Workers Compensation Laws change frequently. This is only a summary; a complete copy of the most up-to-date version can be found at: www.WorkCompResearch.com , an excellent service.
In Kansas workers compensation coverage is compulsory as to all employment, including corporate executives and employees of charitable organizations. Coverage is elective for individuals, partners or the self-employed. There are some exceptions. Real estate brokers and real estate salespeople on commission are excluded from the compulsory requirements. Also, farm labor and employees of any employer whose gross annual payroll is $20,000 or less are excluded from compulsory coverage.
Obtaining Coverage
To obtain workers compensation coverage in Kansas, the employer has three options which are
- purchasing a workers compensation insurance policy from a state approved insurance company
- applying to and being approved for self-insurance status with the Kansas Department of Labor.
- being a part of a group-funded self-insurance plan that has been approved by the Kansas Department of Labor
Claim Reporting
The employee must provide notice of the injury to the employer with 10 days and up to 75 days with just cause. The actual claim of the employee must be served on the employer within 200 days after the accident, or last payment, or within 1 year of the employee’s death with death occurring within 5 years after the date of the accident. WCxKit
Medical Benefits
In Kansas, the employer selects the medical provider for workers compensation claims. The employer is required to provide all reasonable and necessary medical care free of any charges to the employee. The employer is also liable for up to $500 of employee incurred medical bills at a non-authorized doctor. The employee can also apply to the Director of Workers Compensation for a change of doctors. The employee is entitled to all medical treatment needed to cure or relieve the effects of the injury. Prayer or spiritual treatment is permitted by agreement.
Temporary Total Disability Benefits
The temporary total disability (TTD) benefits are calculated as two-thirds of the employee's average weekly. The maximum amount of TTD benefits that can be paid is $555.00 per week. The state maximum is subject to annual increase/decrease each July 1st, based on the state’s average weekly wage. The state minimum weekly benefit is $25.
The first 7 days of disability (the waiting period) is not paid to the injured employee unless the employee is disabled for more than 21 days. TTD benefits can be paid until a cap of $100,000 has been reached.
Temporary Partial Disability Benefits
In Kansas if the employee is able to return to any type of work, but at a lesser rate of pay then the amount the employee was earning prior to the injury, the employee is entitled to temporary partial disability (TPD) benefits. The TPD benefits are paid at two-thirds of the difference between the pre-injury wage and the post-injury wage. The TPD benefits are paid for up to a maximum of $100,000. The TPD benefits plus the post-injury pay rate cannot exceed the state's maximum indemnity benefits rate.
Permanent Partial Scheduled Disability
Kansas uses a Schedule to establish the value of an injury to all extremities, the shoulders, eyes and hearing. Each body part has a set number of weeks it is worth with a shoulder being worth 225 weeks of compensation and the number of weeks decreasing with other extremity body parts having lesser value down to a toe, other than a big toe, being worth 10 weeks of compensation. A 20% loss of use of the arm, which is scheduled at 210 weeks, would result in a permanent partial scheduled disability award of 42 weeks (210 weeks X 20%).
Permanent Partial General Disability
When the employee sustains a permanent partial general disability of a body part not listed on the Kansas Scheduled Injuries list and the employee is not permanent totally disabled, the employee receives permanent partial general disability. If the employee is able to return to work and is earning at least 90% of the average weekly wage, the employee is given a percentage of the whole body impairment based on the AMA Guidelines, Fourth Edition. The maximum in weeks is 415 weeks. An employee with a 10% rating would get an award of 41.5 weeks of compensation. The maximum an employee can collect for permanent partial disability is $100,000.
Permanent total disability
Kansas permits the employee to collect a maximum of 415 weeks of indemnity benefits for all types of indemnity combined, but the total amount of benefits collected for permanent total disability is $125,000 instead of $100,000 (the amount of TTD benefits paid to the employee is included in the $125,000 indemnity benefit cap).
Death Benefits
The burial expenses in Kansas are covered for a work-related death up to $5,000. The death benefits for a dependent spouse and children follow the same guidelines as TTD benefits – two-thirds of the average weekly wage – currently a maximum of $555 week, and a minimum survivor’s benefit of $370 per week, except there is a dollar maximum for death benefits in the amount of $250,000 with children, or $200,000 without children. If there is no spouse and no dependents, the death benefit is reduced to $25,000. WCxKit
Vocational Benefits
Vocational Rehabilitation is on a voluntary basis in Kansas. However, once it is started, it cannot be terminated without the agreement of the employee. The vendor of the vocational rehabilitation may be changed for good cause supported by substantial evidence. If so, the employee may select the replacement vendor from a list of three qualified vendors provided by the employer.
Author Rebecca Shafer, JD, President of Amaxx Risk Solutions, Inc. is a national expert in the field of workers compensation. She is a writer, speaker, and website publisher. Her expertise is working with employers to reduce workers compensation costs, and her clients include airlines, healthcare, printing/publishing, pharmaceuticals, retail, hospitality, and manufacturing. She is the author of the #1 selling book on cost containment, Manage Your Workers Compensation: Reduce Costs 20-50% www.WCManual.com.
Contact: RShafer@ReduceYourWorkersComp.com.
Do not use this information without independent verification. All state laws vary. You should consult with your insurance broker or agent about workers comp issues.
©2011 Amaxx Risk Solutions, Inc. All rights reserved under International Copyright Law. If you would like permission to reprint this material, contact Info@ReduceYourWorkersComp.com.
As any employer with locations in more than one state knows, the workers compensation policy is written specifically for the states where the employer has physical facilities. On the Information Page that comes with each new policy or policy renewal, is Item 3.A (for most insurance carriers) which designates the states where the workers compensation policy is applicable. Workers compensation coverage does not apply to claims filed in other states.
While the insurance carriers attempt to limit the exposure to claims occurring where they may not have claims offices, or knowledge of the workers compensation statutes, the states take a much broader approach. The workers comp statutes of most states specify when and how the workers comp act applies out of state. Normally, the state statute will indicate that if the contract to hire was negotiated within the state, the workers comp laws apply regardless where the injury occurs. (WCxKit)
Most state workers comp statutes will have extraterritorial provisions that state if the principal place of employment is within the jurisdictional boundaries, a workers comp injury occurring outside of the state boundaries is still covered by the state law. The workers comp statutes also normally specify that any work related injury occurring within the borders is subject to the workers compensation statutes, even for employers and employees whose place of business is not within the state line boundaries.
When the employee is injured in another state where the employer does not normally do business, the extraterritorial provisions of the state workers comp act work great, as long as the employee elects to utilize the benefits of the home state workers compensation act. The problems occur when the employee elects to file the claim in a state where the employer does not have a physical location and the employer does not have workers compensation coverage.
The usual reason an employee files for benefits in a state other than the home state is the amount of temporary total disability (TTD) benefits that will be paid. Consider the highly successful salesman from Georgia earning $1,500 per week. If he is injured in Iowa with its high maximum weekly TTD rate, he will receive $1,000 per week while he is unable to work, if he elects Iowa for workers comp benefits. If he elects Georgia benefits, the TTD rate is capped at $500 per week.
This creates a coverage issue for the employer. When the workers comp policy is purchased, the employer should have the insurance agent or broker specify in Item 3.C of the Information Page the other states for which coverage is requested. Some agents will approach this by listing every state and territory except North Dakota, Ohio, Washington, Wyoming, Puerto Rico and the US Virgin Islands (the four monopolistic states and two monopolistic territories where the state/territorial governments provide the workers comp coverage). This can result in an accidental oversight where the agent leaves out a state.
A better approach is to insert the following on the Information Page in Item 3.C: “All states and US territories except North Dakota, Ohio, Washington, Wyoming, Puerto Rico and the U.S. Virgin Islands and those states listed in Item 3.A of the Information Page.” While this is the best approach to out of state coverage, some insurers, especially single state insurers or small regional insurers, will object to providing workers comp coverage in other states where they are not licensed to do business.
Most employers think of the workers compensation policy and the workers compensation coverage as one and the same. Actually, the workers comp policy is divided into several sections with Part 1 being the actual workers comp coverage. Part 2 is employer’s liability insurance which covers injuries to employees when workers comp coverage does not apply. Part 3 is Other States Insurance. With this coverage, workers compensation and employers liability insurance is provided for incidental exposure in states not listed in Item 3.A of the Information Page.
It should be noted that Other States Insurance covers only incidental exposures. When the employer starts to have employees in a state on a regular basis, the states needs to be included in those listed in Item 3.A of the Information Page. If your business has employees who occasionally travel out of state, it is a good idea to routinely review your coverage with your insurance agent to confirm that your policy provides for incidental out of state exposures.
Author Rebecca Shafer, JD, President of Amaxx Risk Solutions, Inc. is a national expert in the field of workers compensation. She is a writer, speaker, and publisher. Her expertise is working with employers to reduce workers compensation costs, and her clients include airlines, healthcare, printing/publishing, pharmaceuticals, retail, hospitality, and manufacturing. She is the author of the #1 selling book on cost containment, Workers Compensation Management Program: Reduce Costs 20% to 50%. Contact: RShafer@ReduceYourWorkersComp.com.
Do not use this information without independent verification. All state laws vary. You should consult with your insurance broker or agent about workers comp issues.
©2012 Amaxx Risk Solutions, Inc. All rights reserved under International Copyright Law. If you would like permission to reprint this material, contact us at: Info@ReduceYourWorkersComp.com.
Washington's job sites were safer in 2010, continuing a trend that began nearly a decade ago, according to survey results released recently by the Department of Labor & Industries.
The Occupational Injury and Illness Survey for Washington State noted that 5 out of every 100 full-time workers in Washington in both the private and public sector industries suffered a job-related injury or illness in 2010, down from the 5.3 rate in 2009. (WCxKit)
It is the lowest rate recorded since 2003, when the injury rate in Washington state was 6.9. That is when L&I began using the North American Industry Classification System (NAICS) which had been adopted by the U.S. Bureau of Labor Statistics (BLS).
For private industry alone, Washington's reported injury and illness rate remains higher than the national rate. For Washington, that rate was 4.8 per 100 full-time workers in 2010, while the national rate was 3.5.
Almost all major industry sectors in Washington reported improved numbers in 2010. In construction, for instance, the injury and illness rate dropped from 8.2 in 2009 to 7.2 in 2010. Nursing and Residential Care Facilities saw a decline of 11.4 injuries per 100 workers in 2009 to 9.4 injuries last year. (WCxKit)
Also declining in the latest survey was the rate of injuries serious enough that a worker had to miss work. In 2010, 2.5 of those 5 workers who were injured or became ill needed time off or modified work duties while they recovered. That rate is down from 2.6 in 2009.
Author Robert Elliott, executive vice president, Amaxx Risk Solutions, Inc. has worked successfully for 20 years with many industries to reduce Workers Compensation costs, including airlines, healthcare, printing/publishing, pharmaceuticals, retail, hospitality and manufacturing. See www.LowerWC.com for more information. Contact: Info@ReduceYourWorkersComp.com.
Author Rebecca Shafer
, JD, President of Amaxx Risk Solutions, Inc. is a national expert in the field of workers compensation. She is a writer, speaker, and website publisher. Her expertise is working with employers to reduce workers compensation costs, and her clients include airlines, healthcare, printing/publishing, pharmaceuticals, retail, hospitality, and manufacturing. She is the author of the #1 selling book on cost containment, Manage Your Workers Compensation: Reduce Costs 20-50% www.WCManual.com.
Contact: RShafer@ReduceYourWorkersComp.com.
Do not use this information without independent verification. All state laws vary. You should consult with your insurance broker or agent about workers comp issues.
©2011 Amaxx Risk Solutions, Inc. All rights reserved under International Copyright Law. If you would like permission to reprint this material, contact Info@ReduceYourWorkersComp.com.
The independent Occupational Safety and Health Review Commission has upheld willful and serious citations and $137,200 in fines issued by the U.S. Department of Labor's Occupational Safety and Health Commission to Sand Cut Properties LLC, a Danbury, Conn., contractor.
According to information from OSHA, the agency cited Sand Cut Properties in November 2008 after inspectors at a Brookfield, Conn., work site found an employee working in a collapsing 6- to 9-foot-deep excavation that lacked cave-in protection and had piles of excavated materials overhanging its edge as well as water seeping into its bottom. The employee was exposed to an additional crushing hazard when he exited the excavation by riding in the bucket of an excavator. The citations and fines reflected the seriousness of the violations and the employer's knowledge of and failure to prevent the cave-in hazards. (WCxKit)
The company contested the willful violations cited and accompanying fines to the review commission in December 2008. A hearing was held before Administrative Law Judge Dennis Phillips on June 28, 2011. On Sept. 22, Judge Phillips issued a decision affirming the citations and ordering Sand Cut Properties to pay $137,200 in fines. The decision will become a final order on Nov. 10 if Sand Cut does not appeal to the commission.
"This was an imminent danger situation that could have resulted in a fatality and should not have existed in the first place," said Marthe Kent, OSHA's New England regional administrator. "This decision should remind employers in Connecticut and elsewhere that failing to supply basic, common sense and legally required safeguards will result in financial and legal consequences, just as employees face the consequences of death or disabling injuries when such safeguards are absent from their workplaces." (WCxKit)
"The U.S. Department of Labor will actively pursue the appropriate legal measures to protect the lives and well-being of America's workers when their employers fail to do so," added Michael Felsen, the Labor Department's regional solicitor for New England.
Author Robert Elliott, executive vice president, Amaxx Risk Solutions, Inc. has worked successfully for 20 years with many industries to reduce Workers Compensation costs, including airlines, healthcare, printing/publishing, pharmaceuticals, retail, hospitality and manufacturing. See www.LowerWC.com for more information. Contact: Info@ReduceYourWorkersComp.com.
Do not use this information without independent verification. All state laws vary. You should consult with your insurance broker or agent about workers comp issues.
©2011 Amaxx Risk Solutions, Inc. All rights reserved under International Copyright Law. If you would like permission to reprint this material, contact Info@ReduceYourWorkersComp.com.
We are always writing articles to assist the employer in dealing with the complexities of the workers compensation system. We thought for a change of pace we would provide an article to assist the employees in dealing with the tangled web of workers compensation.
The following suggestions will make the workers compensation claim go smoother and alleviate the angst that naturally occurs when an employee is injured on the job. (WCxKit)
1. Report your workers compensation claim immediately, even if you do not need medical care at the moment. What may feel like a pulled muscle today may be a major problem next week. It is better to have a record of your injury when it occurs rather than trying to explain why you are reporting the injury late.
2. Ask your supervisor to prepare a written report of the incident. Your supervisor should willingly do so, but if for any reason the supervisor does not act immediately, submit your own written report providing all the details of what you were doing when you got hurt. Be sure the details of your incident are accurate, as the fastest way to lose credibility is to allow inaccurate information to be reported.
3. Select a medical provider from the list posted. If you do not understand the different specialties, ask for guidance. A medical provider close to work or close to your home is often the easiest one to reach.
4. All the medical care related to your injury will be provided until you have recovered from the injury.
5. If you have a pre-existing medical condition, which can be anything from a prior back injury to diabetes, do not try to hide that fact. To get the appropriate medical care you need, all medical conditions or issues should be disclosed to the medical provider.
6. Keep track of your mileage to and from every medical appointment and to/from the pharmacy. Your mileage can be reimbursed in most states, but only if you have a record of it. Keep a copy of all mileage logs turned into the adjuster.
7. Obtain a written copy of the report your employer submits to the insurance claims office. If anything is incorrect on the report, now is the time to correct it, not later.
8. Attend all doctor appointments and all diagnostic testing. If you do not think you are hurt enough to attend the medical appointments, neither will the adjuster.
9. Provide a copy of all off-work (disability) slips to your employer and to the insurance adjuster, and keep a copy for yourself. Ask your employer if they have a more complete form to use, often called an Injury Treatment Form or Accident Report Form that gathers enough information about your injury so your employer can locate a transitional duty job for you.
10. Keep in touch with the employer and the insurance adjuster. After each doctor's visit, call both the employer and the insurance adjuster and give them an update on what the doctor said about your medical progress and when you may be able to return to work. If you are on transitional duty and your capability increases (it should) let your employer and insurance adjuster know about this.
11. Every work place has co-workers that will want to give you unsolicited advice on your workers comp claim. Follow the real doctor's medical guidance not your friends and co-workers.
12. Every state has a waiting period before lost wage compensation can be paid. Ask the claims adjuster what the waiting period is in your state. If you are out of work longer than the waiting period, you will be paid a percentage (often 66.67%) of your average weekly wage.
13. Ask about your employer's return to work program while your doctor has you off work with restrictions. Often your employer can modify your current job duties so that you can return to work sooner.
14. Do not violate the work restrictions placed on you by your doctor while working light duty. You will most likely end up aggravating your prior injury and extending the period of time it will take for you to recover from your injury.
15. If a nurse case manager is assigned to your claim, keep the nurse informed as to your medical progress and understand he/she is there to make sure you obtain the appropriate medical care. (WCxKit)
Your employer hopes you will never get hurt, but if you do, keep the workers comp claim suggestions in mind to improve the claim experience and the overall outcome of your claim.
If you are an employer reading this, the above items can be included in an employee brochure.
Author Rebecca Shafer, JD, President of Amaxx Risk Solutions, Inc. is a national expert in the field of workers compensation. She is a writer, speaker, and website publisher. Her expertise is working with employers to reduce workers compensation costs, and her clients include airlines, healthcare, printing, publishing, pharmaceuticals, retail, hospitality, and manufacturing. Rebecca is the author of Workers Compensation Management Program: Reduce Costs 20-50%. See www.LowerWC.com for more information. Contact: RShafer@ReduceYourWorkersComp.com.
Do not use this information without independent verification. All state laws vary. You should consult with your insurance broker or agent about workers comp issues.
©2011 Amaxx Risk Solutions, Inc. All rights reserved under International Copyright Law. If you would like permission to reprint this material, contact Info@ReduceYourWorkersComp.com.
Author Karen C. Yotis writes, “When a workers’ compensation maven of Rebecca Shafer’s caliber shares her expertise about implementing cost containment best practices, industry professionals can’t afford to do anything but listen.” She, of course, also continues to say, “risk managers, adjusters, vendors, attorneys, agents and brokers, carriers, and employers can’t afford to do anything but
click here to purchase the book, and start reading.”
We like her.
Yotis explains our book is a roadmap that has sharp teeth and notes that its author, Shafer, has more than 25 years of experience in the industry. “This is NOT an intellectual discussion about workers comp issues and trends, but rather a hands-on practicum written from years of field research with a host of companies.” Yotis writes.
She goes on to review and explain both parts of the manual, An Action-Oriented “How To” Template and Cost Containment from Soup to Nuts noting where updates from previous editions make this the one to buy.
To read her full review, follow the link
here. Or, just click on over
here and get your own copy!
Author Rebecca Shafer, JD, President of Amaxx Risk Solutions, Inc. is a national expert in the field of workers compensation. She is a writer, speaker, and publisher. Her expertise is working with employers to reduce workers compensation costs, and her clients include airlines, healthcare, printing/publishing, pharmaceuticals, retail, hospitality, and manufacturing. She is the author of the #1 selling book on cost containment, Workers Compensation Management Program: Reduce Costs 20% to 50%. Contact: RShafer@ReduceYourWorkersComp.com.
Do not use this information without independent verification. All state laws vary. You should consult with your insurance broker or agent about workers comp issues.
©2012 Amaxx Risk Solutions, Inc. All rights reserved under International Copyright Law. If you would like permission to reprint this material, contact us at: Info@ReduceYourWorkersComp.com.
LexisNexis Workers Compensation Law Community directed by attorney
Robin Kobayashi recently teamed up with Work Comp Roundup to deliver expert opinions on the 10 most critical myths and facts about workers compensation.
The article goes into depth on the following 10 myths, in no particular order:
Myth #1: Large discount networks are the key to success in workers compensation managed care – from
Kenneth F. Martino, president and CEO of Broadspire Services, Inc.
Myth #3: Workers compensation claims improve with age, by
Mark Walls, assistant vice president of claims at Safety National.
Myth #4: Technology will cure all of our ills, from
Robert Wilson, president & CEO of WorkersCompensation.com, LLC.
Myth #5: Because FECA is so different from state workers compensation systems, private sector case management best practices won’t work, contributed by
Marianne Cloeren, MD, MPH, FACOEM, and medical director of Managed Care Advisors, Inc.
Myth #8: Doctors prescribe narcotic pain medications because of concerns they may be sued if they don’t treat pain from
Stuart D. Colburn, Esq., shareholder in Downs Stanford, P.C.
Remember, these are all MYTHS! The
article itself goes into depth explaining why they are not FACTS. Work Comp Roundup considers it required reading for everyone in the field – it’s a great way to start the new year.
Author Rebecca Shafer, JD, President of Amaxx Risk Solutions, Inc. is a national expert in the field of workers compensation. She is a writer, speaker, and publisher. Her expertise is working with employers to reduce workers compensation costs, and her clients include airlines, healthcare, printing/publishing, pharmaceuticals, retail, hospitality, and manufacturing. She is the author of the #1 selling book on cost containment, Workers Compensation Management Program: Reduce Costs 20% to 50%. Contact: RShafer@ReduceYourWorkersComp.com.
Do not use this information without independent verification. All state laws vary. You should consult with your insurance broker or agent about workers comp issues.
©2011 Amaxx Risk Solutions, Inc. All rights reserved under International Copyright Law. If you would like permission to reprint this material, contactInfo@ReduceYourWorkersComp.com.
Document, Document, Document
Carriers preach the importance of documentation in claim files using this pithy saying: " If it is not documented, it did not happen." The same should be true for every employer. Risk management or safety team members must properly document everything. This includes tracking numbers and incidents, recording safety problems, and keeping a close watch on injuries and incidents on the work floor.
Why record keeping is important
All workers arrive on the job with various physical issues related to their personal life. Perhaps the worker did a lot of yard work over the weekend and is sore. Maybe the employee fell shoveling snow and has a back injury. Maybe personal turmoil is affecting safety and work. Regardless of cause, it is important to keep proper records on everything heard on the job floor. No one can recall every single detail of a day, so writing it down is critical to document the situation.
When talking to employers, I ask the employer how aware they are of an employee’s personal life. Some answer that question by saying little to no social contact with employees. Other employers will report being friends with coworkers and socializing on a regular basis. Some are right in the middle, reporting casual exchanges in the hallway or break room but not really knowing the employee.
The medical worlds of insurance are interwoven between personal injuries and workers compensation injuries. Some workers have a good combination of both. Some workers never take any time off for a medical condition, whereas others will be off of work frequently for some reason or another.
Many HR people have access to personal medical leave papers. The importance of keeping records shows itself when the time comes and they are needed. If an employee had a knee surgery last year then suddenly claims to injure the same knee at work, a review of personnel files may show the alleged knee injury is not work related. But if the records do not exist, then there is no way to question the claim.
When filing the compensation claim for the knee injury, the adjuster calls and probes about any other past injuries. If the employer is only able to give a vague account of a past injury, the adjuster lacks information to judge the claims compensability. If the claimant does not bring it up to the adjuster, and there are no records as to the employee’s medical leave, there is no way to prove a pre-existing knee injury is present. So with any injury, it is important to keep proper records in every personnel file. No matter the reason for the medical leave, documentation with as much information as possible must be gathered at the time of medical leave. This will help in the future should an issue like the one described happen. The impact documentation has on a workers comp claim can be priceless, in that the employer may not pay workers comp benefits.
Document, document, document …. oh, and write it all down.
Author Rebecca Shafer, JD, President of Amaxx Risk Solutions, Inc. is a national expert in the field of workers compensation. She is a writer, speaker, and website publisher. Her expertise is working with employers to reduce workers compensation costs, and her clients include airlines, healthcare, printing, publishing, pharmaceuticals, retail, hospitality, and manufacturing. She is the author of the #1 selling book on cost containment, Workers Compensation Management Program: Reduce Costs 20% to 50%. www.WCManual.com
Visit www.LowerWC.com for more information for cost saving hints and tips. Contact: RShafer@ReduceYourWorkersComp.com.
Do not use this information without independent verification. All state laws vary. You should consult with your insurance broker or agent about workers comp issues.
©2011 Amaxx Risk Solutions, Inc. All rights reserved under International Copyright Law. If you would like permission to reprint this material, contact Info@ReduceYourWorkersComp.com.
Workers Compensation Laws change frequently. This is only a summary; a complete copy of the most up-to-date version can be found at: www.WorkCompResearch.com an excellent service.
In Indiana, every employer who has one or more employees, whether full time or part time is required to carry workers compensation insurance. There are some exceptions. Railroad workers, real estate professionals, independent contractors, inmates and volunteers of non-profits are not covered by workers compensation. Employers of casual laborers, household employees, agriculture employees, and migrant farm workers may elect to buy workers compensation insurance. All county and municipal governments, and all school districts must carry workers compensation insurance, but police officers and firefighters may not be covered if they are covered for injury through a pension fund.
Obtaining Coverage
To obtain workers compensation coverage in Indiana, the employer has two options of either
purchasing a workers compensation insurance policy from a state approved insurance company
applying to and being approved for self-insurance status with the Indiana Workers Compensation Board. (WCxKit)
Claim Reporting
The employee must report the injury to the employer as soon as practical after the occurrence. If the injury is reported after 30 days, benefits start as of the date of the notice. If the employee incurs disability of one or more days, the employer is required to report the claim to the Board of Workers Compensation within 7 days. If the employer (insurer) fails to report the claim timely to the board, the employer (insurer) can be fined $500.00.
Medical Benefits
The employer selects the medical provider in Indiana workers compensation claims. The employer is required to provide all reasonable and necessary medical care free of any charges to the employee. There is no time limit on how long medical care can be provided.
In cases involving permanent injury, the Board may order future medical care to limit or reduce the extent of the employee’s injury.
Temporary Total Disability Benefits
The temporary total disability (TTD) benefits are calculated as two-thirds of the employee's average weekly wage over the 52 weeks prior to the date of injury, not counting the week of the injury. The maximum amount of TTD benefits that can be paid is $650.00 per week. There is no automatic cost of living increase. The state minimum weekly benefit is $50.
The first 7 days of disability (the waiting period) is not paid to the injured employee unless the employee is disabled for more than 21 days. TTD benefits can be paid for a maximum of 500 weeks
Temporary Partial Disability Benefits
In Indiana if the employee is able to return to any type of work, but at a lesser rate of pay then the amount the employee was earning prior to the injury, the employee is entitled to temporary partial disability (TPD) benefits. The TPD benefits are paid at two-thirds of the difference between the pre-injury wage and the post-injury wage. The TPD benefits are paid for up to 300 weeks. The TPD benefits plus the post-injury pay rate cannot exceed the state's maximum indemnity benefits rate.
Permanent Partial Impairment
It should be noted that Indiana is one of the few states that does not have a schedule for injuries to limbs, sight, hearing, etc. Instead, the treating physician will assign to the employee a permanent partial impairment rating, with the whole body being considered 100 degrees. Limbs and other body parts are worth so many degrees, and then the number of degrees is multiplied by the percentage of disability. The Board maintains a chart that shows what each degree of injury is worth. Interestingly, with this system, the high wage earner does not receive any more than the low wage number when they have the identical degree of injury. However, if the injured employee has already received in excess of 125 weeks of indemnity compensation, the insurer does receive a partial credit against the PPI award.
Permanent total disability
Indiana permits the employee to collect a maximum of 500 weeks of indemnity benefits for all types of indemnity combined, unless the employee is classified as permanent total disability. If the employee is permanently and totally disability, the state’s second injury fund will pay up to 125 weeks of additional benefits after the insurer has paid for 500 weeks.
Death Benefits
The burial expenses in Indiana are covered for a work-related death up to $7,500. The death benefits for a dependent spouse and children follow the same guidelines as TTD benefits – two-thirds of the average weekly wage – currently a maximum of $650 per week, up to a maximum of 500 weeks, except there is a dollar maximum for death benefits in the amount of $294,000. If the spouse remarries, the spouse receives the lesser of 104 weeks or benefits or the remainder of the 500 weeks. (WCxKit)
Vocational Benefits
The employer is not required to pay for vocational rehabilitation under the Indiana workers compensation act. Injured employees who need vocational rehabilitation can obtain assistance through the Office of Vocational Rehabilitation operated by the State of Indiana.
Author Rebecca Shafer, JD, President of Amaxx Risk Solutions, Inc. is a national expert in the field of workers compensation. She is a writer, speaker, and website publisher. Her expertise is working with employers to reduce workers compensation costs, and her clients include airlines, healthcare, printing/publishing, pharmaceuticals, retail, hospitality, and manufacturing. She is the author of the #1 selling book on cost containment, Manage Your Workers Compensation: Reduce Costs 20-50% www.WCManual.com.
Contact: RShafer@ReduceYourWorkersComp.com.
Do not use this information without independent verification. All state laws vary. You should consult with your insurance broker or agent about workers comp issues.
©2011 Amaxx Risk Solutions, Inc. All rights reserved under International Copyright Law. If you would like permission to reprint this material, contact
Catastrophic injury claims make up less than 1% of all workers compensation claims, but different studies show they entail approximately 20% of all workers comp costs. For the small employer, one catastrophic injury claim can distort the severity factor in the workers comp premium calculations and have a major impact on the workers compensation premiums for years into the future.
Catastrophic injuries are injuries that disable the employee to the extent the employee can never return to work and significantly alters the employee's life in general. Common examples of catastrophic injuries are: (WCxKit)
1. Brain/brain stem injuries.
2. Severe burns over 50 % or more of the body.
3. Spinal cord injuries.
4. Multiple amputations.
5. Multiple trauma.
6. Total vision loss.
7. Occupational lung diseases. (WCxKit)
The eventual cost of a catastrophic injury is very difficult to establish early in the life of the claim. Even the experienced adjuster does not have a crystal ball to determine if the overall cost of the claim is going to be $500,000 or $5 million when establishing the initial reserves on the claim. With catastrophic claims, as additional medical and rehabilitation information becomes available, the reserves are often adjusted by large amounts (6 figures or more) several years into the claim.
To establish the value of the catastrophic injury claim, there are various factors the adjuster considers. While it is the adjuster's responsibility to establish the reserve, the smart risk manager does not leave it all up to the adjuster. It behooves the employer to review the factors that go into reserving to be sure the adjuster is setting the proper reserve and not taking the easy way out by reserving a nice round number like $1 million.
The factors that go into establishing the value of the catastrophic injury claims can be divided into the three areas: indemnity, medical, and claim related expenses. Look for vendors specializing in
Life Care Planning.
Lifetime cost of the indemnity includes:
1. The employee's average weekly wage and weekly indemnity benefit.
2. The time span of the indemnity; does it last for a set number of weeks, (500 weeks), as it does in about half of the states, or does it last a lifetime, or to a set cut off point in the retirement years?
3. The employee's age and projected life span on the actuarial tables.
4. Does the indemnity rate remain the same for permanent total disability as for temporary total disability, or does the compensation rate change?
4. What is the amount of the offset for social security disability?
Medical factors in establishing the value of the claim:
1. The cost of immediate medical care following the injury.
2. The cost of surgical interventions in the first years following the injury.
3. The on-going cost of medical care on an annual basis after the medical status is stabilized.
4. The cost of modifications to the employee's home and current and future vehicles.
5. The cost of institutional medical care.
6. The cost of durable medical equipment (wheelchairs, artificial limbs, hospital beds, oxygen tents, etc.).
Claim handling expenses for catastrophic claims:
1. Nurse case managers.
2. Rehabilitation specialist.
3. Defense attorneys.
4. Actuarial experts. (WCxKit)
The above items impacting the value of the catastrophic claim are not the only factors to consider when establishing the future claim cost. If the insurance company decides to settle the catastrophic workers comp claim, they work with the Centers for Medicare and Medicaid Services (CMS) to obtain approval of the Medicare Set Aside Agreement (MSA). The value of the settlement has to be high enough that the claimant (in theory) never has any future medical cost paid by CMS.
Another factor impacting the value of the catastrophic injury claim is the availability, in some states, of a Subsequent Injury Trust Fund to cover part of the future cost of the claim. Also consider whether or not the insurance company can resolve the claim with a structured settlement and of the future cost of the claim being sold to another insurance company. (WCxKit)
While it is possible to calculate the value of the catastrophic injury claim, keep in mind a catastrophic injury is a major life altering event for the employee. The catastrophic injury impacts almost every area of the employee's life and family. It is a personal tragedy far beyond the financial cost of the claim.
Author Rebecca Shafer, JD, President of Amaxx Risks Solutions, Inc. is a national expert in the field of workers compensation. She is a writer, speaker, and website publisher. Her expertise is working with employers to reduce workers compensation costs, and her clients include airlines, healthcare, printing/publishing, pharmaceuticals, retail, hospitality, and manufacturing. Shafer is the author of Workers Compensation Management Program: Reduce Costs 20% to 50%. See www.LowerWC.com for more information. Contact: RShafer@ReduceYourWorkersComp.com.
Do not use this information without independent verification. All state laws vary. You should consult with your insurance broker or agent about workers comp issues.
©2011 Amaxx Risk Solutions, Inc. All rights reserved under International Copyright Law. If you would like permission to reprint this material, contact Info@ReduceYourWorkersComp.com.
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