Wyoming Workers' Comp Claims: Eligibility, Filing, and Appeals

Learn about your rights and benefits under the workers' compensation system in Wyoming.

Updated December 18, 2018

In Wyoming, virtually all employers must carry workers’ compensation insurance through the state. The workers’ compensation system in Wyoming is a no-fault system that compensates injured workers for medical bills, lost wages, and permanent impairments resulting from their injuries. Wyoming Department of Workforce Services (DWS) administers and pays out claims.

Who Is Eligible for Workers’ Comp Benefits?

Most employees are covered by workers’ compensation in Wyoming. However, there are a few exceptions for employees engaged in certain types of work. For example, workers’ comp does not cover casual employees, certain domestic employees, and private in-home nurses.

Workers’ compensation covers all injuries or illnesses that happen in the course and scope of employment, including traumatic injuries and occupational illnesses. Traumatic injuries are those that result from a one-time accident at work, such as a broken bone from a slip and fall. Occupational diseases are injuries or illnesses that occur over a period of time, including injuries caused by repetitive movements at work (such as carpal tunnel syndrome) and illnesses developed from exposure to toxic substances at the workplace (such as cancer from exposure to asbestos).

How Do I Give Notice of My Injury?

To receive workers’ comp benefits, you must report your injury to your employer. You should do so as soon as possible, but no later than 72 hours after your injury. Your claim for benefits may be denied if you fail to give notice. You must also submit a First Report of Injury to the Wyoming Department of Workforce Services (DWS) within ten days of your injury. You can also work with your employer to submit this form.

How Do I Get Medical Treatment?

In Wyoming, employees may select their own treating doctors. However, if you want to change treating doctors, you will need to notify your employer and DWS beforehand. Workers’ comp will pay for all reasonable and necessary treatment related to your work injury—including the cost of doctors’ visits, hospital stays, prescriptions, physical therapy, and medical equipment. You will also be reimbursed for the mileage you incur in traveling to and from medical appointments.

What Benefits Can I Receive?

In addition to medical benefits, you will also be eligible for disability benefits for a temporary and permanent injury.

Temporary Total Disability Benefits

If you need time off from work while you are recovering from your injuries, you can receive temporary total disability benefits. These benefits are two-thirds of your monthly gross wages, or 30% of the statewide average monthly wage, whichever is greater. (For the last quarter of 2018, 30% of the statewide monthly wage is $1,186.90; you can find current amounts on the DWS website.)

You will receive these benefits until you are able to return to work or until your doctor finds that your condition has stabilized and is not expected to improve further. In any case, these benefits typically end after 24 months.

Temporary Light Duty Benefits

If your employer offers you light duty during this time and you accept, your temporary total disability benefits will stop and you will be eligible for light duty benefits. These benefits are 80% of the difference between your light duty wages and your monthly wages before your injury. If you refuse an offer of light duty, your temporary total disability benefits will be reduced by two-thirds.

Permanent Total Disability Benefits

Once your condition has stabilized and is not expected to improve further, your doctor will assess whether you have a permanent disability. If your injury has left you permanently and totally disabled, you can receive permanent total disability benefits. These benefits are available only for the most serious injuries and when a worker is unable to hold any type of gainful employment.

The amount of the monthly benefit depends on the employee’s pre-injury earnings. For many workers, the benefit will be either two-thirds of their actual monthly wages or two-thirds of the statewide average monthly wage ($2,367.69 or the last quarter of 2018). These benefits will be paid for an initial period of 80 months. After that, the worker will need to apply for a yearly extension if he or she is still unable to work.

The child of an employee who is permanently and totally disabled may also receive $250 per month until the age of 21, or until the age of 25 if attending college.

Permanent Partial Impairment Benefits

If you are not totally disabled, but you have suffered a permanent loss of function, you will be eligible for permanent partial impairment benefits. These benefits are two-thirds of the statewide average monthly wage for up to 60 months, depending on the degree of your impairment. For example, if your doctor gives you a 50% impairment rating, you will receive these monthly benefits for 30 months.

Permanent Partial Disability Benefits

Once your permanent partial impairment benefits run out, you might be eligible for permanent partial disability benefits. You will be eligible for an award if you:

  • received permanent partial impairment benefits
  • are unable to earn at least 95% of your pre-injury wages, and
  • have made continuous work search efforts during a six-week period.

Permanent partial disability benefits are paid at the same rate as permanent total disability benefits. However, the length of time that the benefits are paid out depends on the employee’s age, occupation, education, and other qualifications. As an alternative to receiving permanent partial disability benefits, workers can receive vocational rehabilitation training for another line of work.

What Are the Time Limits for Filing a Claim?

In addition to filing a report of injury, workers must file a claim for benefits with the Wyoming Department of Workforce Services for each benefit sought. A claim for benefits must be filed within one year of the date of injury. For occupational diseases, a claim for benefits must be filed within one year of the diagnosis or within three years of the last workplace exposure, whichever happens later.

Can I Get a Lump Sum Settlement?

If you have a lasting impairment and are entitled to permanent partial or total disability benefits, you may want to reach a settlement with the insurance company for a lump sum payment of future benefits. (Permanent partial impairment benefits are never paid in a lump sum.)

To get a lump sum, after your claim is accepted you must submit an application to the Workers’ Compensation Division and give notice to your employer. You must also write a statement explaining why you have an exceptional need for a lump sum payment.

What If My Claim Is Denied?

If your claim is denied, you can ask DWS to grant you an administrative hearing before a workers’ comp judge. If you disagree with the judge’s decision, you will have an opportunity to appeal the decision.

File an Appeal

Once the Department of Workforce Services (DWS) receives your claim for benefits, it will send you a Determination Notice in the mail with its decision. If your benefits have been denied, you can appeal the decision through the DWS. To appeal, you must send a written request for a hearing to the DWS within 15 days of the mailing date on the Determination Notice.

Before the Hearing

After you file your appeal, your case will be scheduled for a workers’ compensation hearing. Before your hearing takes place, however, you and the DWS will have an opportunity to gather information and evidence. As part of this process, the DWS may require you to undergo an independent medical examination (IME) with a doctor of its choosing. The IME doctor will examine you and write up a report with an assessment of your condition, work restrictions, and impairments. This report, or the doctor’s testimony, will be used as evidence in your hearing. If the IME doctor disagrees with your treating doctor, your treating doctor may also need to testify in your case.

During the Hearing

Hearings take place in person at one of the DWS office locations, usually within weeks to months of filing an appeal. A hearing examiner will preside over the hearing and allow both sides to submit evidence, present witnesses, and make legal arguments. After considering all of the evidence, the hearing examiner will mail a decision to the parties within 30 days.

A workers’ comp hearing is a formal proceeding that requires knowledge of complex procedural rules for gathering and presenting evidence. Although you are allowed to represent yourself, it is usually in a worker’s best interest to hire a lawyer.

District Court Appeal

If the hearing examiner does not rule in your favor, you can appeal the decision to a Wyoming District Court. The hearing examiner’s order will include the deadline for filing your appeal. Complicated procedural rules apply to any case brought in civil court, including appeals of workers’ compensation denials. If you haven’t already, you should consult with a workers’ comp attorney before pursuing an appeal in court.

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