Kentucky's system of workers' compensation is compulsory, meaning that employers are required to provide workers' compensation insurance to their employees. Workers' compensation insurance may be provided through private insurance carriers or self-insurance. Waivers may be permitted to exclude certain employees from coverage, including corporate officers.
Exemptions from coverage may apply to certain employees, including agricultural workers, certain domestic employees, and professional athletes.
Medical Benefits are provided to employees entitled to workers' compensation benefits, with coverage for medical care deemed reasonable and necessary. The employee makes an initial choice of physician, and may subsequently change doctors a single time. For any subsequent change of doctor the employee must show reasonable cause for the change.
Indemnity benefits are payable to injured workers to help make up for lost income. There is a waiting period of 7 days before a worker is eligible for indemnity benefits, but if the worker's disability lasts more than two weeks indemnity benefits become retroactive to the date of the injury. Benefits available to injured workers include the following:
Temporary Total Disability (TTD)
Temporary total disability (TTD) benefits are paid to workers who are unable to work due to injury, but who are expected to make full or partial recovery such that they may return to work. Benefits are based upon 2/3 of the worker's average pre-injury weekly wage, subject to a cap, and continue for the duration of the temporary disability, or until the employee receives Social Security retirement and survivor benefits. Offsets may apply for unemployment insurance and for employer-funded disability insurance benefits.
Permanent Total Disability (PTD)
When a worker is not expected to recover from a total disability caused by a work-related injury, and as a result suffers a total loss of earning capacity, the worker becomes eligible for permanent total disability (PTD) benefits. In Kentucky PTD benefits are calculated based upon 2/3 of injured worker's average weekly wage, subject to a cap, and may continue until the injured worker qualifies for Social Security retirement benefits. Offsets may apply for employer-funded disability insurance benefits and for unemployment insurance.
Permanent Partial Disability (PPD)
Once an injured worker has recovered to the maximum possible extent, the worker may be able to return to employment but nonetheless remain partially disabled, and may potentially qualify for permanent partial disability (PPD) benefits. In Kentucky PPD benefits are determined based upon an injured worker's permanent impairment rating and statutory factors, applying 2/3 of the injured worker's average weekly wage subject to a cap. Benefits are payable for up to 425 weeks for impairments of 50% or less, and for up to 520 weeks for impairments over 50%, but end when the worker qualifies for Social Security retirement benefits.
For some, more serious injuries, workers' compensation indemnity benefits may be paid according to a statutory formula, instead of following the standard model of the weekly benefit based on the duration of the disability. Kentucky presumes that certain serious injuries result in permanent total disability.
Coverage may be available for cumulative trauma, disfigurement resulting in permanent impairment, and occupational hearing loss.
When a worker dies as the result of a work-related injury, workers' compensation pays additional benefits, including a burial allowance, and benefits for a surviving spouse and dependents. Survivor benefits are calculated based on 40% of the worker's average weekly wage for a spouse and 30% to a dependent child, subject to a cap in amount. Benefits may continue for minors until the age of 18, the age of 22 if the dependent is a student, or indefinitely in the event of disability. Spousal benefits end upon remarriage.
Attorney fees are limited by statute to 20% of the first $25,000 of income benefits recovered, 15% of the next $10,000, and 5% of any additional recovery, with a maximum permitted fee of $12,000. Attorney fees are subject to review by an administrative law judge with the Department of Workers Claims.
This article provides a quick overview of the benefits available to injured workers, but the full formulas used for assessment of benefits, coordination of different types of benefits, and assessment of injuries and disability ratings can quickly complicate the determination of benefits. Also, states frequently revise their workers' compensation laws. Most workers who suffer a significant injury or wage loss as the result of a workplace injury will benefit from consulting a workers' compensation lawyer.
The state agency responsible for workers' compensation is: Kentucky Labor Cabinet Department of Workers' Claims 657 Chamberlin Avenue Frankfort, KY 40601 (502) 564-5550 or 1-800-554-8601