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Timestamp: 2019-04-20 22:22:52+00:00

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As a general rule, independent contractors are not covered under the Alabama Workers’ Compensation Act. However, the test in determining whether an individual is an independent contractor or employee is the “right of control” test.
The Alabama Workers’ Compensation Act is the exclusive remedy available to employees who sustain work-related injuries, illnesses, or diseases. Ala. Code§ 25-5-52 and 53 set forth the immunity provision for accidents and Ala. Code § 25-5-113 and 114 set forth the immunity provision of occupational diseases.
"The intent of the Legislature is to provide complete immunity to employers and limited immunity to officers, directors, agents, servants or employees of the same employer and to the workers' compensation insurance carrier and compensation service companies of the employer or any officer, director, agent, servant or employee of such carrier or company and to labor unions and to any official or representative thereof from civil liability for all causes of action except those based on willful conduct and such immunity is an essential aspect of the workers' compensation scheme." Ex parte Progress Rail Servs. Corp., 869 So. 2d 459, 465 (Ala. 2003). See also Ala. Code § 25-5-14.
(3) to "an employer's wrongful conduct [that] ... injures an employee's unborn child" (Namislo v. Akzo Chems., Inc., 620 So. 2d 573, 575 (Ala. 1993)).
The Alabama statute also contains a very narrow exception allowing certain claims to survive against co-employees. Co-employee liability is discussed in Ala. Code § 25-5-11.
The Alabama Workers’ Compensation Act generally extends jurisdiction broadly to any employee who physically sustains a work injury in Alabama. 2 Terry A. Moore, Alabama Workers' Compensation § 30:32. Moore notes that Ala. Code § 25-5-35 “implies that all in-state injuries are covered”.
Alabama Circuit Courts have jurisdiction over workers’ compensation claims brought under the Alabama Workers’ Compensation Act. Ala. Code § 25-5-88. Alabama does not have a workers’ compensation tribunal. Cases are tried before the same judges that preside over criminal and civil actions and are governed by the same rules of civil procedure and evidentiary rules as civil actions.
Alabama has time limitations for notice of an accident, discovery of an occupational disease, filing of suit. Written notice of a job-related injury is required so that an employer can make a prompt examination, provide proper treatment, and protect itself against simulated or exaggerated claims. (Ex parte Brown & Root, Inc., 726 So.2d 601 (Ala. 1998)). Although the statute requires written notice, actual knowledge has been deemed to suffice where the employer learns that the employee has sustained an accidental injury in the course of employment. (Ex parte Singleton, 6 So.3d 515 (Ala. 2008)).
An employee is required to give written notice of an accident within 5 days. Ala. Code § 25-5-78. Alabama’s courts eliminated the written notice requirement if the employer had actual notice. (Goodyear Tire & Rubber Co. v. Long, 31 So. 3d 715 (Ala. Civ. App. 2009)). Failure to provide notice within five (5) days of the accident bars the employee from recovery of benefits from the date of accident until the date of notice, unless the employee shows good cause for the failure. Goodyear Tire & Rubber Co. v. Foreman, 551 So.2d 409 (Ala. Civ. App. 1989). “Good cause” includes physical or mental incapacity and fraud.
Workers' compensation claims for injuries resulting from work-related accidents must be brought within two years of either: 1) the accident or 2) the date of the employer's last voluntary payment of compensation benefits resulting from the accident. If a claim is not filed before the applicable period expires, the claim is barred by the statute of limitations in the Act. Ala. Code 1975, § 25-5-80.
The two-year statute of limitations is extended or tolled when the Claimant receives compensation payments. Once expired, the statute of limitations may not be revived by the payment of disability benefits. Payment of medical benefits does not toll or extend the limitations period.
The Alabama Workers’ Compensation Act provides compensation for personal injuries and occupational diseases that “arise out of’ the employment and occur “in the course of” the employment.
The phrase "arising out of" involves the idea of a causal relationship between the employment and the injury. See Wiregrass Comprehensive Mental Health Clinic, Inc. v. Price, 366 So. 2d 725, 726 (Ala. Civ. App. 1978).
Medical causation is concerned with whether the physical condition of the claimant has been changed by a trauma, stress, or exposure. 1 Terry A. Moore, Alabama Workers' Compensation § 10:31 (1998).
In order to recover for a hernia, the employee must prove that it resulted from an accident arising out of and in the course of the employment and must establish that there was an injury resulting in a hernia, that the hernia appeared suddenly and was accompanied by pain, that the hernia immediately followed an accident and did not exist prior to the accident. Ala. Code 1975 § 25-5-57(a)(6)a.
Infectious diseases are covered under the definition of occupational disease, so long as there is “clear and convincing evidence” the disease is acquired as a direct result of the employment. The employee has the burden of proving a causal link between the employment and the disease.
In order for a psychological injury to be compensable under the Alabama Workers’ Compensation Act, it must be "produced [or] proximately caused by some physical injury to the body.” Ala. Code 1975 § 25-5-1(9). See Goolsby v. Family Dollar Stores of Alabama, Inc., 689 So. 2d 104 (Ala. Civ. App. 1996). Additionally, the physical injury need not be the sole cause of the psychological injury so long as it is a contributing cause of the psychological injury. Ex parte Vongsouvanh, 795 So. 2d 625 (Ala. 2000), Jim Walter Res., Inc. v. Riles, 903 So. 2d 118, 122-23 (Ala. Civ. App. 2004). There is no “mental/mental” in Alabama.
“No compensation shall be allowed for an injury or death caused … by an accident due to the injured employee being intoxicated from the use of alcohol or being impaired by illegal drugs.” § 25-5-51, Code of Ala. (1975).
The employer bears the burden of proving that the accident causing the injury was proximately caused by the employee’s intoxication/impairment.
“[N]o compensation shall be allowed for an injury or death caused by the willful misconduct of the employee”. Ala. Code 1975, § 25-5-51. The employer bears the burden of proving that the accident causing the injury was proximately caused by the employee's willful misconduct/intentional conduct.
“No compensation shall be allowed if, at the time of or in the course of entering into employment or at the time of receiving notice of the removal of conditions from a conditional offer of employment, the employee knowingly and falsely misrepresents in writing his or her physical or mental condition and the condition is aggravated or re-injured in an accident arising out of and in the course of his or her employment.” Ala. Code 1975, § 25-5-51.
“[N]o compensation shall be allowed for an injury or death caused by … [the employee’s] willful failure or willful refusal to use safety appliances provided by the employer.” § 25-5-51, Code of Ala. (1975). For this defense, the term “willful” means the employee’s actions were conscious or deliberate. This defense does not require the employer to prove the claimant intended to violate a rule, or intended to cause injury.
The employer bears the burden of proving that the accident or injury was proximately caused by the employee’s misconduct proscribed by the defenses listed in § 25-5-51. These defenses, if successful, only eliminate the employee’s rights to recover “compensation” and do not relieve the employer / carrier of the obligation to provide otherwise reasonably necessary medical treatment.
Accidents occurring during social events or recreational activities sponsored by the employer are generally not covered as falling within the scope of employment. Circumstances may present coverage issues, where there is evidence that attendance is compulsory or that some economic benefits is derived by the employer, other than improved employee moral or employee relations.
Generally, an accident, which occurs while an employee is travelling to or from work, is not deemed to have occurred within the scope of employment and is not covered. Exceptions arise where the trip includes some activity on behalf of the employer, as opposed to a purely personal trip to or from home. Issues such as payment of travel expenses and provision of a company vehicle may also affect the issue.
An employee’s injury arises out of and in the course of his employment when it occurs within the period of the employee's employment, at a place where the employee may reasonably be and while the employee is reasonably fulfilling the duties of the employee's employment or engaged in doing something incident to it. See 25-5-1(8), Code of Ala. (1975). In the course of employment Refers to the time, place, and circumstances under which the accident took place. Arising out of involves a causal relationship between the employment and the injury; that is, the job performance was the cause and source of the injury.
Generally, an accident is not covered where an employee engages in horseplay and is injured. However, where an employee is injured due to the horseplay of others, in which they did not participate, the accident is generally covered.
Generally, assaults based upon reasons purely personal to the attacker are not compensable. If the reason for the attack has any connection to employment activities, compensability may become an issue.
If the degree or duration of disability resulting from an accident is increased or prolonged because of a preexisting injury or infirmity, the employer shall be liable only for the disability that would have resulted from the accident had the earlier injury or infirmity not existed. Section 25-5-58.
If the injured employee refuses to comply with reasonable request for examination, or refuses to accept the medical service or physical rehabilitation, which the employer elects to furnish under this chapter, the employee’s right to compensation shall be suspended and no compensation shall be payable for the period of the refusal. Ala. Code 1975, § 25-5-77(b).
If an injured employee refuses employment suitable to his or her capacity offered to or procured for him or her, he or she shall not be entitled to any compensation at any time during the continuance of the refusal, unless at any time, in the opinion of the judge of the circuit court of the county of his or her residence, the refusal is justified. Ala. Code 1975, § 25-5-57(e).
If a second injury contributes even slightly to the employee’s disability, then the employer at the time of the second injury (and the insurer with coverage for that second injury) is responsible for the workers’ compensation payments. ‘The characterization of the second injury as a new injury, an aggravation of a prior injury, or a recurrence of an old injury determines which insurer is liable.’ North River Ins. Co. v. Purser, 608 So.2d 1379, 1382 (Ala.Civ.App.1992).
Fringe benefits are included in the average weekly wage only if the employer has discontinued the benefit. "Fringe benefits" shall mean only the employer's portion of health, life, and disability insurance premiums. Ala. Code 1975 § 25-5-1(6).
Temporary Partial Disability (TPD) is paid when an employee returns to work, with restrictions, to light duty or part-time. Temporary Partial Disability is paid at 66 2/3% of the difference in the employee’s earnings at the time of injury and the earnings in his restricted capacity. This compensation is paid during the period of disability but not beyond 300 weeks, subject to the maximum only in effect on date of injury. Ala. Code 1975 § 25-5-57.
There is a three (3) day waiting period in the State of Alabama. Compensation is owed beginning on the fourth (4th) day of disability. When the injured employee is out twenty-one (21) days, the three (3) day waiting period is added to the first compensation payment due after the twenty-one (21) days. If the employee sustains an injury, and it is obvious lost time will exceed twenty-one (21) days, the three (3) day waiting period may be waived and compensation begun on the first day of disability. Ala. Code 1975 § 25-5-59.
34. For serious disfigurement, not resulting from the loss of a member or other injury specifically compensated, materially affecting the employability of the injured person in the employment in which he or she was injured or other employment for which he or she is then qualified, 66 2/3 percent of the average weekly earnings for the period as the court may determine, but not exceeding 100 weeks. Ala. Code 1975 § 25-5-57(a)(3)a.34.
Permanent partial disability (PPD) benefits are paid after an employee has reached maximum medical improvement for a period not to exceed 300 weeks (Caveat: successive compensable injuries) less payment of temporary total disability (TTD) benefits.
Permanent partial disability (PPD) benefits are generally paid out over time. The employee may not require a lump sum payment unless the employer is in default on payments. Ala. Code 1975 § 25-5-86. If payments are made in a lump sum, future payments are reduced to present value on a six (6%) percent basis. Ala. Code 1975 § 25-5-83.
A trial court is not bound to accept a physician's assigned impairment rating and is free to make its own determination as to an employee's impairment. Fuller v. BAMSI, Inc., 689 So. 2d 128, 131 (Ala. Civ. App. 1996).
An award of permanent partial disability benefits is based upon the employee’s reduced earning capacity proximately caused by the injury in question. The trial court has discretion in determining the impact of an accident and injury on earning capacity and may consider vocational evidence and testimony from vocational experts.
The American Medical Association Guides to the Evaluation of Permanent Impairment, Fourth Edition, shall be the recommended guide used by physicians in determining impairment and/or disability ratings. Ala. Admin. Code, r. 480-5-5-.35. Medical impairment is not the same as physical impairment, however.
Permanent Total Disability (PTD) does not mean total helplessness. Permanent Total benefits have no limitations on the amount or length of time of payment. If an injured employee is determined to be a permanent total, whereby, he is unable to obtain suitable or gainful employment as a result of the injury, he is entitled to PTD benefits for the remainder of his life so long as he remains disabled, or until he is gainfully employed through vocational rehabilitation. See Thompson & Co. Contractors v. Cole, 391 So. 2d 1042, 1046 (Ala. Civ. App. 1980)(The period of compensation for permanent total disability lasts only so long as the disability continues. Should the disability cease to be other than total at some future time, the compensation for permanent total disability could be terminated).
4. Be retrained for reasonably gainful employment.
Permanent Total Disability is computed at 66 2/3 % of the average weekly wage, not to exceed the maximum in effect at the time of injury. Benefits are paid for duration of disability (lifetime benefits) but can be altered by vocational rehabilitation.
Where death results proximately from the accident within three years, compensation is payable to dependents entitled thereto without administration or to a guardian or other person as the Court may direct, for the use and benefit of the person entitled thereto. Ala. Code 1975, § 25-5-60.
Death benefits are based on the employee’s average earnings at the time of the accident, subject to the maximum and minimum in effect at the time of accident. If the employee leaves one dependent, the dependent is entitled to 50% of the employee’s average weekly wage, subject to maximum and minimum. If the employee leaves two or more dependents, the dependents are entitled to 66 2/3% of the employee’s average weekly wage, subject to maximum and minimum in effect at time of injury resulting in death. Precedence of dependents is listed in Ala. Code 1975, § 25-5-62 and the amount/percentage is determined by the Court. Death benefits are payable for 500 weeks, subject to limitations such as remarriage of the widow, etc., as defined in Ala. Code 1975, § 25-5-61. Death benefits are only payable to United States resident. Ala. Code 1975, § 25-5-82. See also Duran v. Goff Grp., 23 So. 3d 45 (Ala. Civ. App. 2009).
If death follows a period of disability, the period of disability will be deducted from the 500-week period due the dependent(s). If an employee dies of causes not related to the injury, while receiving permanent partial disability or permanent total disability, the remaining compensation due is payable to his dependents if the degree of disability has been agreed upon by the parties or if a court has determined the degree of disability. Compensation payable to dependents shall not exceed the amount due, had the death resulted from the injury. In all death claims where the cause of death is obscure or is disputed, any interested party may require an autopsy, the cost of which is to be borne by the party demanding the autopsy. The 1992 Amendment provided for a $7,500.00 death benefit for an employee who has no dependents at the time of his death. Burial expenses up to $3,000.00 are payable to all employees whose death is the result of an accident or illness arising out of and in the scope of employment.
If the employee is dissatisfied with the initial treating physician selected by the employer and if further treatment is required, the employee may so advise the employer, and the employee shall be entitled to select a second physician from a panel or list of four physicians selected by the employer. Ala. Code 1975, § 25-5-77(a).
Under Alabama’s workers’ compensation laws, the employer selects the initial treating physician. If the employee is dissatisfied with that physician, the employee may request that the employer provide the employee with a list of four other physicians from which the employee chooses another treating physician. The employee may only receive one panel of four physicians. There is a distinction between physicians and surgeons such that an employee who has been prescribed surgery may request a separate panel of surgeon to review the surgical recommendation.
The plain language of the Ala. Code 1975, § 25-5-77 differentiates between physicians and surgeons. The Act allows an employee dissatisfied with the initial treating physician the right to request that the employer provide a panel of four new physicians from which the employee can select a replacement. As to surgeons, the Act states that an employee shall have a right to a panel of four different surgeons if surgery is needed and the employee is dissatisfied with the surgeon designated by the employer. Section 25-5-77(a) provides for both a panel of four physicians and, if surgery is required and the employee is dissatisfied with the surgeon designated by the employer, a panel of four surgeons.
Where the employee has an authorized treating physician, the employee may not unilaterally seek treatment with another physician, even a previously authorized physician. The only procedure available to the employee is a request for a panel of four physicians pursuant to Section 25-5-25(a). The Act allows the employee only one request for a panel of four physicians, should the employee become dissatisfied with the physician chosen by the employer. The statute distinguishes between a panel of four physicians and a panel of four surgeons, when surgery is necessary.
1. Where the employer has neglected or refused to provide the necessary medical care.
2. Where the employer has consented to the selection by the employee.
3. Where notice of and request for alternative care would be futile.
Services or supplies which are medically necessary to treat the work related illness or injury. To be medically necessary, services and supplies shall meet the following criteria: be consistent with the diagnosis and treatment of the work related illness or injury; be consistent with the standard of care for good medical practice; not be solely for the convenience of the patient, family, hospital, physician or other provider; be in the most appropriate and cost effective medical care setting as determined by the patient’s condition; and have scientifically established medical value.
Ala. Admin. Code, r. 480-5-5.02.
“Utilization review” is a process used to determine the medical necessity for medical and surgical in-hospital, outpatient, and alternative settings treatments for acute and rehabilitation care. It includes pre-certification for elective treatments. Concurrent review and retrospective review are required for emergency cases. The Utilization Review process is typically triggered when a physician, or another healthcare provider, prescribes a certain medical procedure or treatment that the employer, or more often the employer’s worker’s compensation insurance carrier, disputes as not being medically necessary.
Chapter 480-5-5 sets forth two methods by which an employer may undertake review of proposed medical treatment: 1) pre-certification review and 2) utilization review. Pre-certification review is defined in Chapter 480-5-5 as “[t]he review and assessment of the medical necessity and appropriateness of services before they occur. Utilization review is defined in Chapter 480-5-5 as “[t]he determination of medical necessity for medical and surgical in-hospital, outpatient, and alternative setting treatments for acute and rehabilitation care. It includes pre-certification for elective treatments.” Ala. Admin. Code, r. 480-5-5-.02(68).
The employer has no obligation to pay for medical treatment, which the trial court determines, is not reasonably necessary. However, should a dispute arise as to whether certain medical treatment is medically necessary, the employer or the employer’s worker’s compensation insurance carrier must first invoke the Utilization Review process prior to seeking a judicial determination of the medical necessity of the treatment. The statutory requirements for the review process must be strictly and carefully followed.
1. Been denied payment or had the charge reduced for medical services rendered.
2. Been denied authorization for payment of services requested or performed when authorization is required.
3. Been ordered by the Director to refund payments received for the provision of medical services.
4. A party to a medical dispute that remains unresolved after a review of medical services as provided by this section may petition the court for relief.
5. In any review under this subsection of medical services provided by a physician, any party to a dispute may request the ombudsman consult with an independent medical expert from a list of at least three names provided by the Workers’ compensation Medical Services Board in a medical specialty appropriate to the issues raised in the dispute and shall secure a written opinion from the independent medical expert. In rendering a decision or recommendation, the ombudsman shall give full consideration to the opinion of the independent medical expert, but shall not be bound by that opinion.
An employer shall be allowed to subrogate medical and vocational benefit expenses recovered in a third-party suit. See Section 7 - Subrogation below.
Mileage Costs - Mileage costs to and from medical and rehabilitation providers shall be paid at the rate as provided by law for official state travel.
The term “physician” shall include medical doctor, doctor of osteopathy and chiropractor.
The Employer and its Workers’ Compensation Insurance Carrier are responsible for reasonable and necessary medical expenses for treatment of an injury caused by a work related accident. The right to medical benefits remains available to the Employee without interruption due to the passage of time or gaps in treatment.
Undisputed medical charges should be paid within 25 days from date of receipt. Ala. Code 1975, § 25-5-77(h). Medical providers have on year from date of service to submit medical bills.
If any installment of compensation payable is not paid without good cause within 30 days after it becomes due, there shall be added to the unpaid installment an amount equal to 15% thereof, which shall be paid in addition to the installment amount. The penalty provision is not frequently applied. Ala. Code 1975, § 25-5-59.
Ala. Code 1975, § 25-5-11 of the Act provides the employer/carrier with a statutory lien against any third party recovery had by the employee against any third party based upon the same accident made the basis of the workers’ compensation claim. The lien covers all benefits paid to or on behalf of the employee, including medical benefits. If the employee does not seek recovery from a liable third party within the two-year limitations period, the employer has an additional six-month period within which to file suit.
The employer has a first dollar right to reimbursement, subject to a pro-rata share of attorney fees and costs. Fitch v. Ins. Co. of N. Am., 408 So. 2d 1017 (Ala. Civ. App. 1981). Fitch set forth a formula, known as the “Fitch Formula” for calculating the employer’s liability for attorney’s fees. The formula provides: Employer's Reduced Liability / Third Party Recovery = X / Attorney's fees & expenses. X is the employer’s liability for attorney’s fees.
The employer is entitled to an offset or credit against any future liability based upon the employee’s third party recovery. Ala. Code 1975, § 25-5-57(c).
Attorneys must be licensed to practice law in the State of Alabama.
Attorney fees are established by statute at a maximum of fifteen (15%) percent of the compensation recovered. Generally, attorney fees may not be paid for recovery of medical benefits. Ala. Code 1975, § 25-5-90.
Attorney fees are not awarded on the recovery of medical expenses in a workers' compensation action, absent willful or contumacious conduct. Fort James Operating Co. v. Thompson, 871 So. 2d 44, 48 (Ala. Civ. App. 2002).
The employee/claimant is responsible for the payment of attorney fees and expenses as part of a settlement. The employer is not responsible for payment of attorney fees or costs. Fort James Operating Co. v. Thompson, 871 So. 2d 44 (Ala. Civ. App. 2002).
Costs may be awarded by the trial court in its discretion. Ala. Code 1975, § 25-5-89. See also Ex parte Ellenburg, 627 So. 2d 398 (Ala. 1993).
Those handling claims in Alabama must be licensed and must obtain required annual continuing education (CE) credits by attending one of several officially sanctioned education seminars put on by the Alabama Department of Labor or by one of a limited number of private organizations. Ala. Code 1975, § 25-5-293; Ala. Admin. Code Rule 480-5-1-.06.
Workers’ Compensation Claims are to be brought and heard in State Circuit Court. Ala. Code 1975, § 25-5-81.
Claims may also be brought, by voluntary agreement of both parties, before an Ombudsman with the Alabama Department of Labor for purposes of a “benefit review conference”.
Disputes between an employer and an employee or between the dependent of a deceased employee and the employer regarding compensation are to be decided in the circuit court in the county that would otherwise have jurisdiction over a civil action between the parties. Generally, this is the county in which the employee resides, any county in which the employer does business or the county in which the accident occurred. Either party may initiate the action by filing a properly verified complaint in circuit court. The required content of a complaint are set forth in [http://codes.lp.findlaw.com/alcode/25/5/3/25-5-88|Ala. Code 1975, § 25-5-88]]. The courts are generally lenient with enforcing the content requirements, provided sufficient information is contained to advise the other side of the nature of the lawsuit and are also lenient in allowing amendments. Venue may be transferred to a county with a greater interest in the subject of the litigation based upon location of the accident, the parties, and witnesses. Costs may be awarded in favor of the prevailing party, in the discretion of the trial court.
3. Mediate and resolve disputed issues.
An agreement shall be effective on the date it is signed, unless one of the parties submits the agreement to the court for approval. An agreement shall be binding on all parties, unless within 60 days after the agreement is signed or approved the court on finding of fraud, newly discovered evidence or other good cause, shall relieve all parties of the effect of the agreement. Expenses of Ombudsmen are borne by the Workers' Compensation Division.
The services of the Ombudsmen are free to all parties. The Ombudsman toll free number is 1-800-528-5166.
The decision of the judge shall be conclusive and binding upon the parties, subject to the right of appeal. Circuit court judges have broad discretion in their decisions, which are generally only subject to reversal where there is a mistake of law or where the decision is not supported by sufficient evidence. The determination of a trial judge on an issue of disputed fact is generally not subject to reversal.
A party who wishes to take an appeal from a final order entered by a Circuit Court shall do so by filing a Notice of Appeal to the Alabama Court of Civil Appeals. Such notice must be filed within forty-two (42) days from the date of entry of the order from which the appeal is taken. Any obligation for the payment of benefits imposed by the order from which an appeal is taken must be secured by a supercedeas bond equal to 125% of the amount then due and owing under the order.
Appeals from the Alabama Court of Appeals may be taken to the Alabama Supreme Court.
Ala. Code 1975, § 25-5-56 of the Act specifically provides for the parties to enter into a settlement of any and all portions of a workers’ compensation claim, including medical benefits. Settlement must be in an amount at least equal to the amount of benefits provided for under the statutory formulas in the Act. The advance payment of benefits is without prejudice and shall not be construed as an admission of liability.
Settlements for less than the amount provided for under the terms of the Act must be approved by the Court. Although not technically required by statute, the prevailing view in Alabama is that settlements should be Court approved. Settlements may also be approved by an Ombudsman from the Alabama Department of Labor. Ala. Code 1975, § 25-5-290.
An employer may secure its workers’ compensation liability by purchasing and maintaining insurance coverage through an insurance company, risk pool, or self-insured group, provided the contract and business plan have been approved by the Alabama Department of Insurance. Ala. Code 1975, § 25-5-8. An employer may also self-insure by establishing to the satisfaction of the Alabama Department of Labor the financial resources and ability to satisfy its liability for benefits, including sufficient net worth of at least $5 Million, demonstrated financial strength through positive net income during prior three years, and balance sheet. Ala. Code 1975, § 25-5-8.
“Any person” has been interpreted to mean not only the employee, but a medical provider, attorney, employer, or any other person who may have an interest in the case. This Act will not eliminate fraud but it will be a deterrent for some employees. The penalty, if convicted of a Class C felony, is one to ten years imprisonment and up to a $5,000 fine. After an investigation is completed by the employer or agent, the case will be reported to the District Attorney in the county where the fraud occurred, or to the Attorney General’s office.
2. Section A of the Supplementary Report (Form WC 3), must be filed within ten days of the date of first payment of compensation after the initial claim (or within 10 days of the date of first payment after previous payments were stopped or interrupted for any reason).
1. Section B of the Supplementary Report (Form WC 3) must be filed within ten days of the expiration of a thirty-day period of nonpayment of compensation after the employer has knowledge of a claim.
2. The Claim Summary Form (Form WC 4) must be filed within ten days of cessation or suspension of compensation payments for any reason.
This page was last modified on 15 Mar 2018 at 11:15 AM.

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