DI 52120.245 Utah Workers’ Compensation (WC)
A. Types of WC payments
1. Temporary Total (TT) –
does not exceed 312 weeks and does not continue over a period of 12 years from the date of the injury
2. Temporary Partial (TP) –
weekly payments do not exceed 312 weeks and do not continue for more than 12 years after the date of injury
3. Permanent Total (PT) –
may exceed 312 weeks; prior to 07/01/1994 the Employers Reinsurance Fund (see DI 52120.245E. below) pays PT benefits in excess of 312 weeks.
4. Permanent Partial (PP) –
does not exceed 312 weeks
B. Cost-of-living adjustments (COLAs)
Utah does not provide for cost of living increases for WC payments with the exception of ERF PT minimum payments (see DI 52120.245E.2. below).
C. Attorney fees
For awards processed after July 1, 2007, the attorney fees allowed for all legal services rendered shall be 25 percent of weekly benefits for the first $25,000, plus 20 percent of the weekly benefits in excess of 25,000 through 50,000, and 10 percent of the weekly benefits balance in excess of $50,000. The current posted maximum attorney fee is $17,468.00 as of January 1, 2013. Fee limits are higher if the case is appealed to the Utah Court of Appeals or the Utah Supreme Court.
D. Retirement insurance benefit (RIB) considerations
On or after 07/01/1994, after the worker has been paid PT for 312 weeks, the State reduces PT by the dollar amount of 50 percent of the SSA RIB received by the worker during the same period. The State computes the reduction based on the RIB that is payable for the four week period beginning the first day the worker is eligible for RIB.
On or after 05/05/2008, the State does not include in the PT reduction any amount related to an SSA cost-of-living adjustment (COLA) of the RIB. If the State was reducing PT because of RIB on or before 05/04/2008, the reduction is limited to the amount of reduction that was in effect as of 05/04/2008.
E. Employers’ Reinsurance Fund (ERF)
1. Types of payments made by ERF
PT payments in excess of 312 weeks for injuries occurring before 07/01/1994
Second injury PT payments in excess of 156 weeks for injuries occurring from 07/01/1988 to 06/30/1994.
ERF payments are offsettable
2. Amount and frequency of ERF payments
Prior to 01/01/2000: ERF payments were paid every 28 days.
Effective 01/01/2000: ERF payments are paid on a monthly basis.
ERF payment for December 1999: This payment was adjusted to reflect any additional monies due because of the conversion from a 28-day payment cycle to a monthly payment cycle. The payment included the additional days due from the end of the 28-day cycle to December 31st.
Example: If the weekly WC rate was $225.00, the $900.00 every 28 day payments would switch to $975.00 per month payments as of January 2000 (which would not be a rate change - even though it might look like one on a payment history printout).
Payments to a worker receiving the minimum ERF PT payment may be readjusted each July 1 based on changes in the State average weekly wage.
F. Verifying WC
For Utah WC claims based on injuries before 07/01/1994, employers or insurance carriers can verify TT, TP and PP payments. If the employer or carrier indicates that payments ended, contact the beneficiary and/or the Employers’ Reinsurance Fund to document if ERF payments (see DI 52120.245E.) took effect after the TT, PT, or PP payments ended.
The Utah Employer’s Reinsurance Fund (ERF) handles claims where a second injury is involved or permanent disability claims after the first 312 weeks if the date of injury was before 1994.
Contact ERF by FAX at 801-530-6804.
A signed release is necessary for them to release information back to you. They will FAX information back if you give them a FAX number.
G. Uninsured Employers’ Fund
This fund assists in the payment of workers compensation benefits to workers injured on the job and whose employer is uninsured and either insolvent or bankrupt.
H. Exhibit - Permanent Partial Disability Agreement, Form 219: