Workers Compensation FAQs

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


Injured Workers

I’ve been injured at work. What should I do?

Get medical help. Many injuries can become serious if not treated. Get first aid at your workplace. If necessary, go to the emergency room or health-care provider of your choice and tell them you were injured at work. Notify your employer immediately. Refer to the Workers Compensation Rights and Responsibilities (K-WC 40-A) guide below for more information about what to do if you are injured at work.

Do I need to file with the state?

No. Unless you are a state employee, your employer’s workers compensation insurance carrier should file with the state and pay your claim.

Will the state pay my claim?

Unless you are a state employee, the state of Kansas does not administer or pay workers compensation claims. In most cases, the claim will be paid by your employer's workers compensation insurance carrier. Your employer should be able to provide you with the name and contact information for the payer of the claims.

I am currently off work. How much of a weekly benefit will I receive?

The weekly benefits are based on 66.67% of your average weekly wage up to a maximum of 75 percent of the state's average weekly wage.

When will I begin receiving my weekly check?

Temporary Total Disability (TTD) benefits are not paid during the first seven days of lost time. If you are off work for 21 consecutive days or more, the first seven days will be paid to you. All days are calendar days, not working days.

What medical treatment can I expect to receive?

You are entitled to medical treatment reasonably necessary to cure and relieve the effects of the work-related injury. This would include diagnostic services and treatments such as surgery, physical therapy and any prescriptions. There are no deductibles or co-payments and no maximum limit. The employer/insurance carrier has the right to select an authorized treating provider.

Will I be compensated for any missed time from work for doctors appointments as well as my travel?

The employer/insurance carrier is not required by statute to pay the employee for time off work in order to seek medical treatment. You are, however, entitled to reimbursement for travel for medical-related mileage, providing the round trip is five miles or more. The mileage is reimbursed by the employer's workers compensation carrier.

I've been offered a settlement, how do I know if it is the correct amount by law?

There are two calculators on our website for calculating a final settlement. For more questions, you can also e-mail kdol.wc@ks.gov. We can walk you through the calculations to better understand your settlement. Remember, a settlement offer will not be made until the authorized physician releases you from care.

I'm dissatisfied with the authorized treating physician. Can I seek a second opinion or see another provider for treatment?

You may seek medical services from an unauthorized provider. The services of the provider can be sought without application or approval. There is a $500.00 limit for the medical treatment payable by the insurer if your claim is compensable. The unauthorized medical allowance cannot be used to obtain a second disability rating.

I still need help. Who should I contact?

Yes, the Kansas Division of Workers Compensation provides assistance and information. You can contact them at (800) 332-0353, (785) 296-4000 or kdol.wc@ks.gov. The office hours are 8:00 a.m. to 5:00 p.m. Monday through Friday.

Employers

What is Workers Compensation insurance?

It is an insurance policy that is provided by the employer (by law) to pay employee benefits for job-related injuries, disability or death. The present law covers all Kansas employers except for those in certain agricultural pursuits or those with a gross annual payroll of $20,000 or less. All payroll is taken into account, including that paid in Kansas or elsewhere. If the employer is a sole proprietor or a partnership, the wages paid to the owners and any of their family members are not used in the computation of the gross annual payroll. Per K.A.R. 51-11-6, the provision in K.S.A. 44-505 excluding the payroll of workers who are members of the employer’s family shall not apply to corporate employers. A corporate employer’s payroll for purposes of determining whether the employer is subject to the workers compensation act shall be determined by the total amount of payroll paid to all corporate employees even when a corporate employee has elected out of the workers compensation act pursuant to K.S.A. 44-543.

Who is considered an employee under Kansas statutes?

Under the definition of  K.S.A. 44-508(b), a 'Workman' or 'Employee' or 'worker' means any person who has entered into the employment of or works under any contract of service or apprenticeship with an employer." The technical definition is quite broad and lengthy and includes all employees whether or not they are full-time, part-time, seasonal, adults, minors or others who have been hired to do certain jobs. The critical test in determining whether or not someone is an employee is the degree of control the employer exercises over the worker.

Do all employers have to carry Workers Compensation on their employees?

Yes. All employers, except those in certain agricultural pursuits or with a gross annual payroll of $20,000 or less, must provide Workers Compensation insurance for all employees (including family members, part and full-time workers, and leased employees). All payroll is taken into account, including that paid outside Kansas. If the employer is a sole proprietor or a partnership, the wages paid to the owners and any of their family members are not used in the computation of the gross annual payroll. 

The provision in K.S.A 44-505 excluding the payroll of workers who are members of the employer's family shall not apply to corporate employers.

Which Kansas employers are excluded from Workers Compensation?

Employment categories excluded from the law are:

  • Certain agricultural pursuits
  • Realtors who qualify as independent contractors
  • Firefighters belonging to a firefighters relief association which has waived coverage under the workers compensation law
  • Sole proprietors, LLC members and partners
  • Certain owner-operator vehicle drivers covered by their own occupational accident insurance policy

Can employers elect in or out of coverage?

Elections in or out of the Workers Compensation Act are options available to employers or employees. Depending on the circumstances, options may be available for:

  • Non-covered employers, those with payrolls of $20,000 or less or certain agricultural pursuits
  • Corporate employees owning 10 percent or more of stock
  • Individuals, proprietors or partnerships
  • Employers seeking coverage for volunteers and other non-covered workers
  • Volunteer directors, officers or trustees of a nonprofit organization

What are the employer's responsibilities when an accident occurs?

Per K.S.A. 44-557, "it is...the duty of every employer to make or cause to be made a report to the director* of any accident, or claimed or alleged accident, to any employee which occurs in the course of the employee’s employment and of which the employer or the employer’s supervisor has knowledge, which report shall be made upon a form to be prepared by the director**, within 28 days, after the receipt of such knowledge, if the personal injuries which are sustained by such accidents, are sufficient wholly or partially to incapacitate the person injured from labor or service for more than the remainder of the day, shift or turn on which such injuries were sustained."

As outlined in K.A.R. 51-9-17, all insurance carriers, group pools and self-insurers are required to use Electronic Data Interchange (EDI) to file First Reports of Injury (FROI) and Subsequent Reports of Injury (SROI) using the Release 3 standards. For details contact Techs and Stats, Division of Workers Compensation at (785) 296-4000 or (800) 332-0353.

Immediately upon learning of an employee's injury or death, the employer must furnish written information to the employee or employee's dependents on available benefits (using K-WC 27-A or K-WC 270-A below), the claims process, an employer or insurance company contact for workers compensation claims, and other matters as required by law.

* As of January 1, 2014, by “make or cause to be made a report to the director” is meant that an employer must report to the employer’s insurer for workers compensation any accident witnessed by the employer, claimed or alleged with sufficient timeliness to allow the insurer to file the accident report with the division within 28 days, as required by K.A.R. 51-9-17.

** The requisite form for reporting by the insurer as of January 1, 2014 is outlined in K.A.R. 51-9-17.
 

Can I purchase a Workers Compensation policy from the state of Kansas and if not, who do I contact?

No. Workers compensation insurance coverage shall be obtained by:

  • Contacting a Kansas licensed insurance agent
  • Contacting the Kansas Insurance Department for information on group-funded pools
  • Contacting the Division of Workers Compensation for information on self-insurance

Can an employer pay claims out of pocket for Worker Compensation injuries sustained by an employee?

Employers must provide for payment of claims in one of three ways:

  1. Workers Compensation insurance: obtained from a licensed insurance carrier. The employer pays the premiums and the insurance company pays the claims. The insurance carriers are regulated by the Kansas Insurance Department.
  2. Self-insurance: an individual employer must demonstrate to the state the financial ability to pay any claims that might arise. This program is administered by the Division of Workers Compensation.
  3. Group-funded pool: a group of employers meeting certain statutory requirements may form a self-insurance program to jointly insure their ability to pay claims. This program is administered by the Kansas Department of Insurance.

I still need help. Who should I contact?

You can contact the division at (785) 296-4000, (800) 332-0353 or kdol.wcemployerservices@ks.gov.

The Division of Workers Compensation has a Speakers Bureau with experts who can speak on fraud and abuse, coverage and compliance, medical services and the fee schedule and general Workers Compensation issues. 

Appeals Board

When must a request for review be filed with the Board?

A request for review must be filed within 10 days from the effective date of the Administrative Law Judge (ALJ) order. The 10 days are counted as follows; The day after the decision is rendered is the effective date even if it falls on a Saturday. Then count 10 days excluding Saturday, Sunday and/or holidays. Thus, if a decision is rendered by the ALJ on Friday, the effective date is Saturday. Do not count Sunday. Start counting on Monday and then exclude the next Saturday and Sunday. Your request for review would then be due on the following Friday.

What information must be included in the request for review?

The case caption should include:

  • Case number
  • Claimant's name
  • Respondent's name 
  • Respondent's insurance carrier

If multiple respondents or insurance carriers, please note who represents each respondent or carrier.

The body of the request should state the ALJ's name and the date of the order. It should also state the issue(s) that you are appealing. 

How do I file a request for review?

Please refer to pages 45-46 of the OSCAR Training Manual. Each regional office follows the same submission process. If you fax the request, you must still mail five copies to the division’s office.

I filed a request for review of a final order or award, now what?

When a request for review of an award has been filed with the division through OSCAR, a briefing schedule and hearing date notice is emailed by the Board to all parties. Appellant has 30 days from the date the application is processed in which to file a brief. The appellee(s) has (have) 20 days to file a brief thereafter. The appellant has 30 days from the date the application is filed to file a brief. Once the briefing schedule is established and a hearing date is scheduled, the appeals board will review the case and determine whether an oral argument is necessary.

If the Board finds that oral argument is not necessary, the case will be placed on the summary docket and a notice will be sent to all parties. Cases not set for oral argument will be deemed submitted the day after the last brief is due. 

Oral argument may be held in person or by telephone conference. The most convenient way to reschedule an oral argument is to call the Board office at (785) 296-4000 for a list of dates/times that are available. Once a date is agreed upon between the party and opposing counsel, notify the board office. A second notice will be mailed by the board confirming the change. Please remember, we schedule several months ahead of time.

I filed a request for review of a Preliminary Hearing Order. Now what?

Once a request for review of a Preliminary Hearing Order is filed with the Board, the Board will mail an acknowledgement of the application and briefing schedule to all parties. The appellant has 10 days from the date the application is filed to file a brief. Once the brief is filed, the appellee has 10 days to respond. The case then goes to a Board member to draft a decision for Board review. Reviews of preliminary orders are conducted without oral argument. 

General Information:

Post Award Medical: For purposes of review, appeals will follow the same procedure as final hearing orders.

Final Orders: For the purposes of review, the procedure for final orders will be the same as for preliminary orders.

Two or More Parties Requesting Review of an Award: If two or more parties request review of an award/order, the party who filed first is the appellant and all others are appellees.

Briefs: Briefs may be in letter form. If relying on the submission letter to the ALJ, please reference that in your brief.   Briefs should be uploaded under the AP number assigned to the appeal at the time the application is filed.

Extensions: Extensions to file briefs are not favored. However, the Board will issue an extension for up to 10 days on the first request. The request should be in written form uploaded to OSCAR under the AP number Motion to Board - Extension of time to file brief.

Dismissal of Case/ Case Settled or Resolved: When a case has settled or the issues are resolved, please notify the Board immediately. A letter will then be sent from the Board requesting that an agreed order of dismissal to be prepared and signed by all parties. The order should be prepared for signature by three Board members.

Certification of Record to Appellate Courts: Supreme Court Rule 9.04 gives responsibility for certification of the record for cases being appealed to the Court of Appeals/Supreme Court to the Director.

Attorneys

Why does the division now send Notices of Hearing by e-mail?

We know your time is important and immediate notification via e-mail means you can begin scheduling long before the posted mail arrives each day. E-mailing also reduces paper consumption and postage expenses.

When we receive an Application for Hearing, all parties with a valid e-mail address will receive the Notice of Hearing by e-mail.

I want to receive notices by e-mail. What should I do?

Submit your contact information to kdol.wchearingnoticessent@ks.gov to receive notices by e-mail. The division will then send any application that lists you as a party to a case to your e-mail automatically.

Required information:

  • Email address (we accept only one email address for each claimant, employer, carrier, and/or attorney)
  • Name or company’s name
  • Physical address (city, state, and zip code)
  • Phone number (including area code)
  • Your role (employer, injured employee, insurance carrier, or attorney)

Why am I no longer receiving hearing notices and applications for hearing by mail?

The adverse party is sent a copy of the application for hearing via their delivery method of choice. Electronic mailing is now included in the mailing requirement for hearing applications and/or notices of hearing (House Bill 2134 (2011 session)).

Why can’t my organization list more than one e-mail address to receive notices?

To processes on our end, we ask that you identify a single mailbox within your organization to receive notifications.

Why can’t you send an email notice of hearing to the employer or insurance carrier at the same time it’s mailed to the attorney?

All parties to the action should receive an e-mail notice of hearing if an e-mail address is on file.

I did not receive an e-mail copy of a hearing notice. What should I do?

Call the Application Unit at (785) 296-4000 to receive a duplicate copy. When you call, have your e-mail address ready, to help us match notices against the address on file.

My organization doesn’t have an e-mail address. What will happen to our hearing notices?

In our effort to go green, we prefer to use e-mail whenever possible. If you do not have an e-mail address, notices will be mailed to your postal address.

What are some key points about the e-mailing of notices?

  • Companies with multiple offices, which have a centralized site for postal must submit only one e-mail address for all.
  • Companies with multiple offices, which each receive their own postal must submit e-mail addresses for each location.
  • If your e-mail address changes for any reason, notify us right away.
  • If you have questions for the division’s Application Unit, contact (785) 296-4000 or kdol.wchearingnoticessent@ks.gov.

Medical Care Providers

Where can I find a copy of the Fee Schedule?

You can find the latest copy of the Fee Schedule in the Workers Compensation section of this website.

Can a Provider be paid less than the Fee Schedule?

Yes, a Provider can be paid less than the Fee Schedule if an employer/carrier enters into a contract with a provider. Such contracts will supersede limitation amounts. Please refer to K.S.A. 44-510i and K.A.R. 51-9-17 for further clarification.

How should I resolve billing problems or claim denials?

In the event a controversy arises between the provider and the payer, an attempt should be made by the involved parties to resolve said issue(s).

If you still cannot resolve your issue, contact the Medical Services and Fee Schedule Unit at (785) 296-4000 (option 8) or Jassina.Washington@ks.gov.

Can the Employer / Carrier refuse payment or adjust fees?

Yes. However, the employer must notify the provider in writing, within 30 days of receipt of the bill, explaining the reason for refusing payment or adjusting fees.

How often is the Fee Schedule updated?

The scheduled of maximum fees is revised when necessary at least every two years to assure that it is current, reasonable, and fair.

Who should I bill?

Employers must provide for payment of medical claims in one of three ways:

  1. Workers Compensation insurance: obtained from a licensed insurance carrier. The employer pays the premiums and the insurance company pays the claims
  2. Self-insurance: an individual employer must demonstrate to the state the financial ability to pay any claims that might arise
  3. Group-funded pool: a group of employers meeting certain statutory requirements may form a self-insurance program to jointly insure their ability to pay claims.

This program is administered by the Kansas Department of Insurance. All medical bills shall be submitted to the appropriate insurance for that employer.

How do I verify an employer’s coverage?

Please contact the employer directly.

Is there a hearing process for unresolved disputes?

If the dispute is not settled after the informal hearing, the director may schedule a formal hearing.

Accident Prevention Program

What does the Accident Prevention Administrator monitor?

Accident Prevention under the Workers Compensation Division of the Kansas Department of Labor monitors insurance company and group-funded self-insurance plan compliance with provisions of K.S.A. 44-5,104.

What information will be gathered under an Accident Prevention inspection?

An inspection ensures insurance companies and group-funded self-insurance plans licensed to write workers compensation coverage in Kansas are providing services when requested by a policyholder, submitting the annual report, using qualified field safety representatives, and printing the notice required under Kansas statute on the front page of every policy delivered or issued for delivery in this state.

Why should I, as an insurance company or group-funded self-insurance plan, participate?

Under Kansas statute K.S.A. 44-5,104, you must maintain accident prevention services and provide such services at the request of a policyholder as a prerequisite for authority to provide such insurance or coverage in the state of Kansas.

How can I submit my completed annual report (K-ISH 28) form?

As soon as you click the [Submit] button, your completed form is automatically sent to our server through a secure Internet connection. We no longer accept paper forms for this report.

If we are not actively soliciting business in the state of Kansas, do we still have to complete the annual report K-ISH 28?

As long as an insurance carrier or group-funded self-insurance plan has a license to write workers compensation in Kansas, the report must be submitted. Complete or update Section I. Check “No” in Section II, and enter your name and title in the Affirmation section as your “signature.” If your company or plan should start writing business in Kansas, we will have a record of the business.

Is the website we use to submit our information secure?

Yes, the connection is secure.

Will you accept other forms submitted by a Workers Compensation carrier?

No, for consistency and to provide what is required in the state statute, we will only accept our automated form and the Excel spreadsheet as found on our website.

Whom do I contact about the annual report or with other questions about Accident Prevention Services?

You may contact the Accident Prevention Administrator at (785) 296-4000 ext. 7360 or kdol.wc@ks.gov.

Electronic Data Interchange (EDI)

What industry codes (DN025) will Kansas accept?

Kansas currently accepts the 2017 North American Industrial Classification System codes (NAICS).

When is the DN68 (Initial Return to Work Date) required?

The Initial Return to Work Date should always be provided on a First Report of Injury (FROI), even if the injured worker returned to work on the same day. The only instances in which an Initial Return to Work Date would not be provided is if the injured worker has not returned to work, or if it is unknown if they have returned to work. Once the Initial Return to Work Date is known, a FROI 02 change report needs to be sent with that Initial Return to Work Date in order to update the First Report of Injury (FROI).

In what instance would DN154 (Employee ID Assigned by Jurisdiction) be used? What is the process for creating this ID?

If there is no available Social Security number for injured worker, then there will need to be an Employee ID Assigned by Jurisdiction sent in its place. This will be assigned by Kansas Division of Workers Compensation by contacting (785) 296-4000 or Dane Curtis at dane.curtis@ks.gov.

What is the current EDI Release?

As of November 29, 2018, Kansas is using EDI Release 3.1.

When is a First Report of Injury (FROI) required to be reported (medical-only as well as indemnity)? Do all incidents, regardless of medical aid, get reported via EDI?

All claim types on a First Report of Injury (FROI) are reportable to the State of Kansas within 28 days of the employer being notified that an injury has occurred.

Either an Original First Report of Injury (FROI 00) or a Denial First Report of Injury (FROI 04), as applicable, must be submitted to Kansas Division of Workers Compensation following an accident or occupational exposure "…if the personal injuries which are sustained by such accidents, are sufficient wholly or partially to incapacitate the person injured from labor or service for more than the remainder of the day, shift or turn on which such injuries were sustained" (K.S.A.44-557(a))

Kansas Division of Workers Compensation understands that K.S.A.44-557(a) merely sets the statutory floor for the timeliness reporting requirement for an Original First Report of Injury or a Denial First Report of Injury. However, any insurance carrier, third party administrator, self-insured employer or group-funded pool may send a FROI 00 for all no-time-loss accidents that do not meet the statutory threshold for mandatory reporting. Reporting entities are strongly encouraged to report any and all injuries regardless of lost time.

When is a Subsequent Report of Injury (SROI) required to be reported?

Subsequent Reports of Injury (SROI) are required for all claims that are indemnity, or became indemnity. The Subsequent Reports of Injury (SROI) are not reported to the Kansas Division of Workers Compensation if the claim is medical-only or became medical-only. With that being said, all payment information is required on a reportable Subsequent Report of Injury (SROI), including any medical payments associated with the claim.

How do I know when a First Report of Injury (FROI) and Subsequent Report of Injury (SROI) need to be filed, and in what order to file them?

There are Event tables (FROI, SROI, Periodic) within our Release 3.1 EDI Tables that show which business events trigger each First Report of Injury (FROI) and Subsequent Report of Injury (SROI) to be filed with the Kansas Division of Workers Compensation. The tables show the report triggers for each maintenance type code and when the report is due.

The sequence for filing the reports can also be found within the Kansas R3.1 Edit Matrix in the table named "KS Sequence Table." This table shows whether a report (FROI or SROI) will be accepted or rejected based on the previous report that was filed.

Do we submit an EDI Subsequent Report of Injury (SROI) on claims for which we previously submitted a paper First Report of Injury (FROI)?

No, it will be EDI only going forward. EDI SROIs can only be submitted if you have filed an EDI FROI.

How do we use the Annual Report (AN)?

The annual report (AN) has now been changed into a true annual report. For any claims having indemnity being paid, the AN is required every calendar year that the claim is still open. The date of annual is based off of the date of injury; this report will be due on the date of injury every calendar year. These will be required every year until a final (FN) is reported which will close the claim.

What is a SROI PY? When is it used?

A PY identifies a lump sum payment/settlement report for indemnity claims only. If the first indemnity payment is included in a lump sum payment/settlement, do not send the IP or AP but send the PY.

What if I have reported a SROI PY (lump sum payment), but the claim is still open for possible future medical payments?

If the Trading Partner would like to leave a claim open on their end for possible future medical payments after a SROI PY, they can still file the SROI FN (final) report with the Kansas Division of Workers Compensation. If payments are in fact made, the Trading Partner can simply submit another SROI FN to report this information.

Where did the MTC code FS go?

The code has been replaced by MTC code EP (Employer Paid). Other than the name and acronym of the MTC code, there has been no change. Use the EP in all instances that an FS was previously used.
Trading Partner Requirements

Where can I find the IAIABC Release 3 Implementation Guide? Where do I find the Data Dictionary?

The IAIABC website has the Implementation Guide available for purchase under EDI, Implementation Guides (Claims 3.0). The data dictionary can be found in section 6.

Do you have a list of approved vendors?

A list of EDI vendors that are currently submitting workers compensation claim reports in other jurisdictions and that have proven technical and business capability to comply with the Kansas EDI Implementation Guide can be found on the Workers Compensation OSCAR and EDI page.

How often do our Trading Partner documents need to be updated?

If there is a change to any of the information within the current Trading Partner documents on file with the Kansas Division of Workers Compensation, the Trading Partner is required to submit updated documents within 5 business days. 

Reminders will be sent out twice a year (in March and September) and the Kansas Division of Workers Compensation can provide Trading Partner with a copy of the current documents on file by requesting this information. You can send the request to Dane Curtis.

When reporting via EDI, what will Closed Claims Study (CCS) reporting obligations be?

Entities will no longer be required to participate in the Closed Claim Study, because the reporting requirements will be met through EDI.