Answers to Workers’ Compensation Questions From a Columbus Attorney
Could you be fired for filing for workers’ comp? Can an employer refuse to provide workplace injury compensation? Get fast answers to your injury questions by browsing our work injury FAQ page.
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Why was my workers’ comp claim for a hernia denied?
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.
I got hurt on the job working for a subcontractor without workers’ compensation coverage. What do I do??
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!
I travel to different worksites during the day. Would I be eligible for workers’ comp if I'm injured in a car accident between sites?
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.
What is the Ohio Disabled Worker Relief Fund?
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 66-2/3rds 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 66-2/3rds 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.
What should I tell my Ohio workers’ comp doctor?
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.
If I relocate out of state, can I still collect Ohio workers’ comp?
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!
How do I prove my injury happened at work?
Ohio workers’ comp is a no-fault system. That means to qualify for benefits, it's unnecessary to prove your employer’s negligence caused your accident, and it doesn’t matter if you made a mistake that led to the injury.
However, you must prove something at work caused your injury. We look at the evidence you need to support that claim.
What the BWC Says
The Ohio Bureau of Workers Compensation (BWC) is clear about what a compensable claim is. The law states the physical injury or disease must be “sustained in the course of and arising out of employment” and there must exist a “causal relationship between the injury or disease and the injured worker’s employment.”
This means your injury or illness must have happened or developed while you were performing work-related duties and resulted from some factor related to your job. While it seems simple enough, it can become a case of your word against your employer’s. That's why you need some key pieces of evidence to prove your claim.
Evidence to Gather After a Work Injury or Illness
The BWC states it needs “statements from the injured worker, employer and any witnesses and, especially, all medical evidence (i.e., progress notes, diagnostic reports, etc.) submitted by any treating providers” in order to approve a claim.
If you reported a work injury and your integrity is being questioned by the BWC or your self-insured employer, call me to discuss your claim. I'll help collect evidence to prove your claim, including the following:
- Injury report. Soon after sustaining your injury, you must report it to your employer. There should be forms available in your workplace to do this. This information will be valuable in documenting that your injury occurred at work.
- Witness statements. If co-workers were present when you were hurt, we'd talk to them about what they saw.
- Security footage. If any surveillance cameras may have captured the accident, we may secure them to be presented as evidence.
- Medical records. A doctor’s assessment of the cause of the injury s/he's treating you for is a crucial piece of evidence. Details about ongoing office visits and treatment are also important.
When You Should Call the Monast Law Office
Many workers’ comp claims proceed without a hitch and can be handled by the employee. However, if the BWC or your employer doesn't believe your injury happened on the job, you've come to the right place.
Give me a call to discuss your case--it's a free call, so what do you have to lose? If I can help, my team and I will get to work right away collecting the evidence to support your claim and get the workers’ comp benefits you deserve. If I can't, then at least you'll have some idea where you stand.
Can I get workers' comp for a shoulder injury?
The shoulder is one of the most complex joints in the body and provides an incredible range of motion we often take for granted on a day-to-day basis. Shoulder injuries can be debilitating. When you can’t lift your arm without pain, even simple tasks like brushing your teeth can be difficult.
Laboring as a construction worker with a shoulder injury may be impossible. If it happened on the job, your medical expenses and lost wages should be covered by Ohio workers’ compensation.
Learn more about these injuries and how to get the benefits you deserve.
Common Construction Worker Shoulder Injuries
In 2016, 6,520 construction workers across the country had to take days off of work due to a shoulder injury sustained on the job, according to the U.S. Bureau of Labor Statistics.
Laborers and artisans who lift and hold things over their heads—such as painters, drywall hangers, and sheet metal workers—are prone to shoulder injuries. Likewise, carpenters and roofers, who perform repetitive tasks for long periods of time, are also at risk for shoulder problems.
Common injuries these workers experience include:
- Dislocations. A sudden or unexpected arm movement can cause the ball of the shoulder joint to pop out of the socket. Even after the shoulder is popped back in, the injured worker can experience chronic pain and frequent recurrence.
- Impingement syndrome or bursitis. Overuse of the shoulder and heavy lifting—common tasks of construction workers—can irritate the rotator cuff, leading to impingement. Immobilization and physical therapy are recommended treatments.
- Torn rotator cuff. A tear in the group of muscles and tendons that surround the shoulder joint is painful and can cause arm weakness. Carpenters and painters can damage the rotator cuff over time due to the repetitive arm motions required by their work.
Any injury of the shoulder joint takes time to heal and often involves expensive physical therapy.
If It's a Workplace Injury, You Should Be Covered
As soon as you realize you've injured your shoulder at work on a construction site, report the injury to your employer, seek medical care, and file a claim for workers’ compensation.
If you have any difficulty getting the approval of your claim, it's wise to contact a workers’ comp attorney. I helped construction workers in Ohio get the benefits they deserve for over 30 years. Get the answers in my free e-book, The Worker’s Guide to Injury Compensation in Ohio, and then call my office to discuss your case.
You should never be made to feel ashamed for filing a workers’ comp claim. I'll fight to get you the compensation—and respect—you deserve.
If I work at a side job, can I include that income when calculating workers’ comp benefits?
I recently saw a statistic I found interesting. According to a survey conducted by Bankrate and reported in the Columbus Dispatch, nearly 40 percent of workers across the country report earning income from a side job.
This means that besides the salary they earn at their primary jobs, almost half of American workers have a supplemental income they rely on to get by.
So what happens if they're injured at their primary workplace and unable to do either job? They should be
compensated for all lost wages, not just the income earned from the primary position.
Why Does This Matter?
- Driving for a rideshare company
- Working for a grocery shopping and delivery service
- Substitute teaching
People who have side jobs earn an average of $686 a month. Losing this much money monthly could have a significant impact on the ability to support yourself and your family. This is why if you're injured at your primary job and unable to work, the loss of any side income should be factored into your wage calculation when filing for workers’ comp with your primary employer. This is why we ask you to tell us about all the work you've done during the year before your injury.
Be Aware of Fraud
Sometimes, you could continue to work your side gig while receiving workers’ comp from your primary employer. For example, a back injury may prevent you from your primary job of delivering packages for Fed Ex, but not from your freelance work as a copywriter.
However, if you're collecting benefits for lost wages from the side job, or if you've claimed you're unable to do the side job, continuing to work could be considered workers' compensation fraud.
Get What You Deserve and Stay Out of Legal Trouble With My Help
Having side jobs can complicate an Ohio workers’ comp claim. Whether you need to include your extra earnings in the wage calculation for lost time benefits or have questions about if you can continue to work a side job while collecting benefits, I can help you figure it out.
Call me to discuss your claim, and I'll let you know if I can be of assistance. You can learn more about applying for Ohio workers’ comp benefits by requesting a free copy of my book, The Worker’s Guide to Injury Compensation in Ohio.
Can I get workers’ comp when I'm injured by a power tool on a jobsite?
The short answer is yes. Under Ohio’s workers’ compensation law, when you're injured at work, your medical costs are covered by your employer’s workers comp insurance.
When you're a construction worker who regularly uses power tools, it's important to be aware of your right to workers’ comp, because you may have a higher risk of being injured than other workers.
Dangers of Power Tools
As an experienced construction worker, you probably know the dangers involved with using power tools. However, long work days, careless coworkers, disabled safety features, and overconfidence can lead to a serious injury that requires medical care and days away from work.
According to the Occupational Safety and Health Administration (OSHA), some of the more common injuries caused by power tools include the following:
- Electric shock. When using electric tools, workers are at risk of a shock that could cause heart fibrillation and burns, or startle the worker to fall off an elevated work surface and suffer other injuries. In some cases, workers can also be electrocuted by an ungrounded power tool.
- Eye injuries. Saws, sanders, grinders, and other similar tools produce debris that can hit a worker in the eye, causing serious and permanent damage. Nail guns and staplers shoot dangerous projectiles that could also do serious damage to the eyes of operators or bystanders.
- Puncture wounds and lacerations. With even a slight slip of the hand, a nail gun, drill, saw, or other tool could easily puncture flesh, causing an injury that requires stitches, damages ligaments and tendons, and puts the victim at risk of infection.
- Crushing injuries and amputations. Electric saws, jackhammers, forklifts, and chippers have the power to crush a person who gets caught in machinery, or cut off the limb of an operator.
- Repetitive-use injuries. While power tools are designed to make tasks easier for the worker, you can still experience soft-tissue and repetitive injuries from long-term use. The vibration from a jackhammer can cause joint and nerve damage that could be permanent.
- Hearing loss. Being exposed to the loud noises caused by power tools—even if you're not the one operating the tool—can cause permanent hearing loss. Treatment for hearing loss caused by workplace conditions is covered by workers’ compensation.
Of course, there are safety measures that must be taken to prevent these injuries, but accidents happen. Workers’ comp should be the safety net you need when the accident happens to you.
Construction Workers May Be Denied Coverage
If you're classified as an independent contractor on a construction site, you won't be covered by workers’ comp insurance. However, construction workers may be misclassified and need legal assistance to fight for the benefits they deserve. Significant additional compensation is available to workers whose employers have violated safety standards.
If you're having trouble getting your construction site injury coverage approved, contact me. I help dozens of construction workers get the coverage they deserve, and I'll put in the time to do the same for you. Call me today for a strategy session.