Oklahoma workers' compensation is governed by the Administrative Workers' Compensation Act, Title 85A of the Oklahoma Statutes. Claims are filed with and decided by the Oklahoma Workers' Compensation Commission. This guide covers the Oklahoma rules: how employers secure coverage, who counts as an employee, benefit levels and deadlines, policy cancellation, and the assigned risk plan. The standard policy (Part One, Part Two, Part Three), rating, and federal programs are in the national Workers Compensation guide.

How an employer secures compensation (85A O.S. 38)

An Oklahoma employer can secure its obligation in any of these ways:

• Buy a policy from an insurer authorized to write workers' compensation in Oklahoma.
• Self-insure by showing the Commission satisfactory proof of financial ability (38(A)(3)).
• Join a group self-insurance association: two or more employers with a common interest pooling their liabilities (38(A)(4)).

Oklahoma is not a monopolistic state, so there is no requirement to buy from a state fund.

The insurer must file notice of a new policy with the Commission within 30 days after its effective date (38(A)(1)). Covered employers must post a notice of coverage in a conspicuous place (85A O.S. 41).

Penalties for not securing coverage (85A O.S. 40):

• A misdemeanor, with a fine up to $10,000.
• The Commission may also fine up to $1,000 per day, capped at $50,000 for a first violation.
• The employer loses the exclusive-remedy protection (below).

Assigned risk plan: an employer declined by two unaffiliated insurers may get coverage through the assigned risk plan administered by the Insurance Commissioner (36 O.S. 608.2).

Exclusive remedy (85A O.S. 5)

Workers' compensation is generally the employee's exclusive remedy against the employer. There are two exceptions:

• The employer failed to secure compensation as required.
• An intentional tort, which exists only when the employer acted with willful, deliberate, specific intent to injure the employee.

Who is not an "employee" (85A O.S. 2(18)(b))

• Workers covered by the federal Longshore and Harbor Workers' Compensation Act, to the extent of that coverage.
• Agricultural workers, when the employer's prior-year agricultural payroll was under $150,000.
• Licensed real estate sales associates paid by commission.
• Employees of an employer with five or fewer employees, all related to the employer within the second degree by blood or marriage.
• Sole proprietors and partners, unless they elect coverage under a policy.
• Volunteers who receive only meals, transportation or similar benefits, not wages.
• Domestic servants in a private household whose prior-year payroll for such workers was under $50,000.

Medical care

• The employer ordinarily chooses the treating physician (85A O.S. 50(A)).
• If the employer doesn't provide treatment within 5 days after learning of the injury, the employee may choose a physician at the employer's expense (50(B)).
• Medical benefits cover treatment that is reasonably necessary for the work injury.

Occupational disease (85A O.S. 65)

• An occupational disease must arise out of and in the course of employment and cause disability or death.
• Ordinary diseases of life to which the general public is exposed are not compensable.
• The employer liable is the one where the worker was last injuriously exposed.

Disability benefits (85A O.S. 45)

Benefits fall into four classes: temporary total, temporary partial, permanent partial and permanent total.

Claim deadlines (85A O.S. 69)

• Accidental injury: file with the Commission within 1 year of the date of injury.
• Death benefits: file within 2 years of the date of death.

Policy rules (85A O.S. 42)

• Cancellation by the insurer: notice must go to both the employer and the Commission.
  • Nonpayment of premium: at least 10 days' notice.
  • Any other reason: at least 30 days' notice.
• Insolvency: the employer's bankruptcy or insolvency doesn't relieve the carrier of paying compensation.
• Split coverage (some employees with one carrier and the rest with another) is prohibited, except for approved job-specific policies.

Fraud and guaranty protection

• Workers' compensation fraud carries a fine up to $10,000, plus possible imprisonment (21 O.S. 1663(A)).
• If an insurer becomes insolvent, the Oklahoma Property and Casualty Insurance Guaranty Association pays covered workers' compensation claims in full. Most other claims are capped at $150,000 (36 O.S. 2007(A)(1)).
• Producers who sell workers' compensation must be licensed producers (36 O.S. 1435.2(5)).

Common exam traps

• Commission, not court. Claims are filed with the Workers' Compensation Commission.
• Not monopolistic. Coverage comes from authorized insurers, self-insurance or group self-insurance. The assigned risk plan is the fallback after two declinations.
• TTD is 70% of the average weekly wage, with a 3-day waiting period and a 156-week cap.
• Cancellation notice is 10 or 30 days, and the notice also goes to the Commission.
• Sole proprietors and partners are covered only if they elect coverage.
• The intentional tort exception requires specific intent to injure. Gross negligence isn't enough.