Workers who suffer injuries on the job normally have many questions running through their mind. Here we have provided many answers to the common questions we are asked about 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 is responsible for filing an Ohio workers’ compensation claim?
You are! When an injury occurs at work, you should 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. “Injury” for workers’ compensation purposes includes any injury, whether caused by external accidental means or accidental in character and result, received in the course of, and arising out of, the injured employee’s employment.
Furthermore, every employee who is disabled because of the contraction of an occupational disease or the dependent of an employee whose death is caused by an occupational disease is entitled to compensation as provided by statute. Learn more
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 covered as well. 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’ compensation case?
Not all claims involve serious injuries and certainly 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 an attorney who specializes in workers’ compensation claims if your injury is serious, if it 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?
First, report the injury to your 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 as soon as possible. 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. Your hospital or employer may furnish necessary paperwork and even file the claim for you, but it is ultimately your responsibility to insure 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 decide to 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 as well as compensation for their lost time from work. This compensation, known as Temporary Total Disability (TTD), is paid as long as 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 more than 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 how long the period of disability lasts.
Injuries resulting in some degree of permanent impairment may result in 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 of your ability to perform your job duties due to the injury. A MEDCO-14 needs to 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 the loss of bodily function, if any, that has resulted from an injury or occupational disease. It is workers’ compensation’s version of a damages award for an industrial injury. There are time limitations that 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 not the same as 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 there is a question as to whether treatment is excessive, appropriate, or cost-effective. MCOs may deny treatment they consider too expensive, even if it is treatment your doctor believes is beneficial. You have the right to appeal decisions denying treatment that your doctor believes is 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. As such, if an employer tells you not to file a claim for a work-related injury, it may be that 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 decide to allow or deny your claim. If you or your employer disagrees with the 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 issue a decision within seven days of the hearing. 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 the filing of an appeal of the district hearing officer’s decision. The staff hearing officer will make a decision within seven days of the hearing. The IC will send each party a written notice of the staff hearing officer’s decision. Each party has 14 days from the receipt of 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 issue a decision within seven days of the hearing. If the commission refuses to hear the appeal, depending upon the issue, you may be able to appeal the matter to the court within 60 days after receipt of the commission order.