RELATES TO:
KRS
18A.110(7)(i),
18A.370,
18A.375,
18A.380,
342.640
NECESSITY, FUNCTION, AND CONFORMITY:
KRS
18A.110(7)(i) requires the
Secretary of Personnel to promulgate administrative regulations to implement
programs to provide for the safety, health and welfare of state employees.
KRS
18A.380 requires the cabinet to promulgate
administrative regulations for the administration of the state employee
workers' compensation fund established by
KRS
18A.375. This administrative regulation
establishes requirements for the workers' compensation fund and program for
state employees.
Section 1. Workers'
Compensation Fund. The self-insured workers' compensation fund and program
established by
KRS
18A.375(1) shall cover all
eligible employees.
Section 2.
Eligibles.
(1) A state employee, as defined
by
KRS
18A.370, shall be eligible to participate in
the program.
(2) Other state
related groups shall be included upon written agreement with the Personnel
Cabinet.
Section 3.
Assessments. The assessment for an individual agency shall be based on the
claims history for the past three (3) years and on the number of employees in
the agency. Premiums shall be assessed at the beginning of each fiscal year.
(1) A biennial actuarial study shall be
carried out to insure the fund's fiscal soundness.
(2) A fund deficit shall be recouped through
an interim billing or additional assessment if deemed necessary by an actuarial
study.
Section 4.
Benefits.
(1)
(a) The required medical expense for a
service rendered by a hospital or doctor, or for a prescribed medication, shall
be paid subject to approval of the claim.
(b) A percentage of the employee's average
weekly wage shall be paid if the employee is unable to work for an extended
period due to a job-related injury or illness.
(c)
1.
Except as provided in subparagraph 2 of this paragraph, compensation shall not
be payable for the first seven (7) days of disability.
2. If the disability continues over two (2)
weeks, compensation shall be allowed from the first day of
disability.
(2)
(a) For
an absence due to illness or injury for which workers' compensation benefits
are received, if the employee elects to accept the workers' compensation
benefits, accumulated leave may be used in order to maintain regular full
salary.
(b) An employee electing to
utilize accumulated leave shall complete and submit a Workers' Compensation
Request to Use Accumulated Leave, Form WCF-2, to the employee's personnel
unit.
(c) If paid accumulated leave
is used, workers' compensation income benefits shall be remitted to the
employee's agency for whatever period of time an employee received paid
leave.
(d) An employee shall not
receive and retain the benefit of paid leave and workers' compensation income
benefits for the same period of time.
(e) The employee's accumulated leave shall be
reinstated to the employee's leave balance to the extent that workers'
compensation benefits are remitted to the employee's agency.
Section 5. Notification
Procedures.
(1) Employee requirements. An
employee shall inform the supervisor of an injury or illness as soon as
physically able to do so.
(2)
Supervisor requirements.
(a) The supervisor
shall:
1. Complete the employer's First Report
of Injury or Illness, Form IA-1, which is incorporated by reference in
803
KAR 25:170. The supervisor shall give specific
information about the injury or illness on the form; and
2. Submit the form to the designated office
in the agency within three (3) working days after the supervisor is notified of
an injury or illness to insure timely payments to the employee.
(b) A Lost Time and Return to Work
Form, Form WCF-1, shall be submitted by the employee's supervisor or personnel
representative if an employee is losing time from work due to a work-related
injury or illness. The supervisor or personnel representative shall notify the
employee's personnel unit when the employee returns. The personnel unit shall
submit Form WCF-1 to the Personnel Cabinet.
(c) Each medical bill, or medical information
regarding treatment of a job-related injury or illness of the employee, shall
be submitted in the same manner as an injury report. An injury report shall be
submitted as soon as possible.
(d)
A safety representative in each agency shall be notified of each accident so
that the representative may review accident causes and provide safety training.
A supervisor shall promote safety with employees.
Section 6. Recordkeeping. All
records maintained by the Personnel Cabinet and by an agency with respect to an
employee claim under this administrative regulation shall be confidentially
maintained.
Section 7. Agency
Withdrawal and Readmission to Program.
(1) If
an agency included in the fund as a result of the employment of persons defined
in
KRS
18A.370 desires to withdraw from the program,
the agency shall provide the Personnel Cabinet with written notice of its
intent to withdraw no later than thirty (30) calendar days prior to the end of
the current fiscal year. If the notice is timely submitted, the agency may
elect to withdraw at the end of the current fiscal year.
(2) An agency which withdraws from the
program may be readmitted to the program at the discretion of the Personnel
Cabinet, based on compliance with the provisions in subsections (3), (4), and
(5) of this section.
(3) As a
condition of withdrawal, the agency shall reimburse the Commonwealth for all
claims incurred by its employees, but not reported to the fund prior to the
effective date of withdrawal, without regard to the length of time after the
withdrawal date that the claims are actually received by the Personnel Cabinet.
(a) The Commonwealth shall bill the agency on
a quarterly basis for the cost of claims that were incurred but not reported as
of the date of withdrawal until all claims have been submitted and
processed.
(b) The agency shall
reimburse the Commonwealth within thirty (30) calendar days of receipt of the
itemized statement of payments made on the agency's behalf.
(4) If an agency that has
withdrawn from the program desires to seek readmission to the fund, the
Personnel Cabinet may restore the agency to the fund upon review and evaluation
of the agency's claims and payment history.
(5) If the Personnel Cabinet approves the
agency's restoration to the fund, the Personnel Cabinet shall assess a premium
based on:
(a) Claims experience over the
preceding three (3) years; and
(b)
The current number of employees in the agency.
Section 8. Incorporation by Reference.
(1) The following material is incorporated by
reference:
(a) "Lost Time and Return to Work
Form", Form WCF-1, May 2012; and
(b) "Workers' Compensation Request to Use
Accumulated Leave", Form WCF-2, May 2012.
(2) This material may be inspected, copied,
or obtained, subject to applicable copyright law, at the Personnel Cabinet, 501
High Street, 3rd Floor, Frankfort, Kentucky 40601, Monday through Friday, 8
a.m. to 4:30 p.m.