Kentucky Administrative Regulations › Title 803 - LABOR CABINET › Chapter 25 - Department of Workers' Claims › Section 803 KAR 25:010 - Procedure for adjustments of claims

Current through Register Vol. 51, No. 1, July 1, 2024
RELATES TO:
				KRS
				342.0011,
				342.020,
				342.033,
				342.035,
				342.040,
				342.120,
				342.1242,
				342.125,
				342.165,
				342.185,
				342.205,
				342.260,
				342.265,
				342.267-342.275,
				342.285,
				342.290,
				342.300-342.316,
				342.320,
				342.335,
				342.340,
				342.395,
				342.610,
				342.650,
				342.710,
				342.715,
				342.730,
				342.732,
				342.760,
				342.792
NECESSITY, FUNCTION, AND CONFORMITY:
				KRS
				342.260(1) requires the
				commissioner to promulgate administrative regulations necessary to implement
				the provisions of KRS Chapter 342.
				KRS
				342.270(3) requires the
				commissioner to promulgate an administrative regulation establishing procedures
				for the resolution of claims.
				KRS
				342.033 requires the commissioner to
				prescribe the format and content of written medical reports.
				KRS
				342.285(1) requires the
				commissioner to promulgate an administrative regulation governing appeals to
				the Workers' Compensation Board. This administrative regulation establishes the
				procedure for the resolution of claims before an administrative law judge or
				Workers' Compensation Board.
Section 1.
			 Definitions.
(1) "Administrative law judge" or
			 "ALJ" means an individual appointed pursuant to
			 KRS
			 342.230(3).
(2) "Board" is defined by
			 KRS
			 342.0011(10).
(3) "BRC" means benefit review conference as
			 described in Section 13 of this administrative regulation.
(4) "Civil Rule" or "CR" means the Kentucky
			 Rules of Civil Procedure.
(5)
			 "Claim" means any claims including injury, hearing loss, or occupational
			 disease.
(6) "Commissioner" is
			 defined by
			 KRS
			 342.0011(9).
(7) "Date of filing" means the date that:
(a) A pleading, motion, or other document is
			 electronically filed with the commissioner at the Department of Workers' Claims
			 (DWC) in Frankfort, Kentucky;
(b) A
			 pleading, motion, order, opinion, or other document is received by the
			 commissioner at the Department of Workers' Claims in Frankfort, Kentucky,
			 except:
1. Documents delivered to the offices
			 of the Department of Workers' Claims after the office is closed at 4:30 p.m. or
			 on the weekend, which shall be deemed filed the following business day;
			 or
2. Documents transmitted by
			 United States registered (not certified) or express mail, or by other
			 recognized mail carriers shall be deemed filed on the date the transmitting
			 agency receives the document from the sender as noted by the transmitting
			 agency on the outside of the container used for transmitting, within the time
			 allowed for filing.
(8) "Employer" is defined by
			 KRS
			 342.630.
(9) "Employer who has not secured payment of
			 compensation" means any employer who employs an employee as defined by
			 KRS 342.640
			 but has not complied with
			 KRS
			 342.340.
(10) "Jurisdictional deadline" means a
			 deadline set by statute or administrative regulation that the Department of
			 Workers' Claims cannot extend or change.
(11) "Litigation Management System" or "LMS"
			 means the electronic filing and document management system utilized in the
			 filing and processing of workers' compensation claims in the Commonwealth of
			 Kentucky.
(12)"Notice of Filing of
			 Application" means the notice issued by the commissioner stating that a claim
			 has been filed, scheduling the date and time of the benefit review conference,
			 and stating the week during which a hearing is to be held.
(13)"Signature" means actual personal
			 handwritten signatures, and includes electronic signatures, which shall be
			 treated as a personal signature for purposes of CR 11.
(14) "Special defenses" means defenses that
			 shall be raised by special answer filed in accordance with Section 7(2)(d) of
			 this administrative regulation.
(15)"Technical failure" means a failure of
			 the Department of Workers' Claims hardware, software, or telecommunications
			 facility that results in the impossibility for an external user to submit a
			 filing electronically and does not include malfunctioning of an external user's
			 equipment.