Frequently Asked Questions About Ohio Workers’ Compensation Cases
Overwhelmed with questions after a work accident? Our legal team has the answers. Find out what to do in the days following your injury, which forms to file, and other information that can increase the odds of getting your workers’ compensation claim approved.
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General Workers' Compensation Claim FAQs
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.
Medical Treatment FAQs
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.
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. 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.
Has a shoulder injury you sustained on the job site stopped you from returning to work? You may be eligible for workers’ comp while you recover.
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 see my own doctor for a work-related injury?
When you're injured in a fork-lift accident at your warehouse job or think you may have developed carpal-tunnel syndrome at your office job, your first move may be to go to the nearest emergency room or your doctor for diagnosis and treatment.
Fortunately, the Ohio workers’ compensation program allows this—but only for that initial visit.
After that, you must see a Bureau of Workers’ Compensation (BWC)-certified physician for your treatment to be covered by workers’ comp. If you work for a self-insured employer such as UPS or Ohio State, your employer will decide regarding your eligibility and who you can see for treatment.
Finding a Certified Doctor
It's possible that your doctor is already BWC-certified—in which case, you won’t have to look further for a doctor to treat your work injury. However, if she's not and you continue to see her, you'll be responsible for all medical costs related to your work injury.
While your employer may suggest a doctor, you're under no obligation to visit that doctor. Instead, you can find a certified physician in your area by checking the provider look-up tool on the BWC’s website. As long as you receive workers’ comp benefits for the injury for which you're seeking treatment, medical costs related to your claim will be covered.
However, even for BWC-certified doctors, treatment has to be approved by your employer’s managed care organization (MCO) with employers who obtain workers' compensation through Ohio's state insurance fund or by your self-insured employer.
Getting Approval From Your MCO
If you're not already familiar with managed care organizations, understand how they work.
All employers who purchase workers’ comp insurance through a state fund must choose one of 13 MCOs recognized by the BWC to manage their workers’ compensation claims. The MCO oversees claim filing, and supervises medical treatment and employer return-to-work programs. Your employer’s MCO manages the medical portion of the claim, so additional medical procedures, treatments, and referrals from the treating physician have to be approved by the MCO.
If medications are prescribed, you have to inform the pharmacist that it's a workers’ comp claim and provide your BWC claim number. Any treatment or services you received before your workers’ comp claim is approved should be reimbursed after that approval. Note that some large Ohio employers are self-insured—this means they administer workers’ compensation claims directly, and your employer may manage the medical portion of your application.
Having Trouble? Call an Experienced Workers’ Comp Attorney
If you're like most of our clients, you may feel frustrated and hopeless when coverage for a needed medical procedure or prescription is denied. However, you may appeal any medical decisions made by your MCO, and you may work with an experienced workers’ comp attorney on your appeal.
If you feel like the BWC is saying you and your doctors are wrong, or even fraudulent, call me for a free review of your claim. I help many workers just like you overcome the challenges of the Ohio workers’ comp system, and I may assist you, too. We're never too busy to take your call or answer questions. Fill out the form on this page to connect with me today.
Do I have to use sick time for my work-related injury?
The intent of workers' compensation in Ohio is to cover all costs related to an injury you sustain at work or an illness you develop because of your job.
The benefits you receive depend on the seriousness of the injury or illness and how much time you must take off work.
If you only miss a few days after a workplace accident, charge that time against your paid time off (PTO).
However, if your injury or illness leads to eight or more days off work, you qualify for temporary total compensation benefits from workers’ comp to replace your lost income.
Understanding Ohio Temporary Total Compensation Benefits
The Ohio Bureau of Workers’ Compensation (BWC) defines temporary total disability as “the temporary inability of the injured worker to return to his former position of employment.” If your claim for workers’ comp benefits is approved, your injury-related medical bills will be paid no matter how long you must miss work.
However, temporary total compensation benefits—or reimbursement for PTO already taken—won't start until the eighth day you're off work. If you miss two weeks of work, you'll only be compensated for the second week. If you're away over 14 days, you'll be compensated for all the days you have missed, including the initial week.
If you're approved to return to work under modified conditions and your employer cannot accommodate you, you can remain on temporary total compensation benefits as you continue to improve. It's important to note that getting these benefits doesn't mean you'll receive 100 percent of your wages. Instead, you'll receive between 72 and 66 2/3 percent of your wages, depending on how long you're off. When you return to work, temporary total compensation benefits end. However, you may be eligible for wage loss benefits if your injury causes work restrictions that lead to a reduction in earnings.
Monast Law Office Can Help Maximize Your Benefits
When you're injured on the job and cannot work, you may be eligible for many benefits. Because every case is unique, call us for a strategy session. We can explain your rights and help you pursue the maximum compensation.
How long do I have to file a workers’ comp claim in Ohio?
As of September 29, 2017, House Bill 27 reduced the amount of time injured workers have to file a claim to one year from the date of the workplace injury or death in Ohio. For claims involving occupational disease, you have two years to file a claim. This is known as the statute of limitations.
That may seem like plenty of time. After all, why would you wait to apply for the benefits you need to pay for medical treatment and lost wages?
While most people file within the first few weeks or months after an accident, others delay their filing and jeopardize their claim. If you do not file a claim before the statute of limitations deadline, you no longer have the right to file a claim.
Why Injured Workers Delay Filing
When injured on the job, immediately report the accident to your employer and seek medical attention. Not doing so could hurt your claim before you've even filed. While those steps are essential, they're not the same as actually filing a claim for compensation.
I've found that injured workers sometimes delay filing a workers’ compensation claim and risk hitting the statute of limitations because:
- Fear of employer retaliation. Some workers are worried they'll be fired, demoted, or moved to a bad shift if they pursue claims, especially for injuries they hope go away on their own. Retaliatory actions are illegal, and fear of them shouldn't discourage you from applying for needed benefits.
- Fear of what people will think. If the injury seems minor, sometimes a worker doesn't want to be a whiner who complains about every little ache and pain. He or she may also worry about the stigma of being on “workmen’s comp” or that co-workers will treat him or her differently.
- Fear of missing work. Some employees worry if they take the time needed to treat their injuries, they'll lose wages they won’t be able to get back. Ohio workers’ comp authorizes payments for lost wages during the period of recovery, so a successful claim will help you more than toughing it out and working while injured. Continuing to work while hurt may lengthen your recovery time or lead to increased problems later. Remember, most of us aren't eighteen anymore: injuries we used to "walk off" take longer to heal as we age.
- Employer pressure. Some employers may encourage or even push injured workers to use their health insurance to pay for treatment. Some small business owners also tell injured employees not to file because their premiums will skyrocket, promising to “take care of them” through other means. Remember: you should have the benefits offered by Ohio workers’ compensation, and it's not up to your employer to decide how you take care of yourself.
- Waiting to see how severe the injury is. It's not uncommon for individuals to push themselves to work through injuries to see if they get better without treatment. However, filing the claim permits a doctor to request diagnostic tests to confirm or rule out a diagnosis, setting you on the road to health much more quickly.
Don’t let these reasons affect your filing. At Monast Law, we've helped hundreds--actually, thousands--of people just like you who have fears about filing claims, and we can help you, too.
Don't Delay, the Statute of Limitations Gives Strict Deadlines to File a Work Injury Claim in Ohio
A year can pass by quickly when recovering from a workplace accident, especially if you're hesitant to file. It's important to take action immediately when injured at work. If you were hurt, or your employer isn't cooperating fully, call me to schedule a free consultation. If I can help, I'll work quickly to make sure you meet the deadlines and present the most persuasive claim possible.
Meanwhile, request a download of my free book to learn what you need to know about workers’ comp in Ohio.
- Fear of employer retaliation. Some workers are worried they'll be fired, demoted, or moved to a bad shift if they pursue claims, especially for injuries they hope go away on their own. Retaliatory actions are illegal, and fear of them shouldn't discourage you from applying for needed benefits.