The following information has been provided directly from Health and Safety.

Timelines

We are currently accepting/approving around 86% of the workers’ compensation claims that come to us. Of the 14% that are denied, the two most common reasons are: (1) There was no “occupational accident” (NRS 616A.030) that arose in the course and scope of employment (NRS 616C.150). An example of this would be someone having a personal medical condition that may have occurred on duty but was not caused by work (e.g., an appendix bursting); and (2) The matter was not reported in a timely manner.

CCMSI

• CCMSI is not an insurance company. They are a third-party administrator hired by LVMPD to administer our claims. LVMPD is self-insured, and every single penny CCMSI pays out for a doctor’s visit, rating, surgery, etc., is paid right back to CCMSI by Health and Safety within a few days.
• CCMSI is physically located in the Health and Safety office (4th floor, B building at HQ), and injured workers are highly encouraged to swing by and meet your claims specialist in person for any questions, drop off paperwork, etc. 
• When speaking with CCMSI as part of an intake interview, please be sure to list all your injured body parts. If it’s not mentioned or diagnosed, it won’t be part of your claim/treatment plan or rating. If something is missing, please tell your adjustor.
• Employees should look at their claim acceptance letters, which list the body parts/injuries that are accepted. If something is missing, please promptly let us know. 
• Injured workers generally can choose their own treating doctor for each body part from a list of health care providers, which CCMSI can email injured folks, and they can then choose accordingly. The doctors CCMSI sends folks to are not LVMPD doctors. They are just a panel of health care providers who are approved by the state to treat under workers’ compensation. 

Heart Bill

The heart bill is outlined in NRS 617.457, and it’s a massive benefit that can potentially cover heart-related medical expenses/disability covering a lifetime. But the heart bill has four major components, which must each be met:

1. The heart bill only covers heart disease; it may not cover things like high blood pressure or high cholesterol unless the underlying cause is heart disease.
2. The heart disease must cause disability.
3. We must go to our annual physicals. If you miss one (or more) and do not have a good reason (military leave, etc.), then you may lose your benefits. We can grant extensions if folks reach out to us in a reasonable timeframe.
4. If you are warned of risk factors during your physical, you must make a good-faith effort to correct/mitigate those. Good examples of good-faith efforts include following up with a PCP, diet and exercise (and being able to show it) or taking medication.

Lung Bill

The lung bill is outlined in NRS 617.455, and it basically works the same way as the heart bill, but with one key difference:

• The heart bill is presumptive; however, the lung bill requires an injured worker to show that the lung disease was caused by exposure to fumes, gas, smoke, toxic chemicals, etc. 
• Exposure to these types of toxins may not cause an instant effect, so if officers have an exposure, they can best protect their rights by doing an occupational injury form documenting the incident, as lung disease may not develop until years later. 
• If officers are exposed to smoke, etc., and it causes an instant reaction, they should promptly seek medical treatment. 

Attorneys

If someone is injured, they absolutely have the right to retain counsel, and we respect that. However, the direction we have been given is to take care of people (within the law) and walk them through the process. Only around 30% of our claimants have an attorney now, but we still frequently see officers who get hurt in the morning and are retaining an attorney that very afternoon without anything having ever been denied. Their claim progresses and is accepted without issue, and they eventually go to a disability rating, where the attorney takes 25–35% of the settlement without having to litigate anything. We would ask that folks give us a chance to take care of them, and if they don’t like what they are hearing, or something does get denied, then they can retain an attorney at that point. If someone does get an attorney, CCMSI will be unable to talk to the employee (as the employee is essentially saying, “Don’t talk to me; talk to my attorney”). However, any LVMPD employee in Health and Safety can still talk to you and offer customer service/advice that you can take back to your attorney. 

What Injured Workers Can Expect From Us/CCMSI

Sara Yant, Amber Nordin and I are now attempting to call every new claimant and walk them through all aspects of the process. If we know you have serious injuries, you can expect to see one of us in the hospital with you. CCMSI has no sinister agenda and has been given the same direction on taking care of people (within the law). 

If you are having problems with any aspect of the process or anything else Health and Safety touches (FMLA/ADA, medication, etc.), then please call us at (702) 828-3696  and give us a chance to help. We will also be more than happy to meet you in person, and you can bring a union rep with you also!