What to do if you get hurt at work
Video
Step 1
Let your supervisor know right away that you got hurt on the job.
Step 2
Important
You only have 7 days to:
- Tell your supervisor that you got hurt.
- Fill out the Workers’ Compensation “C-1 Incident Form” (your job will give you this form).
Step 3
- Ask your job (employer) which doctor you should go to.
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You will fill out a “C-4 Form” at the doctor’s office (you should not go to the Culinary Health Center). On the form you will explain:
- What you were doing
- When you got hurt
- What part of your body hurts
- Take a copy of the doctor’s note to your job. Make sure you follow your doctor’s orders.
- Check your mail. You will get a letter from your job’s insurance company about Workers’ Compensation. You should get the letter within 30 days after you see the doctor.
Step 4
Before the Culinary Health Fund can pay any bills (claims) relating to your injury, you need to file the the 1st and 2nd appeal:
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1st appeal
You have 70 days from the date on the denial letter to send your 1st appeal.
When it’s completed, bring it to this office:
Department of Administrative Hearings Division
2200 South Rancho Drive
Suite 210
Las Vegas, Nevada 89102 -
2nd appeal
If you do not agree with the Hearing Division’s denial of your 1st appeal, you must send a 2nd appeal. You have 30 days from the date of that decision to file the 2nd appeal.
You have the right to have free legal representation (at the 2nd level appeal) from Nevada Attorneys for Injured Workers (NAIW). You can call them at 702-486-2830.
When it’s completed, bring it to this office:
Department of Administrative Appeals Division
2200 South Rancho Drive
Suite 220
Las Vegas, Nevada 89102
If you do not send your appeals within the time listed above, you will lose your right to appeal. That means your bills (claims) won’t be paid by Workers’ Compensation.
We need copies of both appeals that you filed and keep copies for yourself.
If you need help filling out your appeal form call the office of Consumer Health Assistance at 702-486-3587 or the Fund’s Customer Service Office at 702-733-9938. They will help you with your appeal.