The Industrial Commission is the state agency responsible for:
- Regulating workers' compensation activities in Idaho, including companies licensed to issue workers' compensation policies.
- Ensuring that employers have workers' compensation coverage as required by law.
- Settling disputes between injured workers, employers, and insurers.
- Deciding appeals for unemployment decisions from the Idaho Department of Labor.
- Providing compensation to innocent victims of crime through the Crime Victims Compensation Program.
Public Meeting Notice (June 2, 2015 at 2 p.m.):
IDAPA 17 – Industrial Commission
17.02.09 – Medical Fees
Docket No. 17-0209-1502
METHOD OF PARTICIPATION: Per the May 6, 2015 edition of the Idaho Administrative Bulletin; interested persons wishing to participate in the negotiated rulemaking must respond to the “Notice of Intent to Promulgate Rules – Negotiated Rulemaking” by contacting the undersigned either in writing, by email, or by calling the phone number listed below. To participate, responses must be received by May 27, 2015. When contacting the Commission, please list whether you are interested in physician or hospital services. Further information can be found here.
- Commission Secretary Beth Kilian at email@example.com
- Director Mindy Montgomery at (208) 334-6000
- Via fax at (208) 334-2321
- Boise main office address at 700 S. Clearwater Lane, PO Box 83720 (ZIP: 83720)
The public meeting will take place June 2, 2015 at 2 p.m. at the Commission’s main office in Boise. All written comments will be copied and distributed.
For assistance on technical questions concerning this negotiated rulemaking, contact Patti Vaughn, Medical Fee Schedule Analyst, at firstname.lastname@example.org or (208) 334-6084.
Amendments to Idaho Appellate Rule 11 and Adoption of New Idaho Appellate Rule 12.3:
Effective July 1, 2015:
Please visit this link to review the full order, released by the Idaho Supreme Court April 23, 2015
DISCLAIMER NOTICE (4/16/15):
The most current version of the Commission's EDI Claims Release 3.0 and its supporting technical tables are now available.
The documents are substantially complete, but are still in development and should NOT be relied upon for programming purposes.
- Please click here for the EDI Claims Release 3.0: Implementation Guide, Tables and Supporting documents.
2016 Legislative Session: Notices of Intent to Promulgate - Negotiated Rulemaking
(Please check back for up-to-date information)
- 17-0206-1501 Employers' Reports
- 17-0207-1501 Procedures to Obtain Compensation
- 17-0208-1501 Miscellaneous Provisions
- 17-0210-1501 Administrative Rules of the Industrial Commission Under the Workers' Compensation Law -- Security for Compensation -- Insurance Carriers
- 17-0211-1501 Administrative Rules of the Industrial Commission Under the Workers' Compensation Law -- Security for Compensation -- Self-Insured Employers
- 17-0209-1502 Medical Fees (2016)
Temporary Rule 17-0209-1501 (1/1/15)
- The Industrial Commission adopted a Temporary Rule that became effective January 1, 2015, affecting payment for hospital outpatient and ambulatory surgery center (ASC) services.
- The Temporary Rule delays implementation of the new Comprehensive Ambulatory Payment Classification (C-APC) codes finalized by Centers for Medicare & Medicaid Services (CMS) on October 31, 2014. The Commission will extend the use of the 2014 OPPS Relative Weights until further notice.
Please contact Patti Vaughn, for further information at (208) 334-6084.
The next meeting of the Commission's Advisory Committee is scheduled to be held August 12, 2015 beginning at 9:30 AM in the Industrial Commission's first floor conference room, 700 Clearwater Lane, Boise, Idaho.
- August 12, 2015
- November 10, 2015
Records Request Procedures Update:
Effective January 1, 2015:
Procedures for requesting workers’ compensation claim records on claims closed by the Commission prior to January 1, 2004 have changed. A secondary, specialized records request form, the RMR-6, will be used to request closed workers’ compensation claim records that are maintained on microfilm.
Direct form links are available here (UPDATED 3/15):
Please feel free to contact the Records Department at (208) 334-6000, should any questions arise.
IDAHO APPELLATE RULES: UPDATES
The Supreme Court is considering amending the Idaho Appellate Rules to allow for an appeal from an interlocutory order that is final as to the issue of compensable injury when benefits have not yet been determined. Two alternatives are being considered. The first is an amendment to Rule 11 that would make these orders appealable as a matter of right. The second is an amendment to Rule 12 that would allow a permissive appeal without having to show that the appeal involves a controlling question of law as to which there is substantial grounds for difference of opinion. The motion would first have to be made to the Industrial Commission.
- Proposal 1:
Idaho Appellate Rule 11. Appealable Judgments and Orders.
An appeal as a matter of right may be taken to the Supreme Court from the following judgments and orders:
(d) Administrative Proceedings - Industrial Commission.
(1) From any final decision or order of the Industrial Commission or from any final decision or order upon rehearing or reconsideration by the administrative agency.
(2) From any interlocutory order that is final as to the issue of a compensable injury.
- Proposal 2:
Idaho Appellate Rule 12. Appeal by Permission.
(a) Criteria for permission to appeal. Permission may be granted by the Supreme Court to appeal from an interlocutory order or judgment of a district court in a civil or criminal action, or from an interlocutory order of an administrative agency, which is not otherwise appealable under these rules, but which involves a controlling question of law as to which there is substantial grounds for difference of opinion and in which an immediate appeal from the order or decree may materially advance the orderly resolution of the litigation. A permissive appeal from an interlocutory order by the Industrial Commission that is final as to whether there is a compensable injury may be sought solely on the basis that the best interest of the parties would be served by an immediate appeal.
Please click here for additional information at the Idaho Supreme Court website.
Comments on the proposed alternative amendments may be sent to Cathy Derden at email@example.com by Jan. 15, 2015.
JUDICIAL RULES OF PRACTICE AND PROCEDURE
For a copy of the Judicial Rules, effective May 8, 2013, please click the link below.
Change to Application of 30% Penalty In Medical Fee Disputes
For all Motions filed on or after October 1, 2014, unless the payer demonstrates, by timely response to the provider’s Motion, that the payer’s previous payment is adequate, the penalty will now be applied to the underpayment owed at the time the Motion was filed. Payments issued after the filing of the Motion may be deducted from the ordered amount, but will not reduce the penalty. For more information, click here.
On April 7, 2011, the Idaho Industrial Commission stopped mailing premium tax forms to sureties, as this form is now available online. An informational letter was mailed June 7, 2011. Companies must print and submit the completed forms for the semi-annual period January 1, 2011 through June 30, 2011. All reports and payments must be received in our office by close of business on Monday, August 1. Failure to meet this deadline will result in the assessment and collection of penalties provided by law.
On June 8, 2012, the Idaho Industrial Commission sent notices regarding the Premium Tax Rate Reduction to Insurance Companies Approved to Write Workers' Compensation Under Idaho Law. The report and tax payment must be received in our office by July 31, 2012.
This is an important notice of a temporary and proposed rule recently adopted by the Commission and approved by the Division of Financial Management and Governor’s office, effective July 1, 2014. Please click here for a copy of the entire IDAPA rule 17.02.11 governing self-insured employers. New language is underlined; pages 2 and 3 are a result of the statute change (IC §72-301A) last session specific to INL contractors. The new language on pages 6 and 7 relates to the application of an experience modification factor for premium tax assessment.
Under Idaho Code §72-523, every self-insurer pays a premium tax (currently 2%) based on the premium the employer would be required to pay to the State Insurance Fund (SIF) if the employer had obtained a workers’ compensation insurance policy from the SIF.
The SIF applies an experience modification factor (e-mod) when calculating premiums. Historically, the Industrial Commission has not considered an e-mod when computing premium tax for self-insured employers, but the proposed changes may affect how self-insured employers’ premium tax is computed. This change will be effective beginning with the 2014 reporting periods of July 31, 2014 and March 3, 2015. As a result of this rule change, self-insured employers may decide annually whether to submit an NCCI experience modification factor and form with their semiannual premium tax reports. Accordingly, the employer must obtain a current e-mod factor from NCCI for each calendar year they wish to use it in their premium tax calculation.
It is important to note, however, that Idaho Code §72-526 requires timely payment of premium tax. Since the initial reporting due date of July 31, 2014 for the Jan. 1-June 30, 2014 period is fast-approaching, and the fact that NCCI may require up to 45 days lead time to process and issue an e-mod factor, the Commission has further decided to allow self-insured employers to submit an e-mod factor issued by NCCI with a copy of the ERM-6 form, within 90 days following the July 31, 2014 filing deadline. As a result, the Commission will compute the impact to premium tax paid by a self-insured employer had an e-mod been applied and refund any difference. This is only being allowed for the July 31, 2014 reporting period and any future election of an e-mod must be submitted with a copy of the NCCI form ERM-6, the premium tax and computation forms, as indicated in rule.
Please click here for the ERM-6 form link on the NCCI website. Users do NOT need a user ID and password to view/print this form. A $75 check for the experience rating fee should be submitted with the ERM-6 form; information from the check is used to create the self-insured account.
NCCI Customer Service may be reached at 1(800)622-4123, ext. 4 for experience modification factor assistance.
If you have questions regarding any of this information, please contact the Idaho Industrial Commission fiscal department: Jane McClaran at (208) 334-6042, Therese Ryan at (208)334-6095 or Shelly Tudela at (208)334-6026.
Premium Tax Rate Deduction:
Per Idaho Code §72-523, the premium tax rate effective January 1, 2012 through December 31, 2015 has been reduced by 20% from 2.5% to 2.0%. The online premium tax form reflects this change for the semi-annual period January 1, 2012 through June 30, 2012. All reports and payments must be received in our office by close of business July 31, 2012. An informational letter was mailed April 3, 2012.
On April 7, 2011, the Idaho Industrial Commission stopped mailing reporting forms. These forms, as well as the NCCI rates, are now available online. Companies must print and submit the completed forms and tax payment for each six-month period.
A new exemption from the insurance requirement of the Workers’ Compensation Law will go into effect on July 1, 2014.
Idaho Code § 72-212(4) was amended during the 2013 legislative session to exempt family member employees of a single member limited liability company that is taxed as a sole proprietorship. The exemption applies only to family members residing in the employer’s household. Family member employees who meet the criteria to be exempt under the new exemption will not be covered under their employer’s workers’ compensation insurance policy as of July 1, 2014 unless an IC52 Election of Coverage form is filed with the Industrial Commission by the employer and the employer’s workers’ compensation insurance carrier. For additional information on the exemption, contact the Employer Compliance Department by phone at 208-334-6000 or by email to firstname.lastname@example.org.
Effective August 1, 2013, the Idaho Industrial Commission will begin receiving Idaho workers’ compensation insurance policy data from the National Council on Compensation Insurance (NCCI) in the IAIABC EDI POC Release 3.0 format. This change will affect what insurance carriers are required to report to NCCI.
Some of the key changes coming in Release 3.0 are the addition of data elements to identify deductible policies, professional employer organization (PEO) and client company relationships, state premium, as well as the addition of several new cancellation reasons including “failure to submit payroll information”. A copy of the data element requirements, event tables and edit matrix are available on the Commission’s website. Also, please refer to NCCI’s Proof of Coverage Circular, POC-ID-2013-0, which is available on NCCI’s website at www.ncci.com for additional instructions on the requirements for Proof of Coverage Release 3.0.
The administrative rules of the Industrial Commission require that new policies, renewal policies, reinstatements and endorsement information must be reported to NCCI within 30 days of the effective date. Cancellations and non-renewals must be reported to NCCI within the time frames required by Idaho Code §72-311.
If you have any questions regarding the new reporting requirements, please contact Danny Barnett, Employer Compliance Manager, Idaho Industrial Commission, at (208) 334-6099 or by email at Danny.Barnett@iic.idaho.gov.