Understanding the Workers’ Comp Claim Process
The workers’ compensation claim process in Ohio is relatively straightforward. When it operates as intended, it delivers benefits to individuals who get injured or fall ill on the job within a short time and in amounts sufficient to tide the person over until he or she recovers sufficiently to return to work.
The Ohio Workers’ Compensation program also accepts claims for work-related deaths and for major, permanently disabling or disfiguring injuries such as finger amputations and facial scarring. Here, the workers’ comp attorneys with Larrimer & Larrimer will focus only on basic injury claims to make it clear how the claims process should usually operate.
Be aware that if you think you should qualify for workers’ compensation, you have the right to seek advice and representation from a lawyer at any time. An attorney can also help you complete and submit application paperwork even if you go through your employer when applying.
To File a Workers’ Comp Claim, You Must Suffer a Qualifying Injury
For the purposes of workers’ compensation, a qualifying injury is one that occurs while a person engages in work-related activities. Examples include tripping in an office stairway, getting hit by a piece of equipment on the shop floor, losing hearing to an explosion at the worksite, or getting hit by another driver while operating a company vehicle.
Note that the employer can challenge a workers’ comp claim on the grounds that the injured person was not following clearly communicated safety procedures, ignoring a supervisor’s instructions, or using drugs or alcohol. When an employer raises such objections, an injured worker will need to present evidence that disproves the employer’s statements.
Apply to Ohio Workers’ Compensation
An employee must submit an Ohio workers’ comp claim within one year of the date on which the work-related injury occurred. Missing this deadline puts a claim beyond the statute of limitations, and an application received after the statute of limitations expires will be rejected automatically.
All the necessary forms for submitting a claim are available on the Ohio Workers’ Compensation website. Larger employers often keep printouts of the application forms in the safety office or human resources department. Injured workers can cooperate with safety reps or HR staff, but they cannot be forced to let their employer handle all aspects of a workers’ comp claim.
The application that goes to Ohio Workers’ Compensation must be accompanied with documentation of the injury, the treatment the injured worker received, the limitations the injury placed on the person’s ability to work, and a plan for recovery and rehabilitation. Such documentation comes in the form of medical records, hospital bills, prescriptions, and reports from health care providers and therapists.
A detailed description of the incident that caused the injury must also be included with the application. That description can be supported by an official accident report, witness statements, and, in the case of a work-related traffic accident, a police report.
Do Not Panic at a Denial
The first round of the Ohio workers’ comp claim process involves only preparing, submitting, and reviewing paperwork. An approval at the first round means the injured worker will begin receiving up to three-quarters of his or her pre-injury pay within a few weeks. Medical costs and other benefits may also be due, depending on the nature of the claim.
If a new application gets denied, the worker is allowed to appeal. Working with a Columbus workers’ compensation attorney who has handled many workers’ compensation cases while pursuing an appeal is a good idea. Succeeding with an appeal almost always means collecting and presenting additional evidence to address very specific objections. Appealing also means going through a hearing with a claims administrator. If official appeals fail to secure benefits, an injured worker may need to file a lawsuit against the workers’ comp program.
The attorneys with Larrimer & Larrimer welcome further questions regarding the Ohio workers’ compensation process. Call (614) 221-7548 for answers or use this online contact form to schedule a free consultation on your workers’ comp application or appeal.