Commission Posts Memos on Prompt Claims Servicing, Benefit Reduction

Friday, August 17, 2018 | 0

The Idaho Industrial Commission posted a pair of memos explaining its expectations for prompt claims servicing and the process by which employers can seek to reduce compensation when a worker engages in activity that could jeopardize recovery.

One memo published Wednesday explains that the commission expects indemnity payments to start within 28 days of the date of disability unless a denial has been issued.

“The deadline for issuance of income benefits may arrive before the claims administrator’s 30 days to determine compensability has expired,” the commission said. “The investigation may continue beyond the 30-day deadline as long as voluntary payments are made while the determination to accept or deny the claim is made.”

The commission said it expects that compensability determinations will be quick for most claims, with only those “requiring a prolonged investigation” being the exception.

In the second memo, the commission said it must approve requests from employers seeking to reduce benefits owed to injured workers who are engaging in behavior that could “imperil or retard” recovery.

Employers can file a complaint with the commission alleging that a worker is doing things that could jeopardize his or her recovery from an occupational injury.

In cases where a complaint is already on file, a defendant can file a motion seeking an order form the commission to suspend or reduce payments.

In cases where a complaint hasn’t been filed, a defendant may file a complaint including a description of the alleged unsanitary or unreasonable practice sufficient to put the claimant on notice of the claims. After a response or an answer is due, either party can request an emergency hearing, the commission said.