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"NOTICE OF INJURY OR OCCUPATIONAL DISEASE" (Incident Report)
Filing A Workers' Compensation Claim The C-4 form is titled ?Employee's Claim for Compensation/Report of Initial Treatment?. The physician fills out their part of the form, and sends a copy to your employer and the insurer. Be sure to get a copy for your records.
Workers' compensation is a no-fault insurance program in the State of Nevada, which provides benefits to employees who are injured on the job and protection to employers who have provided coverage at the time of injury.
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.
6 Injured Employee's Request for Compensation (7/99)
1. $13.2 million workers comp settlement for ironworker struck by a car (California)
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 $7,309.80 per month, compensation is 66-2/3 percent of the actual earned wage.
Nevada is unique in that it caps payroll at $36,000 regardless of job classification or position. Sometimes out-of-state brokers and agents are unaware of this fact and end up over-charging insureds.