Most states have a workers’ compensation program, though it may not be mandatory. Workers’ comp is a way for employers to provide coverage for employees who get injured or become ill on the job without exposing the employer to tort liability. The employee has the advantage of not being required to prove negligence.
Not having to prove negligence does not mean it is easy to receive benefits. The workers’ compensation case process in Toledo and the surrounding area can become complicated. Following all the steps is essential to obtaining the desired outcome. Our local workers’ comp attorneys at Schaffer & Associates are here to help you through the claims process.
A workers’ comp case does not begin until the employee gives the employer notice of the injury. Even if the circumstances of the injury suggest that the employer has noticed it, the employee still needs to provide the employee with official notice. If the employer has a stated procedure, it is essential to follow those steps. Otherwise, providing written proof should be sufficient. Sending an email to a supervisor and HR is one way to provide written proof and establish an electronic record.
If the employer has an internal accident report, the employee needs to fill that out, too. Sometimes, a severely injured employee will be unable to fill out the report. In that case, they should have someone fill it out for them and then approve the form before turning it in. Like the initial report, the employee should create an electronic trail to prove that they submitted the accident report.
Getting prompt medical care is an integral part of the reporting component of the Toledo workers’ compensation process. The employee should go to a doctor or other healthcare provider for diagnosis and treatment of the injury or illness. Employers cannot force their employees to go to a specific provider; they can go to any provider for the initial visit. After the initial visit, however, the employee must go to a Bureau of Workers’ Compensation (BWC)-certified provider.
The First Report of Injury (FROI) is the application for workers’ compensation benefits and the next step in the case process. The worker, the employer, or the health care provider can all file this claim. Employees should double-check to ensure that the FROI has been filed if the employer or a healthcare provider says they will do it. The employee has one year from the date of injury or the date they became unable to work to file the claim.
The FROI should contain detailed information about the nature of the injury, how it occurred, and any medical treatment received. After the Ohio BWC receives the FROI, they will assign a claim number and send the employee an identification card.
After that, the employer (or their insurer) can investigate the accident. They can confirm or reject the injury with the BWC. If the employer confirms the injury, then they negotiate a settlement with the employee.
If the BWC denies an employee’s claim, then they send the employee an order outlining that decision. The employee has 14 calendar days from the date they received the order to file an appeal. Failing to file an appeal within this time frame means the employee forfeits the right to appeal.
Employees in Toledo and the surrounding area who are worried about a potential denial should talk to the attorneys at Schaffer & Associates during the workers’ compensation claims process so they are prepared to appeal as soon as they receive a denial.
The BWC has very particular guidelines for the workers’ compensation case process in Toledo and for any related appeals. You do not want your claim disallowed because you failed to follow any of their steps.
Schedule a consultation with an experienced attorney at Schaffer & Associates to find out how we can help you preserve and present your claim or proceed with an appeal.