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Workers' Compensation

Claims Process

Introduction

Filing a claim involves a multistep process by which your claim is received and/or approved.


Claims Review

The Claims Review's primary function is processing the Application for Resolution of Injury, Occupational Disease, Coal Workers' Pneumoconiosis (CWP) or Hearing Loss claims. The Claims Review focuses on routing and preparation involved in the processing of an Application for Resolution filing. This includes reviewing the claim for required elements, entering claim information such as parties and addresses into the Department's database, assigning a claim number, and researching insurance coverage through the Department's insurance database. In the fiscal year 2016-2017, there were 5,060 new claims filed including 3,743 Applications for Resolution of Injury (Form 101), 743 Occupational Disease (Form 102 and Form 102 CWP), and 574 Hearing Loss (Form 103). Of the 743 Occupational Disease applications, 682 were Coal Workers' Pneumoconiosis applications.

For further information or questions, please contact:

Connie Morris, Assistant Director
Phone: 502-782-4407
Email: ConnieF.Morris@ky.gov

Claims Assignment

The Claims Assignment responsibilities begin with the assignment of new claims, and older claims that have been reopened by order of the Chief Administrative Law Judge.

Once the claims are filed with the Department of Workers' Claims, the claims are prepared, sorted into regions based on the county of residence of the Plaintiff, and assigned to an Administrative Law Judge. When the Claims are ready to be scheduled, it is this Division's responsibility to ensure that all Parties are notified the Claims has been assigned to an Administrative Law Judge and scheduled for a Benefit Review Conference, at one of the 9 Hearing Sites (including Frankfort), across Kentucky, operated by the Department of Workers' Claims. This Conference is an informal meeting for the Parties to define and narrow the issues of the claim, discuss settlement options and consider other relevant matters that may aid in the resolution of the Claim.

Other duties include routing Motions on claims prior to assignment to an Administrative Law Judge; scheduling court reporters and reserving hearing sites; serving as x-ray and exhibit custodians, and auditing resolved claims to confirm all information is contained in the electronic file before the physical file is purged.

For further information or questions, please contact:

Connie Morris, Assistant Director
Phone: 502-782-4407
Email: ConnieF.Morris@ky.gov

Agreements

The Agreements Section processes all Form 110 Settlement Agreements received by the Department. Most of the agreements come from settlements reached without litigation. The Agreements Staff reviews those Form 110’s for statutory compliance. The agreements are ultimately approved or disapproved by the Chief Administrative Law Judge. Form 110’s received at DWC in litigated cases are routed through the Agreements Section for transmittal to the ALJ assigned to the claim and responsible for review and approval. The Agreements Section also processes Form 11’s, which are requests to continue spousal or dependent benefits upon the death of an injured worker.

For further information, contact:

Hollie Dean
502-782-4472
Hollie.Dean@ky.gov
Aimee Robinson
502-782-4549
Aimee.Robinson@ky.gov
Toni Trisler
502-782-4420
Toni.Trisler@ky.gov
Fax: 502-564-5741

Agreements FAQ

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    Agreements

  • Has my Agreement been received and/or approved?

    ​Once the Agreement is approved, you will receive an approved copy by U.S. mail. If you are represented by an attorney, your attorney will receive a copy.

  • In addition to the Form 11, Motion to Substitue Party and Continue Benefits, what documentation do you need to process my request for widow or dependent benefits?

    You will need to include a copy of the Death Certificate, Marriage License, and any dependent Birth Certificates. You or your attorney will be contacted if any additional information is needed.

  • What is the discount rate?

    ​The discount rate is established each year and information on the current year's rate can be found in the Guides Section of the Publications are of the Department of Workers' Claims website.

  • Is there a tool available to assist in the calculation of both weekly and lump sum settlements?

    ​ Yes. The PPD Calculator is a very helpful tool that illustrates how the Discount Rate and other guidelines apply to the Settlement. Because of Social Security regulations, the PPD Calculator cannot be used for workers who reach retirement age, as defined in KRS during the period of income benefits.

  • Appeals

  • How much time do I have to file an appeal to the Workers' Compensation Board?

    ​Notices of Appeal to the Board should be filed within 30 days of the Administrative Law Judge's opinion or final order.

  • When is the Petitioner's brief due?

    ​Petitioners have 30 days from the filing of the Notice of Appeal to file a brief.

  • When is the Respondent's brief due?

    ​Respondent's briefs are due 30 days from the filing of the Petitioner's brief.

  • Claims Assignment

  • When will a Scheduling Order be issued and what is the pertinent information on it?

    ​All Parties of Record will be notified, by letter, of the Judge assigned to the claim along with the date, time and location of the Benefit Review Conference.

  • Where do I send additional documents associated to the claim such as Motions?

    ​Mail all pleadings/documents to:

    Department of Workers' Claims
    657 Chamberlin Ave.
    Frankfort, KY 40601


  • How can I get my x-ray or other exhibit returned to me?
  • I am a physician and need a claim number for billing purposes?

    ​The number assigned by the Department of Workers' Claims is for litigation purposes and is not the same number used by the insurance carrier to process a claim. Contact the Employer/Insurance Carrier for payment information.

  • Claims Review

  • Where and to whom do I send the Application?

    Send the Application to:

    Department of Workers' Claims
    657 Chamberlin Ave.
    Frankfort, KY 40601


  • How many copies of the Application do you need?

    ​The Department of Workers' Claims must receive the original and enough copies to serve all Parties listed on the claim.

  • Has my Claim been received and when was it received?

    ​You will receive an Acknowledgement Letter with the date it was received.

  • Why was an additional Party added to my Claim?

    ​The Claim is researched and based on our records, any Party with potential liability is included as a Party to the Claim.

  • A First Report of Injury has already been filed, so why did I get this letter saying no matching First Report of Injury has been filed?

    ​Information submitted on the Application and information filed electronically on the First Report of Injury do not match. Therefore, there is no matching First Report of Injury on record.

Appeals

The final awards, orders, and decisions from the Administrative Law Judges that are challenged must pass through this Section to verify timeliness of filings, completeness of records, indexing, scheduling and ensuring compliance with the Administrative Regulations - all in preparation for the Workers' Compensation Board's review and judgment. Motions are tracked daily and a Docket prepared weekly. In the event the decision of the Workers' Compensation Board is contested, Section staff shall, upon request, ready and certify the files for review by the Court of Appeals and, in some cases, the Supreme Court.

The Appeals Section processed 331 appeals to the Workers' Compensation Board this fiscal year. There were 82 Appeals sent to the Court of Appeals with 75 records being requested and sent to Court. There were 28 appeals to the Supreme Court this Fiscal Year.

For further information or questions, please contact:

Melissa Wright, Section Supervisor
Phone: 502-782-4467
Fax: 502-564-3792
Email: Melissa.Wright@ky.gov

Workers' Compensation Board

Since 1987 and pursuant to KRS 342.285, the Kentucky Workers’ Compensation Board has been the first step in the appellate process in a workers’ compensation litigated claim. The three members of the board are appointed to four-year terms by the governor, subject to confirmation by the Senate. Board members must possess qualifications of Court of Appeals judges.

Beginning in 1994, statutory alterations obligated the board to render its opinion within 60 days of the filing of the last brief. The cases are randomly assigned to each board member to be the primary author of that opinion. In each opinion, unless it is necessary for a board member to recuse himself from the case, all three will participate in the decision.

From 1994 to present, approximately 65 percent to 72 percent of the decisions rendered by the Workers’ Compensation Board were appealed no further. In the years in which a higher percentage of appeals occur, it generally follows that many of these cases are addressing new law changes. Because of major changes in the Kentucky Workers’ Compensation Act in 1994, 1996, 2000 and now with a significant change dealing with coal workers’ pneumoconiosis, appeals addressing first-time issues have tended to increase.

The Workers' Compensation Board consists of three Board Members including the Chairman who are appointed for four-year terms.

Board members are:

Michael W. Alvey, Chairman

  • Theresa Absher, Secretary
  • Sarah Bash Brian, Staff Attorney

Rebekkah Bravo Rechter

  • Melanie Montgomery, Secretary
  • Bill Pospishil, Staff Attorney

Franklin A. Stivers

  • Tiffanie Martin, Secretary
  • Silvana Minella, Staff Attorney