Our Workers Compensation Attorneys Provide Valuable Information About Your Benefits
Workers compensation in Ohio involves multiple steps and procedures. The Columbus workers compensation attorneys at Larrimer & Larrimer, LLC outlined the procedures below with important things to remember. If you have any questions, you should contact us right away; we work for your benefit. By focusing our law practice, our attorneys have all developed a high level of authority in Ohio workers comp laws.
How to Begin the Workers Compensation Process
To qualify for workers compensation benefits, you must follow the appropriate steps. If you suffer a work injury, you should immediately complete and file a written accident report. Additionally, you should also file a First Report of Injury Claim with the Ohio Bureau of Workers’ Compensation as soon as possible. You can file this form as the injured worker. Alternatively, your treating physician or your employer can also complete and file this form on your behalf. You do, within certain limits, have the right to choose your own doctor.
When you file the First Report of Injury Claim, the Ohio Bureau of Workers’ Compensation (the Bureau) will issue a claim number. A claim number establishes an electronic file for you; however, filing a claim does not guarantee that you will receive benefits.
If your employer or anyone else contests the claim, the Bureau will refer the claim to the Ohio Industrial Commission for a hearing. You, your employer and your employer’s appointed representatives will receive a hearing notice. In some cases, a Bureau attorney will also appear on behalf of the Bureau at an Industrial Commission hearing. A vast majority of workers compensation claims are:
- medical-only claims
- certified by the employer
- allowed routinely by the Bureau.
Contested claims require Industrial Commission hearings. If an injured worker receives a hearing notice, it is a contested claim. In that case, the injured worker may wish to obtain legal representation.
Work Loss Benefits
If an injured worker misses time from work, he or she may file a request to receive payment for temporary total compensation. Important things to remember:
- Less than seven (7) days off work are not payable.
- Temporary total disability for less than twelve (12) weeks is paid based upon earnings in the week prior to injury or in the six (6) weeks prior to injury.
- If the injured worker is off longer, then the rate of compensation is based upon an average weekly wage of the year prior to injury earnings.
- If an injured worker returns to work in a light duty capacity and earns less as a result of light duty restrictions, the injured worker may be paid wage loss for the difference in pay. However, if the employer cannot accommodate light duty restrictions, the injured worker may also undertake a light duty job search. In that case, the Bureau may consider non-working wage loss. Applications for these benefits are filed directly with the Bureau.
Some employers in Ohio are self-insured. In claims involving a self-insured employer, a claimant must file a request for benefits first with the self-insured employer. If the employer contests the benefits, it should refer the matter to the Bureau and the Industrial Commission. If the employer participates in the Bureau’s state insurance fund, then requests for compensation for time off work are filed with the Ohio Bureau of Workers’ Compensation.
Then, if the Bureau or the employer disputes the request for benefits, the matter goes to the Industrial Commission for a formal hearing.
Workers Compensation Benefits for Medical Expenses
Generally speaking, in an allowed workers compensation claim, medical bills are payable. However, the claimant must obtain prior authorization. The injured worker has a right to choose his or her physician of record; if you change your physician of record, you must file the change in writing.
Requests for medical care are filed with the managed care organization (MCO). The managed care organization is responsible for evaluating whether to initially approve or deny treatment. If you appeal the MCO’s decision, the case will go to the Bureau for further evaluation. If the Bureau denies your claim and you appeal that denial, the case then goes to the Ohio Industrial Commission.
Other workers compensation benefits available include permanent partial disability, loss of use awards, permanent total disability and a full and final settlement payment to close a claim in its entirety.
Appealing Industrial Commission Decisions
You may appeal to the Ohio Court of Common Pleas in the county in which the injury occurred. This includes the original allowance of a claim or an allowance of an additional diagnosis after Industrial Commission hearings. In the vast majority of cases, Court of Common Pleas’ appeals always involve attorneys representing the Ohio Attorney General, the employer of record and the injured worker. The employer and the injured worker are each responsible for retaining their own legal representation.
Act Quickly to Secure Your Workers Compensation Benefits
Each claim has a two year statute of limitations. If you do not file your claim within two years of your injury, you may lose your chance to do so. You should not wait two years to report or file your claim. The sooner you file your claim, the more likely you are to succeed.