What Is Workers’ Compensation?
Workers’ compensation is a form of insurance that is designed to provide monetary benefits and/or medical care for individuals who have sustained an injury or fallen ill as a result of their job. This insurance is provided by the employer, meaning the worker is not at all responsible for contributing to the cost of compensation. Ohio Law provides that in exchange for all employees being covered by workers’ compensation, an injured worker is very rarely able to sue their employer for any matter related to the compensated injury or illness and is relegated to the benefits afforded by workers’ compensation. If you are someone who has been injured on the job in Findlay, you should speak with a Findlay workers’ compensation attorney as soon as possible to understand your rights.
In Ohio, workers’ compensation is overseen by the Bureau of Workers’ Compensation (BWC), which serves over 250,000 employees in Ohio. In fact, the BWC is one of the largest state-run insurance systems in the United States. Alternatively, some very large employers are able to opt out of the state program and can become self-insured. It’s important to know many aspects of self-insured claims will be different from state-funded cases. However, ultimately, the Industrial Commission in Ohio can make decisions in self-insured cases as well as Ohio state-funded cases.
Individuals who were injured on the job may qualify for workers’ compensation benefits to cover the following expenses:
- Medical treatment
- Ongoing care
- Lost income and wages
- Funeral costs
- Disability benefits
The goal of workers’ compensation is to ensure that injured or ill employees are able to recover fully and return to work. In situations where the worker is able to return to some work but unable to earn their former wages due to their restrictions from injury or illness, certain benefits may still be available. In these situations, the employee is generally eligible to receive compensation that is equal to two-thirds of the difference in pre-injury wages versus post-injury wages.
It is also important to note that in workers’ compensation cases, the injury or illness must be a direct result of the employee’s job. In a workers’ compensation case, no individual or party is found to be at fault for the injury or illness under normal circumstances. As such, even if the injury was a result of the worker’s carelessness, they are usually still entitled to compensation. Your Findlay workers’ compensation attorney at Schaffer & Associates LPA can provide further insight into whether you are eligible for benefits under Ohio law.
What Types of Injuries Are Not Covered by Workers’ Compensation?
By design, workers’ compensation in Ohio is designed to cover the majority of injuries and illnesses that occur on the job. There are certain injuries that are not covered by workers’ compensation. The following types of injuries are typically not covered by workers’ compensation in Ohio:
- Pre-existing conditions, unless the condition was substantially aggravated due to an injury.
- Injuries sustained due to drug or alcohol use.
- Short-term, common illnesses such as the flu or headaches.
- Injuries that occur during optional work-sponsored recreational activities.
- Employees’ injuries that resulted from horseplay or fighting.
- Injuries occur while the employee was not on the job.
These exemptions should be seen as guidelines, not absolutes. There may be exceptions granted in special circumstances. If you are unsure whether your injury or illness qualifies you for workers’ compensation, consider speaking with a knowledgeable Schaffer & Associates, LPA attorney to discuss your case in greater detail.
Filing a Findlay Workers’ Compensation Claim
Workers’ compensation is not immediately granted once an employee has been injured. Instead, interested workers must formally initiate the process by filing a workers’ compensation claim. Filing a first report of injury is the first step to securing benefits. This claim must be accompanied by evidence of the injury or illness as well as all necessary forms and documentation. To successfully submit a workers’ compensation claim, it is important to follow the rules and regulations of Ohio law and ensure that all information is properly obtained and filed with the state.
Workers’ compensation coverage is available for the families of deceased employees as well. The surviving loved ones of a worker who passed away due to a job-related accident or incident may file a Findlay workers’ compensation claim. Eligible dependents can file this claim to handle funeral expenses and/or secure accrued benefits. There is a deadline associated with these benefits, so it is important to act quickly to ensure that you file for workers’ compensation correctly and on time.
How Do You File a Workers’ Compensation Claim in Findlay?
After being injured on the job, filing a workers’ compensation claim can seem overwhelming. There is a range of information available regarding how to file a claim and it may not be clear where to begin. The claims process is governed by state law, and there are specific steps that must be followed to file a workers’ compensation claim in Findlay. These steps are the same across the state of Ohio, meaning Findlay residents will follow the same process as Toledo residents. This uniformity is advantageous, as it provides Ohio residents with a standardized process to secure benefits as quickly and easily as possible.
To begin the workers’ compensation claim process, you must first file the First Report of Injury, Occupational Disease, or Death (FROI). The FROI can be filed by either the injured worker or their attorney. This form requires personal information, details regarding your employment, and the facts surrounding the injury and any medical care received as a result. Once this form has been filed, the injured worker will receive a workers’ compensation claim number. Incorrectly completing this form can greatly delay the process of receiving benefits, so it is important to be thorough and diligent at this step. Filing a Findlay workers’ compensation claim is an extensive process, leading many individuals to seek legal guidance from an experienced attorney.
Can Workers’ Compensation Deny a Claim?
It is an unfortunate truth that not all workers’ compensation claims are accepted. In 2019, for instance, the Ohio Bureau of Workers’ Compensation received more than 96,000 claims, but over 12,000 of those claims were disallowed or dismissed. This translates to approximately 12% of cases being denied – an important statistic for Ohio workers to consider. There are several reasons why a claim may be denied, and each claim is assessed on a case-by-case basis. The primary reasons why a workers’ compensation claim may be denied include the following:
- Incorrectly filing a claim. The rules and requirements surrounding workers’ compensation are highly complex and require detailed knowledge of Ohio law. Failure to complete initial forms thoroughly and accurately can result in your claim being denied. For example, if the explanation you provide does not match the injuries you sustained, your claim may be denied.
- Missing the filing deadline. In September 2017, the Ohio legislature passed House Bill 27, effectively changing some workers’ compensation laws in the state. One of the primary changes, listed in Section 4123.84 of this bill, centers around the statute of limitations associated with filing a claim. Currently, an injured worker has one year from the date of their injury to file a workers’ compensation claim. After this one-year statute of limitations has been passed, therefore, you may be no longer able to file a claim and receive benefits.
- Employer disputes. Workers who sustain an injury on the job have a responsibility to notify their employer of an injury in the workplace. The employer then has the option to either accept or reject the claim.
- Insufficient medical treatment. According to Ohio law, an injured worker must lose more than seven days of work to be eligible for workers’ compensation lost-time benefits. Moreover, the first seven days are not payable until the worker loses 14 consecutive days. Therefore, it is important to immediately seek medical treatment.
It can feel frustrating and overwhelming to have your workers’ compensation claim denied. It is possible to appeal a denied claim, however. This ability provides injured workers with an additional opportunity to receive benefits. If your initial workers’ compensation claim was denied, you may dispute the decision and ensure that you still receive the compensation you deserve. It is crucial that you navigate this process carefully to avoid further pitfalls. Your Findlay workers’ compensation attorney can work with you to build your case and successfully appeal your denied claim.
Hiring a Findlay Workers’ Compensation Attorney Near You
Being injured on the job is a life-altering experience, impacting the well-being of both you and your family. Workers’ compensation insurance is designed to protect workers and their loved ones by providing benefits for medical treatment, lost income, and other expenses. Navigating the claims process is not always straightforward and even the smallest missteps can have a detrimental impact on your case.
At Schaffer & Associates LPA we work closely with injured employees to file a workers’ compensation claim. We will help mitigate all potential pitfalls that may arise along the way and ensure that you receive the benefits you deserve. Above all, our team of experienced attorneys makes filing a worker compensation claim in Findlay as smooth and efficient as possible. To begin the process of securing full and fair compensation for your work-related injuries or illness, consider scheduling a free consultation with us at (419) 359-8091 today.
Get Help From a Findlay Workers’ Compensation Attorney
While some injured workers choose to file compensation claims on their own, that is not often advisable. Workers’ compensation laws in Ohio are complex, and we are here to ensure that nothing jeopardizes your chances of recovering as fully as possible.
Our services extend beyond helping you through the claims process. When you hire a workers’ compensation lawyer from our firm, you will have access to the information needed to understand your benefits eligibility, so you do not settle for less than what you are owed. We can also provide guidance and representation in the event you need to file a third-party negligence claim or have been in a work-related car accident.
The earlier you get in touch with our law firm after your accident, the more time we will have to evaluate your claim and provide you with comprehensive information on your rights. To get started, schedule a free consultation with us today.
How Does Workers’ Compensation Work in Findlay, Ohio?
The Ohio Bureau of Workers’ Compensation (BWC) is responsible for the workers’ comp system throughout the entire state. The agency regulates the requirements and rights of both employers and employees. Under the BWC system, you have the right to compensation for injuries sustained at work and within the scope of your job. You should also have access to comprehensive medical care and money to pay related bills.
While you can see any doctor for your initial visit after the accident, you will need to see a BWC-certified provider for subsequent appointments. Note that if you choose to forgo treatment or skip or miss appointments, you could jeopardize your claim. Following through on medical care is a crucial aspect of your benefits eligibility.
Filing a claim is typically done online; however, your attorney can explain the process for mailing your benefits application. The BWC separates compensation claims into medical-only and lost-time categories. If you missed seven or fewer days of work because of your accident, you might be eligible for medical-only benefits. If you missed eight or more days, lost-time benefits might apply.
It’s best practice to file your claim as soon after your accident as possible. In a matter of weeks, you will receive a decision letter. If your claim has been approved, you will most likely receive benefits via direct deposit. In the event your claim is denied, we can walk you through the appeals process and help you present your case to the Industrial Commission of Ohio (IC) to have the decision overturned.
How Can I Get Workers’ Compensation After An Injury?
The benefits you may be eligible for are based on the severity of your injuries and how they impact your ability to return to work. While most injured employees are able to eventually return to their previous position in some capacity, there are instances of permanent disability. The most common benefits awarded include the following:
- Temporary total (TT) compensation
- Permanent partial (PP) – schedule loss
- Percent of permanent partial (%PP)
- Permanent total disability (PTD)
However, there are a variety of other benefits options for which you could be eligible. We will thoroughly review your accident to determine the full scope of your losses. Other forms of benefits offered in Ohio include:
- Accrued compensation
- Change of occupation (COA)
- Death claim (survivor benefit)
- Facial disfigurement (FD)
- Living maintenance (LM)
- Lump-sum advancement (LSA)
- Travel reimbursement
- Violation of specific safety requirement (VSSR)
- Wage loss (WL)
- Wages in place of temporary total compensation (salary continuation)
Our Findlay workers’ compensation attorneys understand the challenges accident victims face. When you hire us, we will walk you through the claims process step by step. In the event your claim is denied, we can also help you navigate the appeals process to have the decision overturned so you can receive the benefits you need.
Contact Schaffer & Associates Today
A workplace accident can completely upend your life. If you or someone you love has been injured at work and is now struggling to learn about their legal rights and options, a Findlay workers’ compensation attorney can help.
Our attorneys represent workplace accident victims throughout Findlay from our Toledo headquarters. No matter what type of accident you were involved in, we can help you determine your eligibility for benefits and assist you with the claims process. To learn more about your rights, schedule a free consultation with our law firm today.