Utah workers face daily health and safety risks, and some even put their lives on the line while on duty. Serious job-related injuries can prevent employees from working or, worse, leave them permanently disabled. In some cases, they may not receive the benefits they deserve, or their workers’ compensation claims may be wrongfully denied. Regardless, every employee deserves a safe workplace and the support they need to recover when injured at work.
In 2021, the Utah Labor Commission’s Division of Occupational Safety and Health Bureau of Labor Statistics, together with the U.S. Department of Labor’s Bureau of Labor Statistics, reported a total of 52 fatal occupational injuries in the state. This number contributed to an overall rate of 3.4, which represents the number of fatal occupational injuries for every 100,000 full-time workers from different groups and employment levels.
The research findings showed that most fatalities occurred in the transportation and warehousing industries and that the majority of these deaths were caused by operating vehicles and other forms of transportation. They also showed that a total of 49 men died due to occupational injuries, while only three women did. Furthermore, the data indicated that work-related fatalities increased from 48 in 2020 in the Beehive State.
In Utah, workers’ compensation is a no-fault insurance system providing disability and medical benefits to an employee who has suffered an illness or injury at work. This is regardless of whether they were only working part-time or had been on the job for a short time. It serves as an exclusive remedy for work-related illnesses or injuries, which means an employee may receive benefits but cannot sue their employer or co-worker in court for damages. This protection starts as soon as the employee starts to work with their employer.
This article provides an overview of the benefits of the workers’ comp system and the process of filing a claim in Utah to help those injured on the job obtain relief and focus on their recovery.
Utah Workers’ Compensation Insurance Requirements
Utah Code §34A-2-201 requires every employer in the state to provide workers’ compensation benefits to all their employees. Businesses that do not have employees or have provided evidence that they are independently established are not required to obtain workers’ comp insurance. As proof of compliance, they may apply for a waiver from the Industrial Accidents Division.
Although a leasing company may provide coverage on behalf of a business, a company that leases its employees is considered the employer for workers’ compensation insurance purposes.
Types of Employees
Almost all types of employees may claim workers’ comp benefits for a job-related illness or injury in Utah. However, certain types of workers are excluded from the coverage:
Some agricultural workers.
Some domestic or casual workers.
Some real estate or insurance brokers.
Members of limited liability companies, partners, and sole proprietors.
Even though they are not automatically covered by the workers’ compensation system in the state, their companies may elect to provide coverage for them.
Utah employees working out-of-state for less than six months may likewise claim workers’ compensation insurance. To extend the initial six-month period, an employer may file a notice with the Industrial Accidents Division. They must comply with the workers’ comp coverage requirements of the other state if their employee is permanently stationed there.
Corporate directors and officers may also claim workers’ compensation benefits. However, a corporation may choose to exclude them from the coverage. To do this, they must first notify their insurance carrier. Small corporations that do not have an insurer can provide notice of exclusion to the Industrial Accidents Division.
An employer who hires a contractor must verify that such contractor has complied with workers’ comp coverage requirements. Otherwise, they will be treated as the “statutory employer” of the uninsured contractor’s employees and will be liable for their workers’ compensation benefits.
Under Utah’s laws, a volunteer for a government entity is not considered an employee and is not entitled to workers’ compensation benefits. However, they may obtain medical and, in some cases, disability benefits if the government entity chooses to provide coverage for them in accordance with Utah Code §34A-2-201.
Types of Injuries
An injury requiring only first-aid treatment on-site or at an employer-sponsored free clinic is not required to be reported.
Workers’ compensation in Utah also does not cover intentional self-inflicted injuries. An employee may receive medical benefits but may be denied disability compensation for injuries caused by alcohol or drug abuse. Disability benefits may be reduced by 15% if the employee willfully fails to follow safety rules or use safety devices. On the flip side, these benefits may be increased by 15% if the employer’s willful failure to follow safety rules caused the worker’s injuries.
An employer or insurance carrier may only require an injured worker to go to a specific hospital or doctor for treatments on their first visit, especially if they have notified them of a “preferred provider organization” or PPO. Otherwise, an employee may obtain initial medical treatment from their chosen provider. An employee who refuses to go to the PPO may be liable for part of the initial treatment cost.
However, after their first visit, they can change their chosen medical provider one time by using the Application to Change Doctors (Form 102). They must also notify the insurance carrier of the change.
Group Health Insurance Plans
An employer is not required to continue their group health insurance plans while their employee is off work and receiving workers’ compensation benefits. They must consider the requirements of the Family and Medical Leave Act. This federal law is separate from workers’ compensation. It requires covered employers to provide up to 12 weeks of unpaid job-protected leave to eligible employees for certain medical or family reasons.
Workers’ Compensation Premiums
The Utah Department of Insurance establishes basic premium rates. These rates are modified according to the risks of particular occupations and the employer’s claim history for work-related illnesses and injuries. If they are too high, an employer may ask their insurance carrier to explain how they were computed. They may also check other carriers with lower premiums or contact the Department for assistance.
An employer must post a notice that they are in compliance with the workers’ comp laws in Utah. They may obtain the notices in English and Spanish from the Labor Commission or the Labor Commission website’s Industrial Accidents Resources page. These notices must be put in conspicuous locations at the place of business.
Penalties and Ways to Comply with Workers’ Comp
An employer who fails to obtain workers’ compensation coverage may face penalties of at least $1,000 and injunctions prohibiting continued business operations. They may lose the protection of the exclusive remedy, which means an injured worker can sue them in court for damages.
To reduce the amount of disability compensation an employer must pay, they may bring an injured employee back to work on a light-duty assignment that is reasonable and within their capabilities, as determined by their medical provider. An employee is required to accept the light-duty work as long as it is within documented medical restrictions. Otherwise, they may lose their temporary disability compensation.
To lower workers’ compensation costs, an employer must implement measures to prevent accidents. They may participate in safety programs and consultations, such as those provided by the Utah Labor Commission, 360training, and the Utah Safety Council. OSHA also facilitates Voluntary Protection Programs, which aim to prevent illnesses, injuries, and fatalities through a system focused on hazard prevention and control, management commitment and worker involvement, training, and worksite analysis. Self-insured employers and insurance carriers may adopt managed healthcare programs to improve the medical care of injured workers.
In an at-will employment state like Utah, an employer may discharge their worker for any reason that is not contrary to the law. However, Utah Code §34A-2-114 prohibits an employer from retaliating against their employee for filing workers’ comp claims. Otherwise, they may face up to $5,000 in fines for unlawfully interfering with their claims.
An employer may also be liable for violating the Utah Anti-Discrimination Act and the Federal Americans with Disabilities Act if they terminate an employee who can still perform the essential functions of their work. The ADA requirements apply to employers with 15 or more employees. To be protected by this law, a worker must have a disability but still be able to perform the essential functions of their job, with or without accommodations.
Under Utah law, an employer who makes false statements or fraudulently underreports payroll to obtain workers’ compensation insurance may face criminal prosecution. The same applies to an employee who claims workers’ comp benefits under false pretenses.
Utah Workers’ Compensation Benefits
An employee may obtain workers’ comp benefits depending on their specific circumstances. In Utah, they are entitled to six different kinds of financial assistance. The benefits that an injured worker may receive are the following:
Reasonable expenses necessary to treat a work-related illness or injury, such as doctor visits, hospital bills, medicines, prosthetic devices, and reimbursement for the costs of mileage for medical travel
For a lifetime, as long the treatments are necessary to continue to address work-related illnesses or injuries
Temporary Total Disability
Paid for the time a doctor determines the injured employee is unable to do any work due to illness or injury
Workers can only receive compensation if their disability prevents them from working for over 14 days in total
Until an employee reaches medical stability or returns to work
The maximum duration is 312 weeks within a 12-year period from the date of injury
Temporary Partial Disability
Paid if a work-related illness or injury prevents an employee from earning their full regular wage while recovering, such as when they work at a light-duty job that pays less than their pre-injury regular job or for fewer hours
In addition to their earned wages
The maximum duration is the same as for temporary total disability benefits
Permanent Partial Disability
Paid if a work-related illness or injury causes an employee’s permanent impairment
Begins when a doctor determines that the employee has reached medical stability
Determined according to an “impairment rating” provided by a physician
Permanent Total Disability
Paid if a work-related illness or injury causes an employee’s permanent disability that prevents them from returning to their former or any other work
Up to $9,000 compensation for funeral and burial expenses
Monthly compensation to surviving spouse and/or dependents
Depending on the extent of their disability, an injured worker is paid a portion of their average weekly wage to cover their income loss.
If a work-related illness or injury results in an employee’s death, the insurance carrier or self-insured employer may request that the deceased worker’s dependents supply copies of birth, death, and/or marriage certificates and divorce decrees before filing their claims.
If an employee has a permanent partial disability that prevents them from completing the same type of work before their illness or injury, they may be eligible for rehabilitation services through the Utah State Office of Rehabilitation.
How to File a Workers’ Compensation Claim in Utah
An employer may provide workers’ comp benefits to employees in one of these three ways:
By purchasing insurance from the Workers’ Compensation Fund.
By purchasing coverage from one of the other carriers authorized by the Utah Insurance Department to sell workers’ compensation insurance.
By obtaining permission from the Industrial Accidents Division to self-insure.
Uninsured employers, on the other hand, must report directly to the Industrial Accidents Division. They may also be required to file a separate report with the Utah Occupational Safety and Health Division. Even if they do not believe that the alleged illness or injury is real, or valid, or that it happened at work, they must still report it and contact their insurance carrier to explain why.
When Is the Deadline for Workers’ Compensation Claims in Utah?
An injured worker must immediately report their illness or injury to their employer, manager, supervisor, or any individual or department that should receive the report within 180 days. If they cannot do so, their next of kin must report on their behalf. Otherwise, the employee may be disqualified from receiving workers’ compensation benefits.
The employer must report the claim to their insurance company within seven days. The carrier must send the First Report of Injury (Form 122) to the Industrial Accidents Division within 14 days. The employer and their insurance company should provide the worker with a copy of this report, along with Injured Workers’ Rights and Responsibilities (Form 100).
Step-By-Step Guide on Filing a Workers’ Compensation Claim in Utah
Assuming an employee has received medical attention for their job-related illness or injury, the workers’ comp claim process still involves several necessary steps. This section explains how to file a workers’ compensation claim in Utah, including the deadlines, to help employers and injured employees know what to expect during the process.
Step 1: Report the injury to the supervisor.
The worker must immediately report their injury to their supervisor within 180 days of the work-related accident or illness. Otherwise, they may lose their right to file a claim.
Step 2: Seek medical treatment.
The employee may ask their employer where to go for medical treatment. They must promptly go to a company-designated physician or first-aid room, or they can visit a doctor of their choice.
The worker must inform the physician how, when, and where the accident happened. The doctor will then fill out an Initial Report of Injury or Occupational Disease (Form 123). A copy of this report will be given to the employee. Other copies will be sent to the insurance company and the Labor Commission within seven days of the visit.
Step 3: Ask the employer to report the accident to their insurance company.
The employee must ask their employer which insurance company pays for their workers’ compensation benefits. They must then ask them to report the accident to the carrier, fill out and submit Form 122, and provide the worker with Form 100 and a claim number.
Step 4: Call the insurance company to start the workers’ comp benefits.
The worker must contact the insurance company to get their workers’ compensation benefits started. The carrier will require the employer’s and physician’s reports and may ask the employee to fill out a request for compensation. To help speed up the process, ask the doctor to send medical reports and the work status statement to the insurance company.
The insurance company will open a claim for benefits when they receive a notification and determine the compensability of the illness or injury within 21 days. They may file for an extension of the investigation with the Industrial Accidents Division by submitting an Insurance Carrier/Self-Insurers’ Notice of Further Notification of Claim (Form 441) for an additional 24 days. The claimant must cooperate with the adjuster’s investigation of the injury. The carrier should determine the compensability of claims within 45 days.
Step 5: Wait for the insurance company to send Form 141 if the claim is approved.
If the claim is compensable, the insurance carrier must send the Initial Statement of Insurance Carrier/Self-Insurer with Respect to Payments of Benefits (Form 141) and the initial indemnity payment to the employee.
The insurance provider must contact the employer to determine the rate of weekly pay the employee received during the incident and the temporary total or temporary partial compensation benefits. The worker must provide their employment history to the insurance company for additional wage consideration.
The insurance claims adjuster will oversee the life of the claim and work directly with the employee on matters related to the claim, such as benefits, return to work, and treatment plans. The carrier or self-insured employer must directly pay the medical benefits related to the illness or injury.
Step 6: Wait for the insurance carrier to provide a copy of Form 089 if they deny the claim.
The insurance company must send the Employee Notification of Denial or Partial Denial of a Claim (Form 089) to the employee and the Industrial Accidents Division if the worker’s claim is denied. The letter must explain the denial and include a copy of the physician’s final report if the worker underwent an independent medical evaluation.
What Should One Do If a Workers’ Compensation Claim in Utah Has Been Denied?
Workers’ comp in Utah is a no-fault system, which means an employee is generally eligible for benefits, regardless of who was responsible for their illness or injury. The worker does not have to provide proof of liability to file a claim. But even though this is the case in Utah, some employers and insurance carriers may make it difficult for injured workers to receive the benefits they deserve.
If an insurance company denies benefits on a claim, the employee may speak with the claims adjuster to inquire why it was rejected and if there is any additional information they can submit to resolve the problem. They may also contact the Intake Claims Department of the Industrial Accidents Division for assistance.
If the Industrial Accidents Division claims staff cannot resolve the issue, they may file an Application for Hearing with the Adjudication Division of the Utah Labor Commission. The employer and the insurance carrier must be identified in the form. They may use the Workers’ Compensation Coverage Verification system to identify the insurance company for the date of injury or period of occupational exposure or contact the Division for more information at (801) 530-6800. They may also request to participate in a Claims Resolution Conference.
Other forms that may need to be filed include:
Medical Provider Treatment List.
Authorization to Disclose, Release, and Use Protected Health Information.
Summary of Medical Records form or copies of medical records supporting the claim.
The forms may be filed by email, fax, mail, or in person with the Adjudication Division. The Division may return incomplete forms with no action taken.
After the required forms have been filed, they will be mailed to the employer and the designated agent of their insurance carrier with an Order requiring that they file a written Answer within 30 days. After the Answer has been filed, the Division will schedule a hearing no sooner than 120 days from the date the Answer is due.
Legal Resources for Injured Workers in Utah
Getting hurt on the job and losing the ability to work, especially through no fault of their own, is one of the most stressful things anyone can go through. This section describes two organizations that can provide the answers people need regarding the workers’ compensation system in Utah.
Industrial Accidents Division Outreach Programs
The Industrial Accidents Division offers outreach and training programs to educate the public on workers’ compensation laws in Utah. Its staff trainer can conduct informational presentations online or in person at workplaces at selected dates and times. These presentations are customized to meet the needs of particular groups, such as associations, employer or employee groups, insurance and medical providers, and unions. For information on how to schedule a seminar or workshop at worksites, one may contact the Division by calling (801) 530-6800 or toll-free at (800) 530-5090.
Utah Legal Services, Inc.
Utah Legal Services, Inc., is a nonprofit law organization providing free legal help to low-income people dealing with non-criminal cases in the state. It has units serving groups with special legal needs, such as farm workers and senior citizens. To obtain legal assistance, call (800) 662-4245 or (800) 328-8891. They may also apply through its website’s eligibility screening.
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