Nevada Claims-Processing Timelines

What timelines apply for claims in Nevada? As Simply Research subscribers know, the following rules apply.

C-1 Form
Notice of Injury or Occupational
Disease - Incident Report
NRS 616C.015
Employee should complete within 7 days after the accident; must be maintained by
employer for 3 years; employer required to keep adequate supply of blank forms for
employee use. Insurer/TPA should supply forms to employer.

C-3 Form
Employer's Report of Industrial
Injury or Occupational Disease
NRS 616C.045
Employer must complete and file with the insurer within 6 working days after receiving
a copy of the C-4 Form. Insurer/TPA should supply forms to employer.
Maximum fine of $1,000 per occurrence.

C-4 Form
Employee's Claim for
Compensation/Report of Initial
Treatment NRS 616C.040
Physician or chiropractor must complete and file with employer and employer’s insurer
within 3 working days of treatment.
Maximum fine of $1,000 per occurrence.

Claim Determination
NRS 616C.065
NRS 616D.120-150
Insurers have 30 days after accident notification (or 30 working days after claim
receipt for occupational disease):
+ Accept the claim & notify claimant or claimant’s rep of acceptance
+ Begin payment on the claim
+ Or deny the claim and notify claimant or claimant’s rep and DIR of denial
+ Insurer’s notification must be documented with a certificate of mailing.
Three (3) times penalty with $3,000 maximum fine.

D-8 Form
Employer's Wage Verification Form
NRS 616C.045 & NRS 616A.480
Employer must complete and file with the insurer within 6 working days of receipt of
the C-4 (if the C-4 indicates the injured employee will be off work for 5 consecutive
days or more or 5 days in a 20 day period) or when requested by the insurer.
Insurer/TPA should supply forms.
Maximum fine of $1,000.00 per occurrence.

D-35 Form
Request for Random Physician or Chiropractor
NRS 616C.490 & NAC 616C.103
Within 30 days of receiving stable & ratable reporting, insurer must schedule
an appointment with a rating physician/chiropractor on the random list.

Medical Billing
NRS 616C.136 & NV Medical Fee Schedule
Billing must be submitted within 90 days after the date of service (if good cause, up to
12 months).
Insurer has 45 days to approve or deny.

Blank Forms
NRS 616A.480
Employer must fully complete any blank form received by the insurer or the
administrator and return to appropriate party within 6 working days.
Maximum fine of $1,000 per occurrence

Filing a claim for compensation
NRS 616C.020
An injured employee shall file a claim for compensation with the insurer within 90
days after an accident if:
(a)The employee has sought medical treatment for an injury arising out of and in
the course of his employment; or
(b)The employee was off work as a result of an injury arising out of and in the
course of his employment.
In the event of the death of the injured employee resulting from the injury, a dependent
of the employee, or a person acting on his behalf, shall file a claim for comp

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