Claims

We’re your partner when workplace injuries occur.

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Proactive Claims Partners

 

Our Idaho-resident, in-house claims team coordinates care between injured workers, their supervisor, and medical professionals to help control claims costs. Injured workers receive consistent care and support with the goal of returning to work as soon as medically able.

We’re all about working with local business and institutions whenever possible; that’s why SIF being an Idaho organization means everything to us.

Jimmie Scrogum

Partner/Agent, Alta Insurance Agency

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Report an Injury

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Resources for Injured Workers

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Payee Choice

Payee Choice is a quick and convenient way for injured workers to select how they receive their workers’ compensation benefits. Options include:

• Direct deposit
• U.S. Bank ReliaCard®
• Zelle®
• Paper Check

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Partnerships That Matter

We partner with Optum and Paradigm to provide treatment and better outcomes for injured workers. Optum offers pharmacy benefits with network contracted discounts for thousands of provider across Idaho and nationally. For catastrophic injuries, Paradigm’s nurse case management services coordinate care at centers of excellence across the United States.

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Idaho Local

Idaho is our home. Our SIF-employee claims adjusters live and work in Idaho. They understand our state’s unique landscape and are experts at coordinating care wherever an injured worker resides.





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Claims FAQs



What are medical benefits?

Workers’ compensation pays medical benefits directly related to a workplace injury or illness based on the fee schedule set by the Idaho Industrial Commission. Injured workers and employers are not responsible for any unpaid balance of approved services related to the claim, but an injured worker is responsible for any cost of treatment unrelated to the workplace injury or illness.

Medical benefits include, but are not limited to: 

  • Treatment and diagnostics such as X-ray, lab test, etc. (These may require pre-approval)
  • Medical, surgical, hospital and nursing care
  • Prescription medications
  • Physician prescribed crutches and apparatuses
  • Necessary replacement or repair of appliances or prosthetics under normal wear
  • Replacement of glasses with like kind if they were broken in a work-related accident where the injury also occurred
  • Reasonable travel expenses for medical exams and treatments
What are income benefits?
If the treating physician prescribes an injured worker be off of work for more than five calendar days (including non-work days), they will be approved for income benefits. These benefit begin accruing on the sixth day. If an injured worker is hospitalized overnight or the disability exceeds fourteen days, benefits are calculated from the first day of disability. Benefits are typically paid every two weeks.
Time away from work (disability) must be authorized by the treating physician to receive income benefits.
There are several types of benefits to be aware of:


  • Temporary Total Disability (TTD): Income benefits are paid when an injured worker is totally unable to work for a temporary period of time.
  • Temporary Partial Disability (TPD): When work restrictions limit an injured worker’s return to work to a part-time basis or at a reduced rate of pay, SIF pays a percentage of the difference between their regular wages and the reduced wages.
  • Permanent Partial Impairment (PPI): Benefits paid following a permanent loss of function of a body part. A doctor’s assessment is required to determine any impairment.
  • Permanent Partial Disability (PPD): If a workplace injury cause a permanent impairment and also causes a decrease in the injured worker’s wage-earning capacity or labor market, they may be entitled to these benefits. The Idaho Industrial Commission evaluates and determines the percentage of disability.
  • Death Benefits (DB): In the unfortunate event that a workplace injury or illness causes a death, SIF provides weekly income benefits for the spouse and dependents for a specified time.

SIF by the Numbers


33,000+
Idaho businesses
insured by
SIF
1,600+
Safety Services
visits in 2021
100+
Safety
trainings in 2021
240
Idaho-based
employees
115
Idaho state
agencies insured
by SIF
33,000+
Idaho businesses
insured by
SIF
1,600+
Safety Services
visits in 2021
100+
Safety
trainings in 2021
240
Idaho-based
employees
115
Idaho state
agencies insured
by SIF