Utah's system of workers' compensation is compulsory, meaning that employers are required to provide workers' compensation insurance to their employees. Workers' compensation insurance may be provided through private insurance carriers, a competitive state fund, or self-insurance. Waivers may be permitted to exclude certain employees from coverage, including corporate officers and children working on family farms.
Exemptions from coverage may apply to certain employees, including many agricultural workers and many domestic employees.
Medical Benefits are provided to employees entitled to workers' compensation benefits, including necessary medical care, with limits on chiropractic care and physical therapy.
An employer may designate a preferred provider for medical care. If no designation is made, the employee may choose the initial treating physician. The employee may make one change of physician, with any subsequent changes requiring approval by the employer or workers' compensation insurer, with disputes subject to review by the workers' compensation agency.
Indemnity benefits are payable to injured workers to help make up for lost income. There is a waiting period of 3 days before a worker is eligible for indemnity benefits, but if the worker's disability lasts more than 14 days indemnity benefits become retroactive to the date of the injury.
Benefits available to injured workers include the following:
Temporary Total Disability (TTD)
Temporary total disability (TTD) benefits are paid to workers who are unable to work due to injury, but who are expected to make full or partial recovery such that they may return to work. Benefits are based upon 2/3 of the injured worker's pre-injury average weekly wage, subject to a cap, and continue for up to 312 weeks.
Permanent Total Disability (PTD)
When a worker is not expected to recover from a total disability caused by a work-related injury, and as a result suffers a total loss of earning capacity, the worker becomes eligible for permanent total disability (PTD) benefits. In Utah PTD benefits are calculated based upon 2/3 of the worker's average weekly wage at the time of the injury, subject to a cap. Benefits may continue for life, but the injured worker may be required to reexamination or to participate in rehabilitation or retraining programs. The minimum PTD benefit is adjusted annually for inflation.
Permanent Partial Disability (PPD)
Once an injured worker has recovered to the maximum possible extent, the worker may be able to return to employment but nonetheless remain partially disabled, and may potentially qualify for permanent partial disability (PPD) benefits. In Utah PPD benefits are determined based on a statutory schedule, and are based upon 2/3 of the worker's average weekly wage, subject to a cap. Benefits for unscheduled injuries are made based upon an impairment rating of the injured worker, and may be payable for a maximum of 312 weeks.
Temporary Partial Disability (TPD)
When a worker suffers an injury that limits his ability to return to work, resulting in a reduction of income as a result of reduced hours or wages, the injured worker may be eligible to receive a benefit based on the difference between the worker's pre-injury earnings and their reduced, post-injury earnings. In Utah, TPD benefits are paid based upon 2/3 of the difference between the injured worker's pre-injury and post-injury wage, with a small additional payment for the worker's spouse and up to four dependent children, subject to a cap. Benefits may continue for up to 312 weeks.
For some, more serious injuries, workers' compensation indemnity benefits may be paid according to a statutory schedule, instead of following the standard model of the weekly benefit based on the duration of the disability. Scheduled injuries include such injuries as the amputation of an arm, the loss of a dominant hand, the loss of a leg, the loss of a foot, the loss of an eye, or loss of hearing in an ear.
Coverage may be available for cumulative trauma, disfigurement, mental stress and occupational hearing loss.
When a worker dies as the result of a work-related injury, workers' compensation pays additional benefits, including a burial allowance, and benefits for a surviving spouse and dependents. Survivor benefits are calculated based on a statutory formula, subject to a cap in amount and duration. Benefits may continue for minors until the age of 18, or indefinitely in the event of a child who remains dependent due to disability. Spousal benefits may continue after remarriage for up to one year.
Attorney fees are determined pursuant to statutory formula and administrative rules, and are limited to 25% of the first $25,000 recovered, 20% of the next $25,000, and 10% of any award in excess of $50,000, with a maximum fee of $17,468.
This article provides a quick overview of the benefits available to injured workers, but the full formulas used for assessment of benefits, coordination of different types of benefits, and assessment of injuries and disability ratings can quickly complicate the determination of benefits. Also, states frequently revise their workers' compensation laws. Most workers who suffer a significant injury or wage loss as the result of a workplace injury will benefit from consulting a workers' compensation lawyer.
The state agency responsible for workers' compensation is:
Utah Labor Commission
Division of Industrial Accidents
160 East 300 South, 3rd Floor
P. O. Box 146610
Salt Lake City, UT 84114-6610
(801) 530-6800 or 1-800-530-5090