Oklahoma
Healing Period
ü Temporary total disability benefits are payable during the healing period.
ü Healing period benefits are payable in addition to permanent partial
disability benefits.
ü Healing period benefits are terminated when the claimant:
§ Reaches 156 weeks in the aggregate, except for good cause shown
§ Reaches maximum medical improvement (MMI)
§ Returns to gainful employment
If the worker has filed a claim for compensation with the court, the
employer may terminate TTD without the court’s involvement if one of
the following occurs:
§ The worker returns to full-time employment with that employer
§ The worker files a permanent disability rating report (i.e. requests a trial
to determine permanent disability)
§ The employee and employer voluntarily agree in writing to terminate
payment of TTD
§ A court-appointed independent medical examiner determines the worker
has reached MMI and is released from active medical care with or
without restrictions.
TTD also can be terminated with the filing of a motion to terminate if there is
no objection from the injured worker. In all other instances, TTD may be
terminated only upon court order.
ü MMI is defined by statute. Specifically, under 85 O.S., Sec. 3(19)
“Maximum Medical Improvement” means that no further material
improvement would reasonably be expected from medical treatment or the
passage of time.
Schedule vs. Non-schedule Compensation
ü Certain permanent partial injuries are compensated according to a
schedule.
ü Certain permanent partial injuries are compensated on a non-schedule
basis. The basis for non-schedule benefits is weeks payable related to
impairment rating of the whole person.
ü Non-schedule benefits are payable in addition to schedule benefits for the
same injury. For example, an injured worker may sustain injury resulting
in 8% PPD to the leg (schedule) or 21 weeks of benefits, and also sustain
injury to the lumbar spine resulting in 15% PPD to the body (unscheduled)
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or 75 weeks of benefits, both from the same incident. The worker would
be entitled to benefits for 96 weeks for PPD over and above TTD benefits.
ü “Disfigurement benefits in an amount to be determined by the Workers’
Compensation Court, but not in excess of $20,000, are payable, provided
that compensation for permanent disfigurement shall not be in addition to
the other compensation provided for in the schedule of benefits but shall
be taken into consideration in fixing the compensation otherwise
provided.” See 85 O.S., Sec. 22.
Impairment Ratings
ü Medical doctors are not the only medical providers authorized to evaluate
permanent impairment. Oklahoma’s survey response lists other categories
of providers with authorization.
ü Final disability ratings for PPD benefits are based solely on medical
impairment ratings.
ü Objective guidelines are used for the determination of medical impairment
ratings for non-schedule injuries. In all cases except impairments to
“scheduled members,” the medical evaluation of permanent impairment
must be performed in substantial compliance with the edition of the AMA
Guides in effect at the time of injury. 85 O.S., Secs. 3(16) and 22(3).
Physicians are prohibited from deviating from the Guides unless
authorized by the Guides or by recommendations of the Physician
Advisory Committee (85 O.S., Sec. 201.1) adopted by the Court
Administrator as provided by law. Physicians may use any reasonable
medical criteria, including the AMA Guides or subjective opinion, to
evaluate permanent impairment of scheduled members.
Benefit Payments
ü There are offsets or reductions to PPD benefits for overpayment of TTD
benefits.
ü PPD benefits are limited to 500 weeks for non-scheduled injuries. Benefits
for schedule injuries are limited to the number of weeks specified per body
part (maximum duration for scheduled injuries is 275 weeks – for loss of
one arm, or one leg, or one eye).
ü Weekly PPD benefits are not subject to annual cost-of-living adjustment.
Dispute Resolution
ü The most common areas of dispute in PPD cases include:
§ Nature and extent of disability
§ Whether the injury arose out of and in the course of employment
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§ Permanency
ü There are procedures to expedite the resolution of disputes prior to a
formal hearing. These include:
§ Prehearing Conferences
§ Judicial Settlement Conferences
§ Voluntary Mediation
§ Ombudsman Program
Prehearing conferences are informal, in-person meetings between the
parties and the assigned trial judge to address a wide variety of issues.
The conference may be used to discuss settlement of the case or issues
related to the case, or to determine issues in dispute.
Judicial settlement conferences permit an informal discussion between the
parties, attorneys, and the settlement judge on every aspect of the case
bearing on its settlement value in an effort to resolve the matter before
trial. The settlement judge is a judge other than the assigned trial judge.
The Oklahoma survey response also mentioned voluntary settlements,
agreed statements of facts, and voluntary dismissals as additional dispute
resolution mechanisms.
ü Dispute resolution and/or formal hearings are required by statute to be
conducted within certain time limits. Workers have three (3) years from
the filing date of a claim to request a trial, or three (3) years from the date
of last payment of compensation or wages in lieu thereof within which to
request a final determination. After that, the claim is barred for want of
prosecution.
ü The following procedures/levels exist for appeals after the formal hearing
process:
§ Final orders of the trial judge are appealable to an intra-court tribunal of
three judges unrelated to the case, or directly to the Oklahoma Supreme
Court. An order of the three-judge panel may be appealed to the
Supreme Court. The appeal to the three-judge panel must be within 10
days of the order being sent to the parties. The appeal to the Supreme
Court, whether directly or from an order of the three-judge panel, must
be within 20 days of the order being sent to the parties.
Attorney Fees
ü Plaintiffs’ attorney fees are generally paid out of the compensation award.
However, employers that engage in specified misconduct, e.g.,
unreasonably denying benefits, may be ordered to pay plaintiffs’ attorney
fees.
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ü Plaintiffs’ attorney fees are based on the total award and determined on a
quantum meruit basis.
ü There are limits on plaintiffs’ attorney fees. All attorney fees are
determined by the court on a quantum meruit basis and are capped at 20%
of the PPD award; 10% of the amount awarded for TTD benefits; 20% of
the amount awarded for death benefits; and 20% of the amount awarded
for PTD based upon a maximum of 400 weeks of compensation.
ü Attorneys have the right to appeal to the court to have their fees increased
when the fee awarded is less than the statutory maximum. .
Termination of Benefits
ü PPD benefits may not be terminated/reduced if the injured employee
returns to work.
ü PPD benefits may not be terminated/reduced if the injured employee turns
down a bona fide offer of employment.
ü There are no work search requirements that injured employees must meet
in order to continue to receive PPD benefits.
Claim Closure/Reopening
ü PPD claims may be closed based on:
§ Statutory Duration
§ Lump Sum Settlement
ü PPD claims may be reopened after closure in certain circumstances.
Specifically, claims may be reopened upon a “change of condition”
following an “order” for PPD on a Form 14 or from a judge following a
formal hearing. However, a Joint Petition, which is a full and final
settlement, cannot be reopened.
Contact Information
Tish Sommer
Special Counsel
Oklahoma Workers' Compensation Court
1915 N. Stiles Avenue
Oklahoma City, Oklahoma 73105-4918
(405) 522-8710
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