{"id":296,"date":"2011-09-09T12:15:00","date_gmt":"2011-09-09T12:15:00","guid":{"rendered":"https:\/\/jhwlawoffice.com\/nevada-workers-comp-law-blog\/?p=296"},"modified":"2015-04-28T12:24:54","modified_gmt":"2015-04-28T12:24:54","slug":"delays-in-getting-medical-care-on-your-nevada-work-comp-claim","status":"publish","type":"post","link":"https:\/\/jhwlawoffice.com\/nevada-workers-comp-law-blog\/2011\/09\/articles\/benefits\/back-injuries\/delays-in-getting-medical-care\/delays-in-getting-medical-care-on-your-nevada-work-comp-claim\/","title":{"rendered":"Delays in Getting Medical Care on Your Nevada Work Comp Claim"},"content":{"rendered":"<p>Delays in getting medical care authorized are the reason most injured workers contact me for help on their claim.&nbsp; Here is some additional information about treatment delays and what&nbsp; you&nbsp;can do to get proper medical care on time on your&nbsp; Nevada workers&#8217; compensation claim.&nbsp;&nbsp;<\/p>\n<ul>\n<li>An insurer won&#8217;t authorize expensive tests like MRI&#8217;s or EMG\/nerve conduction studies until the insurer decides to accept your claim.&nbsp; The adjuster has 30 days to accept or deny the claim.&nbsp;&nbsp; If the claim is denied, no tests or further treatment&nbsp;will be&nbsp;authorized.<\/li>\n<li>Prior authorization must be sent by your treating doctor to the adjuster for diagnostic tests (other than in-office x-rays), physical therapy, consultations with other doctors, or for surgical procedures.&nbsp;<\/li>\n<li>The adjuster has 5 working days to respond to a doctor&#8217;s request for authorization pursuant to NRS&nbsp;616.157.<\/li>\n<li>Insurers can delay treatment or tests by scheduling an injured worker for a consultation or an independent medical exam with a doctor chosen by the adjuster.&nbsp; The adjuster can suspend your benefits for non-cooperation if you don&#8217;t attend this appointment.&nbsp;&nbsp;NRS 616C.140.<\/li>\n<li>The insurer can delay authorizing treatment or diagnostic testing until the&nbsp;requesting doctor&nbsp; provides the adjuster with his dictated medical report.<\/li>\n<li>The insurer might have a medical review done of the request.<\/li>\n<li>&nbsp;An adjuster should copy&nbsp;you on&nbsp;any denial&nbsp;of the&nbsp;requested treatment or test.&nbsp;and give&nbsp;appeal rights instead of just notifying the doctor of the denial.&nbsp; NAC 616C.091(3).<\/li>\n<li>&nbsp; If you&nbsp;moved outside&nbsp;of Nevada, the insurer&nbsp;won&#8217;t &nbsp;authorize medical care with&nbsp;an out-of-state doctor until the insurer is sure that the doctor will accept what the Nevada medical fee schedule allows for office visits and treatment.&nbsp;<\/li>\n<li>&nbsp;<\/li>\n<li><span style=\"font-size: medium\">&nbsp;<strong>What you&nbsp;can do<\/strong><\/span><strong>:<\/strong><\/li>\n<\/ul>\n<ol>\n<li>Make sure that your doctor faxed the request for prior authorization to the adjuster.<\/li>\n<li>If the adjuster hasn&#8217;t acted within 5 working days, and doesn&#8217;t give you a reason for the delay,&nbsp;you may file a complaint with the DIR, with a copy to the adjuster.&nbsp;Some adjusters&nbsp;will&nbsp;then respond, not wanting to deal&nbsp;with a DIR&nbsp;investigation.&nbsp;<em>See<\/em> NAC 616C.092.&nbsp;<\/li>\n<li>&nbsp; File an appeal if you have requested a transfer of doctors or some particular treatment. File appeals of&nbsp;any medical review doctor&#8217;s opinion denying&nbsp;the requested treatment or test.&nbsp; &nbsp; You may appeal an insurer&#8217;s failure to&nbsp;respond to your written request after 30 days.<\/li>\n<li>&nbsp;You may ask your doctor for help by having him talk to the adjuster to explain why treatment or testing is necessary.<\/li>\n<li>&nbsp;Make sure that your out-of-state doctor will accept the Nevada fee schedule before you ask the adjuster to allow treatment with that doctor.<\/li>\n<li>&nbsp;Get legal help if there are delays that&nbsp; prevent you from getting the medical care you need now for all of your injuries.&nbsp; Most attorneys do not charge for an initial consultation.<\/li>\n<\/ol>\n<p>&nbsp;<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Delays in getting medical care authorized are the reason most injured workers contact me for help on their claim.&nbsp; Here is some additional information about treatment delays and what&nbsp; you&nbsp;can do to get proper medical care on time on your&nbsp; Nevada workers&#8217; compensation claim.&nbsp;&nbsp; An insurer won&#8217;t authorize expensive tests like MRI&#8217;s or EMG\/nerve conduction &hellip; <a href=\"https:\/\/jhwlawoffice.com\/nevada-workers-comp-law-blog\/2011\/09\/articles\/benefits\/back-injuries\/delays-in-getting-medical-care\/delays-in-getting-medical-care-on-your-nevada-work-comp-claim\/\" class=\"more-link\">Continue reading <span class=\"screen-reader-text\">Delays in Getting Medical Care on Your Nevada Work Comp Claim<\/span> <span class=\"meta-nav\">&rarr;<\/span><\/a><\/p>\n","protected":false},"author":2,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[71],"tags":[516,156,190,191,194,320,398,469,485],"class_list":["post-296","post","type-post","status-publish","format-standard","hentry","category-delays-in-getting-medical-care","tag-authorization","tag-care","tag-delays","tag-delays-in-getting-medical-care","tag-diagnostic","tag-medical","tag-prior","tag-tests","tag-treatment"],"acf":[],"aioseo_notices":[],"post_mailing_queue_ids":[],"_links":{"self":[{"href":"https:\/\/jhwlawoffice.com\/nevada-workers-comp-law-blog\/wp-json\/wp\/v2\/posts\/296","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/jhwlawoffice.com\/nevada-workers-comp-law-blog\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/jhwlawoffice.com\/nevada-workers-comp-law-blog\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/jhwlawoffice.com\/nevada-workers-comp-law-blog\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/jhwlawoffice.com\/nevada-workers-comp-law-blog\/wp-json\/wp\/v2\/comments?post=296"}],"version-history":[{"count":2,"href":"https:\/\/jhwlawoffice.com\/nevada-workers-comp-law-blog\/wp-json\/wp\/v2\/posts\/296\/revisions"}],"predecessor-version":[{"id":297,"href":"https:\/\/jhwlawoffice.com\/nevada-workers-comp-law-blog\/wp-json\/wp\/v2\/posts\/296\/revisions\/297"}],"wp:attachment":[{"href":"https:\/\/jhwlawoffice.com\/nevada-workers-comp-law-blog\/wp-json\/wp\/v2\/media?parent=296"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/jhwlawoffice.com\/nevada-workers-comp-law-blog\/wp-json\/wp\/v2\/categories?post=296"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/jhwlawoffice.com\/nevada-workers-comp-law-blog\/wp-json\/wp\/v2\/tags?post=296"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}