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Workers Compensation Assistance | (801) 393-5555
Workers’ compensation is a no-fault insurance system established by the Utah Legislature in 1917. This system is intended to pay medical expenses and to help offset lost wages for employees with work-related injuries or illnesses. The rules and procedures involved in workers’ compensation coverage and benefits are complex and must be strictly followed to prevent interruption of or total denial of workers’ compensation benefits. For most injured workers, it is beneficial to hire an experienced workers’ compensation attorney if their workers compensation claim has been denied or if benefits were being paid but have been terminated.
Almost all employers must have workers’ compensation coverage. There are limited exceptions for real estate and insurance sales, certain small agricultural operations, household domestic work and occasional “casual employment.
Protection begins as soon as you begin work. You are entitled to workers’ compensation benefits for work injuries and illnesses even if you have been on the job only a short time, or only work part-time.
No. Workers’ compensation is a no-fault system. However, workers’ compensation does not cover intentional self-inflicted injuries. Disability compensation (but not medical benefits) may be denied for injuries from alcohol or drug abuse. Also, disability compensation can be reduced by 15% for willful failure to use safety devices or follow safety rules.
Note: Disability compensation can also be increased by 15% if an injury results from an employer’s willful failure to follow safety rules.
Report the injury or illness to your employer immediately. If you fail to report an injury or illness within 180 days, you may be disqualified from receiving workers’ compensation benefits.
You can use any method to report your injury or illness to your employer. It is a good idea to make sure your report is documented.
Your employer has 7 days to report the claim to its insurance carrier and the insurance carrier has 14 days to report the “First Report of Injury” to the Industrial Accident Division. Your employer or its insurance carrier must give you a copy of the report.
Your doctor is required to complete a “Physician’s Initial Report of Injury of Illness” (Form 123) and submit the report to the Industrial Accidents Division within 7 days of your first visit. Be sure and explain to your physician HOW, WHEN, and Where the injury or illness occurred. As the patient, you can request a copy of this form from the medical provider.
Depending on your specific circumstances, workers’ compensation can pay one or more of the following benefits:
Note: If you are totally disabled, you may also be eligible for Social Security disability benefits.
An insurance carrier or self-insured employer has 21 days after learning of your work injury or illness to either: 1) begin payment; 2) deny your claim; or 3) notify you that further investigation in required. If further investigation is necessary, the insurance carrier or self-insured employer has an additional 24 days to accept or deny your claim. If your claim is accepted, checks for disability compensation are usually issued every two weeks.
Temporary total disability is computed at two-thirds of your pre-injury weekly wage, plus $5 for your spouse and $5 each for up to four dependent children. The maximum amount of your temporary total disability compensation cannot exceed the Utah average weekly wage issued by Utah Department of Workforce Services.
Wages from the second job may be included in computing the amount of your disability compensation.
You will receive temporary total disability compensation until you can return to your regular work, your employer offers you suitable light-duty work, or you reach medical stability. The maximum duration for temporary total disability compensation is 312 weeks within a 12 year period of time from the date of injury.
Note: If you have a permanent impairment after your temporary total disability compensation ends, you may be entitled to an additional award of permanent disability compensation.
You may be paid temporary total disability benefits for time away from work for necessary medical care. You may be entitled to reimbursement for the expense of your travel to receive medical treatment.
There is no time limit to your right to receive medical care necessary to treat your work injury or illness. However, the provider is required to submit a bill for services to your workers’ compensation insurance company within one year from the date of treatment.
Not without a good reason. If your employer offers suitable light-duty work, you are required to accept the work or risk losing your temporary disability compensation.
If your employer does not offer light-duty work, you are entitled to continue receiving temporary total disability compensation benefits until a doctor finds you are at medical stability or you exhaust your 312 week entitlement.
Only for the first visit. Specifically, if your employer or insurance company has notified you of a “preferred provider organization” (PPO), you must go there for your first medical treatment; if you do not, you may be liable for part of the initial treatment cost. But after your first visit to the PPO, you can obtain treatment from the medical provider of your choice.
If you have not been notified of a PPO, you can obtain your initial medical treatment from the provider of your choice. Remember to choose a medical provider that accepts workers’ compensation cases.
You can change medical providers one time. You must notify your workers’ compensation insurance carrier of the change. After the one time change has been exercised by the injured worker, any subsequent change of provider would need to be approved by the insurance company. A referral from one medical provider to another is not considered a change of medical providers.
Yes, but chiropractic treatment after the initial 8 visits must be pre-authorized by the insurance company.
If your doctor has determined that you have a permanent impairment from your work injury or illness, you are entitled to permanent partial or permanent total disability compensation. Also, you should check with your employer to see if there is a different job you can do that is within your capabilities.
No. Your employer may pay you at the new position’s wage rate. You may be eligible for an award of temporary partial disability compensation to help offset the difference between your old and new wage rates.
No, but you may be eligible for rehabilitation services through the Utah State Office of Rehabilitation. The Utah Office of Rehabilitation phone number is 1-800-473-7530.
You are not eligible for unemployment benefits while receiving temporary total disability compensation or permanent total disability compensation. You may be eligible for unemployment benefits while receiving permanent partial disability compensation if you are able and available for full-time work and can reasonably expect to obtain work despite your disability. Once you have reached medical stability from your work injury or illness and are released to go back to work, you have 90 days to apply for unemployment benefits.
Questions about unemployment insurance benefits should be directed to the Department of Workforce Services at (801) 526-4400 or toll free (888) 848-0688.
Yes. You may file an application for hearing on the application, you can fill out the Coordination of Benefits section providing your private health insurance information. The Adjudication Division would then send a notice to your private health insurance letting them know of their duty to pay. The medical claims would be paid at the same extent it would be if your accident or injury weren’t related to work. In other words, if your private health insurance policy doesn’t normally cover certain procedures or expenses, it’s not obligated to cover those expenses just because you claim that accident or injury is related to work. You will also be responsible for any co-pays or deductibles you would otherwise be obligated to pay.
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