Kentucky Workers’ Comp Laws

No one can guarantee the exemption of any workplace from accidents, which is why the Workers' Compensation Act was established. The law, enacted in 1916, was designed to safeguard individuals who are unable to work due to an occupational injury or illness. Fast-forward to the 21st century, and many people in the U.S. still become injured or ill due to poor working conditions. In fact, 38,600 nonfatal injuries and diseases were documented in Kentucky's private sector in 2021.

According to the Kentucky Occupational Health Indicators Report, while the state has fewer work-related injuries and diseases than it did a decade ago, the current numbers exceed the national average. Moreover, it has a notably high rate of death from pneumoconiosis, a lung disease caused by inhaling dust.

Meanwhile, the National Safety Council says that in 2021, the Bluegrass State’s leading cause of work-related deaths was transportation incidents, which led to 32 fatalities. Other causes were contact with objects and equipment, exposure to harmful substances or environments, and slips and falls.

Workers who have suffered occupational injuries or illnesses know firsthand how these events can damage one’s finances and overall health. As such, if you have been injured while on the clock and want to file for workers' comp benefits, this article aims to help you understand the state's relevant laws. It will also discuss how the judicial system can work in your favor and give a rundown of resources to help you obtain benefits.

Kentucky Workers’ Compensation Insurance Requirements

Did you know Kentucky law requires businesses with one or more full- or part-time employees to carry workers' comp insurance? Nevertheless, just like other states, Kentucky exempts the following from the compulsory coverage: 

• Agricultural laborers.

• Domestic workers in a household with two or fewer staff.

• Sole proprietors.

• Employees who oppose the coverage due to their religion.

• People working in exchange for aid from a charitable or religious organization.

• Handypersons who work fewer than 20 days annually. 

Individuals who are not exempt may opt to reject the coverage by completing a Notice of Rejection of Workers’ Compensation Act (Form 4 Waiver) with the Department of Workers' Claims.

Ways Kentucky Employers Can Obtain Workers' Comp Insurance

Employers can obtain their workers' comp insurance policy from any carrier, broker, or agent authorized by the Department of Insurance. If they can't find coverage suitable for their needs from a private insurance company, they can apply through the Kentucky Employers' Mutual Insurance Authority. Business owners may also opt to become self-insured as long as they:

• Have assets worth more than $10 million after considering all debts and liabilities.

• Apply for the Self-Insurance Package and file Form SI-02 two months before their intended self-insurance date.

• Submit complete workers' compensation loss data for the previous five years.

• Pay a security deposit of at least $500,000.

• Fulfill a Guarantee Agreement.

• Provide a resolution from their Board of Directors agreeing to the self-insurance plan.

• Have a minimum coverage of $10 million per occurrence.

Additional Workers' Compensation Rules

Extraterritorial Coverage for Traveling Workers

It pays to be familiar with Kentucky’s guidelines on extraterritorial coverage if:

• You are hired by an employer with a physical office or location in the state.

• You occasionally or regularly travel for work outside the state.

This is because qualified employees can receive extraterritorial workers’ compensation benefits, whether their injury occurs in Kentucky or another state.

Visible Notice of a Company’s Workers' Compensation Policy

Kentucky law requires employers to post a workers' compensation notice in a place where everyone can see it. This notice must inform employees of their rights under the Kentucky Workers' Compensation Act, including the right to receive medical care and benefits for occupational injuries and illnesses.

Penalties for Workers' Compensation Non-compliance in Kentucky

Employers who fail to comply with the workers’ comp policies above may be subject to fees or penalties. For example, businesses with no insurance policy will be fined $100 to $1,000 per employee per day if they do not have the required coverage. It may also be grounds for business closure and a jail sentence. Moreover, employers will be liable for the lost wages and medical expenses of uninsured employees who have suffered an injury or fallen sick at work.

Kentucky Workers’ Compensation Benefits

At its core, workers' compensation insurance aims to provide employees with financial protection in case their health suffers while fulfilling their work responsibilities. With that in mind, this section discusses the benefits they may receive for their injuries or occupational diseases.

Medical Care

If you have been injured at work in Kentucky, you are eligible to receive workers' compensation benefits for all of your immediate medical expenses, including:

• Emergency room visits: If you need immediate medical attention for an occupational injury, your benefits will include your visit to the ER.

• Prescription medicines: Any prescription medication that you need for a full recovery will be covered by workers' compensation.

• Surgical procedures: If your doctor recommends that you undergo surgery to recover, you will not have to shoulder the cost.

• X-rays: Any medical scan required for your official diagnosis will be free of charge.

• Ambulance rides: If you ride an ambulance to the hospital or another medical facility for treatment, you will not have to pay for it.

Lost Wages

If you cannot work due to an occupational injury or illness, your employer must provide you with benefits to replace your lost earnings. In Kentucky, workers' compensation income is typically 66% of your weekly salary, and it should not be more than 110% or less than 20% of the state average. Overall, the actual amount depends on the severity of your injury or disability. 

Be aware that you may use your accrued leave credits to receive your regular salary while off work. However, if you do this, you might not be eligible for income benefits for the same period. The table below discusses the temporary and permanent disability benefits you may be entitled to.

Death and Burial Benefits

If one passes away within four years after suffering a workplace-related injury or contracting an occupational disease, the surviving spouse and dependents are entitled to compensation. In Kentucky, their estate will also get a lump sum to help pay for their funeral and burial.

Retraining Incentive Benefits for Coal Workers

Retraining incentive benefits are a one-time payment for miners who cannot return to their jobs after developing pneumoconiosis or black lung, a disease caused by long-term exposure to coal dust. If you qualify for RIBs, you may receive a bimonthly payment equal to two-thirds of your average weekly income, up to 75% of the state average. These payments can last for almost two years.

To be eligible, you must enroll in a training or education program with at least 12 weekly credits. This program can be at any accredited vocational school, community college, or university.

Vocational Rehabilitation Benefits

If you are injured at work and are consequently no longer able to do your job, you may seek vocational rehabilitation benefits. These can help cover the cost of retraining and reeducation, enabling you to learn new skills and find new employment compatible with your current condition.

Note that only injuries and illnesses not caused by intoxication, self-harm, horseplay, or commuting are eligible for VRBs. Here are some examples:

• Cumulative injuries, such as carpal tunnel syndrome and degenerative disc disease.

• Wear and tear injuries.

• Burns or electrocutions.

• Injuries from motor vehicle accidents during work-related travels.

• Psychological injuries in relation to physical trauma.

• Diseases that result from exposure to asbestos, coal dust, and hazardous chemicals.

In addition to helping employees recover and improve their quality of life, workers' compensation insurance may protect employers from being sued for injuries or illnesses caused by negligence. This means that if you are injured at work, you cannot always file a case against your employer.

However, you may file a third-party liability claim if someone other than your employer or coworkers caused your injury. These may be someone like your office building’s owner or the manufacturer of a defective product you’re using at work. If you win your case, you can receive compensation for lost wages, medical bills, property damage, and emotional distress.

How to File a Workers’ Compensation Claim in Kentucky

Just like in other states, the workers' compensation claim process in Kentucky is not solely the burden of the injured employee. Thus, employees and employers should cooperate throughout the process, especially when adhering to timelines and procedures. Since remembering all the steps can be tricky, it is ideal to seek the help of a workers' comp lawyer.

When Is the Deadline for Workers’ Compensation Claims in Kentucky?

In Kentucky, the statute of limitations for workers' compensation claims is two years. This means that if you have suffered an injury or acquired an illness at work, you must file your claim within two years from the date you sustained or discovered the occupational injury or illness. 

A scenario that falls under the discovery rule is your doctor diagnosing you with a serious disease caused by your work environment. For deaths resulting from workplace accidents, the family of the victim may file a claim within two years from the date of their death.

A Step-By-Step Guide to Filing a Workers’ Compensation Claim in Kentucky

1. Immediately Seek Medical Care

This is the most crucial step in ensuring your eligibility for workers' comp benefits. In general, employers refer their sick or injured employees to healthcare practitioners belonging to their own insurance network. However, if you are skeptical of the diagnosis or recommendations of your assigned physician, the law allows you to seek a second opinion from an out-of-network doctor at the expense of your employer.

To increase your chances of getting better, following your treatment plan exactly as prescribed by your doctor is essential. This includes avoiding restricted activities and taking your medications as directed.

2. Officially Inform Your Employer of Your Injury or Illness

After consulting your physician and receiving an official diagnosis, notify your employer of your workplace injury or illness within a week. Your report should include all relevant details, such as the date, time, and location of the incident; the names and contact information of witnesses; and the injuries suffered. Remember that the more specific your report is, the better.

3. Carefully Fill Out and Submit the Required Form(s)

The next step is to submit an Application for Resolution of a Claim, which the Division of Claims Processing will review. When filling out the paperwork, you must ensure it's error-free to prevent processing delays. Your application will then be assigned to an administrative law judge based on your residence. Submitting the application will also notify your employer and its insurance carrier.

If you choose to represent yourself, send the form to the Department of Workers' Claims. On the other hand, if you plan to hire a lawyer, they may file your application online. Once it has been received, you will receive an acknowledgment letter.

4. Patiently Wait for the Resolution of Your Claim

Once an ALJ has been assigned to your workers' compensation case, your employer or insurance carrier has 45 days to file a notice of claim denial or acceptance. The ALJ will oversee all legal processes necessary to resolve your claim and may ask you to attend a benefit review conference. 

During this meeting, the ALJ will give you 60 days and your employer 30 days to submit evidence, with an additional 15 days for you to respond or give a rebuttal. If no settlement is reached, the case will go to a hearing in court. 

At the hearing, both parties will present their arguments. The ALJ may require witnesses to testify in person and then decide on your case within 60 days of the last hearing. Note that their verdict — whether it’s in your favor or not — is final and binding unless either party appeals to a higher court.

What Should You Do If Your Workers’ Compensation Claim in Kentucky Has Been Denied?

Fortunately, you have the right to appeal the denial of your claim. But before doing so, you must review and understand the rationale behind the decision. Possible factors for workers’ comp claim denial include the following:

• There were technical issues, like incomplete requirements.

• Your employer argued that you were not on the job at the time of the incident.

• Your employer insisted that your injury or illness was pre-existing. 

You have 14 days to ask for reconsideration or file an appeal to the Kentucky Workers' Compensation Board, which will review the ALJ's decision and see if they applied the law correctly. In this stage, you are not allowed to submit new proof to the WCB, and it will not change the ALJ's findings if irrefutable facts back them up. Ultimately, if you disagree with the WCB's decision, you can reach out to the Court of Appeals and eventually to the Supreme Court. 

Bear in mind that filing an appeal is also an option if you are simply unhappy with the benefits given to you or with other orders issued by the ALJ.

Legal Resources for Injured Workers in Kentucky

If you have been injured at work, have gotten sick from a dangerous work environment, or are still recovering from an occupational injury or illness, these resources can help you file a workers' comp claim:

Kentucky Lawyer Referral Service

This program, sponsored by the Louisville Bar Association, caters to people who need representation in workers' compensation cases and other legal matters. You can visit the program’s webpage or call the office at 502-583-5314 on weekdays from 8:30 a.m. to 4:30 p.m. Meanwhile, individuals outside the Louisville area may seek lawyer referral services in Central Kentucky and Northern Kentucky.

Department of Workers' Claims

If you have concerns about workers' comp guidelines, requirements, or benefits in Kentucky, you can contact the DWC in the following ways:

• Online: Visit the DWC website and submit a question through the Contact Us form.

• Phone: Call its customer service line at 1-800-554-8601.

• In person: Go to its office during regular business hours. The address is 500 Mero Street, 3rd Floor, Frankfort, KY 40601.

If you need help filing a claim, a staff member may book you an appointment with a specialist or supervisor.

Occupational Safety and Health Administration

Every employee has the right to a safe and healthy workplace. This right is protected by the Occupational Safety and Health Act, which OSHA administers. Therefore, if you believe your employer is allowing or forcing employees to work in unsafe or unhealthy conditions, you can file a complaint or contact your local OSHA office for more information.

The organization is required to conduct a thorough investigation and take appropriate action, including issuing citations to your employer and requiring them to change your workplace for the better. Rest assured that OSHA will keep your personal information confidential to protect you from retaliation.