Agricultural businesses should include this Supplemental along with the Policy Application. Email completed applications to your Underwriter or policyapplications@idahosif.org.
Construction Supplemental ApplicationConstruction businesses should include this Supplemental along with the Policy Application. Email completed applications to your Underwriter, or policyapplications@idahosif.org.
Trucking Supplemental ApplicationTrucking businesses should include this Supplemental along with the Policy Application. Email completed applications to your Underwriter or policyapplications@idahosif.org.
First Report of InjuryUse this form to report a workplace injury or illness.
Workers' Comp Posting Notice (English)This poster should be placed in a noticeable area in the workplace.
Workers' Comp Posting Notice (Spanish)This poster should be placed in a noticeable area in the workplace.
Medical Release AuthorizationThis form allows SIF to access medical bills and reports to process claims quickly
Reimbursement for Health Care Travel Expenses FormRequest reimbursement for travel expenses related to your claim
Thirteen Week Wage FormUse this form to provide wage information for an injured worker who has worked more than 12 weeks prior to the date of injury. Use the Injury Date drop down at the top of the form to prefill the dates below.
Similar Employee Wage FormUse this form to provide wage information for an injured worker who has worked less than 12 weeks prior to the date of injury. Use the Injury Date drop down at the top of the form to prefill the dates below.
Surgery, Diagnostic or Ancillary Service RequestMedical providers may use this form to request pre-approval for surgery, diagnostic, or ancillary testing. This form is not for physical medicine requests.
Provider Portal Access FormRegister to view your bills and EOB's in our Provider Portal.
Employer's Supplemental ReportSubmit this form at the end of the injured worker's disability or after 60 days if still unable to work.
Restricted Duty Supplemental ReportSubmit this form every 14 days while your injured worker is on restricted duty. Use the Injury Date drop down at the top of the form to prefill the dates below.
Example - Restricted Duty Work Offer LetterUse this form when the employer is offering work to an injured worker
Example - Work Offer, No Accommodation RequiredUse this form when the injured worker has continued to work in the same position as the time of injury
Example - Restricted Duty With AccommodationUse this form when the injured worker works in their current position with accommodation
Work Status ReportThis form helps address work restrictions at the medical appointment. Use this to help accommodate more immediate light- or modified duty. Give this to an injured worker before they go to the clinic.
Third-party Policyholder Website AuthorizationThis form is for accountant or bookkeeping firms to request access to their client's policy online. The insured must sign to authorize the request.
Agency Website AccessAppointed agents with an active book of business may use this form to request portal access. Our portal shows an agency's policies and more.
Medical Provider Website AccessMedical providers may use this form to register on our secure portal. We provide access to view bills and EOBs, and to submit surgery requests.
Policy ApplicationApply for a workers' compensation policy with SIF.
Agricultural Supplemental ApplicationAgricultural businesses should include this Supplemental along with the Policy Application. Email completed applications to your Underwriter or policyapplications@idahosif.org.
Construction Supplemental ApplicationConstruction businesses should include this Supplemental along with the Policy Application. Email completed applications to your Underwriter, or policyapplications@idahosif.org.
Trucking Supplemental ApplicationTrucking businesses should include this Supplemental along with the Policy Application. Email completed applications to your Underwriter or policyapplications@idahosif.org.
Claims Kit First Report of InjuryUse this form to report a workplace injury or illness.
Workers' Comp Posting Notice (English)This poster should be placed in a noticeable area in the workplace.
Workers' Comp Posting Notice (Spanish)This poster should be placed in a noticeable area in the workplace.
Medical Release AuthorizationThis form allows SIF to access medical bills and reports to process claims quickly
Reimbursement for Health Care Travel Expenses FormRequest reimbursement for travel expenses related to your claim
Thirteen Week Wage FormUse this form to provide wage information for an injured worker who has worked more than 12 weeks prior to the date of injury. Use the Injury Date drop down at the top of the form to prefill the dates below.
Similar Employee Wage FormUse this form to provide wage information for an injured worker who has worked less than 12 weeks prior to the date of injury. Use the Injury Date drop down at the top of the form to prefill the dates below.
Medical Provider Surgery, Diagnostic or Ancillary Service RequestMedical providers may use this form to request pre-approval for surgery, diagnostic, or ancillary testing. This form is not for physical medicine requests.
Provider Portal Access FormRegister to view your bills and EOB's in our Provider Portal.
Return to Work Employer's Supplemental ReportSubmit this form at the end of the injured worker's disability or after 60 days if still unable to work.
Restricted Duty Supplemental ReportSubmit this form every 14 days while your injured worker is on restricted duty. Use the Injury Date drop down at the top of the form to prefill the dates below.
Example - Restricted Duty Work Offer LetterUse this form when the employer is offering work to an injured worker
Example - Work Offer, No Accommodation RequiredUse this form when the injured worker has continued to work in the same position as the time of injury
Example - Restricted Duty With AccommodationUse this form when the injured worker works in their current position with accommodation
Work Status ReportThis form helps address work restrictions at the medical appointment. Use this to help accommodate more immediate light- or modified duty. Give this to an injured worker before they go to the clinic.
Website Access Third-party Policyholder Website AuthorizationThis form is for accountant or bookkeeping firms to request access to their client's policy online. The insured must sign to authorize the request.
Agency Website AccessAppointed agents with an active book of business may use this form to request portal access. Our portal shows an agency's policies and more.
Medical Provider Website AccessMedical providers may use this form to register on our secure portal. We provide access to view bills and EOBs, and to submit surgery requests.
Mistakes happen, if you spot or realize an error, please contact us and we will work with you to sort things out.
Please be aware that any person who knowingly, and with intent to defraud or deceive any insurance company,
submits a statement or claim containing any false, incomplete, or misleading information is guilty of a felony.