Employers in Kentucky are required to carry workers compensation insurance coverage for their employees to provide for medical treatment and income benefits for employees who are injured at work. Under Kentucky Law, an injured worker must proceed with a claim through an Administrative Agency called the Department of Workers’ Claims.
The Workers’ Compensation System was designed to provide injured workers quick access to medical treatment following an injury, to provide benefits to help support themselves and their families while restricted from work during recovery from their injury, and to avoid litigation between an employee and his/her employer.
Further, there are additional benefits based on the injured workers level of disability (partial or total) which results from the effects of the injury. Unfortunately, the system does not always operate as planned and workers’ compensation insurance carriers at times deny injured workers’ claims or refuse to timely pay benefits or authorize recommended medical treatment.
I fight to help injured workers of this Commonwealth recover the benefits they are entitled to under the law and preserve their right to medical treatment for the effect of their injuries.
There are four (4) types of workers’ compensation benefits injured workers may be entitled to recover:
i. Medical Treatment
An injured worker is entitled to all reasonable and necessary medical treatment for the cure and relief of the effects of their injury. The workers’ compensation carrier is required to pay for the treatment with no co-pays or deductibles charged to the injured worker.
Medical treatment includes:
- Doctor’s Visits
- Diagnostic Tests
Travel reimbursement to and from medical appointments are also compensated. If found to have suffered a compensable work-related injury, medical coverage continues for the injured worker’s life for all reasonable and necessary treatment.
ii. Temporary Total Disability Benefits
While completely restricted from work following an injury or under light duty restrictions the employer is unable to accommodate, an injured worker is entitled to Temporary Total Disability Benefits (TTD) paid weekly at 2/3 of the injured worker’s pre-injury average weekly wage up to a state maximum level. These benefits are paid until an injured worker returns to work or is placed at maximum medical improvement by a physician, indicating they are at a level of recovery where no further improvement is expected.
iii. Permanent Total Disability or Permanent Partial Disability Benefits
If, as a result of a work-related injury, an individual is unable to perform regular and sustained employment, (i.e. cannot return to any type of work on a regular basis), they may be entitled to Permanent Total Disability Benefits (PTD) which are paid weekly at 2/3 of the pre-injury average weekly wage up to a State maximum level until the claimant turns 70 years old or 4 years worth of benefits, whichever period is longer.
If an injured worker is able to return to work following recovery from their injury, they may be entitled to Permanent Partial Disability Benefits (PPD) which are calculated based on an impairment rating assessed by a physician as a result of the injury. The impairment rating is inserted into a mathematical formula which takes into account the level of impairment, (the higher the impairment, the greater the benefits), as well as the injured workers’ age, education, post-injury wage level and whether the worker can physically return to the job he/she was performing when injured. PPD benefits are paid weekly for 425-520 weeks, depending on the level of impairment.
If a claim does not settle and is submitted to an Administrative Law Judge to decide an injured worker’s entitlement to benefits, the Judge can only award weekly benefits as set forth above. If, however, a settlement is reached, the benefits may be paid in a lump sum at a “present value” rate.
iv. Vocational Rehabilitation
If an injured worker lacks the physical capacity to return to the type of work he/she was performing when injured and lacks transferable job skills to obtain other employment within their restrictions, the Administrative Law Judge has the discretion to award Vocational Rehabilitation, ordering the employer / workers’ compensation carrier to pay to retrain / educate the injured worker.
If you have been injured as the result of a traumatic event (i.e., you fall at work injuring your Back), or if you suffer cumulative or repetitive trauma in the course of your employment (i.e., you repetitively use your hands and develop Carpal Tunnel Syndrome), you may be entitled to recover workers’ compensation benefits if medical evidence shows the work injury, or repetitive work activity, caused the diagnosed condition. Additionally, if a work injury, or repetitive trauma, aggravates an underlying condition (such as Arthritis or a Degenerative Condition) and causes that condition to become painful, the injury may qualify as a work-related injury entitling you to workers’ compensation benefits under Kentucky Law.
If you have suffered a work-related injury and would like to discuss your claim, please contact my office for a free consultation.
FAQ – WORKERS’ COMPENSATION
Q Do I have to treat with the company doctor / doctor the workers’ compensation carrier sends me to?
No, under Kentucky Law you have the right to choose a physician once and change a physician once as a matter of right. Unless the workers’ compensation carrier has a managed care plan, you can choose any physician you like to treat your injury. If there is a managed care plan, you can choose any physician within the plan.
Q Am I entitled to mileage reimbursement for trips I have to make to the doctor for treatment of my injury?
Yes, but you must send you request for mileage reimbursement on a specific Form generated by the Department of Workers’ Claims (Form 114) within 60 days of the travel.
Q Can my employer terminate me for pursuing a workers’ compensation claim?
No, if an employer terminates you for pursing a workers’ compensation claim, the Kentucky Workers’ Compensation Act provides a remedy as you would be entitled to bring a suit against your employer for wrongful termination / retaliatory discharge.
Q Can I recover pain and suffering in a workers’ compensation claim?
No, Kentucky’s Workers’ Compensation law provides for only certain types of benefits, including medical benefits, income replacement benefits while completely restricted from work, and benefits for whatever level of occupational disability results from your injury.
Q How long do I have to file a claim after being injured at work?
The Statute of Limitations in a workers’ compensation claim is two (2) years from the date of injury or two (2) years from the last date you were paid Temporary Total Disability benefits. Failure to file a claim within the Statute of Limitations may result in you being forever barred from recovering medical or income benefits arising from your injury.