Yes, if the county requires injured workers to be seen first by a designated doctor, the county must make that requirement known to you before you report to a physician in regard to a work-related injury. The county’s designated Occupational Health Care Provider is St. Alphonsus Occupational Health Network.

Can I choose my own doctor?

Yes, if the county has not designated a treating physician. Under emergency conditions you may seek the most available medical treatment, even when another physician has been designated. The county’s designated Occupational Health Care Provider is St. Alphonsus Occupational Health Network. You should not seek treatment from your private physician or chiropractor prior to seeking treatment from the county's designated provider.

Do I have to use sick/vacation time for doctor’s appointments?

Depending on your department's discretion, you may or may not be required to use sick/vacation/comp time for visits to the designated health care provider as a result of a work related injury. You should try to schedule appointments during times that are most convenient for your department. Sick/vacation/comp is always exhausted during the first five day waiting period for income benefits.

Can I use vacation/sick/compensatory time during the time I am receiving workers compensation income benefits?

No. You may not use sick/vacation/compensatory time in conjuntion with receiving workers compensation income benefits.

What if the claims administrator's designated doctor or Independent Medical Examiner disagrees with my physician?

Ada County can accept the opinion of any physician as long as it is reasonable. If you feel that Ada County is unreasonable, you can file a formal complaint {I.C. 72-706} with the Industrial Commission. The complaint initiates the formal legal process to bring the issue to the Commission for a hearing and decision.

Can Intermountain Claims, Inc., require me to see a doctor other than my treating physician?

Ada County may require attendance at an Independent Medical Examination and then choose the medical opinion rendered in that report. Ada County may also refuse to pay for future visits to your treating physician in certain circumstances.

At what time is the treating physician’s opinion no longer considered?

The treating physician’s opinion may be considered as evidence to support your contention, but the third party claims administrator, Intermountain Claims, Inc., may base its decisions on the opinion of a physician other than the treating physician.

Can I change treating physicians?

Yes, you may ask the current treating physician for a referral to a new treating physician. If the physician declines to do so, then the request may be made to Ada County. If Ada County declines the request, you may file a Petition for Change of Physician {I.C. 72-432 (4)}. Without pre-authorization from Ada County or a successful Petition for Change of Physician, you may be liable for the fees charged by a physician of your choice. The AMA Guidelines do not necessarily convert ratings in the exact percentage.

BENEFIT PAYMENTS

What is the income benefit allowance for the medically authorized time I have missed from work?

Computing the income benefit allowance is a complex process. The basic benefit is sixty-seven percent (67%) of your average weekly wage, subject to the (minimums and maximums) of 90% of the average state wage provided in Idaho Code {I.C. 72-408} and {72-409}. After 52 weeks, the basic benefit is 67% of the average state wage subject to (minimums and maximums) in {I.C. 72-409}. Contact the work comp third party administrator, Intermountain Claims, Inc. (208-323-7571) or the Idaho Industrial Commission (208-334-6000) for more information.

When will I get paid for the time I have missed from work?

You may generally expect to receive your first check within twenty-one days of the injury, unless you have been notified that the claim was denied or is being investigated. Contact Intermountain Claims, Inc., the third party claims administrator, to determine exactly when benefits checks are issued.

Will I receive benefits for every day I am injured?

You do not receive income benefits for the first 5 days you are unable to work due to an injury, unless the injury requires overnight hospitalization or the time loss exceeds 14 days. There is no waiting period for eligibility for medical benefits.

Can I use vacation/sick/compensatory time during the time I am receiving workers compensation income benefits?

You may not use sick/vacation/compensatory time in conjuntion with receiving workers compensation income benefits.

RETURN TO WORK

In most cases, yes, if the work can be done within the restrictions imposed by a doctor. Upon release to light duty work, you should contact your employer to express your availability for such work.

Can an employer terminate me while I am receiving workers' compensation benefits?

Generally, yes, unless your illness or injury is protected under another federal or state law. There is no workers’ compensation law that prevents this. Your workers' compensation benefits may or may not continue after termination, depending on the circumstances.

Can I draw workers' compensation benefits and unemployment benefits at the same time?

There is no workers’ compensation statute or rule prohibiting receiving both benefits. You should contact the Department of Labor without delay to determine your eligibility for unemployment benefits.

TIME FRAMES/STATUTE OF LIMITATIONS

Is there a statute of limitations on medical benefits?

If you have met the filing and notice requirements, there is no statue of limitations on medical benefits unless the claim has been closed with a lump sum settlement {I.C. 72-706 (5)}.

Is there a statute of limitations on income benefits?

You must first meet the filing and notice requirements. If you have met these requirements, income benefits may still be subject to a statute of limitations.

If income benefits have been paid and discontinued more than four (4) years from the date of the accident causing the injury or the date of first manifestation of an occupational disease, you shall have one (1) year from the date of the last payment of income benefits within which to make and file with the commission an application requesting a hearing for additional income benefits." {I.C. 72-706 (3)}

Also, if no benefits are paid during the first year after the injury, then income benefits may not be due thereafter. Contact your work comp claims administrator or the Idaho Industrial Commission (208) 334-6000 for more information.

Note: State and federal laws are subject to change.