Workers' Compensation Insurance

Frequently Used Documents

The Kentucky Workers Compensation Program provides medical and disability benefits to state employees (excluding Transportation Cabinet) who may experience a work-related injury or illness. A managed care program is used to provide covered medical benefits.

We encourage our covered employers to submit a First Report of Injury (above) via electronic submission. The first report of injury must be completed "within three (3) working days" per KRS 342.038, after notification of the injury. Please do not forget to print the IA-1 prior to submitting. You will need to maintain a copy for your records.

Frequently Asked Questions & Required Documents

What if I am injured at work?

In a medical emergency, go immediately to the nearest emergency or urgent care center or health care physician, and contact your supervisor within 24 hours of the accident. In a non-emergency, contact your supervisor immediately. Your agency will then assist you through the workers' compensation claim process. A First Report of Injury form must be completed in the event of a work related injury or illness.

1. Have the First Report of Injury Form completed by your supervisor and sign the Signature Page, Medical Waiver and Consent Form and the Designated Physician Form in the beginning of the claim process.

2. You will be assigned a claim representative to investigate and manage your claim.

3. You will receive a temporary prescription card that will allow you to fill your prescriptions without any out-of-pocket expenses. Take the Prescription Form with you to the pharmacy.

4. Select a physician from the list of preapproved providers. You may change your "gatekeeper" physician only one time. Referrals to specialists are not considered a physician change. If you change your gatekeeper physician, you must complete and submit the 2nd Designated Physician Form.

5. Always take the Report of Medical Status form with you to your doctor appointments and bring the completed form back to your agency.

6. To request reimbursment for out-of-pocket expenses related to your injury, use the reimbursment form and send to your claim representative.

Accumulated leave can be used when you must miss work for a work-related injury to make up the difference between Workers' Compensation benefits and your regular salary. To use accumulated leave during your workers' compensation injury, you must remit your workers' compensation check (TTD check) to the agency by completing an Accumulated Leave Form prior to receiving accumulated leave. This form must be signed by the employee, witnessed, and forwarded to the payroll officer for their records.

Click here to learn about workers' compensation benefits.

For information about the Return to Work program, click here.

What if one of my Employees is injured?

When an employee is injured, assist in seeking immediate medical care if needed. A Signature Page and the Medical Waiver and Consent Form, should be completed and submitted to the Workers' Compensation as soon as possible. Additionally, the Accident Investigation Form should be completed to document the facts surrounding the injury and the form submitted to the Workers' Compensation Branch as soon as possible.

Volunteer Firefighters and Ambulance personnel also need to submit a supplemental form with injury reports.

If continued medical treatment is needed, assist the employee in locating a physician from the list of pre-approved providers and complete a designated physician form. Our third party administrator may also assist with selecting a physician. If you have questions or need assistance with the managed care network, please contact CCMSI at 1.866.320.8456.

A provider introduction letter can be sent with the employee to the doctor to show the physician that a work-related injury is being processed. The employee should take this, along with the report of medical status form, to the physician for completion and return them to the agency. A temporary prescription I.D. card may be sent to the employee to help with prescription expenses, and should be activated within 24 hours of the reported injury.

Our Workers' Compensation Manual explains our program procedures and defines the role of our third party administrator, the claim representative, and the Managed Care Plan. Keep the manual within easy reach so you are prepared if an employee is injured on the job. Serious or catastrophic medical claims need to be expedited to ensure prompt and appropriate medical care. You may also be required to report the injury to OSHA.

The Workers' Compensation Notice should be displayed at all locations so all work sites have information and the billing address in the event of a work-related injury. We also recommend printing the Employee Guide to Managed Care for your injured employee. This guide will help your employee understand the claim process and work with their assigned claim representative.

Our Workers' Compensation Program is here to help you and the injured employee through the entire claims process.

If you are concerned that an employee is suffering from depression, displaying unsual behavior or is abusing prescription narcotics, please contact the Kentucky Employee Assistance Program immediately.

How do I select an approved managed care physician?

You can select an approved managed care physician by clicking this link.

Forms and Helpful Links for Workers

Links to Regulations:

View the Administrative Reg (101 KAR 2:140) that covers Workers' Compensation.

View the Administrative Reg (803 KAR 2:181) that covers OSHA Reporting of Amputations, Fatalities and Hospitalizations.

Return-to-Work

If approved by a physician, your agency may be able to provide a temporary modified work plan to make the transition back to work easier. If you have an employee that has been injured on the job, complete the Lost Time and Return-to-Work Form. Click here to read more about the Return-to-Work Program.

Many injuries can be prevented if employees remain safety-conscious at all times. Review the General Safety Rules included in this State Safety Handbook or contact the Kentucky Safety Program at 502.564.9653 for more information. If you are concerned that an employee is suffering from depression, displaying unusual behavior or is abusing prescription narcotics, please contact the Kentucky Employee Assistance Program immediately.