What are the Rules when ‘Criminally Injurious Conduct’ is Involved in Idaho?

Compliance Corner

Boise, ID (WorkersCompensation.com) -- If you're just digging into workers' compensation in the State of Idaho, a good source to turn to is Simply Research, where you can start with some basics, such as the following information regarding a worker who was subjected "criminally injurious conduct," which was recently updated.

Disbursements of Compensation

Eligible payments shall be made directly to the provider of the service unless the claimant has already paid the provider. If the claimant has already paid the provider, payment shall be made to the claimant.

Wage Loss Benefits

“Wages received at the time of the criminally injurious conduct” shall be the claimant’s gross weekly wage.

If the wages were fixed by the hour, and the claimant worked or was scheduled to work the same number of hours each week, the weekly wage shall be the hourly rate times the number of hours that the claimant worked or was scheduled to work each week.

If the wages were fixed by the hour and the claimant did not work the same number of hours each week, or if the claimant was paid on a piecework or commission basis, the weekly wage shall be computed by averaging the amounts that the claimant was paid during his last four completed pay periods prior to the criminally injurious conduct and converting that amount to a weekly basis provided that, if the claimant was employed for less than four pay periods before the criminally injurious conduct, the average shall be computed based upon the time period that they worked.

Weekly Compensation Benefits if Claimant Employable but not Employed

If at the time of the criminally injurious conduct the claimant was receiving unemployment benefits and as a result of that conduct the claimant becomes ineligible for those benefits, the claimant’s weekly benefits under the Crime Victim’s Compensation Act shall be the lesser of $150 or their weekly benefit amount under the Employment Security Law.

If at the time of the criminally injurious conduct the claimant was unemployed, but scheduled to begin employment on a date certain and if they were unable to work for one week as a result of that conduct, weekly benefits under the Crime Victim’s Compensation Act shall be the lesser of $150 or two-thirds of the amount that they would have earned at their scheduled employment, and those benefits shall be payable beginning on the date that their employment was scheduled to begin.

If prior to the criminally injurious conduct the claimant was performing necessary household duties that they are disabled from performing as a result of that conduct and it is necessary to employ a person who does not reside in the claimant’s house to perform those duties, the claimant shall receive weekly benefits under the Crime Victim’s Compensation Act equal to the amount paid to the person so employed, but not exceeding $150 per week.

In other circumstances, the Commission may award an amount it deems appropriate.

Treating Physician

A claimant may choose their own treating physician.

Overpayment

The Commission may reduce future payments by an amount equal to the overpayment or request a refund when overpayments are made to either the claimant or the provider.

Reimbursement for Transportation Expenses

If the claimant utilizes a private vehicle, reimbursement shall be at the mileage rate allowed by the State Board of Examiners for state employees. Reimbursement is limited to one round trip per day. The claimant shall not be reimbursed for the first 15 miles of any round trip, nor for traveling any round trip of 15 miles or less. Such distance shall be calculated by the shortest practical route of travel. The mileage reimbursement amount shall be credited to the medical benefit.

Payment of Bills

Bills for treatment and sexual assault forensic examinations must be submitted within three years from the date of treatment or the date of eligibility, whichever is later, to be compensable. The time for submission may be extended upon Commission approval. For the purpose of dispersing payment, the claimant may be required to provide certain documentation, including a W-9 form.

Right to Recover

The Commission’s right to recover its full economic loss under a restitution order as a victim under Section 19-5304, Idaho Code, is independent from any other legal remedy it may have, including its statutory right to subrogation under Section 72-1023, Idaho Code, and is not barred by civil settlements entered into by other victims.

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