Kentucky Workers Comp Claims: Eligibility, Filing and Appeals

Workers Compensation insurance provides financial compensation and medical care for workers who are injured on the job. Funds paid by employers are managed by the Kentucky Workers Compensation Funding Commission. In the state of Kentucky, all employers must carry workers compensation insurance or become self-insured, except for certain agricultural employers. About 80,000 employers and at least 1.7 million workers are currently covered under workers compensation law in Kentucky. The Kentucky Department of Workers' Claims or DWC, a division of the Kentucky Labor Cabinet, oversees the Kentucky Workers' Compensation Program. The DWC administers benefits and has jurisdiction over all compensation claims. In 2007-2008, there were a total of 4785 general injury claims made in Kentucky.

Common Covered Work Related Injuries

Common injuries covered under Kentucky Workers Compensation law include general workplace injuries, such as accidental injuries or broken bones, hearing loss, and occupational diseases such as coal workers’ pneumoconiosis, or black lung disease. Workers may receive benefits for injuries sustained while on the job, though not if the injuries are a result of intoxication, horseplay, or intentional self infliction. Injuries sustained while traveling to or from work are also not covered.

How to File a Kentucky Workers Compensation Claim

Workers Compensation claim applications must be notarized and filed with the Department of Workers’ Claims. There are three types of claim applications. Form 101 is for injury claims, Form 102 is for occupational disease claims, and Form 103 is for hearing loss claims.

Employees must also file the following forms:

• Form 104: Employment History
• Form 105: Medical History
• Form 106: Medical Waiver and Consent
• Form 115: Social Security Release Form (Not required for Form 101 applications)

A medical report detailing the relationship between the injury and the work related event, along with documentation of the employees wages before and after the injury should also be submitted.

Workers Compensation Claim Denials

One of the major reasons for a claim denial is improper medical documentation and insufficient proof of workplace injury. Claims may also be denied if the employee has not sought medical treatment or has a pre-existing condition that has contributed to the injury or illness. Incomplete or improperly filled out claim forms may also lead to denial.

Appealing a Kentucky Workers Compensation Denial

Appeals must be filed with the Workers Compensation Board within 30 days of a judge's decision. Within 60 days, the board will enter a decision to affirm, modify, or set aside. The board may also choose to return the claim to an Administrative Law Judge. Decisions made by the board may be further appealed through Kentucky Appellate courts, however unless the board significantly misinterpreted the law, the courts generally defer to the board's decisions.

Collecting Kentucky Workers Compensation Benefits

The amount of benefit payments depends on whether the disability is temporary total, permanent partial or permanent total. Payments also depend on the workers average wage and the extent of the disability. For total disability, the payment is two-thirds of the worker's average weekly wage, but no greater than Kentucky's average weekly wage. For permanent partial disability, the maximum payment is 75% of Kentucky's average weekly wage. Payment may be made weekly, though in other cases a settlement may be reached allowing an employee to receive a lump sum.

Hiring a Kentucky Workers Compensation Lawyer

An experienced workers compensation lawyer can ensure that all paperwork is filled out and filed correctly, and can also assist an injured worker in determining the steps to take to make a successful claim. Lawyers may also work with clients in the appeals process, or may negotiate appropriate settlements.

Kentucky Workers Compensation Office Locations

Kentucky Labor Cabinet
1047 U.S. 127 South, Suite 4
Frankfort, Kentucky 40601
(502) 564-3070

Kentucky Department of Workers Claims
657 Chamberlin Avenue
Frankfort, Kentucky 40601
(502) 564-5550

Kentucky Workers Compensation Funding Commission
Street Address:
#42 Millcreek Park
Frankfort, Kentucky 40601
Mailing Address:
Post Office Box 1228
Frankfort, Kentucky 40602-1228
(502) 573-3505

Kentucky Workers Compensation Board
Spindletop Office Complex
2780 Research Park Dr.
Lexington, KY 40511

Ashland Hearing Site
1539 Greenup Avenue
Ashland, KY 41101
606-920-2103

Bowling Green Site
Pushin Building, Third Floor
400 East Main Street
Bowling Green, KY 42101
270-746-7003

Florence Hearing Site
8120 Dream Street
Florence, KY 41042
859-283-1235

Frankfort Hearing Site
657 Chamberlin Avenue
Frankfort, KY 40601
502-564-5550

Hazard Hearing Site
124 Corporate Drive, Suite 102
Hazard, KY 41701
606-435-6031

Lexington Hearing Site
Spindletop Office Complex
2780 Research Park Drive
Lexington, KY 40511
859-389-6989

London Hearing Site
London State Office Building
85 State Police Road
London, KY 40741
606-330-2134

Louisville Hearing Site
410 West Chestnut Street, Suite 700
Louisville, KY 40202
502-595-4844

Madisonville Hearing Site
145 East Center Street
Madisonville, KY 42431
270-824-7600

Owensboro Hearing Site
Masonic Building
227 Saint Ann Street
Owensboro, KY 42303
270-687-7320

Paducah Hearing Site
220 - B North 8th Street
Paducah, KY 42001
270-575-7048

Pikeville Hearing Site
107 Coal Hollow Road/107 Hambley Boulevard
Pikeville, KY 41501
606-433-7579

Pineville Hearing Site
306 Cherry Street
Pineville, KY 40977
606-337-7363

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