SIIS – short for State Industrial Insurance System – was Nevada’s state-run workers’ compensation program. Before 2000, all Nevada businesses bought workers comp coverage through SIIS. But it was beset with management and financial problems. Finally workers’ compensation insurance became privatized, and businesses now buy their coverage from dozens of competitive insurers and self-insured groups. 1
SIIS offered the same benefits as private workers comp insurers do now: Temporary or permanent disability payments following a work-related injury. Historically, SIIS paid out claims far larger than the revenue it collected. This is a big reason why Nevada privatized worker’s comp insurance in 2001. 2
When an employee gets injured in the course of employment, the injured employee needs to file a workers’ compensation claim. In order to have eligibility for benefits under Nevada’s workers’ compensation laws, the claimant has to show that it is more likely than not that the injury or condition resulted from work and not an outside cause.
Under NRS 616, filing a claim under the workers’ compensation system in Nevada requires two steps:
Both the injured employee and the examining workers’ compensation doctor fill out the Employees Claim for Compensation. A worker’s comp claim is considered filed when the physician sends the form to the insurance company after examining the injured employee.
(Note that employers typically contract with a Managed Care Organization (MCO) or a Preferred Provider Organization (PPO), which means injured workers usually cannot choose their own doctor.)
If the insurance company approves the claim, it will give the worker one or more of these workers’ compensation benefits:
If the insurance company denies the claim, the injured worker can appeal. If the appeals officer denies the claim, the claimant/appellant can ask the local district court for a judicial review of the hearing officer’s decision. Some cases go all the way up to the state supreme court.
Note that closed workers’ comp claims can be reopened if the original work injury caused the claimant’s condition to change or worsen. For example, maybe the claimant’s subsequent injury was directly related to the original injury sustained at work. 3
Learn more about worker’s comp procedures at the government websites Nevada Attorney For Injured Workers and Nevada Department of Industrial Relations.
Call our law firm for legal advice. We offer free consultations throughout Nevada, including Washoe County (Reno and Carson City) and Clark County (Las Vegas).
