Articles Posted in Workers Compensation

By Fred J. Lewis

The Idaho Workers’ Compensation Law set up a state agency called the Industrial Special Indemnity Fund or ISIF. This state agency collects 5% of all the workers’ compensation premiums paid by businesses throughout the state of Idaho. The fund holds these funds to be paid out to Idaho Workers’ Compensation claimants that have pre-existing injuries and then suffer an addition accident where the injuries combined with their pre-existing injuries and render them totally and permanently disabled.

In Dumaw v. J.L. Norton Logging, 118 Idaho 150, 795 P.2d 312 (1990), the Idaho Supreme Court listed four requirements a claimant must meet to establish ISIF liability under Idaho Code § 72-432:

By Fred J. Lewis

Idaho Code Section 72-102(18)(b) defines an industrial accident as follows: “Accident” means an unexpected, undesigned, and unlooked for mishap, or untoward event, connected with the industry in which it occurs, and which can be reasonably located as to time when and place where it occurred, causing an injury”. You must be able to reasonably locate the time and place of your accident or you cannot claim that you had an Idaho Workers’ Compensation accident.

The only other type of Idaho Workers’ Compensation claim arises out of an occupational disease, which is defined by Idaho Code Section 72-102(22)(a) as follows: “Occupational disease” means a disease due to the nature of an employment in which the hazards of such disease actually exist, are characteristic of, and peculiar to the trade, occupation, process, or employment…” If you cannot fit your Idaho Workers’ Compensation accident within the definition of an accident or an occupational disease claim, you do not have a viable Idaho Workers’ Compensation claim.

By Fred J. Lewis

We are currently in the 99^th year of the Idaho Workers’ Compensation system. The Idaho legislature has not had to tinker much with the Idaho Workers’ Compensation system during that entire time period. I believe this is in large part due to the Claimants’ direct right of appeal to the Idaho Supreme Court. In other words, if you are injured on the job in the state of Idaho and you receive a result from the Idaho Industrial Commission and you and your lawyer believe the Commission has made a mistake on the application of the law, you can appeal the unfavorable decision directly to the Idaho Supreme Court. This allows the Idaho Supreme Court to make sure that the Idaho Workers’ Compensation Laws are applied evenly and correctly to all injured parties throughout the state.

You can even ask the Idaho Industrial Commission to give you a specific application of Idaho workers compensation law as to your case. This happens by having your Idaho Workers’ Compensation lawyer file papers with the Idaho Industrial Commission.

By Fred J. Lewis

I have been representing individuals involved in Idaho Worker’s Compensation claims for 29 years. Most of these injured workers have had career-ending injuries. They have to completely reinvent themselves. These career-ending injuries always result in losses. Idaho injured workers lose their friends at work. Idaho injured workers lose their sense of identity since Western cultures almost require an individual to define themselves by their job. When someone asks you to introduce yourself, you will often start off by explaining to them where you work and what you do on your job. That is how we define ourselves. To lose this identity is to lose your sense of who you are.

Idaho injured workers dealing with their Idaho worker’s compensation claims often become depressed and find it difficult to reinvent themselves. It then becomes a downward spiral from which they believe there is no escape. Several of my clients have had suicidal thoughts. A significant majority of Idaho injured workers have to end up taking antidepressant drugs. There is no shame in getting help with this situational depression that plagues so many Idaho injured workers.

By Fred J. Lewis

Serious on-the-job accidents often result in permanent injuries that will end your current job. Many employers will not accommodate the new restrictions that you will be given and you will be left in a position such that you will have to reinvent yourself. There is good news. There are several programs available to injured workers in Idaho where you can essentially fashion your own full ride scholarship after you were injured on the job in Idaho:

1. The Idaho Department of Vocational Rehabilitation (IDVR) provides benefits.

By Fred J. Lewis

Most serious on-the-job injuries to Idaho workers result in permanent injuries. Typically, you will be given restrictions by your treating doctor that will end your employment with your current employer. Most injured workers in Idaho have a difficult time after they have lost their employment because of an on-the-job injury. You may find yourself getting depressed and not knowing where to turn next.

If retraining is not possible and you cannot return to your former employment, your new job will be looking for a job and documenting the entire work search. The Idaho Worker’s Compensation law requires that you do all you can to find a job that is at or near your pre-injury wage. The Idaho Industrial Commission provides rehabilitation caseworkers that will assist you in your job search. However, only you can actually go out and do the job search in the form of obtaining job leads from the Idaho Department of Labor, searching the internet, and networking with potential employers. Every step of your job search must be documented and contemporaneous records need to be kept so that you can offer this documentation as proof of your job search. If you do not write this information down and keep copies of applications the Idaho Worker’s Compensation system will assume that you did not do the job search.

By Fred J. Lewis

Under Idaho Worker’s Compensation law, the injured party has the burden of proof to produce medical evidence to support their Idaho Worker’s Compensation claim. This means your treating doctor needs to be on your side. He or she has to be willing to offer an opinion on a more probable than not basis that the industrial accident caused an injury to your body. If your treating doctor is unwilling to offer this testimony, you need to ask your doctor to refer you to a doctor who will help you with your Idaho Worker’s Compensation claim by offering a causation opinion as I have described above.

Sometimes, the doctor does not want to lose you as a patient because the doctor is being paid at a higher rate because it is an Idaho Worker’s Compensation claim. Under the Idaho Worker’s Compensation medical fee schedule, doctors are paid a lot higher rate for treating Idaho Worker’s Compensation claimants. Some doctors want to hold on to you as patients because you are a “cash cow” and they will not want to refer you. This presents a difficult position. At that point in time you essentially have two options. First, you file a petition for a change of physician with the Idaho Industrial Commission under Rule 20 of the Judicial Rules of Practice and Procedure under the Idaho Worker’s Compensation Law. The Commission may or may not grant your petition for change of physician. Your second option is to use your private insurance or some other non-Idaho Worker’s Compensation insurance coverage or Medicare or Medicaid card to go to the doctor of your choice who will help you with your Idaho Worker’s Compensation claim. Without a referral, and without an order changing your doctor from the Idaho Industrial Commision, the worker’s compensation insurance company is not required to pay for their services. However, this may be the only way that you can obtain the necessary medical opinions to make your claim go forward.

By Fred J. Lewis

Sometimes the Commissioners decide that they would like to either come to a different conclusion or write a decision in a different way than the Referee has written the decision. The Commissioners then write their own decision which becomes the final order of the Idaho Industrial Commission.

If either party disagrees with the final decision written by the Industrial Commissioner themselves or an approved Referee decision, they have the right to make a direct appeal to the Idaho Supreme Court. The attorneys then submit briefs to the Idaho Supreme Court and then the case is set for oral argument. Approximately 60-180 days following the Supreme Court argument the Idaho Supreme Court issues its decision which then becomes the final decision in the Idaho Industrial Commission case.

By Fred J. Lewis

There is no way that the three commissioners can hear all of the Idaho Worker’s Compensation cases that must be decided by the Idaho Industrial Commission. Therefore, they hire lawyers to serve as administrative judges or Referees to hear the individual cases. These Referees travel throughout the state and conduct hearings near the homes of the injured Idaho workers. After the hearings are completed, the lawyers for the injured Idaho worker and for the insurance company travel to the offices of doctors and vocational experts throughout the state and take their testimony by way of post hearing depositions. After all the testimony and evidence has been submitted to the Referee, they draft decisions that are then submitted to the three Industrial Commissioners for their approval.

By Fred J. Lewis

The Idaho legislature has provided the structure for how the claims of injured Idaho workers are adjudicated. There are three commissioners appointed by the Governor of the state of Idaho for 6 year terms. First, there is an appointment made by the Governor for a Commissioner that comes from the labor community. R.D. Maynard? is a former AFL-CIO Union representative who was appointed as the employee Idaho Industrial Commissioner. Second, there is an appointment made by the Governor for a commissioner that is a lawyer. Thomas P. Baskin is a highly experienced worker’s compensation lawyer who was appointed as the lawyer Idaho Industrial Commissioner. Third, there is an appointment made by the Governor for a Commissioner that comes from the employer community. Thomas E. Limbaugh is a former orchard owner who was appointed as the employer Idaho Industrial Commissioner. These three Idaho Industrial Commissioners must approve all decisions and settlements reached in Idaho Worker’s Compensation cases.