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 Section focuses on routing and preparation involved in the processing of an Application for Resolution filing. This section reviews the claim for required elements, assembles the file, enters claim information such as parties and addresses into the Department's database, assigns a claim number, and researches insurance coverage through the Department's insurance database. In the fiscal year 2013-2014, there were 4,875 new claims filed including 3,716 Applications for Resolution of Injury (Form 101), 627 Occupational Disease (Form 102 and Form 102 CWP), and 532 Hearing Loss (Form 103). Of the 627 Occupational Disease applications, 586 were Coal Workers' Pneumoconiosis applications.
For further information or questions, please call our Administrative Section Supervisor: Sandy Jump Lester
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 and Medical Disputes.
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 10 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 call Administrative Section Supervisor: Rhonda Pack, Section Supervisor
The Agreement is the processing and recording of all Settlement Agreements/Forms 110s received by the Department. Settlement Agreements are voluntary Agreements reached between the Parties involved including employee and employer/insurance carrier. Pre-litigation Agreements are reviewed by the Agreements staff for accuracy/completeness and approved by the Chief Administrative Law Judge if they meet the statutory/regulatory requirements. In Fiscal Year 2013-2014, a total of 7,148 Settlement Agreements were processed and recorded.
This section also processes and records Settlement Agreements approved by all other Administrative Law Judges.
Motions to Substitute Party (widow's benefits) are also processed and approved in the Agreement Section
For further information or questions, contact: Connie Morris, Assistant Director
Appeals is the other major area of concentration within this Division. 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 Anderson, Section Supervisor
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