Idaho employees who are injured at work or suffer from an employment-related illness are entitled to benefits under the state workers’ compensation system. The workers’ comp system in Idaho covers medical bills related to your workplace injury and pays disability benefits while you’re unable to work due to your illness or injury.
Almost all Idaho employers with one or more employees are required to carry workers’ compensation insurance. (A list of exempt employers can be found at the website of the Idaho Industrial Commission.) The Idaho workers’ comp system is overseen by the Idaho Industrial Commission. However, because most employers are insured through insurance companies, the insurance company typically reviews claims and pays benefits for accepted claims. In order to receive the maximum benefit from your employer’s insurance company, you will need to follow Idaho’s workers’ comp rules for reporting your injury and getting medical treatment.
After a workplace injury, you will naturally be most concerned about getting immediate medical care. In an emergency, you should seek treatment at the nearest emergency room. In non-emergency situations, you must notify your employer of the injury first. If your employer has designated a physician to treat work-related injuries, you must treat with that doctor, unless you get approval from your employer or the Industrial Commission to treat with a different doctor. Idaho workers’ comp covers all reasonable medical bills for authorized treatment for your work injury. You will not be reimbursed for medical bills from unauthorized providers. (To learn more, see our tips for getting medical treatment through workers' comp.)
Idaho law requires you to report your workplace injury to your employer within 60 days. However, the best approach is to notify your employer of your injury immediately after it happens. Sometimes, this will be impossible because you need emergency care or because your supervisor is unavailable. In those cases, report the injury as soon as you can, but before the 60-day deadline.
In Idaho, you should report your injury by filling out a First Report of Injury or Illness form. Your employer should help you fill out the form and submit it to its insurance company and the Industrial Commission. When you report your injury, explain when and where the injury occurred, how the injury occurred, and what type of injury you sustained. Filing this form is the official start to your workers’ comp claim. At this point, your employer’s insurance company will investigate your claim and decide whether to accept or deny it.
Idaho workers’ comp pays temporary disability benefits, which replace part of your lost wages while you are recovering from your injury. These benefits are available once you miss more than five days of work or are hospitalized as an in-patient. You will receive two-thirds of your average weekly wage prior to the injury, but no more than a maximum amount set by the Industrial Commission each year. If you end up having a permanent disability due to your workplace injury, you are entitled to receive wage-replacement benefits for up to 500 weeks. The amount of your benefit is determined by the severity of your permanent disability. (To learn more, see our article on the different types of workers’ comp benefits.)
You don’t need to file any additional paperwork unless you have a dispute with the insurance company—for example, your claim is denied or you believe you are entitled to more in benefits. To challenge the insurance company’s decision, you can file a complaint form directly with the Idaho Industrial Commission.
When you file your complaint, you can indicate whether you would like to participate in mediation. Mediation is an informal process led by a neutral third-party, who will listen to both sides and try to help you reach a settlement agreement. If mediation is unsuccessful, or you’d rather move straight to a formal hearing, you must file a Request for Calendaring. This is simply a letter to the Commission requesting a date for a workers’ comp hearing. A hearing officer will listen to testimony, consider evidence submitted by both sides, and make a decision about your case.