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Las Vegas, NV (WorkersCompensation.com) -- In Nevada, form C-4, Employee's Claim for Compensation/Report of Initial Treatment, grants authorization for the disclosure of medical or other pertinent information with an original signature or digital signature.
Here are the rules surrounding the C-4.
| Topic | Rules and Requirements |
| Injured employees who aren't able to sign the C-4 | If the injured employee is unable to sign, the health care provider is responsible to obtain the injured employee’s signature as soon as possible. |
| Oral communication | An insurer, an employer, an organization for managed care, a third-party administrator or the representative of any of those persons, the Nevada Attorney for Injured Workers or an attorney or other compensated representative of an injured employee will not initiate oral communication relating to the medical disposition of the claim of an injured employee with the injured employee's examining or treating physician or chiropractor. |
| Exceptions regarding oral communication | Oral communication may occur if the initiator of the oral communication: + Maintains in written form or in a form from which a written record may be produced, a log that includes the date, time and subject matter of the communication + Makes the log available, upon request, to each insurer, organization for managed care and third-party administrator interested in the claim or the representative of each of those persons, the Administrator and the injured employee, the injured employee's representative and the injured employee's employer |
| Written communication | Written communication may not be initiated either, unless written communication relating to the medical disposition of the claim with the injured employee's examining or treating physician or chiropractor unless a copy of the communication is submitted to the injured employee or the injured employee's representative in a timely manner. |
| Physician's and Chiropractor's Progress Report Certification of Disability (Form D-39) | The D-39 is simply a progress report that the treating physician or chiropractor may complete versus dictating a report. A copy of the D-39 or a dictated report, including any physical limitations must be forwarded to the insurer along with the bill for service. |
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About The Author
About The Author
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Frank Ferreri
Frank Ferreri, M.A., J.D. covers workers' compensation legal issues. He has published books, articles, and other material on multiple areas of employment, insurance, and disability law. Frank received his master's degree from the University of South Florida and juris doctor from the University of Florida Levin College of Law.
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