Here are answers to ten questions that are frequently asked about Workers’ Compensation in Kentucky.
1. Do I have to go to the doctor my employer sends me to see to receive treatment for my work-related injury?
Generally speaking, NO! An employee injured at work is often sent to seek medical treatment at a specific medical provider, typically an outpatient clinic.
At SSS Law, we encourage our clients to comply with this initial request from the Employer; however, it is important to remember that not only does the injured worker have the right to select his/her own (“designated”) physician, but that the injured worker can also change this physician one time during the life of their claim as a matter of right.
2. I was recently hurt at work and my boss refuses to provide the workers’ compensation insurance carrier notice of my injury. What do I do?
This is a common problem. Many Employers do not want to report injuries to their workers’ compensation carrier. This is not optional. Call SSS Law and we will ensure that your claim is filed with the Department of Workers’ Claims in a swift manner.
Keep in mind that a failure to provide “due and timely notice” of an injury can operate as a complete defense and bar recovery of benefits in your claim. Thus, it is imperative that you contact an attorney promptly to ensure that you preserve your rights to compensation.
3. My employer tells me they don’t have workers’ comp insurance coverage. Is there anything I can do?
First, know that this statement is not always true. At SSS Law, we can help determine whether the employer has an active insurance policy under which benefits may be paid.
Additionally, even in the event that the employer does not have workers’ compensation insurance coverage, an injured worker can pursue the same medical and wage benefits to which he/she would otherwise be entitled by making a claim to the Uninsured Employers’ Fund (UEF).
Generally speaking, NO! The workers’ compensation system is administrative in nature, and it is considered to be an “exclusive” remedy. This means that if you are injured in the course and scope of your employment in Kentucky (i.e. you are at work and doing what you are supposed to be doing when injured), then you are entitled to modest, yet guaranteed, wage benefits and medical benefits.
It is important to note that there are exceptions to this general rule. At SSS Law, we carefully evaluate each claim to determine whether there is a third-party (someone other than the Employer or a co-worker) who may also be liable for causing your injuries. In the event that such a third-party is discovered, you will have the right to bring both an administrative claim for workers’ compensation benefits AND a civil claim for the third-parties’ negligence, and SSS Law’s attorneys and staff will assist you with both cases.
5. I was recently injured while working for my employer. I am a long time employee. I’m worried about suing them and don’t want to get fired. What should I do?
First, please note that you cannot “sue” your Employer. As mentioned in FAQ #4 above, Kentucky’s laws generally do not permit you to file a lawsuit against your Employer; rather, your exclusive remedy is to seek administrative benefits (medical and wage benefits) provided under the workers’ compensation system.
Second, it is important to understand that while one cannot sue their Employer for being hurt at work, a lawsuit against the Employer can exist is an employee is fired for filing a workers’ compensation claim. KRS 342.197(1) provides that “[n]o employee shall be harassed, coerced, discharged, or discriminated against in any manner whatsoever for filing and pursuing a lawful claim under this chapter.” Therefore, your job is likely more secure once you have filed your claim for workers’ compensation benefits than it is before doing so.
Broadly, you are entitled to three significant benefits in your workers’ comp claim:
You are entitled to all medical benefits (with no expense to you whatsoever) for all treatment that is reasonable, necessary and related to your work injury. You are entitled to receive compensation for all mileage (roundtrip) incurred as a result of seeking medical treatment, and you are entitled to have all out-of-pocket medical expenses reimbursed.
Commonly referred to as “workers’ compensation checks”, you are entitled to receive 2/3 (66.67%) of your average weekly wage (AWW) for all time that you are off work and for which you have valid off-work statements. Your AWW is calculated utilizing the best 13 weeks’ wages (highest earning quarter) out of the previous 52 weeks preceding the date of injury. These checks are mailed directly to the injured worker and no attorney’s fee is taken by SSS Law.
At the end of your case, you will be entitled to an Award/Settlement of your claim so long as it is proven that you have permanent partial disability (PPD) as a result of your work-related injuries. The amount to which you are entitled is unique to each claim, but this is based primarily off your average weekly wage, the severity of your injury/impairment, and whether you are able to return to the same employment.
Often referred to simply as an “IME”, you must attend these evaluations. An IME involves a physical examination, and the report generated from that appointment will greatly influence the value of your settlement/award. A permanent partial impairment rating will be included in this report.
It is important to remember that an IME scheduled and paid for by the workers’ compensation insurance carrier rarely yields an impairment rating that reflects the seriousness of the injuries you have sustained. Often, these doctors will say you were not hurt, or if you were hurt, it was due to a pre-existing condition. When you hire SSS Law, we will obtain an impairment rating from either your treating physician or from another qualified professional in an effort to obtain a higher impairment rating. Remember, the higher the impairment rating, the more value your case has.
8. I have been trying to reach the workers’ compensation adjuster assigned to my claim for weeks and have not received a response. What can I do?
Call SSS Law. This is a common occurrence and the frustration generated within injured workers regarding their adjusters’ unresponsiveness is what drives most of our clients to seek legal assistance. Simply put, we fight, so you don’t have to. Once we accept representation of your claim, you will never have to speak with anyone representing the workers’ compensation insurance carrier ever again. If you have a problem, bring it to us, and let us get you the response you deserve.
9. How much of my settlement will SSS Law take as payment for their services? Who pays for the expenses necessary to bring my claim? What happens if there is not a settlement or award at the end of my claim?
Workers’ compensation attorney’s fees are limited by statute. They are always contingent in nature, which means that the injured employee only owes attorney’s fees (which are reduced from the total amount of the settlement or award) in the event that a settlement or award is obtained at the conclusion of your claim.
Pursuant to the statute limiting workers’ compensation attorney’s fees, attorneys are entitled to receive 20% of the first $25,000.00 (or $5,000.00), 15% of the next $25,000.00 (an additional $3,750.00, totaling $8,750.00, if $50,000.00 is obtained), and 10% of anything received over $50,000.00; however, in no event may an attorney fee exceed $18,000.00.
SSS Law will also finance all expenses incurred in connection with prosecuting your claim, and SSS Law will only recover these expenses in the event that a settlement or award is obtained at the conclusion of your case.
SSS Law handles any and all work-related injuries that result in permanent impairment or death. While the following is certainly not an exhaustive list, SSS Law’s attorneys routinely prosecute workers’ compensation claims for the following injuries:
This includes the cervical spine (neck), thoracic spine (upper back) and the lumbar spine (low to mid-back). Back and neck injuries are collectively the most common claims represented by SSS Law.
The second largest class of claims represented by SSS Law arises from shoulder injuries. This includes torn rotator cuffs, torn labrums, separated AC joints, and many more.
SSS Law has successfully prosecuted dozens of workers’ compensation claims for torn meniscuses, torn ACLs, MCLs, total knee replacements, etc.
Work-related accidents that result in amputations and partial amputations are an all-too-common occurrence in Kentucky. The attorneys at SSS Law have represented many clients who have lost one or more fingers and several that have lost entire extremities (arms or legs).
Cumulative Trauma Injuries:
While most workers’ compensation claims arise from a single, traumatic accident, injuries that arise over the course of time through continuous, repetitive exposure are valid claims to which compensation is owed. Examples of these claims are carpal tunnel syndrome, black lung, asbestos-related claims, and hazardous exposure to chemicals that result in permanent impairment.