1. 1. Except as otherwise provided in this section, an injury or disease sustained by an employee that is caused by stress is compensable pursuant to the provisions of chapters 616A to 616D, inclusive, or chapter 617 of NRS if it arose out of and in the course of his or her employment.
2. 2. Except as otherwise provided in subsection 4, any ailment or disorder caused by any gradual mental stimulus, and any death or disability ensuing therefrom, shall be deemed not to be an injury or disease arising out of and in the course of employment.

3. 3. Except as otherwise provided by subsections 4 and 5, an injury or disease caused by stress shall be deemed to arise out of and in the course of employment only if the employee proves by clear and convincing medical, psychological or psychiatric evidence that:

   1. (a) The employee has a mental injury caused by extreme stress in time of danger;
   2. (b) The primary cause of the injury was an event that arose out of and during the course of his or her employment; and
   3. (c) The stress was not caused by his or her layoff, the termination of his or her employment or any disciplinary action taken against him or her.

4. 4. An injury or disease caused by stress shall be deemed to arise out of and in the course of employment if the employee is a first responder and proves by clear and convincing medical, psychological or psychiatric evidence that:

   1. (a) The employee has a mental injury caused by extreme stress due to the employee directly witnessing:

      1. (1) The death, or the aftermath of the death, of a person as a result of a violent event, including, without limitation, a homicide, suicide or mass casualty incident; or
      2. (2) An injury, or the aftermath of an injury, that involves grievous bodily harm of a nature that shocks the conscience; and
   2. (b) The primary cause of the mental injury was the employee witnessing an event or a series of events described in paragraph (a) during the course of his or her employment.

5. 5. An injury or disease caused by stress shall be deemed to arise out of and in the course of employment, and shall not be deemed the result of gradual mental stimulus, if the employee is employed by the State or any of its agencies or political subdivisions and proves by clear and convincing medical, psychological or psychiatric evidence that:

   1. (a) The employee has a mental injury caused by extreme stress due to the employee responding to a mass casualty incident; and
   2. (b) The primary cause of the injury was the employee responding to the mass casualty incident during the course of his or her employment.
6. 6. An agency which employs a first responder, including, without limitation, a first responder who serves as a volunteer, shall provide educational training to the first responder related to the awareness, prevention, mitigation and treatment of mental health issues.
7. 7. The provisions of this section do not apply to a person who is claiming compensation pursuant to NRS 617.457.

8. 8. For the purposes of any claim arising out of this section:

   1. (a) An insurer shall maintain a list of providers of mental health care who have agreed to accept and treat injured employees pursuant to this section, from which an injured employee has the right to choose a mental health care provider of his or her choice.
   2. (b) For each county whose population is 100,000 or more, the list maintained pursuant to paragraph (a) must include not less than 12 providers of mental health care.
   3. (c) Each insurer shall, on or after September 1 and on or before October 1 of each year, update the list maintained pursuant to paragraph (a) and submit the list to the Administrator.
   4. (d) If the list maintained pursuant to paragraph (a) contains a provider of mental health care that does not accept and treat patients pursuant to this section, an injured employee may choose any provider of mental health care who agrees to accept the schedule of fees and charges established pursuant to NRS 616C.260.

9. 9. As used in this section:

   1. (a) “Directly witness” means to see or hear for oneself.

   2. (b) “First responder” means:

      1. (1) A salaried or volunteer firefighter;
      2. (2) A police officer;
      3. (3) An emergency dispatcher or call taker who is employed by a law enforcement agency or other public safety agency in this State;
      4. (4) A civilian employee of a law enforcement agency whose primary duties involve responding to and investigating crime scenes; or
      5. (5) An emergency medical responder, emergency medical technician or paramedic who is employed by a public safety agency in this State.
   3. (c) “Law enforcement agency” has the meaning ascribed to it in NRS 289.010.
   4. (d) “Mass casualty incident” means an event that, for the purposes of emergency response or operations, is designated as a mass casualty incident by one or more governmental agencies that are responsible for public safety or for emergency response.
   5. (e) “Provider of mental health care” means a psychiatrist, a licensed psychologist, a licensed clinical professional counselor or a licensed marriage and family therapist.

   6. (f) “Public safety agency” means:

      1. (1) A public fire department, fire protection district or other agency of this State or a political subdivision of this State, the primary functions of which are to control, extinguish and suppress fires;
      2. (2) A law enforcement agency; or
      3. (3) An emergency medical service.

(Added to NRS by 1993, 663; A 1993, 2445; 2019, 1901; 2023, 1341; 2025, 196, 394, 3304)