Posted December 6th, 2018 by Jason Metz
Utah requires all businesses to have workers comp for employees, with only a few exceptions.
Workers compensation insurance generally pays medical bills and helps replace a portion of lost income for a worker who's hurt while performing a job-related task. The types of work injuries typically covered by workers comp range from foot joint pain to broken bones to stress and anxiety.
Utah workers compensation law defines who can be exempt from coverage, who is required to be covered and the limits of workers comp payments. Below are many of the specifics contained in the workers comp law in Utah. The Utah Insurance Department also has a page with helpful information for employers.
Who has to be covered by Utah workers compensation?
Can any employees opt out of Utah workers compensation with a waiver?
Yes - corporate officers can.
Is self-insurance for workers comp allowed in Utah?
Yes, for individual employers and political subdivisions. Political subdivisions in Utah are typically the state or a city, county, special district, school district or public agency.
Employers, both public and private, may become self-insured by satisfying statutory requirements. Public entities may form public agency insurance mutual associations to establish group self-insurance claims.
By self-insuring, a business assumes responsibility for paying their own workers comp claims. A self-insured company typically hires a claims service company to handle claims administration and other services.
Are there exclusions for:
Small employers? No.
Agricultural employers? Yes, sole proprietors, partners and agricultural employers and immediate family (i.e. spouse, grandparent, sibling, child, grandchild, nephew or niece) are exempt. Non-immediate family employees are exempt if non-immediate family payroll is less than $8,000 (or payroll is $8,000 but less than $50,000, and the employer has general liability insurance of $300,000 with health benefits of $5,000).
Domestic employers? Yes, for work week totals less than 40 hours.
Independent contractors? Yes. In Utah, in order for an independent contractor not to be considered an employee, the independent contractor must have either a workers compensation policy or a workers compensation waiver.
Casual employees? No.
Volunteers? Yes, any state or local government volunteer receives workers compensation medical benefits as the exclusive remedy for any work-related injuries or occupational diseases. The same exclusive remedy is provided to interns at public and private schools and institutions of higher learning.
Professional athletes? No.
Utah workers comp medical benefits
Is there a Utah workers comp fee schedule?
Fee schedules define payments for surgery, radiology, hospital services, chiropractic care, ambulance service, prescription drugs and other medical services for an injured worker.
Are there limits on medical treatment?
Yes, physical therapy and chiropractic care are limited to eight visits; additional visits beyond the initial eight visits must be approved by the employer/insurer.
Who makes the initial choice of treating physician?
Disability payments for workers compensation insurance in Utah
Workers comp typically pays a worker some lost income when they cannot work because of a job-related injury. State laws specify limits on the disability payment amounts and length, based on both temporary and permanent disability.
How are temporary total disability (TTD) payments calculated?
66 2/3% of the employee's average weekly wage (AWW) at the time of the injury, not to exceed the statewide average weekly wage (SAWW).
Weekly minimum: $45
Weekly maximum: $811
Maximum length of TDD benefits: 312 weeks.
How are permanent total disability (PTD) payments calculated?
66 2/3% of the employee's average weekly wage (AWW) at the time of the injury, not to exceed 85% of the statewide average weekly wage (SAWW).
Weekly minimum: $45 for the first 312 weeks; 36% of the SAWW after 312 weeks.
Weekly maximum: $689
Are there cost of living increases for PTD payments? No. However, the minimum benefit is adjusted annually at 36% of the SAWW.
Maximum length of PTD benefits: PTD benefits are awarded for life, but PTD status may be reexamined by submitting the employee to reasonable medical evaluations, rehabilitation and retraining efforts, and disclosure of federal income tax returns.
How are permanent partial disability (PPD) payments calculated?
Weekly PPD is 66 ⅔% of the employee's average weekly wage (AWW), not to exceed 66 ⅔% of the statewide average weekly wage (SAWW)
Weekly minimum: $45
Weekly maximum: $541
Fatality benefits under Utah workers compensation law
Maximum burial benefit: $9,000
Dependency benefits, weekly minimum / maximum: $45 / $689
When do children's dependency benefits end? At age 18; if child is disabled, benefits can continue as long as the child is a dependent.
Other injuries covered by Utah workers compensation
Mental stress with no physical injury? Yes, mental stress claims are allowed without a physical injury only when there is extraordinary mental stress from a sudden stimulus arising out of and in the course and scope of employment. Mental stress claims are not allowed if the basis for the claim is good faith employer personnel actions.
Cumulative trauma (such as injuries caused by repeated exposure or repetitive motion)? Yes.
Occupational hearing loss? Yes.
Source: Workers Compensation Research Institute, May 2016 report
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