Episode 2: Louisville workers’ compensation attorney Ched Jennings provides a general overview of the Kentucky workers’ compensation system. He explains what you need to know regarding your claim and benefits. He’ll discuss the process for filing for workers’ compensation benefits in Kentucky.
What Is the First Step after a Workplace Injury?
A worker who is injured on the job is required to give notice to a supervisor or other manager. Telling a peer does not satisfy the requirement, under the workers’ compensation law. It may not be possible to inform the supervisor, immediately, but as soon as otherwise possible, you need to inform him/her. Having your spouse contact the employer does satisfy the notice requirement. This preserves your right to begin filing for workers’ compensation benefits.
What if the Company Says I Have to Inform Them within 24-48 Hours?
Kentucky law overrides company policy. The company cannot deny your ability to file a workers’ comp claim, just because you didn’t inform them within 24-48 hours.
There Is No “Pain and Suffering” Benefit in KY Workers’ Comp
Unlike a car wreck claim, pain and suffering is not part of the Kentucky worker’s comp system. Medical benefits and compensation for wages are part of the benefits.
You Have the Right to Choose Your Doctor
Kentucky Law gives the injured worker the right to choose his/her doctor. This is extremely important. Even if your employer has a medical department or wants to refer you to a “company doctor,” you have a right to seek your own medical treatment for your workplace injuries. Managed care programs may limit that choice, but you still have the right to select from a number of doctors within that managed care program.
Make sure you fully describe the injury history. Doctors and other specialists need to document that they are treating a workplace injury. This is important information to have in your medical record when filing for workers’ compensation benefits.
What’s a Utilization Review?
This process is there to justify the medical treatment. If the insurance company tries to deny a specific treatment or medication, the issue may go for utilization review. A third party will make a decision. Although this third party may be part of the insurance company. It may still be possible to get the treatment using Medicare or private health insurance, but ideally, your attorney may be able to present enough information to get the treatment approved via the utilization review so it’s covered under workers’ comp.
Temporary Total Disability Benefits (TTD)
This refers to the benefits you receive while you are actively treating for your work-related injury, and during your recovery. These go on until a physician determines you have achieved Maximum Medical Improvement (MMI). At this point, there’s nothing else they can do to improve your recovery. You’ve reached the maximum. At that point, TTD benefits are over.
What is an Impairment Rating?
Once an injured worker reaches MMI, a doctor will assign him/her an impairment rating. This number indicates limit of their ability to perform certain work activities (i.e. loss of motion or function). The rating has a direct impact on the permanent injury benefits you’ll receive, as a result of your injury.
The impairment rating may indicate the workers is permanently, totally disabled. The benefits would typically continue until age 70, under the current law. Benefits for a permanent partial disability, based on an impairment rating of greater than 35%, may continue for 10 years. If the rating is less than 35%, the benefits could continue for approximately 8 years. The rating is a critical component for the calculations used when filing for workers’ compensation benefits.
What Happens if there’s a Medical Dispute Related to My Workers’ Comp Treatment?
This is not uncommon. When the treating doctor and the insurance company disagree on the necessity of the recommended treatment, a medical dispute arises. This can also include medications, testing (i.e. MRIs), surgeries, etc.
The ultimate question is whether the treatment is reasonable and necessary. At this point, the issue will be sent to Utilization Review. The person reviewing the issue has never seen or examined the worker. This is why it’s so important to have an experienced Kentucky workers’ compensation attorney on your side. This system is still a legal process.
If the Utilization Review decides not to allow the treatment, your attorney will now officially file the Kentucky workers’ compensation claim with Frankfort. Up until this point, the actual claim hasn’t been filed, because the system has worked. Now it’s time to file the claim to ensure your rights are preserved and you still have an opportunity to get the benefits you deserve.
Filing Your Workers’ Compensation Claim
Ched normally will file the claim much earlier in the process. During this segment of this episode, he explains why this is so important for your case when filing for workers’ compensation benefits. It helps should there be an issue with medical treatment. He’ll be able to get a judge involved in the various decisions. It also preserves your right to future medicals. You may have the right to reopen your case, if your medical condition worsens down the road.
After the Claim has been Filed
Eventually, the injured worker will be involved in a deposition. The worker will be sworn in and asked about the details of the injury and the progress made. The insurance company may then send the worker for an independent medical exam (IME). If a settlement still cannot be successfully negotiated, it may go to a mediation. This can expedite the settlement verses having to go through the full claims process.
Ched briefly explains how some of the benefits can be increased when certain “multipliers” are applied to the value of your claim.
The Jennings Law Offices values communication and education when it comes to helping their clients. Ched is committed to ensuring clients receive return calls and that they are kept up to date on the status of the claim.
Do You Need a Kentucky Workers’ Compensation Attorney?
Office Phone: (502) 583-3882
Follow the Jennings Law Offices on Facebook
Principal Office Address: 401 West Main St., Suite 1910, Louisville, KY 40202
The Jennings Law Offices doesn’t charge for phone calls. Many union stewards and others have Ched’s cell phone number. If possible, we’d like you to come to the office. For some people, that doesn’t always work. Video calls might be an option. In fact, due to the pandemic, many of the hearings and other activities are handled via Zoom video conferencing. You can do a video call from your computer or a cell phone.
That’s it for this episode. We’ll have another one ready for you in 2 weeks. Until next time, remember, this is the Kentucky Workers’ Compensation Podcast. It’s what you need to know.