Idaho Workers Compensation Claims: Eligibility, Filing and Appeals

The Idaho Workers’ Compensation Commission enforces Idaho workers compensation laws. Idaho also offers a state insurance fund to employers, which provides workers compensation insurance.

Employers with one or more employees are required to carry worker’s compensation on their employees. Domestic servants, family members employed in a family business, sole proprietors and partners, and corporate offices that are also stockholders and directors are exempt.

An Industrial Special Indemnity Fund is also available to provide benefits to disabled workers who become permanently and totally injured as a result of a work related injury or illness.

Common Work Related Injuries

Idaho workers compensation law pays benefits for workers who sustain an injury caused by an accident arising out of and in the course of employment. An accident is defined as an unforeseen mishap that is connected with the job industry. The accident has to have occurred at a recognizable time and place. An injury is defined as damage to the physical structure of the body.

Idaho Workers Compensation also covers occupational diseases. Occupational diseases are covered if they are “due to the nature of an employment in which the hazards of such disease actually exist, are characteristic of and peculiar to the trade, occupation, process or employment.” (Idaho Code Section  72-102)

Idaho Workers Compensation Claims Procedure

You must report injuries and file claims both with your employer and the Idaho Industrial Commission. When injured, you should notify your employer in writing. You must provide written notice of an injury within 60 days or you risk losing all benefits due.

Your employer should then fill out a First Report of Injury or Illness Form. If your employer is unwilling to fill out a form and submit it, you can fill out the form directly and submit it to the Industrial Commission. The form is available from the Industrial Commission website (www.iic.idaho.gov/forms/forms.htm) or via phone, email or in person request from the Idaho Industrial Commission.

You should obtain medical care as soon as possible after the injury and inform the treating physician that the injury is job related. Your employer may have a designated physician and you must visit this physician or obtain approval from the Industrial Commission in order to visit another doctor, in order to maintain coverage. 

Workers Compensation Claim Denials

Common reasons for denial include failure to file notice of injury within 60 days, and failure to prove that an accident or injury arose out of the context of the employment.

Appealing an Idaho Workers Compensation Denial

If you are denied benefits you can file an appeal with the Industrial Commission. You can speak to an Industrial Compensation Commission Consultant to set up an informal mediation, in which the Commission facilitates settlement discussions between you and your employer. The mediation is presided over by an Industrial Commission Mediator who helps to resolve the dispute.

You can also request a formal hearing, which will be presided over by a judicial referee or Commissioner employed by the Industrial Commission. To request a formal hearing, you need to file  “Complaint Form” IC 72-706 which can be found at the Industrial Commissions’ Web Page. You also need to file a “Request for Calendaring” which will facilitate the scheduling of the hearing.  The judge or commissioner will hear your case and testimony by expert witnesses, and decide the dispute. The decision will be provided in a binding written order.

Collecting Idaho Workers Compensation Benefits

Benefits include medical care, death benefits and disability benefits. Medical care must be reasonable and necessary in order to be covered. You may be required to visit a designated physician and/or obtain permission from the Industrial Commission to visit an alternate doctor. Death benefits are paid for up to 500 weeks and are paid to dependents including spouses, siblings, parents, children or grandchildren. Burial costs are also paid.

If you missed more then 5 days of work, you are qualified to receive temporary disability benefits until your doctor either releases you to return to work or declares that your condition will not improve any further. Temporary disability benefits can either be full disability if you are completely unable to work, or partial disability if you are able to work part time or on restricted duty.

If your disability is permanent, you may be entitled to either full or partial permanent impairment benefits. Benefits are usually not taxed. The usual calculation is 67% of your average weekly wages, subject to state maximums. For partial permanent disability, this number also factors in your “impairment rating” which measures your level of impairment. Retraining benefits may also be provided if you are able to work in some capacity but not able to return to your original job.

Your benefits usually begin within 21 days after filing notice of an injury, unless there is a question of liability.

Hiring an Idaho Workers Compensation Lawyer

The Idaho Worker’s Compensation Commission advises hiring an attorney if you need to request a formal hearing to appeal a worker’s compensation denial. An attorney can help to ensure you are filing the proper forms to ensure you obtain a hearing, and can help you present a strong case to maximize your chances of recovering benefits due.

Idaho Workers Compensation Office Locations

Boise
4355 W. Emerald St., Suite. 105
Boise, ID 83706
Phone: 208-334-2024
Fax: 208-334-3711

Burley
127 W. 5th N., Suite A
Burley, ID 83318
Phone: 208-678-3332
Fax: 208-677-3616

Coeur d’Alene
1111 W. Ironwood Drive, Suite A
Coeur d’Alene, ID 83814
Phone: 208-769-1452
Fax: 208-769-1465

Idaho Falls
1820 E. 17th, Suite 300
Idaho Falls, ID 83404
Phone: 208-525-7248
Fax: 208-525-7013

Kellogg
35 Wildcat Way, Suite B
Kellogg, ID 83837
Phone: 208-786-4600
Fax: 208-786-7110

Lewiston
1118 “F” Street
Lewiston, ID 83501
Phone: 208-799-5035
Fax: 208-799-3482

Nampa
847 Parkcentre Way, Suite 7
Nampa, ID 83651
Phone: 208-442-8341
Fax: 208-442-8344

Payette
501 N. 16th, Suite 107
Payette, ID 83661
Phone: 208-642-0181
Fax: 208-642-6163

Pocatello
1070 Hiline, Suite 300
Pocatello, ID 83201
Phone: 208-236-6399
Fax: 208-236-6040

Sandpoint
2101 West Pine St.
Sandpoint, ID 83864
Phone: 208-263-5747
Fax: 208-265-9637

Twin Falls
1411 Falls Avenue East, Suite 915
Twin Falls, ID 83301
Phone: 208-736-4700
Fax: 208-736-3053