When an insurer or self-insured employer makes a decision that the injured worker does not agree with, the injured worker has seventy (70) days to appeal the decision to the Hearings Officer. If the injured worker has written a request to the insurer, and the insurer fails to respond to the written request within thirty (30) days, the injured worker may appeal to a Hearings Officer. The injured worker must appeal the failure of the insurer to respond within seventy (70) days from when the worker mailed the written request to the insurer or the right to do so will be lost. NRS 616C.315.

When a managed care organization (MCO) which has contracted with a workers' compensation insurer makes a decision that the injured worker does not agree with, the decision must be appealed through the MCO's system for review within fourteen (14) days or the right to do so will be lost. This appeal must follow the procedure established by the MCO. NRS 616C.305. The MCO must resolve the dispute within fourteen (14) days after it is submitted. If the injured worker is still dissatisfied with the determination, or if the MCO fails to make a final determination in fourteen (14) days, an appeal may be made directly to the Hearings Division Appeals Officer as provided for in NRS 616C.345 and must be made within seventy (70) days after the review or the right to do so will be lost.

If the injured worker loses at the Hearing Officer level, but still wants to pursue his case, he must complete a form called a Notice of Appeal and Request for Hearing Before the Appeals Officer, and file it with the Hearings Division within thirty (30) days. If the injured worker would like to request the free service of the Nevada Attorney for Injured Workers' (NAIW), the form includes a box to be checked and a place for the injured worker to sign to indicate he is requesting those services. If the injured worker sends the completed form back to the Appeals Officer, the Appeals Officer will appoint NAIW to represent him.

If the injured worker has lost at the Appeals Officers' level, NAIW has discretion to represent the injured worker at the district court, and even the supreme court levels. The appeals to the district court also must be made within thirty (30) days and is by means of filing a pleading called a Petition for Judicial Review.

The Hearings Division is a state agency within the Department of Administration. All contested workers' compensation claims are heard and decided in the Hearings Division. The Hearings Officer level is the first level and is an informal process. The Appeals Officer level is the second level and is a more formal process.