Forms File Search

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Category:	All Categories Benefits Disciplinary Action Employee Separation Grievance Procedure Hiring/Compensation Leave Payroll Performance Risk Management Student Employment Professional / Faculty Search Use of Alcohol or Drugs Workers' Compensation

Results:

Form title	Description
Affidavit of Rejection of Coverage for Corporate Owners/Officer or Manager of an LLC	Use when an officer of a quasi-public or non-profit corporation, or an officer who is an owner of a private corporation or a manager of a limited liability company has rejected workers' compensation coverage
Affidavit of Rejection of Coverage for Individual/Sole Proprietor	Use when an individual or sole proprietor has rejected workers' compensation coverage
Application for Reimbursement of Claim-Related Travel Expenses	D-6 - Used by employee to receive compensation when missing more than 5 days from work in a 20 day period
Application for Reimbursement of Claim-Related Travel Expenses	D-26 - Can be used when requesting reimbursement for travel
Global Companion/MEDEX	Use this card when traveling out of country. It provides insurance information for foreign voluntary workers' compensation coverage.
Leave Choice Option Form	Used to choose leave option when an employee is eligible for temporary total disability (TTD) benefits
Notice of Injury or Occupational Disease Incident Report	C-1 - Completed by employee when an injury or occupational disease occurs. Must be submitted within 7 days of the incident.
Personal Data Form	Completed by all employees at hire, including volunteers, and some demographic data changes Description of Military Veteran Status
Procedure for a Student Employee Work Related Injury	Describes the Nevada workers' compensation system
Supervisor Training Responsibilities for Student Employees
Volunteer Agreement	Used when a volunteer Category "B" volunteer is engaged: A category "B" volunteer is a person who performs a volunteer assignment for more than three days or on a recurring basis.
Workers' Compensation Waiver Flowchart and Excluded Employees Summary	Use this chart as a guideline to determine when Workers' Compensation coverage is required or when it can be waived.