Workers’ compensation is meant to provide injured workers with relief for injuries or illnesses sustained on the job; however, workers who submit claims for benefits do not always receive the compensation they need to recover from their injury and return to work.
At Morgan & Morgan, our attorneys have helped clients, who first elected to navigate the claims process on their own, appeal decisions which denied their claims or minimized their benefits. The attorneys in our Lexington office have extensive experience navigating the Kentucky workers’ compensation claims process and have gained insight into the tactics used by insurance companies and employers to avoid or limit payouts.
If you or a loved one was recently injured on the job, our Lexington workers’ compensation attorneys may be able to help you retrieve the benefits which you are qualified to receive. To ascertain how we may be able to help, please complete our free case review form today.
How Can a Lexington Attorney Help Me?
The process of recovering proper workers’ compensation benefits for your work-related injury is inherently complex, but can be simplified with the help of an experienced attorney in Lexington. Your attorney can help ensure that your claim is submitted with the necessary documentation and supporting evidence. Additionally, your attorney can:
- Explain rights that insurers may not have disclosed to you (e.g. the right to choose your own doctor and the right to receive reimbursement for certain costs)
- Ensure all deadlines are met
- Uncover information you may not have known was necessary for a successful claim
- Increase your overall chances of recovering proper compensation
Overview of the Workers’ Compensation Claims Process
If you have sustained an injury on the job, you must complete the following steps to successfully collect compensation for your injuries and lost wages.
Notice and Claim. You must notify your employer of your on the job injury within the time period established by workers’ compensation laws in Kentucky. Your employer must then complete a First Report of Injury form and submit it to the Kentucky Department of Workers’ Claims. You will then be required to complete paperwork regarding your accident. An attorney can help you complete these forms, each of which will request information on your work history, medical records and injury evaluation. After these forms are submitted to your employer, they will be sent to the Kentucky Department of Workers’ Claims.
Medical Evaluation. After your injury, it is important to seek prompt medical attention to evaluate and treat your injury. This medical report will likely be used in support of the existence of the injury, the extent of the injury, and the likely timeframe for recovery.
Evaluation Process. Once the claim is received, the Kentucky Department of Workers’ Claims will assign your case to an Administrative Law Judge (ALJ), who will then notify all parties of its assignment and provide guidelines for submitting evidence or proof (typically 60 days from the date of assignment). Your employer and their insurer have 45 days to file a Notice of Claim Denial or Acceptance, which acknowledges and rejects specific issues in the claim.
Once evidence has been submitted, the involved parties will receive notification detailing the date, time, and location of your benefit review conference. The review conference is informal and used to define and narrow issues related to your claim. The conference will aim to reach a settlement between the parties.
If a settlement is not reached, the judge will schedule an official hearing to take place within two weeks of the conference. The judge is required to issue a written decision within 60 days of the formal hearing.
Both parties have 14 days to file a Petition for Reconsideration, if sufficient grounds exist, to have the award, order, or decision re-examined.
Appeals Process. If your claim has been denied, your attorney may file an appeal with the Workers’ Compensation Board if sufficient grounds exist.
Black Lung Workers’ Compensation Claims
Kentucky has one of the largest coal mining industries in the nation, consistently ranking in the top three coal producing states for over fifty years. Coal mining, believed to be the second most dangerous job industry in the nation, puts workers at extreme risk for disease, injury, disability, and death. Each year in Kentucky, an estimated 3 percent of workers are affected by Black Lung disease (also known as coal workers’ pneumoconiosis).
Filing a workers’ compensation claim for benefits stemming from Black Lung disease is considerably different than filing a claim for other types of work-related injuries. To determine the presence of black lung, multiple x-rays will be taken and examined solely by physicians certified by the National Institute of Occupational Safety and Health (NIOSH) as proficient in x-ray diagnosis of pneumoconiosis. The miner will also undergo pulmonary breathing tests to determine the extent and progression of the disease. This information is submitted along with a special claim workers’ compensation form.
Within 45 days of filing the claim to an ALJ, the employer must have the employee re-examined and re-tested. If the examinations are comparable, they will establish the level of impairment and debilitation the miner has sustained, which will determine the benefits to which the worker is entitled.
Third Party Black Lung Claims
While workers’ compensation claims prevent miners from suing their employers for the disease they sustain on the job, they still have the option to pursue compensation from an at-fault third party, such as an entity or individual indirectly involved in the mining process.
In many cases, workers may file product liability lawsuits against the manufacturers of protective mining equipment, such as face masks, if they believe the product did not work to block the destructive particles from entering their lungs, as warranted. Typically, in these lawsuits, the worker’s attorney will only have to prove a defect existed at the time the product was manufactured and that the miner contracted an injury or disease.
If you or a loved one has been injured on the job or sustained a serious occupational illness, you may have legal options if your Kentucky employer denies your claim for workers’ compensation benefits. To learn how our Lexington workers’ compensation attorneys could assist you in recovering the compensation to which you are entitled, please complete our free case review form today.