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For Injured Workers |
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(click on bold titles for additional information)
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What is Workers' Compensation Insurance?
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Workers' compensation
insurance is a no-fault insurance policy, which provides wage loss and
medical benefits to workers with a job-related injury or disease. Nearly
every working Idahoan is protected by workers' compensation insurance,
as state law requires most employers to have workers' compensation
insurance.
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If you are not sure
whether your employer has workers' compensation insurance, ask your
supervisor.
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If
your employer is required to carry workers' compensation insurance, you
are covered from your first day of work and normally every minute you
are on the job.
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The workers'
compensation law lists the few types of employers not required to have
workers' compensation insurance. If your employer does not have workers'
compensation insurance and you believe that you should receive workers'
compensation benefits, you may contact an Idaho Industrial Commission
Compensation Consultant by calling toll free 1-800-950-2110 V/TDD;
or consult with an attorney.
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What is the Idaho Industrial Commission?
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The Idaho Industrial
Commission is the state agency, which administers the Idaho Workers'
Compensation Law.
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When formal hearings
are held on disputed workers' compensation claims, the Industrial
Commission makes findings of fact and reaches legal conclusions, then
issues a decision containing its findings of fact and conclusions of
law.
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Industrial Commission
employees can assist you with many of your questions or concerns about
workers' compensation. However, they cannot provide you with legal
advice. If you believe that you need legal advice, you should consult an
attorney.
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The Idaho Industrial
Commission is NOT:
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The
State Insurance Fund.
The State Insurance Fund is an insurance company and issues workers'
compensation insurance policies.
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The Industrial Special Indemnity Fund. The Industrial Special Indemnity Fund provides
special disability benefits for workers who are totally and
permanently disabled due to job-related injuries and diseases.
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The Department of Insurance.
The Department of Insurance administers Idaho insurance laws and
regulations, to protect the interest of the public in all insurance
transactions, and to provide safety and stability of insurance
institutions through regulations.
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The Division of Building Safety. The Division of Building Safety has fixed jurisdiction in the
areas of electrical, plumbing, building, logging, public employee
safety, and employee/employer relations, as well as mine.
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What Should I Do If I Experience a Job-Related Injury or Disease?
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If you believe you have
suffered a job-related injury or disease, you should:
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Tell
your employer immediately.
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Seek
first aid and medical care.
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Tell the medical care
provider that your injury or disease is job-related.
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Your employer may
have a designated physician for treating all work-related diseases or
injuries except for emergency care. Ask your employer before seeking
medical treatment. If your employer has designated a physician, you
must have your employer's approval or petition for approval from the
Industrial Commission before visiting another physician. (Click
here for information on petitioning for a change of physician.)
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Help your employer fill out your "First Report of Injury or Illness"
form.
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Click here to view a version of the form. (Acrobat Reader
required.)
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Call your employer or
your employer's insurance company if you have questions about your
workers' compensation benefits.
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Call the Idaho
Industrial Commission at 1-208-334-6000, toll free 1-800-950-2110, if
you have problems or if your employer or your employer's insurance
company cannot help you with your questions or concerns. The Idaho
Industrial Commission has people trained to assist you.
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How Do I Request Workers' Compensation Benefits?
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Report your job-related
injury or disease immediately!
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To qualify for
workers' compensation benefits, you must report your job-related
injury or disease to your employer IMMEDIATELY. You could lose all
benefits if you wait longer than 60 days to report your injury.
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Tell your employer
about your injury or disease.
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You should tell your
employer when, where, and how the injury happened. If possible, help
your employer fill out your "First Report of Injury or Illness" form.
The employer should file this notice with the Industrial Commission.
If your employer declines to do so, file the form yourself.
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If your employer does
not have the "First Report of Injury or Illness" form, call the
Industrial Commission at one of the phone numbers listed and request
that a form be sent to you.
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Report ALL injuries
even minor injuries.
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To protect your right
to receive workers' compensation benefits, you must report any
job-related injury or disease to your employer.
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What Do I Do If My Employer Does Not Have Workers' Compensation Insurance?
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If you have a
job-related injury or disease and you believe
your employer may not have but should
have workers' compensation insurance, you should:
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Call the Idaho
Industrial Commission at 208-334-6000, toll free 1-800-950-2110, and
request the name of your employer's insurance company. The Industrial
Commission can confirm whether or not your employer has coverage.
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Ask your employer or
the Idaho Industrial Commission for a "First Report of Injury or
Illness" form. Fill out the form to the best of your ability.
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Return your completed
form to the
Idaho Industrial Commission's main office in Boise.
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The Idaho Industrial
Commission will notify your employer of your claim. In addition, your
employer will be advised of its responsibility to pay your workers'
compensation benefits. The Industrial Commission's Employer Compliance
department will also take the appropriate action to make sure that your
employer obtains the required insurance.
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What Are Workers' Compensation Benefits?
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If you suffer a
job-related injury or disease, you may be entitled to receive
compensation for medical care, lost wages, or other related benefits
and/or services, depending upon your individual situation. Note:
Your employer's insurance carrier or your employer, if self-insured, is
responsible for payment of your workers' compensation benefits if the
injury or disease is found to be compensable.
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MEDICAL CARE
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Your employer's
workers' compensation insurance company pays for "reasonable and
necessary" medical care to treat your job-related injury or disease.
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Such care usually
includes, but is not limited to, payment for emergency medical care,
doctor bills, x-rays, medications, hospitalization, crutches, and some
travel expenses required for medical care.
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You are not
responsible for the cost of medical treatment covered by workers'
compensation. Bills for medical treatment are to be sent by the
medical care provider directly to the insurance carrier, or to the
employer if self-insured.
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TEMPORARY DISABILITY
BENEFITS
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If your physician
confirms that you cannot work because of your job-related injury or
disease, you may be eligible for
temporary total disability benefits
until you are released to return to work or your condition has
reached a point of maximum improvement. You normally qualify for time-loss benefits (compensation for lost wages)
if your injury or disease causes you to miss more than five days of
work, or you are hospitalized as an in-patient.
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If you are able to
return to part-time or modified work while you are still recovering
from your injury or disease, and you are receiving less than your
usual earnings, you may be entitled to
temporary partial disability benefits.
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PERMANENT DISABILITY
BENEFITS
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If it is determined
that the result of your job-related injury or disease is permanent,
but that you will be able to return to the same or some other type of
work, you will receive benefits for your
permanent partial impairment and/or
disability.
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The benefits you
receive and how long you receive them depends on the extent of your
permanent impairment or disability.
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If it is determined
that you are totally and permanently disabled as a result of a
job-related injury or disease, you may receive income benefits for an
extended period of time. If such a
total and permanent disability
was partly caused by a previous injury or condition, the Industrial
Special Indemnity Fund may pay some of your benefits.
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DEATH BENEFITS
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If you die of a
job-related injury or disease, your surviving spouse usually receives
benefits for 500 weeks. (Benefits will change if your spouse
remarries). Your children (up to a maximum of 3) ordinarily receive
benefits until they are 18 years of age. The amount of these benefits
depends on the average weekly state wage.
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If the death occurred
within four (4) years of the job-related injury or disease, the law
provides some compensation for funeral expenses.
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To discuss the
specific details regarding the benefits for which you may be entitled,
contact an Industrial Commission Compensation Consultant by calling
1-208-334-6000 or toll free 1-800-950-2110.
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REHABILITATION SERVICES
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If you have suffered
a job-related injury or disease, the Industrial Commission
Rehabilitation Division provides rehabilitation services and
consultants to assist you in returning to employment in a position as
close as possible to your pre-injury status and wage. The consultants
do not work for employers, insurance companies, attorneys or anyone
else involved in the workers' compensation process. Instead, they are
employees of the Industrial Commission and serve as professionals who
are neutral and objective in their efforts to assist you in your
recovery.
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For more information
about the service provided by the Industrial Commission Rehabilitation
Division, refer to the section entitled
What If I Need Help Returning to Work?
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What If I Do Not Receive the Benefits to Which I Believe I Am Entitled?
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If you believe you are
entitled to receive certain workers' compensation benefits and are not
receiving them, you should:
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Talk
directly with your employer and your employer's insurance company about
your concerns.
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If your employer or
your employer's insurance company cannot help you with your questions or
concerns, contact an Idaho
Industrial Commission Compensation Consultant, by calling
1-208-334-6000, toll free 1-800-950-2110 V/TDD.
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While discussing your
case with your Compensation Consultant,
ask about Mediation, a
voluntary, informal dispute resolution process.
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You may also choose to
resolve your differences, regarding your claim for benefits, through the
formal hearing process. Hearings are formal litigation proceedings where
disputed workers' compensation claims are presented before
representatives of the Idaho Industrial Commission, either judicial
referees (attorneys working for the Commission) or the Commissioners.
After the hearing, you will receive a written order resolving the
dispute.
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If you choose to
formally contest the decision of your employer or the employer's
insurance company, you may want to consult an attorney.
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The Formal Hearing
Process
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To begin the formal
hearing process, you must file a "Complaint
Form" with the Industrial Commission. You may obtain a
copy of the Complaint Form from the Industrial Commission or your
attorney.
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To obtain a date for
your hearing, you or your
attorney must file a "Request for Calendaring" with
the Idaho Industrial Commission.
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What is Mediation and Why Should I Consider It?
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Mediation is a
voluntary, informal meeting between the people involved in a disputed
workers' compensation claim. The goal of the meeting is for all sides to
reach agreement on a fair solution to the dispute.
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A neutral Industrial
Commission mediator who has experience in resolving disputes assists in
mediation. The mediator conducts the meeting but does not give advice to
the participants.
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Mediation is often
requested because it:
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Makes Everybody a
Winner
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All participants must
agree to mediate a dispute or mediation will not take place. The
participants control the outcome. Everybody must be in agreement for a
settlement to be reached.
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Saves Time
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Mediation frequently
results in an immediate solution. The formal hearing process is often
very time-consuming.
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Has a High Success Rate
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Over 90% of mediated
disputes are successfully resolved.
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Involves No Risk
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Cases unsuccessfully
mediated may pursue a formal hearing or work toward settlement outside
the mediation process.
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Contact the Idaho
Industrial Commission at 1-208-334-6000; toll free 1-800-950-2110 V/TDD,
for more information about the mediation process.
Click here for a form to request mediation.
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Can I Take My Claim to a Civil Court?
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Any dispute concerning
your workers' compensation benefits should be referred to the Idaho
Industrial Commission.
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If you believe a person
other than your employer is responsible -- in whole or in part --
for your injury, you may be able to seek compensation from that party in
a civil court.
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What If I Need Help Returning to Work?
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Rehabilitation
Consultants at the Idaho Industrial Commission will assist you with
returning to work within the physical limits set by your treating
medical provider. Rehabilitation Consultants may:
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Help you set
return-to-work goals.
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Conduct a job-site
evaluation to help your doctor understand what is required of you at
work.
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Work with your employer
to make job modifications or to identify other job possibilities.
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Help you develop a new
employment goal if a job change is required due to your job-related
injury or disease.
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Help you find a job
with a new employer that is as close to your pre-injury status and wage
as possible.
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Help you develop a plan
for on-the-job or formal training when such training is required to
restore your pre-injury wage.
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If you would like more
information about the Rehabilitation Division and the services it
offers, call toll free 1-800-950-2110 V/TDD, or
contact one of our offices.
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What Else Should I Know?
- LEGAL HELP
- The information
contained in this web page is general in nature and is not intended as
a substitute for legal advice. Changes in the law or the specific
facts of your case may result in legal interpretations, which are
different than presented here.
- The Idaho State
Bar can provide you names of lawyers in your area who are familiar
with workers' compensation issues. The Idaho State Bar is located in
Boise, Idaho and can be reached by calling 1-208-334-4500.
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NO JOB GUARANTEE
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Idaho's Workers'
Compensation Law does not require your employer to hold your job or
rehire you after you recover from your job-related injury or disease.
However, Rehabilitation Consultants with the Idaho Industrial
Commission can provide return-to-work assistance. You can contact the
Idaho Industrial Commission Rehabilitation Division at 1-800-950-2110
V/TDD, or at
one of the local offices.
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TAXABLE BENEFITS
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Questions often arise
regarding whether or not workers' compensation, disability and/or
Social Security benefits are taxable. Since each person's tax
situation is different and related tax laws are complex, contact your
accountant or an Internal Revenue Service representative to address
your specific concerns.
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ANTI-DISCRIMINATION LAW
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The Idaho
Human Rights Act and the federal Americans with Disabilities Act (ADA)
prohibit employment discrimination based on disability. It is illegal
to discriminate against a worker or job candidate because that person
has a physical or mental disability. An employer has an obligation to
attempt reasonable accommodation to meet the special needs of persons
with disabilities. For more information about your rights within these
laws, contact your employer, attorney, or the Idaho Human Rights
Commission by calling 1-208- 334-2873, TDD 1-208- 334-4921. All calls
are confidential.
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Want Return to Work
Help? |
Idaho workers injured on the job can get help returning to work. We
have Rehabilitation staff at each of our Idaho offices.
Click here to find an office near you.
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Need to Report an
Accident? |
The First Report of Injury or Illness is available in two formats:
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