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Utah Free Printable Labor Law Posters Posters Workers' Compensation Notice for the State of Utah Poster Required

 Workers' Compensation Notice for the State of Utah PDF

The Workers' Compensation Notice for the State of Utah is a labor law posters poster by the Utah Labor Commission. This is a mandatory posting for all employers in Utah, and businesses who fail to comply may be subject to fines or sanctions.

This poster must be posted in a conspicuous place by all employers so that all employees can see it. This poster describes how an employee can qualify for workers' compensation if injured when at work, how to report an accident at work, how to get workers' compensation, and what happens to those who commit fraud.


UT All-In-One Labor Poster: Instead of printing out dozens of posters, employers can also purchase an all-in-one poster that covers both Utah and Federal poster requirements by clicking here .

WORKERS’ COMPENSATION NOTICE	 	
Employer:	 	 	
has complied with the provisions of the Workers’ Compensation Act (§34A	-2-101, Utah Code Annotated), the 	
Utah Occupational Disease Act (§34A	-3-101, Utah Code Annotated), and the rules of the Labor Commission by 	
insuring the liability to pay the compensation and other benefits provided by said Acts	 through:	 	
Insurance	 Company:	   	 	
Policy	 Number:	 ______________________________________________________________	 	
Address for the above insurance	 company: 	  	 	
Telephone	 number: 	  	 	
  Check	 here	 if the	 employer	 has	 been	 authorized	 by	 the	 Division	 of Industrial	 Accidents	 to self	-insure	 and	 directly	 pay 	
workers’ compensation	 benefits.	 	
WORKERS’ COMPENSATION	 	
Workers’ Compensation is insurance which pays medical expenses and 	helps offset lost wages for employees with work	- 	
related injuries or illnesses. If you have an on	-the	-job injury or occupational disease, it may pay for: hospital and medical bills, 	
time lost from work, permanent loss of body function, prosthetic devices, 	and burial and dependent benefits in case of death.	 	 	
HOW TO REPORT AN ACCIDENT	 	
1. Report the injury, no matter how slight, immediately to your 
supervisor. You may lose your rights if your injury is not 
reported within 180 days of the injury or wor	k-related	 illness.	 	
2. Ask your employer where you should go for treatment. 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.	 	
 
3. Tell the doctor 	HOW, WHEN and WHERE 	the 	accident	 	
happened. The doctor will fill out a 	physician’s initial 	report 	
form. A copy of the report is given to you and copies of the 
report are sent to the insurance company and the Labor 
Commission within seven (7) days of your doctor	 visit.	 	
 
4. Your employ	er shall fill out the employer’s first report of 	
injury form. A copy of this report is sent to the insurance	 	
company within seven (7) days of 	the accident. The insurance 	
company will report the injury to the Labor	 Commission.	 	
HOW TO START COMPENSATION	 	
1. Ask	 your employer which insurance company pays	 workers’ 	
compensation benefits for the company.	 	
 
2. Ask your employer to report the accident to the	 insurance 	
company and give you the claim	 number.	 	
 
3. Call the insurance company and ask them to start your 
workers’ 	compensation benefits. The insurance company 	
will require the employer’s report, the physician’s report, 
and may ask you to fill out a request for compensation. 
Cooperate with the adjuster’s investigation of the	 injury.	 	
 
4. Ask your doctor to send medical rep	orts to the insurance 	
company, including the work status	 statement.	 	
REHABILITATION	 	
If you cannot return to work, you may be eligible for a 
rehabilitation program. Contact the insurance company 
listed above or the Utah State Office of Rehabilitation	. 	
 	
FRAUD STATEMENT: “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 fraudu	lent	 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.”	 	
 
 	
 	
 	
160 East 300 South 3	rd Floor P.O. Box 146610 Salt Lake City, Utah 84114	-6610	 	
Office: (801)	-530	-6800 Fax: (801)	-530	-6804 Toll Free: (800)	-530	-5090 	www.laborcommission.utah.gov	 	
 
If you want copy of an 	Employee's Guide to Workers' Compensation 	booklet or have questions, contact the 	
Labor Commission or go to the webpage at 	www.laborcommission.utah.gov	. 	
Note:	 This	 notice	 must	 be	 posted	 and	 kept	 continuously	 in public	 and	 conspicuous	 places	 in the	 office,	 shop	 or 	
place	 of	 business	 of	 the	 employer	 as per	 §34A	-2-204	 and	 §34A	-2-104.5,	 Utah	 Code	 Annotated.	 	
 	
Rev 10/2019

Other Utah Labor Law Posters 4 PDFS

There are an additional five optional and mandatory Utah labor law posters that may be relevant to your business. Be sure to also print all relevant state labor law posters, as well as all mandatory federal labor law posters.


View all 6 Utah labor law posters


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Instead of printing out pages of mandatory Utah and Federal labor law posters, you can purchase a professional, laminated all-in-one labor law poster that guarantees compliance with all Utah and federal posting requirements. Fully updated for 2020!

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URGENT: Mandatory Coronavirus Paid Leave Poster (FFCRA)

As of April 1 2020, all employers in the United States with less than 500 employees MUST display or digitally distribute a Families First Coronavirus Response Act paid leave poster.

This poster describes new laws that mandate paid leave for employees affected by the COVID-19 / Coronavirus epidemic.

Purchase Bilingual Laminated Poster Print Free Poster
Official CDC Coronavirus Safety Posters:

The CDC has published several optional Coronavirus safety posters that are recommended for workplaces open during the pandemic.

Purchase Laminated Multi-Poster COVID-19 Notice Print Free COVID-19 Posters

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If your workplace or store is open to the public, you may be required by your state or locality to display adequate social distancing notices and markers. These professional floor decals can be used in store aisles, checkout lines, or high-traffic workplace areas.

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While we do our best to keep our list of Utah labor law posters up to date and complete, we cannot be held liable for errors or omissions. Is the poster on this page out-of-date or not working? Please let us know and we will fix it ASAP.

** This Document Provided By LaborPosters.org **
Source: http://www.laborposters.org/utah/345-utah-workers-compensation-poster.htm