Claims

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

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.

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.