Maximum Weekly Benefit Amounts: |
|
|
2023 = $1090 |
2020 = $925
|
2021 = $911
|
2022 = $992 |
2017 = $846
|
2018 = $883
|
2019 = $899 |
2014 = $777
|
2015 = $786
|
2016 = $812 |
2011 = $731
|
2012 = $747
|
2013 = $762 |
2008 = $696
|
2009 = $725
|
2010 = $745 |
2005 = $622
|
2006 = $654
|
2007 = $678
|
2002 = $564
|
2003 = $580
|
2004 = $596
|
1999 = $519
|
2000 = $529
|
2001 - $547
|
1996 = $496
|
1997 = $501
|
1998 - $508
|
1993 = $460
|
1994 = $481
|
1995 - $491
|
1990 = $383
|
1991 = $412
|
1992 - $437
|
1987 = $318
|
1988 = $334
|
1989 - $358
|
In other words, if you are injured in 2023 your weekly disability payments will either be two
thirds of your average weekly wages or $1,090 which ever is less.
$1090 is the equivalent of $27.27 an hour and this is what you would get weekly if your average
weekly income had been $1,635.00 (that is $40.88 an hour) or more.
But, if you were injured in 2022 your weekly disability payments will either be two
thirds of your average weekly wages or $992 which ever is less.
$992 is the equivalent of $24.80 an hour and this is what you would get weekly if your average
weekly income had been $1,488.00 (that is $37.20 an hour) or more.
And, if you were injured in 2021 your weekly disability payments will either be two
thirds of your average weekly wages or $911 which ever is less.
$911 is the equivalent of $22.78 an hour and this is what you would get weekly if your average
weekly income had been $1,366.43 (that is $34.16 an hour) or more.
On the other hand, if you were injured in 2020 your weekly disability payments will either be two
thirds of your average weekly wages or $925 which ever is less.
$925 is the equivalent of $23.13 an hour and this is what you would get weekly if your average
weekly income had been $1,387.43 (that is $34.69 an hour) or more.
Or, if you were injured in 2019 your weekly disability payments will either be two
thirds of your average weekly wages or $846 which ever is less.
$899 is the equivalent of $22.48 an hour and this is what you would get weekly if your average
weekly income had been $1,348.43 (that is $33.71 an hour) or more.
Likewise, if you were injured in 2018 your weekly disability payments will either be two
thirds of your average weekly wages or $846 which ever is less.
$883 is the equivalent of $22.08 an hour and this is what you would get weekly if your average
weekly income had been $1,324.50 (that is $33.11 an hour) or more.
And, if you were injured in 2017 your weekly disability payments will either be two
thirds of your average weekly wages or $846 which ever is less.
$846 is the equivalent of $21.15 an hour and this is what you would get weekly if your average
weekly income had been $1,269.00 (that is $31.73 an hour) or more.
COMPENSABILITY PRINCIPLES
- The disability is compensable if the claimant has suffered personal injury by accident
arising
out of and in the course of employment, or by disease proximately caused by or resulting from
the
nature of the employment.
- It is not compensable if the injury was caused by or resulted from employee's intoxication
or
wilful intent to injure oneself or another.
- Sequela and/or consequences are also compensable.
- Aggravation (or 2nd injury), if it too is job related, will be compensated
at the later (usually higher) disability rate than for just a Recurrence.
BASIC CLAIM FILING REQUIREMENTS:
If you are injured you should first report the injury or disability to your employer or immediate
supervisor. It is then your employer's responsibility under the law to file a WC-1 form report
with
the State DLIR Disibility Compensation Divivision accepting or denying liability. The employer
must do this within seven days of your notice if there was lost time or the injury required medical
care beyond ordinary first aid.
If you have an Adobe Acrobat Reader, you can download
the State of Hawaii's
[FORM WC-1], "Employer's Report of Industrial Injury."
Additionally the employee needs to tell his or her doctor of the
claim so that the doctor will file a report on Form WC-2 with the Department of Labor.
Notice of injury should be given as soon as possible, but the employee's claim must be filed with
the Department of Labor within two years from the date at which the effects of the injury or
disability first became manifest and five years from the accident (longer in the case of certain
toxic
or carcinogenic
exposures).
If the employer or the insurance carrier denies liability or refuses to pay the required benefits, the
employee must file a WC-5 form with the Disability Compensation Division of Department of
Labor who will render a decision as to the compensability of the claim.
Important Note:
Denial of a claim by the employer or the insurance carrier should not be confused with a denial
by
the Department of Labor.
If you have an Adobe Acrobat Reader, you can download
the State of Hawaii's
[FORM WC-5], "Employee's Claim for Workers' Compensation Benefits."
The WC-5 form:
- On the line for INSURANCE CARRIER you should write the name of the employer's
Workers' Comp. Ins. carrier not your personal medical or health insurance company.
- On the line for INJURY give as closely as possible the exact date and time of the accident
or
of the time you were exposed to the disease. This time will usually be during your work time.
Remember, everything you write on this form will be used to support or challenge your claim
that
this is an injury or disability arising out of and in the course of your employment.
- Where it asks 'Reason for filing,' if none of the blocks seem to apply, then it is always safe
to
write here: To establish my claim for compensation.
Once the Department of Labor receives your completed WC-5 claim form they will hold it until
the employer's WC-1 and the doctor's WC-2 come in and then they will schedule a hearing
before
a department hearings officer.
If you have an Adobe Acrobat Reader, you can download
The State Administative Rules, General Provisions for Workers' Comp.
[Title 12, Chapter 10].
;
and
The State Administative Rules, Medical Fee Schedule
[Title 12, Chapter 15].
Medical Fee Schedule website
and
The State Administative Rules, on Rehabilitation
[Title 12, Chapter 14].
APPEALS:
Any party disagreeing with the decision of the Department of Labor & Industrial Relations, may
file an appeal within twenty days with the LABOR AND INDUSTRIAL RELATIONS
APPEALS BOARD, a three member, full-time Board appointed by the Governor of the
State.
If the Director of Labor, the Appellate Board or any Court finds that
proceedings under the workers compensation law have been brought, prosecuted,
or defended without reasonable ground the whole costs of the proceedings may be
assessed against the party who has brought, prosecuted, or defended the
proceedings.
The SUPREME COURT OF THE STATE OF HAWAIʻI is the final judicial review panel.
Appeals from decisions of the Appeals Board are heard by the Court on the record
compiled at the Appeals Board.
PHYSICIANS:
Physician, as defined by the statute, includes: doctors of medicine, dentists, chiropractors,
osteopaths, naturopaths, psychologists, optometrists, and podiatrists.
Workers' Compensation pays for all medical care, services and supplies as the nature of the
injury
reasonably requires, including physical rehabilitation services; all necessary aids, appliances,
apparatus, and supplies to cure or relieve the effects of the injury, including repairs thereto or
replacement thereof due to ordinary wear and tear, or damaged due to subsequent compensable
injury or accident; services of an attendant as need for same is determined by the Director of
Labor; and vocational rehabilitation services, including tuition, books, travel, and maintenance
expenses while enrolled in the vocational rehabilitation program.
The injured worker has the right of free choice of physician. Switching doctors or 'doctor
hopping', however, is discouraged. If the claimant changes a doctor more than once, such change
is subject to the approval of the department (DLIR-DCD). On the other hand, Workers' Comp
does cover the cost of specialists, therapists, etc. to whom the injured worker is referred by his or
her treating physician.
As provided in HRS §386-79, after an injury and
during the period of disability, the employee, whenever ordered by the
director
of the State Department of Labor & Industrial Relations, must submit to examination at
reasonable times and places by the employer's physician. The employer's physician can only
examine the worker and not treat or prescribe medicine or any other treatment. On the other
hand, if the employee in anyway obstructs such an examination, the employer may suspend
payment of benefits with the approval of the director of the Deprtment of Labor.
Federal Employees
Compensation Act (FECA).
This workers' compensation law provides compensation benefits to civilian employees of the
United States for disability due to personal injury or disease sustained while in the performance
of
duty. The FECA also provides for the payment of benefits to dependents if a work-related injury
or disease causes an employee's death. Injury compensation benefits available to employees
whose duties involve vessel operations are set forth in 42 U.S.C. 249 and benefits paid to United
States Park Police are covered under the Policemen and Firemen's Relief Fund, District of
Columbia Code, Title 4.
FECA is administered by the Office of Workers' Compensation Programs (OWCP), U.S.
Department of Labor, through district ofices located across the country. Hawai'i's federal workers
must file claimes through OWCP's San Francisco office:
Office of Workers' Comp. Programs
U.S. Department of Labor
District No. 13
71 Stevenson Street, Box 3769
San Francisco, CA 94119-3769
.......phone: (415) 744-6610
U.S. Dept. of Agriculture's Q&A
page about FECA
An injured worker is expected to give notice to the employer within 30 days, though a claim may
be filed within three (3) years of the original date of injury.
Form CA-1 "Federal Employee's Notice of Traumatic Injury and Claim for
Continuation of Pay/Compensation" is the official claim form to use when reporting an
injury.
Form CA-2 "Federal Employee's Notice of Occupational Disease and Claim
for Compensation" is the official claim form to use for claiming job-related disease(s).
All injuries, including disease proximately caused by employment, sustained while in the
performance of duty by civilian employees of the Department including volunteers and
emergency
hires are covered as well as other types of employees such as job corps. It is the responsibility
of
the employee to provide medical and factual evidence to establish the essential elements of the
claim, i.e., that the claim was filed within the statutory time requirements of the FECA, the
injured
or deceased person was an employee within the meaning of the FECA, the employee sustained
an
injury or disease, the employee was in the performance of duty when the injury occurred, and the
condition found resulted from the injury. Benefits cannot be paid if injury or death is caused by
willful misconduct of the injured employee, by intent to bring about the injury or death of oneself
or another, or by intoxication of the injured employee. Benefits provided under the FECA
constitute the sole remedy against the Department for work related injury or death. An employee
or surviving dependent is not entitled to sue the Department or recover damages for such injury
or death under any other statute.
A "traumatic injury" is defined as a wound or other condition of the body caused by external
force, including stress or strain. The injury must be identifiable as to time and place of
occurrence
and member or function of the body affected. It must be caused by a specific event or incident or
series of events or incidents within a single day or work shift.
An "occupational disease" is defined as a condition produced in the work environment over a
period longer than one workday or shift. It may result from systemic infection, repeated stress or
strain, exposure to toxins, poisons, fumes or other continuing conditions of the work
environment.
Time limit for filing notice of injury and claim for compensation: A claim for compensation must
be filed within three years of the date of injury. There is an exception to this rule and you should
talk with your servicing personnel office.
There is no maximum period of time during which an employee can receive compensation
payments for wage loss. An employee can receive compensation payments for as long as the
medical evidence shows that total or partial disability is related to the accepted injury or
condition. The employee may be required to undergo medical examinations.
An injured employee must report for medical examinations when directed by OWCP Failure to
do so without adequate reason may result in suspension of compensation or denial of the
claim.
Benefits: Compensation is paid at two-thirds of the employee's pay rate if he or she has no
dependents, or augmented to three-fourths of the pay rate if he or she is married or has one or
more dependents.
Generally, hospital, physician and medication costs are covered as well as transportation costs to
the doctor's office for medical treatment. Also you may be entitled disability benefits such as
compensation, as well as a scheduled award. Other benefits may include an attendant's
allowance,
vocational rehabilitation, and death benefits if cause of death is related to the accepted job
injury.
A pre-existing condition that is aggravated by factors of employment is also covered by the
FECA. The employee must submit medical and factual evidence that establishes that the
employment aggravated, accelerated, or precipitated the condition.
A recurrence of an employment-related disability is covered by FECA if an injured employee is
again disabled as a result of the original injury or occupational disease.
An injured employee is entitled to initial selection of a physician or facility for treatment of an
injury. The provider must meet the definition of "physician" under the FECA. An agency may
examine the employee at its own facility in accordance with OPM regulations, but the
employee's
choice of physician must be honored, and treatment by the employee's physician must not be
delayed.
OWCP uses a schedule of maximum allowable medical charges. The employee is not
responsible
for amounts charged in excess of the maximum allowable medical charges. The schedule is not
applicable to hospital, pharmacy, or nursing home charges.
An employee change physicians, but the employee must contact OWCP and request
authorization
to change to another physician.
Continuation of Pay or COP is continuation of an
employee's regular salary for up to 45 calendar days of wage loss due to disability and/or medical
treatment following a traumatic injury. The intent of this provision is to eliminate interruption of
the employee's income while OWCP is processing the claim. COP is subject to deductions for
income tax, retirement, etc.
If it appears that the disability will continue beyond 45 days, the employee and the bureau should
complete Form CA-7,"Claim for Compensation on Account of Traumatic Injury or Occupational
Disease," and submit it on the 40th day of COP to the appropriate OWCP district office.
If an employee's medical report indicates that the employee is capable of returning to duty, the
employee must do so in order for pay to continue. If the physician's report indicates light duty,
the employee is required to accept any reasonable offer of suitable light or limited duty. If the
employee refuses to accept the work offered or fails to respond to the job offer within five
working days, the bureau should terminate COP. OWCP will then resolve the dispute on the
basis of the evidence submitted.
Only OWCP has the authority to adjudicate a claim for compensation. While the
Department/bureau has a role in paying or withholding COP, this action is reviewed in every
case
by OWCP.
If found guilty of filing a false claim a claimant can be fined not more than $10,000 or
imprisoned
not more than five years or both. Conspiracy to commit fraud $10,000 and 10 years
imprisonment.
The Longshore and Harbor Workers' Compensation Act (33 USC 901 et. seq.)
This Act, administered by the Office of Workers' Compensation Programs (OWCP) Employment Standards Administration, U.S. Department of Labor, offers compensation
and medical care to employees disabled from injuries that occur on the navigable
waters of the United States, or in adjoining areas customarily used in loading,
unloading, repairing, or building a vessel. The Act also offers benefits to dependents if
the injury causes the employee's death. These benefits are paid by an insurance
company or by an employer who is authorized by the OWCP to be self-insured. The
term "injury" includes occupational disease arising out of employment.
The Act Covers
- EMPLOYERS who employ workers in a maritime occupation, either full or part-time, on
the navigable waters of the United States or in an adjoining area customarily used by
an employer in loading, unloading, repairing, or building a vessel.
- EMPLOYEES in a maritime occupation-including a longshoreman or other person in longshoring operations, and any harbor worker, including a ship repairman, shipbuilder,
and shipbreaker.
- OTHER EMPLOYEES are covered similarly through the following Acts:
DEFENSE BASE ACT, applying to employment by Federal contractors outside the continental U.S., Alaska or Hawai'i.
OUTER CONTINENTAL SHELF LANDS ACT, applying to employees of private
industry, conducting certain operations on the Outer Continental Shelf of the United States.
NONAPPROPRIATED FUND INSTRUMENTALITIES ACT, applying to civilian
employees of nonappropriated fund instrumentalities (post exchanges, etc.) of the
Armed Forces.
EXCLUDED by the Longshore Act are the following individuals if covered by a state workers' compensation law:
- Individuals employed exclusively to perform office clerical, secretarial, security, or data
processing work;
- Individuals employed by a club, camp, recreational operation, restaurant, museum, or
retail outlet;
- Individuals employed by a marina and who are not engaged in construction,
replacement, or expansion of such marina (except for routine maintenance);
- Individuals who (A) are employed by suppliers, transporters, or vendors, (B) are
temporarily doing business on the premises of a maritime employer, and (C) are not
engaged in work normally performed by employees of that employer covered under
this Act;
- Aquaculture workers;
- Individuals employed to build, repair, or dismantle any recreational vessel under sixty-five feet in length;
- Small vessel workers if exempt by certification of the Secretary under certain conditions.
EXCLUDED also are:
- A master or member of a crew of any vessel; or
- Any person engaged by a master to load or unload or repair any small vessel under
eighteen tons net.
Injury Benefits
MEDICAL CARE--Includes all medical, surgical, and hospital treatment and other
medical supplies and services required by the employment related injury.
The employee may obtain medical treatment from a physician of his or her choice, as
designated by the OWCP. The term "physician" includes doctors of medicine (MD),
surgeons, podiatrists, dentists, clinical psychologists, optometrists, and osteopathic
practitioners within the scope of their practice as defined by State law. Chiropractors
are also included to the extent that their treatment consists of manual manipulation of
the spine to correct subluxation (dislocation).
An employee may not choose a physician who is currently not authorized by the
Department of Labor to render medical care under the Act. The list of physicians not
authorized is available from the local OWCP district office.
DISABILITY COMPENSATION-- Compensation is paid every two weeks during an
employee's total disability because of a work-related injury.
Compensation is paid at a lesser rate if the employee is only partially disabled for his
regular work.
Disability means inability to earn the same wages earned at the time of injury.
Compensation is payable tor disabilities that are permanent total, temporary total,
permanent partial, or temporary partial.
PERMANENT TOTAL AND TEMPORARY TOTAL DISABILITY--Compensation is
two-thirds of the employee's average weekly wage, subject to a maximum amount.
The maximum rate payable for temporary total disability changes each October 1,
based on the current national average weekly wage for the affected period.
Compensation for permanent total disability is adjusted each October 1, based on the
percentage change in the national average weekly wage from the previous year,
subject to a maximum adjustment of 5%.
PERMANENT PARTIAL DISABILITY-- Compensation is payable for the permanent
loss or loss of use of certain members or functions of the body, such as the toss of
arm, hand, fingers, leg, foot, toes, hearing and vision. Compensation is payable for a
certain number of weeks for each type of disability as specified in the Act. For
example, total loss of use of a foot entitles the employee to 205 weeks of compensation.
TEMPORARY PARTIAL AND NONSCHEDULED PERMANENT PARTIAL
DISABILITY--Compensation is two-thirds of the employee's weekly wage loss or loss
of wage-earning capacity.
REHABILITATION SERVICES--Medical rehabilitation may include exercise and
muscle conditioning to help restore the employee to full usefulness.
Vocational rehabilitation may include evaluation, testing, counseling, selective
placement and retraining, if the employee is injured and cannot return to the former job. Rehabilitation services may include the cost of tuition, books and supplies, and provide a maintenance allowance during retraining.
Death Benefits
DEATH BENEFITS are paid to a widow or widower or other eligible survivors if the
injury causes the employee's death. Reasonable funeral expenses are paid, up to a
maximum of $3,000.
The widow or widower receives 50% of the average weekly wage of the deceased employee for life or until remarriage. Additional compensation is payable--16 2/3% of
the employee's average weekly wage--for one or more children.
If children are the sole survivors, 50% of the employee's average weekly wage is paid on behalf of the first child. Where more than one child is entitled to benefits, a maximum
of 66 2/3% applies, shared equally. OTHER ELIGIBLE SURVIVORS--parents, brothers, sisters, grandparents and grand-children who were dependent on the
employee.
Upon remarriage, a widow or widower receives a lump sum payment of compensation
covering two years. Benefit payments to children, brothers, sisters, and grandchildren
terminate when they reach 18, but may be extended to age 23 if the child or beneficiary
is a student. Payments may continue indefinitely if a child remains incapable of self
support due to mental or physical disabilities.
The total amount of compensation may not exceed two-thirds of the employee's wage.
In computing death benefits, the average weekly wage of the deceased shall be
considered to have been not less than the national average weekly wage effective at
the time of the employee's death. The total weekly benefits, however, may not exceed
the average weekly wage of the deceased or 200% of the national average weekly
wage, whichever is lesser.
Maximum and Minimum Payment
DISABILITY--compensation payable under the Act may not exceed 200% of the
national average weekly wage, applicable at the time of injury, or the employee's full
average weekly wage, whichever is less.
Waiting Period and Beginning of Compensation
NO COMPENSATION--is allowed for the first three days of disability unless disability
lasts longer than fourteen days. In such cases compensation is paid from the first day
of wage loss. The first installment of compensation is due 14 days after the employee
stops work, or as directed by the OWCP.
Claimant Assistance
The OWCP will help claimants prepare claims, explain benefits and proceedings under
the Act, and will advise about medical, manpower and vocational rehabilitation services.
District Offices in the OWCP are located in Boston. New York, Philadelphia. Baltimore,
Norfolk, Jacksonville, New Orleans, Houston, Chicago, San Francisco, Long Beach,
Seattle, and Honolulu. Office addresses can be supplied by the employer or the
compensation insurance carrier.
What To Do If You Are Injured:
- NOTIFY your employer immediately and ask tor a Form LS-1, which authorizes
treatment by a doctor of your choice.
- OBTAIN medical treatment as soon as possible.
- GIVE written notice of your injury within 30 days to your employer on Form LS-201.
Notice of death must also be given within 30 days. Additional time is provided for
certain hearing loss and occupational disease claims. Contact your nearest OWCP
district office for additional information regarding these types of claims.
- FILE a written claim for compensation within one year after injury if full compensation
and medical care have not been provided. A claim must also be filed within one year
after death. The time for filing claims in certain occupational disease cases has been
extended to two years.