On The Job Injuries

Injuries Covered by Oklahoma Workers’ Compensation Law

INJURIES COVERED BY OKLAHOMA WORKERS’ COMPENSATION-IN GENERAL

Generally, the compensation and benefits provided for in the Oklahoma Workmans Comp Act shall be payable to an employee for death or injuries arising out of and in the course of his or her employment–without regard to fault as a cause of such injury. According to Oklahoma City and Tulsa Workmens Compensation Court rules a “Compensable injury” in Oklahoma means only any injury or occupational illness, causing internal or external harm to the worker’s body, which injury arises out of and in the course of the worker’s employment, and if such employment was the major cause of the specific injury or illness to the injured employee. Any injury, other than one caused by cumulative trauma, is compensable under the Oklahoma Workers Comp Court Rules only if it is established by the injured worker &/or his or her attorney or lawyer that such injury was caused by a specific incident and is identifiable by time, place and occurrence. A compensable injury must be established by objective medical evidence* supplied to either the Oklahoma City or Tulsa Workmans Compensation Court by the injured employee &/or his or her attorney or lawyer. ”Major cause” has been defined by the Oklahoma City & Tulsa Workmens Comp Court as an injury causing more than fifty percent (50%) of the resulting injury, disease or illness. A finding of major cause by either the Oklahoma City or Tulsa Work Comp Court shall be established by a preponderance of the evidence supplied by the injured worker &/or his attorney or lawyer.

OBJECTIVE MEDICAL EVIDENCE: The Oklahoma City & Tulsa Workers Compensation Courts have defined “objective findings” as those findings which cannot come under the voluntary control of the injured employee. Furthermore, when determining physical or anatomical impairment, neither a physician, any other medical provider, a judge of the Oklahoma City or Tulsa Workmans Comp Court, may consider complaints of pain. Medical opinions addressing compensability must be stated within a reasonable degree of medical certainty.

WORKERS COMP COVERAGE FOR PARTICULAR TYPES OF INJURIES

COVERAGE FOR OCCUPATIONAL DISEASES IN OKLAHOMA: According to Oklahoma City & Tulsa Workers Compensation Court rules the term “occupational disease” means only that disease or illness which is due to causes and conditions characteristic of or peculiar to the particular trade, occupation, process or employment in which the employee is exposed to such disease. An occupational disease arises out of the employment only if the injured worker &/or his attorney or lawyer can prove to the Tulsa Work Comp Court that the employment was the major cause of the resulting occupational disease and such is supported by objective medical evidence, as defined above.

COVERAGE FOR CUMULATIVE TRAUMA & REPETITIVE MOTION INJURY IN OKLAHOMA: “cumulative trauma” as defined by Oklahoma Workmans Compensation law means a compensable injury, the major cause of which results from employment activities which are repetitive in nature and engaged in over a period of time and which is supported by objective medical evidence as defined above. Generally, where compensation is payable for an injury resulting from cumulative trauma, the last employer in whose employment the employee was last injuriously exposed to the trauma during a period of at least ninety (90) days or more, and the insurance company, if any, on the risk when the employee was last so exposed under such employer, shall alone be liable for the cumulative trauma injury–without right to contribution from any prior employer or its insurance carrier.

NOTE: If there is no employer in whose employment the employee was injuriously exposed to the trauma for a period of at least ninety (90) days, then the last employer in whose employment the employee was last injuriously exposed to the trauma and the insurance carrier, if any, on the risk when such employee was last so exposed under such employer, shall be liable therefor, with right to contribution from any prior employer or insurance carrier.

COVERAGE FOR HEART ATTACKS & STROKES: The Oklahoma City & Tulsa Workers Comp Court has determined that a compensable injury in Oklahoma can include a heart-related or vascular injury, illness or death only if the injured worker’s employment is the major cause of the heart-related or vascular injury. Furthermore, Such injury shall be compensable only if it is demonstrated by the injured employee &/or his or her attorney or lawyer that the exertion necessary to produce the harm was extraordinary and unusual in comparison to other occupations and that the occupation was the major cause of the harm. The injury must be established by objective medical evidence, as defined above.

COVERAGE FOR MENTAL INJURIES & PSYCHOLOGICAL OVERLAY: The Oklahoma City and Tulsa Workmens Compensation Court has determined that the term “injury” or “personal injury” does not include mental injury that is unaccompanied by physical injury, except in the case of rape which arises out of and in the course of employment.

COVERAGE FOR DEGENERATIVE CONDITIONS IN OKLAHOMA: Oklahoma City & Tulsa Workmens Comp Court Rules provide that the term “Compensable injury” shall not include the ordinary, gradual deterioration or progressive degeneration caused by the aging process, unless the employment is a major cause of the deterioration or degeneration and is supported by objective medical evidence, as defined above. Provided, however, any claim, and subsequent disability, that has as its source a physical condition resulting from incremental damage or injury or a gradual deterioration of physical health, which is caused by a condition arising out of and in the course of employment, must be proven by the injured worker &/or his or her attorney or lawyer by a preponderance of the evidence presented to the Tulsa Work Comp Court.

COVERAGE FOR INJURIES OCCURING DURING & AS A RESULT OF RECREATIONAL & SOCIAL ACTIVITIES: Oklahoma City & Tulsa Workmens Compensation Court rules provide that the term “compensable injury” shall not include injury incurred while engaging in, performing or as the result of engaging in or performing any recreational or social activities.

employment shall be deemed to commence when an employee arrives at the employee’s place of employment to report for work and shall terminate when the employee leaves the employee’s place of employment, excluding areas not under the control of the employer or areas where essential job functions are not performed; provided, however, when the employee is instructed by the employer to perform a work-related task away from the employee’s place of employment, the employee shall be deemed to be in the course of employment when the employee is engaged in the performance of job duties directly related to the task as instructed by the employer, including travel time that is soley related and necessary to the employee’s performance of the task. Travel by a policeman, fireman, or a member of a first aid or rescue squad, in responding to and returning from an emergency, shall be deemed to be in the course of employment.

EMPLOYEES SPECIFICALLY COVERED BY OKLAHOMA WORKERS’ COMPENSATION

OKLAHOMA NATIONAL GUARD EMPLOYEES: The Oklahoma City & Tulsa Workmans Comp Court has determined that the term “employee” shall include a member of the Oklahoma National Guard while in the performance of duties only while in response to state orders.

VOLUNTEER FIREMEN & PEACE OFFICERS: The Oklahoma City & Tulsa Workmens Comp Court rules extend workers’ compensation coverage to any authorized voluntary or uncompensated worker, rendering services as a firefighter, peace officer or emergency management worker.

EMPLOYEES NOT COVERED BY OKLAHOMA WORKERS’ COMPENSATION BENEFITS

The Workers Compensation Act shall not apply to the following employees:

HOUSEKEEPERS, NANNIES, & OTHER DOMESTIC WORKERS: The Oklahoma & Tulsa Workers Comp Court rules do not extend coverage and benefits to any person who is employed as a domestic servant or as a casual worker in and about a private home or household, which private home or household had a gross annual payroll in the preceding calendar year of less than Ten Thousand Dollars ($10,000.00) for such workers.

PERSONS COVERED BY FEDERAL COMPENSATION PROGRAMS: The Oklahoma & Tulsa Workmans Compensation Court rules do not extend coverage to any person for whom an employer is liable under any Act of Congress for providing compensation to employees for injuries, disease or death arising out of and in the course of employment including, but not limited to, the Federal Employees’ Compensation Act, the Federal Employers’ Liability Act, the Longshoremen’s and Harbor Workers’ Act and the Jones Act, to the extent his or her employees are subject to such acts.

FARM, RANCH & OTHER AGRICULTURE WORKERS: Any person who is employed in agriculture or horticulture by an employer who had a gross annual payroll in the preceding calendar year of less than One Hundred Thousand Dollars ($100,000.00) cash wages for agricultural or horticultural workers is excluded from benefits under the Oklahoma Workers Comp Act. Additionally, agricultural employees who are not engaged in the operation of motorized machines are likewise exempt from coverage of the Oklahoma Work Comp Act.

‘OWNER-OPERATOR’ TRUCK DRIVERS: Oklahoma City & Tulsa Workmans Compensation Court rules exclude from coverage under the Oklahoma Workmens Compensation Act any person, commonly referred to as an owner-operator, who owns or leases a truck-tractor or truck for hire, if the owner-operator actually operates the truck-tractor or truck and if the person contracting with the owner-operator is not the lessor of the truck-tractor or truck.

BUSINESS OWNERS: Sole proprietors, members of a partnership, members of a limited liability company who own at least ten percent (10%) of the capital of the limited liability company or any stockholder-employees of a corporation who own ten percent (10%) or more stock in the corporation are excluded from the definition of “employee”, and shall not be deemed to be employees as respects the benefits of the Workmans Comp Act.

REAL ESTATE AGENT &/OR BROKER: Any person who is a licensed real

estate sales associate or broker, paid on a commission basis, is not entitled to coverage under the Oklahoma Workmens Comp Act.

SMALL FAMILY-OWNED BUSINESSES: Any small family-owned business with five or less total employees, all of whom are related by blood or marriage to the employer or a general or limited partner of the employer, shall be exempt from the Workers Compensation Act.

where work is performed on a single family residential dwelling or its premises occupied by the owner, such owner shall not be liable for compensation under the workers compensation act. such owner shall not be liable to the employee of any independent contractor or subcontractor, where applicable.

INJURIES NOT COVERED BY THE OKLAHOMA WORKERS COMPENSATION ACT

The following types of injuries are NOT COVERED by definition in the Oklahoma Workers Compensation Act:

INTENTIONAL INJURIES: any injury occasioned by the willful intention of the injured employee to bring about injury to himself or herself, or another
any injury resulting directly from the willful failure of the injured employee to use a guard or protection against accident furnished for use pursuant to any statute or by order of the Commissioner of Labor
an injury which occurs when an employee is using substances defined and consumed or is using or abusing alcohol or illegal drugs, or is illegally using chemicals; this paragraph shall only apply when the employee is unable to prove by a preponderance of the evidence that the substances, alcohol, illegal drugs, or illegally used chemicals were not the proximate cause of the injury or accident. For the purposes of this paragraph, post-accident alcohol or drug testing results shall be admissible as evidence.
except for innocent victims, an injury caused by a prank, horseplay, or similar willful or intentional behavior.

FILING & PROCEDURAL REQUIREMENTS IN ALL CASES

All claims for any compensation or benefits under the Oklahoma Workers’ Compensation Act are commenced with the injured worker &/or his or her attorneys or lawyers filing a notice of injury with the Workers’ Compensation Administrator. At the request of either party, a prehearing conference shall be held before the judge assigned to the case within forty-five (45) days of the filing of a claimant’s request for a hearing. The purpose of the prehearing conference is to mediate and encourange settlement of the case or determine issues in dispute.

NOTE: Benefits for an injury shall be determined by the law in effect at the time of injury.

IF INJURY IS COVERED WORKERS’ COMP IS ‘EXCLUSIVE REMEDY’

The liability prescribed in Section 11 of the Oklahoma Workers’ Compensation Act is exclusive and in place of all other liability of the employer and any of his employees, any architect, professional engineer, or land surveyor retained to perform professional services on a construction project, at common law or otherwise, for such injury, loss of services, or death, to the employee, or the spouse, personal representative, parents, or dependents of the employee, or any other person, except in case of an intentional tort, or where the employer has failed to secure the payment of compensation for the injured employee as provided for and by the Oklahoma Workers’ Compensation Act.

The determination of disability shall be the responsibility of the Workers’ Compensation Court. Any claim submitted by an employee for compensation for permanent disability must be supported by competent medical testimony which shall be supported by objective medical findings and which shall include an evaluation by the treating physician or an independent medical examiner and which shall include an evaluation by the treating physician or an independent medical examiner if there is no evaluation by the treating physician, stating his or her opinion of the employee’s percentage of permanent impairment and whether or not the impairment is job-related and caused by the accidental injury or occupational disease. Medical opinions addressing compensability and permanent impairment must be stated within a reasonable degree of medical certainty.

Any party may object to the opinion of the treating physician by giving written notice to all other parties and to the Court. Upon receipt of such notice, if the parties fail to agree on the selection of an independent medical examiner, the court shall randomly select an independent medical examiner who shall be afforded a reasonable opportunity to examine the employee together with all medical records involved and any other medical data or evidence that the independent medical examiner may consider to be relevant. The independent medical examiner shall issue a verified written report on a form provided by the administrator to the court stating his or her finding of the percentage of permanent impairment of the employee and whether or not the impairment is job-related and caused by the accidental injury or occupational disease.

There shall be a rebuttable presumption in favor of the treating physician’s opinions on the issue of temporary disability, permanent disability, causation, apportionment, rehabilitation or necessity of medical treatment. Any determination of the existence or extent of physical impairment shall be supported by objective medical evidence.

The Independent Medical Examiner shall be allowed to examine the claimant, receive any medical reports submitted by the parties and review all medical records of the claimant. If the independent Medical Examiner. If the Independent Medical Examiner determines that the opinion of the treating physician is supported by the objective medical evidence, the Independent Medical Examiner shall advise the Court of the same. If the Independent Medical Examiner determines that the opinion of the treating physician is not supported by objective medical evidence, the Independent Medical Examiner shall advise the Court of the same and shall provide the court with his or her own opinion. In cases in which an independent medical examiner is appointed, the court shall not consider the opinion of the Independent Medical Examiner unless the Independent Medical Examiner determines that the opinion of the treating physician is not supported by objective medical evidence, in which case the court shall follow the opinion of the independent medical examiner, the opinion of the treating physician or establish its own opinion within the range of opinions of the treating physician and the Independent Medical Examiner. If the Court does not follow the opinion of the treating physician, the court shall set out its reasons for deviating from the opinion of the treating physician.

In no event may an indepent medical examiner, whether directly, or indirectly by virtue of a pecuniary interest, economically benefit from the performance of treatment of an employee whose claim the independent medical examiner has reviewed for permanent impairment, return to work, or the necessity of further medical treatment, unless both employee and employer agree through written stipulation and said stipulation occurs prior to appointment, referral and notice to said independent medical examiner.

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