Medical Benefits

The Workers' Compensation Program provides state government employees many benefits in the event of an on the job injury. Each benefit is briefly described in the following paragraphs. You will also find a description of the Workers' Compensation Forms.

As of October 1, 2005, the program has elected to utilize a managed care program to provide covered medical benefits.

An employee who sustains a compensable injury or disease is entitled to immediate and continuing medical treatment at the expense of the employer. An employee should never use their health insurance when they are seeking treatment under workers' compensation. The employer shall pay for the cure and relief from the effects of an injury or occupational disease as may reasonably be required at the time of the injury and thereafter during disability.

Requiring employees to make co-payments for treatment of work-related injuries is unlawful per Kentucky law. Likewise, medical providers may not engage in "balance billing" by charging employees separately for amounts in excess of those set forth in the medical fee schedule.

TTD Benefits are paid during the period in which the worker is recovering from an injury or disease and is unable to return to some type of work. TTD is not payable unless the employee is unable to work for more than seven (7) calendar days. Once an employee misses eight (8) calendar days from work due to a work-related injury, the employee is entitled to benefits for each additional day he or she is unable to work. If the employee misses a total of fifteen (15) calendar days from work, benefits for the first seven days will be paid. Kentucky law makes no allowance for temporary partial disability benefits.

When a worker is recovering from an injury or disease and is unable to return to work, the employee may elect to use their sick, annual, and/or compensatory leave to receive full pay while off work. Once an employee has met the criteria for receiving Temporary Total Disability Benefits (TTD Check) this check shall then be used to purchase back sick leave at 66 2/3 percent per 101 KAR 2:140, Section 4(2). Under no circumstances should an employee receive more than 100 percent of his/her normal salary.

In order to buy back sick leave, the employer must have the employee sign the Sick Leave Form (WCF-2). This form must be signed by the employee, indicating how they wish to use their workers’ compensation benefits, prior to employee using leave time for a work related injury.

An employee who has reached maximum medical improvement, but still has some permanent impairment resulting in a permanent partial loss of wages or wage earning capacity, may be entitled to permanent partial disability.

Permanent total disability means the condition of an employee who, due to an injury, has a permanent disability rating and has a complete and permanent inability to perform any type of work as a result of an injury.

If death of employee occurs within four (4) years from date of injury as a direct result of the injury, a lump sum payment to estate will be made, from which burial expenses are to be paid.