What are the Most Common Issues in Workers’ Compensation Cases? While workers’ compensation insurance is a requirement for employers in the state of Ohio, those injured on the job often find they are facing workers’ compensation issues. Perhaps a legitimate claim is denied and an appeal needs to be filed. Perhaps the claim was approved, but all medical bills are not being properly paid. There are many reasons a workers’ compensation claim could go awry—the best course of action is to contact an experienced Schaffer & Associates workers’ compensation attorney. Additional information regarding Ohio workers’ compensation can be found on the BWC website.
What Rights Do Employees Have in Workers’ Compensation Issues?
You have certain rights following a workplace injury. You have the right to appropriate and timely medical attention, paid for by BWC. If you will be off work for any significant length of time, you may also be entitled to lost wages. Lost wage benefits usually equal about two-thirds of your normal weekly salary. Your employer is not allowed to discriminate against you because you file a workers’ compensation claim.
Is There a Time Limit for Filing a Toledo, Ohio Workers’ Compensation Claim?
You have one year from the time of your workplace injury to file a claim with the Ohio BWC. Your application should be processed, and a decision issued within 28 days of when you initially filed. If your claim involves an occupational disease, you have two years from the date of your disability (inability to work) in which to file your Ohio workers’ compensation claim. Compliance with deadlines is among the most common issues in workers’ compensation cases.
The date your disability begins will depend on your specific circumstances. You could have a relatively short period of time to file a claim for brain damage due to chemical exposure, and certain other occupational diseases or illnesses. While you have from one to two years to file your BWC claim, it is to your benefit to file your claim as quickly as possible following your injury or occupational illness.
What are No-Fault Provisions Related to Workers’ Compensation Claims?
While workers’ compensation issues can and do arise, there are no-fault provisions built into the system. This means that even if the work-related accident that resulted in your injury was partially your fault, this is not a consideration in whether you will receive workers’ compensation benefits.
Under workers’ compensation, claims are paid regardless of fault, offering an important layer of protection for workers. The benefit of a no-fault workers’ compensation system is that claims are typically processed much more quickly because no burden of proof exists.
How Does the Ohio BWC Differ from IC?
The Ohio BWC collects workers’ compensation insurance premiums, oversees the insurance system, and pays out compensable workers’ compensation claims. The IC conducts hearings on any disputed claim and provides a forum for the impartial resolution of claims. The IC also determines total disability benefit eligibility and adjudicates claims involves the violation of safety requirements by an employer.
What if My Workers’ Compensation Claim is Delayed or Denied?
Sometimes, despite the no-fault system, an Ohio workers’ compensation claim is denied. Your claim could be denied simply because you did not provide sufficient information. Other common reasons for a denial include:
- Missing the filing deadline
- A discrepancy between your documented injuries and the accident report
- Failure to seek prompt medical treatment
- An injury that is not severe enough to warrant benefits
- A finding that the injury did not occur at work
- Your employer is disputing the claim
- The medical providers you used were outside the certified list
If your claim is denied or delayed, you should receive a letter stating the exact reason for the denial, as well as information regarding a potential appeal, including the appeal filing time frame.
Can I Appeal a Workers’ Compensation Denial?
Anxiety about a denial is, of course, among the most common issues in workers’ compensation cases. If you believe your workers’ compensation claim denial was in error, you can appeal the decision. In the state of Ohio, there are three levels of appeals: District, Staff, and Commission. At all levels, a hearing will occur within 45 days of when you file the appeal. A hearing officer will then decide within seven days whether to approve your workers’ compensation claim. If you are denied at the District level, you have 14 days to file an appeal to the next level. The Commission could refuse to hear the appeal, in which case you may choose to pursue the matter through the Ohio court system.
Can My Employer Retaliate If I File a Workers’ Compensation Claim?
Under Ohio law, your employer may not retaliate against you for filing a workers’ compensation claim. You have rights under the laws of the state that entitle you to medical treatment and lost wages in the event of a workplace accident with injury. That being said, there is no guarantee that your employer may not retaliate against you in more subtle ways. If you believe this is happening, contact an Ohio Workers’ Compensation lawyer immediately. Also, if you purposely file a false or fraudulent claim, you may not be afforded the same protections.
How Can a Toledo, Ohio Workers’ Compensation Lawyer Help?
If you are having issues collecting Ohio workers’ compensation, Schaffer & Associates LPA can help. We will work hard to obtain the workers’ compensation benefits you need and deserve. We will guide you through the entire process, ensuring you receive the medical treatments you need and deserve. Contact Schaffer & Associates LPA today for a comprehensive evaluation of your Ohio workers’ compensation claim.