Injured employees are entitled to certain benefits under the Act. Most claims are resolved through a settlement agreement and approved by an Administrative Law Judge (ALJ). However, sometimes disputes arise between employees and employers over whether the injury or disease was incurred while working, the severity of the injury, which medical treatment is most appropriate, what capabilities the employer has retained after recovery or the length of time for which benefits are owed. When this occurs, the dispute must be decided by an ALJ. To initiate this process, the employee or employer files an Application for Resolution of a Claim form with the Department. Employees and employers represented by an attorney must file this form electronically through the Department’s Litigation Management System (LMS). Employees representing themselves may file the form electronically through LMS or use a paper form.
When a claim is filed it is routed to the Division of Claims Processing for review and docket assignment. The Department will issue an order assigning the case to an ALJ and schedule a Benefit Review Conference (BRC). A BRC is an informal proceeding held before the ALJ; it gives the parties the opportunity to discuss the case, allows the ALJ the opportunity to rule on any procedural disputes, and to set a date for the formal hearing. At the formal hearing, the parties present evidence and testimony to be considered by the ALJ when making a decision. The hearing will be recorded by a court reporter.
The ALJ will render a decision in the case within 60 days after the hearing. Any party who disagrees with the ALJ’s decision may file an appeal to the Workers’ Compensation Board (WCB). The WCB will review the ALJ’s decision and determine whether the ALJ erred in applying the law to the facts of the case. A party cannot submit new or additional evidence to the WCB. Any party who disagrees with the decision of the WCB may appeal to the Kentucky Court of Appeals and then to the Supreme Court of Kentucky.
It is recommended that you hire an attorney to represent you through this process; however, it is not required. If you proceed without legal counsel, you are proceeding “pro se”. A “pro se” claimant is held to the same standards an attorney. The following are the required forms to file the Application for Resolution of Claim.