Filing a Claim
Accident or Blood Borne Pathogen
If you are injured by accident or exposed to a blood borne pathogen or bodily fluid on the job, report it immediately to your Battalion Chief or the Infection Control RN and contact the 24/7 Employee Injury Call Center at (877) 764-3574.
Injury, Occupational Disease or Exposure
An injury or an occupational disease and/or exposure must be reported to your employer within 7 calendar days from the date of accident on the Notice of Injury or Occupational Disease, Form C-1. Please also review the Brief Description of Rights and Benefits, Form D-2 at this time. Calling the hotline does not take the place of completing the C-1 form.
If you need medical treatment, you must seek treatment and complete the Claim for Compensation/Physician’s Report of Initial Injury, Form C-4, within 90 days from the date of injury. The C-4 form is the legal document for filing a claim in Nevada.
Medical Attention
If you wish to seek medical attention, you must take the Physician’s Disability Statement Form with you to each medical appointment (this includes the initial visit as well as all on-going treatment visits). It is your responsibility to obtain the Physician’s Disability Statement Form from your department prior to seeking medical attention. Failure to do so could affect the approval of your claim, as well as approval of time off due to the injury. This statement is to be completed by the attending physician on the date of treatment and provided to you. It is your responsibility to make sure that the physician fills the form out completely. You must present the completed statement to your supervisor as evidence of continued disability from work or ability to return to work.
If you have questions, please do not hesitate to reach out to a member of the Workers' Comp Committee for help navigating this process. Also, see the guides to your rights and the FAQ contained in this section of the app.