The Workers Compensation Fund (WCF) of Utah is a non-profit mutual insurance company that provides no-fault coverage to more than 24,000 of Utah's employers. Among the WCF's responsibilities is handling claims and providing underwriting. Coverage is divided into two categories: (1) workers compensation insurance and (2) employer's liability insurance. Workers compensation covers medical expenses and reimburses employees for lost wages accrued from work-related accidents. Employer's liability insurance protects employers from lawsuits brought outside the workers compensation system by employees injured in work-related incidents.
Utah law requires that employers with one or more employees whether full time, part time, or temporary, obtain workers compensation insurance. Household and agricultural workers are covered under Section 34A-2-103 (4-6) of the Utah Code to determine their requirements. There are other limited exceptions.
Reporting an Injury to WCF
- An employee should immediately report the injury or disease to the supervisor who must file Form "Employer's First Report of Injury or Illness" (Labor Commission Form 122) within seven days to both WCF and the Labor Commission.
- The employee should seek immediate medical or first aid treatment. The employer may require the employee to obtain initial treatment from a company doctor or designated clinic. However, if the employer does not have a designated medical provider, the employee should preferably receive treatment from a preferred provider organization (PPO) facility under WCF.
- The employee should inform the treating physician that he or she was injured in a work-related accident and ask the physician to file Form "Physician's Initial Report of Work Injury or Occupational Disease" (Labor Commission Form 123). The employee should also inform the physician your employer is insured with WCF.
- If an employee does not seek help with a PPO provider, he or she may be responsible for any charges in excess of the PPO rates.
- The employee should promptly provide information requested by the WCF and cooperate with any claims investigation. Lack of cooperation may result in a claim denial.
- The employee should contact his or her claims adjuster to determine any pre-authorization requirements.
The employee should also keep the claims adjuster and employer informed about the medical progress and updated about changes in the employee's employment status.
Lost Wage Compensation
The WCF provides lost wage compensation once a treating physician confirms through appropriate documentation that an employee is unable to work because of a work-related accident or illness. If the employee is off work for 14 days or less, lost wage compensation is paid after the first three days from the date of injury. However, if the employee is off work for 15 or more days, the lost wage compensation begins the day following the injury.Lost wage compensation is calculated based on a percentage of an employee's average weekly wage at the time of the injury and is subject to the minimum and maximum amounts set by Utah's law. The compensation includes a $5 dependent allowance per week for an injured employee's spouse and up to four dependent children. Lost wage compensation benefits are not taxable.
Talk with an Attorney
If you were injured in a work-related accident in Utah, you may seek compensation through Utah's workers compensation fund. Talk with a Utah attorney to discuss how to file a claim and receive due compensation.