TT and PT benefits pay 2/3 of the worker’s average weekly wage. The payments will be paid for the duration of the disability and are subject to minimum and maximum rates.

For injury dates of April 4, 1994 or later PP benefits are calculated based upon 2/3 of the worker’s average weekly wage. PP benefits will be paid for a maximum of 425 weeks for a disability rated less than 50 percent and a maximum of 520 weeks for a disability rated over 50 percent. For injuries prior to April 4, 1994 most PP benefits were paid for a maximum of 425 weeks. NOTE: A PP benefit is often referred to as an “impairment” benefit because of its relationship to the impairment rating. For State maximum rates, see DI 52150.045.

Multiple awards can be paid on a Kentucky WC claim.  Most of the awards do not stipulate that they are final.  The claimant can request to have the case reopened.  They can only be reopened for fraud, error or due to an improved condition.  After 4 years there are no reopenings.  All claims reopened after 12/12/96 will be subject to new benefit determination procedures including assignment to an arbitrator.  Any increase in benefits are payable from the date of filing for the motion to reopen.  The CA/CTE/CR may need to contact the WC attorney to obtain the date of the request for reopening.

Miners can file claims while working, but they may not receive benefits until they stop working. Benefits are paid equally by the employer and the State Coal Workers Pneumoconiosis Fund.

Payment begins when the employee enrolls and participates in an approved vocational training program on a full-time basis (attending classes for a minimum of 12 hours per week). Payments are paid at a rate of 66 2/3 percent of the employee’s average weekly wage, not to exceed 75 percent of the State average weekly wage. Benefits are paid for a maximum of 104 weeks.

Most awards will State the benefits will begin the 2^nd pay period following approval of the award. If unable to obtain the exact beginning date of the payments, use 14 days from the date the award was signed.

Payments for part time students (taking from 6 to 11 credits per semester) are 33 1/3 percent of the individual’s average weekly wage not to exceed 75 percent of the State average weekly wage and are payable over 208 weeks.

GED Students can receive 66 2/3 percent of their average weekly wage not to exceed 75 percent of the State average weekly wage for 17 weeks in addition to the 104 weeks.

Individuals who are 57 or older as of the date of last exposure can receive 66 2/3 percent of their average weekly wage not to exceed 75 percent of the State average weekly wage multiplied by a 25 percent impairment rating for 425 weeks or up to age 65, whichever is earlier.

The benefit rate is equal to 50 percent of the PP rate payable over 208 weeks.

Any party may file for reconsideration of a lump sum award within 14 days. If no reconsideration is filed, the award is final and binding unless it is appealed to the circuit court. The only other basis for change after that time is for fraud, mistake, new evidence, or change of condition.

Kentucky WC will often make an award based upon a given number of weeks and then convert the award to a LS by discounting that number of weeks. (i.e., In 2008, if an award for periodic payments is awarded for 425 weeks, it will be converted to an LS award by using a calculation that uses 359.0785 weeks rather than 425. See examples below and links for yearly discount tables).

The dollar amount that is multiplied by the number of weeks is always the weekly WC rate that will be used for prorating the LS settlement for SSA purposes. The computation formula may contain additional multipliers before arriving at a weekly amount. However, the multipliers are not important. Extract the dollar amount that is multiplied by the number of weeks.

Example 1:

The W/E is awarded a lump-sum settlement of $5000 based on a permanent disability of 3 percent.

The lump-sum award included $278.60 for waiver of right to vocational rehabilitation, and $2000 for waiver of right to reopen.

The individual received weekly temporary total disability of $332.02.

The settlement computation formula is shown as follows: $332.02 x .03 x0.75 = $7.47 x 364.3106 (number of weeks) = $2721.40.

Total settlement is $2721.40 + $2000 + $278.60 = $5000. When prorating the $5000 settlement, use the weekly rate of $7.47.

Example 2:

The W/E is awarded a $21,237.11 lump-sum settlement based on 15 percent permanent disability. No periodic payments were made.

The “Settlement Computation” is shown as follows: “$220.54 x 15 percent x 1.25 x 1.5 x 342.3683 = $21,237.11”

When prorating this settlement, use the weekly rate of $62.03 ($220.54 x .15 = 33.08 x 1.25 = 41.35 x 1.5 = $62.03.

For contracts made on or after 07/14/ 2000 there is a maximum fee that an attorney may charge. Based upon the total award attorneys are permitted to charge up to 20 percent on the first $25,000, 15 percent on the next $10,000, and 5 percent of the balance up to a maximum of $12,000 in total fees.

If an attorney is involved, the claimant decides how the attorney will be paid and how the attorney fee is recouped.  Therefore, determine the following:

• •

  if the fee was recouped from a lump sum,

• •

  if the weekly benefits were reduced, or

• •

  if the weekly benefits were stopped.