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collapse Division : Claims Processing and Appeals ‎(16)
collapse Section : Agreements ‎(4)
Has my Agreement been received and/or approved?
Once the Agreement is approved, you will receive an approved copy by U.S. mail. If you are represented by an attorney, your attorney will receive a copy.
AgreementsClaims Processing and Appeals
In addition to the Form 11, Motion to Substitue Party and Continue Benefits, what documentation do you need to process my request for widow or dependent benefits?
You will need to include a copy of the Death Certificate, Marriage License, and any dependent Birth Certificates. You or your attorney will be contacted if any additional information is needed.
AgreementsClaims Processing and Appeals
What is the discount rate?
The discount rate is established each year and information on the current year's rate can be found in the <a href="/workersclaims/Pages/Publications.aspx" title="Click here for Workers' Claims Publications">Guides Section</a> of the Publications are of the Department of Workers' Claims website.
AgreementsClaims Processing and Appeals
Is there a tool available to assist in the calculation of both weekly and lump sum settlements?
Yes. <a href="/workersclaims/Pages/PPD-Calculator.aspx" title="Click here for the PPD Calculator">The PPD Calculator</a> is a very helpful tool that illustrates how the Discount Rate and other guidelines apply to the Settlement. Because of Social Security regulations, the PPD Calculator cannot be used for workers who reach retirement age, as defined in KRS during the period of income benefits.
AgreementsClaims Processing and Appeals
collapse Section : Appeals ‎(3)
How much time do I have to file an appeal to the Workers' Compensation Board?
Notices of Appeal to the Board should be filed within 30 days of the Administrative Law Judge's opinion or final order.
AppealsClaims Processing and Appeals
When is the Petitioner's brief due?
Petitioners have 30 days from the filing of the Notice of Appeal to file a brief.
AppealsClaims Processing and Appeals
When is the Respondent's brief due?
Respondent's briefs are due 30 days from the filing of the Petitioner's brief.
AppealsClaims Processing and Appeals
collapse Section : Claims Assignment ‎(4)
When will a Scheduling Order be issued and what is the pertinent information on it?
All Parties of Record will be notified, by letter, of the Judge assigned to the claim along with the date, time and location of the Benefit Review Conference.
Claims AssignmentClaims Processing and Appeals
Where do I send additional documents associated to the claim such as Motions?
Mail all pleadings/documents to:<br/><div style="margin: 5px 0px 0px 30px;">Department of Workers' Claims<br/>657 Chamberlin Ave.<br/>Frankfort, KY  40601</div>
Claims AssignmentClaims Processing and Appeals
How can I get my x-ray or other exhibit returned to me?
All X-rays are returned after the Claim is resolved and has been closed for at least 60 days to the Party that submitted the exhibit. All other exhibits over $25 in value are destroyed unless otherwise requested. X-rays and other exhibits can only be returned to the party that submitted the exhibit. If you wish to have an exhibit under $25 in value returned, requests must be made in writing to:<br/><div style="margin: 5px 0px 0px 30px;">Department of Workers' Claims<br/>657 Chamberlin Ave.<br/>Frankfort, KY  40601</div>
Claims AssignmentClaims Processing and Appeals
I am a physician and need a claim number for billing purposes?
The number assigned by the Department of Workers' Claims is for litigation purposes and is not the same number used by the insurance carrier to process a claim. Contact the Employer/Insurance Carrier for payment information.
Claims AssignmentClaims Processing and Appeals
collapse Section : Claims Review ‎(5)
Where and to whom do I send the Application?
Send the Application to:<br/><div style="margin: 5px 0px 0px 30px;">Department of Workers' Claims<br/>657 Chamberlin Ave.<br/>Frankfort, KY  40601</div>
Claims ReviewClaims Processing and Appeals
How many copies of the Application do you need?
The Department of Workers' Claims must receive the original and enough copies to serve all Parties listed on the claim.
Claims ReviewClaims Processing and Appeals
Has my Claim been received and when was it received?
You will receive an Acknowledgement Letter with the date it was received.
Claims ReviewClaims Processing and Appeals
Why was an additional Party added to my Claim?
The Claim is researched and based on our records, any Party with potential liability is included as a Party to the Claim.
Claims ReviewClaims Processing and Appeals
A First Report of Injury has already been filed, so why did I get this letter saying no matching First Report of Injury has been filed?
Information submitted on the Application and information filed electronically on the First Report of Injury do not match. Therefore, there is no matching First Report of Injury on record.
Claims ReviewClaims Processing and Appeals
collapse Division : Information and Research ‎(32)
collapse Section : Data Entry ‎(5)
Has my pleading been received and filed by the DWC?
When contacting the Data Entry Section, the following information is needed:<br/><div style="margin: 5px 0px 0px 30px;"><ul><li>DWC Claim Number</li><li>Name of plaintiff</li><li>Type of pleading</li><li>Date the pleading was mailed to the DWC</li></ul></div>
Data EntryInformation and Research
How is a physician assigned a medical index number?
An index number shall be assigned to a physician upon the filing of the physician's qualifications with the DWC. A medical index number is assigned and the Medical Index Listing on the DWC homepage is updated. A copy of the CV is scanned into our Imaging System using the assigned medical index number. Revisions or updates to the CV may be filed with DWC in the same manner.
Data EntryInformation and Research
Can a physician make a request directly to DWC for a medical index number to be assigned?
Yes, however, when a physician provides their curriculum vitae to DWC, a cover letter requesting an index number or informing DWC of revisions to a current CV must accompany the request.
Data EntryInformation and Research
Could you please provide me with the physician's medical index number?
This can be accessed by going to the following web address:<br/><a href="/workersclaims/Pages/Publications.aspx" title="Click here for Workers' Claims Publications">http://labor.ky.gov/workersclaims/Pages/Publications.aspx</a>
Data EntryInformation and Research
Could you please send me a copy of a specific physician's Curriculum Vitae?
You may mail, fax or call in your request for this copy to:<br/><div style="margin: 5px 0px 0px 30px;">Department of Workers' Claims<br/>Attn: Ashley Estep, Open Records<br/>657 Chamberlin Ave.<br/>Frankfort, KY  40601<br/>Phone: 502-782-4429<br/>Fax: 502-564-5732<br/><br/></div>Please provide the physician's name and your mailing address and the copy will be mailed to you.
Data EntryInformation and Research
collapse Section : EDI Claims ‎(17)
How do I become a trading partner with the Kentucky Department of Workers' Claims?
Obtain the KYWC EDI documentation which contains state-specific information required for submitting electronic reports to the KYWC. Obtain the IAIABC Implementation Guide which contains the standardized information used by all jurisdictions that are receiving workers' compensation reports electronically. Be sure to request the proper guide based on the information provided in the KYWC EDI documentation. Establish a mailbox account with one of the value-added networks used by the KYWC. Complete the Trading Partner Agreement, Trading Partner Profile and Transmission Profile and return them to the KYWC by fax or mail. If we have any questions regarding these profiles, we will contact you using the information provided on the Trading Partner Profile. If your profiles have been completed accurately, you will receive written notification that your trading partner account has been established. Do not begin sending test transmissions until you receive this notification.
EDI ClaimsInformation and Research
What are "test" transmissions?
Test transmissions serve two purposes. Initially, they verify that all technical details regarding the transmission process itself are correct for all three systems involved: yours, the VAN's and the KYWC's. Ultimately, they are used by the KYWC to assess your ability to send acceptable electronic reports.
EDI ClaimsInformation and Research
What types of test reports should I send?
When testing First Reports of Injury (FROI) with the KYWC, send only original reports (MTC "00"). Upon obtaining production status, all additional first report Maintenance Type Codes (MTC) become reportable. Do not send test transmissions for Subsequent Reports of Injury (SROI) until production status has been obtained for First Reports of Injury. When testing subsequent reports, send only initial payment reports (MTC "IP"). Upon obtaining production status, all additional subsequent report  MTCs become reportable.
EDI ClaimsInformation and Research
When will I be placed in production status by the KYWC?
The KYWC uses an abbreviated testing process in order to place each trading partner in production status as quickly as possible. Trading partners able to send three consecutive transactions containing at least 10 reports each with no more than 30 percent of the reports rejected per transaction will be given production status.
EDI ClaimsInformation and Research
I just sent an EDI transmission to the KYWC. When can I expect an electronic acknowledgment?
The KYWC downloads incoming EDI transmissions from the VANs each business morning. Functional acknowledgments are returned immediately. Detailed acknowledgments are normally returned by close of business on the same day. Occasionally, the volume of data to be processed causes the detailed acknowledgments to be returned the morning of the following business day.
EDI ClaimsInformation and Research
What's the difference between a Functional Acknowledgment and a Detailed Acknowledgement?
Functional acknowledgments are used to inform the sender that their EDI transmission was received. They are not supported by the IAIABC flat-file standards, and therefore are only returned to trading partners sending ANSI transactions. Detailed acknowledgments are returned to all trading partners after the electronic acknowledgement has been analyzed by the KYWC. These detailed acknowledgments inform the trading partner that their transactions have been accepted or rejected. If a transaction is rejected, the detailed acknowledgment includes codes which identify any errors found by the KYWC.
EDI ClaimsInformation and Research
Enough time has passed for me to have received an electronic acknowledgment, but my VAN mailbox is empty. What should I do now?
Contact your value-added network. The VANs keep logs which show when your transmission was uploaded to your mailbox, when the transmission was routed to the KYWC mailbox, when it was downloaded by the KYWC, etc. If this log shows that your transmission was downloaded by the KYWC, contact our office and we will continue this tracking process.
EDI ClaimsInformation and Research
I received a detailed acknowledgment which says that an original First Report of Injury was rejected, and includes the message, "NON-REPORTABLE: LOST TIME IS NOT MORE THAN A FULL WORK DAY" in the free-form text field. What does that mean?
If an original First Report of Injury is received with a Nature of Injury Code (DN0035) lower than "60," it indicates a traumatic injury is being reported. For a traumatic injury to be reportable to the KYWC, the employee must have missed more than one day. This determination is made by comparing the Date Last Day Worked (DN0065) to the Date of Return-to-Work (DN0068), if any. There must be more than a calendar day separating these two dates. If not, the transaction is rejected and the above message is inserted in the free-form text field for clarification.
EDI ClaimsInformation and Research
What does "accepted with errors" mean? (Application Acknowledgement Code TE)
This Acknowledgement Code is no longer used. It was used prior to January 16, 2009 and reflected that the record had been received by DWC and accepted with errors. At that time, the coding staff had determined that certain fields within that record required changes to conform to DWC data quality standards. Prior to January 16, 2009, records with errors in the Nature, Cause, Body Part or SIC Code fields were modified by DWC staff and accepted with errors. However, as of January 16, 2009, electronically transmitted records are no longer modified when errors are discovered in these key fields. If an error is found, the record will be rejected and an (00) Original transaction must be resubmitted.
EDI ClaimsInformation and Research
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