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Despite its relatively low population count, Utah puts a lot of people to work: nearly 1.5 million, or 45% of the state’s total population of all ages. While our jobs make us prosperous, they can also lead to work-related injuries and other mishaps. Some occupational injuries are even fatal.
There were 52 work-related deaths in Utah in 2021, per the U.S. Bureau of Labor Statistics (BLS). Over half (55%) of these deaths occurred in the agriculture, forestry, fishing, and hunting sectors. Over half (52%) also involved vehicles and transportation-related accidents.
No matter what sector you work in or what your job entails, there is a risk of injury. Some injuries happen suddenly because of a single accident, while others are the result of cumulative stress and wear upon the body. In either case, employers are supposed to provide their workers with medical coverage for their injuries, as well as partial replacement wages for their days of missed work.
Getting workers’ compensation coverage from your employer is not always easy. Many claims undervalue the full costs of treatment, or they deny benefits that should rightly have been provided under the language of the policy. In these situations, it can literally pay to get your own attorney.
Valley Law Accident and Injury Lawyers are prepared to represent you during your workers’ compensation claim. We assist with filing claims, estimating total damages, seeking all available benefits, and appealing any unwarranted denials or reductions in coverage. If you are ready to see how much your claim might be worth, call (801) 810-9999 or contact us online to schedule a free, confidential case review today.
Filing a workers’ comp claim is supposed to be easy, but some employers and insurers make it anything but.
When you file a claim, you are expected to provide concrete proof that you were hurt as a result of on-the-job duties (more on this later). You also need an accurate diagnosis, one that says exactly what is wrong, one that leads to the right treatment, and one that suggests you don’t go back to work until you are ready.
The only catch? The insurance company gets to pick your doctor. That doctor, referred to as an independent medical examiner (IME), knows that they are being paid by the insurance company. They are often subtly influenced to minimize the severity of the diagnosis and to suggest that the hurt employee returns to work much sooner than would usually be advisable. Worse, your insurer will interpret your injury case as conservatively as possible, trying to leave out benefits that you might desperately need in order to avoid falling behind on your expenses.
Valley Law can provide you with an experienced Utah workers’ compensation lawyer to represent you and fight for the maximum benefits available. We have a deep history of handling insurance claims and dealing with things like inaccurate doctors’ opinions. We can help you get the most accurate diagnosis possible, and we work closely with physicians and other experts to get you all of the coverage you need to fully heal and return to work at your best-possible state.
Know that the only person looking out for you during the workers’ compensation claims process is you — unless you get an attorney. Obtaining representation can not only make the claims process easier; it also raises the chances that you will walk away from your injury with the total value of benefits needed to cover all medical expenses, lost wages, and other incidentals.
There are a few steps involved in filing your claim. Know that you can obtain representation from an attorney at any step. Having an attorney to assist with your case is particularly important when you receive a diagnosis you didn’t expect, your coverage is less than you need to pay for all your bills, or your claim has been denied.
Here are the steps you can follow to file a workers’ compensation claim in Utah:
Note that an attorney can be acquired at any step in this process in order to assist with the filing of a claim and review that the benefits offered are appropriate.
Your employer’s workers’ compensation insurance carrier has the right to pick the first doctor you visit for an evaluation and diagnosis. After this initial visit, you are allowed to see a separate physician of your choosing, but you can only switch doctors once. After switching, you are expected to remain under the care of that physician for the duration of your treatment or to return to the IME chosen by the insurer.
Going to a doctor of your own choosing can be very important in a workers’ comp claim! The IME hired is often anything but “independent.” They are likely to minimize the severity of your diagnosis and suggest that you return to work much sooner than expected. They may also overlook complications related to your initial injury, or submit an opinion saying that your injury is related, in-part or in-full, to a pre-existing condition, giving the insurer an excuse to further reduce your benefits.
Make sure to report all symptoms completely and accurately, and insist that your treating physician performs all tests and imaging needed to fully investigate your condition. Review their documentation during your visit to ensure it mentions all symptoms and other information you feel is relevant. It can be difficult to get some aspect of your injury included on a claim after it has been overlooked, so stay on top of this part of the process, and ask for help from an attorney if you are worried that your diagnosis or documentation was inaccurate.
Utah offers a fairly favorable workers’ compensation system to workers, one that aims to cover 100% of all reasonable and necessary medical treatment costs as well as 100% of all lost wages.
Lost wages are calculated as the difference between what you were earning prior to the injury compared to after the injury occurred. A lost wages (or indemnity) claim on a workers’ compensation policy can involve:
“With few exceptions, Utah employers are required to maintain workers’ compensation insurance coverage.” That’s according to the state’s Insurance Department website.
Most exemptions are only available to single-person LLCs and sole proprietorships, which require a waiver to be in compliance. In the construction industry, all general contractors are expected to perform due diligence and ensure that all subcontractors involved on the project have their own form of workers’ compensation insurance. Otherwise, the subcontractor is considered an employee of the general contractor for insurance purposes.
Any business that fails to provide state-mandated workers’ compensation insurance opens itself to direct liability for all damages. In other, the employee that should have had insurance can now sue their employer, going after them for all costs and other damages. Importantly, this type of claim could also include compensation for pain and suffering, as well as punitive damages in the event it goes in front of a jury at a trial.
In short: denying you workers’ comp coverage can put your boss in really hot water. Take the time to fully investigate what coverage they might have, and any time you are denied the right to even explore a claim, talk to an attorney as soon as you can.
A workers’ compensation policy is supposed to cover any and all medical expenses arising from an injury acquired as a result of a person operating within the “scope of employment.”
A more casual way to phrase “scope of employment” might be: “on the job,” “on the clock,” or while working “on orders.”
Importantly, your injury does not have to have occurred at the office or job site for it to be considered a situation that is in the scope of employment. Driving accidents — one of the most common types of occupational injury scenarios — are supposed to be covered so long as the person in the vehicle was operating for the purposes of their employer. That can even include situations where an employee is technically “off-the-clock” or “on-break” if they were running an errand for their boss or otherwise operating on behalf of their employer while on the trip.
Since many employees incorrectly assume that their injury will not be covered by workers’ comp, below are some of the most-likely scenarios where a covered injury occurs.
Injuries that happen on work premises are covered in the vast majority of scenarios. If an injury or illness is related directly to the job environment, the employee may still be covered while “on-break,” coming to/leaving work, or otherwise technically not operating in the scope of employment. This may include scenarios where an employee is attacked by another person. The only exceptions are for situations where the employee is engaging in certain types of “horseplay” not related to the job, where they instigated a violent incident, or where they were operating under the influence of drugs or alcohol at the time of the accident.
Some workplace injuries don’t happen all at once but, rather, as the result of cumulative wear and tear on the body. Examples include hernias, carpal tunnel syndrome, worn spinal discs, certain foot/ankle injuries, shoulder injuries, and other types of injuries inflicted through repetitive stress. Employees may first notice symptoms of such an injury and not be sure exactly what it stems from. They still have an obligation to get their condition evaluated as soon as possible and to document it’s possible connection to their occupation. After receiving a repetitive stress diagnosis — or finding their symptoms too much to bear prior to a diagnosis — they should notify their employer of the injury.
Making up a high percentage of workplace fatalities, sometimes the most dangerous place to be while working is in a car or other vehicle. As mentioned above, any trip made on behalf of the employer could qualify as a covered incident. This rule excludes most trips to/from work, but it may include trips being made while the employee is on a work trip out-of-town and are receiving mileage and/or a per diem.
Many workplace environments are extremely dangerous because of the equipment they use. That’s likely why the manufacturing sector in Utah had one of the highest rates of non-fatal injury in 2021, with 3.3% of workers experiencing some type of on-the-job affliction. Workplace injuries can happen because of faulty safety equipment, as well, which may not provide the protections expected in the event of an incident.
Illnesses resulting from exposure to hazardous conditions or substances at the workplace qualify as a covered medical condition. Proving that your illness is related to your job can be difficult, even when working in the presence of substances known to be harmful. Getting the right doctor and obtaining the proper evidence is often vital to the success of the claim.
Any time an employee is attacked at their workplace or while on the job, their injuries should be covered. The only exceptions are when the employee attacks someone prior to their injury and they were hurt by their own attempt or by someone acting in self-defense.
Valley Law Accident and Injury Lawyers wants to represent you during the entire lifecycle of your workers’ compensation claim. The moment you notice you are hurt, you can call us. We also are happy to provide you with representation when you have begun your claim and aren’t happy with the way it’s going. Our sole goal is to keep you informed of your rights and to do everything possible to maximize your chances of getting the benefits you need.
We have helped many clients recover from injuries resulting from car accidents in West Valley, Salt Lake City, and the greater Utah area. We are here to help you recover after an accident. If you've been injured, don't hesitate to call Valley Law Accident and Injury Attorneys for a free consultation. We have recovered millions for our clients and we are ready to fight for you.
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