Chapter 616C - Industrial Insurance: Benefits for Injuries or Death
- ACCIDENT BENEFITS
- 616C.245 - Injured employee entitled to accident benefits; limitation on receipt of modified motor vehicle as accident benefit; regulations establishing maximum benefit.
- 616C.250 - Establishment, revision and compliance with standards of care for provision of accident benefits.
- 616C.255 - Premium for accident benefits paid by employer; accident benefits provided by private carrier; separate account for accident benefits.
- 616C.260 - Fees and charges for accident benefits: Restrictions; establishment and revision of schedule; powers and duties of Administrator; penalty for refusal to provide information; regulations.
- 616C.265 - Election by employer to provide accident benefits; reporting requirements; payment of assessments.
- 616C.270 - Employers to notify Administrator when injured employee receives medical services.
- 616C.275 - Change of physicians, chiropractors or other requirements; cost of change borne by insurer; cause of action of injured employee assigned to private carrier.
- 616C.280 - Withdrawal of approval for employer to provide accident benefits: Grounds supporting withdrawal.
- 616C.285 - Withdrawal of approval for employer to provide accident benefits: Request for hearing; notice of decision.
- CATASTROPHIC INJURIES
- COMPENSATION FOR INJURIES AND DEATH
- CONTESTED CLAIMS
- 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 educatio
- 616C.300 - Hearing officers: Appointment; salary; disqualification from particular case.
- 616C.305 - Procedure for appeal of final determination of organization for managed care which has contracted with insurer.
- 616C.310 - Contested cases: Procedures; format; redaction of personal identifying information; representation of insurer or employer by legal counsel or other agent.
- 616C.315 - Request for hearing; forms for request to be provided by insurer; prerequisites to scheduling of hearing; expeditious and informal hearing required; direct submission to appeals officer.
- 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.
- 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 representativ
- 616C.330 - Date, time and place for hearing; evaluation of injured employee; powers and duties of hearing officer; issuance of decision; procedure for obtaining stay of decision.
- 616C.335 - Award of interest.
- 616C.340 - Appointment, term, qualifications and salary of appeals officers and special appeals officers; conflicts of interest; finality of decision by appeals officer.
- 616C.345 - Notice of appeal; notice of contested claim; prerequisites to scheduling of hearing on appeal; effect of appeal on enforcement of decision of hearing officer; setting of date, time and plac
- 616C.350 - Testimony of physician or chiropractor before appeals officer; privileged communications.
- 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.
- 616C.360 - Record of hearing before appeals officer; rules of evidence; evaluation of injured employee; submission to external review organization; powers and duties of appeals officer; transcripts; i
- 616C.363 - External review: Duties of external review organization; contents and submission of decision by organization; costs; regulations.
- 616C.365 - Reimbursement of employee’s expenses incurred and wages lost as result of hearing requested by employer or insurer; regulations.
- 616C.370 - Judicial review.
- 616C.375 - Stay of decision of appeals officer.
- 616C.380 - Payment pending appeal when decision not stayed; effect of final resolution of claim.
- 616C.385 - Costs and attorney’s fees for frivolous petitions for judicial review.
- 616C.390 - Reopening claim: General requirements and procedure; limitations; applicability.
- 616C.392 - Reopening claim: Circumstances under which insurer is required to reopen claim for permanent partial disability.
- DETERMINATION AND PAYMENT OF BENEFITS
- 616C.150 - Compensation prohibited unless preponderance of evidence establishes that injury arose out of and in course of employment; rebuttable presumption if notice of injury is filed after terminat
- 616C.155 - Payment of compensation by insurer prohibited before required; recovery of overpayment by insurer.
- 616C.157 - Request for prior authorization: Time to respond; effect of failure to respond in timely manner.
- 616C.160 - Newly developed injury or disease: Inclusion in original claim for compensation; limitation.
- 616C.165 - Determination of responsibility of insurer for undisputed claim for compensation; reimbursement of insurer initially providing compensation to injured employee.
- 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 bene
- 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.
- 616C.177 - Medical records concerning preexisting condition: Authority of insurer to request records; injured employee required to release records under certain circumstances.
- 616C.180 - Injury or disease caused by stress.
- 616C.185 - Compensation for mastectomy and reconstructive surgery.
- 616C.190 - Compensation of employee injured out of State.
- 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.
- 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
- 616C.205 - Compensation not assignable; exempt from attachment, garnishment and execution; accrued compensation payable to dependents.
- 616C.210 - Compensation of nonresident alien dependents; notification of dependent required.
- 616C.215 - Actions and proceedings to recover damages in tort or from proceeds of vehicle insurance: Reduction of compensation by amount of recovery; rights of injured employee or dependents and of in
- 616C.220 - Compensation from Uninsured Employers’ Claim Account: Administration and payment of claims; eligibility of employee; liability of employer; powers and duties of Division; appeals; penalty;
- 616C.225 - Misrepresentation or concealment of fact to obtain benefits: Insurer entitled to reimbursement or deduction from benefits; appeal of determination; alternative remedies.
- 616C.230 - Grounds for denial, reduction or suspension of compensation; evidence of and examination for use of alcohol or controlled substance.
- 616C.232 - Denial of compensation for temporary total disability because of discharge for misconduct.
- 616C.235 - Closure of claim by insurer: Procedure; notice; special procedure if medical benefits less than $300.
- REPORTS OF INJURIES AND CLAIMS FOR COMPENSATION
- 616C.005 - Forms for reporting injuries: Insurer to distribute revised forms to employers periodically; Administrator to make revised forms available to physicians and chiropractors.
- 616C.010 - Employee to report accident and injury to employer; examination of employee; employee leasing company to provide to leased employees instructions regarding reporting of injuries.
- 616C.015 - Notice of injury or death: Requirements; availability of form; retention; notice by leased employee.
- 616C.020 - Claim for compensation: Requirements for injured employee, dependent or representative to file claim; form.
- 616C.025 - Recovery of compensation barred if notice of injury or claim for compensation is not filed; exceptions.
- 616C.030 - Dependent of injured employee barred from filing claim for compensation if untimely or previously denied.
- 616C.035 - Application for death benefit.
- 616C.040 - Claim for compensation: Duty of treating physician or chiropractor to file or delegate duty to medical facility; electronic filing; form and contents; maintenance of forms; penalty.
- 616C.045 - Report of industrial injury or occupational disease: Duty of employer to file; electronic filing; form and contents; penalty.
- 616C.050 - Information required to be provided by insurer to claimant.
- 616C.052 - Exposure of police officer, firefighter or arson investigator to contagious disease: Reporting and testing requirements; eligibility for compensation.
- 616C.055 - Use of fee schedules which unfairly discriminate among physicians and chiropractors prohibited; payment for services rendered by physician or chiropractor after removal from panel prohibite
- 616C.065 - Duty of insurer to accept or deny claim; new determination; penalty; failure of insurer to indicate acceptance or denial of claim; written determination.
- 616C.070 - Persons who are conclusively presumed to be totally dependent on injured or deceased employee; exception.
- TREATMENT AND RATING OF INJURED EMPLOYEES
- 616C.085 - Duties of employer when employee injured: First aid; reimbursement.
- 616C.090 - Selection of physician or chiropractor: Powers and duties of Administrator; selection and alternate selection from established panel or pursuant to contract; responsibility for charges.
- 616C.095 - Duty of physician or chiropractor to advise injured employee of rights.
- 616C.100 - Additional determination of percentage of disability permitted if cost paid by injured employee; authority of injured employee to seek reimbursement of cost; results of determination may be
- 616C.105 - Requirements for designation of chiropractor to rate permanent partial disabilities.
- 616C.110 - American Medical Association’s Guides to the Evaluation of Permanent Impairment: Duty of Division to adopt Guides by regulation.
- 616C.115 - Prescription of generic drugs required; exceptions.
- 616C.120 - Employee may elect treatment through prayer in lieu of medical treatment.
- 616C.125 - Insurer may contract with suppliers for provision of services and goods to injured employees.
- 616C.130 - Insurer’s payment to physician or chiropractor attending injured employee conditioned upon receipt of itemized statement and certificate.
- 616C.135 - Liability of insurer for payment of charges for treatment related to industrial injury or occupational disease; acceptance of payment by provider of health care from injured employee or hea
- 616C.136 - Action by insurer on bill from provider of health care; payment of interest; request for additional information; compliance with requirements.
- 616C.137 - Denial of payment for unrelated services: Requirements for notification; liability of injured employee; appeal.
- 616C.138 - Payment of provider of health care upon insurer’s denial of authorization or responsibility for treatment or other services provided; reimbursement of injured employee or health or casualty
- 616C.140 - Medical examination of claimant; effect of refusal to submit to examination; communications not privileged.
- VOCATIONAL REHABILITATION
- 616C.530 - Priorities for returning injured employee to work.
- 616C.540 - Supervision, ratio and review of uncertified counselors; knowledge of labor market required.
- 616C.542 - Prohibiting vocational rehabilitation counselor employed by entity administering injured employee’s case from providing services to injured employee without provision of certain written dis
- 616C.543 - Prohibited acts of vocational rehabilitation counselor.
- 616C.545 - Duty of insurer to determine physical limitations on injured employee’s ability to work.
- 616C.547 - General duties of vocational rehabilitation counselor.
- 616C.550 - Written assessment of injured employee.
- 616C.555 - Plan for program of vocational rehabilitation.
- 616C.560 - Extension of program for vocational rehabilitation.
- 616C.570 - On-the-job training as component of plan for program of vocational rehabilitation.
- 616C.575 - Payment of vocational rehabilitation maintenance.
- 616C.580 - Provision of services outside of State; limited lump-sum payment in lieu of services.
- 616C.585 - Limit on goods and services which may be provided; exceptions.
- 616C.590 - Eligibility for services; effect of incarceration; effect of refusing services offered by insurer; effect of inability of insurer to locate injured employee.
- 616C.595 - Agreements for payment of compensation in lump sum in lieu of provision of vocational rehabilitation services.
- 616C.597 - Response to request for payment of compensation in lump sum in lieu of provision of vocational rehabilitation services.
- 616C.600 - Orders for self-employment or payment of compensation in lump sum for vocational rehabilitation prohibited; agreements concerning self-employment authorized.