Workers' Compensation Notice for the State of Utah Mandatory
The Workers' Compensation Notice for the State of Utah is an Utah workers compensation law poster provided for businesses by the Utah Labor Commission. This is a required poster for all Utah employers, and any business that fails to post this notification may be subject to penalties or fines.
This poster details the rules of employer compensation of workers for on the job incidents that occur and leave employees negatively impacted in any way. The poster is required by law to be displayed in a conspicuous place in any place of employment. More specifically, employers must list the name of their business as well as their insurance carrier and policy number on the form in order to assuage any fear employees might have of not being covered or compensated in case of an incident.
Further, the poster defines workers? compensation according to the State of Utah; specifically, it asserts that worker's compensation is insurance which protects employees during work. If an employee suffers an on the job injury or occupational disease, it will pay for: Hospital and medical bills, time lost from work, permanent loss of body function, prosthetic devices, and burial benefits in death cases. The poster goes on to detail how to report an accident. It also discusses how to begin the process of receiving compensation for an incident. It also notes that those for too injured by an incident that they may be eligible for a rehabilitation program. The poster goes on to warn against fraud in the covering of employees for incidents that occur in the workplace. The poster ends by encouraging anyone with questions or in need of help to contact that State of Utah Labor Commission (contact information is included on the poster).
WORKERS’ COMPENSATION NOTICE Employer: has complied with the provisions of the Workers’ Compensation Act (§34A -2-101, Utah Code Annotated), the Utah Occupational Disease Act (§34A -3-101, Utah Code Annotated), and the rules of the Labor Commission by insuring the liability to pay the compensation and other benefits provided by said Acts through: Insurance Company: Policy Number: ______________________________________________________________ Address for the above insurance company: Telephone number: Check here if the employer has been authorized by the Division of Industrial Accidents to self -insure and directly pay workers’ compensation benefits. WORKERS’ COMPENSATION Workers’ Compensation is insurance which pays medical expenses and helps offset lost wages for employees with work - related injuries or illnesses. If you have an on -the -job injury or occupational disease, it may pay for: hospital and medical bills, time lost from work, permanent loss of body function, prosthetic devices, and burial and dependent benefits in case of death. HOW TO REPORT AN ACCIDENT 1. Report the injury, no matter how slight, immediately to your supervisor. You may lose your rights if your injury is not reported within 180 days of the injury or wor k-related illness. 2. Ask your employer where you should go for treatment. If your employer has a first -aid room or company designated doctor, go there promptly for treatment. If not, go to a doctor of your choice. 3. Tell the doctor HOW, WHEN and WHERE the accident happened. The doctor will fill out a physician’s initial report form. A copy of the report is given to you and copies of the report are sent to the insurance company and the Labor Commission within seven (7) days of your doctor visit. 4. Your employ er shall fill out the employer’s first report of injury form. A copy of this report is sent to the insurance company within seven (7) days of the accident. The insurance company will report the injury to the Labor Commission. HOW TO START COMPENSATION 1. Ask your employer which insurance company pays workers’ compensation benefits for the company. 2. Ask your employer to report the accident to the insurance company and give you the claim number. 3. Call the insurance company and ask them to start your workers’ compensation benefits. The insurance company will require the employer’s report, the physician’s report, and may ask you to fill out a request for compensation. Cooperate with the adjuster’s investigation of the injury. 4. Ask your doctor to send medical rep orts to the insurance company, including the work status statement. REHABILITATION If you cannot return to work, you may be eligible for a rehabilitation program. Contact the insurance company listed above or the Utah State Office of Rehabilitation . FRAUD STATEMENT: “Any person who knowingly presents false or fraudulent underwriting information, files or causes to be filed a false or fraudulent claim for disability compensation or medical benefits, or submits a false or fraudu lent report or billing for health care fees or other professional services is guilty of a crime and may be subject to fines and confinement in state prison.” 160 East 300 South 3 rd Floor P.O. Box 146610 Salt Lake City, Utah 84114 -6610 Office: (801) -530 -6800 Fax: (801) -530 -6804 Toll Free: (800) -530 -5090 www.laborcommission.utah.gov If you want copy of an Employee's Guide to Workers' Compensation booklet or have questions, contact the Labor Commission or go to the webpage at www.laborcommission.utah.gov . Note: This notice must be posted and kept continuously in public and conspicuous places in the office, shop or place of business of the employer as per §34A -2-204 and §34A -2-104.5, Utah Code Annotated. Rev 10/2019
More Utah Labor Law Posters 6 PDFS
Minimum-Wage.org provides an additional five required and optional Utah labor law posters that may be relevant to your business. Be sure to also print and post all required state labor law posters, as well as all of the mandatory federal labor law posters.
|Utah Poster Name||Poster Type|
|Required Pregnancy and Related Conditions under the Utah Antidiscrimination Act||Workers Rights Law|
|Required Workers' Compensation Notice for the State of Utah||Workers Compensation Law|
|Required Unemployment Insurance Notice to Workers||Unemployment Law|
|Required Workplace Safety and Health in the State of Utah||Job Safety Law|
|Required Utah Smoke Free Business Sign||Anti-Smoking Law|
Utah Labor Law Poster Sources:
Labor Poster Disclaimer:
While Minimum-Wage.org does our best to keep our list of Utah labor law posters updated and complete, we provide this free resource as-is and cannot be held liable for errors or omissions. If the poster on this page is out-of-date or not working, please send us a message and we will fix it ASAP.