reglab/statecodes huggingface dataset:
Wyoming Administrative Code › Agency 053 - Workforce Services, Department of › Sub-Agency 0021 - Workers' Compensation Division › Chapter 2 - EMPLOYER COVERAGE, COMPLIANCE, AND DISCOUNT PROGRAMS › Section 2-1 - General

Current through July 13, 2024
(a) Application for Determination of
				Coverage. No employer subject to the Wyoming Workers' Compensation Act, Wyoming
				Statute § 27-14-101, et seq., shall commence business or engage in any
				work in Wyoming without applying for coverage and receiving a statement of
				coverage from the Division. The application shall supply such information as
				the Division requests regarding the nature, location, extent and duration of
				the intended work. Employers determined by the Division to be non-resident
				employers must comply with the bond or security requirements of W.S.
				§§ 27-1-106 and 27-14-302; a non-resident employer is defined in W.S.
				§ 27-14-102(a)(xiii).
(b)
				Proof of Coverage (POC) Certificate.
(i) For
				the purposes of W.S. § 27-14-306 a POC certificate shall further include
				all of the following:
(A) The applicable
				time-frame of the certificate; and
(B) A statement as to the applicability of
				insurance coverage for employees of the nonresident employer, to specifically
				address employees that are Wyoming residents; and
(C) A list of all employees who are insured
				under the proof of coverage certificate.
Wyoming Administrative Code › Agency 053 - Workforce Services, Department of › Sub-Agency 0021 - Workers' Compensation Division › Chapter 2 - EMPLOYER COVERAGE, COMPLIANCE, AND DISCOUNT PROGRAMS › Section 2-2 - Successor Employer

Current through July 13, 2024
(a) For purposes of
				W.S. § 27-14-207(b), "account" includes: premium rate, experience
				modification rating, premium credit program, safety discount program, drug and
				alcohol testing discount program, health and safety consultation discount
				program, and outstanding accounts receivable including past due or delinquent
				premium, interest, penalties, small employer group credit, and claims
				reimbursement, until recalculated for the subsequent rate year.
(b) For purposes of W.S. § 27-14-207(c),
				"account" includes: premium rate, experience modification rating, premium
				credit program, safety discount program, drug and alcohol testing discount
				program, health and safety consultation discount program, and small employer
				group credit, until recalculated for the subsequent rate year.
Wyoming Administrative Code › Agency 053 - Workforce Services, Department of › Sub-Agency 0021 - Workers' Compensation Division › Chapter 2 - EMPLOYER COVERAGE, COMPLIANCE, AND DISCOUNT PROGRAMS › Section 2-3 - Experience Rating

Current through July 13, 2024
(a) One (1)
				experience modification rating (EMR) shall be assigned to each employer number
				for those eligible employers under the Act. An employer who elects to establish
				a separate employer number for each separate legal entity of the employer's
				businesses shall be assigned an experience rating for each employer
				number.
(b) An employer's EMR is
				computed by using three (3) years claims experience [or maximum available
				portions of three (3) years] for each eligible employer.
(i) Private sector employers will receive an
				EMR based on three (3) years claims experience effective January 1 of their
				fifth (5th) calendar year.
(ii)
				Public sector employers will receive an EMR based on three (3) years claims
				experience effective July 1 of their sixth (6th) fiscal year.
Wyoming Administrative Code › Agency 053 - Workforce Services, Department of › Sub-Agency 0021 - Workers' Compensation Division › Chapter 2 - EMPLOYER COVERAGE, COMPLIANCE, AND DISCOUNT PROGRAMS › Section 2-4 - Classifications

Current through July 13, 2024
The employer shall provide a true and accurate description of
				  its business operations prior to commencing operations, which require coverage
				  under the Act for eligible workers in the State of Wyoming. The employer is
				  required to notify the Division in writing of any change in business
				  operations, which affect the industrial classification of the business for
				  purposes of workers' compensation. The employer shall grant reasonable access
				  to the Division's representative to verify information provided by the employer
				  with respect to the business operations.
(a) Classification Procedures. The Division
				will assign an industrial classification or classifications pursuant to the
				North American Industry Classification System (NAICS) codes provided by the
				Federal Bureau of Labor Statistics via the Internet or in a printed manual
				dated 2002 or later. The industrial classification(s) assigned will be that
				which best describes the primary business of the employer. Businesses conducted
				at one or more locations which normally prevail in the primary industrial
				classification will not be assigned separate classifications for supporting
				operations, with certain specific standard exceptions for clerical office
				occupations, inside sales occupations, outside sales occupations, or temporary
				help occupations.
(b)
				Classification Revisions. The Division shall correct industrial classifications
				which it determines to be incorrect. The Division shall give the employer
				written notification of any change in industrial classification and such
				changes shall become effective on the first day of the reporting period
				following the reporting period in which the Division gives written
				notification.
(c) Contesting
				Classification. Any employer may contest the industrial classification assigned
				by the Division. Contest shall be made by written objection to the Division
				within thirty (30) days of the employer's notification of the classification
				assigned by the Division. The Division shall resolve the matter
				administratively within forty-five (45) days or refer the objection to an
				independent hearing officer appointed for such purpose, pursuant to the Wyoming
				Administrative Procedure Act.
Wyoming Administrative Code › Agency 053 - Workforce Services, Department of › Sub-Agency 0021 - Workers' Compensation Division › Chapter 2 - EMPLOYER COVERAGE, COMPLIANCE, AND DISCOUNT PROGRAMS › Section 2-5 - Audits

Current through July 13, 2024
Investigation and examination of an employer's records may be
				  conducted in accordance with W.S. § 27-14-803. The Division may examine
				  books, accounts, payrolls or the business operation of any employer to
				  determine if the employer has engaged in activity in violation of the Act, to
				  verify information provided to the Division by the employer, and for the
				  administration of this Act. The employer shall grant reasonable access to the
				  Division's representative to examine information pertinent to the employers'
				  business operations.
(a) Audit
				Procedures. The Division's representative will conduct an audit and review the
				preliminary findings with the employer. These audit findings will then undergo
				final review by the Division with correction of any findings, which it
				determines to be incorrect. The Division will then issue a Final Audit
				Determination Notice to the employer upon completion of the audit.
(i) Any unreported payments made to any
				individual, as found in an audit of an employer's records, shall be presumed to
				be unreported gross earnings unless documentation is provided by the employer
				that the individual meets the statutory requirements of W.S. § 2714-
				102(a)(xxiii) as an independent contractor. The burden is upon the employer to
				provide such documentation.
Wyoming Administrative Code › Agency 053 - Workforce Services, Department of › Sub-Agency 0021 - Workers' Compensation Division › Chapter 2 - EMPLOYER COVERAGE, COMPLIANCE, AND DISCOUNT PROGRAMS › Section 2-6 - Non-Resident Employers' Surety Bond

Current through July 13, 2024
(a) Pursuant to
				W.S. § 27-1-106, all firms, corporations or employers of any kind who are
				non-resident employers as defined in W.S. § 27-14-102(a)(xiii) and expect
				to pay wages above the set statutory threshold in the state of Wyoming, are
				required to file a surety bond or other security with the Division.
(b) Non-resident employer definitions for:
				Individual, Sole Proprietor, Limited Liability Company (LLC), Limited Liability
				Partnership (LLP), Limited Partnership (LP), and/or Corporations:
(i) Employer and/or Individual or Sole
				Proprietor is not domiciled in Wyoming for at least twelve (12) months;
				or
(ii) If any partner or LLC, LLP
				or LP member is not domiciled in Wyoming for at least twelve (12) months;
				or
(iii) If more than three fourths
				(3/4) of the capital stock of the business is owned by individuals not
				domiciled in Wyoming for at least twelve (12) months (Corporations).
Wyoming Administrative Code › Agency 053 - Workforce Services, Department of › Sub-Agency 0021 - Workers' Compensation Division › Chapter 2 - EMPLOYER COVERAGE, COMPLIANCE, AND DISCOUNT PROGRAMS › Section 2-7 - Deductible Program

Current through July 13, 2024
(a) Pursuant to
				W.S. § 27-14-201(t)(i), an employer may apply to participate in a
				deductible program. Employers must apply for the deductible program in writing
				on a form prescribed by the Division. Terms of the deductible program shall be
				defined by contract entered into between the employer and Division.
(b) The Division may require applying
				employers to undergo a financial audit to ensure financial stability. The audit
				may include a credit check and review of company financial reports. The
				Division shall analyze each applicant based on risk analysis and sound business
				practices. The Division may refuse any applicant into the deductible program if
				it determines that the proposed contract does not represent a sound business
				practice or decision.
(c) For any
				employer enrolled in the deductible program, the Division will process and pay
				claims in accordance with the Act. The employer shall reimburse the Division
				for all costs paid by the Division on individual claims up to the amount of the
				contractually agreed deductible.
(d) The deductible levels available are:
				$1,000.00, $5,000.00, $10,000.00, $25,000.00, $50,000.00, $75,000.00, or
				$100,000.00. The maximum deductible level offered to an employer by the
				Division shall not be more than fifty percent (50%) of the employer's standard
				premium.
(e) The amount of the
				contractually agreed upon deductible will be applied to the employer's industry
				base rate before any discounts under, Sections 8-10, of this chapter are
				calculated and applied.
Wyoming Administrative Code › Agency 053 - Workforce Services, Department of › Sub-Agency 0021 - Workers' Compensation Division › Chapter 2 - EMPLOYER COVERAGE, COMPLIANCE, AND DISCOUNT PROGRAMS › Section 2-10 - Health and Safety Consultation Employer Discount Program

Current through July 13, 2024
(a) Pursuant to W.S. § 27-14-201(o),
				employers may receive a premium base rate discount, as determined through the
				Division's premium rate setting process for its employment classification, by
				participating in a health and safety consultation program.
(b) Applications to participate in this
				program may be submitted to the Division at any time and upon approval premium
				base rate discounts shall be implemented in the subsequent calendar
				quarter.
(c) Employers must have at
				least one (1) employee to participate in this program, establish and maintain
				certificates of good standing with Wyoming Workers' Compensation, Unemployment
				Insurance, and the Secretary of State. Certificates of good standing shall be
				reviewed on an annual basis to ensure compliance. If certificates of good
				standing cannot be established and maintained by the employer, that employer
				shall be disqualified from this program until such time as the employer
				reapplies for the program and all program requirements have been met.
(d) Pursuant to W. S. § 27-14-803 and in
				accordance with Section 5 of this chapter the Division may investigate and
				examine the employer's documentation as pertains to compliance with its
				approved health and consultation safety program(s). If the Division finds the
				employer to be in noncompliance after reviewing the relevant documentation,
				participation in the health and safety consultation employer discount program
				may be revoked or reduced to a lower tier.
(i)
				If an audit is conducted and the employer is found to be out of compliance,
				and/or an employer has a workplace related fatality, and/or an employer has an
				inspection where they are issued a repeat serious or willful citation during
				any time while receiving this discount they shall be immediately removed from
				the program until such time that they have abated all hazards and they have
				completed any other required obligations with state agencies. Upon completion
				of abatement and obligations the employer can reapply for the discount and all
				program requirements have been met.
Wyoming Administrative Code › Agency 053 - Workforce Services, Department of › Sub-Agency 0021 - Workers' Compensation Division › Chapter 2 - EMPLOYER COVERAGE, COMPLIANCE, AND DISCOUNT PROGRAMS › Section 2-11 - Specifically Enumerated Volunteers; Elected, County or Local Officials; School-to-Careers Program

Current through July 13, 2024
(a) A governing
				body's election of coverage as defined in W.S. § 27-14-108(e)(ix), shall
				be on forms provided by the Division containing information as requested by the
				Division.
(b) The school-to-careers
				program applies to those employers and participants who are not eligible for
				coverage under a qualifying employer-employee relationship. Participants under
				this program are not eligible for temporary total wage benefits under the
				Act.
(c) If the school district or
				community college district chooses to make the reports and payments for the
				employer, the wage calculation will be based on the presumed pay of the
				participant. The premium rate used to calculate the payment will be that of the
				specific school district or community college district making the report. All
				claims will be reported and processed against the reporting school district or
				community college district.
(d) If
				an employer-employee relationship exists, the participant will be treated as
				any other employee under the Act.
Wyoming Administrative Code › Agency 053 - Workforce Services, Department of › Sub-Agency 0021 - Workers' Compensation Division › Chapter 2 - EMPLOYER COVERAGE, COMPLIANCE, AND DISCOUNT PROGRAMS › Section 2-12 - Student Learner Agreements

Current through July 13, 2024
(a) Pursuant to
				W.S. § 27-14-110, a Wyoming school district, community college or
				technical school and an employer may enter into a student learner agreement.
				Student learner agreements are for students ages sixteen (16) to eighteen (18)
				years of age, who will be engaged in learning an extra-hazardous occupation. A
				copy of the agreement shall be submitted by the employer to the division prior
				to the first day of employment/learning. Employers must apply for the student
				learner agreement on a form prescribed by the division.
(i) The division requires that employers who
				employ a student learner follow the requirements laid out by the Child Labor
				Provision for Nonagricultural Occupations under the Fair Labor Standards Act.
(A) Eligible Hazardous Occupations for youth
				student learners aged 16-17 are limited to those occupations outlined by the
				U.S. Department of Labor, Wage & Hour Division's website:
https://www.dol.gov/agencies/whd/fact-sheets/43-child-labor-non-agriculture
Wyoming Administrative Code › Agency 053 - Workforce Services, Department of › Sub-Agency 0021 - Workers' Compensation Division › Chapter 2 - EMPLOYER COVERAGE, COMPLIANCE, AND DISCOUNT PROGRAMS › Section 2-13 - Exclusions

Current through July 13, 2024
(a) Private Schools. Any private entity
				classified under NAICS 519 and 611 Education Services, is excluded from
				coverage under the Act, unless an election of coverage is made as provided in
				W.S. § 27-14-108(j).
Wyoming Administrative Code › Agency 053 - Workforce Services, Department of › Sub-Agency 0021 - Workers' Compensation Division › Chapter 2 - EMPLOYER COVERAGE, COMPLIANCE, AND DISCOUNT PROGRAMS › Section 2-14 - Concurrent Coverage

Current through July 13, 2024
(a) Employers
				covered under the Act having employees working in a state that requires
				workers' compensation coverage in addition to the employer's Wyoming coverage,
				must submit written proof of coverage from the other state. The employer may
				then submit its payroll report, which lists only the wages paid for hours
				worked in Wyoming. The proof of coverage shall be submitted on forms required
				by the Division. When the Division receives proof of coverage, it will not
				require premium payments and coverage in Wyoming during the time the employee
				is working and being covered in another state.
(b) The employer and employee must notify the
				Division of any claim for benefits filed in another state for any injury
				reported in Wyoming. An employer's experience rating to be computed by using
				three (3) years (or maximum available portions thereof) of claims experience
				for each eligible employer.
(c)
				Three (3) years claims experience shall begin July 1 of the fifth (5th)
				calendar year prior to the rating year and end June 30 of the second (2nd)
				calendar year prior to the rating year.
Wyoming Administrative Code › Agency 053 - Workforce Services, Department of › Sub-Agency 0021 - Workers' Compensation Division › Chapter 2 - EMPLOYER COVERAGE, COMPLIANCE, AND DISCOUNT PROGRAMS › Section 2-15 - Employer Reimbursements or Allowances for Employee Business Expenses

Current through July 13, 2024
(a) Employer
				reimbursements or allowances of employee business expenses are not considered
				gross earnings if the employer has appropriate records to substantiate that an
				"accountable plan" has been established and implemented as follows:
(i) There must be a business connection for
				expenses incurred while performing services as an employee, officer or member
				of the employer.
(ii) The expense
				must be reasonable.
(iii) There
				must be actual accounting for the expense, by the employer and the employee,
				officer or member.
(A) For travel expenses
				reimbursed at established federal per diem rates, documentation of the trip
				will be considered actual accounting.
(B) For business entities with federally
				recognized expense allowances, the U. S. Treasury allowance will be considered
				actual accounting.
(iv)
				All excess reimbursement or allowance must be repaid by the employee, officer
				or member to the employer within one-hundred and twenty (120) days after the
				expense was paid or incurred.
Wyoming Administrative Code › Agency 053 - Workforce Services, Department of › Sub-Agency 0021 - Workers' Compensation Division › Chapter 3 - FAILURE OF EMPLOYER TO COMPLY › Section 3-1 - Delinquency - Case Liability

Current through July 13, 2024
(a) Employers will
				be charged for all injury case costs if the employers' account is in
				non-compliance in the following circumstances:
(i) Delinquent During the Reporting Period
				the Injury Occurred. Employers whose accounts are in a delinquent status for
				the reporting period during which an injury occurred will be charged case costs
				for the life of any such injury.
(ii) Injured Worker not Reported. Employers
				who omit the name of any injured worker on the Division's report form
				corresponding to the month of injury and fail to pay premium on that injured
				worker's earnings will be charged case costs for the life of any such
				injury.
(iii) No Account on Date of
				Injury. Employers who fail to establish an account, or fail to reactivate an
				inactive account on any date of injury will be charged case costs for the life
				of any such injury.
Wyoming Administrative Code › Agency 053 - Workforce Services, Department of › Sub-Agency 0021 - Workers' Compensation Division › Chapter 3 - FAILURE OF EMPLOYER TO COMPLY › Section 3-2 - Civil Liability

Current through July 13, 2024
(a) When a payroll
				report or payment of premium is past due, pursuant to Wyoming Statutes §
									
										27-14-202(a), the Division
				shall send to the employer a notice that the report and/or premium is past due
				and that the employer's account will become delinquent if the required report
				and payment are not postmarked within 30 days of the date due. When an
				employer's account becomes delinquent, the Division shall send to the employer
				a notice of delinquency.
(b) For
				purposes of all penalties and rights of action under the Act, an employer shall
				be considered delinquent if a payroll report or any payment required by the Act
				is not postmarked within 30 days of the due date.
(c) Applying Payments. When an employer makes
				a payment to the Division, the Division shall apply it to the oldest premium or
				interest owed by the employer unless the employer has specified in writing that
				the payment should be applied to a particular portion of the employer's debt.
				However, bankruptcy laws or reorganization plans take priority over the
				employer's written specification.
Wyoming Administrative Code › Agency 053 - Workforce Services, Department of › Sub-Agency 0021 - Workers' Compensation Division › Chapter 3 - FAILURE OF EMPLOYER TO COMPLY › Section 3-3 - Cancellation of Optional Coverage

Current through July 13, 2024
Coverage for an employer with optional coverage will be
				  terminated if the account remains delinquent 30 days following notification by
				  certified mail to the employer that the employer has been delinquent in
				  reporting of payment of premium for one calendar quarter. The employer remains
				  liable for the unpaid premium and case cost reimbursement, as applicable,
				  through the date of termination. Following termination under this section, the
				  employer shall not be eligible for reinstatement of optional coverage for a
				  period of six months.
Wyoming Administrative Code › Agency 053 - Workforce Services, Department of › Sub-Agency 0021 - Workers' Compensation Division › Chapter 3 - FAILURE OF EMPLOYER TO COMPLY › Section 3-5 - Waiver and Settlement - Tax

Current through July 13, 2024
Upon good and sufficient cause, the Administrator of the
				  Workers' Compensation Division may waive, compromise or otherwise settle any
				  amount owed to the Division by an employer.
Wyoming Administrative Code › Agency 053 - Workforce Services, Department of › Sub-Agency 0021 - Workers' Compensation Division › Chapter 3 - FAILURE OF EMPLOYER TO COMPLY › Section 3-6 - Out of State Employers - Experience Modification Rating

Current through July 13, 2024
If an employer who meets the criteria under Wyoming Statutes
				  §
									
										27-14-207(h) refuses or
				  fails to provide the Division with the experience history from their insurance
				  company, that employer will be assigned the maximum experience modification
				  rating (EMR) of 1.85.
Wyoming Administrative Code › Agency 053 - Workforce Services, Department of › Sub-Agency 0021 - Workers' Compensation Division › Chapter 4 - INJURY REPORT PROCEDURE › Section 4-1 - Worker Report of the Injury

Current through July 13, 2024
The report of the injury is not a claim for benefits. W.S.
				  § 27-14-503(a). The injured worker is required by the statute to report
				  the occurrence and general nature of the injury to the employer as soon as
				  practical within 72 hours after the injury becomes apparent, and to file a
				  signed injury report on the required form with the Division within ten days
				  after the injury becomes apparent. The Report of Injury is timely filed if the
				  employer is notified within seventy-two (72) hours of the injury or the Injury
				  Report is filed within ten (10) days of the injury.
Otherwise, there is a statutory presumption that the claim
				  shall be denied. However, this presumption may be rebutted if the worker can
				  establish by clear and convincing evidence that the delay does not prejudice
				  the employer or Division in investigating the injury and in monitoring medical
				  treatment.
Wyoming Administrative Code › Agency 053 - Workforce Services, Department of › Sub-Agency 0021 - Workers' Compensation Division › Chapter 4 - INJURY REPORT PROCEDURE › Section 4-2 - Contents of the Worker's Report

Current through July 13, 2024
The report shall be on a form provided by the Division,
				  available from the Division or employer, and shall contain the following
				  information:
(a) The worker's full
				name, mailing address, telephone number and Social Security Number;
(b) The worker's birth date, sex, marital
				status and number of dependents;
(c) The employer's full name, address and
				telephone number;
(d) The worker's
				date of hire and job title;
(e) A
				statement of whether the worker is a regular worker, volunteer, inmate, a
				governmentally subsidized work experience program participant, or has an
				interest in the business as owner, partner, or corporate officer;
(f) The worker's current monthly
				earnings;
(g) The date, time and
				location of the accident or injury;
(h) A statement of how the injury occurred,
				including what the worker was doing at the time and what objects or substances
				caused the injury;
(j) A statement
				identifying the parts of the worker's body affected by the injury;
(k) The name(s) of any witness(es) to the
				events causing the injury;
(l) The
				names and addresses of all health care providers who have treated or provided
				medical services to the worker for the injury being reported;
(m) If the report is prepared by a person
				other than the worker, the full name, address and telephone number of the
				person preparing the report, and that person's relationship to the
				worker;
(n) Such additional
				information as the Division deems appropriate; and
(o) The report form shall be signed and dated
				by the worker, or his personal representative if the worker is incapacitated.
(i) Acceptance of legal recognition of
				electronic records; electronic signatures and electronic contracts (W.S. §
				40-21-107) includes:
(A) A record or signature
				may not be denied legal effect or enforceability solely because it is in
				electronic form.
(B) A contract may
				not be denied legal effect or enforceability solely because an electronic
				record was used in its formation.
(C) If a law requires a record to be in
				writing, an electronic record satisfies the law.
(D) If a law requires a signature, an
				electronic signature satisfies the law.
Wyoming Administrative Code › Agency 053 - Workforce Services, Department of › Sub-Agency 0021 - Workers' Compensation Division › Chapter 4 - INJURY REPORT PROCEDURE › Section 4-3 - Employer Report of the Injury

Current through July 13, 2024
The employer must file a report of injury within ten (10)
				  days after the date on which the employer is notified of the injury. Failure by
				  an employer to report may result in a fine or jail. W.S. § 27-14-506(c).
				  The Report of Injury is timely filed if the employer is notified within
				  seventy-two (72) hours of the injury or the Injury Report is filed within ten
				  (10) days of the injury.
The report must be filed with the Division; it shall be on
				  the required form, dated, signed by the employer or employer's authorized
				  representative and shall contain the following information:
(a) The worker's date of hire and job
				title;
(b) A statement of whether
				the worker is a regular employee, volunteer, inmate, governmentally subsidized
				work experience program participant, or has an interest in the business as
				owner, partner or corporate officer;
(c) The worker's current monthly
				earnings;
(d) The opinion of the
				employer as to whether the worker suffered a work-related injury that is
				compensable under the Act; and
(e)
				If the employer's opinion is that the injury is not compensable under the Act,
				the employer shall specify its reason for that opinion. Those matters will be
				addressed by the Division as part of the determination process.
Wyoming Administrative Code › Agency 053 - Workforce Services, Department of › Sub-Agency 0021 - Workers' Compensation Division › Chapter 4 - INJURY REPORT PROCEDURE › Section 4-4 - Injury Report Forms

Current through July 13, 2024
Injury report forms are available, without charge, from the
				  Division or its district offices. W.S. § 27-14-502(a) and (c). The
				  limitation of time for filing does not apply if the worker is mentally
				  incompetent or a minor and has no guardian. W.S. § 27-14-505. The report
				  form shall contain a statement in boldface type that the report is not a claim
				  for benefits.
Wyoming Administrative Code › Agency 053 - Workforce Services, Department of › Sub-Agency 0021 - Workers' Compensation Division › Chapter 4 - INJURY REPORT PROCEDURE › Section 4-5 - Notification of Injury

Current through July 13, 2024
Any affected party may give notice, by electronic means to
				  the Division, of an occurrence of injury to a worker in covered employment.
				  Upon receipt of notice of injury, the Division will mail the appropriate forms
				  to the injured worker and the employer for completion and signatures.
(a) If notification was electronically
				submitted within the deadline prescribed in W.S. § 27-14-502(a) and the
				Division receives the signed report within ten days of its mailing by the
				Division, the report shall be deemed to have been timely filed. In such a case,
				the Division's allotted time to respond will begin when it receives the signed
				report.
(b) If the Division
				receives the signed report more than ten days after its mailing by the
				Division, the report shall be deemed filed on the date the signed report is
				received by the Division.
(c) The
				Division will not approve any award nor pay any claim prior to its receipt of a
				signed waiver from the injured employee, on a form provided by the Division,
				authorizing the Division to release benefit, employment or medical information
				to those parties designated recipients in W.S. § 27-14-805(d).
(d) Nothing in this section shall relieve any
				party of the duty to submit documents bearing original signatures, when
				required by the Act or these Rules.
Wyoming Administrative Code › Agency 053 - Workforce Services, Department of › Sub-Agency 0021 - Workers' Compensation Division › Chapter 5 - DETERMINATIONS BY DIVISION - COVERAGE & COMPENSABILITY & CLAIMS › Section 5-1 - Coverage

Current through July 13, 2024
(a) Upon receipt of the injury report, the
				Division will investigate and review the matter and will address questions of
				jurisdiction and compensability. The Division may gather additional facts prior
				to the determination. W.S. §
									§
									
										27-14-601(k) and
				27-14-801(d). The
				procedures for review, determination, redetermination and request for hearing
				shall be as provided in Sections
				2 and
				3 of this chapter.
Wyoming Administrative Code › Agency 053 - Workforce Services, Department of › Sub-Agency 0021 - Workers' Compensation Division › Chapter 5 - DETERMINATIONS BY DIVISION - COVERAGE & COMPENSABILITY & CLAIMS › Section 5-2 - Determination Procedure

Current through July 13, 2024
The following procedures apply to all determinations by the
				  Division, including coverage/compensability determinations, all benefits claim
				  applications, and all medical bill reviews.
(a) The Division will review the matter
				within 15 days from the date any completed employer or employee injury report
				or claim is filed and will issue either a final determination or request for
				additional information.
(b) At the
				earliest possible date within 45 days following the request for additional
				information, the Division will make its final determination as to whether the
				injury, or death resulting from injury, is compensable and within the
				jurisdiction of the Act or whether and in what amount a claim or bill is
				allowed.
(c) Upon mutual consent of
				the worker, the employer, and the Division, the time limit for the
				determination by the Division may be extended. Otherwise, upon failure of the
				Division to make a decision within the time allowed by the Act, at the request
				of any affected party the matter shall be referred by the Division for
				hearing.
(d) The final
				determination shall be mailed to all affected parties at their last known
				addresses, and, when required by law, shall include a statement of reasons, and
				a notice of right to request a hearing and right to counsel. An affected party
				shall immediately notify the Division, in writing, of any change of address or
				physical residence.
(e)
Objection
. Any affected party may object to the
				Division's final determination by filing a written request for hearing with the
				Division within 15 days following the mailing of the determination. W.S. §
									
										27-14-601. A timely written request for
				hearing is prerequisite to review by the appropriate hearing
				authority.
Wyoming Administrative Code › Agency 053 - Workforce Services, Department of › Sub-Agency 0021 - Workers' Compensation Division › Chapter 5 - DETERMINATIONS BY DIVISION - COVERAGE & COMPENSABILITY & CLAIMS › Section 5-3 - Redetermination Procedure

Current through July 13, 2024
(a) The Division
				may issue a redetermination within one year following the issuance of a final
				determination if the Division receives sufficient information to establish the
				compensability of the case or claim. W.S. §
									
										27-14-601(k)(vi).
(i) The Division will not issue a
				redetermination, or award benefits to an injured worker, if information
				substantiating the compensability of a case or claim is submitted more that one
				year after the Division issued the final determination denying the
				compensability of the case or claim.
(ii) The redetermination shall be formal
				written notification sent to the employee, employer, and known treating health
				care provider(s).
(A) Any affected party may
				object to the Division's redetermination by filing a written request for
				hearing within 15 days following the issuance of the redetermination.
(B) A timely request for hearing is
				prerequisite to review by the appropriate hearing authority.
Wyoming Administrative Code › Agency 053 - Workforce Services, Department of › Sub-Agency 0021 - Workers' Compensation Division › Chapter 5 - DETERMINATIONS BY DIVISION - COVERAGE & COMPENSABILITY & CLAIMS › Section 5-4 - Claims for Benefits

Current through July 13, 2024
A person seeking an award of benefits under the Act must
				  submit a written application for benefits to the Division, on a form provided
				  by the Division. A report of injury is not a claim for benefits. W.S. §
									
										27-14-503(a). A claim for
				  benefits may be filed by the injured worker, that worker's personal
				  representative, or, in case of an injured worker who is mentally incompetent or
				  a minor, the worker's legal guardian. In order to make an application, a
				  claimant shall submit one of the following:
(a)
Claim for
				Reimbursement.
A claim for reimbursement of any expense(s)
				incurred by an injured worker because of his work-related injury must be
				submitted on a form provided by the Division according to the procedure
				outlined in Chapter 7, Section
				3(a)
				(iii)
Medical Reimbursement to
				Injured Worker
.
(b)
Claim for Temporary Total Disability (TTD) Benefits (Lost
				Wages)
.
(i)
When
				Submitted
. A claim for TTD must be filed within 60 days after the
				first day of certified temporary total disability. W.S. §
										
											27-14-404(d).
(ii)
Certification
.
				An award of TTD cannot be made without certification from a treating health
				care provider that the worker is temporarily and totally disabled (that is,
				incapacitated from performing any gainful employment for which the worker is
				reasonably suited by experience or training). The certification shall specify
				the reasons for the total disability and the expected period of
				disability.
(iii) A physician
				assistant shall be deemed a health care provider for purposes of examinations
				and TTD certifications pursuant to W.S. §
										§
										
											27-14-404(d)(ii), 404(g) and
				501(b), if the TTD certification is accompanied by or the Division has on file,
				a written statement, signed and dated by the supervising licensed physician,
				stating "I [insert name of physician] certify that the physician assistant
				signing this form has authority to do so and that the certification is provided
				under my supervision." W.S. §
										
											33-26-502(b). Both the
				supervising physician and the physician assistant shall have a continuing duty
				to notify the Division immediately if a previously-designated physician
				assistant is no longer employed by the physician, is no longer licensed as a
				physician assistant in Wyoming, or is no longer authorized by the physician to
				certify TTD.
(iv)
Where
				Submitted
. A claim for TTD benefits must be filed with the
				Division. W.S. §
										
											27-14-501(3).
Wyoming Administrative Code › Agency 053 - Workforce Services, Department of › Sub-Agency 0021 - Workers' Compensation Division › Chapter 5 - DETERMINATIONS BY DIVISION - COVERAGE & COMPENSABILITY & CLAIMS › Section 5-5 - Waiver and Settlement-Benefits

Current through July 13, 2024
Upon good and sufficient cause the Administrator or
				  designee(s) of the Workers' Compensation Division may waive, compromise or
				  otherwise settle any claim for benefits.
Wyoming Administrative Code › Agency 053 - Workforce Services, Department of › Sub-Agency 0021 - Workers' Compensation Division › Chapter 6 - CONTESTED CASE PROCEEDINGS › Section 6-1 - Referral for Hearing

Current through July 13, 2024
(a) Upon receipt of
				a request for hearing, the Division shall immediately transmit a copy of the
				request and a notice of request for hearing to the Office of Administrative
				Hearings (OAH) or Workers' Compensation Medical Commission as appropriate. For
				purposes of judicial review of agency inaction under W.S. §
									
										16-3-114(a), the Division is
				deemed to have denied any timely, written request for a hearing pursuant to
				W.S. §
									
										27-14-601(k)(iv) when it has
				failed to transmit a notice of request for hearing within 30 days after receipt
				of the request.
(i) For purposes of referring
				contested cases to the Workers' Compensation Medical Commission for hearing,
				W.S. §
										
											27-14-616(b)(iv), the phrase
				"medically contested cases" shall include those cases in which the primary
				issue is:
(A) a claimant's percentage of
				physical impairment;
(B) whether a
				claimant is permanently totally disabled;
(C) whether a claimant who has been receiving
				TTD benefits remains eligible for those benefits under W.S. §
											
												27-14-404(c); or,
(D) any other issue, the resolution of which
				is primarily dependent upon the evaluation of conflicting evidence as to
				medical diagnosis, medical prognosis, or the reasonableness and appropriateness
				of medical care.
Wyoming Administrative Code › Agency 053 - Workforce Services, Department of › Sub-Agency 0021 - Workers' Compensation Division › Chapter 6 - CONTESTED CASE PROCEEDINGS › Section 6-2 - Establishment of Fees for Members of Medical Commission

Current through July 13, 2024
Members of the medical commission established pursuant to
				  W.S. §
									
										27-14-616 shall be compensated at the rate of
				  $200 per hour for their professional services on behalf of the commission,
				  including necessary travel time. In addition, members of the commission shall
				  be reimbursed for necessary travel expenses to the same extent and upon the
				  same conditions as Wyoming State employees are reimbursed under the rules and
				  regulations of the State Auditor.
Wyoming Administrative Code › Agency 053 - Workforce Services, Department of › Sub-Agency 0021 - Workers' Compensation Division › Chapter 6 - CONTESTED CASE PROCEEDINGS › Section 6-3 - Small Claims

Current through July 13, 2024
If the Division requests that the matter be resolved as a
				  small claims hearing, the Notice of Referral shall include the following
				  notice:
(a) The Division determines
				that the amount at issue is less than $2,000 and does not involve an issue of
				the compensability of the injury. The Division therefore requests that the
				matter be resolved as a small claims hearing as provided in W.S. §
									
										27-14-602(b)(i).
(b) The purpose of a small claims hearing is
				to provide expedited review by a hearing examiner. In a small claims hearing,
				the Division will not pay a claimant's attorney, nor will the Office of the
				Attorney General represent the Division.
(c) If any party objects to a small claims
				hearing request within 15 days of the notice, the hearing examiner will decide
				whether a small claims hearing or a contested case hearing is appropriate.
Wyoming Administrative Code › Agency 053 - Workforce Services, Department of › Sub-Agency 0021 - Workers' Compensation Division › Chapter 7 - BENEFITS › Section 7-1 - Awards of Compensation

Current through July 13, 2024
(a) Computation of
				Disability Awards.
(i) Procedure for
				Determining Temporary Total Disability (TTD).
(A) Temporary wage rate is computed as
				follows:
(I) Hourly rate multiplied by the
				total number of hours worked within the employer's established work week =
				weekly rate;
(II) Weekly rate
				multiplied by 52 and divided by 12 = monthly rate.
Wyoming Administrative Code › Agency 053 - Workforce Services, Department of › Sub-Agency 0021 - Workers' Compensation Division › Chapter 7 - BENEFITS › Section 7-2 - Benefit Suspension, Limitations and Discounting

Current through July 13, 2024
(a) Failure to
				Appear for Medical Appointment. TTD benefits shall be suspended if the worker
				fails to appear and cooperate in any examination or testing at an appointment
				with his health care provider(s), or one scheduled by the Division. Payment
				shall be suspended until such time as the worker appears at a subsequent
				rescheduled appointment. Payment will not be suspended if:
(i) The worker notifies the Division prior to
				the appointment or within 24 hours after missing the appointment. The worker
				should call his claims analyst at the claims analyst's direct number and leave
				a message if the claims analyst is not available;
(ii) The Division determines that the worker
				made all reasonable efforts to appear at the appointment.
Wyoming Administrative Code › Agency 053 - Workforce Services, Department of › Sub-Agency 0021 - Workers' Compensation Division › Chapter 8 - CHIROPRACTIC PANEL: REHABILITATION PANEL › Section 8-1 - Chiropractic Panel

Current through July 13, 2024
The Administrator shall establish a Chiropractic Panel to
				  provide guidance to the Division in making recommendations and establishing
				  utilization guidelines, which shall address the appropriateness and
				  reasonableness for the care and treatment of injured workers, for use in
				  auditing and adjudicating chiropractic claims. Membership on the panel is
				  limited to those chiropractors that have a current license to practice in the
				  state of Wyoming; are in good standing with the applicable state regulatory
				  bodies; and have demonstrated special competence and interest in industrial
				  health. The panel will provide guidance to the Division on utilization matters
				  and standards of care, and will function as peer review for Division issues.
				  The Administrator will solicit expressions of interest in serving on the panel
				  from the membership of the Wyoming Chiropractic Association.
Wyoming Administrative Code › Agency 053 - Workforce Services, Department of › Sub-Agency 0021 - Workers' Compensation Division › Chapter 8 - CHIROPRACTIC PANEL: REHABILITATION PANEL › Section 8-2 - Rehabilitation Panel

Current through July 13, 2024
The Administrator shall establish a Rehabilitation Panel to
				  provide guidance to the Division in making recommendations and establishing
				  utilization guidelines, which shall address the appropriateness and
				  reasonableness for the care and treatment of injured workers, for use in
				  auditing and adjudicating physical, occupational and speech therapy claims.
				  Membership on the panel is limited to those therapists that have a current
				  license to practice in the state of Wyoming; are in good standing with the
				  applicable state regulatory bodies, and have demonstrated special competence
				  and interest in industrial health. Recruitment of the panel members will be by
				  the Administrator who will solicit expressions of interest in serving on the
				  panel from each therapy discipline's state association. This panel may include,
				  but is not limited to members of Wyoming Physical Therapy Association, Wyoming
				  Occupational Therapy Association, and/or Wyoming Speech-Language-Hearing
				  Association.
Wyoming Administrative Code › Agency 053 - Workforce Services, Department of › Sub-Agency 0021 - Workers' Compensation Division › Chapter 9 - FEE SCHEDULES › Section 9-1 - General Guidelines

Current through July 13, 2024
Pursuant to Wyoming Statutes §
									27-14-401(b), (e), and
				  (g)  medical and or hospital care shall be reviewed for appropriateness and
				  reasonableness and shall be reimbursed according to the adopted schedule(s).
				  The following guidelines are applicable to each section within this
				  chapter.
(a) All claims shall be paid
				in accordance with the fee schedule in effect at the time of service.
(b) Certain services may be subject to
				preauthorization pursuant to Chapter 10 of these rules. These guidelines can be
				found at:
https://dws.wyo.gov/dws-division/workers-compensation/resources-information/provider-bulletins
.
(c) The Division shall use accepted medical
				resources and publications to aid in adjudicating bills. This shall include,
				but not be limited to, the most recent edition of the following sources at the
				time services are rendered; the American Medical Association (AMA), Optum 360,
				Current Procedural Terminology code book (CPT), the AMA Knowledge Base System
				and The American Academy of Orthopaedic Surgeons, Complete Global Values
				Service Data for Orthopaedic Surgery Guidelines, Centers for Medicare and
				Medicaid Services (CMS), and the Division's medical advisors.
(d) The Division may change billed codes to
				achieve compliance with the current rules and regulations. The provider payment
				statement shall advise of code changes and the right to appeal.
(e) Codes where no value is established in
				the Geographically Adjusted Resource Based Relative Value Scale (RBRVS)
				methodology will pay using gap fill values as established by OPTUM or By Report
				(BR); whichever is less. If the value is determined BR, a comparable code value
				will be assigned; if no value is found, the billed charges will be reduced by
				20%.
(f) In no case shall any
				provider bill for charges greater than those charged the general public for
				like services.
(g) The Division
				shall not pay more than the total billed amount.
(h) A health care provider or facility shall
				provide records to the Division without charge after a claim has been
				accepted.