WORKERS’ COMPENSATION OVERVIEW
Workers’ compensation is an insurance program that provides compensation for disability, medical and recuperation benefits, for workers injured on the job. In the case of a fatal accident of an employee, it includes benefits to the employee’s wards. Under workers’ compensation, both workers and employers are protected. Each covered employee has a right to benefits for a compensation injury. As a result, employers are protected from lawsuits outside the workers’ comp system.
The National Council on Compensation Insurance collects data used to set compensation insurance rates, and their data says that Oklahoma workers are far more likely than those in neighboring states to file workers comp claims, and to miss days of work because of claimed injuries. This causes the total costs for workers comp claims to be higher in Oklahoma than in surrounding states.
Oklahoma’s workers’ compensation system is governed by the body of law found in Title 85 of the Oklahoma Statutes. This statute provides for medical, indemnity and rehabilitation benefits to injured workers.
The law is managed by the Oklahoma Workers’ Compensation Court. Though it is part of the judicial branch of government, the Court is both judicial and administrative in essence. Ten judges listen to disputed cases and approve settlements at both Oklahoma City and Tulsa court locations. An applicant may request a hearing before a judge or may settle their claim without a trial. Petitions from a trial judge’s ruling may be made to the Court En Banc or to the Oklahoma Supreme Court. The Court Administrator categorizes, directs and cultivates all administrative work of the court. Among the Administrator’s responsibilities are the regulation of all self-insurance and the application of the Schedule of Medical Fees. The Administrator also has the authority to approve certain settlements.
By law, coverage is mandatory for all employers except when the employees are domestic or household employees where total payroll is less than $10,000 per annum; agricultural or horticultural employees where total payroll is less than $100,000 per annum; and certain licensed real estate sales persons and brokers. Other specific exceptions can be found in Sections 311 through 312 of Title 85 of the Oklahoma Statutes. Coverage for workers’ compensation can be obtained in three ways: by securing coverage from a private carrier licensed to provide workers’ compensation coverage in the state of Oklahoma; from CompSource Oklahoma; or by obtaining approval from the Court to self-insure against workers’ compensation liability.
Basis for Compensation
An injured worker is eligible for reimbursement for all practical and essential medical treatment resulting from an on-the-job injury. In order for an injured worker to be entitled to temporary benefits, they must be unable to work for more than three calendar days. Compensation for permanent disability is based upon the impairment resulting from an injury and the benefit amounts provided by law. The manner for determining permanent disability under Oklahoma’s system is two-PART: TO begin, a physician provides an evaluation of an individual’s level of impairment and then a determination of the individual’s disability is made. Technically, “impairment” is a medical assessment of an individual’s health and “disability” is a non-medical assessment of an individual’s ability to meet personal, social or occupational needs.
Once the level of disability has been verified, benefits are calculated based upon both the state’s average weekly wage (SAWW) and the employee’s average weekly wage (AWW). Benefits are referred to in terms of “weeks” or “weeks of compensation” for a particular injury. The law provides benefits equal to 70% of the employee’s AWW up to 100% of the SAWW for temporary total, permanent total and death benefits. The current SAWW is $736. Please refer to Title 85 of the Oklahoma Statutes, Section 311 (Schedule of Compensation) for further information or contact the Oklahoma Workers’ Compensation Court.
More on this topic coming in Part 2 of this article.