Hawaii Workers' Compensation Laws

If you’re injured at work in Hawaii, workers’ compensation pays for your medical care and replaces part of your lost wages while you recover. The state also has a separate program that covers injuries that happen off the job. Which system applies affects both the amount and timing of your workers’ compensation benefits.

If your employer or its insurance carrier disputes your injury or the amount you are owed, consider meeting with a Hawaii workers’ compensation attorney. They can review your claim, check your payments, and challenge a denial before your appeal deadline passes.

Who Is Covered by Workers’ Compensation in Hawaii?

Hawaii has one of the broadest workers’ compensation mandates in the country. State law requires employers, even with a single employee, to carry workers’ compensation insurance or approved self-insurance. This rule applies to temporary, part-time, and full-time employees. The state also has no small-business or nonprofit exception and no waiting period before coverage kicks in.

Most independent contractors aren’t covered by workers’ compensation laws. To determine coverage classification, the state looks at how employees do their work, who directs them, who provides the tools, and how employers pay them.

The following is a small group of workers who fall outside Hawaii’s mandate:

• Real estate salespersons and brokers whose pay comes solely from commission
• Corporate officers who own at least 50% of the corporation, and LLC members with a distributional interest of at least 50%, though either may elect voluntary coverage
• Partners in a partnership, provided the partner is an individual rather than a business entity
• Federal employees, who fall instead under the federal Employees’ Compensation Act
• Domestic workers whose cash pay stays under $225 in the present quarter and in each of the four quarters immediately before it
• Properly classified independent contractors, since they fall outside the statutory definition of “employee” in the first place

If you’re unsure about your job classification, the Disability Compensation Division can help you figure it out before filing a claim. You can also contact a workers’ compensation attorney to review the circumstances surrounding your employment and tell you which classification you fall under.

What Benefits Can You Receive?

Hawaii’s workers’ compensation system breaks down into four categories:

• Medical care
• Wage-replacement benefits
• Death benefits
• Vocational rehabilitation

That last category applies to an injured worker who can’t return to work in their old job.

Medical Benefits

Your employer’s insurance must pay for reasonable medical treatment related to your injury, including surgery, hospital care, medication, and equipment, until a physician declares you fit to return to work. You can choose your own doctor or surgeon, as long as they practice on the island where you were hurt. Doctors can’t bill you directly for treatment covered by workers’ compensation.

Wage-Replacement Benefits

If your injury keeps you from working or reduces your earnings, workers’ comp may cover part of your salary. You may be eligible for the following disability benefits:

• Temporary total disability: If you can’t work at all while you recover, this pays two-thirds of your average weekly wage, subject to a yearly maximum and minimum set by the state. If you were earning $900 a week, you’d receive $600 a week from workers’ comp.
• Temporary partial disability: If your injury lets you return to work in a limited capacity but you earn less than before, this pays two-thirds of the difference between your old wage and your new one. For instance, if you went from $900 a week to $600 in a modified role, you would receive two-thirds of that $300 gap, or $200 a week.
• Permanent partial disability: If your condition stabilizes and a doctor finds a lasting impairment, you may qualify for this benefit. For a scheduled injury or disfigurement, such as losing a specific body part or its function, the award is based on a set number of weeks at the maximum weekly rate. Whole-person impairments use a different formula tied to that same rate.
• Permanent total disability: If you can’t return to any work, you receive this benefit at the same rate as temporary total disability, with no time limit. Hawaii presumes total disability for injuries such as total blindness or paralysis of both arms or both legs. Other cases are reviewed individually.

Every workers’ comp claim is different.

Death Benefits

If a work injury leads to death, dependents such as a spouse, reciprocal beneficiary, or children may receive weekly benefits. A surviving spouse usually receives benefits until death or remarriage. Dependent children qualify until age 18, or longer if they are full-time students. The employer must also pay for funeral and burial expenses, based on a multiple of the maximum weekly benefit rate for that year.

How Are Your Benefits Calculated?

Your benefit is based on your average weekly wage, calculated in the way that best reflects your actual earnings. This usually includes recent wages, tips, and non-cash compensation such as housing if it applies.

The state of Hawaii updates its maximum and minimum weekly benefit amounts every January. This means a claim filed late in the year may use different numbers than one filed earlier. For example, a worker earning $500 a week would receive about $333 a week in temporary total disability benefits. Someone earning $900 a week would get about $600. If your earnings are above the state’s cap, the state limits your claim to the maximum rate instead of two-thirds of your actual wage.

How Do You File a Workers’ Compensation Claim?

After an injury, your first priority should be getting the medical care you need. A doctor’s evaluation not only protects your health, but also creates a medical record to support your healthcare claims. After receiving medical treatment, follow the steps below to file your workers’ comp claim.

• Report your injury to your employer as soon as possible: Hawaii requires prompt notice after an injury occurs
• Your employer must file a report with the state: The Disability Compensation Division requires employers to submit an injury report within a set number of working days after learning about an injury that causes lost work time or needs more than first aid
• Get medical treatment from a physician who practices on the island where you suffer injury: Follow their treatment plan

If your benefits are denied or unpaid, either you or your attorney can file a formal claim with the Disability Compensation Division to start a determination. Attend any required meetings. If the administrative process doesn’t resolve the dispute, a hearing officer will decide the contested issues.

Important Deadlines

You must notify your employer as soon as practicable after suffering work-related injuries. Your employer then has a set number of working days to report it to the state. You also have a limited time after your injury becomes apparent to file a written claim, with an overall deadline from the date of the accident. Occupational disease claims, such as those from asbestos or radiation, have a separate deadline that starts when the injured employee learns the illness is job-related.

Missing these deadlines can permanently block your right to benefits. Report an injury even if it seems minor at first.

What if Your Claim Gets Denied?

Insurance companies often deny workers’ comp claims for medical expenses or argue that the injury isn’t compensable. They might claim the injury didn’t occur at work, the reporting was late, or that a pre-existing condition wasn’t worsened by your job. They can also argue the injury resulted from intoxication or misconduct.

You can challenge most of these reasons, especially if you have strong medical evidence and witness statements. If your claim is denied in whole or in part, you can request a hearing before a Disability Compensation Division hearings officer. A decision usually follows within a set time after the hearing. If either side disagrees, they have a limited time from the date the decision is mailed to file an appeal.

Talk to a Hawaii Workers’ Compensation Attorney

Workers’ compensation laws are meant to provide medical care and partial wage replacement without requiring you to sue your employer. It’s not always easy to receive the right amount of workers’ compensation benefits or to meet filing deadlines. If you’re feeling overwhelmed during the claims process, speaking with a workers’ compensation attorney can help. They can help ensure you receive what you’re owed and represent you if your insurer denies your claim.