Most Kentucky employers are subject to the Workers' Compensation Act and are required to carry workers' compensation insurance or become self-insured, even if they have only one part-time employee. This is to cover expenses the employee might accumulate from any work-related injuries. The employer must have knowledge of the accident and a report must be filed with the employer within 60 days. Private insurance carriers actually provide the insurance for employers. Assistive devices, equipment, and home modifications can all be paid under Workers' Compensation under certain conditions. There is an exemption for employers engaged exclusively in agriculture.
If a person is injured on the job, she or he is entitled to have all expenses paid that are deemed reasonable and necessary due to the work-related injury. This could include any device, equipment, or modification that is determined is needed as a result of the work-related injury. The insurance company may attempt to question if a device or medical treatment is needed because of the injury or if it is needed because of some other reason unrelated to the injury.
When there is a permanent disability involved, workers' compensation carriers generally want to settle the claim as soon as possible. However, it is advisable not to be too hasty in settling the claim. Allow sufficient time to know the full extent of the disability, its impact on daily functioning and what types of assistive devices or equipment are needed and for how long. Let the insurance personnel know that you will not settle the claim or sign any waivers or release forms until there is ample medical evidence that the disability is permanent and unchanging. If there is an attorney involved, make sure he or she understands why the client may need certain AT devices and services. Be sure you know how the workers' compensation benefits are structured.
The injured worker can submit any requests for devices to the insurance carrier for purchase. If the carrier feels that the request is for an item that is needed by the individual because of the work-related injury, they will voluntarily purchase it. In many cases, however, the carrier may dispute the claim as not being a necessary item or as not being necessary as a result of the work-related injury.
Once the Administrative Law Judge issues an award, an order or decision, either party may appeal to the Workers' Compensation Board. The deadline for filing an appeal is 30 days after the judge files the final decision. However, no additional evidence may be introduced and the Board shall not substitute its judgment for that of the judge.
If the Administrative Law Judge was presented with conflicting evidence, the Workers' Compensation Board will uphold the decision as long as any portion of the evidence supports the judges decision.
The Workers' Compensation Board shall rule on an appeal of a decision of an Administrative Law Judge no later than 60 days following the date on which the last appeal brief was filed. The Board shall enter its decision affirming, modifying or setting aside the award, order or decision or return it to the Administrative Law Judge for further proceedings to conform to the direction of the Board.
A decision agreed upon by any two of the three members of the Workers' Compensation Board shall constitute a decision of the Board.
Appealing a decision made by the Workers' Compensation Board will take the claim into the Kentucky appellate courts. These courts grant deference to Board decisions and will affirm the decisions made by the Workers' Compensation Board unless it has made a significant misinterpretation of the law.
The Workers' Compensation Guidebook is available from the website listed above.
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KATS Network Coordinating Center
Charles McDowell Center
8412 Westport Road
Louisville, KY 40242
Local: (502) 429-4484
Toll Free: (800) 327-5287
Fax: (502) 429-7114