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

The Workers' Compensation Notice for the State of Utah is a workers compensation law 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 .

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Revised May 2017 
WORKERS’ COMPENSATION NOTICE 
 
Employer: __________________________________________________ ___________________________ 
has complied with the provisions of the Workers’ Co mpensation Act (§34A-2-101, Utah Code Annotated), t he 
Utah Occupational Disease Act (§34A-3-101, Utah Cod e 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 medic al expenses and helps offset lost wages for employees with work-
related injuries or illnesses. If you have an on-th e-job injury or occupational disease, it may pay fo r: hospital and medical bills, 
time lost from work, permanent loss of body functio n, prosthetic devices, and burial and dependent benefits in case of death. 
 
HOW TO REPORT AN ACCIDENT 
1.  Report the injury, no matter how slight, immediatel y to your 
supervisor. You may lose your rights if your injury  is not 
reported within 180 days of the injury or work-rela ted illness. 
 
2.  Ask your employer where you should go for treatment . If 
your employer has a first-aid room or company desig nated 
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 in itial report 
form. A copy of the report is given to you and copi es of the 
report are sent to the insurance company and the La bor 
Commission within seven (7) days of your doctor vis it.
 
 
4.  Your employer shall fill out the employer’s first r eport of 
injury form. A copy of this report is sent to the i nsurance 
company within seven (7) days of  the accident. The insurance 
company will report the injury to the Labor Commiss ion.
 
HOW TO START COMPENSATION 
1. Ask your employer which insurance company pays work ers’ 
compensation benefits for the company.
 
 
2.  Ask your employer to report the accident to the ins urance 
company and give you the claim number.  
 
3.  Call the insurance company and ask them to start yo ur 
workers’ compensation benefits. The insurance compa ny 
will require the employer’s report, the physician’s  report, 
and may ask you to fill out a request for compensat ion. 
Cooperate with the adjuster’s investigation of the  injury.  
 
4.  Ask your doctor to send medical reports to the insu rance 
company, including the work status statement. 
REHABILITATION 
    If you cannot return to work, you may be eligible  for a 
rehabilitation program. Contact the insurance compa ny 
listed above or the Utah State Office of Rehabilita tion
. 
 
FRAUD STATEMENT: “Any person who knowingly presents false or fraudu lent underwriting 
information, files or causes to be filed a false or  fraudulent claim for disability compensation or me dical
 
benefits, or submits a false or fraudulent report or billing for health care fees or other professional services is 
guilty of a crime and may be subject to fines and c onfinement in state prison.”
 
 
STATE OF UTAH -  LABOR COMMISSION
 
160 EAST 300 SOUTH – 3rd FLOOR, PO BOX 146610 
SALT LAKE CITY, UT  84114-6610 
Phone: (801) 530-6800  Toll Free: (800)530-5090   Email: [email protected] 
 
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 continuou sly 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.

Other Utah Labor Law Posters 5 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.

Poster Name Poster Type
Mandatory Workers' Compensation Notice for the State of Utah Workers Compensation Law
Mandatory Unemployment Insurance Notice to Workers Unemployment Law
Mandatory Workplace Safety and Health in the State of Utah Job Safety Law
Mandatory Workers' Compensation Notice for the State of Utah (Spanish) Workers Compensation Law
Mandatory Unemployment Insurance Notice to Workers (Spanish) Unemployment Law

View all 6 Utah labor law posters


Get a 2018 Utah all-in-one labor law poster

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 2018!

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Disclaimer:

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