Frequently Asked Questions
1. I have been injured at work. What are my rights?
ANSWER: All employees in Kentucky must be insured by their employers for workers’ compensation coverage. Any injury which “arises out of” the work may be an injury that is compensable under Kentucky Workers’ Compensation law. The employer is required to give notice “as soon as practicable” to the employer, written notice is – although not required – is highly advisable. The employer’s insurance carrier will make the initial determination as to whether or not the claim will be paid on a voluntary basis. If the they determine that coverage applies, the employer’s insurance carrier will begin to pay all medical expenses.
In the event of a loss-time injury, after two (2) weeks of missed work, the employer is required to compensate the injured worker with temporary total disability from the date of injury for so long as the injured worker reaches “maximum medical improvement”.
2. May I choose my own physicians and health care treatment?
ANSWER: The employee generally has the right to choose his/her treatment source and physician. In some Managed Care Plans, there may be some limitations on the employee’s right to make this choice and the employer may require the employee to choose from a list of participating physicians. The employer will typically send the injured worker to a physician of its choice (Occupational Physicians, Urgent Care Treatment facilities, etc.). The employee has a right to be treated by a specialist of his/her own choice and may change that designated treating physician at least once by filling out the appropriate forms.
3. I am working as an Independent Contractor. Am I entitled to workers’ compensation for a work-related injury?
ANSWER: Even if an injured worker is described by the employer as an “Independent Contractor”, workers’ compensation law focuses on whether or not workers are truly “independent contractors”. If the employer merely controls the outcome of the work and neither controls the means of production nor the details of how the work is accomplished, the worker is more likely to be found as an “Independent Contractor”. If, however, the injured worker is simply designated as an Independent Contractor but the work is controlled by the employer and the work is within the regular and recurrent of the employer, the injured worker is more likely to be found to be an employee in Kentucky regardless of how the employer may designate the worker’s status.
4. I live in Kentucky and was hired in Kentucky, but I was injured in another state. Which state law applies?
ANSWER: Generally, most states provide that workers injured within that state may file a claim within that state, and that is true in Kentucky. Even though a worker may be injured in another state, he/she may file a workers’ compensation claim in Kentucky if the worker lives in Kentucky and/or was hired in Kentucky for work in another state. Workers whose work is not localized in any one state but who reside in Kentucky may also be entitled to file a workers’ compensation claim in Kentucky. Generally, workers’ compensation law in Kentucky is more favorable to employees than most of the contiguous states.
5. My claim is compensable. What type of benefits may be available?
ANSWER: Workers’ compensation benefits generally fall within three (3) categories:
- Income benefits
- Medical benefits
- Vocational Rehabilitation benefits
Temporary total disability income benefits are paid while the injured worker is off work by physician’s orders and until the worker reaches “maximum medical improvement”. If the injury produces permanent impairment, as measured by the AMA – American Medical Association Guidelines for the Evaluation for Permanent Impairment, some permanent partial disability benefits may be available for this permanent injury. Employees who, because of an injury, had a complete and permanent inability to perform any type of work that they were qualified to do prior to the injury may be entitled to permanent total disability.
Generally, income benefits are payable for 425 weeks, unless the injury produces a permanent total disability, in which the payments from the employer cease when the injured worker reaches normal retirement age.
6. Is my employer required to provide light-duty or hold open my position while I am off on a workers’ compensation injury?
ANSWER: An employer is not required to either hold an injured worker’s job or is the employer required to provide light-duty. The Workers’ Compensation Act provides some incentive for employers to hold open jobs and provide light-duty but it is not required of employers. Employers may not however “retaliate” against an employee because he/she has had a work-related injury.
7. My employer is sending me for an evaluation to a specialist of its choice. Am I required to attend?
ANSWER: Employers do have the right to require injured workers to be examined by a physician of the employer’s choice for purposes of evaluation only, not for treatment. An employer may be permitted to suspend temporary total disability payments if the employee unjustifiably refuses to attend an Independent Medical Examination.
8. I have been injured at work and my employer terminated me. May I apply for Unemployment Insurance benefits?
In unemployment law, if an injured worker whose injury “arises out of the work” and who is involuntarily separated from employment may be entitled to unemployment benefits. A workers’ compensation carrier may however take credit for unemployment benefits paid due to a work-related injury.
9. My workers’ compensation injury was serious enough that I am unable to return to work. May I apply for social security disability?
An injured worker may apply for social security disability but social security disability benefits may be offset by workers’ compensation benefits paid to the injured worker “after six (6) months of disability”
10. My employer is refusing to pay my medical bills. What are my options?
ANSWER: While the initial payment of workers’ compensation benefits, including medical benefits, is “voluntary”, an injured worker who has a dispute with the employer regarding benefits may file a claim with the Office of Workers’ Claims. The Office of Workers’ Claims assigns an Administrative Law Judge to hear the case and all pending issues are resolved by the Administrative Law Judge.
11. When do I need a Lawyer?
ANSWER: Generally, more serious injuries may justify employment of an attorney to represent the injured worker. The fees of the attorney are paid by the employer from the income benefits due to the injured worker and are capped pursuant to the workers’ compensation statutes at 25% of the first $25,000.00, 15% of the next $10,000.00, and 5% of all amounts in excess of $35,000.00. The maximum attorneys’ fee in Kentucky for representation of an injured worker is $12,000.00. The employer pays this fee directly to the attorney and reduces the portion of the week of benefits of the injured worker by the amount paid to the attorney.
12. Can I sue my employer for my work-related injury?
ANSWER: You may not sue an employer unless the employer intentionally caused the injury. Workers’ compensation is the employee’s “exclusive” remedy under Kentucky law.