NRS 616C.015) says the injured worker has 7 days to provide written notification, but adjusters deny claims if notification is not made as soon as possible.  There is an excuse provision in the law (NRS 616C.025) , but it is better not to have to rely on it.

2. If you need medical care, obtain a Medical Evaluation Packet from your supervisor and go to one of the clinics designated for treatment.  Go to the closest emergency facility if it is an extreme emergency.

3. At the medical clinic, complete the C-4 Claim for Compensation form.   It is very important that you complete the top half very carefully, correctly noting the date and time of the accident, and that you correctly describe an injury by accident (click for more info), and that you list all the body parts you think were injured.  It is harder than you think to add treatment for other body parts that weren’t injured as bad initially. This must be filed within 90 days of the accident (NRS 616C.020), or you must again argue that the excuse law applies (NRS 616C.025).

4. There may be additional reports required, depending on the type of accident, i.e. traffic accident.

5. Give your supervisor a copy of any off work  or restricted work slips from the physician.  

6. If required by current policy guidelines, copy the Health and Safety Manager on off work/restricted work slips.  Obtain a physician progress report from the doctor after every visit. 

7. Be informed about your right to change physicians, how your benefits are calculated, and what you are entitled to if you have a serious permanent injury.  Don’t rely on co-workers. There are almost 200 blog posts covering Nevada law here.  You may also call  699-5336 for a free Guide, or get a free consultation with an experienced lawyer. 

 A few of the benefits that Nevada injured workers overlook include the following:

1. Prescription coverage

 Make sure that your pharmacy has your claim number, and the phone and fax number for your adjuster.  If the adjuster sends you a pharmacy card, be sure to use it.  If your pharmacy tells you they are waiting for authorization and you can’t wait, pay for the medicine and send your adjuster the receipt. Don’t confuse the issue by using your private insurance.     

2.  Mileage Reimbursement 

If you travel more than 40 miles a week, or 20 miles one way, to your doctors’ appointments, and to therapy, right now the mileage reimbursement rate is fifty-five cents (55 cents) a mile.  A common mistake is to wait more than 60 days to turn in the request for reimbursement form.  Turn in the forms each month after making a copy for yourself.  

3.  Concurrent Wages           

 If you were working for two employers on the date you were injured, you need to make your adjuster aware of that by sending in paycheck stubs for that second employer.  Send paycheck stubs for three months before the date of your accident.

4.  Wrong Average Monthly Wage

When you receive the adjuster’s letter advising you what your daily benefits will be, look carefully at the amount the adjuster says is your average monthly wage.  Ask for the wage verification form your employer gave the adjuster to check it against your old paycheck stubs.  There are various ways to calculate average monthly wage. If yours seems too low, get a free consultation with a knowledgeable lawyer.

5.  Low permanent impairment award

Unless you are familiar with the AMA Guides to Evaluation of Permanent Impairment, fifth edition, there is no way you will know whether the percentage found by the rating doctor is correct or not.  There is no excuse for accepting a low PPD award without first getting reliable information about whether the percentage and the way the lump  sum is calculated is correct.  Many workers’ compensation attorneys will review your PPD award election papers for free.  

Some employers have a nasty way of reducing  injured employees hours who are recovering from a work accident with temporary light duty work restrictions.  You may be entitled to workers’ compensation  called temporary partial disability benefits if your take home pay is drastically reduced.  Here’s how to know whether you are entitled to these benefits, and how to get them:

1. Find the letter from the adjuster that tells you what your average monthly wage is and what your daily compensation rate is when you are taken off work completely by your treating doctor.  If you haven’t received an average monthly wage determination letter, you will have to ask the adjuster to send you one so that you both know whether you are entitled to TPD while working reduced hours on light duty

2. Multiply the daily compensation rate by the number of days in your employer’s pay period.  If your employer pays you bi-weekly, you will multiply the daily rate by 14 to get your biweekly compensation rate. If your employer pays you weekly, multiply the daily rate by 7.

3. Get your paycheck stub and note what your net wages are (meaning those after taxes and deductions).  Do this for each paycheck while you are working light duty.

4. If your net wages are less than your compensation rate for the same time period, then you are entitled to the difference.  (Subtract your net wages from your compensation rate to get the difference.)

5. Send a copy of each paycheck stub that is less than your compensation rate to the adjuster with a request that the adjuster pay TPD.  Allow two weeks before you bug the adjuster about not getting a check.

6. Make sure that it is your employer that is reducing your hours; not that you are asking for less hours or calling in sick.

How to treat chronic pain was a topic addressed by several of the featured speakers at the WILG convention in Las Vegas this weekend.  (WILG is a non-profit organization that assists attorneys in advocating the rights of injured workers.)  Dr. Steven Simon, M.D. of the Kansas University Medical Group spoke about CRPS complex regional pain syndrome.  He defined CRPS as an inciting event (usually trauma, but sometimes  immobilization) to a a nerve that then moves into the spinal cord where it becomes a systemic  chronic pain problem. 

Dr. Simon stressed that the earlier the problem is diagnosed, the better the patent’s chances were for a successful treatment orientation.   He acknowledged that many treating orthopedic physicians were not knowledgeable enough about treating  chronic pain systems consisting of depression,  anger, sleep deprivation, hormonal deprivation, and pain. When the patient doesn’t get better and the cause of the problem is not readily identified using traditional diagnostic methods, the adjuster likewise becomes frustrated and schedules an independent medical exam. That results in more delays in getting the injured worker to an appropriate physician to treat the CRPS.   Many CRPS sufferers find that an attorney advocate is necessary to ensure proper treatment and a fair impairment evaluation.

A featured speaker at the WILG convention today was Dr. Tim Tollestrup, M.D., a Las Vegas physician who specializes in peripheral nerve surgery.    Dr. Tollestrup had recently operated successfully on one of my clients with a crush injury to his foot,  so I was interested in knowing more about him and his approach to treating difficult chronic pain cases.  Dr. Tollestrup is one of only several surgeons in the country who focuses on eliminating chronic pain by applying accepted surgical techniques to peripheral nerve decompression or segmental denervation (cutting a peripheral nerve to interrupt the pain response.)

Peripheral nerves are all of the nerves in the body other than the spinal cord.  Dr. Tollestrup explained that most physicians, including orthopedic surgeons,  have very little training in the anatomy of the peripheral nerves.   When patients have severe pain lasting longer than six months following an injury or surgery to a knee, shoulder, elbow, hand or foot, a compression, stretching, laceration, or crush-type njury to a peripheral nerve may be cause of the chronic pain.  Surgery to treat the peripheral nerve injury may successfully eliminate the pain completely.

Dr. Tollestrup stated that it was very satisfying to be able to  provide  relief  to a patient who may have had to take  narcotic pain killers for months or even years.  He also confirmed that it was very  frustrating to chronic pain patients to be passed from one doctor to another after unsuccessful pain management.

X-rays, MRI’s, EMG and nerve conduction studies, are not very helpful in diagnosing  a peripheral nerve injury according to Dr. Tollestrup,  Instead, he depends on taking a careful history of the problem from the patient and on a hands-on clinical examination.  Peripheral nerve surgery is a relatively new field, and additional research must be done before it can be applied to treat spine pain. tt was particularly exciting to learn about its success in treating  complex regional pain syndrome and other types of chronic pain that have been baffling to physicians treating injured employees.  Dr. Tollestrup’s website is NevadaNerveSurgery.org.

Here’s an intersting article on PTSD:that sheds some light on why subsequent events that are minor can trigger such a strong reaction in the PTSD patient.   http://psychcentral.com/news/2012/10/08/mice-study-suggests-brain-switch-implicated-in-ptsd/45723.html?

     One of the sad realities representing people with serious work injuries, is that the financial, physical, and psychological stresses caused by the injury or the claims process, often result in failed marriages.  It really is unfortunate when I am asked for the name of a divorce attorney by a client once he or she receives the permanent partial disability award.  An attorney I can highly recommend for divorce or child custody issues is Stacy Rocheleu of Right Lawyers.  Stacy contributed the following blog post as an exclusive article for my readers.  Thanks, Stacy.

Do you need a lawyer on a divorce case?

by Stacey Rocheleau, Esq.

      Deciding whether or not you need an attorney on a divorce case depends greatly on your circumstances. While it would be wonderful to believe you can agree to everything and sort out your differences on your own, this rarely happens. Most divorces are due to the fact couples can’t get along anymore so agreeing to the final terms of a divorce can be allusive.  

     When filing for a divorce there are five major areas to take into consideration; division of property, division of debt, child custody, child support, and sometimes alimony.  We would rarely recommend for couples needing to draft the terms of child support or child custody without an attorney review. Divorces that are simply about division of property or debt are simpler in nature and are often decided without an attorney involved. 

     An attorney is not only well versed on court procedures, they are knowledgeable on the ever changing divorce laws. A divorce attorney can help with question like; Who gets the house when it is titled in both our names?, Is child support modifiable?, Can I get lump sum alimony?, Am I entitled to his worker compensation benefit?

     With all the emotional stress that comes along with a divorce, you shouldn’t’ add to the level of worry and concern. Hiring a divorce attorney who has your best interests at heart and who can assure your rights are protected it most often the best advice. 

Permanent, work-related hearing loss can result when an employee is exposed to an unexpected loud noise, like an explosion at a manufacturing plant.  However, many cases of occupationally-related hearing loss are caused by excessive noise exposure over months, or years  in a work environment that is too loud.   Difficulty hearing or understanding spoken words happens to most of us as we age, so it isn’t always easy to identify a progressive hearing loss problem as work-related. It is even more difficult finding good information about what to do if you suspect that your worsening hearing problem is caused by your job.  

Most employers whose employees are routinely  exposed to loud noises at work require a base line hearing test when the employee is  hired, and then an annual hearing test.  Police officers and fire fighters, for example, are required by law to undergo an annual hearing test, called an audio gram,  when the annual heart and lung medical exams are done. Police officers may wear protective hearing gear when re-certifying their weapons permits, but hearing protection obviously isn’t  handy during a shoot out, or during a chase with sirens  wailing, or when on traffic patrol. 

Large employers  with loud equipment or very noisy work environments  must hire  occupational hygienists to  measure noise levels to ensure compliance with national health and safety standards and to satisfy their insurers’ loss control programs.   A  contested hearing loss claim might involve experts who  disagree about what the noise  exposure really is  for an  employee  who is claiming hearing loss.    Most denied hearing loss claims however, are denied because the insurer says that the employee knew about his hearing loss  for weeks, months, or years  before he or she filed a compensation claim.  Those denials by the insurer are often upheld simply because the employee was confused about when to file a claim and what information to put on the claim form.

The same  C-4 Claim for Compensation form used for work injuries caused by accidents  is used for occupational illnesses, including occupational hearing loss.  The box on the form that asks when the accident happened isn’t relevant to an occupational hearing loss that happens gradually over time.  Nonetheless, clinics  insist that the employee fill in a date on that box.  Sometimes the office personnel at the medical clinic will direct the employee to write in the date that the employee first noticed a hearing problem.   

Nevada law requires that employees report occupational illnesses within  7 days.  However, an employee rarely tells his employer about a hearing problem when the employee first notices that he or she is hard of hearing, unless the hearing loss results from a loud explosive-like noise.  Usually, the employee has  co-workers or family complain about having to repeat themselves before the employee takes the problem seriously. Ordinarily, there is a decrease in hearing ability long before most people are motivated to get their hearing tested.

 In order to avoid a denial of this important claim, however, the employee should complete a written Notice of Occupational Disease with the employer, and ask the employer where to go to complete a Claim for Compensation form  as soon as the employee suspects an occupational hearing loss.  The decision to wear amplification can always be made later, once the claim is accepted.

Hearing aids are expensive.  Hearing loss claims often require a reopening every couple of years to replace batteries or outdated equipment, particularly if the hearing loss is progressive.   Additionally, the employee may be entitled to a permanent partial disability award for the occupational  hearing loss.  Don’t overlook your right to benefits under the Nevada Occupational Disease Act for a hearing loss that is caused by occupational noise exposure.