Nevada Workers' Comp Claims Kit

How to report a workplace injury

Phone: (844) 581-0828

For life-threatening medical emergencies, call 911

Preferred method: Submit the claim information online here

Another option to report a claim is via e-mail within 24 hours of the incident (or as soon as possible):

E-mail: claims@pieinsurance.com

In the e-mail, include the following information:

• Name of business
• Policy Number
• Reporting party’s contact information (name, phone, e-mail)
• The name, phone and e-mail address of injured employee
• Date of incident
• Location of incident (address and/or city, state)
• Description of incident

NV Reporting Forms

C-1 Form - Employee should complete within 7 days after the accident; must be maintained by employer for 3 years; employer required to keep adequate supply of blank forms for employee use. Insurer/TPA should supply forms to employer.

C-3 Form - Employer must complete and file with the insurer within 6 working days after receiving a copy of the C-4 Form. Insurer/TPA should supply forms to employer. Maximum fine of $1,000 per occurrence.

Posting Notices

Prominently display the notice where each employee is likely to see the notice on a regular basis.

NV Posting Notice

NV Employer Guide

NV Employee Guide - English

NV Employee Guide - Spanish

NV Claim Processing Timeframe

NV D-1 Poster

NV D-2 Description of Rights and Benefits

NV Report of Injury or Occupational Disease Form

Reference Material

Nevada Workers Compensation Commission Website

Employer Information

Injured Worker Information

What is the waiting period for lost wages in Nevada:

Temporary compensation benefits must not be paid for an injury which does not incapacitate the employee for at least 5 consecutive days, or 5 cumulative days within a 20-day period, from earning full wages, but if the incapacity extends for 5 or more consecutive days, or 5 cumulative days within a 20-day period, compensation must then be computed from the date of the injury.