The following guide is provided for quick reference and basic understanding of the Arkansas Workers’ Compensation system. This guide is not comprehensive and cannot address all issues of the system. Only a detailed consultation with an experienced Workers’ Compensation attorney can address all of your concerns. For more information, contact Fayetteville, AR workers’ comp lawyer Ken Kieklak, Attorney at Law by calling (479) 316-0438 or contact us online. A version formatted for printing is also available.
An Overview of Workers’ Compensation in Arkansas
In 1939, Arkansas enacted the no-fault compensation law to provide prompt and automatic benefits to workers injured while performing their job. Before the Workers’ Compensation Law went into effect, any injured employee was required to file a lawsuit against their employer to recover medical costs and any lost wages. However, lawsuits took time, were expensive, and relied on judges and juries to determine fault and compensation. It was often an unfair system because of the resources available to a company.
Now, if an employee is unable to work because they were injured on the job, the workers’ compensation insurance policy provides benefits to cover medical expenses and money to compensate an employee for their lost income. Typically, these benefits go into effect immediately and without any bureaucratic red tape.
While most people working in Arkansas are protected under the Workers’ Compensation Law, there are some exceptions. For example, if a business has two or fewer employees, those employees might not be covered. Anyone employed as agricultural farm labor or domestic help is not covered as well. Likewise, any employee of a non-profit, charitable, or religious organization is also exempt. Additionally, maritime and railroad workers are covered under federal laws.
What is Covered Under Arkansas Workers’ Compensation Law?
In Arkansas, workers are covered for accidental injuries that occur during the course of their employment. These injures could include external or internal bodily harm and must be caused by a specific incident that has an identifiable time and place.
To better understand what is meant by a specific incident, it might be easier to review the three exceptions to that requirement. First, any injury that is the result of rapid and repetitive motion is exempt, such as carpal tunnel syndrome. Next, back injuries that occur over time and are gradual in nature are not covered. Finally, hearing loss is not covered under the Worker’s Compensation Law.
If you suffered a heart attack, the accident must have been the primary cause of the physical injury to be eligible for benefits. For example, the heart attack was caused by an extraordinary level of exertion that was outside the ordinary scope of work. Or the heart attack occurred due to some unpredicted incident that was the major cause of the injury. The injury suffered does not have to be physical and could be a mental injury as long as it resulted from a specific work-related incident.
The law also covers employees who contract an occupational disease that arises during the course of their employment. However, workers are not covered for common diseases that also affect the general population, such as the flu.
This coverage goes into effect the moment you begin working and continues during the length of your employment. You are not required to work a set number of hours or days before the coverage is available.
How Do I Apply for Workers’ Compensation Benefits in Arkansas?
If you suffer an injury on the job, you should report it to your supervisor or employer immediately. Be sure to provide your employer with a written statement that details the time, place, and nature of your injury. You should also include any information that will allow your employer to arrange medical treatment and complete any required reports.
You should not hesitate to report the incident. Even though your benefits are automatic, nothing will begin until you report the injury to your employer. It is essential to protect your rights, even if you believe the injury is slight. No work-related injury should go unreported. You are not a doctor and the full extent of your injury might not be readily apparent. A small cut on your finger could become infected, resulting in an unwanted amputation or other disability.
You are not required to apply for benefits. Your employer or insurance carrier should provide you medical treatment, disability payments if applicable, and file all the required reports with the Workers’ Compensation Commission. If your employer is not doing what is needed, contact our workers’ compensation attorney immediately to protect your legal rights.
Types of Benefits Available Under Workers’ Compensation
Arkansas law provides injured workers with three types of workers’ compensation benefits.
First, an injured worker is entitled to medical treatment to care for their injury. This benefit covers more than just your doctor’s bills. An employee should recover for hospital costs, medication, x-rays, lab tests, crutches, and other expenses related to medical treatment. The employee is not responsible for any type of deductible and all reasonable costs and expenses for necessary services should be paid directly to the provider by the insurance carrier.
Depending on the injury, an employee might require rehabilitative services. Often, physical or occupational therapy is an extension of medical treatment. However, depending on the severity of the injury, a disabled employee might require vocational rehabilitation.
In addition to medical expenses, the Arkansas Workers’ Compensation law provides employees that are unable to work disability payments. Injured workers could also receive cash payments in the form of temporary disability payments. These payments are paid during the period an injured employee is healing and unable to work. In situations where an employee suffers a permanent impairment, such as losing the use of an arm, the employee will be paid permanent partial disability benefits after being cleared to return to work. If your injury prevents you from earning your regular salary, you might be entitled to compensation for your lost wages. In the case an injury is fatal, the surviving family dependents might be eligible for payments. In cases where an employee is unable to return to work, the disability could be permanent.
If you are injured and unable to work, disability benefits will not be paid during the first seven days if the disability does not last two weeks. If your injury results in a disability that last over fourteen days, your benefits will be paid starting from the day after your injury occurred.
Temporary total disability benefits are calculated at sixty-six and two-thirds percent of an injured employee’s average weekly salary. However, there is a set maximum that is set under state law. Additionally, any payments made under the Workers’ Compensation Law are tax-free.
General Information about the Arkansas Workers’ Compensation System
|Role of the Arkansas Workers’ Compensation Commission (AWCC)||The Arkansas Workers’ Compensation Commission is the state government organization that enforces the Workers’ Compensation rules in Arkansas. If your claim proceeds routinely, your interaction with the AWCC will be, at most, minimal.|
|Your cost||Workers’ compensation should be available to most employees. Your coverage is paid by your employer at no cost to you.|
|Worker coverage||Almost all workers in Arkansas are covered because most for-profit business entities consisting of 3 or more employees are covered. Exceptions to coverage include those employed in domestic help, agricultural farm laborers, and Arkansans employed by non-profit, religious, charitable or relief organizations. Railroad workers, maritime workers, and dock workers are not generally covered by Arkansas’ Workers’ Compensation program but by federal programs.|
|Coverage effective date||Your coverage begins the moment you start your employment and continues throughout.|
|Covered injuries||Accidental injuries which arise out of, and in the course of employment, cause internal or external harm to the body, are caused by a specific incident and are identifiable by time and place of occurrence. Repetitive motion injuries, gradual on-set back injuries, and hearing loss are exceptions to the general rule.|
Types of Disability Determinations
|Temporary total disability (TTD)||When an injury or injuries cause a complete disability that is not expected to be permanent, a designation of TTD may be issued. The maximum time for TTD is 450 weeks. Compensation at 66 and two-thirds percent of gross average weekly wage. State Maximum: $617/wk, Minimum: $20/wk.|
|Temporary partial disability (TPD)||When an injury or injuries cause a complete disability that is not expected to be permanent, a designation of TTD may be issued. The maximum time for TTD is 450 weeks. State Maximum: $617/wk, Minimum: $20/wk.|
|Permanent partial disability (PPD)||Permanent partial disability occurs when your injuries or condition results in only a partial disability, but that condition is not expected to improve. PPD injuries are scheduled for every body part excluding the back, neck and shoulders which are whole body injuries based on 450 weeks. The impairment percentage is multiplied by the total number of weeks corresponding to the rated body part. See §11-9-521 for schedule. State maximum: $463/wk, Minimum $20/wk.|
|Permanent total disability (PTD)||When disability is all-encompassing and not expected to improve a determination of PTD may be made. Caps on PTD benefits are described in the following section.|
|Death||Death benefits are available and up to $6,000 may be paid for funeral expenses. The amount of death benefits are computed as per AR Code §11-9-527. Death benefits are subject to the PTD cap as listed above.|
Beginning Your Workers’ Compensation Claim in Arkansas
|Starting your Workers’ Compensation claim||The worker must report the injury to his or her employer. The employer will then typically complete and submit AWCC Form 1– Employer’s First Report of Injury or Illness.|
|Workers’ Compensation Statute of Limitations||Your claim must be filed within 2 years of the injury date.|
|Claims challengeable?||Your employer may challenge or controvert your claim. Your employer must file its reply within 15 days by filing AWCC Form 2 – Employer’s Intent to Accept or Controvert Claim.|
|Formal claims available?||If you need to open a formal claim with the AWCC, as per ACA § 11-9-702, you or your attorney should file AWCC Form C – Claim for Compensation.|
|Expected waiting period for a hearing||30 to 60 days for your hearing. An administrative law judge (ALJ) must issue a decision within 90 days of the hearing date.|
Workers’ Compensation Benefits in Arkansas
|Types of benefits||The Workers’ Compensation system may provide compensation for medical expenses; like hospital bills, rehabilitative expenses; like physical therapy, and compensation for lost wages.|
|Preapproval?||Yes. You should always have medical services pre-approved or risk non-payment.|
|Emergency treatment?||If the situation is a true emergency, seek emergency medical care that your employer or insurer may be required to cover.|
|Initial choice of doctor||At the outset, your employer will have the choice of the treating physician. The physician will report on your medical condition by filing AWCC Form 3 — Physician’s Report.|
|Change of treating physician||Yes, you may change your treating physician however there is a set procedure for doing so. One should be extremely careful and work within the system for the change while complying with all instructions.|
|Procedure for change of doctor||A claimant may request to change their treating doctor by contacting the AWCC. However, you may only change your doctor once. If the employer is associated with a managed care organization (MCO), the doctor you select must be associated with the MCO or be your regular treating doctor. If the employer is not part of a MCO network, then the claimant may select a doctor associated with any certified MCO.|
|Benefit payment methods|| “Compensation shall be paid by check, by electronic funds transfer, or by state warrant.” Ark. Code Ann. § 11-9-801. Payment may be made by means of an electronic system if:
If a fee will be charged to a claimant that method may not be implemented.
|Benefit caps||For claims prior to 1/1/2008 PTD benefits were capped at $75,000. Furthermore, benefits paid for PPD would also count against that cap. However, the benefits are now adjusted yearly based on when the injury occurred:
|Settlement||Settlement is permitted and handled through a formal hearing before an ALJ.|
Glossary of Common Workers’ Compensation Terms
|AR Code||Arkansas Code|
|AWCC||Arkansas Workers’ Compensation Commission|
|Claim||A request for benefits due to a disability.|
|Controvert||In a Workers’ Compensation claims context, controvert means that your employer is denying liability for your Workers’ Compensation benefits.|
|CoP||Change of physician|
|DEN||Date Employer Notified|
|DoD||Date of Disability|
|DoI||Date of Injury|
|EE||The claimant who is applying for benefits or employEE.|
|FEIN||Federal Employer Identification number|
|IR||The insurance agent or adjuster|
|Major cause||50% or more of the reason for the injury or condition|
|MCO||Managed care organization|
|TPA||Third party administrator|
Medical Treatment Under Workers’ Compensation in Arkansas
When you are employed, you should be provided with a copy of your comprehensive rights to medical treatment. Your employer is required under law to provide all necessary and reasonable medical care. Under the Arkansas Workers’ Compensation Law, your employer is entitled to contract with a certified managed care organization and designate your initial medical provider.
An employee should not seek medical treatment on their own. Should this occur, your employer or insurer might not be required to pay for any medical treatment you received. However, you are entitled to seek authorization from your employer or the insurance provider to see your own doctor. It is important to coordinate treatment with your employer and your medical professionals. In most cases, any issues that arise could be addressed through cooperation between you, your employer, and the insurance carrier.
In some situations, if your benefits are denied, the insurance provider or your employer could still be liable for the cost of your medical treatment. If you had requested medical assistance in writing or your employer refused to refer you to a medical provider within 48 hours of receiving your written request, they could be held liable for any expenses you incurred.
There are also situations where an employee will require immediate emergency medical treatment and will not have the opportunity to report the incident to their employer. Under these circumstances, the treatment should be covered. If it is not, speak with our experienced Arkansas workers’ compensation attorney.
Changing Doctors Under Arkansas Workers’ Compensation Law
As stated above, your employer or insurance carrier is entitled to choose your medical provider. However, the Arkansas Workers’ Compensation Law has specific procedures in place that allow you to change doctors. If you request a change of physician and your employer or insurance company does not approve the switch, you have the right to file an appeal with the Workers’ Compensation Commission. If you fail to follow the rules and procedures regarding changing your physician, your request could be denied. Our Workers’ Compensation attorney will assist you during this process.
What to Do If There Are Mistakes or Errors With My Workers’ Compensation Benefits
In most cases, if there is an error or a problem with your benefits, it can be handled rather routinely. Your workers’ compensation benefits are supposed to be automatic and the amounts paid are specified by law. However, mistakes and errors do occur. There are situations where benefits are denied or are less than what an employee believes they should be. When this does happen, the first course of action should be to contact your employer or insurance provider – in most situations, a phone call could fix the problem or help clarify the decision.
If talking with your employer or insurance carrier does not resolve the problem, you can speak directly with the Workers’ Compensation Commission. The commission’s office has trained staff members that are available to help you understand your legal rights and options regarding your benefits. The commission will schedule conferences between you and your employer or a representative from the insurance company to try and resolve any disputes.
If you are still unable to resolve your problem through a conference or mediation, you could file an appeal with the Workers’ Compensation Commission. Our Arkansas workers’ compensation attorney is available to assist you with the appeal process. You will be required to file a “Form C” with the commission, who will review your case to determine if you were unjustly denied benefits. Your claim must be filed within two years from the date of your injury or the date of your last compensation payment.
Once your claim has been filed, it will be assigned to an administrative law judge (ALJ). The ALJ will conduct any further proceedings required to settle the matter. At this point, either side is permitted to hire legal representation. Our office strongly advises that, since all other avenues have failed to resolve the situation, you should have our experienced workers’ compensation attorney representing you during any hearings or other parts of the proceeding. If your benefits are denied at this level, you will unlikely receive the disability payments you might need.
Can I Keep My Job if I Receive Workers’ Compensation Benefits in Arkansas?
Another question that concerns workers who have suffered an injury is their job’s status once they can return to work. Under the Workers’ Compensation Law, an employer is prohibited from firing or discriminating against an employee who exercised their rights under Arkansas law. However, no provision in the Workers’ Compensation Law requires an employer to keep a job open while you are recovering from your injury. That does not mean you do not have legal recourse once you can return to work. A Arkansas employer that refuses to allow you to return to work without a reasonable cause could have to compensate you for the difference in your weekly wages and any benefits you should receive for one year. If you are experiencing any difficulty with returning to work after an absence due to injury, contact our Arkansas workers’ compensation attorney.
Contact Our Arkansas Workers’ Compensation Attorney to Understand Your Legal Rights
Arkansas has developed a legal process to provide benefits to workers who are injured on the job. While your workers’ compensation benefits are supposed to go into effect automatically and immediately, mistakes and errors occur. Sometimes employers or insurance providers will dispute the severity of your injury or that it happened in the course of your employment. If you are out of work because of an injury, your workers’ compensation benefits could be necessary to pay your medical cost and living expenses. If you are denied, you and your family could suffer. For your free and confidential consultation with a Arkansas workers’ compensation lawyer, contact us at (479) 316-0438 or contact us online.