Claims

We're your partner as you deal with workplace injuries

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Proactive Claims Partners

 

Our Idaho-resident, in-house claims team coordinates care between all parties to help keep claims costs low.

Injured workers receive 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

Doctor appointment post injury

Report an Injury

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Resources for Injured Workers

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Payee Choice

Payee Choice is a quick, convenient way for injured workers to select how they receive their workers’ comp 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 excellent treatment and benefits for inured workers

• Pharmacy benefits with thousands of providers across Idaho and nationally
• Care at centers of excellence across the United States

 

 

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Idaho Local

Idaho is our home. We understand our state's unique landscape and are experts at coordinating care wherever an injured worker resides:

• 250 Idaho-based employees
• Return to work programs, keeping Idahoans on the job as they recover
• Insuring over 30,000 Idaho businesses

 

 

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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?

Income benefits help replace some of an injured worker's lost salary. There are several types of benefits to be aware of:

  • Temporary Total Disability
    If they're unable to work, TTD pays some of an injured worker's salary while they're recovering. This payment is for a temporary period of time.
  • Temporary Partial Disability
    If an injury limits a worker to part-time or at a lower rate of pay, SIF pays a percent of the difference between their regular wages and the reduced wages.
  • Permanent Partial Impairment
    When a workplace injury causes the permanent loss of function, a PPI is paid. 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.
When do I qualify for 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 a worker is hospitalized overnight, or if their disability is more than 14 days, benefits are calculated from the first day of disability. Benefits are usually paid every two weeks.

The treating physician must authorize time away from work (disability) to receive income benefits.