Our built-in tools help you complete, sign, share, and store your documents in one place.
Make edits, fill in missing information, and update formatting in US Legal Forms—just like you would in MS Word.
Download a copy, print it, send it by email, or mail it via USPS—whatever works best for your next step.
Sign and collect signatures with our SignNow integration. Send to multiple recipients, set reminders, and more. Go Premium to unlock E-Sign.
If this form requires notarization, complete it online through a secure video call—no need to meet a notary in person or wait for an appointment.
We protect your documents and personal data by following strict security and privacy standards.

Make edits, fill in missing information, and update formatting in US Legal Forms—just like you would in MS Word.

Download a copy, print it, send it by email, or mail it via USPS—whatever works best for your next step.

Sign and collect signatures with our SignNow integration. Send to multiple recipients, set reminders, and more. Go Premium to unlock E-Sign.

If this form requires notarization, complete it online through a secure video call—no need to meet a notary in person or wait for an appointment.

We protect your documents and personal data by following strict security and privacy standards.
The following forms need to be completed and submitted to EMPLOYERS when a work-related injury occurs: Form C-1 Notice of Injury or Occupational Disease (Incident Report). Form C-3 Employer's Report Of Industrial Injury or Occupational Disease. Form C-4 Employee's Claim for Compensation/Report of Initial Treatment.
You are eligible to receive 66.66% of your average monthly wages until your injury is healed to the point where you are able to return to work and safely perform your duties.
Nevada Worker's Comp Lawyer Workers' compensation, a no-fault insurance plan, provides guaranteed financial payments for work related injuries and illnesses. Financial compensation includes lost wages (i.e. temporary disability payments), medical bills, and lump sum permanent disability payments.
Maximum disability compensation in Nevada is 66-2/3 percent of the Average Monthly Wage (NRS 616A. 065 and 616C. 475). If the earned wage on the date of injury was less than $8,445.64 per month, compensation is 66-2/3 percent of the actual earned wage.
Your workers compensation carrier should only be charging your company for premium on no more than $36,000 on payroll for each individual employee. If an employee makes less than the $36,000 cap, then their true payroll should be reported.
C3 – Employer's Report of Industrial Injury or Occupational Disease: The employer must provide this completed, signed and dated form to the insurance carrier within 6 working days of receipt of the C-4 form (Employee's Claim for Compensation/Report of Initial Treatment) per Nevada Revised Statute NRS 616C.
INJURED EMPLOYEE'S REQUEST FOR COMPENSATION.