Workers' Compensation Program

Click on the appropriate ring in the image above to proceed to the desired program area.

PLEASE NOTE: The Personnel Cabinet's Workers Compensation coverage excludes Transportation Cabinet employees. For more information about workers compensation coverage for Transportation employees, please use the following link: http://transportation.ky.gov/legal-services/pages/workers-compensation.aspx.

The Kentucky Workers' Compensation Program is designed to compensate employees for loss of earning power due to work-related injuries or illness arising out of, and in the course of their employment. Workers' Compensation provides state government employees many benefits, in the event of an on-the-job injury, including medical costs and disability benefits. Effective October 1, 2005, the program utilizes a managed care program to provide covered medical benefits.

Reminder: The First Report of Injury (IA-1) must be submitted by the supervisor (or designee) immediately after notification of injury. The First Report of Injury must be completed "within three (3) working days" per KRS 342.038, after the injury to meet the requirement of making the first payment to the employee. This requirement can not be met if the injury report is not received promptly. Failure to comply with this statute can result in a fine being levied of up to $1000.00 for each occurrence.

More Information 

Workers' Compensation Notice (PDF - 21 KB)

Workers Compensation Manual (PDF - 463 KB)

First Report of Injury or Illness Form IA-1 

Completing the IA-1 - Questions and Answers (PDF - 19KB)

IA-1 First Report Of Injury Signature Form Page 2 (MSWord - 33 KB)

Volunteer Firefighters / Ambulance Supplement to IA-1 (PDF - 18KB)

Request To Use Accumulated Leave Form - WCF-2 (MSWord -82KB)

Wage Certification (AWW-1) (PDF-24KB)

Managed Care Plan (PDF - 545 KB)

Employer Overview (PDF -  237 KB)

Employee Guide to Managed Care (PDF  540 KB)

New - Managed Care Physicians Listings

In order to provide you with the most up to date listing of physicians, we have made the following change. If you have questions or need assistance with the managed care network, please contact CCMSI at 1-866-320-8456.

Tips on how to use : The easiest search method is by choosing "Region Search" and either using a zip code or selecting the state and county where you would like to be treated. In the top box listed "Networks", please leave "Coventry Integrated Network" in this selection.

Make sure to : select from Primary Treating Providers, First Treatment Sites, or Hospitals.

Prescription Program (PDF - 74 KB)

Provider Intro Letter (PDF - 19 KB)

Medical Waiver - Form 106 (PDF - 75 KB)

Report of Medical Status - Form WCF-5 (PDF - 179 KB)

Notice of Designated Physician - Form 113 (PDF - 17 KB)

Notice of Second Designated Physician - Form 113 (PDF - 26 KB)

Request for Reimbursement - Form 114 (PDF -77KB)

Supervisor's Accident Investigation Form (Word - 95KB)

Department of Workers' Claims: Down load the latest version of the Workers' Compensation Guidebook (PDF - 7 MB) and current benefits schedules.

It is unlawful to knowingly file or permit to be filed any false or fraudulent claim to obtain workers’ compensation benefits. Likewise, it is unlawful to misrepresent important facts to avoid responsibility under the law.

Incidents of suspected fraud should be reported to an Department of Workers' Claims ombudsman or specialist at 1-800-554-8601. The DWC refers all fraud complaints to the Department of Insurance. The DOI actively investigates and prosecutes workers comp fraud through its insurance Fraud Division.