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“Off Work” Condition for Nevada Insurance Claims has No Specific Time Requirement

Under Nevada law, certain insurance claims cannot be re-opened a year from their closure date. Nevada’s Industrial Insurance Benefits statute, NRS 616C.390(5), “provides that: [a]n application to reopen a claim must be made in writing within 1 year after the date on which the claim was closed if:

(a) The claimant was not off work as a result of the injury; and
(b) The claimant did not receive benefits for a permanent partial disability.”

“NRS 616C.390(5) conditions an employee’s ability to reopen a claim on either receiving a permanent partial disability award or losing time from work and a causal relationship between the injury and that time off work.” If the year old claim passes this bar, under NRS 616C.390(1), it will be re-opened if: there is a change in circumstances warranting increased or different compensation, the change can be attributed to the original injury claimed, and there is a certificate from a physician or chiropractor that confirms additional compensation is warranted.

In Williams v. United Parcel Services, the Nevada Supreme Court clarified that NRS 616C.390(5)’s “off work” condition does not require someone be off work for any specific period of time.

Joseph Williams suffered an injury during his employment with United Parcel Services (UPS). While working with live wires, he was shocked and fell off a ladder onto his back. Shortly after the accident, Williams sought medical treatment and was advised to take a few days off from work. UPS’s insurer accepted Williams claim agreeing to reimburse him for the cost of injuries to his “left ankle/foot, left lower leg, and left hand.” The insurer granted him no compensation for his back. Williams did not appeal the decision. Two years later, Williams developed back pain and “underwent medical procedures that revealed damage to his back.” Due to this discovery, Williams attempted to re-open his insurance claim under NRS 616C.390. The insurer rejected his request.

Following the rejection, Williams appealed to a hearings officer. The hearings officer denied his request as well. On a second appeal, Williams went in front of an appeals officer. Based on the statutes’ legislative history, the appeals officer interpreted NRS 616C.390(5)’s “off work” condition to require an employee miss at least 5 days of work to re-open a year old case and denied Williams’ claim. On June 06, 2013, the Nevada Supreme Court overturned the appeals officer and remanded the case to the district court to determine whether Williams met the requirements of NRS 616C.390(1).

The Nevada Supreme Court explained that the hearing officer was mistaken in looking at the statute’s legislative history. Under Nevada law, an unambiguous statute needs to be interpreted based on the plain meaning of its text. The Court held “NRS 616C.390(5) conditions an employee’s ability to reopen a claim on either receiving a permanent partial disability award or losing time from work and a causal relationship between the injury and that time off work.” Since NRS 616C.390(5) merely required an injured party have been off work without reference to a time limit, the Court decided it was inappropriate to read one into it.