In Kentucky, injured workers are eligible for workers’ compensation benefits. Depending on your claim, your benefits may include medical treatment, compensation for wage loss and disability, and other financial assistance. However, you must notify your employer and file a timely workers' compensation claim. Otherwise, you may lose your right to workers’ compensation.
In Kentucky, most employers must have workers’ compensation coverage. Employers are usually insured through private insurance companies, which pay out claims. However, large companies can seek approval from the state to be self-insured, in which case they pay out their own claims. The Kentucky Department of Workers’ Claims oversees all workers’ comp claims in the state.
Kentucky workers’ compensation is a no-fault system. As long as your injury happened on the job or was caused by your work activities, you will typically be eligible for benefits. Unlike with a personal injury lawsuit, you do not need to show that your employer's actions caused your injury. Similarly, you will usually still be eligible for benefits even if your carelessness contributed to the accident. (However, violations of safety regulations may increase or decrease your weekly benefits, depending on who was at fault.)
In exchange for this no-fault system, workers are only entitled to specific benefits. You cannot receive compensation for your pain and suffering in a workers’ compensation claim. However, eligible workers may receive:
Worker’s comp is also your exclusive remedy against your employer. In other words, you cannot file a personal injury or other civil lawsuit against your employer and demand additional damages.
Every workers’ compensation claim is different. Your eligibility for benefits will vary, depending on the facts of your claim and the severity of your injuries. If you need help calculating your benefits or understanding your claim, contact a workers’ comp lawyer. Or, to learn more, see our article on the different types of workers' comp benefits.
In Kentucky, you should promptly notify your employer of a work-related injury. Your injury report may be either written or oral. It is important to give notice and request medical treatment as quickly as possible. Prompt medical treatment may lead to a faster and fuller recovery. Additionally, employers and insurance companies are skeptical of delayed claims and tend to deny them. Giving notice and getting treatment early on will reduce the likelihood of a claim denial.
Your notice should include the following information:
Your employer may also ask you to complete a written accident report. When completing the report, be as accurate as possible. Accident reports are frequently used as evidence in disputed claims, and any inconsistencies may be used against you.
Once you report an injury, your employer should send you to an occupational doctor or emergency department. At your doctors' appointments, you should always provide accurate information about how your accident occurred and the severity of your symptoms. Insurance companies rely heavily on initial medical records when they evaluate claims. Either downplaying or exaggerating your symptoms may result in a denial of benefits.
In Kentucky, reporting an injury does not start the claim process. You must also file a written claim for benefits with the Department of Workers’ Claims. Your employer should provide you with the appropriate form when you report your injury. They include:
These forms must be signed and notarized. You must also submit a medical release (giving access to your medical records) and forms detailing your employment history and medical treatment. You typically must file your claim within two years of your injury or last payment of benefits. (HIV-related claims have a five-year deadline.)
Once your claim is filed, the insurance company will investigate and determine your eligibility for benefits. This may involve:
Under Kentucky law, the insurance company must either approve or deny your workers’ compensation benefits within 60 days of receiving your claim. If your claim is approved, you will start receiving disability payments and other benefits. Unfortunately, insurance companies deny many workers’ compensation claims. (For common grounds for a denial, see Denied Workers’ Compensation Claims.)
If your claim is denied, you have the right to appeal. Unless your claim is very simple, you should consider hiring a workers’ compensation lawyer. A lawyer can ensure that your case is properly developed and presented to the workers’ comp judge. To learn more, see Should I Hire a Workers' Comp Attorney or Can I Handle My Own Case?