The Making Of A DIR Complaint
In a prior blog, the readers were introduced to DIR complaints. In short, a DIR complaint is a complaint that is filed with the Nevada Division of Industrial Relations which alleges misconduct on the part of the industrial insurance adjuster. Please see my prior blog entitled, “Can An Industrial Insurance Adjuster Act In Bad Faith?” for a detailed introduction into DIR complaints.
The question is now, what do you put in your DIR complaint? The Division of Industrial Relations offers a very short form, but they do not really offer the injured worker any information nor guidance on how to make the complaint and how it should be worded. (Click here for the Northern Nevada form and here for the Southern Nevada form). There are numerous steps that should be considered when making writing a complaint and submitting it to DIR.
First, make sure that the item you are complaining about falls into an offense that is considered a violation. For example, in my prior blog, we discussed the violations under NRS 616D.120, which included:
Refused to pay or unreasonably delayed payment to an injured worker of compensation or other relief found to be due the injured worker by a hearing officer or appeals officer or a written settlement agreement, if the refusal or delay occurs:
(a) Later than 10 days after the date of the settlement agreement or stipulation;
(b) Later than 30 days after the date of the decision of a hearing officer or appeals officer or the Division, unless a stay has been granted; or
(c) Later than 10 days after a stay of the decision of a court, hearing officer, appeals officer.
Engaged in a pattern of untimely payments to injured employees.
Next, the complaint should lay out a timeline of events that has occurred that documents the bad behavior of the insurance company. This should include exhibits to back up the facts that you are expressing. For example, if the adjuster did not comply with a decision of the Hearings Officer, then you should include a copy of the Hearing Officer’s decision as an exhibit.
Next, the complaint should have a legal argument, which explains what the law is for this particular set of facts. The facts are placed into the law in order to show a violation by the adjuster.
The problem with the DIR complaint form is that the typical injured worker may not realize how much information they should actually place in the complaint. For example, the injured worker can discuss in the complaint the degree of physical harm suffered by the injured worker or their dependents as a result of the insurer’s violation, the amount of compensation found to be due the injured worker, the degree of economic harm suffered by the injured worker, and the number of fines and benefit penalties previously imposed against the insurer.
The bottom line is the injured worker needs to make sure that you have a well written complaint. You are telling a story and need to have the DIR investigator understand what you are talking about, what you and your family have suffered through, and why you need the state’s help to stop the bad behavior on the part of the insurer. Yet another reason that every injured worker in Nevada should seek out and retain a qualified and experienced Nevada workers compensation attorney so that things are done properly from the beginning.
I hope that this has been helpful and informative. Please read the other blogs for more free, valuable information.
Joel A. Santos, Esq., is a Nevada worker’s compensation attorney. He is certified by the State Bar of Nevada as a Worker’s Compensation Expert and Specialist.
Copyright 2020 - Joel A. Santos, Esq.
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