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If your business has employees in the state of Idaho, you’ll need to make sure you adhere to Idaho’s Workers’ Compensation Insurance laws. Workers’ Compensation provides medical and financial benefits for employees who suffer work-related injuries or illnesses or for their survivors in the case of an employee death.
Who needs Workers’ Compensation Insurance in Idaho?
Idaho requires all employers with one or more employees to obtain Workers’ Compensation Insurance. In Idaho, an “employee” is generally defined as any individual who has entered into the employment of, or who works under contract of service or apprenticeship with, an employer, and is not an independent contractor.
The Idaho Workers’ Compensation Law (WCL) defines all of the requirements for Workers’ Comp in Idaho, and the Idaho Industrial Commission (IIC) monitors, enforces, and administers the program. Ensuring your company is in compliance is critical, as there are serious penalties and fines for those who fail to abide by state regulations.
What employees are covered under Workers’ Compensation in Idaho?
Almost all workers are covered under Workers’ Compensation in Idaho. If you provide work or services for an employer, and you are not an independent contractor, you will likely be eligible for Workers’ Compensation Insurance.
The following are categories of employees that are eligible for Workers’ Comp coverage:
- Full-time and part-time employees
- Interns and apprentices
- Undocumented workers
- Seasonal workers
- Occasional workers
- Minors
The following are categories of employees that are generally excluded from Workers’ Comp coverage:
- Independent contractors
- Domestic workers
- Owners of a sole proprietorship and members of a partnership or LLC
- Family members of a sole proprietor who live in the same household as the proprietor
- Corporate executives who own at least 10 percent of the company’s stock
- Real estate salespeople and brokers who are paid on commission only
- Casual workers whose work occurs occasionally or at irregular times and which is not related to the type of business conducted by the employer
What Workers’ Compensation benefits do employees receive?
Under Workers’ Compensation in Idaho, employers are required to provide the following benefits to employees who are injured in the course of employment:
Medical Benefits
- Employers are required to pay for all necessary medical care for injured employees, including emergency medical care, doctor bills, hospitalization, medication, and other expenses.
- Employers have the right to select the employee’s physician. If the employer does not select a physician, the employee may choose one instead. Employees whose physician was selected by the employer may request a change in physician.
- Some travel expenses necessary for medical treatment may be reimbursed.
Temporary Total Disability Benefits
- Employees who are unable to work due to a work-related injury are eligible for Temporary Total Disability (TTD) benefits, which provides 67 percent of the worker’s average weekly wage before injury for 52 weeks. After 52 weeks have passed, the employee may be paid at the rate of 67 percent of the state average weekly wage.
- The IIC establishes minimum and maximum benefit amounts, which change yearly. For accidents that occurred in 2021, the maximum TTD benefit was $757.80 per week, and the minimum benefit amount was $126.30 per week.
- TTD benefits are payable until the employee is able to return to work or reaches maximum medical improvement.
Temporary Partial Disability Benefits
- If injured employees are able to return to work in a partial or limited capacity while recovering, they may be eligible for Temporary Partial Disability (TPD) benefits. TPD benefits provide 67 percent of the difference between a worker’s pre- and post-injury average weekly wage.
- TPD benefits may not exceed the maximum allowable for TTD benefits, which in 2021 was $757.80 per week.
- TPD benefits are payable until the employee is able to return to work or reaches maximum medical improvement.
Permanent Partial Disability Benefits
- Employees who recover from a covered injury but suffer a permanent partial impairment may be eligible for Permanent Partial Disability (PPD) benefits.
- The number of benefit weeks available from PPD can vary based on the body part that was injured and the severity of the injury. The WCL’s schedule of injuries explains how long benefits will be paid and what benefits are available for different types of injuries.
- The IIC establishes minimum and maximum benefit amounts, which change yearly. For accidents that occurred in 2021, the maximum PPD benefit was $463.10 per week.
Permanent Total Disability Benefits
- Employees who are permanently disabled and unable to earn any wages may be eligible for Permanent Total Disability (PTD) benefits.
- Permanent disabilities include loss of sight in both eyes; loss of two major members or a combination of members of the body such as eyes, arms, hands, legs, or feet; paralysis of both arms, both legs, or one arm and one leg; or skull injuries causing incurable damage.
- The IIC establishes minimum and maximum benefit amounts, which change yearly. For accidents that occurred in 2021, the maximum PTD benefit was $757.80 per week, and the minimum benefit amount was $126.30 per week.
Death Benefits
- Employers are required to pay burial expenses of up to $6,000.
- A worker’s dependents may be eligible to receive up to 60 percent of the worker’s average weekly wage, up to the maximum amount allowed by the IIC. For accidents that occurred in 2021, the maximum benefit was $757.80 per week, and the minimum benefit amount was $126.30 per week.
- Death benefits can be paid to a surviving spouse for a maximum of 500 weeks or until remarriage. Remarried spouses may be entitled to a lump-sum payment of 100 weeks of benefits or the remaining amount of benefits, whichever is less. Dependent children can receive benefits until they are 18, or until they are 22 if they are full-time students and are not married.
What are the penalties for breaking Idaho Workers’ Compensation laws?
Failure to adhere to the Workers’ Compensation laws set out by the WCL can result in significant fines and even imprisonment. In order to avoid any costly penalties, it’s important to consult the WCL or your insurer to ensure you are in compliance. Below are the major ways in which companies can be penalized:
Failure to Maintain Coverage
- Uninsured employers may be required to pay a penalty of 10 percent of the amount of medical and wage loss benefits as well as paying the injured worker’s attorney fees if applicable.
- Uninsured employers must also pay a fine of $2 per day per employee or $25 per day (whichever is greater).
- The IIC may prohibit employers from operating while they are in violation of workers’ compensation laws.
- Businesses without workers’ compensation coverage are guilty of a misdemeanor, which is punishable by imprisonment for up to six months and a fine of up to $1,000.
Failure to Pay Compensation
- Employers that fail to pay required compensation for 10 or more days after the due date are subject to a penalty of 10 percent of the original amount due for every 10 day period during which the compensation was not paid.
- Employers that fail to pay compensation and have paid a penalty within the last three years must pay an additional penalty of $500 for the second violation and $1,000 for the third and any subsequent violations.
Fraud
- Employers that intentionally conceal or destroy records in order to avoid paying compensation are guilty of a misdemeanor, which is punishable by imprisonment for up to six months and a fine of up to $1,000.
- Employers that misrepresent the amount of benefits paid must pay a penalty of 10 times the difference between the payments that were made and the amount that should have been paid.
How much does Workers’ Compensation Insurance cost in Idaho?
According to the National Academy of Social Insurance Workers’ Compensation Report (November 2020), the average employer cost for Workers’ Compensation in Idaho was $1.64 per $100 of covered wages. This figure is estimated across all insurers and all industries, so the cost to your particular business may vary.
How does the Workers’ Compensation claims process work in Idaho?
Employers must report work-related conditions that cause workers to need medical treatment or be unable to work. Reports must be made within 10 days of the employer learning of the condition. Employers must also keep records of all work-related conditions that occur, as well as records of employees, and their job classifications and wages. Employee’s claim files should be kept by the employer for either the life of the claim or five years after the claim is closed (whichever is shorter).
Employers must make required benefit payments to employees within four weeks of the first day of disability. Payments are made on a weekly basis, but employers may request a biweekly or monthly schedule from the IIC if they wish.
Idaho Workers’ Compensation Insurance Resources
For more information on Idaho Workers’ Compensation laws and requirements, please visit the following resources: