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Simplifying the Work of Workers' Compensation



Utah Workers' Compensation Information

  • Home
  • States
  • Workers' Compensation Information


  • State Telephone Numbers
  • State Forms
  • State Rules & Statutes

Please Note: for Claims assistance or questions about coverage and exemptions You will need to call one of the numbers listed below.

Also be aware that the Workers' Compensation Assistance Offices in different states may go by different names such as "Industrial Accidents".
These are the only numbers that we are aware of and have available for Utah Workers' Compensation.


Utah Workers' Compensation Telephone Directory


Division of Industrial Accidents: 801-530-6800

Occupational Safety: (801) 530-6918

Fraud Division - Phone, Fax & Email Address: 801-468-0233

Vocational Rehabilitation: 866-454-8397

Labor Commission Main Office - Mailing Address, Phone, Fax & Emailing Address: 801-530-6800

Employers Reinsurance Fund - Mailing Address, Phone, Fax & Email Address: 801-530-6953

WC Self Insured Employers - Mailing Address & Fax: 801-530-6800

Office of Coal Mine Safety - Mailing Address, Phone & Fax: 435-613-5902

Appeals (Adjudication Division): 801-530-6856

Appeals (Adjudication Division) - Southern UT: 801-530-6800

Appeals (Adjudication Division) - Southern UT - In State Long Distance: 800-530-5090

Records Department: 801-530-6844

Coal Miner Certification: 435-613-5901

Outreach & Training Programs: 801-530-6271

UOSH (Compliance) - Mailing Address, Phone, Fax & Email Address: 801-530-6494

UOSH (Compliance) - Second Phone & Email Address: 801-530-6497

WC Coverage Waivers: 801-530-6800

Fraud - Toll Free: 800-955-2210

Department of Workplace Services - Mailing Address, Phone & Email Address: 801-526-9675

Rehabilitation Services (USOR): 866-454-8397

Specialist I: 802-828-2993

Specialist I: 802-828-2206

Specialist I: 802-828-2995

Insurance Department (State): 801-957-9200

Department of Insurance (State) - Toll Free: 800-439-3805

Department of Insurance (State) Acting Commissioner Johnathan T. Pike: 801-957-9320

UOSH Consultation: 801-530-6855

Labor Commission Bureau of Labor Statistics: 801-530-6926

Labor Commission Bureau of Labor Statistics: 801-530-6823

Labor Commission/Industrial Accidents Div./WC Issues: 801-530-6800

Death & Burial Benefit Questions: 801-530-6800

OSHA Utah State Plan applies to all Public & Private Employees - Salt Lake City Ofc: 801-530-6901

Industrial Accidents: 801-530-6800

Industrial Accidents - Toll Free: 800-530-5090

Forms & Publications


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Some "Revision Dates" may be displayed as part of the Description.

(122c) First Report of Injury or Illness 10/19
(122) Employer's First Report of Injury or Illness 10/19
(100) Injured Workers' Rights and Responsibilities 10/19
(123) Physician's Initial Report of Work Injury or Occupational Disease 10/19
(020) Wage Claim Assignment Form 7/14
(form043) Attending Physician's Statement 10/19
(form044) Employee's Intent to Leave State / Change Dr. / Hospital 10/19
(102) Application to Change Doctors 10/19
(205) Request for Copies form Claimant's File 10/19
(302) Medical Records - Copies 10/19
(134) Application for Lump Sum or Advance Payment 5/16
(Form089) Employee Notification Denial of Claim 10/19
(441) Insurance Carrier/ Self Insurers Notice of Further Notification of WC Claim 10/21
(130) Insurance Company's / Self Insured Final Report of Injury / Statement of Total Loss 10/19
(141) Initial Statement of Insurance Carrier / Self Insurer with Respect to Payment of Benefits 10/19
(142) Statement of Insurance Carrier / Self Insurer with Respect to Discontinuance of Benefits 10/19
(219) Permanent Partial Disability Statement of Compensation 10/19
(215) Insurer/Employer Request to Waive/Postpone Reemployment Referral 10/09
(239) Insurer's Report on Rehabilitation and Reemployment Efforts for Claimants 10/09
(307) Medical Treatment Provider List - Industrial Accidents 1/21
(308) Authorization to Disclose, Release and Use Protected Health Information Non Permanent Total Disability Claims (10 YEARS OF RECORDS) 6/20
(308.15) Authorization to Disclose, Release and Use Protected Health Information Permanent Total Disability Claims (15 YEARS OF RECORDS) 6/20
(110) Release to Return to Work 5/16
(198) Insurer Request for Extension of Time to Obtain 2nd Dental Opinion 10/14
(221a) Spine Restorative Services Authorization / Denial Form 10/19
(221b) Upper Extremity Restorative Services Authorization / Denial Form 10/19
(221c) Lower Extremity Restorative Services Authorization / Denial Form 10/19
(223) Authorization Request for Medical Procedures 10/19
(310) Request / Appeal for Additional Medical Information 2/09
(350) Emergency Medical Service Provider Exposure Report Form 8/12
(erf) Petition for Reimbursement 8/08
(Form001) Application for Hearing - Industrial Accident Claim 7/18
(Form024) Application for Hearing Medical Care Provider 6/14
(form025) Application for Dependents benefits and/or Burial Benefits - Industrial Accidents Claim 3/12
(form025inst) Instructions for Filling Out Form 025 8/16
(form026) Application for Hearing - Occupational Disease Claim 7/18
(form026inst) Instructions for Filling Out Form 026 3/12
(form027) Application For Dependents Benefits and/or Burial Benefits - Occupational Disease Claim 5/16
(form027inst) Instructions for Filling Out Form 027 8/16
(046) Authorization to Release Labor Commission Records 6/03
(113a) Summary of Medical Record – Industrial Accident 3/10
(113b) Summary of Medical Record – Occupational Exposure 3/10
(151) Dependent's Benefit Order 2/09
(152) Appointment of Counsel 6/16
(402) Application for Hearing For Termination or Reduction of Compensation 3/12
(sub) Subpoena 3/16
(complaint form) Workers' Compensation Coordination of Benefits Untimely Payment Complaint Form N/D
(deathbenguide) Workers' Compensation Guide to Death Benefit Claims 5/17
(dependentapp) Continued Dependent's Benefit Declaration N/D
(form109) Application for Self-Insurance 10/2019
(form215E) Agreement of Assumption and Guaranty of Workers' Compensation 10/2019
(form213E) Self-Insurance Aggregate Surety Bond 10/2019
(form303) Utah Bankruptcy and Insolvency Endorsement 10/2019
(form223E) Renewal Application for Self-Insurance 10/2019
  • Utah Rules
  • Utah Statutes

Rule R612-100. Workers' Compensation Rules - General Provisions.


  • R612-100-1. Authority.

  • R612-100-2. Definitions.

  • R612-100-3. Forms Used By Industrial Accidents Division.

  • R612-100-4. Designation As Informal Proceedings.
  • Rule R612-200. Workers' Compensation Rules - Filing and Paying Claims.


  • R612-200-1. Reporting And Investigating Injuries.

  • R612-200-2. Payment Of Benefits, Interest And Attorney Fees.

  • R612-200-3. Statement Of Compensation.

  • R612-200-4. Insurance Carrier/employer Liability.

  • R612-200-5. Permanent Total Disability.

  • R612-200-6. Burial Expenses.
  • Rule R612-300. Workers' Compensation Rules - Medical Care.


  • R612-300-1. Purpose, Scope And Definitions.

  • R612-300-2. Obtaining Medical Care For Injured Workers.

  • R612-300-3. Required Reports.

  • R612-300-4. General Method For Computing Medical Fees.

  • R612-300-5. Fees For Specific Procedures.

  • R612-300-6. Limitations On Fees For Specific Medical Providers And Non-physicians.

  • R612-300-7. Billing And Payment.

  • R612-300-8. Travel Allowance For Injured Workers.

  • R612-300-9. Permanent Impairment Ratings.

  • R612-300-10. Medical Records.

  • R612-300-11. Utilization Review Standards.

  • R612-300-12. Commission Approval Of Health Care Treatment Protocols.

  • R612-300-13. Hiv, Hepatitis B And C Testing And Reporting For Emergency Medical Service Providers.

  • R612-300-14. Advance Practice Registered Nurse.
  • Rule R612-400. Workers' Compensation Insurance, Self-Insurance and Waivers.


  • R612-400-1. Policy Reporting By Workers' Compensation Insurance Carriers.

  • R612-400-2. Workers' Compensation Coverage For Professional Employer Organizations And Client Companies.

  • R612-400-3. Self Insurance Of Workers' Compensation Obligations.

  • R612-400-4. Waivers.

  • R612-400-5. Premium Rates For The Uninsured Employers' Fund And The Employers' Reinsurance Fund.
  • Chapter 1. Labor Commission Act

    Part 1. General Provisions


  • 34A-1-101 Title.

  • 34A-1-102 Definitions.

  • 34A-1-103 Labor Commission -- Creation -- Seal.

  • 34A-1-104 Commission authority.

  • 34A-1-105 Commission budget -- Reports from divisions.

  • 34A-1-106 Fees.
  • Part 2. Organization


  • 34A-1-201 Commissioner -- Appointment -- Removal -- Compensation -- Qualifications -- Responsibilities -- Reports.

  • 34A-1-202 Divisions and office -- Creation -- Duties -- Labor Relations Board, Appeals Board, councils, and panel.

  • 34A-1-203 Commissioner -- Jurisdiction over division directors -- Authority.

  • 34A-1-204 Division directors -- Appointment -- Compensation -- Qualifications.

  • 34A-1-205 Appeals Board -- Chair -- Appointment -- Compensation -- Qualifications.
  • Part 3. Adjudicative Proceedings


  • 34A-1-301 Commission jurisdiction and power.

  • 34A-1-302 Presiding officers for adjudicative proceedings -- Subpoenas -- Independent judgment -- Consolidation -- Record -- Notice of order.

  • 34A-1-303 Review of administrative decision.

  • 34A-1-304 Definitions -- Rulemaking -- Electronic or similar methods of proceedings.

  • 34A-1-305 Orders of commission -- Presumed lawful.

  • 34A-1-306 Orders not to be set aside on technicalities.

  • 34A-1-307 Action permitted in adjudicative proceedings.

  • 34A-1-308 Depositions.

  • 34A-1-309 Attorney fees.

  • 34A-1-310 Record of proceedings before commission.
  • Part 4. Miscellaneous


  • 34A-1-401 Attorney general and county attorneys -- Duties.

  • 34A-1-402 Publication of orders, rules, and rates.

  • 34A-1-403 Judgments in favor of commission -- Preference.

  • 34A-1-404 Injunction prohibited.

  • 34A-1-405 EmployerÂ’s records subject to examination -- Penalty.

  • 34A-1-406 Right of visitation.

  • 34A-1-407 Investigation of places of employment -- Violations of rules or orders -- Temporary injunction.

  • 34A-1-408 Investigations through representatives.

  • 34A-1-409 Partial invalidity -- Saving clause.
  • Chapter 2. Workers' Compensation Act

    Part 1. General Provisions


  • 34A-2-101 Title.

  • 34A-2-102 Definition of terms.

  • 34A-2-103 Employers enumerated and defined -- Regularly employed -- Statutory employers -- Exceptions.

  • 34A-2-104 "Employee," "worker," and "operative" defined -- Specific circumstances -- Exemptions. (Effective 5/14/2019)

  • 34A-2-104.5 Nongovernment entity volunteers.

  • 34A-2-105 Exclusive remedy against employer, and officer, agent, or employee of employer.

  • 34A-2-106 Injuries or death caused by wrongful acts of persons other than employer, officer, agent, or employee of employer -- Rights of employer or insurance carrier in cause of action -- Maintenance of action -- Notice of intention to proceed against third party -- Right to maintain action not involving employee-employer relationship -- Disbursement of proceeds of recovery -- Exclusive remedy.

  • 34A-2-107 Appointment of workers' compensation advisory council -- Composition -- Terms of members -- Duties -- Compensation.

  • 34A-2-107.3 Mental Health Protections for First Responders Workgroup.

  • 34A-2-108 Void agreements between employers and employees.

  • 34A-2-109 Interstate and intrastate commerce.

  • 34A-2-110 Workers' compensation insurance fraud -- Elements -- Penalties -- Notice. (Effective 5/14/2019)

  • 34A-2-111 Managed health care programs -- Other safety programs.

  • 34A-2-112 Administration of this chapter and Chapter 3.

  • 34A-2-113 Designated agent required.
  • Part 2. Securing Workers' Compensation Benefits for Employees


  • 34A-2-201 Employers to secure workers' compensation benefits for employees -- Methods.

  • 34A-2-201.3 Direct payments prohibited except by self-insured employer.

  • 34A-2-201.5 Self-insured employer -- Acceptable security -- Procedures.

  • 34A-2-202 Assessment on self-insured employers including the state, counties, cities, towns, or school districts paying compensation direct.

  • 34A-2-202.5 Offset for occupational health and safety related donations. (Effective 5/14/2019)

  • 34A-2-203 Payment of premiums for workers' compensation.

  • 34A-2-204 Compliance with chapter -- Notice to employees.

  • 34A-2-205 Notification of workers' compensation insurance coverage to division -- Cancellation requirements -- Penalty for violation.

  • 34A-2-206 Furnishing information to division -- Employers' annual report -- Rights of division -- Examination of employers under oath -- Penalties.

  • 34A-2-207 Noncompliance -- Civil action by employees.

  • 34A-2-208 Right to compensation when employer fails to comply.

  • 34A-2-209 Employer's penalty for violation -- Notice of noncompliance -- Proof required -- Admissible evidence -- Criminal prosecution.

  • 34A-2-210 Power to bring suit for noncompliance.

  • 34A-2-211 Notice of noncompliance to employer -- Enforcement power of division -- Penalty.

  • 34A-2-212 Docketing awards in district court -- Enforcing judgment.

  • 34A-2-213 Coordination of benefits with health benefit plan -- Timely payment of claims.
  • Part 3. Protection of Life, Health, Safety, and Welfare


  • 34A-2-301 Places of employment to be safe -- Willful neglect -- Penalty.

  • 34A-2-302 Employee's willful misconduct -- Penalty.
  • Part 4. Compensation and Benefits


  • 34A-2-401 Compensation for industrial accidents to be paid.

  • 34A-2-402 Mental stress claims.

  • 34A-2-403 Dependents -- Presumption.

  • 34A-2-404 Injuries to minors.

  • 34A-2-405 Employee injured outside state -- Entitled to compensation -- Limitation of time.

  • 34A-2-406 Exemptions from chapter for employees temporarily in state -- Conditions -- Evidence of insurance.

  • 34A-2-407 Reporting of industrial injuries -- Regulation of health care providers. (Effective 5/14/2019)

  • 34A-2-407.5 Rules regarding treatment protocols and determinations of medical necessity -- Contracts.

  • 34A-2-408 Compensation -- None for first three days after injury unless disability extended.

  • 34A-2-409 Average weekly wage -- Basis of computation.

  • 34A-2-410 (Effective 7/1/2018) Temporary disability -- Amount of payments -- State average weekly wage defined.

  • 34A-2-410.5 Employee cooperation with reemployment.

  • 34A-2-411 (Effective 7/1/2018) Temporary partial disability -- Amount of payments.

  • 34A-2-412 (Effective 7/1/2018) Permanent partial disability -- Scale of payments.

  • 34A-2-413 (Effective 7/1/2018) Permanent total disability -- Amount of payments -- Rehabilitation.

  • 34A-2-413.5 Injured worker reemployment.

  • 34A-2-414 Benefits in case of death -- Distribution of award to dependents -- Death of dependents -- Remarriage of surviving spouse.

  • 34A-2-415 Increase of benefits to a dependent -- Effect of death, marriage, majority, or termination of dependency of children -- Death, divorce, or remarriage of spouse.

  • 34A-2-416 Additional benefits in special cases.

  • 34A-2-417 Claims and benefits -- Time limits for filing -- Burden of proof.

  • 34A-2-418 Awards -- Medical, nursing, hospital, and burial expenses -- Artificial means and appliances.

  • 34A-2-419 Agreements in addition to compensation and benefits.

  • 34A-2-420 Continuing jurisdiction of commission -- No authority to change statutes of limitation -- Authority to destroy records -- Interest on award -- Authority to approve final settlement claims.

  • 34A-2-421 Lump-sum payments.

  • 34A-2-422 Compensation exempt from execution -- Transfer of payment rights.

  • 34A-2-423 Survival of claim in case of death.
  • Part 5. Industrial Noise


  • 34A-2-501 Definitions.

  • 34A-2-502 Intensity tests.

  • 34A-2-503 Loss of hearing -- Occupational hearing loss due to noise to be compensated.

  • 34A-2-504 Hearing loss -- Extent of employer's liability.

  • 34A-2-505 Loss of hearing -- Compensation for permanent partial disability.

  • 34A-2-506 Loss of hearing -- Time for filing claim.

  • 34A-2-507 Measuring hearing loss.
  • Part 6. Medical Evaluations


  • 34A-2-601 Medical panel, director, or consultant -- Findings and reports -- Objections to report -- Hearing -- Expenses.

  • 34A-2-602 Physical examinations.

  • 34A-2-603 Autopsy in death cases -- Certified pathologist -- Attending physicians -- Penalty for refusal to permit -- Liability.

  • 34A-2-604 Employee leaving place of treatment.
  • Part 7. Funds


  • 701 Premium assessment restricted account for safety. (Effective 5/14/2019)

  • 34A-2-702 Employers' Reinsurance Fund -- Injury causing death -- Burial expenses -- Payments to dependents.

  • 34A-2-703 Payments from Employers' Reinsurance Fund.

  • 34A-2-704 Uninsured Employers' Fund.

  • 34A-2-704 Uninsured Employers' Fund.

  • 34A-2-705 Industrial Accident Restricted Account.
  • Part 8. Adjudication


  • 34A-2-801 Initiating adjudicative proceedings -- Procedure for review of administrative action.

  • 34A-2-802 Rules of evidence and procedure before commission -- Admissible evidence.

  • 34A-2-803 Violation of judgments, orders, decrees, or provisions of chapter -- Grade of offense.
  • Part 9 Workers' compensation presumption for emergency medical services providers.


  • 34A-2-901. Workers' compensation presumption for emergency medical services providers.

  • 34A-2-902. Workers' compensation claims by emergency medical services providers -- Time limits.

  • 34A-2-903. Failure to be tested -- Time limit for death benefits.

  • 34A-2-904. Volunteer emergency medical services providers -- Workers' compensation premiums.

  • 34A-2-905. Rulemaking authority -- Rebuttable presumption.
  • Part 10. Workers Compensation Coverage Waivers Act.


  • 34A-2-1002 Definitions.
  • Part 11 Presumptions for First Responders


  • 34A-2-1101. Definitions.

  • 34A-2-1102. Workers' compensation presumption for first responders.

  • 34A-2-1103. Workers' compensation claims.

  • 34A-2-1104. Failure to be tested -- Rebuttable presumption.

  • 34A-2-1105. Determining employers of first responders -- Volunteer first responders -- Workers' compensation premiums.

  • 34A-2-1106. Construction -- Rulemaking authority.
  • Chapter 3. Utah Occupational Disease Act


  • 34A-3-101 Title -- Definitions.

  • 34A-3-102 Chapter to be administered by commission -- Exclusive remedy.

  • 34A-3-103 Occupational diseases.

  • 34A-3-104 Employer liability for compensation.

  • 34A-3-105 Last employer liable -- Exception.

  • 34A-3-106 Mental stress claims.

  • 34A-3-107 Benefits -- Disability compensation, death, medical, hospital, and burial expenses -- Procedure and payments.

  • 34A-3-108 Reporting of occupational diseases -- Regulation of health care providers.

  • 34A-3-109 Limitations -- Rights barred if not filed within limits -- Burden of proof.

  • 34A-3-110 Occupational disease aggravated by other diseases.

  • 34A-3-111 Compensation not additional to that provided for accidents.

  • 34A-3-112 Employee's willful misconduct.
  • Chapter 4. Hospital and Medical Service for Disabled Miners


  • 34A-4-101 Who entitled.

  • 34A-4-102 Application for benefits.
  • Chapter 6. Utah Occupational Safety and Health Act


  • 34A-6-101 Title.

  • 34A-6-102 Legislative intent.

  • 34A-6-103 Definitions -- Unincorporated entities -- Joint employers -- Franchisors.

  • 34A-6-104 Administration of chapter -- Selection of administrator -- Powers and duties of commission -- Application of chapter and exceptions.

  • 34A-6-105 Procedures -- Adjudicative proceedings.

  • 34A-6-107 Research and related activities.

  • 34A-6-108 Collection, compilation, and analysis of statistics.

  • 34A-6-109 Educational and training programs.

  • 34A-6-110 Requirements of other laws not limited or repealed -- WorkerÂ’s compensation or rights under other laws with respect to employment injuries not affected.

  • 34A-6-111 Federal aid.

  • 34A-6-201 Duties of employers and employees.

  • 34A-6-202 Standards -- Procedure for issuance, modification, or revocation by division -- Emergency temporary standard -- Variances from standards -- Statement of reasons for administratorÂ’s actions -- Judicial review -- Priority for establishing standards.

  • 34A-6-203 Discharge or retaliation against employee prohibited.

  • 34A-6-204 State agencies and political subdivisions to establish programs.

  • 34A-6-301 Inspection and investigation of workplace, worker injury, illness, or complaint -- Warrants -- Attendance of witnesses -- Recordkeeping by employers -- Employer and employee representatives -- Request for inspection -- Compilation and publication of reports and information -- Rules.

  • 34A-6-302 Citations issued by division -- Grounds -- Posting -- Limitation.

  • 34A-6-303 Enforcement procedures -- Notification to employer of proposed assessment -- Notification to employer of failure to correct violation -- Contest by employer of citation or proposed assessment -- Procedure.

  • 34A-6-304 Procedure for review of order entered by administrative law judge -- Continuing jurisdiction of commission.

  • 34A-6-305 Injunction proceedings.

  • 34A-6-306 Disclosure of trade secrets -- Protective orders.

  • 34A-6-307 Civil and criminal penalties.




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