Wyoming Notification of Workers' Compensation Injury - Illness

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Multi-State
Control #:
US-294EM
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Word; 
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Description

This form is used to inform a worker's compensation firm of an injury or illness of sustained by an employee while on duty.

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FAQ

Workman's compensation insurance provides coverage for the costs of necessary treatments if your employee gets sick due to a work-related condition or incident. In some cases work-related injuries may be severe enough to cause temporary or permanent disability.

How does workers' comp work in Wyoming? The goal of workers' compensation insurance is to help employees recover from a work injury and return to their job. It covers the cost of medical bills related to a workplace injury or occupational disease, and also covers part of their lost wages.

Note: Wyoming Workers' Safety and Compensation is a monopolistic state fund with a state-controlled workers compensation plan that prohibits private insurers from competitively writing mandatory coverage. NCCI collects the following types of policy data: Voluntary Compensation (VC) Employers Liability (EL)

The 5 Most Common Workers' Compensation InjuriesStrains (30.06% of workers' compensation claims)Contusions (20.83% of claims)Lacerations (11.79% of claims)Sprains (8.85% of claims)Punctures (5.50% of claims)

An injured worker's wage paid is 66 2/3% of actual wage. The weekly payment has no minimum. The weekly maximum is $779, 100% of the Wyoming state average weekly wage. Maximum period of payments is 24 months.

Your employer is legally responsible for reporting your injury on duty to the Compensation Fund within seven (7) days of receiving notice from you and within fourteen (14) days when it is an occupational disease as well as submitting the necessary forms and documents.

The DPSA provides employees with injury-on-duty leave with pay when an employee is unable to work, due to an accident or illness directly related to their job or worksite. Injury- on-duty leave without pay is provided to cover extended periods of absence due to injury.

I had an accident at work. How do I file a workers compensation claim in my state? You must report your injury to your employer within 72 hours of the accident causing your injury and to the Workers' Compensation Division of Wyoming within 10 days.

Workers' Compensation Insurance in Wyoming can be purchased from private insurance companies authorized by the state to provide coverage. The Assigned Risk Pool, or an alternate State Insurance Fund, is available for businesses that are unable to find coverage from a private company.

There are five basic types of workers' compensation benefits that include medical care, temporary disability benefits, permanent disability benefits, supplemental job displacement benefits, and death benefits. Injured workers may be entitled to one or more of these benefits.

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Wyoming Notification of Workers' Compensation Injury - Illness