Workers Compensation Division
The Kansas Department of Labor Workers Compensation Division is responsible for the administration of the Kansas Workers Compensation laws and rules. Our goal is to ensure employees injured at work, employers, health care providers and insurance carriers receive timely, impartial and fair claim resolution.
Following a 1993 mandate from the Kansas legislature, the Fraud and Abuse Section was first staffed in January 1994. Its mission is to combat fraudulent or abusive acts and practices by employers, employees, and healthcare providers. This unit does not investigate misconduct by insurance carriers or agents. Instead, the Kansas Insurance Department addresses these complaints.
The section is responsible for the investigation of alleged violations of the Workers Compensation Act. Most of the fraud and abuse violations are listed under K.S.A. 44-532, K.S.A. 44-5,120, and K.S.A. 44-5,125. If a violation of the Act is discovered, the section is willing to pursue administrative remedies. In certain cases, the section may ask a county or district attorney to file criminal charges.
Identifying and prosecuting workers compensation fraud is a priority for Kansas. Per Kansas Law, an Assistant Attorney General is assigned to direct and assist in the investigation and prosecution of alleged fraudulent or abusive acts or practices.
Areas of Investigation
Fraudulent or Abusive Acts: Administrative and Criminal: As defined in K.S.A. 44-5,120(d) and 44-5,125 – examples of fraudulent or abusive acts include but are not limited to:
- Making false or misleading statements to obtain benefits
- Presenting a false certificate of insurance
- Submitting a charge for health care not furnished
The penalty for committing such acts are:
- $2,000 civil fine for each act of fraud or abuse
- Misdemeanor or felony criminal charges
Employer Failure to Secure Workers Compensation Insurance: : In general, an employer with a payroll exceeding $20,000 must secure workers compensation coverage for its employees. The civil penalty for violating this provision is twice the annual premium or $25,000, whichever is greater.
Employer Failure to Timely File Accident Report: Every employer has a duty to report employee accidents within 28 days if the injuries wholly or partially incapacitate the person for more than the day, shift or turn. The civil penalty for repeated violations is a $250 civil find for each violation.
Reports of fraud come into the Fraud and Abuse Section from many sources:
- Anonymous Tips
- Employers and Employees
- General Public
- Insurance Companies
- Kansas Insurance Department
If you believe or have knowledge that a violation of the Workers Compensation Act has occurred or is occurring, you may notify the Division of Workers Compensation, Fraud and Abuse Investigation section by using the online reporting option or downloading the Report of Fraud or Abuse form (K-WC 44) to be submitted. You can also contact:
What is Immunity?
Any person who refers a possibly fraudulent or abusive practice to any state or governmental investigative agency, shall be immune from civil or criminal liability arising from the supply or release of such referral as long as such referral is made in good faith with the belief that a fraudulent or abusive practice has, is or will occur and said referral is not made by the person or persons who are in violation of the workers compensation act, to avoid criminal prosecution or administrative hearings.
Educating the Public
The Kansas Insurance Department's Fraud unit is also available to make presentations to groups about fraud and related issues. To schedule a speaker, please contact the Department's Government and Public Affairs Division at (785) 296-3918 or KID.AntiFraud@ks.gov
The Data, Systems and Statistics Unit is tasked with the development and implementation of technical processes, management of data and the retrieval and reporting of various kinds of information. The primary functions of the unit are to administer and provide support for the division’s Electronic Data Interchange (EDI) program, coordinate with KDOL Information Technology in the ongoing development, maintenance and enhancement of the database and the web application OSCAR, generate reports for departmental sections and units, respond to ad hoc research requests from internal and external customers and publish the department’s annual statistical report.
Federal regulations mandated by the Health Insurance Portability and Accountability Act (HIPAA) went into effect in 2003. One of the goals of HIPAA is to protect the privacy of health records used and disclosed by covered entities, which include health care providers, health care clearinghouses and health plans. The HIPAA regulations require covered entities to obtain authorization from an individual before disclosing health information about that individual. This authorization requirement does not apply to disclosure of health information for purposes of workers compensation.
The Workers Compensation Exception: The HIPAA regulations specifically allow covered entities to disclose health information as authorized by, and to the extent necessary to comply with, workers compensation laws (45 CFR § 164.512). Kansas workers compensation law and regulations require health care providers to provide health information to employers, insurance carriers and the Director of Workers Compensation without the injured worker's authorization (K.S.A. 44-515; 44-557a, K.A.R. 51-9-10; 51-9-16). Therefore, a health care provider may disclose health information related to a workers compensation claim to the parties involved in the claim, or to the Division of Workers Compensation without the patient's authorization and such disclosure will not violate the HIPAA regulations.
Privacy Notice: HIPAA regulations do require that health care providers develop a privacy notice for patients (CFR 45 § 164.520). The division recommends that such notice include an advice that medical records can be disclosed to employers, insurance companies and the division for purposes of workers compensation claims.
For more detailed information on HIPAA, visit the following websites:
- Department of Health and Human Services Administrative Simplification
- Department of Health and Human Services Disclosures for Workers Compensation Purposes
- Office of Civil Rights Health Information Privacy
- American Medical Association CPT Coding, Billing and Insurance: Health Insurance Portability and Accountability Act
To obtain the authorized signature from the Workers Compensation Division, please contact the Workers Compensation Division. All subpoenas must be requested by OSCAR.
The subpoena will be signed and returned to your business. Subpoenas with a revision date other than 1/17 will be returned without a signature.
The party requesting a subpeona is responsible for ensuring it is properly served.
Would you like one of our professional staff to make a presentation to your group? Please contact Ryan Boswell at Ryan.Boswell@ks.gov from the Workers Compensation Division with your request.
Topics to be covered include:
- General workers compensation issues
- Training for employers
- Insurance carriers, agents and other interested parties
Forms and Publications
- Neutral IME Professionals List (to download)
- Workers Compensation Laws and Regulations
- K-WC Form D (Rev. 11-16) - fillable enabled.pdf
- Workers Compensation Closed Claims Analysis - CY 2018
- Workers Compensation Information for Kansas Employers and Employees (K-WC 25) (English)
- Workers Compensation Information for Kansas Employers and Employees (K-WC 250) (Spanish)
- Information for Injured Employees (K-WC 27-A) (English)
- Information for Injured Employees (K-WC 270-A) (Spanish)
- Workers Compensation Rights and Responsibilities (K-WC 40-A)
- K-WC E-1 (11-18) fillable enabled
- K-WC E-3 (11-18) fillable enabled
- K-WC E-4 (11-18) fillable enabled
- Independent Contractor or Employee Fact Sheet (K-WC 126)
- Employee Notification Forms Available Online (K-WC 530)
- Assessment Information (K-WC 121)
- Death Benefits Information (K-WC 140)
- Self-Insurance Information (K-WC 144)
- Why Audited Financial Statements are Required (K-WC 309)
- Information for Self-Insured Employers on the Kansas Workers Compensation Act and Regulations (K-WC 1441)
- Annual Report 2020
- Annual Report 2019
- Annual Report 2018
- Annual Report 2017
- Annual Report 2016
- Annual Report 2015
- Annual Report 2014
- Annual Report 2013
- Medicare Set-Aside Arrangement Reference Guide
- Self-Administration Toolkit for Workers’ Compensation Medicare Set-Aside Arrangements (WCMSAs),Version 1.1, January 5, 2015
- Kansas Commission on Disability Concerns
- Kansas Insurance Department
- Medicare Information Resources
- NCCI Experience Rating Information
- NCCI Residual Market (Assigned Risk) Information
- U.S. Department of Labor, Office of Workers' Compensation Programs (OWCP)