Answers to Workers’ Compensation Questions From a Columbus Attorney

Columbus employees and workers throughout Ohio who suffer injuries on the job normally have many questions running through their mind. Here we have provided many answers to common questions we are asked regarding general claim information. We have also provided many questions and answers regarding medical treatment and receiving compensation.

• Who is responsible for filing an Ohio workers’ compensation claim?
• Do I qualify for workers’ compensation benefits?
• What kind of injuries are covered by workers’ compensation?
• Do I need an attorney for my workers’ compensation case?
• How do I claim workers' compensation? 
• How long does it take to process a workers’ compensation claim?
• What types of benefits will I receive?
• What is a C84?
• What’s a MEDCO-14?
• What is permanent partial disability?
• If my injury happened at work, why is my employer denying treatment?
• What if my employer tells me not to file a workers' compensation claim?
• Can I appeal a denied workers' compensation claim?

Who files an Ohio workers’ compensation claim?

You do! When an injury occurs at work, immediately report the accident to your employer.  They are supposed to help you file the claim with the company’s Managed Care Organization (MCO). Reporting the claim online at ohiobwc.com is the Bureau’s preferred way of filing a claim. When you file a claim online, you will immediately receive a claim number. Learn more about filing a claim if you have already seen a doctor.

Do I qualify for workers’ compensation benefits?

Unfortunately, the answer is not so simple. Workers' compensation laws are very complex and it is sensible to work with an experienced Columbus workers compensation attorney. It really does depend on your individual situation. Please call our office at (614) 334-4649.

What kind of injuries are covered by workers’ compensation?

In Ohio, workers’ compensation covers physical injuries sustained in the course of and arising out of employment. Pre-existing physical conditions substantially aggravated by a work injury/incident may also be covered. Psychiatric/psychological conditions that develop from or, if pre-existing, are substantially aggravated by physical injuries are also covered. Ohio is one of a minority of states that does NOT recognize as compensable psychiatric/psychological conditions that develop without a corresponding physical injury.

Do I need an attorney for my workers’ comp case in Columbus?

Not all claims involve serious injuries and not all claims need attorney involvement. If an injury is relatively minor, requiring maybe a trip to the emergency room and a stitch or two with no residual impairment, it may go through without a hitch. It’s likely you will want to talk with a Columbus attorney who specializes in workers’ compensation claims if your injury is serious, will likely involve lost-time from work, and/or is being contested by your employer and/or the BWC. Learn more

How do I claim workers' compensation in Columbus? 

First, report the injury to your Columbus or Ohio employer in writing. While reporting in writing isn’t a legal requirement, doing so documents your actions and lessens the possibility that your claim will be contested. Second, seek medical attention from an urgent care facility, hospital emergency room, company nurse, or doctor soon. Provide a complete history of what you were doing, how you were injured, and where it hurts. Third, if you are claiming workers’ compensation, file your claim promptly. The time you have to file a claim is limited by the statute of limitations. Your hospital or employer may furnish necessary paperwork and even file the claim for you, but it is ultimately your responsibility to ensure that your claim is filed with the Ohio Bureau of Workers’ Compensation and a claim number is assigned.

How long does it take to process a workers’ compensation claim?

Within 28 days, the Bureau of Workers’ Compensation (BWC) will allow or deny your claim. By responding to any inquiries from them or from your managed care organization (MCO), you will speed up the decision process and receipt of benefits.

What types of benefits will I receive?

Injured workers in Ohio are eligible to receive medical treatment for their work-related injuries and compensation for their lost time from work. This compensation, known as Temporary Total Disability (TTD), is paid if the injury results in more than a week off work. If the lost time is less than a week, no compensation is payable. If it’s between one and two weeks, only the period during the second week is compensable. If over 2 weeks, it’s all paid.

Temporary Total Disability compensation is paid based on a percentage of the worker’s earnings for one week, 6 weeks or 52 weeks prior to the injury, depending on how long the period of disability lasts. Injuries resulting in some permanent impairment may permit an additional award of compensation known as permanent partial disability.

What is a C84?

The Ohio Bureau of Workers’ Compensation requires Form C84 as proof of ongoing temporary total disability. The injured worker must complete the form, verifying the period of disability and that she has not worked and has not received other wages during the period of temporary total disability. These forms must be periodically updated for compensation to continue. Your doctor must complete a separate form certifying temporary total disability. Both forms are required before compensation can be paid.

What’s a MEDCO-14?

A MEDCO-14 is a Physician’s Report of Work Ability. Your doctor completes this form to certify that you are temporarily and totally disabled due to your work injury or to identify any restrictions on your ability to perform your job duties due to the injury. A MEDCO-14 must be submitted every time you submit a C-84.

What is permanent partial disability?

Permanent partial disability (PPD) is a form of compensation that may be payable following a work injury. It is paid by the Ohio Bureau of Workers’ Compensation or a self-insured employer following an exam (or sometimes multiple exams) at which a physician is asked to provide an opinion regarding lost bodily function that has resulted from an injury or occupational disease. It is workers’ compensation’s version of a damages award for an industrial injury. Time limitations may apply in requesting an award of PPD. In addition, the percentage of disability resulting from an injury may be disputed by the injured worker, the employer, and/or the BWC. In such situations, the Industrial Commission conducts a hearing to determine a proper award. This is differs from a settlement of your claim.

If my injury happened at work, why is my employer denying treatment?

Treatment may be denied by your employer, your managed care organization (MCO), or the BWC if excessive, inappropriate, or not cost-effective. MCOs may deny treatment they consider too expensive, even if it is treatment your doctor believes is beneficial. You may appeal decisions denying treatment that your doctor believes appropriate.

What if my employer tells me not to file a workers' compensation claim?

Penalties may be assessed against employers who fail to provide workers’ compensation coverage. If an employer tells you not to file a claim for a work-related injury, maybe s/he tried to cut costs by not obtaining the mandatory workers’ compensation coverage. Reporting the injury would notify the BWC of the employer’s non-compliance. It could also be the employer has had so many claims filed against them they fear the BWC will increase their insurance premiums.

Injured employees are still covered by the workers’ compensation system even if their employer is non-complying, so it is still best to file a claim. Learn more

Can I appeal a denied workers' compensation claim?

The BWC has 28 days to allow or deny your claim. If you or your employer disagrees with BWC’s decision, either party can file an appeal with the Industrial Commission (IC) within 14 days.

There are three hearing levels for workers’ claims at the IC:

• District level hearings — These take place in locations throughout Ohio within 45 days of filing an appeal. The district hearing officer will decide within seven days. The IC sends both parties a written notice of the hearing officer’s decision. Each party has 14 days from receipt of the district hearing officer’s decision to file an appeal to the next level.

• Staff level hearings — These take place within 45 days after an appeal of the district hearing officer’s decision is filed. The staff hearing officer will decide within seven days. The IC will send each party a written notice of the staff hearing officer’s decision. Each party has 14 days from receiving the staff hearing officer’s decision to file an appeal to the next level.

• The commission level — After studying the staff hearing officer’s decision, the commission either agrees to hear the appeal or refuses to permit further appeal. If the commission accepts the appeal, a commission hearing will occur within 45 days. The commission will decide within seven days. If the commission refuses to hear the appeal, depending upon the issue, you may appeal the matter to the court within 60 days after receipt of the commission order. Learn more about your options if your workers' comp claim has been denied.

It only takes a split second for an accident at work to turn a person’s life upside-down as the medical bills roll in. We've aimed to answer all of your questions regarding receiving the medical treatment you need. If you still have questions about workers' compensation or receiving medical treatment, please contact our office at (614) 334-4649. We've also answered many FAQs regarding general claim info and receiving compensation.

• Who approves treatment?
• Can I go to my family doctor?
• I want to change doctors. How?
• I can’t get my prescriptions filled. What should I do?
• What is MMI?
• Why do I have to wait for treatment?
• What is Independent Medical Examination (IME)?
• How will I know if a doctor is certified by BWC?
• How do I get my medical bills paid for?
• What should I do if I get medical bills?
• Can I get reimbursed for prescriptions?

Who approves treatment?

Requests for treatment are submitted by your doctor to the MCO assigned to your case. If your employer is self-insured, requests are sent to your employer’s TPA (third-party administrator). The MCO or TPA may request additional information from your doctor or a medical review before approving the treatment. Denials of treatment may be appealed.

Can I go to my family doctor?

An injured Ohio worker may be treated by a doctor of his choice, as long as the doctor is a BWC-certified healthcare provider. Often, family doctors do not treat job-related injuries because they are concerned about the paperwork involved and/or the hassles associated with claims procedures. Your family doctor refer you to a BWC-certified provider. You can also ask for recommendations from co-workers, your union representative, your attorney, or other people who have received treatment for a work injury. The BWC and your MCO also maintain lists of physicians who treat industrial injuries.

I want to change doctors. How?

You may decide to change physicians for a variety of reasons, ranging from the retirement of the provider, travel distance, or a desire for a different treatment option. Injured workers who wants to change physicians should notify the MCO and submit BWC Form C23. If your employer is self-insured, this form should be sent directly to the employer or its TPA.

I can’t get my prescriptions filled. What should I do?

Your pharmacist can explain why payment for a prescription is denied. It may be a coding error or a concern that the medication is inappropriate. Your doctor can provide additional information regarding the need for and the propriety of the medication. If the bill was denied pending the allowance of the claim, you will be reimbursed once your claim is allowed. Keep all receipts for medications and treatment related to your injury if you need to request reimbursement.

What is MMI?

Temporary total disability (TTD) compensation is payable following an on-the-job injury until the injured worker is released to return to her former job, actually returns to that job, or is determined to have reached maximum medical improvement (MMI). MMI indicates that the injury has reached a treatment plateau under the current treatment regimen, meaning it has gotten about as good as it will get! Although temporary benefits are no longer payable if the condition is no longer improving, other forms of compensation may be available for injured workers whose TTD has been terminated after a finding that their condition has reached MMI.

Why do I have to wait for treatment? I just want to get back to work!

During the initial processing period (i.e., when the Ohio BWC or your employer is deciding whether to allow or contest the claim), physicians may be reluctant to provide treatment, as there is no guarantee they will be paid. Some doctors will provide treatment, pending the allowance of the claim, expectating the claim will be allowed or that you have other means of paying (for example, other insurance) should the claim be disallowed. While your claim is considered, avoid large unpaid medical bills you may have to pay should your claim be disallowed. Once the claim is allowed, providers (other than pharmacies) who have treated you for the job-related injury should submit their bills to your MCO.

What is an Independent Medical Examination (IME)?

An independent medical examination (IME) is a medical evaluation scheduled by the BWC or employer's representative to opine about various medical issues related to your claim, including, but not limited to, whether treatment or testing is necessary, the degree of your permanent impairment and whether you have reached MMI. When scheduled by an employer, I believe it more accurate to describe this as a DME: Defense Medical Exam. Employers hire the same doctors over and over to render medical opinions on their behalf--they are not "independent".

How will I know if a doctor is certified by BWC?

The simplest way is to ask your doctor when you make the initial appointment. You may also call the employer's MCO, the BWC at 1-800-644-6292, or research BWC certified providers (by name, location and/or specialty) at the BWC's website.

How do I get my medical bills paid?

Medical bills should be payable in an allowed claim. Give your claim number to all of your medical providers who treat you in your claim. They will then request authorization for the medical treatment they request from the MCO.

What should I do if I get medical bills?

You should forward the bills to your MCO or self-insured employer. Unpaid bills can be appealed to the BWC for further investigation.

Can I get reimbursed for prescriptions?

Like medical bills, prescriptions for allowed conditions in your claim should be payable in an allowed claim. Inform your pharmacist that the prescription is for a workers' compensation claim.  You may need to pay for the initial prescription, but if the BWC determines the medicine was for the allowed conditions, you will be reimbursed.

Obviously, you are responsible for any bill or prescription that the BWC determines is not related to your claim.

 

Workers who suffer injuries on the job normally have many questions running through their mind. Here we have provided answers to the questions we are commonly asked. We have also provided many questions and answers regarding medical treatment and general questions.

• When will I get paid? How much will I be paid?
• How long can I get paid for missing work?
• What decides how much money I receive while out of work?
• Can I ask for a settlement?
• What happens if I go back to work after being deemed permanently and totally disabled?
• Do I still get any benefits when I return to work?
• Is any tax taken out of my benefits check?
• Why do my Worker's Comp checks come in for different amounts?
• How long does it take for me to receive my benefits check?

When will I get paid? How much will I be paid?

Filing a claim doesn’t guarantee payment of compensation or benefits. Your claim may be denied or disputed by the BWC or your employer. The Ohio Bureau of Workers’ Compensation has 28 days from claim filing to accept or deny a claim. Learn about your options if your claim has been denied. Compensation won’t be paid until a claim is allowed.

The amount you are paid depends in part on how long you cannot work. The Ohio BWC or a self-insured employer will calculate your earnings prior to your injury, and you will be paid a percentage of those wages. The wage calculation and rate of payment often change, depending upon how long you cannot work. Wages may be set too low, and in these cases we can request an adjustment to consider special circumstances, periods of unemployment, or additional wage information, including wages from a second job.

How long will I be paid for the work I miss?

Generally, you could be compensated until you are released to return to your former job, actually return to that job, or are determined to have reached maximum medical improvement (MMI).

How is the money I am paid determined?

Your benefits are based on the money you earned working for the year prior to injury. Your Full Weekly Wage (FWW) is determined by the greater of your gross wages (including overtime) earned over the 6 weeks prior to injury, divided by 6; or your gross wages (excluding overtime) for the 7 days before the injury. The first 12 weeks of temporary total disability (TTD) compensation will be paid at 72% of your FWW. Benefits after the first 12 weeks of TTD will be paid based on your Average Weekly Wage (AWW), which is generally calculated by taking your earnings from all employers for the year prior to the injury and dividing that amount by 52 weeks. Those benefits are paid at 66⅔% of your AWW.

Can I ask for a settlement?

This is an issue you should consult an attorney about. There may be factors you are not aware of, and an experienced attorney can help secure the maximum settlement amount. At a minimum, wait until you are sure you will have no further complications from your work injury. Most employers will not settle with an employee while they are still working there, as the risk of re-injury and a new claim is present.

What happens if I go back to work after being deemed permanently and totally disabled?

You will lose any permanent total disability (PTD) benefits and likely be charged with fraud if you collect PTD compensation while working (unless you are receiving statutory PTD). If you believe you have medically recovered to the point of returning to work, consult an attorney about options before you do.

Do I still get any benefits when I return to work?

There are other benefits that may be available after returning to work. For instance, you may be entitled to a Working Wage Loss if your injury prevents you from making the same salary as you did prior to the injury. This is something you should consult with an attorney about.

Is any tax taken out of my benefits check?

No. Workers' compensation benefits are tax-free.

Why do my Worker's Comp checks come in for different amounts?

The first 12 weeks of TTD compensation are paid at 72% of your FWW. After the first 12 weeks, it is paid at 66⅔% of your AWW. It is possible that, because of the day of the week a check is originally issued or other factors, a check may only cover a portion of the standard 2-week pay period. The period covered will be listed on the payment. You will receive the amount you are entitled to, and eventually, the checks will be for a consistent amount and released on a consistent basis.

How long does it take for me to receive my benefits check?

Unfortunately, there is no definitive answer to this question. It may take many weeks (and sometimes, months) before compensation is received after it is awarded.

Yes. Under Ohio workers’ compensation law, employers required to carry workers’ comp insurance must provide coverage to all of their employees, including those who work part-time or who were hired on a temporary basis.

At this time of year, many Columbus-area companies bring on additional workers to manage an increased workload, and the jobs they do can be stressful and demanding.

Whether you're a college student working over winter break or someone taking on an additional job to earn extra money, if you are injured in the course of your employment, you may collect workers’ comp benefits.

Seasonal Workers Are at Risk of Injury

Given the reasons companies hire seasonal workers, not surprisingly, individuals are at particular risk for on-the-job injuries. Crowded malls and stores, increased online orders, expanded deliveries, and special seasonal sales push employers to add to their workforces in the weeks between Thanksgiving and New Year’s Day. In this rush, companies often fail to adequately train their temp workers, putting them at risk of injury.

Typical seasonal jobs include working at:

• Order fulfillment centers. Companies such as Amazon add hire over 100,000 seasonal employees across the U.S. to help with holiday demand. Individuals in fulfillment centers can work long hours doing strenuous tasks.
• Christmas tree lots. Seasonal workers cut down trees, transport them, and load them on top of cars often in cold temperatures. They can suffer sprain and strain injuries, and more severe falls and power tool accidents.
• Stockrooms. Major retailers such Target and Wal-Mart must keep inventory moving from delivery trucks to the store floor. They often do this by hiring temporary night staff to unload products and stock shelves.
• Restaurants. Wait staff members and kitchen workers are pushed to their limits during the busy holiday season, and untrained temp workers may be brought in to help. Inexperienced restaurant workers can experience slip and falls, knife accidents, and back injuries.
• Stores and malls. Temporary retail workers are often given the worst jobs during the holiday season, including stocking shelves, working door security, and cleaning after closing. These tasks can lead to severe injuries.

Don’t Be Bullied by a Temporary Employer

If you're injured while working a temporary seasonal job, it’s vital that you report the injury to your employer and seek medical care. If you encounter any resistance—including being told that you can’t file for workers’ comp because you're a temporary employee, or being accused of faking an injury—contact me soon. Don't stand for employers lying to you or about you.

Related Links: Ohio Workers’ Compensation for Traveling Workers Ohio Workers’ Compensation for Shoulder Injuries Workers’ Comp for Injured Ohio Distribution Center Workers

 

 

When a workers’ comp claim is denied in Ohio, it's usually because the applicant failed to prove the injury happened at work, and that it's severe enough to warrant benefits.

This could be a particular problem if you're applying for benefits for a hernia injury because the symptoms of a hernia are often vague enough it can be difficult to connect it to a workplace incident.

However, if your hernia occurred while you were on the job and you're unable to work because of the injury for at least 14 consecutive days, you qualify for workers’ comp in Ohio. Let’s take a look.

What Is a Hernia?

A hernia is a general term for when an internal organ or fatty tissue squeezes through an opening or weak spot in the muscle or connective tissue that usually contains it. Hernias usually occur in the abdominal cavity, but can also happen in the groin, upper thigh, or belly button area.

You may experience symptoms such as the following:

• A bulge or lump in the affected area.
• Pain or discomfort.
• Weakness or pressure in the abdomen.
• A burning or aching sensation at the site of the bulge.

Doctors can usually diagnose a hernia with a physical examination. If a hernia is growing larger or causing pain, surgery to repair the tissue may be required.

When Did Your Hernia Happen?

The sticking point regarding qualification for workers’ comp benefits due to a hernia is whether the injury happened performing your job duties. Similar to heart attacks and strokes, it's challenging to make a direct connection between the injury or illness and your job.

Because hernias are often caused by physical strain, it's possible that yours happened suddenly when you lifted a heavy object; or was produced over time by repeated strenuous activity. It will be essential to your claim to do these things:

• If you feel a sharp pain in your abdomen or groin while lifting something at work, report it to a supervisor and see a doctor.
• If you first notice the bulge or lump when you're not at work, try to recall what you were doing at work that may have caused a hernia.
• See a doctor soon for a thorough exam. Tell him or her you believe the injury is work-related.
• Complete an incident report at work and explain what happened.

As with any workplace accident, it's vital that you report the injury, see a doctor, and document everything.

We Can Answer Your Questions

If you were denied workers’ comp for a hernia, or are having trouble getting accurate information from your employer, call us at Monast Law Office. We've handled lots of hernias (so to speak), can answer your questions and help you get on the right path to workers’ compensation approval. 

Related Links: Evidence Needed to Document a Legitimate Work Injury Ohio Workers’ Compensation for Shoulder Injuries Workers’ Comp for Injured Ohio Distribution Center Workers

 

Ohio Revised Code §4123.01(A) treats general or prime contractors as the employer of workers hired by subcontractors or independent contractors who have failed to obtain coverage as required by law or who have permitted their coverage to lapse, unless the employees or their legal beneficiaries elected to regard the subcontractor as their employer.

This means the general contractor is considered, as a matter of law, to be the employer of the injured employees of the subcontractor who failed to maintain coverage (unless the employees affirmatively elected to have the non-complying subcontractor treated as their employer). Claims for these injuries by the sub’s employees would be covered by the general.

The Ohio Supreme Court upheld this provision as constitutional in 1932. This provision applies presuming both the general contractor and the subcontractor must have coverage. The few exceptions to the general requirement that all employers must provide workers’ compensation coverage are found in §4123.01.

The general contractor’s risk includes the cost of claims brought by the subcontractor’s employees just as if they had been employed directly by the general contractor. S/he also remains liable for the subcontractor’s unpaid premium based on the subcontractor’s payroll. This provides an obvious incentive for general contractors to insure their subs have proper coverage. A devious self-employed subcontractor could elect to cover herself but permit her coverage to lapse by defaulting on her premiums and then recover against the general contractor. Just don’t try this trick against Tony Soprano or you may end up with cement shoes!

It all depends. In Ohio, if your work duties don't begin until you reach a specific work location designated by your employer, you're not covered for injuries sustained while traveling to or from that location. This is known as the “coming and going” rule, and it applies to all “fixed-situs” employees.

Most workers who travel between work sites are considered fixed-situs employees in Ohio, but there may be exceptions.

Are You Considered a Fixed-Situs Worker?

Some workers are clearly fixed-situs employees. For example, if you work in an office, restaurant, or store like Walmart, and your duties don't begin until you enter the building, you're a fixed-situs employee. If you're in a car accident on your way to work, or fall in the parking lot outside your building, your injuries probably won't be covered by workers’ comp under the coming and going rule. However, there are several situations where offsite injuries are covered by Ohio workers' comp.

You're clearly a non-fixed-situs employee if your duties aren't tied to a fixed location. For example, if you drive a truck for UPS, an ambulance for MedCare, or a taxicab for Express Cab, your worksite is your vehicle and the places you visit as part of your job. If you're in a car accident or have a bad fall while on the clock, your injuries should be covered by workers’ comp.

It gets trickier when we look at workers whose jobs require them to be at different locations throughout the day, or from one day or week to the next. Construction workers, home health care aides, repair technicians, housekeepers, and similar workers report to various locations to complete their job duties. It may seem like this would give these employees the non-fixed-situs designation, but Ohio courts sometimes determine otherwise.

Even though these workers don't report to the same physical location every shift, they're usually not on the clock until they arrive at their designated location. Because of this, they're subject to the coming and going rule. If injured in a car accident while traveling between work sites, they are typically ineligible for workers’ comp–but, again, there are exceptions.

If a worker is paid for travel time or reimbursed for travel expenses, it could be argued they're performing work duties and on the clock while driving from one site to another and, if injured during travel, they may be eligible for workers’ comp.

Confusing? Call Me to Explain

If you find this confusing, welcome to the club! The Industrial Commission and Ohio courts seemingly can rule one way one day and another way the next given the very same set of facts. These cases are very fact-specific and decisions can turn on nuances. Employers and the BWC are quick to deny such claims even when they're legitimate. If you have questions whether you're subject to the coming and going rule, it's worth your time at least to consult with an Ohio workers’ comp attorney. This can be a complicated issue even for experienced lawyers and judges, and you deserve to understand your rights as an employee.

When you call Monast Law Office, you can get answers to your workers’ compensation questions. We also invite you to download a complimentary copy of our book, The Worker’s Guide to Injury Compensation in Ohio to learn more.

Related Links: What to Expect at Your Ohio Workers' Comp Hearing Handling Your Workers’ Comp Claim vs. Calling a Lawyer Answers to Ohio Workers’ Compensation Claim Questions

 

In Ohio, when a worker is awarded permanent total disability (PTD) status, he isn't expected to return to work. Along with paying medical bills associated with the illness or injury that caused the disability, the worker is also entitled to wage replacement benefits from the Bureau of Workers’ Compensation (BWC) or his self-insured employer. These benefits are calculated based on the worker’s earnings before the injury or illness and never increase as the years go by since compensation rates are governed by the year of injury.

As such, they don't adjust for increases in the cost of living and the injured workers' earning power diminishes as time goes by.

If the PTD amount falls below a certain level, the worker may qualify for a cost of living adjustment in the form of supplementary benefits from the Disabled Worker Relief Fund (DWRF).

Calculating Wage Replacement Benefits

In Ohio, a worker with PTD status receives 66-2/3^rds percent of his pre-injury average weekly earnings, up to a set maximum amount ($932 in 2018).

For example, if the worker was earning $1,200 a week at the time of his injury, he would get $792 in workers’ comp benefits. However, the BWC also sets a minimum benefit payment based on the cost of living, so if a worker was earning less than a certain amount during his disability, he would be given supplemental income from the DWRF. In 2018, the minimum wage replacement benefit is $466. If 66-2/3^rds of the workers’ weekly earnings is less than $466, he should get additional money from the DWRF.

All Applicants Are Automatically Considered for DWRF Benefits

Low-income workers granted PTD status need not apply for DWRF benefits. If their income is determined to be below BWC minimums, they should automatically qualify for the supplemental income. However, if an injured worker isn't granted DWRF benefits and believes he should have been, the BWC decision can be appealed.

The Monast Law Office May Be Able to Help

If you believe you should have received supplemental income—or you're struggling with the workers’ comp application process in another way—the Monast Law Office may help get the benefits you deserve. You shouldn't be made to feel like you've done something wrong because you were injured on the job. Call us to discuss your situation today. If we can help, we will.

Related Links: Moving Out of State While Collecting Ohio Workers’ Comp Handling Your Workers’ Comp Claim vs. Calling a Lawyer Answers to Ohio Workers’ Compensation Claim Questions

 

Injured workers are often suspicious of the doctor they're required to see for treatment of a job-related incident. This may be because they're unfamiliar with the medical provider, or because they're worried about saying or doing something that will jeopardize their worker’s comp claim.

As a result, they may not be entirely honest or detailed enough with their answers to the doctor’s questions. This could harm their claims. As with many things in life, honesty is the best policy when talking to your workers’ comp doctor.

What to Tell Your Doctor

When you're injured on the job or develop a work-related illness, your priority is to get the immediate medical help you need.

Under Ohio law, you're permitted to see any doctor for your initial visit. After that, your continuing care must be with a Bureau of Workers’ Compensation (BWC)-certified doctor if the state program insures your employer; or an employer-approved doctor if your employer is self-insured.

No matter who your first visit is with, it's important to claim success you:

• Fill out the intake form completely and accurately. You may have filled out an incident report at work, but you must still take care to fill out the patient information form completely. Describe every symptom, source of pain, twinge, or bruise—not just the most painful or problematic. It's possible something that doesn't bother you much at first will develop into a severe injury, and your claim will be stronger if your physician documents it on your first visit.
• Give a complete history of the work injury. Often the moment you feel the pain—or the day you're diagnosed with an illness—wasn't when the injury or exposure occurred. When filling out a form or speaking to the doctor, describe everything that happened which may contribute to your injury. For example, you may have fallen off a ladder one day and woke up the next day in extreme pain. The doctor needs to know how and when the fall happened, not just that you woke up in pain.
• Be honest about previous injuries/symptoms. People may experience many back or knee injuries over their work-life. Often, these heal in a few weeks and have nothing to do with subsequent injuries. If you had treatment or injuries before, tell your doctor. If you've been symptom-free for months or years, these prior problems don't undermine your current claim (even though your employer may try to make a big deal of it). Better to be open and honest about these things as past treatment will be discovered. If you hide it, you'll be painted as a liar.
• Don't sign inaccurate or incomplete forms. The medical provider, employer, or managed care organization (MCO) may ask you to sign an initial workers’ compensation claim application (Form FROI-1). Don't sign the form if the details of the accident or injury are incomplete or inaccurate. The FROI-1 can be filed without your signature, and you can correct it later. However, if you signed it, this will be more difficult.
• Never exaggerate or fake symptoms. A doctor can identify the nature and extent of your injuries through examinations and medical testing. He or she will know when you're lying, and this could do irreparable harm to your workers’ comp claim. Always be honest but thorough.

How a Worker’s Comp Attorney Can Help

It’s unfortunate but true that some employers and Managed Care Organizations (MCO) do everything they can to limit the scope of coverage, including taking advantage of your mistakes, omissions, and inaccuracies when reporting injuries.

If you're struggling with an employer or MCO that thinks you're dishonest, contact the Monast Law Office to discuss your situation. For more information about your rights, download my free book, The Worker’s Guide to Injury Compensation in Ohio.

Related Links: What to Expect At Your Ohio Workers' Comp Hearing Evidence Needed to Document a Legitimate Work Injury Handling Your Workers’ Comp Claim vs. Calling a Lawyer

We get this question a lot at the Monast Law Office. The short answer is yes—as long as you continue to qualify, your workers’ comp payments will follow you wherever you move. However, as with many things in life, it can be a bit of a pain.

Unlike federal programs such as Social Security and Medicare, workers’ comp is a state-run program, so living outside of Ohio may make certain aspects of your claim more difficult.

What You Need to Know

As soon as you know you're moving, notify the Ohio Bureau of Workers’ Compensation (BWC), or your employer if the company is self-insured. Once you have a forwarding address and information for your new bank account, make those changes so payments can be sent to you without interruption.

Because the BWC requires you to use their certified medical providers for ongoing care, you may have to return to Ohio for treatment and required medical exams. If you relocate farther than a neighboring state, this could be impracticable. Otherwise, you must find a local provider willing to become BWC certified and accept Ohio workers' compensation payments.

Your Options When Moving Out of State

If you're not already working with a workers’ comp attorney, you'll want to find one to help you navigate your move. An Ohio attorney can be a helpful point of contact once you leave the state and can communicate with the BWC as your representative.

An attorney will also discuss the option of settling your claim before you move, which may be your best option. If you settle, your attorney negotiates a lump-sum payment that will close your Ohio workers’ comp claim. You may use the settlement money in any state and with any doctor. As long as you work with an attorney to ensure you're offered a fair settlement, and it's structured to your advantage if you're also collecting other benefits, this could be a good solution for you. 

The Monast Law Office Can Help

If moving out of state is a possibility, call us to discuss how you should manage your workers’ comp claim. We'll help you understand the options and determine what's right for your circumstances. I work with hundreds of other Ohio workers injured on the job, many of whom have subsequently moved out of state. My team and I can guide you through this sometimes-tricky situation too. Contact us today!

Related Links: Handling Your Workers’ Comp Claim vs. Calling a Lawyer Answers to Ohio Workers’ Compensation Claim Questions Seeing a BWC Approved Doctor for Workers’ Comp Care