An Ohio Workers' Compensation Lawyer Can Improve Your Changes for a Successful Outcome
The Buckeye State's workers' compensation system involves several levels of hearings overseen by the Industrial Commission. If your claim is denied, it's essential to understand the reasons for this action and your right to appeal. Hiring an Ohio workers' compensation lawyer at Monast Law Office can significantly increase your chances of success by navigating complex processes, maximizing benefits, and providing effective advocacy throughout the appeals process.
Levels of Industrial Commission Hearings
There are three levels at which the Industrial Commission may hear a disputed claim.
District Hearing Officer (DHO)
At this level, disputes over issues such as medical treatment, compensation, and other benefits are first heard. The hearing officer reviews the evidence presented by both parties and makes a decision. If either party is dissatisfied with the DHO's decision, they can appeal either in writing or online. The appeal must be filed within 14 days of receiving that decision.
Staff Hearing Officer (SHO)
If you disagree with the DHO's decision, you can appeal to the Staff Hearing Officer. The SHO conducts a de novo review, which means they consider the case anew without regard to the DHO's decision.
Industrial Commission (IC)
If you're dissatisfied with an SHO's decision, you may file an appeal either in writing or online within 14 days of receiving the decision. Appeals from the SHO level go to the Ohio Industrial Commission (IC), which has three commissioners. The IC commissioners have the authority to either accept or decline to hear the appeal. Hearings at this level are informal and don't require legal representation, although having a workers' comp lawyer is advisable.
Reasons for Denial and Your Right to Appeal
When faced with a denial of workers' compensation benefits, it's essential to understand the reasons behind the decision and your subsequent right to appeal. Here are further insights into the reasons for a denial of workers' compensation benefits and the appeal process:
- Lack of evidence or documentation. One of the primary reasons for denial is insufficient evidence or documentation supporting your claim. This might include medical records, incident reports, witness statements, or other pertinent evidence that clearly shows the link between your injury or illness and your work duties.
- Disputes over work-relatedness. Another common reason for denial is disputes over whether the injury or illness is work-related. Insurance providers or employers might argue that the injury occurred outside work hours or resulted from preexisting conditions not impacted by your work-related activities. Establishing a clear connection between your job duties and the injury is important in overcoming this obstacle.
- Failure to meet deadlines or requirements. Denials can also occur due to procedural errors, such as missing deadlines or failing to fulfill specific requirements set by the Ohio Bureau of Workers' Compensation. This could involve not reporting the injury within the specified timeframe, not seeking medical treatment promptly, or not completing necessary paperwork accurately.
If your claim is denied, you have the right to appeal. The appeals process involves escalating through the levels of hearings outlined above, beginning with a request for reconsideration and potentially culminating in an appeal to the Ohio courts.
Importance of Hiring an Ohio Workers' Comp Lawyer
Having a workers' comp lawyer guide you through this process is essential for several reasons:
- We understand the workers' comp system. Our team at Monast Law Office can guide you through the entire process, ensuring you meet deadlines, gather necessary evidence, and present your case effectively.
- Maximizing benefits. A skilled attorney will help you understand the full scope of benefits available under Ohio's workers' compensation laws and work toward a successful outcome.
- Advocacy at hearings. Although not a requirement, an attorney will represent you at hearings, presenting your case persuasively and advocating for your rights and interests before the IC or other relevant bodies.
- Appeals representation. If your claim is denied and you need to appeal, having legal representation is invaluable. We'll handle the complexities of the appeals process, including gathering more evidence, preparing legal arguments, and representing you in court if necessary.
