Administering Idaho's Workers' Compensation Law

Insurance Information

Benefit Tables (top)

To calculate benefits an injured worker may be entitled to, use the following tables to:

STEP 1: Convert the Average Weekly Gross Wage to a benefit percentage

STEP 2: Convert your benefit percentage to a Weekly Dollar Amount

Filing Calendar (top)

IC-36: Outstanding Awards Report
Due quarterly: January 31, April 30, July 31, October 31

IC-211: Self-Insured Employer Report of Total Unpaid Liability
Due July 31 (Jan - Jun payments), January 31 (Jul - Dec payments)

IC2-327: Workers' Compensation Payment on Medical-Only Claims or Indemnity Payments
This report is to be submitteed annually. It is to be received in this office no later than March 3rd of the subsequent year.

IC-4008LD: Workers' Compensation Deductible Policy Report
This report is to be submitteed annually. It is to be received in this office no later than March 3rd of the subsequent year.

IC-4008: Premium Tax Report Form
Due semi-annually: in this office no later than July 31 (Jan-Jun payments) and in this office no later than March 3 (Jul-Dec payments).

IC-4010: Premium Tax Report Form, Self-Insured
Due semi-annually: in this office no later than July 31 (Jan-Jun payments) and in this office no later than March 3 (Jul-Dec payments). (Also IC-4010a, computation form.)

Electronic Data Interchange (top)

IAIABC EDI Claims Release 3

Notice of Intent to Mandate Claims EDI Release 3.0 for First Report of Injury (FROI) and Subsequent or Supplemental Report of Injury (SROI) forms

The Idaho Industrial Commission intends to mandate electronic filing through IAIABC Claims EDI Release 3 of First Reports of Injury (FROI) and Subsequent or Supplemental Reports of Injury (SROI) forms.

The International Association of Industrial Accident Boards and Commissions (IAIABC) is a private association of workers’ compensation professionals from public and private sectors with a basic objective to strengthen and improve the administration of workers’ compensation laws. The IAIABC has developed Claims EDI Release 3.0, a standardized format for the computer-to-computer exchange of data.

EDI (Electronic Data Interchange) is a computer-to-computer exchange of data in a standardized format. Standardized transactions sets allow hundreds of different documents to be electronically exchanged. Electronic submissions are a much more efficient method to transmit the legally required information and forms on workers’ compensation claims. EDI will streamline the submission of required documents by eliminating the need for most paper forms.

The Idaho Industrial Commission’s Benefits Department is responsible to code, enter, and digitize or microfilm all documents related to workplace injuries filed with the division by employers, carriers, and physicians. Each year there are approximately 35,000 claims filed in Idaho, representing 136,500 pages of documents to process. This amounts to around 2,625 pages of documents per week. Although EDI Claims Release 3.0 has start-up resource costs, the electronic submission of workers’ compensation claim information has many advantages over the submission of paper forms, including:

      • Improved reporting performance
      • Time savings
      • Cost savings
      • Improved accuracy and efficiency

IIC contact information:
Business: Scott McDougall, 208-334-6063
Technical: Mary Stumpp, 208-334-6039

FAQs:

What is the IAIABC?

The International Association of Industrial Accident Boards and Commissions (IAIABC) is a private association of workers’ compensation professionals from both the public and private sector working together to improve the administration and application of Workers’ Compensation Laws across the nation. The IAIABC has developed EDI standards for reporting First and Subsequent Reports of Injury, medical and proof of coverage information. Over two thirds of the states have adopted some form of EDI in their workers’ compensation systems. The IAIABC is committed to the EDI process and is constantly evaluating and enhancing the standards for reporting workers’ compensation insurance data.

What is EDI?

EDI (Electronic Data Interchange) is defined as a computer-to-computer exchange of data in a standardized format.

What are the benefits of using Claims Release 3.0?

EDI requires standardization of electronic formats. Each trading partner (parties who exchange data) must use the standardized format and set of rules for the data information transfer. Standardizing and automating front-end edits allow for better data integrity, and reduced data rejections. For the parties trading claims information via EDI, additional benefits include:

    1. The opportunity for the jurisdiction and insurance carrier to exchange real-time data to ensure accuracy;
    2. Elimination of most paper documents and the attendant handling and storage concerns for data exchanged between the jurisdiction and carriers;
    3. Digitized data to facilitate long-term record retention; and
    4. An electronic audit trail to document timely compliance with filing requirements.

When will EDI become mandatory?

The EDI Committee proposes requiring electronic submission of a First Report of Injury (FROI) and a Subsequent or Supplemental Reports of Injury (SROI) by January 1, 2017.

In-State Adjuster Change Form

Use the In-State Adjuster Change Form to either change your Primary in-state adjusting company designation, or the in-state adjuster for policyholders not handled by the Primary adjusting company.

Out-of-State Check Waivers (top)

To apply for an Out-of-State Check-Writing Waiver, submit a completed application and affidavit to the Industrial Commission at PO Box 83720, Boise, ID 83720-0041. Each surety/underwriter must apply for its own waiver. Waivers are not issued to insurance groups, or to third party adjusters.

Upon receipt of the application, we will review and determine whether we will issue the waiver, based upon the information you return to us and independent information available to us regarding your claims management practices.

Medical Fee Disputes (top)

NOTICE:

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.

Added 08/26

---

The Commission has prepared some items to help navigate the medical fee dispute process.  The Commission has also created a separate page to answer frequently asked questions

Reporting injuries (top)

If a work-related injury or illness results in lost work time or requires medical treatment, that injury or illness must be reported to the Idaho Industrial Commission. This is done with a First Report of Injury or Illness form. Before completing the form, be sure to read the instructions. The form can be filled out and sent as an email attachment.

Surety Audits (top)

The Industrial Commission Claims and Benefits department conducts compliance audits of insurers and their designated in-state adjustors. Periodic audits are performed to ensure insurer and self-insured employers are in compliance with claims adjusting requirements as required by Statute and Rule. Click to view a list of the primary audit criteria used during the site audit.

For further information or comment, please contact Faith Cox, Surety Claims Audit Coordinator at 208-334-6004 or Faith.Cox@iic.idaho.gov

Claims and Benefits Newsletters and Guidance(top)