803 KAR 25:010. Procedure for adjustments of claims

Link to law: http://www.lrc.ky.gov/kar/803/025/010.htm
Published: 2015

Subscribe to a Global-Regulation Premium Membership Today!

Key Benefits:

Subscribe Now
      803 KAR 25:010. Procedure for adjustments

of claims.

 

      RELATES TO: KRS 342.0011, 342.125,

342.260, 342.265, 342.270, 342.300, 342.310, 342.315, 342.710, 342.715,

342.732, 342.760

      STATUTORY AUTHORITY: KRS 342.033,

342.260(1), 342.270(3), 342.285(1)

      NECESSITY, FUNCTION, AND CONFORMITY: KRS

342.260(1) requires the executive director to promulgate administrative regulations

necessary to implement the provisions of KRS Chapter 342. KRS 342.270(3)

requires the executive director to promulgate an administrative regulation

establishing procedures for the resolution of claims. KRS 342.033 requires the

executive director to prescribe the format and content of written medical

reports. KRS 342.285(1) requires the executive director to promulgate an administrative

regulation governing appeals to the Workers' Compensation Board. This

administrative regulation establishes the procedure for the resolution of

claims before an administrative law judge or Workers' Compensation Board.

 

      Section 1. Definitions. (1)

"Administrative law judge" means an individual appointed pursuant to

KRS 342.230(3).

      (2) "Board" is defined by KRS

342.0011(10).

      (3) "Civil rule" means the

Kentucky Rules of Civil Procedure.

      (4) "Date of filing" means the

date that:

      (a) A pleading, motion, or other document

is received by the Executive Director at the Office of Workers' Claims in

Frankfort, Kentucky, except:

      1. Final orders and opinions of

administrative law judges, which shall be deemed "filed" three (3)

days after the date set forth on the final order or opinion; and

      2. Documents delivered to the offices of

the Office of Workers' Claims after the office is closed at 4:30 p.m. or on the

weekend, which shall be deemed filed the following business day; or

      (b) A document is transmitted by United States

registered (not certified) or express mail, or by other recognized mail

carriers, and the date the transmitting agency receives the document from the

sender as noted by the transmitting agency on the outside of the container used

for transmitting, within the time allowed for filing.

      (5) "Employer" means

individuals, partnerships, voluntary associations and corporations.

      (6) "Employer who has not secured

payment of compensation" means any employer who employs an employee as

defined by KRS 342.640 but has not complied with KRS 342.340.

      (7) "Executive director" is

defined by KRS 342.00111(9).

      (8) "Latest available edition"

means that edition of the "Guides to the Evaluation of Permanent

Impairment" which the executive director has certified as being generally

available to the office, attorneys, and medical practitioners, by posting prominently

at the office's hearing sites the date upon which a particular edition of the

"Guides to the Evaluation of Permanent Impairment" is applicable for

purposes of KRS Chapter 342.

      (9) "Special defenses" means

defenses that shall be raised by "special answer" filed in accordance

with Section 5(2)(d) of this administrative regulation.

 

      Section 2. Parties. (1) The party making

the original application for resolution of claim pursuant to KRS 342.270 or

342.316 shall be designated as "plaintiff". Adverse parties shall be

designated as "defendants".

      (2) All persons shall be joined as

plaintiffs in whom any right to any relief pursuant to KRS Chapter 342, arising

out of the same transaction and occurrence, is alleged to exist. If a person refuses

to join as a plaintiff, that person shall be joined as a defendant, and the

fact of refusal to join as a plaintiff shall be pleaded.

      (3)(a) All persons shall be joined as

defendants against whom the ultimate right to relief pursuant to KRS Chapter

342 may exist, whether jointly, severally, or in the alternative. An

administrative law judge shall order, upon a proper showing, that a party be

joined or dismissed.

      (b) The Special Fund may be joined as a

defendant in accordance with the appropriate statutory provisions for claims in

which the injury date or date of last exposure occurred before December 12,

1996.

      (c) Joinder shall be sought by motion as

soon as practicable after legal grounds for joinder are known. Notice of

joinder and a copy of the claim file shall be served in the manner ordered by

the administrative law judge.

 

      Section 3. Pleadings. (1) An application

for resolution of claim and all other pleadings shall be typewritten and

submitted in accordance with this administrative regulation.

      (a) For an injury claim, an applicant

shall submit a completed Form 101, Application for Resolution of Injury Claim.

      (b) For an occupational disease claim

other than coal workers' pneumoconiosis, an applicant shall submit a completed

Form 102-0D, Application for Resolution of Occupational Disease Claim.

      (c) For a hearing loss claim, an

applicant shall submit a completed Form 103, Application for Resolution of

Hearing Loss Claim.

      (2) An application for resolution of

claim shall be filed with sufficient copies for service on all parties. The

executive director shall make service by first class mail. Incomplete

applications may be rejected and returned to the applicant. If the application

is refiled in proper form within twenty (20) days of the date it was returned,

the filing shall relate back to the date the application was first received by

the executive director. Otherwise, the date of second receipt shall be the

filing date.

      (3) All pleadings shall be served upon

the executive director and shall be served upon all other parties by mailing a

copy to the other parties or, if represented, to that representative, at the

party's or representative's last known address. A certificate of service

indicating the method and date of service and signed by the party shall appear

on the face of the pleading. Notices of deposition and physical examination

shall be served upon the parties and shall not be filed with the executive

director.

      (4) After the application for resolution

has been assigned to an administrative law judge, subsequent pleadings shall

include, within the style of the claim and immediately before the claim number,

"Before Administrative Law Judge (name)". Upon consolidation of claims,

the most recent claim number shall be listed first.

      (5)(a) All documents involved in an

appeal to the Workers' Compensation Board shall include the language

"Before Workers' Compensation Board" before the claim number within

the style of the claim.

      (b) Parties shall insert the language

"Appeals Branch" or "Workers’ Compensation Board" on the

outside of the envelope containing documents involved in an appeal.

 

      Section 4. Motions. (1) The party filing

a motion shall tender a proposed order granting the relief requested.

      (2) The party filing a motion may file a

brief memorandum supporting the motion and opposing parties may file brief memoranda

in reply. Further memoranda (for example, reply to response) shall not be

filed.

      (3) Every motion and response, the

grounds of which depend upon the existence of facts not in evidence, shall be

supported by affidavits demonstrating the facts.

      (4) Every motion, the grounds of which

depend upon the existence of facts which the moving party believes are shown in

the evidence or are admitted by the pleadings, shall make reference to the

place in the record where that evidence or admission is found.

      (5) A motion, other than to reopen

pursuant to KRS 342.125 or for interlocutory relief, shall be considered ten

(10) days after the date of filing. A response shall be considered if filed on

or before the tenth day after the filing of the motion.

      (6)(a) A motion to reopen shall be

accompanied by as many of the following items as may be applicable:

      1. A current medical release Form 106

executed by the plaintiff;

      2. An affidavit evidencing the grounds to

support reopening;

      3. A current medical report showing a

change in disability established by objective medical findings;

      4. A copy of the opinion and award,

settlement, voluntary agreed order or agreed resolution sought to be reopened;

      5. An affidavit certifying that a

previous motion to reopen has not been made by the moving party, or if one (1)

has previously been made, the date on which the previous motion was filed;

      6. A designation of evidence from the

original record specifically identifying the relevant items of proof which are

to be considered as part of the record during reopening; or

      7. A certification of service that the

motion was served on all parties as well as counsel for the parties.

      (b)1. A designation of evidence made by a

party shall list only those items of evidence from the original record that are

relevant to the matters raised on reopening.

      2. The burden of completeness of the

record shall rest with the parties to include so much of the original record,

up to and including the award or order on reopening, as is necessary to permit

the administrative law judge to compare the relevant evidence that existed in

the original record with all subsequent evidence submitted by the parties.

      3. Except for good cause shown at the

time of the filing of the designation of evidence, a party shall not designate

the entire original record from the claim for which reopening is being sought.

      (c)1. A motion to reopen shall not be

considered until twenty-five (25) days after the date of filing.

      2. Any response shall be filed within

twenty (20) days of filing the motion to reopen.

      3. A response may contain a designation

of evidence specifically identifying evidence from the original record not

already listed by the moving party that is relevant to matters raised in a

response.

      (d) Any party may use the following forms

provided by the office for motions to reopen:

      1. Form MTR-1, Motion to Reopen by

Employee;

      2. Form MTR-3, Motion to Reopen by

Defendant; and

      3. Form MTR-2, Motion to Reopen KRS

342.732 Benefits.

      (7) A motion for allowance of a

plaintiff's attorney fee shall:

      (a) Be made within thirty (30) days

following the finality of the award, settlement or agreed resolution upon which

the fee request is based;

      (b) Be served upon the adverse parties

and the attorney's client;

      (c) Set forth the fee requested and

mathematical computations establishing that the request is within the limits

set forth in KRS 342.320; and

      (d) Be accompanied by:

      1. An affidavit of counsel detailing the

extent of the services rendered and the time expended;

      2. A signed and dated Form 109 as

required by KRS 342.320(5); and

      3. A copy of the signed and dated

contingency fee contract.

      (8) A motion for allowance of defendant's

attorney's fee shall be:

      (a) Filed within thirty (30) days

following the finality of the decision; and

      (b) Accompanied by an affidavit of

counsel detailing:

      1. The extent of the services rendered

and the time expended;

      2. The hourly rate and total amount to be

charged; and

      3. The date upon which agreement was

reached for providing the legal services.

      (9) The following motions relating to

vocational rehabilitation training provided by the office may be used by all

parties:

      (a) Form VRT, Petition for Vocational

Rehabilitation Training; and

      (b) Form WVR, Joint Motion and Agreement

to Waive Vocational Rehabilitation Evaluation.

      (10) If a plaintiff is deceased, a Motion

to Substitute Party and Continue Benefits shall be filed on Form 11.

 

      Section 5. Application for Resolution of

an Injury Claim and Response. (1) To apply for resolution of an injury claim,

the applicant shall file Form 101 with the following completed documents:

      (a) Work history (Form 104), to include

all past jobs performed on a full or part-time basis within twenty (20) years

preceding the date of injury;

      (b) Medical history (Form 105), to

include all physicians, chiropractors, osteopaths, psychiatrists,

psychologists, and medical facilities such as hospitals where the individual

has been seen or admitted in the preceding fifteen (15) years and including

beyond that date any physicians or hospitals regarding treatment for the same

body part claimed to have been injured;

      (c) Medical release (Form 106);

      (d) One (1) medical report, which may

consist of legible, hand-written notes of the treating physician, and which

shall include the following:

      1. A description of the injury which is

the basis of the claim;

      2. A medical opinion establishing a causal

relationship between the work-related events or the medical condition which is

the subject of the claim; and

      3. If a psychological condition is

alleged, an additional medical report establishing the presence of a mental

impairment or disorder;

      (e) Documentation substantiating the

plaintiff's preinjury and postinjury wages; and

      (f) Documentation establishing additional

periods for which temporary total disability benefits are sought.

      (2)(a) The defendant shall file a Notice

of Claim Denial or Acceptance on a Form 111 - Injury and Hearing Loss within

forty-five (45) days after the notice of the scheduling order or within

forty-five (45) days following an order sustaining a motion to reopen a claim.

      (b) If a Form 111 is not filed, all

allegations of the application shall be deemed admitted.

      (c) The Form 111 shall set forth the

following:

      1. All pertinent matters which are

admitted and those which are denied;

      2. If a claim is denied in whole or in

part, a detailed summary of the basis for denial;

      3. The name of each witness whose

testimony may be relevant to that denial; and

      4. A description of the physical

requirements of the plaintiff's job at the time of the alleged injury and the

name, address and telephone number of the individual responsible for gathering

this information for the employer and its insurer.

      (d) In addition to the Form 111, a

defendant shall file a special answer to raise any special defenses in

accordance with this paragraph.

      1. A defendant may incorporate special

defenses that have been timely raised in the Form 111.

      2. A "special answer" shall be

filed within:

      a. Forty-five (45) days of the scheduling

order; or

      b. Ten (10) days after discovery of facts

supporting the defense if discovery could not have been had earlier in the

exercise of due diligence.

      3. A special defense shall be waived if

not timely raised.

      4. A special defense shall be pleaded if

the defense arises under:

      a. KRS 342.035(3), unreasonable failure

to follow medical advice;

      b. KRS 342.165, failure to comply with

safety laws;

      c. KRS 342.316(7) or 342.335, false

statement on employment application;

      d. KRS 342.395, voluntary rejection of

KRS Chapter 342;

      e. KRS 342.610(3), voluntary intoxication

or self-infliction of injury;

      f. KRS 342.710(5), refusal to accept

rehabilitation services; or

      g. Running of periods of limitations or

repose under KRS 342.185, 342.270, 342.316, or other applicable statute.

 

      Section 6. Application for Resolution of

an Occupational Disease Claim and Response. (1) To apply for resolution of an

occupational disease claim, the applicant shall file Form 102-0D with the following

completed attachments:

      (a) Work history (Form 104), to include

all past jobs performed on a full or part-time basis within twenty (20) years

preceding the date of last exposure and all jobs in which plaintiff alleges exposure

to the hazards of the occupational disease;

      (b) Medical history (Form 105), to

include all physicians, chiropractors, osteopaths, psychiatrists,

psychologists, and medical facilities such as hospitals where the individual

has been seen or admitted in the preceding fifteen (15) years and including

beyond that date any physicians or hospitals regarding treatment for the same

body part claimed to have been injured;

      (c) Medical release (Form 106);

      (d) One (1) medical report supporting the

existence of occupational disease; and

      (e) Social Security Release Form (Form

115).

      (2)(a) The defendant shall file a Notice

of Claim Denial or Acceptance on a Form 111-OD:

      1. Within forty-five (45) days after the

notice of the scheduling order; and

      2. In accordance with Section 5(2)(b),

(c), and (d) of this administrative regulation.

      (b) In addition to the Form 111-OD, a

defendant shall file a special answer to raise any special defenses in

accordance with Section 5(2)(d) of this administrative regulation.

      (3) For all occupational disease and

hearing loss claims, the executive director shall promptly schedule an

examination pursuant to KRS 342.315 and 342.316.

 

      Section 7. Application for Resolution of

a Hearing Loss Claim and Response. (1) To apply for resolution of a hearing

loss claim, the applicant shall file Form 103 with the following completed

documents:

      (a) Work history (Form 104), to include

all past jobs performed on a full or part-time basis within twenty (20) years

preceding the last date of noise exposure;

      (b) Medical history (Form 105), to

include all physicians, chiropractors, osteopaths, psychiatrists,

psychologists, and medical facilities such as hospitals where the individual

has been seen or admitted in the preceding fifteen (15) years and including

beyond that date any physicians or hospitals regarding treatment for hearing

loss or ear complaints;

      (c) Medical release (Form 106);

      (d) One (1) medical report describing the

hearing loss which is the basis of the claim and, if a psychological condition

is alleged, an additional medical report establishing the presence of a mental

impairment or disorder. Medical reports required under this paragraph may

consist of legible, hand-written notes of a treating physician; and

      (e) Social Security Release Form (Form

115).

      (2)(a) The defendant shall file a Notice

of Claim Denial or Acceptance on a Form 111 - Injury and Hearing Loss:

      1. Within forty-five (45) days after the

notice of the scheduling order; and

      2. In accordance with Section 5(2)(b),

(c), and (d) of this administrative regulation.

      (b) In addition to the Form 111 - Injury

and Hearing Loss, a defendant shall file a special answer to raise any special

defenses in accordance with Section 5(2)(d) of this administrative regulation.

 

      Section 8. Discovery, Evidence, and

Exchange of Records. (1) Proof taking and discovery for all parties shall begin

from the date of issuance by the executive director of the scheduling order.

      (2)(a) Plaintiff and defendants shall

take proof for a period of sixty (60) days from the date of the scheduling

order;

      (b) After the sixty (60) day period,

defendants shall take proof for an additional thirty (30) days; and

      (c) After the defendant’s thirty (30) day

period, the plaintiff shall take rebuttal proof for an additional fifteen (15)

days.

      (3) During the pendency of a claim, any

party obtaining or possessing a medical or vocational report or records shall

serve a copy of the report or records upon all other parties within ten (10)

days following receipt of those reports or records or within ten (10) days of

receipt of notice if assigned to an administrative law judge.

      (4) All medical reports filed with Forms

101, 102-0D, or 103 shall be admitted into evidence without further order if:

      (a) An objection is not filed prior to or

with the filing of the Form 111; and

      (b) The medical reports comply with

Section 10 of this administrative regulation.

 

      Section 9. Vocational Reports. (1) A

vocational report may be filed by notice and shall be admitted into evidence

without further order and without the necessity of a deposition, if an

objection is not filed.

      (2) Vocational reports shall be signed by

the individual making the report.

      (3) Vocational reports shall include,

within the body of the report or as an attachment, a statement of the

qualifications of the person making the report.

      (4) An objection to the filing of a

vocational report shall:

      (a) Be filed within ten (10) days of the

filing of the notice or motion for admission; and

      (b) State the grounds for the objection

with particularity.

      (5) The administrative law judge shall

rule on the objection within fifteen (15) days.

      (6) If a vocational report is admitted as

direct testimony, an adverse party may depose the reporting vocational witness

in a timely manner as if on cross-examination at its own expense.

 

      Section 10. Medical Reports. (1) A party

shall not introduce direct testimony from more than two (2) physicians by

medical report except upon a showing of good cause and prior approval by an

administrative law judge.

      (2) Medical reports shall be submitted on

Form 107-I (injury), Form 107-P (psychological), Form 108-OD (occupational

disease), Form 108-CWP (coal workers' pneumoconiosis), or Form 108-HL (hearing

loss), as appropriate, except that an administrative law judge may permit the

introduction of other reports.

      (3) Medical reports shall be signed by

the physician making the report, or be accompanied by an affidavit from the

physician or submitting party or representative verifying the authenticity of

the report.

      (4) Medical reports shall include, within

the body of the report or as an attachment, a statement of qualifications of

the person making the report. If the qualifications of the physician who prepared

the written medical report have been filed with the executive director and the

physician has been assigned a medical qualifications index number, reference

may be made to the physicians index number in lieu of attaching qualifications.

      (5) Narratives in medical reports shall

be typewritten. Other portions, including spirometric tracings, shall be

clearly legible.

      (6)(a) Upon notice, a party may file the

testimony of two (2) physicians, either by deposition or medical report, which

shall be admitted into evidence without further order if an objection is not

filed.

      (b) Objection to the filing of a medical

report shall be filed within ten (10) days of the filing of the notice or the

motion for admission.

      (c) Grounds for the objection shall be stated

with particularity.

      (d) The administrative law judge shall

rule on the objection within fifteen (15) days of filing.

      (7) If a medical report is admitted as

direct testimony, an adverse party may depose the reporting physician in a

timely manner as if on cross-examination at its own expense.

 

      Section 11. Medical Evaluations Pursuant

to KRS 342.315. (1) All persons claiming benefits for hearing loss or

occupational disease other than coal workers' pneumoconiosis shall be referred

by the commissioner for a medical evaluation in accordance with contracts

entered into between the executive director and the University of Kentucky

and University of Louisville medical schools.

      (2) Upon all other claims except coal

workers' pneumoconiosis claims, the executive director or an administrative law

judge may direct appointment by the executive director of a university medical

evaluator.

      (3) Upon referral for medical evaluation

under this section, a party may tender additional relevant medical information

to the university medical school to whom the evaluation is assigned. This

additional information shall not be filed of record. The additional medical

information shall be:

      (a) Submitted to the university within

fourteen (14) days following an order for medical evaluation pursuant to KRS

342.315;

      (b) Submitted by way of medical reports,

notes, or depositions;

      (c) Clearly legible;

      (d) Indexed;

      (e) Furnished in chronological order;

      (f) Timely furnished to all other parties

within ten (10) days following receipt of the medical information; and

      (g) Accompanied by a summary that is

filed of record and served upon all parties. The summary shall:

      1. Identify the medical provider;

      2. Include the date of medical services;

and

      3. Include the nature of medical services

provided.

      (4) Upon the scheduling of an evaluation,

the executive director shall provide notice to all parties and the employer

shall forward to the plaintiff necessary travel expenses as required by KRS

342.315(4). Upon completion of the evaluation, the executive director shall

provide copies of the report to all parties and shall file the original report

in the claim record to be considered as evidence.

      (5) The administrative law judge shall

allow timely cross-examination of a medical evaluator appointed by the

executive director at the expense of the moving party.

      (6) Unjustified failure by the plaintiff

to attend the scheduled medical evaluation may be grounds for dismissal,

payment of a no-show fee, sanctions, or all of the above.

      (7) Failure by the employer or its

insurance carrier to pay travel expenses within seven (7) days of notification

of a scheduled medical evaluation may be grounds for imposition of sanctions.

 

      Section 12. Interlocutory Relief. (1)

During a claim, a party may seek interlocutory relief through:

      (a) Interim payment of income benefits

for total disability pursuant to KRS 342.730(1)(a);

      (b) Medical benefits pursuant to KRS

342.020; or

      (c) Rehabilitation services pursuant to

KRS 342.710.

      (2) Upon motion of any party, an informal

conference:

      (a) Shall be held to review the

plaintiff's entitlement to interlocutory relief; and

      (b) May be held telephonically.

      (3) Any response to a request for

interlocutory relief shall be served within twenty (20) days from the date of

the request and thereafter, the request shall be ripe for a decision.

      (4)(a) Entitlement to interlocutory

relief shall be shown by means of affidavit, deposition, or other evidence of

record demonstrating the requesting party:

      1. Is eligible under KRS Chapter 342; and

      2. Will suffer irreparable injury, loss

or damage pending a final decision on the application.

      (b) Rehabilitation services may be

ordered while the claim is pending upon showing that immediate provision of

services will substantially increase the probability that the plaintiff will

return to work.

      (5) If interlocutory relief is awarded in

the form of income benefits, the application shall be placed in abeyance unless

a party shows irreparable harm will result. The administrative law judge may require

periodic reports as to the physical condition of the plaintiff. Upon motion and

a showing of cause, or upon the administrative law judge's own motion,

interlocutory relief shall be terminated and the claim removed from abeyance.

      (6) An attorney's fee in the amounts

authorized by KRS 342.320 that does not exceed twenty (20) percent of the

weekly income benefits awarded pursuant to a request for interlocutory relief

may be granted. The approved fee shall be deducted in equal amounts from the

weekly income benefits awarded and shall be paid directly to the attorney.

      (7) A party seeking interlocutory relief

may use the following forms:

      (a) Motion for Interlocutory Relief, Form

MIR-1;

      (b) Affidavit for Payment of Medical

Expenses, Form MIR-2;

      (c) Affidavit for Payment of Temporary

Total Disability, Form MIR-3; and

      (d) Affidavit Regarding Rehabilitation

Services, Form MIR-4.

 

      Section 13. Benefit Review Conferences.

(1) The purpose of the benefit review conference shall be to expedite the

processing of the claim and to avoid if possible the need for a hearing.

      (2) The benefit review conference shall

be an informal proceeding.

      (3) The date, time, and place for the

benefit review conference shall be stated on the scheduling order issued by the

executive director.

      (4) The plaintiff and his or her

representative, the defendant or its representative, and the representatives of

all other parties shall attend the benefit review conference.

      (5) If the defendant is insured or a

qualified self-insured, a representative of the carrier with settlement

authority shall be present or available by telephone during the benefit review

conference.

      (6) The administrative law judge may upon

motion waive the plaintiff’s attendance at the benefit review conference for

good cause shown.

      (7) A transcript of the benefit review

conference shall not be made.

      (8) Representatives of all parties shall

have authority to resolve disputed issues and settle the claim at the benefit

review conference.

      (9)(a) The defendant shall provide a

completed Form AWW-1, Average Weekly Wage Certification.

      (b) The plaintiff shall bring copies of

unpaid medical bills and documentation of out-of-pocket expenses including

travel for medical treatments.

      (c) Each defendant shall bring copies of

disputed medical bills and medical expenses.

      (10) Ten (10) days before the benefit

review conference, the parties shall exchange final stipulations and lists of

known witnesses and exhibits that:

      (a) Name each proposed witness;

      (b) Summarize the anticipated testimony

of each witness;

      (c) For medical witnesses, include in the

summary:

      1. The diagnosis reached;

      2. Clinical findings and results of

diagnostic studies upon which the diagnosis is based;

      3. The functional impairment rating

assessed by the witness; and

      4. A description of any work-related

restrictions imposed; and

      (d) Identify any exhibits.

      (11) At the benefit review conference,

the parties shall:

      (a) Attempt to resolve controversies and

disputed issues;

      (b) Narrow and define disputed issues; and

      (c) Facilitate a prompt settlement.

      (12) A party seeking postponement of a

benefit review conference shall file a motion at least fifteen (15) days prior

to the date of the conference and shall demonstrate good cause for the

postponement.

      (13) If at the conclusion of the benefit

review conference the parties have not reached agreement on all the issues, the

administrative law judge shall:

      (a) Prepare a summary stipulation of all

contested and uncontested issues which shall be signed by representatives of

the parties and by the administrative law judge; and

      (b) Schedule a final hearing.

      (14) Only contested issues shall be the

subject of further proceedings.

      (15) Upon motion with good cause shown,

the administrative law judge may order that additional discovery or proof be

taken between the benefit review conference and the date of the hearing and may

limit the number of witnesses to be presented at the hearing.

 

      Section 14. Evidence - Rules Applicable.

(1) The Rules of Evidence prescribed by the Kentucky Supreme Court shall apply

in all proceedings before an administrative law judge except as varied by

specific statute and this administrative regulation.

      (2) Any party may file as evidence before

the administrative law judge pertinent material and relevant portions of

hospital, educational, Office of Vital Statistics, Armed Forces, Social Security,

and other public records. An opinion of a physician which is expressed in these

records shall not be considered by an administrative law judge in violation of

the limitation on the number of physician's opinions established in KRS

342.033.

 

      Section 15. Extensions of Proof Time. (1)

An extension of time for producing evidence may be granted upon showing of

circumstances that prevent timely introduction.

      (2) A motion for extension of time shall

be filed no later than five (5) days before the deadline sought to be extended.

      (3) The motion or supporting affidavits

shall set forth:

      (a) The efforts to produce the evidence

in a timely manner;

      (b) Facts which prevented timely

production; and

      (c) The date of availability of the

evidence, the probability of its production, and the materiality of the

evidence.

      (4) In the absence of compelling

circumstances, only one (1) extension of thirty (30) days shall be granted to

each side for completion of discovery or proof by deposition.

      (5) The granting of an extension of time

for completion of discovery or proof shall:

      (a) Enlarge the time to all:

      1. Plaintiffs if the extension is granted

to a plaintiff; and

      2. Defendants if an extension is granted

to a defendant; and

      (b) Extend the time of the adverse party

automatically except if the extension is for rebuttal proof.

 

      Section 16. Stipulation of Facts. (1)

Refusal to stipulate facts which are not genuinely in issue shall warrant

imposition of sanctions as established in Section 24 of this administrative

regulation. An assertion that a party has not had sufficient opportunity to

ascertain relevant facts shall not be considered "good cause" in the

absence of due diligence.

      (2) Upon cause shown, a party may be

relieved of a stipulation if the motion for relief is filed at least ten (10)

days prior to the date of the hearing, or as soon as practicable after

discovery that the stipulation was erroneous.

      (3) Upon granting relief from a

stipulation, the administrative law judge may grant a continuance of the

hearing and additional proof time.

 

      Section 17. Discovery and Depositions.

(1) Discovery and the taking of depositions shall be in accordance with the

provisions of Civil Rules 26 to 37, inclusive, except for Civil Rules 27, 33,

and 36 which shall not apply to practice before the administrative law judges

or the board.

      (2) Depositions may be taken by telephone

if the reporter administering the oath to the witness and reporting the

deposition is physically present with the witness at the time the deposition is

given. Notice of a telephonic deposition shall relate the following

information:

      (a) That the deposition is to be taken by

telephone;

      (b) The address and telephone number from

which the call will be placed to the witness;

      (c) The address and telephone number of

the place where the witness will answer the deposition call; and

      (d) Opposing parties may participate in

the deposition either at the place where the deposition is being given, at the

place the telephone call is placed to the witness, or by conference call. If a

party elects to participate by conference call, that party shall contribute

proportionate costs of the conference call.

      (3) The executive director shall

establish a medical qualifications index.

      (a) An index number shall be assigned to

a physician upon the filing of the physician's qualifications.

      (b) Any physician who has been assigned

an index number may offer the assigned number in lieu of stating

qualifications.

      (c) Qualifications shall be revised or

updated by submitting revisions to the executive director.

      (d) A party may inquire further into the

qualifications of a physician.

 

      Section 18. Hearings. (1) At the hearing,

the parties shall present proof concerning contested issues. If the plaintiff

or plaintiff's counsel fails to appear, the administrative law judge may

dismiss the case for want of prosecution, or if good cause is shown, the

hearing may be continued.

      (2) At the conclusion of the hearing, the

claim shall be taken under submission immediately or briefs may be ordered.

      (3) Briefs shall not exceed fifteen (15)

pages in length. Reply briefs shall be limited to five (5) pages. Permission to

increase the length of a brief shall be sought by motion.

      (4) The administrative law judge may

announce his decision at the conclusion of the hearing or shall defer decision

until rendering a written opinion.

      (5) A decision shall be rendered no later

than sixty (60) days following the hearing.

      (6) The time of filing a petition for

reconsideration or notice of appeal shall not begin to run until after the

"date of filing" of the written opinion.

      (7) An opinion or other final order of an

administrative law judge shall not be deemed final until the administrative law

judge has certified that a certification of mailing was sent to:

      (a) An attorney who has entered an

appearance for a party; or

      (b) The party if an attorney has not

entered an appearance.

      (8) The parties with approval of the

administrative law judge may waive a final hearing. Waiver of a final hearing

shall require agreement of all parties and the administrative law judge. The

claim shall be taken under submission as of the date of the order allowing the

waiver of hearing. A decision shall be rendered no later than sixty (60) days

following the date of the order allowing the waiver of hearing.

 

      Section 19. Petitions for

Reconsideration. (1) If applicable, a party shall file a petition for

reconsideration within fourteen (14) days of the filing of a final order or

award of an administrative law judge, clearly stating the patent error which

the petitioner seeks to have corrected and setting forth the authorities upon

which petitioner relies. The party filing the petition for reconsideration

shall tender a proposed order granting the relief requested.

      (2) A response shall be served within ten

(10) days after the date of filing of the petition.

      (3) The administrative law judge shall

act upon the petition within ten (10) days after the response is due.

 

      Section 20. Benefit Calculations for

Settlements. (1) For computing lump sum settlements, the employer shall utilize

the prescribed discount rate for its weeks of liability only, not for the

entire award period. A discount shall not be taken on past due benefits by the

employer or Special Fund. Lump sum settlements shall be calculated as follows:

      (a) Determine the entire lump sum

liability:

      1. Compute the remaining weeks of

liability in the award by subtracting the number of weeks past due from the

entire number of weeks in the award;

      2. Discount the number of weeks remaining

in the award at the prescribed discount rate;

      3. Multiply the weekly benefit rate by

the discounted number of weeks remaining (subparagraph 2 of this paragraph) in

the award. This product shall equal the entire future lump sum liability for

the award; and

      4. Add the amount of past due benefits to

the future lump sum liability award (subparagraph 3 of this paragraph). The sum

shall represent the entire lump sum value of the award.

      (b) Determine the employer's lump sum

liability as follows:

      1. The employer's future liability shall

be computed by determining its total weeks of liability less the number of

weeks of liability past due.

      2. The number of weeks remaining shall be

discounted at the prescribed discount rate and multiplied by the amount of the

weekly benefit.

      3. Multiply the number of past due weeks

by the amount of the weekly benefit.

      4. The employer's entire liability for a

lump sum payment shall be determined by adding the results of subparagraphs 2

and 3 of this paragraph.

      (c) Determine the Special Fund's portion

of the lump sum liability by subtracting the value of the employer's liability

in lump sum (paragraph (b) of this subsection) from the entire value of the

lump sum settlement (paragraph (a) of this subsection). The remainder shall be

the Special Fund's lump sum liability.

      (2) If the employer settles its liability

for income benefits with the employee for a lump sum payment and a

determination is made of the Special Fund's liability, the Special Fund's

portion of income benefits shall be paid commencing with the date of approval

of the employer's settlement and continuing for the balance of the compensable

period.

      (3) In computing settlements involving

periodic payments, the employer shall pay its liability over the initial

portion of the award, based on the number of weeks its liability bears to the

entire liability for the claim. The Special Fund shall make all remaining

payments for the balance of the compensable period.

      (4) Pursuant to KRS 342.265, election by

the Special Fund to settle on the same terms as the employer shall mean the

Special Fund agrees to settle in the same manner as the employer in either a discounted

lump sum or in periodic payments based upon its proportionate share of the

permanent disability percentage paid by the employer. "Same terms"

shall not include any additional payments the employer included for buy out of

medical expenses, temporary total disability, rehabilitation, or other benefits

for which the Special Fund is not liable.

      (5) Parties involved in a lump-sum

settlement of future periodic payments shall use the discount factor computed

in accordance with KRS 342.265(3).

      (6) Parties who reach an agreement pursuant

to KRS 342.265 shall file the agreement on the applicable form as listed below:

      (a) Form 110-F, Agreement as to

Compensation and Order Approving Settlement- Fatality;

      (b) Form 110-I, Agreement as to

Compensation and Order Approving Settlement- Injury;

      (c) Form 110-O, Agreement as to

Compensation and Order Approving Settlement - Occupational Disease; or

      (d) Form 110-CWP, Agreement as to

Compensation and Order Approving Settlement - Coal Workers' Pneumoconiosis.

 

      Section 21. Review of Administrative Law

Judge Decisions. (1) General.

      (a) Pursuant to KRS 342.285(1), decisions

of administrative law judges shall be subject to review by the Workers’ Compensation

Board in accordance with the procedures set out in this administrative regulation.

      (b) Parties shall insert the language

"Appeals Branch" or "Workers’ Compensation Board" on the

outside of an envelope containing documents filed in an appeal to the board.

      (2) Time and format of notice of appeal.

      (a) Within thirty (30) days of the date a

final award, order, or decision rendered by an administrative law judge

pursuant to KRS 342.275(2) is filed, any party aggrieved by that award, order,

or decision may file a notice of appeal to the Workers’ Compensation Board.

      (b) As used in this section, a final

award, order or decision shall be determined in accordance with Civil Rule

54.02(1) and (2).

      (c) The notice of appeal shall:

      1. Denote the appealing party as the

petitioner;

      2. Denote all parties against whom the

appeal is taken as respondents;

      3. Name the administrative law judge who

rendered the award, order, or decision appealed from as a respondent;

      4. If appropriate pursuant to KRS 342.120

or 342.1242, name the director of the Division of Workers’ Compensation Funds

as a respondent; and

      5. Include the claim number.

      (d) Cross-appeal.

      1. Any party may file a cross-appeal

through notice of cross-appeal filed within ten (10) days after the notice of

appeal is served.

      2. A cross-appeal shall designate the

parties as stated in the notice of appeal.

      (e) Failure to file the notice within the

time allowed shall require dismissal of the appeal.

      (f) The executive director shall issue an

acknowledgement to all parties of the filing of a notice of appeal or

cross-appeal.

      (3) Number of copies and format of

petitioner's brief.

      (a) The petitioner's brief shall be filed

within thirty (30) days of the filing of the notice of appeal.

      (b) An original and two (2) copies of the

petitioner's brief shall be filed with the Executive Director of the Office of

Workers’ Claims.

      (c) The petitioner's brief shall conform

in all respects to Civil Rule 7.02(4).

      (4) Petitioner's brief. The petitioner's

brief shall designate the parties as petitioner (or petitioners) and respondent

(or respondents) and shall be drafted in the following manner:

      (a)1. The name of each petitioner and

each respondent shall be included in the brief.

      2. The petitioner shall specifically

designate as respondents all adverse parties.

      3. The administrative law judge who

rendered the award, order, or decision appealed from shall be named as a

respondent.

      (b) The workers’ compensation claim

number, or numbers, shall be set forth in all pleadings before the Workers’

Compensation Board.

      (c) The petitioner's brief shall state

the date of entry of the final award, order, or decision by the administrative

law judge.

      (d) The petitioner's brief shall state

whether any matters remain in litigation between the parties in any forum or

court other than those for which an appeal is being sought.

      (e) The petitioner's brief shall include

a "Need for Oral Argument" designating whether the party requests an

argument to be heard orally before the board and, if so, a brief statement

setting out the reason or reasons for the request.

      (f) The petitioner's brief shall include

a "Statement of Benefits Pending Review" which shall set forth

whether the benefits designated to be paid by the award, order, or decision for

which review is being sought have been instituted pursuant to KRS 342.300.

      (g) The organization and contents of the

petitioner's brief for review shall be as follows:

      1. A brief "Introduction" shall

indicate the nature of the case.

      2. A "Statement of Points and

Authorities" shall set forth, succinctly and in the order in which they

are discussed in the body of the argument, the petitioner’s contentions with

respect to each issue of law on which he relies for a reversal, listing under

each the authority cited on that point and the respective pages of the brief on

which the argument appears and on which the authorities are cited. This requirement

may be eliminated for briefs of five (5) or less pages.

      3. A "Statement of the Case"

shall consist of a chronological summary of the facts and procedural events

necessary to an understanding of the issues presented by the appeal, with ample

reference to the specific pages of the record supporting each of the statements

narrated in the summary.

      4. An "Argument" shall:

      a. Conform with the statement of points

and authorities, with ample supportive references to the record and citations

of authority pertinent to each issue of law; and

      b. Contain, at the beginning of the

argument, a statement with reference to the record showing whether the issue

was properly preserved for review and, if so, in what manner.

      5. A "Conclusion" shall set

forth the specific relief sought from the board.

      6. An "Appendix" shall contain:

      a. Copies of the final award, order, or

decision of the administrative law judge from which review is being sought;

      b. Any petitions for reconsideration filed

by the parties pursuant to KRS 342.281;

      c. The administrative law judge’s order

addressing any petitions for reconsideration;

      d. Copies of cases cited from federal

courts and foreign jurisdictions, if any, upon which reliance is made; and

      e. Copies of prior board opinions in accordance

with subsection (9) of this section.

      7. Civil Rule 76.28(4)(c) shall govern

the use of unpublished opinions of the Court of Appeals or Supreme Court.

      (5) Respondent's brief, combined brief,

or cross-petitioner's brief.

      (a) Each respondent shall file an

original and two (2) copies of a brief, combined brief if cross-petition or

cross-petitioner's brief, within thirty (30) days of the date on which the

petitioner's brief was filed with the Executive Director of the Office of

Workers’ Claims.

      (b) The respondent's brief shall include

a "Need for Oral Argument" similar to the statement required of the

petitioner by subsection (4)(e) of this section.

      (c) The respondent's brief shall include

a "Statement of Benefits Pending Review" similar to the statement

required of the petitioner by subsection (4)(f) of this section.

      (d) Respondent’s counter-argument shall

follow the organization and content of the petitioner's brief as set forth in

subsection (4)(g) of this section.

      (6) Reply brief.

      (a) If applicable, the petitioner may

file a reply brief within ten (10) days after the date on which the

respondent's brief was served or due, whichever is earlier.

      (b) The organization and contents of the

reply brief shall be as provided in Civil Rule 76.12(4)(e), except that an

index, or contents page shall not be required.

      (c) If a cross-appeal has been filed, the

cross-petitioner's reply brief may be served within ten (10) days after the

date on which the last cross-respondent's brief was served or due, whichever is

earlier.

      (7) Certification. The petitioner's

brief, respondent's brief, and reply brief shall be signed by each party or his

counsel and that signature shall constitute a certification that the statements

contained in the document are true and made in good faith.

      (8) Service of notice of appeal,

cross-appeal, petitioner's brief, respondent's brief, and reply briefs on

adverse parties.

      (a) Before filing a notice of appeal,

cross-appeal, or any brief with the Executive Director of the Office of

Workers’ Claims, a party shall serve, in the manner provided by Civil Rule

5.02, a copy of the document on each adverse party.

      (b) Every brief filed in an appeal to the

Workers' Compensation Board shall bear, on the front cover, a signed statement,

in accordance with Civil Rule 5.03 by the attorney or party that service has

been made as required by paragraph (a) of this subsection. The statement shall

identify by name each person served.

      (c) The name of each attorney submitting

a document to the Workers' Compensation Board with a current address and telephone

number shall appear following its "conclusion".

      (d) If the respondent is also a

cross-petitioner, the respondent may file a combined brief or separate

cross-petitioner's brief which shall address issues raised by the cross-appeal.

      (e) If a separate cross-petitioner's

brief is filed, the format shall be the same as a respondent's brief.

      (9) Form of citations.

      (a) All citations of Kentucky statutes

and reported decisions of the Court of Appeals and Supreme Court shall conform

to the requirements of Civil Rule 76.12(4)(g).

      (b) All citations of Kentucky unpublished

decisions shall conform to the requirements of Civil Rule 76.28(4)(c).

      (c) Citations for prior decisions of the

board shall include the style of the case, the appropriate claim or case number,

and the date the decision was rendered.

      (10) Number of pages.

      (a) The petitioner's brief and the

respondent's brief shall be limited to twenty (20) pages each.

      (b) Reply briefs shall be limited to five

(5) pages.

      (c) Combined briefs shall be limited to

twenty-five (25) pages.

      (d) The parties shall make every effort

to comply with the above page limitations.

      (e) Permission to increase the length of

a brief shall be sought by motion, but shall only be granted upon a showing of

good cause.

      (11) Sanctions. Failure of a party to

file a brief conforming to the requirements of this administrative regulation

or failure of a party to timely file a response may be grounds for the imposition

of one (1) or more of the following sanctions:

      (a) Affirmation or reversal of the final

order;

      (b) Rejection of a brief that does not

conform as to organization or content, with leave to refile in proper form

within ten (10) days of the date returned. If timely refiling occurs, the

filing shall date back to the date of the original filing;

      (c) Striking of an untimely response;

      (d) A fine of not more than $500; or

      (e) Dismissal.

      (12) Motions.

      (a) Except for a brief, a motion or

pleading shall require the original to be filed with the Executive Director of

the Office of Workers’ Claims.

      (b) The style of the case, including the

claim number and title of the motion or pleading, shall appear on the first

page of the motion or pleading.

      (c) The party filing a motion may file a

brief memorandum supporting the motion and opposing parties may file brief

memoranda in response. To be considered, a response shall be filed within ten

(10) days of the motion. Further responses shall not be filed.

      (d) Every motion and response, the

grounds of which depend upon the existence of facts not in evidence, shall be

supported by affidavits demonstrating those facts.

      (e) Every motion and response, the

grounds of which depend upon the existence of facts which the moving or

responding party believes are shown in the evidence or are admitted by the pleadings,

shall make reference to the place in the record where that evidence or admission

is found.

      (f) Before filing a motion or pleading

with the Executive Director of the Office of Workers’ Claims, a party shall

serve, in the manner provided by Civil Rule 5.02, a copy of the document on

each adverse party.

      (g) The filing of a motion to dismiss an

appeal shall stay the remaining time for the filing of a responsive pleading.

If the petitioner's brief has been previously filed and a motion to dismiss has

been overruled, the respondent shall have fifteen (15) days from the order to

file a respondent's brief.

      (h) Except for motions that call for

final disposition of an appeal, any board member designated by the chairman may

dispose of a motion. An intermediate order may be issued on the signature of

any board member.

      (13) Oral arguments.

      (a) Upon motion of a party or upon the

board’s own motion, the board may order an oral argument on the merits in a

case appealed from a decision, award or order of an administrative law judge.

      (b) Oral arguments shall occur on a date

and at a time and location specified by the board.

      (c) Appeals designated for oral argument

shall be held in abeyance and all subsequent appeal time in the case shall be

calculated from the date of the oral argument.

      (14) Continuation of benefits pending

appeal.

      (a) Benefits awarded by an administrative

law judge which are not contested shall be paid during the pendency of an

appeal. A motion requesting the payment of these benefits shall not be

required. Uncontested benefits shall include income benefits at an amount

lesser than what was awarded if the issue on appeal addresses the amount of

benefits to be awarded as opposed to the entitlement to income benefits.

      (b) Upon the motion of a party pursuant

to KRS 342.300, the board may order payment of benefits pending appeal in conformity

with the award, decision, or order appealed from.

      (c) Entitlement to relief pursuant to KRS

342.300 shall be granted upon motion establishing that:

      1. The probability of the existence in

fact of:

      a. Financial loss;

      b. Privation, suffering, or adversity

resulting from insufficient income; or

      c. Detriment to the moving party’s

property or health if payment of benefits is not instituted; and

      2. There exists a reasonable likelihood

that the moving party will prevail on appeal.

      (d) Any response to a motion for

continuation of an award pending appeal shall be served within ten (10) days

from the date of the request and, thereafter, the request shall be ripe for a

decision.

      (e) Entitlement to relief by the moving

party and responses shall be shown by:

      1. Affidavit if the grounds for the

motion or response depend upon the existence of facts not in evidence; or

      2. Supporting memorandum citing to

evidence existing within the record and making reference to the place in the

record where that evidence is found.

      (15) Decisions.

      (a) The board shall:

      1. Enter its decision affirming, modifying,

or setting aside the order appealed from; or

      2. Remand the claim to an administrative

law judge for further proceedings.

      (b) Motions for reconsideration shall not

be permitted.

      (c) The decision of the administrative

law judge shall be affirmed if:

      1. A board member is unable to sit on a

decision; and

      2. The remaining two (2) board members

cannot reach an agreement on a final disposition.

      (16) Appeal from board decisions. If

applicable, pursuant to KRS 342.290, the decision of the board shall be

appealed to the Kentucky Court of Appeals as provided in Civil Rule 76.25.

 

      Section 22. Coverage - Insured Status.

Upon the filing of an application for resolution of claim, the executive

director shall ascertain whether the employer or any other person against whom

a claim is filed and who is not exempted by KRS 342.650 has secured payment of

compensation by obtaining insurance coverage or qualifying as a self-insurer

pursuant to KRS 342.340. If an employer does not have insurance coverage or

qualify as a self-insurer, the executive director shall notify the

administrative law judge and all parties by service of a certification of no

coverage.

 

      Section 23. Withdrawal of Records. (1) A

portion of any original record of the office shall not be withdrawn except upon

an order of the executive director, an administrative law judge, or a member of

the board.

      (2)(a) All physical exhibits, including

x-rays, shall be disposed of sixty (60) days after the order resolving the

claim has become final except x-rays filed in coal workers' pneumoconiosis

claims which shall be returned to the party who filed the x-ray.

      (b) A party filing an exhibit may make

arrangements to claim an exhibit prior to that time.

      (c)1. If an unclaimed exhibit has no

money value, it shall be destroyed.

      2. If an unclaimed exhibit has a value of

more than $100, it shall be sold as surplus property.

      3. If an unclaimed exhibit has a value of

less than $100, it shall be donated to the appropriate state agency.

      4. If an unclaimed exhibit has historic

value, it shall be sent to the state archives.

 

      Section 24. Sanctions. (1) Pursuant to

KRS 342.310, an administrative law judge or the board may assess costs upon a

determination that the proceedings have been brought, prosecuted, or defended

without reasonable grounds.

      (2) A sanction may be assessed against an

offending attorney or representative rather than against the party.

      (3) If a party is a governmental agency

and attorney's fees are assessed, the fees shall include fees for the services

of an attorney in public employment, measured by the reasonable cost of similar

services had a private attorney been retained.

      (4) Failure of a party to timely file a

pleading or document or failure to comply with the procedures required by this

administrative regulation may be treated by an administrative law judge or the

board as prosecuting or defending without reasonable grounds.

 

      Section 25. Payment of Compensation from

Uninsured Employers' Fund. (1) Payment from the Uninsured Employers' Fund of

compensation shall be made upon the determination by an administrative law

judge that the responsible employer failed to secure payment of compensation as

provided by KRS 342.340; and

      (a) Thirty (30) days have expired since

the finality of an award or issuance of an interlocutory relief order and a

party in interest certifies the responsible employer has failed to initiate

payments in accordance with that award;

      (b) Upon showing that the responsible

employer has filed a petition under any section of the Federal Bankruptcy Code;

or

      (c) The plaintiff or any other party in

interest has filed in the circuit court of the county where the injury occurred

an action pursuant to KRS 342.305 to enforce payment of the award against the

uninsured employer, and there has been default in payment of the judgment by

the employer.

      (2) The plaintiff may by motion and

affidavit demonstrate compliance with this section and request an

administrative law judge to order payment from the Uninsured Employers' Fund in

accordance with KRS 342.760.

      (3) This section shall not be construed

to prohibit the voluntary payment of compensation by an employer, or any other

person liable for the payment, who has failed to secure payment of compensation

as provided by KRS Chapter 342, the compromise and settlement of a claim, or

the payment of benefits by the Special Fund or Coal Workers' Pneumoconiosis

Fund.

      (4) Form UEF-P, Motion for Payment from

Uninsured Employers' Fund, provided by the office may be used by the employee.

 

      Section 26. Forms. The Office of Workers'

Claims shall not accept applications or forms in use prior to the forms

required by and incorporated by reference in this administrative regulation.

Outdated applications or forms submitted shall be rejected and returned to the

applicant or person submitting the form. If the application or form is

resubmitted on the proper form within twenty (20) days of the date it was

returned, the filing shall date back to the date the application or form was

first received by the executive director. Otherwise, the date of the second

receipt shall be the filing date.

 

      Section 27. Incorporation by Reference.

(1) The following material is incorporated by reference:

      (a) Form 101, "Application for

Resolution of Injury Claim", (revised April 2006), Office of Workers'

Claims;

      (b) Form 102-0D, "Application for

Resolution of Occupational Disease Claim", (revised June, 2005), Office of

Workers' Claims;

      (c) Form 103, "Application for

Resolution of Hearing Loss Claim", (June 2005 Edition), Office of Workers'

Claims;

      (d) Form 104, "Plaintiff's

Employment History", (January 1, 1997 Edition), Office of Workers' Claims;

      (e) Form 105, "Plaintiff's

Chronological Medical History", (January 1, 1997 Edition), Office of

Workers' Claims;

      (f) Form 106, "Medical Waiver and

Consent", (July 2003 Edition), Office of Workers' Claims;

      (g) Form 107-I, "Medical Report -

Injury", (revised April 2005), Office of Workers' Claims;

      (h) Form 107-P, "Medical Report -

Psychological", (revised April 2005), Office of Workers' Claims;

      (i) Form 108-OD, "Medical Report -

Occupational Disease, (April 2005 Edition), Office of Workers' Claims;

      (j) Form 108-CWP, "Medical Report -

Coal Workers' Pneumoconiosis", (April 2005 Edition), Office of Workers'

Claims;

      (k) Form 108-HL, "Medical Report -

Hearing Loss", (revised April 2005), Office of Workers' Claims;

      (l) Form 109, "Attorney Fee

Election", (March 15, 1995 Edition), Office of Workers' Claims;

      (m) Form 110-F, "Agreement as to

Compensation and Order Approving Settlement -Fatality", (revised January

2005);

      (n) Form 110-I, "Agreement as to

Compensation and Order Approving Settlement - Injury", (revised July

2006), Office of Workers' Claims;

      (o) Form 110-O, "Agreement as to

Compensation and Order Approving Settlement - Occupational Disease",

(revised July 2006), Office of Workers' Claims;

      (p) Form 110-CWP, "Agreement as to

Compensation and Order Approving Settlement - Coal Workers'

Pneumoconiosis", (July 2002 Edition), Office of Workers' Claims;

      (q) Form 111- Injury and Hearing Loss,

"Notice of Claim Denial or Acceptance", (January 1, 1997 Edition),

Office of Workers' Claims;

      (r) Form 111-OD, "Notice of Claim

Denial or Acceptance", (January 1, 1997 Edition), Office of Workers'

Claims;

      (s) Form 115, "Social Security Release

Form", (January 1, 1997 Edition); and Office of Workers' Claims;

      (t) Form AWW - 1, "Average Weekly

Wage Certification ", (January 1, 1997 Edition), Office of Workers'

Claims;

      (u) Form MIR-1, Motion for Interlocutory

Relief (May 29, 1997 Edition);

      (v) Form MIR-2, Affidavit for Payment of

Medical Expenses (May 29, 1997 Edition);

      (w) Form MIR-3, Affidavit for Payment of

Temporary Total Disability (May 29, 1997 Edition);

      (x) Form MIR-4, Affidavit Regarding

Rehabilitation Services (May 29, 1997 Edition);

      (y) Form VRT, Petition for Vocational

Rehabilitation Training (April 2005 Edition);

      (z) Form MTR-1, Motion to Reopen by

Employee (May 29, 1997 Edition);

      (aa) Form MTR-2, Motion to Reopen KRS

342.732 Benefits (May 29, 1997 Edition);

      (bb) Form MTR-3, Motion to Reopen by

Defendant (May 29, 1997 Edition);

      (cc) Form WVR, Joint Motion and Agreement

to Waive Vocational Rehabilitation Evaluation (April 2005 Edition);

      (dd) Form UEF-P, Motion for Payment from

Uninsured Employers' Fund (April 2005 Edition); and

      (ee) Form 11, Motion to Substitute Party

and Continue Benefits (January 31, 2005).

      (2) This material may be inspected,

copied, or obtained, subject to applicable copyright law, at the Office of

Workers' Claims, Prevention Park, 657 Chamberlin Avenue, Frankfort, Kentucky

40601, Monday through Friday, 8 a.m. to 4:30 p.m. (21 Ky.R. 2576; Am. 3032;

eff. 6-15-95; 22 Ky.R. 2071; eff. 7-5-96; 23 Ky.R. 3958; 24 Ky.R. 349; eff.

7-17-97; 24 Ky.R. 2436; eff. 7-13-98; 27 Ky.R. 1084; 1478; eff. 12-21-2000; 28

Ky.R. 1216; 1638; eff. 1-14-02; 29 Ky.R. 552; 945; eff. 10-16-2002; 30 Ky.R.

94; 648; eff. 10-31-03; 32 Ky.R. 142; 487; eff. 10-7-05; 33 Ky.R. 236; 770;

eff. 10-6-06.)