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The complete guide to winning your Utah workers comp claim

January 18th

The complete guide to winning your Utah workers comp claim

Are you an injured worker in Utah who is struggling to receive the workers’ compensation benefits that you deserve? If so, this guide is for you.

Here at Davis & Sanchez, we have expertise representing injured employees in Utah and we know a thing or two about filing successful claims.

By following our complete guide on winning your workers’ compensation claim in Utah, you will be well-prepared to get the financial support that is rightfully yours due to a workplace injury or illness.

What is workers compensation in Utah and why is it important?

Workers compensation in Utah is an important system that ensures employees are well taken care of in the event of a workplace injury or illness. It requires employers to provide injured workers with medical care, wage replacement benefits, and other benefits while they are unable to work due to their injury.

With few exceptions, employers are required by Utah state law to carry workers compensation insurance.

In addition, workers compensation also provides death benefits to surviving family members if the employee died as a result of their workplace injury or illness.

Workers comp not only protects employees, but also helps employers limit their liability in the event of a workplace-related incident.

Overview of the Utah workers comp claim filing process

Filing a Workers’ Compensation Claim in Utah can be a confusing and complicated process. Usually, it will look something like this:

  1. Report the injury or illness to your employer as soon as possible — but no later than 180 days after your injury.
  2. File a claim with the Utah Labor Commission, which will review it and decide whether or not to approve it. You must file your claim within one year of the date of your injury.
  3. If approved, the Commission will contact your employer’s insurance carrier who will provide benefits for medical expenses and lost wages while you recover from your injury or illness.
  4. If denied, you may appeal your denial

Note that filing a claim does not guarantee compensation. All claims are reviewed on a case-by-case basis and must meet certain criteria to be approved.

Filing a claim does NOT guarantee you will receive workers compensation benefits.

Additionally, if you disagree with the Commission’s decision, you may appeal their decision within 30 days of the denial.

Deadlines for filing a workers compensation claim in Utah

Work-related injuries must be reported within 180 days, and claims must be filed within one year of the date of your injury.

This deadline is necessary to ensure that workers receive prompt compensation for their medical bills and lost wages.

Consequences of missing claim deadlines

The consequences of missing this deadline can be severe. Employees who fail to meet it are not eligible to receive any type of compensation — even if they have suffered a serious injury due to their job.

Regardless of legal requirements, file your claim ASAP. Insurance companies will think it’s “suspicious” if you wait to file or report your injury.”

Extenuating circumstances

Although in most cases you will be unable to seek compensation after missing one of these deadlines, your case may be unique. If you’re unsure whether or not you can seek workers compensation, contact a workers comp attorney immediately.

Information needed to complete a Utah workers comp claim

Whether you’re an employer or an employee, it’s worth noting what information is required to file a workers compensation claim. Completing a workers compensation claim in Utah can seem daunting, but having the right information will make the process easier and help ensure success.

Personal information

To begin, you’ll need to provide appropriate contact details and information about the injured employee including:

  • Name
  • Date of birth
  • Social security number
  • Address
  • Phone number

Injury information

You will also need to provide information about the employer and the accident that occurred including:

  • Date of injury
  • Location
  • Type of injury sustained
  • How it happened

Additional information

Additionally, you’ll need to submit medical records from the health care provider outlining diagnosis and treatment plan for the injury.

You’ll also need wage statements indicating current earnings before taxes.

Finally, if the employee was using a piece of equipment when the accident occurred or if a third party was involved (such as another driver in an auto accident), other documentation may be needed such as a police report or pictures of the scene.

Utah workers compensation benefits

In Utah, workers compensation is a form of disability insurance that provides medical benefits and wage replacement to workers injured on the job. It’s a way for employers to protect their employees from financial hardship in the event of an accident or serious injury.

Utah workers compensation benefits include:

  • Wage replacement
  • Medical bill repayment
  • Vocational rehabilitation
  • Death benefits
  • Disability payments

Wage replacement

Under Utah law, injured employees are entitled to wage replacement benefits equal to two-thirds of their average weekly wages up to the state maximum.

These payments begin after a seven-day waiting period and typically last until the employee can return to work or reaches maximum medical improvement.

Maximum medical improvement — the point at which either treatment cannot improve your condition any further, or you fully recover from your injuries.

Medical bill repayment

Utah workers compensation also covers medical bills for the treatment of the injury or illness. This includes doctor visits, hospital stays, rehabilitation services, medications, and more.

Vocational rehabilitation

Vocational rehabilitation can help an injured employee get back into the workforce by providing training in a new field or job skills.

Death benefits

Death benefits provide financial assistance to surviving family members when an employee dies as a result of a workplace injury or illness.

Temporary total disability (TTD)

Temporary total disability payments are intended to cover lost wages while an employee is receiving medical treatment for an injury or illness related to their employment.

Temporary partial disability (TPD)

Payments are also available for workers who can return to work in a limited capacity after an injury or illness.

Permanent total disability (PTD)

In cases where an employee can no longer work due to their injury or illness, they may be eligible for permanent total disability payments.

Permanent partial disability (PPD)

In cases where an employee is unable to perform their job duties in the same capacity as before, they may be eligible for permanent partial disability payments.

Workers’ compensation insurance covers all costs associated with an employee’s recovery, which allows them to focus on getting better instead of worrying about the financial burden of their injury.

Tips to increase your chances of winning a Utah workers comp claim

Workers comp cases might be complicated, but they’re not impossible. You can boost your odds of success by:

  • Hiring an experienced lawyer
  • Gathering evidence
  • Knowing the basics
  • Staying organized

Hire an experienced Utah workers compensation lawyer

First and foremost, it’s important to understand that having an experienced attorney by your side can make all the difference when filing a Utah workers comp claim.

Insurance companies love to low-ball hurt workers without legal assistance.

An attorney can help you navigate the complex paperwork and ensure that your rights are protected throughout the process.

Gather evidence

It is also important to gather as much evidence as possible to support your claim. This may include medical records, statements from witnesses, pay stubs, proof of employment, or other evidence. All of this should be presented to your attorney to strengthen your case.

Know the basics of workers comp law

Before a hearing or trial begins in front of a judge, it’s important to be aware of the laws and regulations outlined in the Utah workers compensation act. Your lawyer will be able to explain these statutes and how they may affect your case.

Stay organized

Lastly, it’s critical to remain organized throughout the entire process and make sure all documentation is filed on time. This will demonstrate diligence on your part which could improve your chances for success.

Understanding pre-existing conditions and their effect on your claim

When it comes to filing for workers’ compensation in Utah, pre-existing conditions can be an important factor. Here are some key points to understand about pre-existing conditions.

Pre-existing conditions and workers comp law

Pre-existing conditions refer to medical problems you had before the workplace injury occurred.

Injuries may aggravate a pre-existing condition and make it worse than it was before, which can result in negative outcomes on a worker’s comp claim.

Pre-existing conditions may also be used as evidence that your injury could have been caused by something other than a workplace incident, which could result in a denial of benefits.

Qualifying for workers compensation with a pre-existing condition

If you have a pre-existing condition that is made worse through a workplace injury, you can still qualify for workers’ comp benefits under Utah law. However, the amount of those benefits may be reduced or limited.

Pre-existing conditions complicate your workers compensation claim. Don’t let insurance companies bully you into accepting smaller payouts — contact Davis & Sanchez instead.

Common reasons workers comp claims are denied (and how to challenge them)

The workers’ compensation system in Utah is designed to provide injured workers with medical coverage and financial compensation when they experience an injury or illness related to their job.

However, there are times when a claim can be denied. Here are some of the common reasons why a claim might be denied in Utah, as well as how to challenge them.

Pre-existing conditions

As we discussed earlier, pre-existing conditions are complicated.

If you have an existing health condition that makes you more susceptible to certain injuries, your claim may be denied due to pre-existing conditions.

To challenge this denial, you should provide medical records showing that the work-related injury is not connected to any pre-existing condition — which is why

Inadequate proof of injury or illness

If your employer does not believe that the injury or illness is work-related, they may deny your claim. To challenge this denial, make sure you have adequate evidence such as doctor’s notes and other medical reports.

Unreported injuries

If you did not report your injury or illness within 180 days of it occurring, you are legally unable to seek compensation (in most cases).

However, 180 days is the absolute maximum — in reality, you should report your injury as soon as possible.

Insurance companies will look for any small reason to deny your claim.

The best way to challenge this type of denial is by avoiding it altogether. Report your injury ASAP, and don’t give the insurance company ammo to deny your claim.

Non-work related activities leading to injury

If you were engaging in activities outside of work involving risky behavior at the time of the incident, your employer may deny your claim on these grounds.

To dispute this type of denial, provide witnesses and/or video footage proving that your activity was unrelated to work and did not contribute to your injuries.

Hiring a Utah workers compensation attorney

If your workers comp claim is denied, hiring a seasoned Utah workers compensation attorney can help you appeal the decision and get you the benefits you deserve.

But appeals aren’t the only scenario where it’s smart to hire a workers compensation lawyer. By working with an attorney, you can rest assured that your rights are being protected and that you won’t be taken advantage of by insurance companies or employers.

An experienced workers comp lawyer can help level the playing field and get you the full compensation you deserve. Contact Davis & Sanchez today for a free consultation — we’ll fight to make sure you’re taken care of.

Frequently asked questions about Utah workers compensation

Still have questions about Utah workers comp claims? We have answers.

1. What injuries qualify for workers compensation in Utah?

Any injury or illness sustained while on the job can qualify for workers compensation in Utah. This includes physical injuries such as broken bones and strains, occupational illnesses like asbestos or black lung, as well as psychological issues like stress and depression.

2. What are the benefits of hiring a Utah workers comp lawyer?

A Utah workers comp lawyer can help injured employees obtain the benefits they are entitled to. An experienced lawyer will have a deep understanding of the law and will work diligently to ensure that their clients receive fair compensation for their injuries.

Additionally, a lawyer can help injured employees access other forms of financial support such as Social Security Disability Benefits, or negotiate a settlement.

3. What are some of the common reasons why a Utah workers comp claim is denied?

There are several common reasons why a Utah workers comp claim can be denied, including failing to report the injury within the allotted time frame, not providing sufficient evidence of your injury or illness, and making a false statement about your condition.

An experienced lawyer can help you navigate these issues and ensure that your claim is successful.

4. How do I know if I am eligible for workers compensation benefits in Utah?

If you have been injured or fallen ill on the job in Utah, you may be eligible for workers compensation benefits. It is important to contact an experienced attorney to discuss your case.

5. What are the workers compensation benefits available in Utah?

Workers compensation benefits in Utah vary depending on the severity of the injury or illness. In general, workers compensation benefits can include medical expenses, lost wages, and job retraining.

An experienced lawyer can help you understand what is covered by your claim and ensure that you receive the full amount of your entitled benefits.

6. How long do Utah workers compensation benefits last?

The length of time you will receive workers compensation benefits in Utah depends on the type of injury or illness, and its severity. Generally, you can expect to receive benefits until your treating physician states that you have reached maximum medical improvement.

An experienced lawyer can help calculate your expected duration of benefits and ensure that you get the full amount owed to you.

7. How do I file a workers compensation appeal in Utah?

If your workers compensation claim has been denied, you can file an appeal. An experienced lawyer can help guide you through the appeals process and fight to get your claim approved. The length of time it takes for a workers compensation appeal in Utah depends on the complexity of your case.

8. What are the deadlines for filing a workers compensation appeal in Utah?

You must file your workers compensation appeal in Utah within 30 days of the date you received the denial. If you fail to appeal within this time frame, you may lose your right to receive benefits.

An experienced attorney can help make sure that all deadlines are met and that your appeal is filed timely.

9. How do I know if my workers compensation claim has been denied in Utah?

You should receive a letter from the Utah Workers’ Compensation Division that informs you of their decision. This letter will explain why your claim was denied and provide information about how to file an appeal.

An experienced lawyer can help review this letter and determine if there is any legal recourse available.

10. How can I avoid mistakes when filing my workers compensation claim in Utah?

It is important to consult with an experienced lawyer who can help you understand the workers compensation process in Utah. A lawyer will be able to review your claim and ensure that all paperwork is filed properly.

Additionally, a lawyer can help inform you of any deadlines or requirements that must be met for your claim to be successful.

11. How do I find a workers compensation attorney in Utah?

There are a variety of resources available to help you find a workers compensation attorney in Utah.

You can look online for attorneys who specialize in workers compensation, ask friends or family members for referrals, or contact your local bar association.

12. How much does a workers compensation attorney cost in Utah?

The cost of a workers compensation attorney in Utah varies. Generally, attorneys work based on contingency. That means they will only be paid if they can successfully obtain benefits for you. An experienced lawyer can provide an estimate of their fees before taking your case.

13. Am I required to hire a lawyer to file my Utah workers comp claim?

No, you aren’t required to hire an attorney. However, it is highly recommended to seek legal help, as the process can be complex and confusing.

An experienced lawyer can help ensure that you receive all of the benefits you are entitled to and protect your rights throughout the claim process.

Perhaps one of the biggest reasons to hire an attorney is that many insurance companies will try to bully you into accepting a lower workers comp payout without a legal advocate.

14. What are the most common types of work-related injuries in Utah?

The most common types of work-related injuries in Utah include musculoskeletal disorders, such as carpal tunnel and repetitive strain injuries.

Other common workplace injuries are slips and falls, cuts, lacerations, burns, machinery accidents, and exposure to hazardous materials or substances.

An experienced lawyer can help assess the severity of your injury and ensure that you receive the benefits to which you are entitled.

15. How can I prevent a work-related injury in Utah?

The best way to prevent a work-related injury in Utah is to be aware of your job responsibilities and take proper safety precautions.

Make sure you are wearing the appropriate safety gear for the type of work you are doing, and pay attention to any hazardous conditions that may exist.

Additionally, it is important to report any unsafe working conditions or practices that you may observe.

16. What should I do if I am injured at work in Utah?

If you are injured at work in Utah, you should seek medical attention immediately. Then, you should notify your employer of your injury.

It is also recommended that you speak with an experienced workers compensation lawyer who can help assess your case and ensure that all paperwork is filed properly.

17. How do I know if my employer has Utah workers compensation insurance?

Your employer is required by law to carry workers compensation insurance in Utah.

You should ask your employer directly or contact the Utah Workers’ Compensation Division for any additional information about their insurance coverage.

18. What are my rights if I am injured at work in Utah?

Under Utah state law, you have the right to file a claim for workers compensation benefits if you are injured at work. You also have the right to receive medical care and benefits related to your injury, as well as reimbursement for lost wages.

An experienced lawyer can help ensure that your rights are protected throughout the claim process.

19. Can I sue my employer if I am injured at work?

In most cases, you cannot sue your employer directly for a work-related injury in Utah. Instead, you must file a claim with the Utah Workers’ Compensation Division and pursue benefits through that process.

However, there may be circumstances where it is possible to sue an employer or third party for damages related to your injury. Speak with your attorney for details specific to your case.

20. Can I receive both unemployment benefits and workers comp benefits in Utah?

Yes, if you meet the eligibility requirements for both programs, it is possible to receive both unemployment benefits and workers comp benefits in Utah.

However, it is important to note that you cannot receive more than the maximum amount of your wages through these combined benefits.

21. Can I get fired while receiving Utah workers comp benefits?

Under the Utah Workers’ Compensation Act, an employer is allowed to terminate the employment of a worker whose injury prevents them from performing their job duties.

However, if your employer retaliates against you due to filing a workers comp claim or receiving benefits, this could be considered illegal and an experienced lawyer can help advocate for your rights.

22. How much total money can I get from workers comp in Utah?

The amount of money you can receive from workers comp in Utah depends on the severity of your injury and how long it takes for you to recover.

Generally, benefits are calculated based on a percentage of your average wages over the past 12 months, up to a maximum amount set by law.

An experienced lawyer can help assess your case to determine the total amount of benefits you may be eligible to receive.

23. Who pays for Utah workers compensation benefits?

The Utah Workers’ Compensation Division is funded by premiums paid by employers for their workers compensation insurance coverage. It is ultimately the employer who pays for benefits, as they are responsible for filing claims and making payments to injured workers.

24. Can independent contractors get workers comp benefits in Utah?

In most cases, independent contractors are not eligible to receive workers comp benefits in Utah. However, there are some exceptions, so it is best to speak with an experienced lawyer who can help determine if you qualify for benefits.

25. Do I have to perform light duty while receiving workers comp benefits in Utah?

Yes, if you are medically able to do so, you must perform light duty while receiving workers comp benefits in Utah.

You should also note that any wages earned from a light-duty job will be offset against the amount of your total benefits. An experienced lawyer can offer further guidance on how to maximize your benefits while performing light-duty work.

26. What is an independent medical evaluation?

An independent medical evaluation (IME) is an examination conducted by a doctor who is usually recommended by your employer’s insurance company.

The doctor will assess your injury and provide an opinion on whether you are medically able to continue working. If the IME finds that you are unable to return to work, it can be used as evidence in support of your workers comp claim.

However, the reality is that independent medical evaluations are anything but independent. A lawyer can help you prepare for an IME and ensure that your rights are protected throughout the process.

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*The information provided on this website does not, and is not intended to, constitute legal advice; instead, all information, content, and materials available on this site are for general informational purposes only.

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