Do I Qualify for Workers’ Compensation After a Workplace Accident in Ohio?

Accidents at the workplace can lead to very serious injuries, lost income, and long-term consequences for the victim and their family. In Ohio, as in most states, businesses are required to have workers' compensation insurance, which covers bills for those who are injured at work. However, not every injured worker is eligible for this. There are specific types of eligibility that must be met, and navigating the process can be difficult and confusing.

Understanding what type of work-related injury qualifies for workers comp isn't always easy, and many workers need the help of a workers compensation attorney. The team at Larrimer & Larrimer have been helping people understand their rights for decades, and they can help an injured employee recover the benefits they are entitled to receive. Our team can also help answer questions like Do I qualify for workers’ compensation with a repetitive strain injury?

Ohio’s Workers’ Comp System: A Brief Overview

The state of Ohio has a state-run workers’ compensation system. This means that most claims are administered by the Ohio Bureau of Workers’ Compensation (BWC), the exclusive provider, rather than private market insurance companies. The BWC covers things like medical expenses, lost wages, rehabilitation services, and other benefits when a worker is hurt on the job.

Employers in Ohio must carry workers’ compensation coverage unless they are exempt. Most fall under one of two categories:

• State fund employers, who pay into the BWC’s fund

• Self-insured employers, who manage their own claims under BWC guidelines

Ohio works under a no-fault workers’ compensation system. That means an employee may still receive workers comp benefits even if they were partially responsible for the accident — so long as the injury occurred within the scope of employment.

Eligibility Requirements for Workers’ Compensation in Ohio

The system is designed to support injured workers, but, it does not cover every accident or every person. Private employers must carry it in Ohio if they have a certain number of employees and meet certain qualifiers. (Other state laws vary.) Consider consulting workers comp law firms in Columbus Ohio for more information.

Though state law in Ohio requires workers compensation, work related injury coverage depends on the following:

The Injured Worker Must Be a Covered Employee

Only employees are covered under Ohio’s workers’ compensation laws. This includes full-time, part-time, and temporary workers, as long as they are classified as employees, and that's where many employers try to cheat the system, and people may not receive benefits they deserve.

The following individuals are typically not covered:

• Independent contractors

• Volunteers (with some exceptions)

• Certain agricultural or domestic workers

• Individuals who are self-employed and do not opt into coverage

Disputes sometimes arise over worker classification, or if they are on actual payroll. In those cases, the BWC or Industrial Commission may need to determine whether a person was truly an employee under Ohio law, or if the employer miss-categorized the worker.

The Injury Must Be Work-Related

To qualify, the injury must occur "in the course and scope of employment." Rules vary, but it generally means:

• The injury happened at the work site or while performing job duties

• The activity benefited the employer or was part of the worker’s responsibilities

• The injury occurred during working hours or during a sanctioned work activity

Not all injuries qualify, though, and there are several factors that may go into that. For example:

• Accidents that happen while commuting to or from work typically are not covered

• Injuries that occur during a lunch break may or may not qualify, depending on circumstances

• Injuries caused by horseplay, fighting, or intoxication may be excluded, even if they occurred when on the job and was otherwise work related.

Timely Reporting and Filing

An injured worker must notify their employer and file a claim with the BWC. The form used is called the First Report of Injury (FROI), and the worker, a doctor, or the employer can do this. If the injury is not reported on time, even if the worker got medical attention, their medical bills might not be covered.

In Ohio, the statute of limitations to file a workers’ compensation claim is one year from the date of injury, or one year from the date of diagnosis for occupational diseases.

Types of Injury or Illness That May Be Covered

Ohio workers’ compensation law recognizes a wide range of injuries and illnesses. If they are not covered, the worker might have to contact their own insurance carrier for coverage.

• Traumatic injuries like fractures, burns, lacerations, or amputations resulting from workplace accidents

• Repetitive strain injuries like carpal tunnel syndrome or chronic back pain from lifting

• Occupational diseases caused by long-term exposure to toxic substances or environmental hazards

• Mental health injuries are more complex — they must usually be tied to a physical injury to be covered

• Aggravation of pre-existing conditions, if the work activity directly worsened the prior condition

Each claim must be supported by medical documentation that shows the injury is related to the person’s work duties or environment.

Why Workers’ Compensation Claims Are Denied

Even when injuries are clearly work-related, payments are sometimes denied due to:

• Disputes about how the injury occurred

• Failure to report the injury on time

• Not enough medical evidence or lack of physician support

• The employer arguing the worker was not acting within the scope of employment

• Issues with employment classification (e.g., independent contractor vs. employee)

• Pre-existing condition claims without proof of aggravation

Fortunately, a denied claim can often be appealed through the Ohio Industrial Commission (OIC). The appeals process allows for hearings, legal arguments, and submitting additional evidence.

It's not easy to win an appeal, however. An experienced workers’ compensation attorney can greatly improve the chances of success at this stage.

How Larrimer & Larrimer Can Help with Ohio Workers’ Compensation Claims

Working through the Ohio workers’ compensation system without a lawyer can be overwhelming — especially when injuries result in long-term disability, surgery, or job loss.

Attorneys at Larrimer & Larrimer help clients by:

• Determining whether the worker qualifies for compensation under Ohio law

• Helping obtain and submit medical records, diagnostic reports, and expert opinions

• Filing the FROI and other required documents with the BWC

• Appealing denials and representing clients at OIC hearings

• Advising on return-to-work options and potential settlements

Working with a lawyer ensures that every deadline is met and that the injured worker is not pressured into accepting reduced benefits or waiving rights prematurely, which is common.

Not every workplace injury leads to workers’ compensation benefits in Ohio — but many do. Whether the injury is a sudden accident or a condition that develops over time, workers who meet the criteria may be entitled to receive medical care, lost wages, and other benefits through the Ohio Bureau of Workers’ Compensation.

Understanding the eligibility requirements is the first step. When issues come up — or when a claim is denied — getting help from a lawyer is imperative.

Larrimer & Larrimer has built a reputation for trusted assistance and skilled representation. For over 90 years, the firm has helped injured workers, understand their rights and obtain the benefits they deserve under the law. Victims of work-related injuries don't have to suffer. They can get treatment covered in most cases by using the Ohio workers compensation system.