WHAT TO DO IF AN ACCIDENT OCCURS ON THE JOB
1. Tell your supervisor immediately that you were hurt on the job.
2. Follow your supervisor' s instructions on getting medical aid.
3. Follow the doctor' s instructions.
4. Within 200 days of the date of the accident or the date of last payment of compensation for disability or authorized medical care, tell your
agency in writing that you expect workers compensation benefits for your injury. Your agency might know you were hurt and compensation
may be paid, however, you could lose all rights to future compensation if you do not tell the agency in writing. This is called a Written Claim.
Written claim may be served in person by taking it to the agency and getting a receipt for it or by mailing it to the agency by certified mail,
return receipt requested. The receipt is generally sufficient proof that you sent written claim.
AVERAGE WEEKLY WAGE
A worker' s "average weekly wage" is calculated by adding together the base wage, the average weekly overtime and the weekly value of fringe benefits that have been discontinued.
WEEKLY BENEFITS
Disability Benefits for state employees are paid by the State Self-Insurance Fund, Room 951S, Landon State Office Building, Topeka, KS 66612. Injured workers are not entitled to compensation for the first week they are off work
unless they lose three consecutive weeks. The first compensation payment is normally due on the next payday of the pay period in which the injury occurred.
SSIF Form-27 (9-99)
An injured employee is entitled to a weekly amount of 66 2/ 3 percent of the average weekly wage up to a maximum amount as set by state law. If an injury results in permanent impairment, the statute provides for additional disability
and medical benefits.
MEDICAL BENEFITS
An injured worker is entitled to all medical services reasonably necessary to cure and relieve the effects of injury. The employer has the right to select the doctor who will treat the injury. In some areas, the injured worker will be
directed to a contract provider. Ask your agency following an injury if there is a contracted provider in your area. If not, an injured employee may see their primary care provider unless otherwise directed. A worker may seek the
services of any other provider, but those services provided may be considered unauthorized and payment will be limited to $500. A worker may apply to the Workers Compensation Director to change the authorized treating
doctor. Any selection will be limited to one of three providers submitted by the Employer. Reimbursement for travel to obtain medical treatment is payable at a mileage rate set by law. Round trips that are five miles or longer are
reimbursable.
RESPONSIBILITIES OF THE AGENCY
1. Upon receiving notice of injury, agencies must provide employees with written information to assist injured workers in obtaining
compensation.
2. Agencies must report all employee injuries to the State Self-Insurance Fund immediately by mailing Form 1101-A to SSIF, 900 SW Jackson,
Room 951S, Landon State Office Building, Topeka, KS 66612 or by faxing this form to 785-296-6995.
3. The State of Kansas is a self-insured, self-administrative employer. All benefits are paid by the State Self-Insurance Fund.
4. The State Self-Insurance Fund provides payment of workers compensation benefits without charge to employees.
5. Agencies will post written notice of workers compensation coverage in both Spanish and English.
STATE SELF-INSURANCE FUND
The State Self-Insurance Fund office is located at Room 951S, Landon State Office Building, 900 SW Jackson, Topeka, KS 66612. The telephone number is 785-296-2364 and the Fax number is 785-296-6995. You may inquire about your claim by asking for the adjuster handling your claim. If you do not know your
adjuster, the receptionist will identify the adjuster and transfer you.
FRAUD AND ABUSE
The Workers Compensation Act contains penalties for acts of fraud or abuse. If you know of anyone who is making false reports, working while drawing disability benefits, or otherwise abusing the workers compensation system,
please report such activity by calling (785) 296-2364. SSIF Form-27 (9-99)