Once an insurance company providing workers’ compensation coverage to an injured or sick worker in Nevada decides that the worker has reached “maximum medical improvement,” that insurance company will take steps to formally close that worker’s claim. If there are any benefits the insurance company still owes that worker, they will typically try to negotiate a settlement agreement that either sets up a specific and finite payment structure or ends the claim immediately with a lump-sum payment.
It is important for workers’ comp claimants to understand that they are not required by law to accept workers’ compensation settlements in Las Vegas, and that they may have legal options for formally contesting a settlement offer they feel is unfair. When you receive a notice from your workers’ comp insurance provider that they intend to close your claim or offer a settlement, get in touch with a qualified workers’ compensation lawyer at Shook & Stone.
Insurance companies that want to end workers’ comp claims must notify the claimant by sending them a written “Notice of Intent to Close Claim.” This notice must include details about how the claimant may appeal the insurer’s attempt to close their claim, what would happen if they do not file an appeal or their appeal is unsuccessfully, and whether the insurer has scheduled a permanent partial disability evaluation for the claimant or why they have refrained from doing so.
The purpose of this evaluation would be to determine whether the claimant has lost more or less than 30 percent of their overall bodily function through their disability, and whether remaining disability benefits will be paid on a monthly basis for several years to come or whether the insurance company can settle the matter through a single lump-sum payment. Claimants who accept such a lump-sum settlement can continue to get certain other benefits and may request to reopen their claim at a later date, but they cannot appeal the settlement once it is paid out.
The insurance company can also negotiate with the claimant on whether to pay out vocational rehabilitation benefits such as job retraining as a lump-sum settlement. Someone who accepts a settlement offer for this type of benefit has 20 days to cancel the agreement after signing off on it, or they will otherwise be unable to appeal it in the future.
So long as a workers’ comp claimant does not accept a settlement offer the insurance company makes, they have the right to formally appeal any decision the insurer makes about closing their claim or the value of specific benefits. Importantly, though, there are different deadlines for different types of appeals. For example, a claimant who wants to appeal a decision made about their medical condition or disability status has just 14 days after receiving notice of the insurer’s decision to do so.
Likewise, appeals of determinations made by a workers’ comp insurance provider in Las Vegas about the value of benefits to be incorporated into a settlement offer must occur within 70 days of the claimant being notified of the insurer’s decision. Support from seasoned legal counsel can be crucial to building a strong case within these extremely strict time limits.
The prospect of permanently settling your workers’ comp claim can be intimidating, even if it is the best course of action for your situation. Things can get even more complicated if your insurance provider tries to lowball you on the value of a fair settlement—which, unfortunately, is almost guaranteed to happen in any interaction with any insurance provider.
Fortunately, you have help available when it comes to getting the best possible result from workers’ compensation settlements in Las Vegas. Call Shook & Stone today to learn how our team of dedicated workers’ comp lawyers could assist you.