DI 52120.200: Oklahoma Workers’ Compensation (WC)

changes
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~~Effective Dates: 03/30/2018 - Present~~
Effective Dates: 06/25/2018 - Present
TN 11 (03-18)
DI 52120.200 Oklahoma Workers’ Compensation (WC)
A. Types of WC payments subject to WC offset
* Oklahoma’s Administrative Workers’ Compensation Act (AWCA) (Effective 02/01/2014): The AWCA applies to claims for injuries and death based on accidents occurring on or after 02/01/2014 and provides for the following types of WC benefits:
* Temporary Total (TT) Disability
TT disability may be available if the injured employee is temporarily unable to perform his or her job or any alternative work offered by the employer.
Amount: compensation equal to 70% of the injured employee’s average weekly wage; but not to exceed 70% of the state average weekly wage.
Duration: may not exceed 104 weeks (plus up to 52 weeks for a consequential injury).
* Temporary Partial (TP) Disability
TP disability may be available if the injured employee is temporarily unable to perform his or her job, but may perform alternate work offered by the employer.
Amount: compensation equal to 70% of the difference between the employee’s average weekly wage (before the injury) and the employee’s weekly wage for performing alternative work after the injury. This only applies if the weekly wage for the alternative work is less than the TT disability rate.
Duration: TP disability may not exceed 52 weeks.
* Permanent Partial (PP) Disability
PP disability may be available if the injured employee has permanent loss of, or loss of use of, one or more body parts. In this situation, the employee is unable to perform his or her same job duties from prior to the injury, but is still capable of working in some capacity. Each body part has a legally determined number of weeks of WC payments that the disabled worker is entitled to receive.
Amount: compensation equal to 70% of the injured employee’s average weekly wage; but not to exceed $323.00 per week.
Duration: may not exceed a total of 350 weeks for the body as a whole. The law sets forth the total weekly duration of PP disability for specific parts of the body.
* Disfigurement Awards
Payments made due to a permanent injury, usually to the head, face, or neck, which impedes the progress of finding future employment.
Amount: compensation for disfigurement may not exceed $50,000.00.
* Permanent Total (PT) Disability
PT disability may be available if the employee’s injury or illness permanently removes the person from the work force.
Amount: compensation equal to 70% of the injured employee’s average weekly wages; but not to exceed 100% of the state’s average weekly wage.
Duration: paid during the continuance of the disability and until the employee reaches the age of maximum Social Security retirement benefits, or for a period of 15 years, whichever period is longer. PT disability awards shall not be commuted to a lump-sum payment.
* or additional information, see Okla. Stat. Ann. tit. 85a, §§ 3, 45, 46, 49.
* Oklahoma WC Code (08/26/2011 to 01/31/2014): The Oklahoma WC Code applies to claims for injuries or deaths based on accidents occurring from 08/26/2011 to 01/31/2014. It provides the following types of WC benefits:
* TT Disability
TT disability may be available if the injured employee is temporarily unable to perform his or her job or any alternative work offered by the employer.
Amount: compensation is equal to 70% of the injured employee’s average weekly wages; but not to exceed 100% of the state’s average weekly wage.
Duration: may not exceed 156 weeks (plus up to 52 weeks for a consequential injury).
* TP Disability
TP disability may be available if the injured employee is temporarily unable to perform his or her job, but may perform alternate work offered by the employer.
Amount: compensation is equal to 70% of the difference between the employee’s average weekly wages and the employee’s wage-earning capacity in the same employment or otherwise, if less than before the injury. It may not exceed 80% of the employee’s average weekly wages at the time of the accident.
Duration: may not exceed 156 weeks.
* PP Disability
PP disability may be available if the injured employee has permanent loss of, or loss of use of, one or more body parts. In this situation, the employee is unable to perform his or her same job duties from prior to the injury, but is still capable of working in some capacity. Each body part has a legally determined number of weeks of WC payments that the disabled worker is entitled to receive.
Amount: compensation is equal to 70% of the injured employee’s average weekly wage; but not to exceed $323.00 per week. It may not be less than $150 per week for the period prescribed for scheduled members (parts of the body).
Duration: may not exceed 500 weeks. The employee may ask the WC Court to change the award to a lump-sum payment rather than weekly payments, but the lump-sum payment shall not exceed 25% of the total award. Any balance of the total award shall be paid in periodic payments.
* Disfigurement Awards
Payments made due to a permanent injury, usually to the head, face, or neck, which impedes the progress of finding future employment.
Amount: compensation for disfigurement may not exceed $50,000.00.
* PT Disability
PT disability may be available if the worker’s injury or illness permanently removes the person from the work force.
Amount: compensation is equal to 70% of the injured employee’s average weekly wages; but not to exceed 100% of the state’s average weekly wage.
Duration: paid during the continuance of the disability and until the employee reaches the age of maximum Social Security retirement benefits, or for a period of 15 years, whichever period is longer. PT disability awards shall not be commuted to a lump-sum payment.
* f. For additional information, see Carlock v. Workers’ Compensation Commission, 324 P.3d 408 (Okla. 2014); Okla. Stat. Ann. tit. 85a, §§ 3, 400(L); Okla. Stat. Ann. tit. 85, §§ 332-334, 336, 345, 404; 2011 Okla. Sess. Law Serv. Ch. 318, S.B. 878 (effective 08/26/2011).
NOTE: See POMS DI 52150.045C.39 for Oklahoma’s state maximum weekly WC benefit amount.
B. Cost-of-living adjustments (COLAs)
Oklahoma does not provide for cost of living increases for WC payments.
C. Attorney fees under the AWCA
When evaluating attorney fees, consider the following:
* An attorney representing an injured employee may recover attorney fees subject to limitations set forth in the law.
* Attorney fees paid or incurred by the employee in connection with the employee’s WC claim are “excludable expenses”. See DI 52150.050 for more information on legal fees as excludable expenses.
D. Retirement insurance benefit (RIB) considerations
Oklahoma does not offset its WC for SSA retirement benefits.
E. Oklahoma WC Court of Existing Claims and Oklahoma WC Commission
* Oklahoma WC Court of Existing Claims
* For claims involving injuries and death based on accidents that occurred prior to 02/01/2014, the Oklahoma WC Court of Existing Claims determines claims for compensation, the liability of employers and insurers, and rights asserted under the prior WC law found in Title 85 of the Oklahoma Statutes (now repealed).
* Information regarding the Oklahoma WC Court of Existing Claims, including current court forms such as Compromise Settlement forms, is available at http://cec.ok.gov/.
* Information is available regarding the Oklahoma WC Court of Existing Claims, including current court forms such as Compromise Settlement forms.
* Oklahoma WC Commission
* For claims involving injuries and death based on accidents that occurred on or after 02/01/2014, the Oklahoma WC Commission administers the AWCA.
* The Commission’s responsibility is to determine claims for compensation, the liability of employers and insurers, and any rights asserted under the AWCA. An administrative law judge will issue the judgment/award on WC claims. Any appeal of an administrative law judge’s decision goes to the Oklahoma WC Commission.
* Information on the Oklahoma WC Commission is available at http://ok.gov/wcc/.
* Information on the Oklahoma WC Commission is available.
F. Verifying WC payments under the AWCA
Sources to Verify Payments: In order of priority, the following are potential sources for WC information:
* Claimant;
* Claimant's attorney;
* Insurance carrier;
* Self-insured employer;
* CompSource Mutual Insurance CompanyP. O. Box 53505 Oklahoma City, OK 73105
* CompSource Mutual Insurance Company P. O. Box 53505 Oklahoma City, OK 73105
(405) 232-7663 or (800) 347-3863
Formerly CompSource Oklahoma, this is an insurance carrier that must provide WC insurance to any employer in Oklahoma that seeks coverage and meets certain requirements.
* Oklahoma WC Court of Existing ClaimsRecords DepartmentDenver Davison Building1915 N. Stiles Ave, Suite 127 Oklahoma City, OK 73105(405) 522-8640
~~http://cec.ok.gov/records.htm~~
* Oklahoma WC Court of Existing Claims Records Department Denver Davison Building 1915 N. Stiles Ave, Suite 127 Oklahoma City, OK 73105 (405) 522-8640
For claims prior to 02/01/2014, the records department of the Oklahoma WC Court of Existing Claims contains specific information on obtaining claims records.
* Oklahoma WC Commission
For claims on or after 02/01/2014, the Oklahoma WC Commission website provides that the contact for records issues is Norma McRae, Director (405) 522-8776. http://ok.gov/wcc/About_the_Commission/Contact_Us/index.html
For claims on or after 02/01/2014, the Oklahoma WC Commission website provides that the contact for records issues is Norma McRae, Director (405) 522-8776.
* Assistance from SSA Oklahoma City District Office
FOs should request verification from the WC Court of Existing Claims or WC Commission via Form SSA-562U3 (Request for Assistance Certification) or Form E562 (Electronic 562), sent to:
~~D/O 783SSA, Oklahoma City District Office~~
D/O 783 SSA, Oklahoma City District Office
12301 N Kelley Ave
Oklahoma City, OK 73131
The FO’s can FAX requests to the SSA Oklahoma City District Office at (405) 752-4726.
A fully completed Form SSA-1709 (Request for Workers' Compensation/Public Disability Benefit Information) must accompany the SSA-562 or E562. Instructions for completing the SSA-1709 are in DI 52145.010. Show the address of the contact source in the applicable block on the SSA-1709. Be sure to include both sides of the SSA-1709 when faxing. Finally, if the WC verification request is the result of a Processing Center memorandum, include a copy of the memorandum with the SSA-1709 and SSA-562 or E562. The information on the memorandum often aids in the search for WC records.
G. References
* Oklahoma WC Court of Existing Claims website:http://cec.ok.gov/
* Oklahoma WC Commission website: http://ok.gov/wcc/
* Oklahoma Insurance Commissioner’s website: https://www.ok.gov/oid/
* Titles 85 and 85a of the Oklahoma Statutes are available on the Oklahoma Legislature’s website: http://www.oklegislature.gov/osStatuesTitle.aspx
* Oklahoma WC Court of Existing Claims website
* Oklahoma WC Commission website
* Oklahoma Insurance Commissioner’s website
* Titles 85 and 85a of the Oklahoma Statutes are available on the Oklahoma Legislature’s website

POMS Reference

DI 52120.200: Oklahoma Workers’ Compensation (WC)