Workers Compensation is a system of state laws which makes your employer pay you while you are unable to work if you are injured on the job, and makes your employer pay medical and chiropractic bills you have because of an injury or accident on the job.
If you have a permanent disability because of an injury on the job, you are paid for your lost ability to earn money. There are benefits for widows of injured workers, and a lump sum death payment to your estate.
The program also lets workers who cannot return to their prior work because of an on the job accident get help finding a new job that they can do.
Workers’ Compensation Insurance
Workers compensation benefits (workmans comp or workers comp) are paid for by your employer, usually through a Workers compensation insurance company or self-insurance fund. In some cases, state funds are used to pay the benefits.
The Workers compensation law does not pay you for the pain and suffering resulting from a work injury. Getting benefits does not depend on who caused the injury, unless it came about because the person who got hurt meant to injure himself or someone else, or because of his or her intoxication. The amount of benefits can be increased by 30% if your employer has violated a safety law.
The Workers compensation law also prevents you from suing your employer in court for negligence, unless the employer has failed to obtain Workers compensation insurance.
Coverage Under Kentucky Workers’ Compensation
Most jobs are covered by the Workers compensation law, including part-time work, from the moment you begin working. Farming or agricultural work is not covered by the Workers compensation system. A housekeeper employed by a person who has less than two such housekeepers is not covered. Riverboat and railroad workers, if they are covered by federal law, are also exempt, as are United States government employees. There may be other ways that you can recover for injuries if you are not covered by the Kentucky Workers Compensation system, depending on how the injury happened.
An injury is covered by the Kentucky Workers Compensation law if it happens in the course and scope of your work and it happens while you are in the state of Kentucky. If you were hired in Kentucky and your job takes you to many states, such as in over-the-road truck driving, your injury may still be covered by Kentucky law even though your injury happened in some other state. If you were injured outside of the state but you work from a Kentucky place of business, or if you live and work mostly in Kentucky, the injury may be covered by Kentucky law.
Workers’ Compensation Questions Answered
When an employee is hurt at work, the Kentucky Workers’ Compensation Act requires an employer to pay for medical treatment, a portion of lost wages, and for permanent disability caused by the injury. Most employers purchase insurance to cover this liability, although some larger employers are self-insured. When an employee has an injury on the job, he or she must report it to the employer as soon as practicable after it has happened or after he or she has learned that the injury was caused by work. By law the employer must report the injury to its insurance company, although many times employers do not want to turn claims into their insurance carriers. The report to the insurance carrier begins an investigation of the injury using the employee’s statement, the employer’s knowledge of the events, other witnesses’ statements, and a thorough review of the medical records pertinent to the injury. For this reason, the most important step in obtaining workers’ compensation payments and medical coverage is to give an accurate report of the injury to the first doctor who examines the employee, and to give a consistent report of the injury to every doctor who is consulted thereafter. A doctor can only testify that an injury or other medical condition is caused by work if he has a complete and accurate history of the injury.
Many injures are cured by medical treatment and a short period of recovery requiring time off from work. If this time off from work extends for more than seven days, the employee is paid two-thirds of his average weekly wage for the time he is off, and if the disability extends for more than two weeks, payments are made starting on the first day of disability. To prove that the work has caused disability, an employee needs to have an off work statement from his treating doctor, or the restrictions on activities provided by the doctor must prevent the employee from performing his regular work. If the employer has a light duty program which allows the employee to work within those restrictions, the employee can be required to return to work or face a loss of temporary disability payments. After a period of recuperation, and perhaps a surgery or other major medical treatment, an injury may cause a permanent impairment in functioning. For instance back surgeries, ankle fractures, shoulder surgeries, and hand surgeries can cause permanent impairment. The Workers’ Compensation Act in Kentucky provides for compensation for loss of function, increased by certain factors if the injury causes the employee to be unable to perform their previous job, or if the employee returns to work after the injury but then loses that job for any reason. Additionally, there are factors increasing benefits for workers who are over 50, or who have a low educational level. If an injury causes a worker to be unable to return to his previous employment, workers’ compensation and other state programs provide vocational rehabilitation services to train an injured employee to be able to find other work.
Medical treatment for an injury continues for two years after the injury, or two years after the date of the last payment of voluntary disability payments, unless the employee files a claim proceeding at the Kentucky Department of Workers’ Claims. This process usually requires a lawyer, and if the case is settled before filing an Application for Adjustment of Claim and beginning litigation a Settlement Agreement (Form 110) must be filed to record the specifics of the injury. Medical treatment will then be provided for lifetime if the medical treatment is related to the injury, and is reasonable and necessary. Workers’ compensation medical, income and disability benefits are provided to an employee who is injured on the job regardless of whether it was the employee’s fault, whether it was the fault of a coworker or whether the injury occurred simply as the result of an accident. However, if the employer has violated a safety regulation a 30% penalty on income benefits is paid to the worker. If the employee has been injured as a result of his willful violation of a safety regulation, his benefits may be reduced 15%. However, if the employee was intoxicated at the time of the injury, which caused his injury to occur, no medical or disability payments are payable . Similarly, if the employee intended to injure himself or another, the injury is not covered by workers’ compensation.
Workers’ compensation is the only legal action that can be taken against an employer for an injury that happens on the job, if the employer has workers’ compensation insurance coverage. He cannot sue the employer for negligence to recover compensation for pain and suffering even if the employer was negligent. Historically, this was the trade-off for coverage of employment related injuries regardless of fault. However, a third party may be legally liable for pain and suffering as well as other damages if the third party negligently caused the injury. This happens frequently when an employee is injured in an automobile accident while driving for his work, or where a defectively manufactured machine or product injures him on the job. In some situations where a subcontractor of the employer has caused a dangerous condition or accidentally injures an employee, the subcontractor’s general liability insurance can be made to pay civil damages to the employee. However, the workers’ compensation insurance carrier, having paid medical and disability benefits to the worker, will be reimbursed some or all of its expenses.
If you have an injury at work, you can consult the author of this article without charge. Workplace injuries can be life altering events and the consequences need to be very carefully considered. You can be sure that the workers’ compensation insurance carrier and your employer have adequate legal advice to inform them of their responsibilities under the law, and whether or not to pay benefits for an injury. By the same token, you should have adequate legal advice in your workers’ compensation case.