The Kentucky Department of Workers’ Claims (DWC)
is responsible for providing a fair, efficient and effective arena for resolving disputes that arise under the Kentucky Workers’ Compensation Act. The DWC ensures that once an employee has been injured in the workplace, the employee receives required benefits from insurers or self-insured employers along with any necessary medical attention.
The Claims Processing Division
provides support to the Administrative Law Judges, the Workers’ Compensation Board and completes each step in the processing of required forms for establishment of a claim. The Division is broken up into four sections: Claims Review, Claims Assignment, Agreements and Appeals.
The Constituent Services (Specialists-Ombudsmen) Division
provides a wide variety of services from mediating disputes and advising parties of their rights and obligations under the Workers’ Compensation Act to responding to inquiries and complaints about the system and participants in the program. They serve as a neutral source for employees, employers, medical providers and other program participants.
The Division of Information & Research
is responsible for collecting and retrieving data as well as disseminating information. This division includes the records branch (which encompasses Data Entry, EDI Claims, EDI Proof of Coverage and the Research Section) and the Imaging Branch (includes Open Records and the Scanning Section). These sections combine to ensure the data submitted to the department is reliable and accurate.
The Security & Compliance Division
is made up of the Self-Insurance Branch and the Compliance Branch. The Self-Insurance branch audits self-insured employers’ claim files, monitors their financial strength and determines the surety requirements necessary to secure benefits for the self-insured employers’ workforce. The Compliance Branch encompasses the enforcement section (responsible for investigating the status of insurance coverage through on-site visits to employers) and the administrative processing section (responsible for certifying coverage, maintaining records and registering employee leasing organizations).
The DWC also provides information and services to claimants, employers, attorneys, the insurance community, judges, legislators, governmental entities and other parties. The DWC determines whether an employer may self-insure and maintains information on the mandatory insurance requirement of employers. Some of the responsibilities of the DWC include adjudication, compliance inspections, auditing and enforcing payments, reviewing settlements, compiling statistics, and general oversight of medical services & cost containment in workers’ compensation. The DWC encourages rehabilitation and reemployment for workers injured in the workplace and promotes the reduction of work related injuries, illnesses and fatalities. Visit the Kentucky Department of Workers’ Claims