Alaska Workers Compensation Claims: Eligibility, Filing and Appeals
Worker’s Compensation Claims are administered on a state-by-state basis. Alaska provides comprehensive protection for injured workers through a worker’s compensation plan.
Alaska Worker Injury: Worker’s Compensation Protection
Workers compensation imposes the obligation upon employers to protect injured employees. Employers must have workers compensation insurance for covered workers, who will provide benefits in the case of work related injury, disability or death. In the event that the employer is underinsured and/or the insurer is unable to pay, the Alaska government has established a fund, called the Workers’ Compensation Benefits Guaranty Fund, to provide coverage for eligible employees. The fund can then attempt to recover the cost from underinsured or uninsured employers.
Almost all employees in Alaska are covered under workers compensation laws. Exceptions include some commercial fishers (fish processors are covered), contract entertainers, part-time babysitters or cleaning people, some taxi drivers, harvest help, some realtors, volunteers (except volunteer firefighters, police, ambulance attendants, federal disaster workers and EMTs) and participants in the Alaska Temporary Assistance program. Most self-employed individuals, and members of partnerships, are not covered but can opt to be covered if they choose to.
Workers comp is the sole remedy for covered employees injured at work in Alaska.
Work Related Injuries
According to the Alaska Department of Workers Compensation, only injuries that “arise out of and occur during the course and scope of your employment” are covered. Injuries caused by an employee’s willful intent to injure or kill himself or others, or by an intoxicated employee are not covered.
In order for an injury to be covered, the employee must establish a causal link between his job and the injury or impairment.
How to file an Alaska Workers Compensation Claim
To file a worker’s comp claim, you must provide written notice of your injury using Form 6101 within 30 days after the accident occurs or the illness becomes apparent. Form 6101 (Report of Occupational Injury) should be given to your employer, who will then fill out the required employer information. You must include relevant details including your employer’s name and address, the insurer’s name and address, your supervisors contact information, the names of witnesses, and details about the injury.
You must obtain treatment from a licensed physician, and the doctor must file a report with both the insurer and the state workers compensation board within fourteen days of treating you. You can only change doctors once in order for the bills to be covered; otherwise you have to get written consent from the workers comp insurer for changes.
Keep all receipts regarding medical care and submit copies to the workers comp insurer. If your injury has temporarily or permanently prevented you from working, you also need to submit written evidence of your wages, in the form of a pay stub or W2. This information should be submitted directly to the workers compensation insurer.
The insurer must begin paying benefits or issue a notice of denial within 21 days of receiving the Report of Injury submitted to your employer. If your benefits are denied, you are sent a letter notifying you of the denial and explaining how to file an appeal.
Workers Compensation Claim Denials
Claims are denied for a variety of reasons. Claims are denied if the paperwork is not complete or if the doctor’s report does not indicate a covered injury or disability. Claims may also be denied if the injury was not reported within the required period of time. Denied claims may be appealed. In 2008, 38 appeals were filed with the Workers Compensation Commission.
Appealing an Alaska Workers Compensation Denial
You have two years from the date you receive notice of the denial to file an appeal. When an insurer denies benefits, you must file a Workers Compensation Claims directly with the Workers Compensation Board. Once a claim is filed, the board will investigate the claim. You are entitled to request a hearing to speak before the board and to present your claim for benefits.
The Workers Compensation Appeals Commission hears appeals from claims denied by the Workers Compensation Board.
Collecting Workers Compensation Benefits
Benefits include reimbursement for medical expenses up to two years after the injury. Payments are paid to the injured worker, or to surviving family members in the event of death. The first payment is due fourteen days after the insurer is informed of the claim.
If you are disabled, you may be entitled to disability and impairment benefits. These benefits are paid biweekly. Temporary total disability benefits provide you with the full amount of your wages until you are able to return to work or become medically stable (no additional improvement in your condition is possible).
Temporary partial disability benefits are paid to those who are able to work part time while recovering. They pay a portion of your wages (80% of the amount of the difference between your current wages and your pre-injury wages).
Permanent partial impairment benefits are additional benefits paid if you suffered a permanent physical loss such as an amputation or loss of bodily function. Finally, permanent total disability benefits are paid if you are permanently unable to work. Benefits are calculated based on your previous wages.
Hiring an Alaska Workers Compensation Lawyer
The Alaska Department of Worker’s compensation states that you can hire an attorney at any time throughout the claims process. The attorney can help you file your initial claim, or present your case at a hearing. The Department of Worker’s Compensation recommends contacting the Alaska Bar Association to find a qualified workers compensation claim.
Alaska Workers Compensation Office Locations
3301 Eagle Street
P.O. Box 107019
Anchorage, Alaska 99510-7019
675 Seventh Ave.
Fairbanks Alaska 99701-4593
111 W. Eighth Street
PO Box 11512
Juneau, Alaska 99811-5512