What are you entitled to after a workplace accident? Do you know how to file a Kentucky workers’ compensation claim? Attorney David Troutman explains what you may and may not know about workers’ compensation.
1. If your claim is denied by the workers’ compensation insurance company, you can ask a Judge to preside over your claim.
If the workers’ compensation insurance company denies your claim or refuses to pay for medical treatment or lost wages, you can file your claim with the Department of Workers’ Claims (DWC) of Kentucky. When you do this, you are asking that an Administrative Law Judge (ALJ) preside over your claim and decide whether you are entitled to compensation. By filing the claim, you are initiating litigation against your employer which forces them, or most likely their insurance company, to hire a lawyer to defend them. After filing the appropriate paperwork with the DWC, both the injured worker and the employer will submit evidence to the ALJ, which consists of medical records of the worker and evidence of the incident or injury. Depositions of the injured worker, witnesses, and the employer will also most likely take place. This process is called discovery. Once discovery is complete, a final hearing takes place in front of the ALJ. Once the hearing is complete, the ALJ has 60 days in which to issue a written opinion regarding whether the worker was injured on the job and what benefits, if any, are appropriate.
2. An injured worker is entitled to primarily 3 (three) types of Kentucky workers’ compensation benefits.
When someone successfully proves they were permanently injured during the scope and course of their employment, they should be entitled to medical treatment for that injury for the rest of their life. Even if they retire at a later date or become eligible for Medicare or other type of health coverage, the workers’ compensation insurance company is first in line to pay for the body part injured at work. Secondly, when a worker is injured on the job and has been taken off of work for at least one (1) week by a doctor, they are entitled to what is called Temporary Total Disability (TTD) payments. A TTD payment is a weekly check the injured worker should receive while healing from his or her injuries. This check amount should be 2/3 of the injured worker’s Average Weekly Wage (AWW) while they were working. The worker’s gross pay should be used to make this calculation (not the net, or take home pay). Finally, if the injured worker has suffered a permanent impairment due to the injury, he or she is entitled to future weekly checks known as Permanent Partial Disability (PPD) payments. The amount of these checks are based on: (a) how disabling the impairment is, (b) how much the injured worker’s salary was, and (c) whether they have the physical capacity to return to the work they were doing when injured.
3. If you have a successful Kentucky workers’ compensation claim, you are not entitled to a lump sum award of future benefits.
If your claim is successful, you could be entitled to future monetary benefits called Permanent Partial Disability (PPD) benefits, as explained above. In Kentucky, the worker is entitled by law, to receive weekly checks for a certain amount of time to compensate them for any permanent injury. However, the injured worker is not entitled to receive a lump sum amount as opposed to weekly checks. The injured worker will only receive a lump sum settlement or award if the workers’ compensation insurance company agrees to it. If the insurance company does agree to pay the worker in a lump sum as opposed to weekly checks, they are entitled to a slight discount in the overall payment. If you need help with a Kentucky workers’ compensation claim, contact Edwards & Kautz at 866-795-5087 to schedule a free legal consultation.