Claims Kit
Wyoming
Forms
State Compliance Information
Physician Selection WS 27-14-401
An employer or the division may designate health care providers to provide nonemergency medical attention to their employees or to claimants under the act. The employee may for any reason, select any other health care provider. Once they choose a health care provider to treat their work-related injury, they may change health care providers with proper notification to the Wyoming Workers’ Compensation Division or by referral from the health care provider.
In the case of an inmate employed in a correctional industries program or performing services pursuant to W.S. 7-16-202, the department of corrections will select the health care provider for the inmate.
Posting Requirements 27-14-507
Each employer must keep a notice posted in a conspicuous place for employees. The notice will be furnished by the division and must contain a brief summary of this act and procedures for filing claims. Each employer must also keep a copy of this act and have it available for all employees.
Unemployment Insurance & Workers Compensation First Quarter 2020 Due Dates & Waiver Policy April 6, 2020
The first quarter 2020 reporting due date for Workers' Compensation and Unemployment Insurance will remain as the last day of the month following the end of the quarter, per Wyoming Statutes 27-14-201(b); 27-3-503 and Unemployment Commission Rules Chapter 9, Section 3. This means that these reports and payments will still be due on April 30, 2020. We recognize an urgent need for a grace period with the effects of the COVID-19 pandemic. The following guidance applies to those business affected by the pandemic. Workers’ Compensation will consider writing off any interest and/or late file penalties that accrue from Q1-2020 reporting due to issues related to or a direct result of COVID-19. Employers wishing to avail themselves of this write-off should send a written request explaining how the COVID-19 pandemic interfered with its ability to timely pay Q1-2020 premiums
You may email your request: covid19wcuirequests@wyo.gov You may fax your request to: 307-235-3278 You may mail your request to:
Workers’ Compensation Division
Attn: Michele Johnson
PO Box 20006
Cheyenne, WY 82002
Penalties for Late Reporting 27-14-506 (c)
Willful failure or gross negligence to report injuries by an employer is a misdemeanor, punishable by a fine of up to $750.00, imprisonment up to 6 months, or both.
Reporting of Claim by Employer 27-14-506
An employer must file an employer's injury report with the division within 10 days after the date the employer is notified of the injury and must mail or deliver a copy of the report to the employee.
Posters & Brochures
Brochure
Documents Provided by CopperPoint
Portal User Help
Pharmacy First Fill - ENG/SPA
Change of Address
Witness Statement - ENG/SPA
Accident Report - ENG/SPA
Gramm-Leach-Bliley Act (GLBA) Privacy Notice
Return To Work
Return To Work Transitional Employment Offer Template - ENG/SPA
Return To Work Policy Guide
Injured Worker Guide
The worker's compensation system can be complicated, and each state has its own laws regarding workers' compensation.
The information contained in your state's guide provides a general guide for workers injured or made ill on the job.
This state-issued publication will assist you in navigating the workers' compensation system and serve as a resource for basic legal rights as well as steps to take to initiate workers' compensation benefits, deadlines and who to contact for additional assistance.
If you have questions about the workers' compensation process, this guide will provide the contact information for the regulatory agency for your state. In addition, many states have an ombudsman to oversee and assist all interested parties in the workers' compensation system.
Publications
Need help?
Phone: 800.231.1363
For Claim Reporting, please complete your First Notice of Loss and email to reportaclaim@copperpoint.com