Claims

If you're injured at work, workers’ comp pays for the related medical care. The Idaho Industrial Commission sets these benefits in their fee schedule. Injured workers and employers do not owe the unpaid balance of approved services if they're related to the claim. Injured workers do owe the cost of any treatment not related to the injury or illness.  

Medical benefits may include: 

• Treatment and diagnostics, like: x-rays, lab tests, etc. (these may need pre-approval)
• Medical, surgical, hospital, and nursing care
• Prescription medicine
• Crutches and equipment, if prescribed
• Replacement or repair of appliances or prosthetics due to normal wear, when needed
• Eyeglasses, if they broke when the injury occurred
• Reasonable travel expenses for medical exams and treatments

Talk with your Claims Examiner to learn more.

Income benefits help replace some of an injured worker's lost salary. If you're injured and out of work for a period of time, you may qualify.

Temporary Partial Disability
Some injuries may limit you to part-time or a lower rate of pay. If this occurs, SIF pays a percent of the difference between your regular and reduced wages.

Temporary Total Disability
If you're unable to work, SIF pays some of your salary while you're recovering. This payment is for a temporary period of time.

Permanent Partial Impairment (PPI)
If your a workplace injury causes the permanent loss of function, PPI is paid. A doctor’s assessment is required to determine any impairment.

Permanent Partial Disability (PPD)
PPD may be paid when a workplace injury causes:

•  A permanent impairment, and
•  A decrease in your wage-earning capacity or labor market

The Idaho Industrial Commission evaluates and determines the percentage of disability.

Death Benefits
If a workplace fatality occurs, SIF pays a weekly income benefit for the spouse and their dependents for a period of time.

If your doctor has you stay out of work for more than five days (including non-work days) you may qualify for income benefits. These benefit start accruing on the sixth day.

Your benefits are calculated from the first day of disability if:

• You're hospitalized overnight, or
• Your disability is more than 14 days

Benefits are usually paid every two weeks. Your treating physician must authorize time away from work (disability) to receive income benefits.

Mistakes happen, if you spot or realize an error, please contact us and we will work with you to sort things out.

Please be aware that any person who knowingly, and with intent to defraud or deceive any insurance company, files a claim, application or other statement containing any false, incomplete, or misleading information is guilty of a felony.

If you feel incorrect or fraudulent information has knowingly been submitted to SIF, please contact us.

If you mistakenly submitted incorrect or incomplete information, please contact us directly so we can work with you to update our records.