Frequently Asked Questions

Workers’ Compensation ι Prepaid Health Care ι Temporary Disability Insurance

 

Workers’ Compensation (WC)

Employer’s section

Who is required to provide WC coverage?
How does an employer provide WC coverage?
As an employer, how do I obtain a Department of Labor (DOL) account number when the Unemployment Insurance (UI) Division has determined I am exempt under the UI law?
I am an employer and my employee has asked me to fill out form WC-14, “Employee’s Wage Report for Fifty-two weeks prior to date of injury.” I pay my employees every two weeks. How am I to report this informaton on the form?

Employee’s section

Who is eligible for WC benefits?
How do I file a WC claim?
From whom can I obtain medical treatment?
What types of WC benefits are available?
What do I do if my employer fails or refuses to file my WC claim?
My employer or my employer’s insurance carrier has denied my claim or liability of my claim pending further investigation. What should I do?
I have two jobs. I got hurt on one of them, and now I cannot work on either because of my injury. Can I get paid for the second job as well?
How can I reopen my old WC claim?
If I file a WC claim, am I required to hire an attorney?
What if I hire an attorney?

WC Insurance Carrier’s Section

What is a WC insurance contract?

Who is required to provide WC coverage?

Any employer, other than those excluded below, having one or more employees, full-time or part-time, permanent or temporary, is required to provide WC coverage for the employees.

Excluded employment includes voluntary or unpaid workers for a religious, charitable, educational or nonprofit organization; student workers performing services for a school, university or college club in return for room, board or tuition; duly ordained, commissioned or licensed minister, priest or rabbi; domestic workers earning less than $225 (cash) per calendar quarter; domestic workers of public welfare recipients; certain twenty-five percent stockholders; all fifty percent stockholders; and real estate salespersons and brokers paid solely on a commission basis. An employer may, however, elect to cover the excluded employees.

Federal laws cover workers employed by the federal government and workers engaged in fishing, maritime and longshoring activities.

Each employer shall post and maintain in places readily accessible to employees a printed statement concerning benefit rights, claims for benefits, and such other matters relating to the administration of the workers’ compensation law. Each employer shall furnish within three working days of notice of injury to each injured employee a copy of the brochure, Hawaii Workers’ Compensation Law (Highlights).

Back to top

How does an employer provide WC coverage?

An employer may secure WC coverage by:

  • Purchasing insurance from a carrier authorized to transact WC insurance in this State. Hawaii has no State Fund from which employers can purchase WC insurance.
  • Becoming a self-insured employer who pays statutory benefits directly to its employees. The employer must be approved to self-insure by showing proof to the Director of Labor and Industrial Relations of its solvency and ability to pay benefits or by depositing securities. (Form WC-21 Application for WC Self-Insurance Authorization)

As an employer, how do I obtain a Department of Labor (DOL) account number when the Unemployment Insurance (UI) Division has determined I am exempt under the UI law?

You may obtain a temporary DOL account number assigned by this Division known as a “Z”-number. If you need a Z-number, call the Insurance Section.

Back to top

I am an employer and my employee has asked me to fill out form WC-14, “Employee’s Wage Report for Fifty-two weeks prior to date of injury.”  I pay my employees every two weeks.  How am I to report this informaton on the form?

It does not matter if your payroll frequency is bi-weekly or semi-monthly, complete the form according to your pay periods. It is important you indicate the beginning and ending dates of each pay period. Besides providing payroll information, please make sure you complete the entire Form WC-14.

Back to top

Employee’s Section

Who is eligible for WC benefits?

Most employees who suffer from any injury or illness, which results from work or working conditions, are covered. However, under the law, certain kinds of employees are not covered as described above in “Who is required to provide WC coverage?”
Hawaii’s federal workers must file their WC claim through the Office of Workers’ Compensation Programs (OWCP), U. S. Department of Labor, District No.13, 71 Stevenson Street, Box 3769, San Francisco, CA 94119-3769. The phone number is (415) 744-6610.

Back to top

How do I file a WC claim?

If you are injured on the job, you should report the date, time and circumstances of your injury immediately to your employer or supervisor. Your employer should file Form WC-1, “Employer’s Report of Industrial Injury/Illness” with its WC carrier and this Division within seven working days after the employer has knowledge of the injury causing absence from work for one day or more or requiring medical treatment beyond ordinary first aid.

If your employer fails to file Form WC-1, you should contact this Division or on the neighbor-island, the nearest Department of Labor and Industrial Relations District Office and file Form WC-5, “Employee’s Claim for Workers’ Compensation Benefits.”

Each employer shall post and maintain in places readily accessible to employees a printed statement concerning benefit rights, claims for benefits, and such other matters relating to the administration of the workers’ compensation law. Each employer shall furnish within three working days of notice of injury to each injured employee a copy of the brochure, Hawaii Workers’ Compensation Law (Highlights).

Back to top

From whom can I obtain medical treatment?

You may obtain medical treatment from a physician of your choice. However, you may be under the care of only one attending physician. Your attending physician may refer you to other specialist(s) with the approval of your employer’s insurance carrier.

You may change your attending physician once, but you must notify the insurance carrier before making the change. Any other changes in attending physician require approval from the insurance carrier before the change. You should tell your physician that this is an industrial injury. Ask the physician to send the medical reports and bills to your employer’s insurance carrier. You should be able to obtain the name of your employer’s insurance carrier from your employer.

Within seven days after the date of first attendance or services rendered, any physician, surgeon or hospital shall make an initial report, Form WC-2, “Physician’s Report” to this Division and the insurance carrier and at appropriate intervals to verify your continued treatment.

If your claim is accepted, the WC carrier should pay for all required medical care, services, and supplies, as the nature of the injury reasonably requires.

If your physician does not have “Physician’s Report,” you may give him a copy.

Back to top

What types of WC benefits are available?

    1. Temporary Total Disability (TTD) If you are unable to work because of an industrial injury, after a three-day waiting period, you may receive temporary wage replacement benefits equal to 66 2/3% of your average weekly wage, but no more than the maximum weekly benefit amount annually set by this Division.The weekly compensation for TTD is set and fixed according to your wages or the maximum amount existing the year you were first injured. For example, the maximum weekly benefit amount for the year 2008 is $696.00. In other words, if you were injured anytime in 2008, your weekly TTD benefit payment will either be two thirds of your average weekly wages or $696.00, whichever is less.
    2. Permanent Partial Disability (PPD) After you reach the point of stability or maximum medical recovery, you may be sent to a physician to evaluate the extent of your permanent impairment. The evaluation will be used to determine the amount of your PPD award. The PPD is an indemnity benefit and is payable even if you have returned to work.
    3. Permanent Total Disability (PTD) If you are permanently unable to do any kind of work, you may be eligible for PTD benefits. Whether you are eligible for PTD benefits is determined at a hearing held by this Division.
    4. Disfigurement If an injury results in a permanent disfigurement, you may be entitled to additional compensation. Disfigurement includes scars, deformity, and discoloration. Laceration scars and surgical scars are reviewed six months from date of occurrence; however, burn scars are evaluated after one year. At the appropriate six-month or twelve-month timeframe, you may call this Division or on the neighbor-island, the Department of Labor and Industrial Relations District Office nearest you, to request your disfigurement be evaluated.
    5. Death Benefits Where an industrial injury results in death, the surviving spouse and dependent minor children (including full-time students up to 21 years of age) are entitled to weekly benefits as provided in the WC law. Funeral expenses up to 10 times the maximum weekly benefit rate and burial expenses up to 5 times the maximum weekly benefit rate are also allowed.
    6. Vocational Rehabilitation Should your injury prevent you from returning to your usual occupation, you may be eligible for vocational rehabilitation services. You, as the injured worker, may select your own certified provider of rehabilitation services. The carrier does have a right to challenge your right to vocational rehabilitation services. You may obtain a current list of certified providers from your WC carrier.
    7.  Concurrent Employment Benefits  If you have two or more jobs and cannot work because of an injury you sustained on one of those jobs, you may be eligible for additional benefits from the WC Special Compensation Fund. To determine your eligibility for this benefit, Form WC-14, “Employee’s Wage Report for Fifty-Two Weeks Prior to Date of Injury,” must be completed by each of your employers and submitted to this Division or on the neighbor-island, the Department of Labor & Industrial Relations District Office nearest you, with your written request for concurrent benefits.

Back to top

What do I do if my employer fails or refuses to file my WC claim?

If you have already reported your injury to your employer or supervisor, and your employer has not filed a claim, you may file Form WC-5, “Employee’s Claim for Workers’ Compensation Benefits” with this Division or on the neighbor-island, the Department of Labor and Industrial Relations District Office nearest you.

Back to top

My employer or my employer’s insurance carrier has denied my claim or liability of my claim pending further investigation.  What should I do?

You may file Form WC-5, “Employee’s Claim for Workers’ Compensation Benefits” with this Division or on the neighbor-island, the Department of Labor and Industrial Relations District Office nearest you.

You may be eligible for Temporary Disability Insurance (TDI) benefits while your WC claim is being investigated. Ask your employer for the TDI claim form and file the TDI claim. For more information about TDI see About Temporary Disability Insurance.

Back to top

I have two jobs.  I got hurt on one of them, and now I cannot work on either because of my injury.  Can I get paid for the second job as well?

You may be eligible for concurrent benefits from the WC Special Compensation Fund. Have all your employers complete “Employee’s Wage Report for Fifty-Two Weeks Prior to Date of Injury,” and submit the completed WC-14s with your written request for concurrent benefits to this Division or on the neighbor-island, the Department of Labor and Industrial Relations District Office nearest you.

Back to top

How can I reopen my old WC claim?

Call the WC insurance carrier to request a re-opening. If your request is denied, you may file “Employee’s Claim for Workers’ Compensation Benefits” with this Division or on the neighbor-island, the Department of Labor and Industrial Relations District Office nearest you.

Back to top

If I file a WC claim, am I required to hire an attorney?

No. The WC law does not require an employee to hire an attorney. Whether or not you decide to hire an attorney is a personal decision. If you have complaints about the attorney you hired, those complaints are addressed by the Office of Disciplinary Council at (808) 521-4591 and not the Department of Labor & Industrial Relations, Disability Compensation Division.

Back to top

What if I hire an attorney?

Your attorney should provide a Letter of Representation to you and this Division or on the neighbor-island, the Department of Labor and Industrial Relations District Office nearest you. Your attorney will represent you in all maters with the carrier/employer and this Division or on the neighbor-island, the Department of Labor and Industrial Relations District Office nearest you. Any attorney fees have to be approved by this Division or on the neighbor-island, the Department of Labor and Industrial Relations District Office nearest you . Attorney fees usually are a lien upon any workers’ compensation benefits due you.

Back to top

What is a WC insurance contract?

The insurance carrier must be authorized to write WC policy in Hawaii, and the Notice of Insurance must be signed by an authorized representative of the insurance carrier. The WC carrier then acts on behalf of and assumes the liability of the employer during the life of the policy.

Any carrier wishing to terminate a policy before the expiration date must serve a minimum ten-day notice of intent to cancel on the employer and this Division.

An employer is prohibited from having the employee pay for any portion of the WC premium.

Back to top