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Last Reviewed / Modified On 27 Apr 2017.

Oklahoma Workers' Compensation Claim Handling Guidelines

Contents [hide]

DEFINITIONS

Employer

(85A O.S., §2(19)) “’Employer’ means a person, partnership, association, limited liability company, corporation, and the legal representatives of a deceased employer, or the receiver or trustee of a person, partnership, association, corporation, or limited liability company, departments, instrumentalities and institutions of this state and divisions thereof, counties and divisions thereof, public trusts, boards of education and incorporated cities or towns and divisions thereof, employing a person included within the term "employee" as defined in this section. Employer may also mean the employer's workers' compensation insurance carrier, if applicable.”

“Employer shall not include a qualified employer with an employee benefit plan as provided under the Oklahoma Employee Injury Benefit Act in Sections 107 through 120 of this act.”

Statutory Employer

There is no corresponding material in the new law OR the material provided may not be entirely on point

Employee

(85A O.S., §2(18)(a)) “’Employee’ means any person, including a minor, in the service of an employer under any contract of hire or apprenticeship, written or oral, expressed or implied, but excluding one whose employment is casual and not in the course of the trade, business, profession, or occupation of his or her employer and excluding one who is required to perform work for a municipality or county or the state or federal government on having been convicted of a criminal offense or while incarcerated.”

Borrowed Employee

There is no corresponding material in the new law OR the material provided may not be entirely on point

Contractor

(85A O.S., §2(43)) A prime contractor is a person, firm, corporation or other legal entity with the authority to hire subcontractor to perform a specific task for the completion of a work-related activity

EXCLUSIVE REMEDY

General Rule

(85A O.S., §5(A)) “The rights and remedies granted to an employee subject to the provisions of the Administrative Workers' Compensation Act shall be exclusive of all other rights and remedies of the employee . . . “

Exceptions

(85A O.S., §5(B)(1), (2)) Exclusions are permitted for (1) intentional torts committed by the employer, and (2) failure of the employer to fulfill its workers’ compensation obligations

JURISDICTION AND LIMITATIONS OF ACTIONS

General Rule

(85A O.S., §27(A)) “The Workers' Compensation Commission shall be vested with jurisdiction over all claims filed pursuant to the Administrative Workers' Compensation Act. All claims so filed shall be heard by the administrative law judge sitting without a jury.”

Extraterritorial Jurisdiction

There is no corresponding material in the new law OR the material provided may not be entirely on point

Time Limitation

Discovery Rule

There is no corresponding material in the new law OR the material provided may not be entirely on point

Notice of Injury

(85A O.S., §67(A)(2)) “Written notice shall be given to the employer of an occupational disease or cumulative trauma by the employee, or a representative of the employee in the case of incapacity or death, within six (6) months after the first distinct manifestation of the disease or cumulative trauma or within six (6) months after death.”

Statute of Limitations

Special Rules of Death Claims

(85A O.S., §69(A)(3)) “A claim for compensation on account of death shall be barred unless filed with the Commission within two (2) years of the date of such a death.”

Occupational Disease Death Claims

(85A O.S., §69(A)(2)(a)) “A claim for compensation for disability on account of injury which is either an occupational disease or occupational infection shall be barred unless filed with the Commission within two (2) years from the date of the last injurious exposure to the hazards of the disease or infection.”

(85A O.S., §69(A)(2)(b)) “A claim for compensation for disability on account of silicosis or asbestosis shall be filed with the Commission within one (1) year after the time of disablement, and the disablement shall occur within three (3) years from the date of the last injurious exposure to the hazard of silicosis or asbestosis.”

Occupational Disease Claims

(85A O.S., §69(A)(2)(a)) “A claim for compensation for disability on account of injury which is either an occupational disease or occupational infection shall be barred unless filed with the Commission within two (2) years from the date of the last injurious exposure to the hazards of the disease or infection.”

Extension of Limitation Period

(85A O.S., §69(B)(1)) “In cases in which any compensation, including disability or medical, has been paid on account of injury, a claim for additional compensation shall be barred unless filed with the Commission within one (1) year from the date of the last payment of disability compensation or two (2) years from the date of the injury, whichever is greater.”

COMPENSABILITY

General Rule

(85A O.S., §2(10)) “’Compensation’ means the money allowance payable to the employee or to his or her dependents and includes the medical services and supplies provided for in Section 50 of this act and funeral expenses”

“Injury”Defined

(85A O.S., §2(9)) “‘Compensable injury’ means damage or harm to the physical structure of the body, or prosthetic appliances, including eyeglasses, contact lenses, or hearing aids, caused solely as the result of either an accident, cumulative trauma or occupational disease arising out of the course and scope of employment.”

Types of Injuries

Accident Not Required

There is no corresponding material in the new law OR the material provided may not be entirely on point

Infectious Diseases

There is no corresponding material in the new law OR the material provided may not be entirely on point

Heart

(85A O.S., §14(A)) “A cardiovascular, coronary, pulmonary, respiratory, or cerebrovascular accident or myocardial infarction causing injury, illness, or death is a compensable injury only if, in relation to other factors contributing to the physical harm, the course and scope of employment was the major cause.”

Psychological Injury

(85A O.S., §13(A)(1)) “A mental injury or illness is not a compensable injury unless caused by a physical injury to the employee, and shall not be considered an injury arising out of and in the course and scope of employment or compensable unless demonstrated by a preponderance of the evidence; provided, however, that this physical injury limitation shall not apply to any victim of a crime of violence.”

Occupational Diseases

(85A O.S., §65(D)(1)) “’Occupational disease’, as used in this act, unless the context otherwise requires, means any disease that results in disability or death and arises out of and in the course of the occupation or employment of the employee or naturally follows or unavoidably results from an injury as that term is defined in this act. A causal connection between the occupation or employment and the occupational disease shall be established by a preponderance of the evidence.”

EXCLUSIONS AND DEFENSES

Course of Employment

Engaged in the Furtherance of Employer’s Business

(85A O.S., §2(13)) “The term includes activities conducted on the premises of an employer or at other locations designated by an employer and travel by an employee in furtherance of the affairs of an employer that is specifically directed by the employer.”

Not in Furtherance of Employer’s Business

(85A O.S., §2(13)(d)) “’Course and scope of employment,’. . . does not include: any injury occurring while an employee is on a work break, unless the injury occurs while the employee is on a work break inside the employer's facility and the work break is authorized by the employee's supervisor”

Traveling Employees

(85A O.S., §2(13)(a), (b)) “’Course and scope of employment’ . . . does not include:

a. an employee's transportation to and from his or her place of employment,

b. travel by an employee in furtherance of the affairs of an employer if the travel is also in furtherance of personal or private affairs of the employee”

Commuting

No Fixed Place of Work Exception

There is no corresponding material in the new law OR the material provided may not be entirely on point

Transportation Included in Employment Exception

There is no corresponding material in the new law OR the material provided may not be entirely on point

Special Missions, Assignments, or Circumstances Exception

There is no corresponding material in the new law OR the material provided may not be entirely on point

Premises and Parking Lot Cases

(85A O.S., §2(13)(c)) “’Course and scope of employment’ . . . does not include: any injury occurring in a parking lot or other common area adjacent to an employer's place of business before the employee clocks in or otherwise begins work for the employer or after the employee clocks out or otherwise stops work for the employer”

Related to Employment

There is no corresponding material in the new law OR the material provided may not be entirely on point

Intentionally Self-Inflicted Injury or Death

There is no corresponding material in the new law OR the material provided may not be entirely on point

Employee’s Violation of the Law, Intoxication, and Illegal Use of Drugs

(85A O.S., §2(9)(b)(4)) “’Compensable injury’ does not include: (4) injury where the accident was caused by the use of alcohol, illegal drugs, or prescription drugs used in contravention of physician's orders. If, within twenty-four (24) hours of being injured or reporting an injury, an employee tests positive for intoxication, an illegal controlled substance, or a legal controlled substance used in contravention to a treating physician's orders, or refuses to undergo the drug and alcohol testing, there shall be a rebuttable presumption that the injury was caused by the use of alcohol, illegal drugs, or prescription drugs used in contravention of physician's orders. This presumption may only be overcome if the employee proves by clear and convincing evidence that his or her state of intoxication had no causal relationship to the injury”

Employee’s Violation of Positive Orders of Employer

There is no corresponding material in the new law OR the material provided may not be entirely on point

Personal Animosity

There is no corresponding material in the new law OR the material provided may not be entirely on point

Hostile Attacks

(85A O.S., §2(9)(b)(1)) “‘Compensable injury’ does not include:

(1) injury to any active participant in assaults or combats which, although they may occur in the workplace, are the result of non-employment-related hostility or animus of one, both, or all of the combatants and which assault or combat amounts to a deviation from customary duties; provided, however, injuries caused by horseplay shall not be considered to be compensable injuries, except for innocent victims”

Retirement

General Rule

There is no corresponding material in the new law OR the material provided may not be entirely on point

Proof of Voluntary Retirement

There is no corresponding material in the new law OR the material provided may not be entirely on point

BENEFITS

Calculation of Average Weekly Wage

(85A O.S., §2(42)) “"State average weekly wage" means the state average weekly wage determined by the Oklahoma Employment Security Commission in the preceding calendar year. If such determination is not available, the Commission shall determine the wage annually after reasonable investigation”

(85A O.S., §59(A)(1)) “[T]he employee's average weekly wage shall be computed by dividing the employee's gross earnings by the number of full weeks of employment with the employer, up to a maximum of fifty-two (52) weeks.”

(85A O.S., §59(C)) “If, because of exceptional circumstances, the average weekly wage cannot be fairly and justly determined by the above formulas, the Commission may determine the average weekly wage by a method that is just and fair to all parties concerned.”

Total Disability

(85A O.S., §2(35)) "’Permanent total disability’ means, based on objective findings, incapacity, based upon accidental injury or occupational disease, to earn wages in any employment for which the employee may become physically suited and reasonably fitted by education, training, experience or vocational rehabilitation provided under this act. Loss of both hands, both feet, both legs, or both eyes, or any two thereof, shall constitute permanent total disability”

(85A O.S., §45(D)(1)) “In case of total disability adjudged to be permanent, seventy percent (70%) of the employee's average weekly wages, but not in excess of the state's average weekly wage, shall be paid to the employee during the continuance of the disability until such time as the employee reaches the age of maximum Social Security retirement benefits or for a period of fifteen (15) years, whichever is longer.”

(85A O.S., §45(A)(1)) (re temporary total disability) “If the injured employee is temporarily unable to perform his or her job or any alternative work offered by the employer, he or she shall be entitled to receive compensation equal to seventy percent (70%) of the injured employee's average weekly wage, but not to exceed seventy percent (70%) of the state average weekly wage, for one hundred four (104) weeks. Provided, there shall be no payment for the first three (3) days of the initial period of temporary total disability.”

Partial Disability

Impairment Rating

(85A O.S., §45(C)(1)) “A physician's opinion of the nature and extent of permanent partial disability to parts of the body other than scheduled members must be based solely on criteria established by the current edition of the American Medical Association's ‘Guides to the Evaluation of Permanent Impairment’.

*This language was found under the heading “Permanent Partial Disability,” although it may have broader applicability.

(85A O.S., §60) “The Physician Advisory Committee may recommend the adoption of a method or system to evaluate permanent disability that shall deviate from, or be used in place of or in combination with the Guides.”

Vocational Rehabilitation

(85A O.S., §45(E)(2)) “If [an] injured employee is unable to return to his or her pre-injury or equivalent position due to permanent restrictions as determined by the treating physician, upon the request of either party, the Vocational Rehabilitation Director shall determine if it is appropriate for a claimant to receive vocational rehabilitation training or services, and will oversee such training.”

(85A O.S., §45(E)(4)) “Except as otherwise provided in this subsection, refusal to accept rehabilitation services by the employee shall in no way diminish any benefits allowable to an employee.”

(85A O.S., §45(E)(6)) “Vocational rehabilitation services or training shall not extend for a period of more than fifty-two (52) weeks.”

Return to Work with Loss of Earnings

There is no corresponding material in the new law OR the material provided may not be entirely on point

Earning Power Assessment

There is no corresponding material in the new law OR the material provided may not be entirely on point

Employer Job Offer

(85A O.S., §45(C)(5)(c)) “If the employee refuses an offer to return to his pre-injury or equivalent job, the permanent partial disability award shall continue to be deferred and shall be reduced by seventy percent (70%) of the employee’s average weekly wage for each week he refuses to return to his pre-injury or equivalent job.”

*This language was found under the heading “Permanent Partial Disability,” although it may have broader applicability.

Vocational Expert

(85A O.S., §45(E)(4)) Claimant may be referred to “a qualified expert for evaluation of the practicability of, need for and kind of rehabilitation services or training necessary and appropriate in order to restore the employee to gainful employment.”

Amputation or Loss of Use

84A O.S., §45(C)(9) “The permanent partial disability rate of compensation for amputation or permanent total loss of use of a scheduled member specified in Section 46 of this act shall be seventy percent (70%) of the employee’s average weekly wage, not to exceed Three Hundred Twenty-three Dollars ($323.00), multiplied by the number of weeks set forth for the member in Section 46 of this act, regardless of whether the injured employee is able to return to his or her pre-injury or equivalent job.”

Disfigurement/Scarring

(85A O.S., §45(F)(1), (2))

1. If an injured employee incurs serious and permanent disfigurement to any part of the body, the Commission may award compensation to the injured employee in an amount not to exceed Fifty Thousand Dollars ($50,000.00).

2. No award for disfigurement shall be entered until twelve (12) months after the injury

Loss of Sight

(85A O.S., §46(B)) “The permanent partial disability rate of compensation for amputation or permanent total loss of use of a scheduled member specified in this section shall be seventy percent (70%) of the employee’s average weekly wage, not to exceed Three Hundred Twenty-three Dollars ($323.00), multiplied by the number of weeks as set forth in this section [(85A O.S., §46(A)(14)) 275 weeks], regardless of whether or not the injured employee is able to return to his or her pre-injury job.”

(85A O.S., §46(E)(1)) “Compensation for the permanent loss of eighty percent (80%) or more of the vision of an eye shall be the same as for the loss of an eye.”

Loss of Hearing

(85A O.S., §46(B)) “The permanent partial disability rate of compensation for amputation or permanent total loss of use of a scheduled member specified in this section shall be seventy percent (70%) of the employee’s average weekly wage, not to exceed Three Hundred Twenty-three Dollars ($323.00), multiplied by the number of weeks as set forth in this section [(85A O.S., §46(A)(15), (16)) 110 weeks for loss of hearing of one ear; 330 weeks for loss of hearing of both ears], regardless of whether or not the injured employee is able to return to his or her pre-injury job.”

Penalties

(85A O.S., §40(B)(1), (6))

1. Whenever the Commission has reason to believe that any employer required to secure the payment of compensation under this act has failed to do so, the Commission shall serve on the employer a proposed judgment declaring the employer to be in violation of this act and containing the amount, if any, of the civil penalty to be assessed against the employer under paragraph 5 of this subsection.

6. If an employer fails to secure the payment of compensation or pay any civil penalty assessed against the employer after a judgment issued under this section has become final by operation of law or on appeal, the Commission may petition the Oklahoma County District Court or the district court of the county where the employer's principal place of business is located for an order enjoining the employer from engaging in further employment until such time as the employer secures the payment of compensation or makes full payment of all civil penalties.

Interest

(85A O.S., §91) “Compensation shall bear interest pursuant to Section 727.1 of Title 12 of the Oklahoma Statutes from the day an award is made by either an administrative law judge or the full Workers' Compensation Commission on all accrued and unpaid compensation.”

Costs

There is no corresponding material in the new law OR the material provided may not be entirely on point

Counsel Fees

There is no corresponding material in the new law OR the material provided may not be entirely on point

Death Benefits

Widow/Widower

85A O.S., §47(C)(1) “If an injury or occupational illness causes death, weekly income benefits shall be payable as follows:

1. If there is a surviving spouse, a lump-sum payment of One Hundred Thousand Dollars ($100,000.00) and seventy percent (70%) of the lesser of the deceased employee's average weekly wage and the state average weekly wage. In addition to the benefits theretofore paid or due, two (2) years' indemnity benefit in one lump sum shall be payable to a surviving spouse upon remarriage;”

Death Benefits/Children

(85A O.S., §47(C)(2), (3)) If an injury or occupational illness causes death, weekly income benefits shall be payable as follows:

2. If there is a surviving spouse and a child or children, a lump-sum payment of Twenty-five Thousand Dollars ($25,000.00) and fifteen percent (15%) of the lesser of the deceased employee's average weekly wage and the state average weekly wage to each child. If there are more than two children, each child shall receive a pro rata share of Fifty Thousand Dollars ($50,000.00) and thirty percent (30%) of the deceased employee's average weekly wage;

3. If there is a child or children and no surviving spouse, a lump-sum payment of Twenty-five Thousand Dollars ($25,000.00) and fifty percent (50%) of the lesser of the deceased employee's average weekly wage and the state average weekly wage to each child. If there are more than two children, each child shall receive a pro rata share of one hundred percent (100%) of the lesser of the deceased employee's average weekly wage and the state average weekly wage. With respect to the lump-sum payment, if there are more than six children, each child shall receive a pro rata share of One Hundred Fifty Thousand Dollars ($150,000.00)

Death Benefits/Parents and Siblings

(85A O.S., §47(C)(4)) If an injury or occupational illness causes death, weekly income benefits shall be payable as follows:

4. If there is no surviving spouse or children, each legal guardian, if financially dependent on the employee at the time of death, shall receive twenty-five percent (25%) of the lesser of the deceased employee's average weekly wage and the state average weekly wage until the earlier of death, becoming eligible for social security, obtaining full-time employment, or five (5) years from the date benefits under this section begin

Death Benefits/Amounts of Benefits

There is no corresponding material in the new law OR the material provided may not be entirely on point

Medical Benefits

(85A O.S., §50(A)) “The employer shall promptly provide an injured employee with medical, surgical, hospital, optometric, podiatric, and nursing services, along any with medicine, crutches, ambulatory devices, artificial limbs, eyeglasses, contact lenses, hearing aids, and other apparatus as may be reasonably necessary in connection with the injury received by the employee. The employer shall have the right to choose the treating physician.”

Refusal of Medical Treatment

(85A O.S., §50(E)) “An employee claiming or entitled to benefits under this act, shall, if ordered by the Commission or requested by the employer or insurance carrier, submit himself or herself for medical examination. If an employee refuses to submit himself or herself to examination, his or her right to prosecute any proceeding under this act shall be suspended, and no compensation shall be payable for the period of such refusal.”

(85A O.S., §53(C)) “Failure of the employee to obey a judgment of the Commission for an examination or treatment for a period of one (1) month from the date of the judgment shall bar the right of the claimant to further compensation in respect to the injury.”

(85A O.S., §54)) “Except in cases of hernia, which are specifically covered by Section 61 of this act, where an injured employee unreasonably refuses to submit to a surgical operation which has been advised by at least two qualified physicians and where the recommended operation does not involve unreasonable risk of life or additional serious physical impairment, the Commission shall take the refusal into consideration when determining compensation for permanent partial or permanent total disability.”

SUBROGATION OR CREDIT

General Rule

(85A O.S. § 43 (B)(1)) “An employer or carrier liable for compensation under this act for the injury or death of an employee shall have the right to maintain an action in tort against any third party responsible for the injury or death. However, the employer or the carrier shall notify the claimant in writing that the claimant has the right to hire a private attorney to pursue any benefits to which the claimant is entitled in addition to the subrogation interest against any third party responsible for the injury or death.”

(85A O.S. § 43 (B)(3)) “If the employer recovers against the third party, by suit or otherwise, the injured employee shall be entitled to any amount recovered in excess of the amount that the employer and carrier have paid or are liable for in compensation, after deducting reasonable costs of collection.”

(85A O.S. § 43 (B)(4)) “An employer or carrier who is liable for compensation under this act on account of injury or death of an employee shall be entitled to maintain a third-party action against the employer's uninsured motorist coverage or underinsured motorist coverage.”

(85A O.S. § 100 (A)) “The Self-insurance Guaranty Fund Board shall be a party in interest in all proceedings involving compensation claims against an impaired self-insurer whose compensation claims have been paid or assumed by the Commission and shall have all rights of subrogation of the impaired self-insurer. In such proceedings, the Board may assume and exercise all rights and defenses of the impaired self-insurer . . . ”

(85A O.S. § 203 (G)) “The Guaranty Association shall be a party in interest in all proceedings involving any claims for benefits under this act with respect to an impaired insurer and shall have all rights of subrogation of the impaired insurer. In those proceedings, the Guaranty Association may assume and exercise all rights and defenses of the impaired insurer . . . “

Attorney’s Fee

(85A O.S. § 82)

A.1. (a) Fees for legal services rendered in a claim shall not be valid unless approved by the Commission.

(b) An attorney representing an injured employee may only recover attorney fees up to ten percent (10%) of any temporary total disability or temporary partial disability compensation and twenty percent (20%) of any permanent partial disability, permanent total disability, or death compensation awarded to an injured employee by the Commission from a controverted claim. If the employer makes a written offer to settle permanent partial disability, permanent total disability, or death compensation and that offer is rejected, the employee's attorney may not recover attorney fees in excess of thirty percent (30%) of the difference between the amount of any award and the settlement offer.

(1) Attorney fees may not be collected for recovery on noncontroverted claims.

(2) Attorney fees shall not be awarded on medical benefits or services.

(3) The fee for legal services rendered by an attorney representing an employee in connection with a change of physician requested by the injured employee, controverted by the employer, and awarded by the Commission, shall be Two Hundred Dollars ($200.00).

(4) Attorney fees may include not more than ten percent (10%) of the value, or reasonable estimate thereof, of vocational rehabilitation services.

(c) A "controverted claim" means that there has been a contested hearing before the Commission over whether there has been a compensable injury or whether the employee is entitled to temporary total disability, temporary partial disability, permanent partial disability, permanent total disability, or death compensation. A request for a change in physician shall not trigger a controverted claim for purposes of recovering any attorney fees except the fees under division 3 of subparagraph b of this paragraph. A controverted claim shall not exist if the employee or his or her representative has withheld pertinent information in his or her possession related to the claim from the employer or has violated the provisions of Section 6 of this act.

3. In any case where attorney fees are allowed by the Commission, the limitations expressed in subparagraph b of paragraph 1 of this subsection shall apply.

B. An attorney representing an employee under this act may not recover fees for services except as expressly provided in this section.

*This language was not specifically referring to attorney’s fees for subrogation claims.

Motor Vehicle Accidents

There is no corresponding material in the new law OR the material provided may not be entirely on point

Health Benefits

There is no corresponding material in the new law OR the material provided may not be entirely on point

Credits

There is no corresponding material in the new law OR the material provided may not be entirely on point

ATTORNEYS

Certifying Organization

There is no corresponding material in the new law OR the material provided may not be entirely on point

Required Documentation

(85A O.S., §83)(A)(1), (3))

1. “Every claim, request for benefits, controversion of benefits, request for a hearing, pleading, motion, and other paper of a party represented by an attorney shall be signed by at least one attorney of record in his or her individual name, whose address shall be stated.”

2. If a claim, request for benefits, request for additional benefits, controversion of benefits, request for a hearing, pleading, motion, or other paper is not signed, it shall be stricken unless it is signed promptly after the omission is called to the attention of the pleader or movant.

Additional Information

(85A O.S., §82(A)(1)(a), (b), (c))

a. Fees for legal services rendered in a claim shall not be valid unless approved by the Commission

b. An attorney representing an injured employee may only recover attorney fees up to ten percent (10%) of any temporary total disability or temporary partial disability compensation and twenty percent (20%) of any permanent partial disability, permanent total disability, or death compensation awarded to an injured employee by the Commission from a controverted claim.

c. A "controverted claim" means that there has been a contested hearing before the Commission over whether there has been a compensable injury or whether the employee is entitled to temporary total disability, temporary partial disability, permanent partial disability, permanent total disability, or death compensation.

CLAIMS PROFESSIONALS

There is no corresponding material in the new law OR the material provided may not be entirely on point

LITIGATION AND APPEAL

Workers’ Compensation Judge Proceedings

Office of Adjudication

There is no corresponding material in the new law OR the material provided may not be entirely on point

Appointment of Workers’ Compensation Judges

(85A O.S., §169(A))

The Workers' Compensation Court shall be renamed the Workers' Compensation Court of Existing Claims for the purpose of hearing disputes relating to claims that arise before February 1, 2014. The Court shall consist of the existing judges for the remainder of his or her term. Each judge of the Court shall continue to serve as the appointment to a designated numbered position on the Court. The positions shall be numbered one through ten. The terms of the judges by position number shall expire on the following dates:

Position 1 shall expire 7-1-14.

Position 2 shall expire 7-1-14.

Position 3 shall expire 7-1-14.

Position 4 shall expire 7-1-20.

Position 5 shall expire 7-1-20.

Position 6 shall expire 7-1-16.

Position 7 shall expire 7-1-16.

Position 8 shall expire 7-1-20.

Position 9 shall expire 7-1-20.

Position 10 shall expire 7-1-14.

Provided, judges who are serving unexpired terms on the Workers' Compensation Court on the effective date of this section shall serve on the Court created by this section until their respective terms expire as provided in this act. Thereafter, each position shall be dissolved. After a judge serves this term, such judge shall be eligible to reapply for an administrative law judge with the Workers’ Compensation Commission.

When a vacancy on the Court occurs or is certain to occur, the Workers’ Compensation Commission shall assign administrative law judges from the Commission to assist in the duties of the Workers’ Compensation Court of Existing Claims.

Qualifications of WCJ

There is no corresponding material in the new law OR the material provided may not be entirely on point

Procedure

(85A O.S., §169(I)) “The Court shall be vested with jurisdiction over all claims filed pursuant to the Workers' Compensation Code. All claims so filed shall be heard by the judge sitting without a jury. The Court shall have full power and authority to determine all questions in relation to payment of claims for compensation under the provisions of the Workers' Compensation Code. The Court, upon application of either party, shall order a hearing. Upon a hearing, either party may present evidence and be represented by counsel. The decision of the Court shall be final as to all questions of fact and law; provided, the decision of the Court may be appealed to the Commission. The decision of the Court shall be issued within sixty (60) days following the submission of the case by the parties.”

Investigatory Powers

(85A O.S., §72(A)(1)) “In making an investigation or inquiry or conducting a hearing, the administrative law judges and the Commission shall not be bound by technical or statutory rules of evidence or by technical or formal rules of procedure, except as provided by this act. The administrative law judges and the Commission may make such investigation or inquiry, or conduct the hearing, in a manner as shall best ascertain the rights of the parties.”

Reasoned Decision

(85A O.S., §72(A)(4)) “Administrative law judges are required to make specific, on-the-record findings of ultimate facts responsive to the issues shaped by the evidence as well as conclusions of law on which its judgment is to be rested.”

Workers’ Compensation Commission(Appeal)

General Rule

(85A O.S., §78(A)) “Any party feeling aggrieved by the judgment, decision, or award made by the administrative law judge may, within ten (10) days of issuance, appeal to the Workers' Compensation Commission.”

Scope of Review of WCC

(85A O.S., §78(A)) “After hearing arguments, the Commission may reverse or modify the decision only if it determines that the decision was against the clear weight of the evidence or contrary to law. All such proceedings of the Commission shall be recorded by a court reporter, if requested by any party. Any judgment of the Commission which reverses a decision of the administrative law judge shall contain specific findings relating to the reversal.”

Original Jurisdiction

(85A O.S., §169(I)) “The Court shall be vested with jurisdiction over all claims filed pursuant to the Workers' Compensation Code.” “The power and jurisdiction of the Court over each case shall be continuing and it may, from time to time, make such modifications or changes with respect to former findings or orders relating thereto if, in its opinion, it may be justified.”

Commonwealth Court and Supreme Court

Jurisdiction

(85A O.S., §147) “The Commission has exclusive jurisdiction to enforce and enter judgment confirming, vacating, correcting or modifying an award under this act.”

Appeal to Supreme Court

(85A O.S., §78(C)) “The Supreme Court may modify, reverse, remand for rehearing, or set aside the judgment or award only if it was:

1. In violation of constitutional provisions;

2. In excess of the statutory authority or jurisdiction of the Commission;

3. Made on unlawful procedure;

4. Affected by other error of law;

5. Clearly erroneous in view of the reliable, material, probative and substantial competent evidence;

6. Arbitrary or capricious;

7. Procured by fraud; or

8. Missing findings of fact on issues essential to the decision.”

SETTLEMENT

Mandatory Mediation

(85A O.S., §153(A)) Although highly encouraged, mediation is not mandatory.

Voluntary Mediation

(85A O.S., §153(C)) ” Mediation shall be voluntary, informal, and nonbinding in any claim arising pursuant to the provisions of this act, except for claims against the Multiple Injury Trust Fund and medical treatment issues subject to a certified workplace medical plan. Provided, however, the parties may waive mediation and proceed directly to an administrative hearing.”

Informal Settlement Conferences

(85A O.S., §153(F), (K)) Informal settlement conferences are available in the context of mediation. A settlement agreement reached during mediation must be submitted to an administrative law judge for final approval.

Compromise and Release

(85A O.S., §158)(A)) “If the employee and employer shall reach an agreement for the full, final and complete settlement of any issue of a claim pursuant to this act, a form designated as "Joint Petition" shall be signed by both the employer and employee, or representatives thereof, and shall be approved by the Workers' Compensation Commission or an administrative law judge, and filed with the Commission.”

INSURANCE

General Rule

There is no corresponding material in the new law OR the material provided may not be entirely on point

Particular Requirements

(85A O.S., §42(A)) Contents. Every policy or contract of insurance issued by a carrier to an employer to secure the payment of compensation under this act shall contain:

1. a. Provisions that identify the insured employer and either identify each covered employee or describe covered employees by class or type of labor performed and the estimated number of employees of each such class or type. b. No single policy of workers' compensation insurance may be issued to any group of employers who are unaffiliated with one another in terms of ownership, control, or right to participate in the profits of the affiliated enterprises;

2. Provisions that insolvency or bankruptcy of the employer or discharge therein shall not relieve the carrier from payment of compensation for compensable injuries sustained by an employee during the term of the policy or contract;

3. a. The agreement of the carrier that it shall promptly pay to the person entitled to compensation every installment of compensation that may be awarded or agreed on and that this obligation shall not be affected by any default of the employer or by any default in the giving of any notice required by the policy or otherwise.

b. The agreement shall be construed to be a direct obligation by the carrier to the person entitled to compensation, enforceable in that person's name; and

4. Such other provisions as the Insurance Department allows or requires carriers to include in workers' compensation policies.

General Rule Where Employer is Uninsured

(85A O.S., §31(A)(1)) “The Oklahoma Tax Commission shall assess and collect from any uninsured employer a temporary assessment at the rate of five percent (5%) of the total compensation for permanent total disability awards, permanent partial disability awards, and death benefits paid out during each quarter of the calendar year by the employers;”

*This language was found under the heading “Multiple Injury Trust Fund,” although it may have broader applicability.

Damages by Action at Law Where Employer is Uninsured

There is no corresponding material in the new law OR the material provided may not be entirely on point

Uninsured Employers Guaranty Fund

There is no corresponding material in the new law OR the material provided may not be entirely on point

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