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Workers' Compensation Forms and Worksheets. Download Election for Nevada Workers' Compensation Coverage for Out-of-State Injury – Business and Industry (Nevada) form.Any business partners in Nevada will automatically be excluded from workers' compensation benefits. But they can choose to be included in coverage if they wish. Complete this form if you are an employee and would like to be reject coverage, or Waive the rejection. Election of Coverage for Out of State Injury. Workers compensation in Nevada is a no-fault insurance program that provides benefits to working individuals who are injured while on the job. To do that, they'll fill out an election of coverage form (D-44), which you'll submit to your insurance company. (s) D14, Permanent Total Disability Report of Employment. (t) D15, Election for Nevada Workers' Compensation Coverage for OutofState Injury.