IDAHO WORKERS’ COMPENSATION
The following information relates primarily to Idaho Workers’ compensation claims, but there are similarities to Workers’ Compensations laws in other states. For complete information, please contact your local attorney.
REPORTING AN IDAHO WORK INJURY
1. Report an accident or injury to your supervisor immediately.
2. Ask that a Notice of Injury be filed with the Idaho Industrial Commission.
3. If you need medical attention, see a doctor as soon as possible. Tell the doctor how the work injury happened and where it hurts.
4. Follow your doctor’s orders – and ask about what you shouldn’t do.
5. Don’t sign anything without legal advice.
6. If your Idaho work comp claim is denied or if you are confused, see an attorney.
WHO IS COVERED BY IDAHO WORKERS’ COMPENSATION? Everyone who works for wages, whether the employer is a public entity or a private business. There are a few exceptions to this rule, but even these exceptions are subject to interpretation.
WHAT QUALIFIES AS AN IDAHO WORKERS’ COMPENSATION CLAIM? Any injury that occurs while you are performing an assigned task for your employer, no matter where that task may be. Many illnesses, also called occupational diseases, may be covered if we can prove that they are caused by your working conditions.
HOW DO I FILE AN IDAHO WORK INJURY CLAIM? Notify your employer immediately, if possible. If there were no witnesses with you at the time of the injury, you should turn in a short written statement that tells the date you were hurt, the time of day, what you were doing when you were hurt, and the nature of the injury. Even though it may not seem serious at the time, the injury may cause future medical problems or complications. It is much better to let your employer know about your injury than to take a chance and possibly lose your right to benefits.
After your employer knows about the injury it is his responsibility to file a Notice of Injury with the Idaho Industrial Commission, and send a copy to the insurance company. However, if the employer refuses to file a Notice of Injury with the Idaho Industrial Commission, you should do so. You should read the information carefully to be sure it is correct, and sign it if you are physically able. Pay particular attention to the amount of your wages as this information will be used to figure your income benefit payments.
WHAT WORKERS’ COMPENSATION BENEFITS ARE AVAILABLE TO AN INJURED WORKER IN IDAHO? The insurance company should pay for all of the medical expenses related to the injury. This includes the ambulance, X-rays, and all other emergency costs, as well as charges for any medical doctors, eye doctors, dentists, osteopaths, therapists, and chiropractors. However, you should be careful about changing physicians. You must have a referral from your treating physician or you should submit a written request for a change of physicians to the insurance company before seeing any other doctors. Without a referral or approval from the insurance company, the employer may not be obligated to pay for those medical services. You are also entitled to all your prescription medicines and any other items that your doctor feels will help you get better, including physical therapy and prosthetic devices.
If you are going to be off work for a period of time, you will receive a percentage of your gross income. The actual dollar amount you will receive depends upon your rate of pay and the established state scale. These income benefits should continue as long as you are still under medical treatment and your doctor says you are unable to work.
MY DOCTOR DOESN’T LISTEN TO ME, AND I DON’T ESPECIALLY LIKE HIM. WHAT CAN I DO? Ask him to refer you to another doctor. As long as your attending physician makes the referral, the insurance company is not likely to object. If he does refuse, talk to your employer or the insurance company. Laws on changing your doctor vary from state to state, so be sure to check with your attorney before you change doctors.
MY DOCTOR IS RELEASING ME, BUT HE SAYS I CAN’T GO BACK TO MY TIME-OF-INJURY EMPLOYMENT. WHAT SHOULD I DO? Unfortunately, this is not unusual. In Idaho you may be entitled to up to two years of retraining benefits, payment of additional permanent disability benefits, or both. Check with your attorney for details. Each case is different and your attorney will need to evaluate your particular case to advise you about what you may be entitle to.
Most State Workers’ Compensation Agencies have a Worker Rehabilitation Division or insurance funded private Vocational Counseling to help you get back to work. In Idaho this state agency is the Idaho Industrial Commission Rehabilitation Division. You should cooperate with these counselors. However, if the vocational counselor states that you can do a job and you disagree with this, you should advise your lawyer.
THE INSURANCE COMPANY HAS OFFERED ME MONEY TO SETTLE MY CLAIM. SHOULD I ACCEPT IT? Prior to accepting a settlement offer, careful consideration should be given to the ramifications of a settlement. Some important questions must be asked. Some of these questions include: Are all of your hospital, doctor and other related medical bills paid? Is any amount included for your future medical care? If you need to be retrained, has this been included? What type of agreement do they want you to sign? Read it very carefully, and be sure of what it says.
A settlement offer should be accepted only after a lot of thought. Settlement offers are usually made based on an impairment rating given to you by your doctor. This impairment rating considers your physical conditions only and does not include other important factors like age, education and work experience. Keep in mind that accepting a settlement sometimes means you will never to able to open your claim again – even if you require additional treatment or can no lo0nger work because of that injury.
I DON’T WORK FOR THE SAME COMPANY I WAS WORKING FOR WHEN I GOT HURT. AM I STILL COVERED? Possibly! As long as your claim was properly filed, and any time limits on the claim have not run out, you may be entitled to addition benefits. If you were fired, or you quit, or even if the company went out of business, you may still be covered. These issues can be very complex, so check with your attorney.
IS MY CLAIM TOO OLD? Time limits vary from state to state. However, generally in Idaho, if any benefits were paid on your claim, it is open for at least five years, and maybe longer. If no benefits were paid on your claim, you usually only have one year from the date of your injury to start legal action. Occupational disease claims allow ever less time for filing a claim. The time within which a claim must be filed often requires complex legal analysis. Check with your attorney.
IT WAS MY COMPANY’S FAULT THAT I WAS HURT. CAN I SUE THEM FOR MORE THAN WORKERS’ COMPENSATION? Not usually. There are many complaints about negligence, dangerous working conditions, and unnecessary hazards. If this is the case, you can report it to your union, OSHA, or a state agency, but workers’ compensation is usually your only legal remedy for your injury.
There is an exception to this, however. If a product or piece of machinery or equipment was faulty, malfunctioned, or in some way caused you to be hurt, or if some person not employed by your company was in the wrong, you may be able to make a claim against a third party, even though you cannot sue your employer for more than workers’ compensation benefits. If this is the case, you should get legal advice.
WHAT IS AN OCCUPATIONAL DISEASE UNDER IDAHO’S WORKERS’ COMPENSATION LAWS? As we gain knowledge of our working conditions and the various materials and chemicals that we are exposed to at work, it is being proven that more illnesses and diseases than we ever imagined are being caused by the type of work that we do and the various materials that we use to do that work. If you are injured over a period of time due to the nature of your work, or substances present in your work, this can be an occupational disease. These cases often require complex legal analysis. If there is any doubt in your mind… ASK YOUR ATTORNEY!
WHAT IS A DISABILITY RATING? Arriving at a disability rating can be a complicated procedure. It is not done by the doctor. Your doctor may give you a “permanent partial impairment rating” for your injury. A disability rating involves more. If you agree with the impairment rating the doctor has given you, this is used as a place to start.
If, however, you do not feel that the impairment rating your regular doctor has given you is fair and in line with your physical condition, it is possible to seek another opinion from another doctor. The insurance company may not agree to pay for this, unless you can show it is reasonable to do so in your case.
To arrive at a disability rating, your impairment rating is then combined with non-medical considerations such as age, education, the present state of the labor market, the area where you live, your work history, your ability to go back to your former employment and any other information that may be important to your case. Your lawyer will help you determine what is fair disability rating would be for your case. If the insurance company does not agree, then a hearing before the Idaho Industrial Commission can be requested, and the Industrial Commission will decide your disability rating.