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 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

NV Employee Guide - English

NV Employee Guide - Spanish

NV Claim Processing Timeframe

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.