Workers Compensation Division

The Kansas Department of Labor Workers Compensation Division is responsible for the administration of the Kansas Workers Compensation laws and rules. Our goal is to ensure employees injured at work, employers, health care providers and insurance carriers receive timely, impartial and fair claim resolution.

Following a 1993 mandate from the Kansas legislature, the Fraud and Abuse Section was first staffed in January 1994. Its mission is to combat fraudulent or abusive acts and practices by employers, employees, and healthcare providers. This unit does not investigate misconduct by insurance carriers or agents. Instead, the Kansas Insurance Department addresses these complaints.

The section is responsible for the investigation of alleged violations of the Workers Compensation Act. Most of the fraud and abuse violations are listed under K.S.A. 44-532, K.S.A. 44-5,120, and K.S.A. 44-5,125. If a violation of the Act is discovered, the section is willing to pursue administrative remedies. In certain cases, the section may ask a county or district attorney to file criminal charges.

Identifying and prosecuting workers compensation fraud is a priority for Kansas. Per Kansas Law, an Assistant Attorney General is assigned to direct and assist in the investigation and prosecution of alleged fraudulent or abusive acts or practices.

Areas of Investigation

Fraudulent or Abusive Acts: Administrative and Criminal: As defined in K.S.A. 44-5,120(d) and 44-5,125 – examples of fraudulent or abusive acts include but are not limited to:

  • Making false or misleading statements to obtain benefits
  • Presenting a false certificate of insurance
  • Submitting a charge for health care not furnished

The penalty for committing such acts are:

  • $2,000 fine for each act of fraud or abuse
  • Misdemeanor or felony criminal charges

Employer Failure to Secure Workers Compensation Insurance: : In general, an employer with a payroll exceeding $20,000 must secure workers compensation coverage for its employees. The penalty for violating this provision is twice the annual premium or $25,000, whichever is greater.

Employer Failure to Timely File Accident Report: Every employer has a duty to report employee accidents within 28 days if the injuries wholly or partially incapacitate the person for more than the day, shift or turn. Penalty for repeated violations is a $250 fine for each violation.

Reporting Fraud

Reports of fraud come into the Fraud and Abuse Section from many sources:

  • Anonymous Tips
  • Employers and Employees
  • General Public
  • Insurance Companies
  • Kansas Insurance Department

If you believe or have knowledge that a violation of the Workers Compensation Act has occurred or is occurring, you may notify the Division of Workers Compensation, Fraud and Abuse Investigation section by using the online reporting option or downloading the Report of Fraud or Abuse form (K-WC 44) to be submitted. You can also contact:

Workers Compensation Division
Fraud and Abuse Investigation Unit

kdol.wcfraud@ks.gov

401 SW Topeka Blvd, Suite 2
Topeka, KS 66603-3105

(785) 296-4000 (option 3)
(800) 332-0353 (TTY) (option 3)

What is Immunity?

Any person who refers a possibly fraudulent or abusive practice to any state or governmental investigative agency, shall be immune from civil or criminal liability arising from the supply or release of such referral as long as such referral is made in good faith with the belief that a fraudulent or abusive practice has, is or will occur and said referral is not made by the person or persons who are in violation of the workers compensation act, to avoid criminal prosecution or administrative hearings.

Educating the Public

The Kansas Insurance Department's Fraud unit is also available to make presentations to groups about fraud and related issues. To schedule a speaker, please contact the Department's Government and Public Affairs Division at (785) 296-3918 or antifraud@ksinsurance.org.

The Technology and Statistics section is responsible for delivering workers compensation information to the Kansas Department of Labor (KDOL), the legislature and the general public through annual statistical reports, a website, annual seminars and reports from research studies and evaluations. This unit functions as database administrator and is closely involved with the division's information systems. The Information Services division of the KDOL continues to maintain and manage the Workers Compensation's information technology artifacts.

Specifically, this unit is responsible for research studies mandated by statute, including studies of closed claims and the effectiveness of the Workers Compensation Act. The staff also respond to individual research requests from both internal and external customers, performing survey instrument research design, data collection, statistical analysis and reporting.

Technology and Statistics maintains several data marts of workers compensation claims information on work-related injuries and occupational illnesses in the state of Kansas. Unit staff, in conjunction with the Information Services division of KDOL, works to maintain and enhance the database to ensure data integrity and accuracy for both the division's administrative and statistical needs. In addition, the unit launched and continues to manage all content for the division's web pages located on the KDOL website.

The Technology and Statistics unit also administers the division's statutory Electronic Data Interchange (EDI) program. EDI is an electronic method for insurance carriers and self-insured employers to report work-related injuries, occupational illnesses and workers compensation claims costs data by utilizing the International Association of Industrial Accident Boards and Commissions' (IAIABC) national data standard. The program went into production in November 2003. By the close of fiscal year 2005 more than 40 trading partners, sending on behalf of more than 200 insurance carriers and self-insured employers, were sending first and subsequent reports of injury to the division via EDI.

The unit has also worked with insurance carriers, the division's Coverage and Compliance unit, the Information Services division and the National Council on Compensation Insurance (NCCI) to implement three innovations in proof of coverage reporting and information access. First, at the end of FY2005 the division launched a new web-based coverage verification service which allows external users access to coverage information over the website. Second, in April of 2005, the unit led the launching of a new digital data exchange between the division and insurers. The unit worked with all internal stakeholders to create a proof of coverage data warehouse that makes digitally submitted reports available to other units.

The unit's latest major project has been to assist division-wide in the implementation of a document imaging process in order to consolidate, by means of electronic storage, as much of the division's data as possible. This data is accessible via the division's production database screens. Technology and Statistics staff also provide training of other staff on creating imaged document files and accessing the database to retrieve them. As with other claims records in the database, the unit is responsible for ensuring the system is performing as intended and preparing work orders for system maintenance.

For questions, please contact (785) 296-4000 (option 8, then option 1) or (800) 332-0353.

Federal regulations mandated by the Health Insurance Portability and Accountability Act (HIPAA) went into effect in 2003. One of the goals of HIPAA is to protect the privacy of health records used and disclosed by covered entities, which include health care providers, health care clearinghouses and health plans. The HIPAA regulations require covered entities to obtain authorization from an individual before disclosing health information about that individual. This authorization requirement does not apply to disclosure of health information for purposes of workers compensation.

The Workers Compensation Exception: The HIPAA regulations specifically allow covered entities to disclose health information as authorized by, and to the extent necessary to comply with, workers compensation laws (45 CFR § 164.512). Kansas workers compensation law and regulations require health care providers to provide health information to employers, insurance carriers and the Director of Workers Compensation without the injured worker's authorization (K.S.A. 44-515; 44-557a, K.A.R. 51-9-10; 51-9-16). Therefore, a health care provider may disclose health information related to a workers compensation claim to the parties involved in the claim, or to the Division of Workers Compensation without the patient's authorization and such disclosure will not violate the HIPAA regulations.

Privacy Notice: HIPAA regulations do require that health care providers develop a privacy notice for patients (CFR 45 § 164.520). The division recommends that such notice include an advice that medical records can be disclosed to employers, insurance companies and the division for purposes of workers compensation claims.

For more detailed information on HIPAA, visit the following websites:

Disclaimer: This page is intended to provide general information about HIPAA regulations, as of the date of writing. Regulations are subject to change. This page does not contain legal advice.

To obtain the authorized signature from the Workers Compensation Division, please contact the Workers Compensation Division. All subpoenas must be requested by OSCAR.

The subpoena will be signed and returned to your business. Subpoenas with a revision date other than 1/17 will be returned without a signature.

Would you like one of our professional staff to make a presentation to your group? Please contact Ryan Boswell at Ryan.Boswell@ks.gov from the Workers Compensation Division with your request.

Topics to be covered include:

  • General workers compensation issues
  • Training for employers
  • Insurance carriers, agents and other interested parties

Forms and Publications

Publications for Sale

Newsletters

Annual Reports

Rehabilitation Resources

Guides

External Resources

Kansas Department of Labor
Workers Compensation Division

kdol.wc@ks.gov

401 SW Topeka Blvd, Suite 2
Topeka, KS 66603-3105

For specific Workers Compensation related inquiries, please visit the KDOL Contact page for more information.