Claims Kit

Penalties for Late Reporting SDCL 62-6-2, SDCL 62-6-3

Any employer who fails to file a report is guilty of a Class 2 misdemeanor and is subject to an administrative fine of $100.

The insurer is required to send a copy of the injury report to the Department of Labor within 10 days. Failure to comply may result in a fine of $100.

Physician Selection Statutes 62-4-1, 62-4-43, 62-7-1, Rule 47:03:04

The employee has the right to make the initial selection of a medical practitioner (defined as a licensed health care provider) and must notify the employer of his selection prior to treatment or as soon as reasonably possible after treatment has been provided. The employee must obtain written permission from the employer or insurer before changing health care practitioners. The employee may obtain a second opinion at his own expense. The employer also has the right to a second opinion. Services may also be regulated by the insurer's designated managed care plan.

All workers' compensation insurers have been required to provide case management services in their policies since January 1, 1995. Self-insured employers were required to have such services as of January 1, 1996.

Workers' compensation insurance companies are required to contract with one or more case management plans. The Department must certify the plans. A self-insured employer may also have its plan certified by the Department. An insurer or self-insurer can contract with as many certified plans as it chooses.

Every injury has to be reported to the employer's case management plan. However, the insurer may consider some claims to be so minor that management of the treatment is unnecessary, and may elect not to have the claim managed. Employees retain the right, in any case, to have access to medical services within 48 hours after they request them.

The plans are certified each fall for the following year.

Reporting of Claim by Employer SDCL 62-6-2

An employer who has knowledge of an injury that requires medical treatment other than minor first aid or that incapacitates the employee for 7 or more calendar days must file a written report with The Department of Labor when the employer is self-insured or the employer's insurer.

The report must be filed within seven calendar days, not counting Sundays and legal holidays, after the employer has knowledge of the injury unless the employer had good cause for failing to file the written report within the seven-day period.

Posting Requirements Statute 62-2-11, Rule 47:03:03:01

Employers must display informational postings promoting safety in the workplace in visible locations throughout the business premises. There is no required format for this poster.