Oklahoma'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, a competitive state fund, or self-insurance. Waivers are not permitted.
Exemptions from coverage may apply to certain employees, including many agricultural workers, some household domestic servants and casual laborers, and licensed real estate brokers and agents who are paid on commission.
Medical Benefits are provided to employees entitled to workers' compensation benefits, including reasonable and necessary medical treatment. Medical care is subject to treatment guidelines and utilization controls.
The employer chooses the initial treating physician, except in the case of an emergency. If the employer fails or refuses to select a doctor, the employee may choose a physician. The employee may petition the workers compensation for one change of physician for a body party affected by the injury, with no more than two changes of physician allowed per claim. An independent medical examination (IME) may be allowed, if ordered by the workers' compensation commission.
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 21 days 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 70% of the injured worker's average pre-injury weekly wage, subject to a cap, and continue for up to 156 weeks. TTD benefits are not paid if the injured worker is receiving unemployment 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 Oklahoma PTD benefits are calculated based upon 70% of the injured worker's pre-injury wage, subject to both a cap and a minimum benefit, and are payable for up to fifteen years or until the worker reaches the age of retirement, whichever is longer.
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 Oklahoma PPD benefits are determined based on statutory, and 70% of the employee's average weekly wage, subject to a cap. For unscheduled injuries, PPI benefits are based on an assessment of the injured worker's functional impairment, and are payable for a maximum of 500 weeks.
Temporary Partial Disability (TPD)
When a worker suffers an injury that limits his ability to return to work, resulting in a reduction of income as a result of reduced hours or wages, the injured worker may be eligible to receive a benefit based on the difference between the worker's pre-injury earnings and their reduced, post-injury earnings. In Oklahoma, TPD benefits are paid based upon 70% of the difference between the injured worker's pre-injury and post-injury wage, subject to a cap. Benefits may be payable for up to 52 weeks.
For some, more serious injuries, workers' compensation indemnity benefits may be paid according to a statutory schedule, instead of following the standard model of the weekly benefit based on the duration of the disability. Scheduled injuries include such injuries as the amputation of an arm, the loss of a dominant hand, the loss of a leg, the loss of a foot, the loss of an eye, or loss of hearing in an ear.
Coverage may be available for cumulative trauma, disfigurement, 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 85% of the worker's average weekly wage, subject to a cap in amount. Benefits may continue for minors until the age of 18, the age of 23 if the dependent is a student, or indefinitely in the event of disability that results in incapacity for self-support. Spousal benefits end upon remarriage, with the spouse receiving a two year lump sum benefit.
Legal heirs who are not entitled to death benefits but who can show a pecuniary loss associated with the worker's death may be entitled to a lump sum benefit.
Attorney fees are limited to 10% of the recovery in a contested temporary total disability (TTD) claim, or 20% of the recovery for a permanent total disability (PTD), permanent partial disability (PPD) or death claim, and are subject to court approval.
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:
Oklahoma Workers' Compensation Court
1915 North Stiles Avenue
Oklahoma City, OK 73105
(405) 522-8600 or 1-800-522-8210