Basic Workers' Comp Law

Workers' compensation insurance allows employees to collect benefits for job-related injuries or diseases without regard to fault. State workers' compensation and occupational disease laws establish workers' compensation benefits available to employees with job-related injuries or diseases. An employee who collects workers' compensation benefits generally cannot bring a civil action against the employer for the job-related injury or disease. Workers' compensation benefits are the employee's sole remedy for job-related injuries or diseases.

Utah's Workers Compensation Act and Occupational Disease Act are found in Chapters 2 and 3 of Title 34A of the Utah Code. The Utah Injured Worker Re-employment Act is found in Chapter 8 of Title 34A of the Utah Code. Workers' compensation administrative rules are found in sections R602 and R612 of the Utah Administrative Code. Employers with employees working in other states must also comply with the workers compensation laws of the other states.

Employers Covered
A person or entity who employs one or more employees in the same business or same establishment, under any contract of hire, expressed or implied, oral or written, is considered an employer. Employers must secure the payment of workers' compensation benefits by purchasing a workers' compensation policy from WCF Insurance or another Utah licensed workers' compensation insurance carrier, or by establishing a self-funded program authorized by the Labor Commission. Certain agricultural and domestic employers are exempt from Utah's workers' compensation laws.

Employers who hire independent contractors may be found to be statutory employers of the independent contractors, their employees and subcontractors. An employer is the statutory employer of the independent contractor if the employer retains the right to supervise or control the independent contractor's work, and the work is a part or process in the trade or business of the employer.

Employees Covered 
Generally, an employee is each person in the service of an employer, and includes aliens and minors, whether legally or illegally working for hire. Sole proprietors and partners of a partnership are not covered employees unless they elect coverage. Officers and directors of a corporation are covered employees unless they elect not to be covered. Independent contractors, their employees and subcontractors are statutory employees of employers who hire them for work in the employer's trade or business.

Out-of-State Workers' Compensation Coverage 
Utah's workers' compensation laws cover employees who are injured while working outside Utah in limited circumstances. To collect Utah benefits for out-of-state injuries, an employee must be hired or regularly employed in Utah. Utah benefits are only available to the employee for injuries received within six months after leaving Utah, unless the employer elects to extend coverage by filing notice with the Labor Commission within the six month period.

An employee injured while temporarily working in another state may be allowed to collect benefits under the other state's workers' compensation laws. However, states which have reciprocal agreements with Utah will not take jurisdiction over a Utah employee injured while temporarily working in their state. These states include California, Idaho, Maryland, Montana, Nevada, North Dakota, Oregon, South Dakota, Tennessee, Texas, Washington, West Virginia and Wyoming; Montana and Nevada currently exclude construction operations from the reciprocal agreement.

Utah employers with employees working temporarily or permanently in other states must comply with the requirements of the workers' compensation laws of the other states.

Covered Injuries and Diseases 
Employee injuries which occur by accident, arising out of and in the course of employment, if the accident was not purposely self-inflicted, are covered by Utah's workers compensation laws. A compensable occupational disease is any disease or illness which arises out of and in the course of employment and is medically caused or aggravated by that employment.

Utah Labor Commission 
The Utah Labor Commission is the state regulatory agency which administers Utah's workers compensation system. The Commission is responsible for ensuring that every Utah employer has workers compensation insurance or an authorized self-funded program. The Commission adjudicates disputes between injured employees and their employers/insurance carriers. The Labor Commission can be contacted at 801.530.6800, 160 East 300 South, P.O. Box 146610, Salt Lake City, Utah 84114-6610.

Adjudication of Workers Compensation Claims 
If an employee's claim for workers compensation coverage is denied by the employer or insurance carrier, the employee can initiate a formal hearing before the Labor Commission by filing an Application for Hearing. A formal administrative hearing on the employee's claim will be held in which both parties present evidence regarding the contested claim. An Administrative Law Judge (ALJ) presides over the hearing. The ALJ may appoint a Medical Panel to evaluate the medical evidence to assist in resolving disputed medical issues. The Medical Panel will submit a medical opinion for the ALJ's consideration. A party can appeal the ALJ's order with the Labor Commissioner. Alternatively, a party can request that the appeal be heard by the Appeals Board, a division of the Labor Commission. Upon review of the ALJ's Order, the Labor Commissioner, or if specifically requested, the Appeals Board issues an opinion which is final unless appealed and set aside by the Utah Court of Appeals or the Utah Supreme Court.

This is not intended to be a complete legal analysis of Utah's workers compensation laws. Contact legal counsel to determine your specific legal rights and obligations under these laws. WCF Insurance customers may contact WCF Insurance's Legal Department at 385.351.8051, or at 800.446.2667 ext. 8051.

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Insurance coverage in all states other than Utah is provided by Advantage Workers Compensation Insurance Company, a wholly-owned subsidiary of WCF Mutual Insurance Company, doing business as WCF Insurance. Advantage is domiciled in Indiana; NAIC number: 40517. Administrative office: P.O. Box 571918, Salt Lake City, UT 84157-1918.
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