This page provides answers to the following questions:
- I had an accident at work. How do I file a workers compensation claim in my state?
- Should my employer have workers compensation insurance? How do I know I am covered?
- What are the conditions that enable me or prevent me from claiming benefits under my state's law?
- What benefits might I be eligible to receive?
- How much time do I have to file my claim? What are the stages of the claim process? What should I expect?
- If I'm not happy with the determination, how do I appeal?
1. I had an accident at work. How do I file a workers compensation claim in my state?
If you have an accident at work, notify your employer as soon as possible and seek the appropriate medical treatment if necessary. You may contact your employer or your employer's insurance company about the injury. When seeking medical care, it is also important to inform the doctor, nurse, or medical professional attending to you that this injury occurred at work.
In order to request benefits in a workers' compensation claim, you should aim to notify your employer or your employer's insurance company within sixty (60) days of the injury. You must also complete a First Report of Injury or Illness form to provide to the Idaho Industrial Commission.
It is important to report any injury or illness you believe to be resultant from work, no matter how large or how small.
2. Should my employer have workers compensation insurance? How do I know if I am covered?
Your employer is expected to carry workers' compensation insurance and to pay benefits related to your workers' compensation claim. If your employer is not insured or fails to provide you with information about the insurance coverage plan your employer partakes in, contact the Idaho Industrial Commission's Employer Compliance Department.
3. What are the conditions that enable me or prevent me from claiming benefits under my state's law?
The best way to guarantee that you will receive benefits in a possible workers' compensation claim is to comply with the proper reporting procedures and filing requirements. Report your injury or illness, no matter how minor, to your employer if you believe it is work-related. Also, help your employer or your employer's insurance provider to complete the First Report of Injury or Illness form.
4. What benefits might I be eligible to receive?
Depending on the nature of your workers' compensation claim and the severity of your injury, you may be entitled to the following benefits:
- Medical Benefits: Your employer will pay for all reasonably necessary medical care related to treatment for your injury or illness. These may include, but are not limited to, emergency medical care, doctor's bills, x-rays, medications, and travel expenses related to seeking treatment and care.
- Total Disability Benefits: To be eligible for total disability benefits, your doctor or treating physician must first determine that your injury or illness is work-related. These benefits will be in form of wage replacement should your injury/illness causes you to miss more than five days of work or if you require hospitalization.
- Total Partial Disability Benefits: If you are able to return to work after suffering a work-relate injury/illness but only part-time, these benefits will compensate you for the difference of pay between your former full-time wages and your new part-time wages.
- Permanent Impairment/Disability Benefits: These are benefits to compensate you when you face permanent disability, but you are still able to return back to work. These benefits will be calculated on a case-by-case basis, determined by the extent of your injury. In certain situations, you may be able to apply for extended benefits.
- Death: Death benefits are paid to dependents of an individual who dies as a result of a work-related injury or illness. These benefits will be paid for a period of 500 weeks. If the decedent leaves behind children as dependents, up to three children may qualify for benefits until the age of eighteen (18). These death benefits may also include compensation for funeral expenses should the death occur within four years of the injury.
- Rehabilitation Services: The Idaho Industrial Commission provides a wide array of rehabilitation and vocational services to assist you in returning to work after treating your injury or illness.
5. How much time do I have to file my claim? What are the stages of the claims process? What should I expect?
You must notify your employer within sixty (60) days of your injury should you plan to file a workers' compensation claim. Should you have any issues with receiving benefits or filing your claim, approach your employer or contact your employer's insurance provider. An Idaho Industrial Commission Compensation Consultant is also available to assist you with any issues you may have while filing your claim.
6. If I am not happy with the determination, how do I appeal?
Should you have any problems with your employer or your employer's insurance provider related to receiving benefits or filing your claim, request a formal hearing process with the Industrial Commission. These formal hearings are litigation proceedings overseen by judicial referees or commissioners. You have the option of hiring an attorney to assist you in these proceedings should you find yourself in need of one. Once the case is presented before the Industrial Commission, you will receive the Commission's determination via a written order.
The Industrial Commission encourages you to seek mediation if feasible prior to filing for a formal hearing. A mediation is a voluntary, informal meeting to work on the issues of a disputed claim. A neutral intermediary will facilitate the mediation and seeks to administer a settlement or agreement through the course of the proceedings. Mediations are highly recommended because they often save time, involve no risk, exhibit high success rates in many cases.