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FREQUENTLY ASKED QUESTIONS

ABOUT KENTUCKY WORKERS COMPENSATION

Prepared by:

Scott F. Scheynost
Scheynost Law Offices, P.S.C.
7619 Dixie Highway
P.O. Box 58308
Louisville, KY. 40268
Toll Free: (866) 439-1044
Telephone: (502) 937-5287
sscheynost@scheynostlaw.com

These are common questions about workers compensation, with answers that emphasize the law in Kentucky. This is a general discussion about Workers Compensation, and not legal advice about a specific claim.

There are many exceptions to the issues discussed here. Laws can also change before this is updated. Therefore, you should talk to an attorney before you take action.

1. Question: What is Workers Compensation?
   
   Answer: Workers Compensation refers to laws that make employers pay medical benefits, lost wages, and money for permanent impairment for job related injuries. In Kentucky, all medical expenses related to the injury are paid by the employer, with no co-payments or deductibles (KRS 342.020). While off work and recovering from an injury, employees are entitled to lost wage benefits, called Temporary Total Disability Benefits (KRS 342.720). If an employee has a permanent disability, the employee is generally entitled to additional benefits based on many factors (KRS 342.720). Workers compensation laws vary greatly from state to state.
   
   
2. Question: Who is Covered by Workers Compensation?
   
   Answer: Almost all employees in Kentucky are covered by Workers Compensation Law. Even if there is only one employee in the company, and even if the employee is injured the first day on the job. Part-time employees, government employees (including police and firefighters), seasonal and temporary employees, minors, and workers who are on "probation" before being formally hired are normally covered (KRS 342.640). The worker must be engaged in the "scope of employment" at the time of the injury. People classified as independent contractors can sometimes still be eligible for benefits, depending on the specific facts of their job.
   
   
3. Question: Who is not Covered by Workers Compensation?
   
   Answer: In Kentucky, you may not be covered by workers compensation if you work in a strictly agricultural job (KRS 342.630), are a true independent contractor, are a domestic servant, work for less than 20 days at another's home, and some jobs working for a charity. Also, you can waive your right to Workers Compensation benefits by "willingly" signing the appropriate forms (KRS 342.395). Federal government employees, railroad workers, and maritime workers are usually not subject to Kentucky Workers Compensation Law, but have similar Federal laws that protect them.
   
   
4. Question: What Injuries are Covered?
   
   Answer:  Almost any injury to an employee that occurs during the scope of employment is covered by Workers Compensation. This can include injuries not caused by trauma, such as diseases caused by the occupation, (e.g., Black Lung). It also includes injuries that develop over long periods of time, such as repetitive motion injuries (e.g., carpal tunnel syndrome and degenerative disc disease). Also, injuries caused when work accelerates the natural aging process are covered. Exposure to hazards such as chemicals, coal dust, or asbestos, as well as other diseases caused because of the nature of someone's work, are covered (KRS 342.0011).
   
   
5. Question:  How does an injured Employee get Benefits?
   
   Answer: An employee is required to give notice to their employer as soon as possible after a work related injury (KRS 342.185). Normally, the employer will then report the injury to its workers compensation insurance carrier. The insurance carrier should then begin payment of benefits. If there are problems, the employee should contact the Kentucky Office of Workers Claims (1-800-554-8601) or an attorney, because they may have to file a formal claim to receive benefits.

   All employers are required by law to carry workers compensation insurance (KRS 342.630), and to give their employees the name, address and telephone number of their workers compensation insurance carrier (KRS 342.610). If an employer's workers compensation insurance carrier unreasonably refuses to pay benefits, a complaint can be filed with the Office of Workers Claims for a violation of the Unfair Claims Settlement Practices Act, and a fine can be issued against the employer or its insurance carrier (KRS 342.267). If the employer has violated the law and failed to obtain workers compensation insurance, the injured employee can still recover benefits from Kentucky's Uninsured Employer's Fund.

6. Question: What Benefits are Available?
   
   Answer:  Injured employees can receive medical expenses, lost wages, compensation for permanent disability, and vocational retraining. (Coal miners suffering from Black Lung may be eligible for additional benefits.)

7. Question:  What type of Medical expenses are Covered by Workers Compensation?
   
   Answer:  Employers must pay an injured employee's medical expenses reasonably related to the "cure and relief" of the injury (KRS 342.020). Medical expenses include doctors charges, prescription expenses, hospital bills, nursing treatment, charges for tests (such as x-rays and MRI's), braces, travel expenses and many other items. In Kentucky, medical expenses can be payable for life. The employee is not required to pay co-payments or deductibles for medical treatment obtained in Kentucky. Medical expenses are required to be paid within 30 days of receipt by the employer (KRS 342.020).
   
   
8. Question:  How are Lost Wage Benefits Computed?
   
   Answer: Workers receive two-thirds (2/3's) of their average weekly wage (AWW), while off work and recovering from the injury (KRS 342.730). This is called Temporary Total Disability Benefits, or TTD. A complicated statute spells out how AWW is computed (KRS 342.140). But, the employer is required to look at the wages for the one year period prior to the injury, and consider overtime if the employee is paid hourly. There are also statutory limits on the amount that can be paid for TTD. The weekly limit for TTD is $670.02 for an injury that occurred in 2008. An employee must be off work for at least seven consecutive days before TTD benefits are payable. If an employee is off work for at least 14 consecutive days, TTD benefits are payable from the first day off work (KRS 342.040).
   
   
9. Question: How are Permanent Disability Benefits Computed?
   
   Answer: If an employee has reached Maximum Medical Improvement (MMI) from an injury, and also sustained a permanent impairment, additional benefits may be awarded for that impairment. The amount, and length of time of benefits, depends on many factors. These factors include: the impairment rating assigned by a medical expert pursuant to the latest edition of the American Medical Association's Guides to the Evaluation of Permanent Impairment ; restrictions on the employee's physical activities; average weekly wage at the time of the injury and at return to work; age; and, educational level (KRS 342.730). Employers are only required to pay permanent disability benefits weekly, not in a lump sum.
   
   
10. Question: What are Vocational Retraining Benefits?
    
    Answer:  If an injured worker is unable to return to the job performed at the time of an injury, an Administrative Law Judge can award Vocational Retraining Benefits. This can allow the employee to receive up to 52 weeks of Vocational Retraining benefits (KRS 342.710).
    
    
11. Question: What can I do if the Workers Compensation Carrier does not act reasonably?
    
    Answer: Workers compensation insurance carriers, Third Party Administrators, (TPA's), and self insured employers, must handle claims in an appropriate manner, or they can be fined by the Office of Workers' Claims for violation of the Unfair Claims Settlement Practices Act (UCSPA). This act requires claims to be handled promptly, and benefits to be paid when liability is clear (KRS 342.267, KRS 304.12-230).
    
    
12. Question:  What if the Employer committed a Safety Violation?
    
    Answer: If the employer intentionally violated safety regulations, the employee can be entitled to 30% more monetary benefits (KRS.342.165). If a violation of a safety regulation occurred, it would also be appropriate to file a complaint with OSHA.
    
    
13. Question: What if the worker committed a Safety Violation?
    
    Answer: If the employee violated safety regulations, benefits can be reduced by 15% (KRS 342.165). Employees intoxicated, or under the influence of drugs, who are injured because of those facts, may not be allowed to receive benefits. Employees injured because of horseplay, or activities clearly outside the scope of employment, may also be ineligible for benefits.
    
    
14. Question: How long do I have to file a claim?
    
    Answer: In Kentucky, there is a two year statute of limitations to file a workers compensation claim for a traumatic injury (KRS 342.185). This time begins to run from the date of the injury, or the last payment of TTD, whichever date is later. The time limit is three years from the "last injurious exposure" for occupational diseases (KRS 342.316). In some rare cases, such as where the employer has not filed the correct forms with the Office of Workers Claims, the statute can be extended.
    
    
15. Question: Can anyone besides an employer be responsible for damages?
    
    Answer: If an employee is injured by someone other than his employer or fellow employee, he can pursue a third-party lawsuit. In Kentucky, an employee can not sue a fellow employee unless it was for an intentional injury. The statute of limitations may be shorter for a third party lawsuit, and often requires a lawsuit to be filed within a year of the injury.
    
    
16. Question: Can I receive Social Security Disability and Workers Compensation at the same time?
    
    Answer: Someone totally disabled can recover Social Security Disability benefits, in addition to Workers Compensation Benefits, if they qualify. The Social Security Administration may decrease (offset) what it pays, depending on the amount of workers compensation payments and amount of Social Security Disability benefits.
    
    
17. Question: How do I file a Formal Workers Compensation Claim?
    
    Answer: For a traumatic injuries, a completed Form 101, Application for Resolution of Injury Claim, is filed with the Office of Workers Claims in Frankfort, Kentucky. Other forms are required for occupational diseases and other injuries.
    
    
18. Question: How is my attorney paid?
    
    Answer: Attorneys generally handle claims for employees on a contingency fee basis. (This means they do not get paid unless the employee gets benefits.) In Kentucky, attorney's fees are limited by statute. KRS 342.520 (2) provides for an attorney's fee of 20% of the first $25,000.00 recovered, 15% of the next $10,000.00 recovered, and 5% of the remainder recovered, with a limit on the total attorney's fee of $12,000.00. Generally, expenses are also paid by the client, after the attorney's fee is computed.
    
    
    

Common Abbreviations in Workers Compensation