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Download a copy, print it, send it by email, or mail it via USPS—whatever works best for your next step.

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Small business owners, or policyholders, who wonder “should I file a workers' comp claim?” can rely on a simple rule of thumb: any worker injury that requires medical help beyond self-treating first-aid is an injury that should be filed.
How do you claim? Inform your supervisor or employer as soon as possible (verbally or in writing). Make note of anyone who witnessed the accident. The form that needs to be completed is WCL 2: Notice of Accident and Claim for Compensation.
Sole Proprietorships with no employee other than the owner. Partnerships with no employees other than the partners. Limited Liability Companies are treated as Partnerships and, as such, the members of an LLC may be eligible for a waiver. Director and/or officers of a corporation.
How Do You Get Workers' Comp Exempt? To get an exemption for workers' compensation coverage, your business must go through your state's screening process. You may have to apply for or renew your exemption by filing a “Notice of Election to be Exempt From Workers' Compensation” with your local workers' comp office.
(180 day reporting requirement of employees, link) If the injury or illness is beyond first-aid or a medical bill is generated for the medical service, the employer must report a First Report of Injury or Occupational Disease (Form 122) within seven days of being informed of the incident.
In general, ERISA does not cover plans established or maintained by governmental entities, churches for their employees, or plans which are maintained solely to comply with applicable workers compensation, unemployment or disability laws.
To apply for workers' compensation in Utah, report your injury to your employer within 180 days and submit a Worker's Compensation Claim Form (Form 122) to the Utah Labor Commission. Ensure your healthcare provider submits a Medical Report (Form 123) to support your claim.
A claimant must pursue at least one ERISA appeal before filing suit. This is known as the exhaustion of administrative remedies doctrine. A claimant can typically file a lawsuit after the first appeal, although some plans do require a mandatory second appeal before litigation can commence.
Mediation or Settlement. If an ERISA settlement is reached, this means both sides (after offers, counter offers, and much discussion) ultimately agree on a settlement amount. You cannot be forced or manipulated into settling your claim, and either party may walk away from the settlement discussion at any time.
An ERISA claim refers to a legal action taken under the Employee Retirement Income Security Act (ERISA) of 1974. This law protects employees' rights to their benefits, such as retirement and health plans, ensuring fair treatment by employers.