Report an accident or injury to your supervisor immediately.
Ask that a Notice of Injury be filed with the Idaho Industrial Commission.
If you believe you need medical attention, see a doctor as soon as possible. Tell the doctor how it happened and every part of you that hurts.
Follow your doctor’s orders – and ask about what you shouldn’t physically do.
Do not sign anything without legal advice.
Do not give a statement to an insurance representative or investigator without legal advice.
If your claim is denied, investigated, or if you are confused, call our office immediately.
WHO IS COVERED BY 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 A 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 they are caused by your working conditions.
HOW DO I FILE A 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 as soon as possible than to take a chance and possibly lose your right to benefits.
After your employer knows about the injury it is their 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 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 BENEFITS AM I ENTITLED TO?
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 need to either get a referral from your treating physician or notify the insurance company before you see other doctors. You are also entitled to all your prescription medicines and any other items 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 doctors says you are unable to work.
MY DOCTOR DOESN’T LISTEN TO ME, AND I DON’T WANT HIM/HER TO CONTINUE TO TREAT ME. 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/she does refuse, call our office.
MY DOCTOR IS RELEASING ME, BUT HE SAYS I CAN’T GO BACK TO MY OLD JOB. WHAT SHOULD I DO?
Unfortunately, this is not unusual. You may be entitled to retraining benefits, payment of additional permanent disability benefits or other benefits. 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 entitled to.
Idaho has a division named Industrial Commission Rehabilitation Division to help you get back to work. 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?
Be very careful. 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. If the same injury should trouble you again in the future, will it be taken care of?
A settlement offer should be accepted only after much thought. Settlement offers are usually made based on an impairment rating given 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 be able to open your claim again – even if you require more surgery or can no longer work because of that injury.
I DON’T WORK FOR THE SAME COMPANY ANYMORE. AM I STILL COVERED?
Yes, you are still covered. As long as your claim was properly filed, and time limits on the claim have not run out. If you were fired, or you quit, or even if the company went out of business, you are still covered. It is the insurance company’s responsibility to take care of you. That is why your former employer paid premiums to them.
IS MY CLAIM TOO OLD?
If any benefits were paid on your claim, it is open for at least five years, and maybe longer. If no benefits where paid on your claim, you usually only have one year from when your claim was filed to start legal action.
WHAT IF WHILE ON THE JOB I WAS HURT BY SOMEONE OR SOMETHING NOT ASSOCIATED WITH MY EMPLOYER?
If a piece of machinery, equipment or product is faulty, malfunctioned, or in some way caused you to be hurt, you can bring a separate action against the other liability party. If some person not employed by your company was in the wrong, you may be able to make a claim against a third party.
WHAT IS AN OCCUPATIONAL DISEASE?
As we gain knowledge of our working conditions and the various materials and chemicals 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 we do and the various materials 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 is an occupational disease. 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 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, though, 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 a 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.