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Utah NOTICE Labor Law Poster

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  • Utah NOTICE Labor Law Poster

    Employer__________________________________________ ___________
    has complied with the provisions of the Workers’ Compensation Act, Title §34A-2-101, Utah Code Annotated, 1997 (as amended), and the rules of the Labor Commission, and has insured the liability to pay the compensation and other benefits provided by said Act by insuring with
    Insurance Carrier: ________________________________ Policy #: ____________________
    Address for the above insurance carrier is ___________________________________________
    and telephone number is……………….

    WORKERS’ COMPENSATION
    IS INSURANCE WHICH PROTECTS YOU DURING WORK. IF YOU HAVE 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 • BURIAL BENEFITS IN CASES.

    HOW TO REPORT AN
    1. Report the injury - no matter how slight - to your boss
    immediately. (You may lose your rights if your injury is not reported promptly.)
    2. Ask your employer to fill out the employer’s first report of injury form. A copy of this report is to be given to you and copies are to be sent to the Labor Commission and to the insurance company within seven (7) days of the .
    3. 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.
    4. Tell the doctor HOW, WHEN, and WHERE the
    happened. The doctor will fill out a medical report form. Copies of the report should be sent within seven (7) days of your visit to (1) the insurance company, (2) the Labor Commission and (3) you, the employee.

    HOW TO START COMPENSATION
    1. Ask your employer which insurance company pays workers’ compensation for your company.
    2. Ask your doctor to send a medical report to that insurance company.
    3. Ask your employer to send a report of to that
    insurance company.
    4. Call the insurance company and ask them to start your workers’ compensation benefits. The insurance company will require the doctor’s report, employer’s report, and may ask you to fill out a request for compensation.
    REHABILITATION
    IF YOU CANNOT RETURN TO YOUR JOB, YOU MAY BE ELIGIBLE FOR A REHABILITATION PROGRAM - CALL YOUR INSURANCE CARRIER AS LISTED ABOVE.


    FRAUD
    “For your protection, Utah law requires the following to appear on this form, 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 fraudulent 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.”
    If you want an Employee’s Guide to Workers’ Compensation or have questions, call the Labor Commission at the above listed numbers.
    NOTE: This notice must be posted and kept continuously posted in a public and conspicuous place in the office, shop, or place of business of the employer as per § 34A-2-204, Utah Code Annotated, 1997.
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