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Idaho Local
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:
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.