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What's the Process of Workers Compensation for Occupational Diseases?
While many people associate workers compensation with injuries caused by accidents, it also covers occupational diseases, which are illnesses developed due to exposure to harmful conditions or substances in the workplace.
At Slape & Howard, located in Wichita, Kansas, we aim to help individuals who have been injured at work seek fair compensation for their injuries. Our goal is to make the process of filing for workers compensation as straightforward as possible.
Continue reading for more information on the process of workers compensation for occupational diseases in Kansas, including key definitions, eligibility, the process for filing a claim, and how compensation is determined.
What Is Workers Compensation?
Workers compensation is a state-mandated insurance program that provides financial benefits and medical care to employees who are injured or become ill as a direct result of their job.
Kansas, like all other states, has its own system of workers compensation, which operates under a legal structure designed to offer a no-fault system. This means that workers don’t need to prove that their employer was negligent in order to receive compensation. However, workers must still prove that their illness or injury is work-related.
While the system covers a variety of injuries, occupational diseases represent a significant portion of workers compensation claims. These diseases can range from respiratory diseases like asthma or pneumonitis caused by exposure to chemicals to chronic conditions like hearing loss due to noise exposure.
Let’s take a closer look at what legally constitutes an occupational disease.
Defining Occupational Diseases
An occupational disease, in the context of Kansas workers compensation law, refers to a condition or illness that develops as a result of long-term exposure to certain hazards found in a worker’s environment. It differs from a sudden injury because it typically develops over time due to prolonged exposure. Examples of occupational diseases include:
Respiratory illnesses such as asbestosis, black lung disease, or silicosis caused by inhaling dust or chemicals.
Musculoskeletal disorders, including carpal tunnel syndrome and repetitive strain injuries from overuse of specific muscles or joints.
Cancer due to exposure to toxic substances, such as benzene or asbestos.
Noise-induced hearing loss from prolonged exposure to high noise levels without proper protection.
Kansas law acknowledges that occupational diseases are work-related, and workers who develop such conditions are entitled to compensation under workers compensation laws. We’ll go into more detail about eligibility for workers compensation below.
Eligibility for Workers Compensation for Occupational Diseases
In order to qualify for workers compensation for an occupational disease in Kansas, certain criteria must be met. These criteria focus on the nature of the disease, the work environment, and the duration of exposure. The primary eligibility requirements are as follows:
Employment relationship: The worker must be employed by a company that is required to carry workers compensation insurance. This includes nearly all employers in Kansas with one or more employees, with a few exceptions like federal workers or certain agricultural workers.
Diagnosis of an occupational disease: The worker must be diagnosed with a disease that can be linked directly to their job or work environment. This requires medical evidence showing that the disease developed due to work-related exposure.
Timing of the disease: The disease must be one that arose over a period of time due to exposure to specific workplace hazards. It’s essential that the disease isn’t an acute condition but rather something that has developed as a result of prolonged exposure to harmful substances or work-related activities.
Notice requirements: The worker must notify their employer of the occupational disease within a specific time frame. Failure to report the disease within the time frame may result in the denial of benefits.
Causation: It must be demonstrated that the worker’s condition was directly caused by the work environment. For example, if a worker develops a respiratory disease due to inhaling toxic chemicals, they must show that the exposure occurred as a part of their job duties.
Individuals who determine that they’re eligible for workers compensation will need to follow the appropriate filing procedures.
Filing a Workers Compensation Claim for an Occupational Disease
The process of filing a workers compensation claim for an occupational disease in Kansas involves several steps. These steps are designed to make sure the claim is processed efficiently and fairly, but they also require workers to be diligent in documenting their condition and following the necessary procedures.
The steps you’ll need to complete are as follows:
Report the disease to the employer: The first step in the process is to report the occupational disease to your employer. This notification should include information such as the nature of the disease and how it’s related to your job.
Seek medical treatment: Once the disease is reported, you should seek medical treatment from a healthcare provider. Your employer may provide a list of approved doctors, or you can choose your own provider. It’s important that the medical provider evaluates the condition and documents the diagnosis, linking it to the workplace exposure. Medical evidence will be crucial in proving the connection between the illness and your job.
File a workers compensation claim: After notifying the employer, the next step is to file a formal claim for workers compensation benefits. The claim is submitted to the Kansas Division of Workers Compensation (DWC). The claim should include the medical diagnosis, the timeline of the illness, the specifics of the exposure, and any other supporting documents.
Employer's response: Once the claim is filed, your employer and their workers compensation insurance company will review the claim. The employer may accept the claim, deny it, or contest the connection between the disease and the workplace. If the claim is denied, you have the right to challenge the denial through legal proceedings.
Investigation: In many cases, the workers compensation insurer will conduct an investigation to determine the validity of the claim. This may involve interviewing the worker, reviewing medical records, and gathering additional evidence to support the claim. Investigations may also include visiting the workplace to examine the conditions that might have led to the disease.
Hearing and decision: If the claim is disputed, the case may proceed to a hearing before an administrative law judge. At the hearing, both you and your employer will present your evidence, and the judge will make a decision based on the facts of the case.
If your workers compensation claim is successful, you may be entitled to several types of benefits, which we’ll discuss in more detail below.
Determining Compensation for Occupational Diseases
The amount and type of compensation you receive will depend on the severity of the illness, the extent of your disability, and other factors.
Medical benefits: Workers are entitled to receive medical care for their occupational disease. This includes doctor visits, hospital stays, surgeries, medications, and other necessary treatments related to the illness. In Kansas, the employer’s insurance company generally covers all reasonable and necessary medical expenses.
Temporary Total Disability (TTD): If you’re temporarily unable to work due to your occupational disease, you may be entitled to temporary total disability benefits. This benefit provides a portion of your weekly wage while you’re unable to work. In Kansas, the weekly benefit amount is usually two-thirds of the worker’s average weekly wage, per the Kansas Department of Labor.
Permanent Partial Disability (PPD): If your disease results in permanent partial disability, you may be entitled to permanent partial disability benefits. This benefit is paid based on the severity of the disability, as determined by a medical evaluation.
Permanent Total Disability (PTD): In cases where an occupational disease leads to total and permanent disability, the worker may be entitled to permanent total disability benefits. These benefits provide ongoing financial support for workers who are unable to perform any type of work due to their illness.
Death benefits: If an occupational disease leads to the death of the worker, the worker’s dependents may be entitled to death benefits. These benefits can cover funeral expenses and provide compensation for lost income.
If your claim has been denied or you don’t feel that the benefits you’ve received are sufficient, an experienced workers compensation lawyer can help you appeal the decision.
Disputes and Appeals
If a worker’s claim for workers compensation is denied or if they disagree with the amount of compensation awarded, they have the right to appeal the decision.
In Kansas, the first step in the appeals process is to request a hearing before an administrative law judge. If the worker is dissatisfied with the judge’s decision, they can appeal further to the Workers Compensation Appeals Board. Finally, if necessary, the case can be taken to the Kansas Court of Appeals.
Reach Out to an Experienced Workers Compensation Attorney
By understanding the eligibility requirements, the claims process, and the types of compensation available, individuals can better traverse the workers compensation system to secure the support they need for occupational diseases. If you’re suffering from an occupational disease, professional assistance is available to help you file for workers compensation. Serving all of Kansas, our firm can provide the legal support you need in this challenging time. Contact Slape & Howard today to learn more.