Maximize your workers compensation claim with expert legal representation.
Filing a claim for workers’ compensation benefits can be very confusing, stressful, and time-consuming. If you choose to retain our services, we will thoroughly review your injury, give you honest information, and help you get the treatment and benefits to which you are entitled.
Who qualifies for workers’ compensation?
You must be injured in the course of and scope of employment.
You must establish jurisdiction with the state of Ohio. This can be accomplished in many ways and is determined on a case by case basis. Some relevant factors include, but are not limited to: a) where the injury occurred; b) where the employer is located; c) where the contract of employment took place; and d) where the Claimant resides
Initially, you must prove that at least one condition either directly arose from the injury or, if the condition pre-existed the injury, said pre-existing condition was substantially aggravated by the injury.
*This list is only for injuries. Occupational Diseases are more complex and are subject to slightly different rules. Please contact us if you believe that you may have contracted a disease or illness as a result of a workplace exposure.
Understanding your benefits:
To receive a benefit, a Claimant must prove that a benefit is related to an allowed condition in the claim.This is a complex legal question, and either the BWC or employer can dispute any benefit request. Workers’ compensation benefits can be divided into two categories: medical and indemnity.
Medical benefits are fairly self-explanatory. If awarded, these benefits include things such as office visits, chiropractic treatment, counseling, surgeries, medications, and any other treatment modality requested by a qualified expert in a claim.
Indemnity benefits are monetary. These benefits include temporary total disability compensation, working wage loss compensation, non-working wage loss compensation, permanent partial disability compensation, facial disfigurement, loss of use disability, and permanent total disability compensation.
Navigating the claims process.
If you suffer a workplace injury or occupational disease, immediately report it to your employer and seek medical attention. File a workers' compensation claim within 1 year of the injury or, in the case of an occupational disease, within 1 year from the disability onset or six months from the diagnosis, whichever is later. Please be aware that it is always best to file a claim as soon as possible.
Upon filing, the BWC (state-funded) or employer (self-insured) makes an initial decision. Disagreements lead to hearings before the Ohio Industrial Commission at three administrative levels:
District Hearing Officer
Staff Hearing Officer
Full Commission or Deputy (appeals at this level are rare and may be declined).
Once a final administrative decision is made on the initial allowance of a claim, further appeal can be filed into the Court of Common Pleas. If a claim is initially recognized, there will likely be other issues, such as additional condition requests and treatment requests, which must be adjudicated at hearing. As with the initial allowance of the claim, additional condition requests can be filed into the Court of Common Pleas after a final administrative decision is made. Other issues do not qualify for an appeal into the Court of Common Please, but there may have additional appeal options.
Approved claims remain statutorily active for 5 years after the last medical payment or compensation payment, extending with each payment.
Your workers' compensation questions answered.
If you can't find the answer you're looking for, don't hesitate to get in touch. Our team is here to provide you with the information and support you need.
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As mentioned in the introduction section, workers’ compensation is a social engineering program. Filing a claim against your employer is not a lawsuit. You are only requesting to participate in the program for the injuries (or occupational disease) that you sustained. However, there is an exception if your employer intentionally caused your injury. In such cases, you may have an intentional tort action against them.
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No, Ohio Workers’ Compensation claims are a no-fault system. However, if the employer violated a codified specific safety regulation, you may have an additional VSSR claim.
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In short, no. Be aware that Ohio is an employment at will state. Therefore, your employer is able to terminate you without reason. However, if you are able to prove that your employer fired you in retaliation for filing a claim, you can pursue a separate action against them. In addition to this protection, there may be other limited protections against an unlawful termination.
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Private insurance, Medicare and Medicaid are considered to be a secondary coverage. If they are aware that the requested treatment is the result of a work injury, they may not cover the treatment until the claim or treatment has been denied through workers’ compensation first.
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No, hearings before the Industrial Commission are not court hearings. They are administrative proceedings. These proceedings are “informal”. This simply means that there are no rules of evidence, and there is no strict decorum as is the case with actual court proceedings. Hearing Officers are not judges. However, hearings are legal determinations, the findings are based upon law, and the Hearing Officers must be licensed attorneys. Unless properly appealed, a decision is final.
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Workers’ compensation claims are designed to stay open for the benefit of a Claimant. Benefits are applied for and drawn real-time during the course of a claim. Some claims never settle because they are more valuable to the Claimant if left open. Of course, there are some situations in which it is to the benefit of a Claimant to settle. We will help you decide the best option.
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No, workers’ compensation benefits are not taxable. However, we do not give tax advice so always check with your tax professional.
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Addressing only workers’ compensation, we are contingent fee, unless otherwise agreed. This means that we do not charge you unless you are awarded something through the claim. We then charge a percentage of what you are awarded.
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For more information regarding Workers’ Compensation in Ohio, visit the Ohio BWC FAQs for Injured Workers.
Reach out for help with your workers’ compensation claim.
If you are dealing with a workers' compensation issue and need guidance, contact Spears & Marinakis, LLC today. Our experienced team is dedicated to ensuring that you receive the full benefits to which you are entitled.