When you have been hurt at work, it can be difficult to understand precisely how the workers’ compensation claims process works, and what you should expect after you have filed a claim following a workplace injury. The Ohio Bureau of Workers’ Compensation (BWC) provides information about the claims process, and we want to tell you more about what to expect after you file your Ohio workers’ compensation claim.
You Will Be Assigned a Claims Service Specialist
The first thing that will happen in your workers’ compensation case after you file a claim is that your claim will be assigned to a claims service specialist (CSS) by the BWC. The CSS is the person who handles your claim, and you will receive information with the contact information for your CSS. You can also look up the contact information for your CSS on the BWC site.
CSS Will Begin the Initial Investigation
Once a CSS is assigned to your claim, the CSS will begin an initial investigation. The initial investigation will involve the CSS requesting many different types of information related to your case, including medical documentation, information about your work restrictions from your medical provider (through the Physician’s Report of Work Ability Form), the Request for Temporary Total Compensation Form--if you cannot work for seven days or more, and information about your wages from your employer. Wage documentation is important because it will determine the amount of workers’ compensation benefits you can receive as wage replacement. Typically, wage information is documented on an Injured Worker Earnings Statement.
In addition to requesting documentation as part of the initial investigation, the CSS will also seek information from your employer about whether your employer will certify or reject the claim. When an employer certifies the claim, that means the employer agrees with you about your injury or illness. When an employer rejects a claim, that means the employer does not agree with you about the injury or illness. Although the BWC will consider the employer’s certification or rejection, you should know that this is not the sole factor in determining whether you are eligible to receive workers’ compensation benefits.
CSS Will Complete the Investigation and Issue a Decision
After the CSS finishes the initial investigation, the CSS will close the investigation and will issue a decision or determination about your claim. Assuming the CSS completes the investigation, you will receive a notice that your claim has been either “allowed” (meaning you are eligible for workers’ compensation benefits) or “denied” (meaning that you are not eligible for workers’ compensation benefits according to the BWC). If your claim is denied and you want to appeal the decision, you must do so within 14 days of receiving the decision notice.
If you withdraw your claim before the CSS completes the investigation—even if the investigation has begun—you will receive a decision of “dismissed.” This decision means that the CSS has dismissed your claim, but you may be able to refile if you do so within one year from the date of injury.
Contact an Ohio Workers’ Compensation Lawyer
If you have questions about the workers’ compensation claims process, you should seek advice from an experienced Ohio Workers’ Compensation attorney as soon as possible. Contact Nager, Romaine & Schneiberg Co., LPA today for more information.
As the COVID-19 pandemic continues, we are often asked, “If I am injured while I am working from home, can I file for Workers’ Compensation benefits?”
The simple answer is “it depends.” Whether you will be able to get compensation from your employer, or whether you will need to rely on your own health insurance depends on the factors below.
How Do You Know Whether You Were Injured on the job?
Workers’ Compensation is granted when an employee is injured in the course of their duties or at their workplace. Since many people are working from home these days, the lines are blurred. The Ohio Bureau of Workers’ Compensation usually errs on the side of granting benefits, since it is a win-win situation for everyone. Employees get their wages and medical costs covered, while employers and courts avoid negligence lawsuits.
In the COVID-19 work-from-home era, defining a “work injury” is more complicated. It is much harder to determine whether that injury would have occurred in the scope of your duties, or if you could have suffered the same fate while off duty.
Here’s how to tell whether you may have a claim.
- Did your employer require you to perform the activity that caused the injury? For example, if you drop a cup of coffee on your foot in your own kitchen and suffer severe burns, you probably will not have a case. However, if the same injury had occurred in your workplace, you might. Your physical presence on work premises benefits your employer.
- Did they approve of the activity in advance? If the specific activity you were performing isn’t in the normal scope of your duties, or if you normally would not do it at home, then knowing whether the employer approved can indicate whether it is “work-related.”
- Did the activity actively benefit your employer? This question does not arise as often when you are on the employer’s premises, since your presence is beneficial to them. You are considered available to help, even when you are on break. At home, that line is blurred. Is getting coffee “actively benefitting your employer?” Probably not. However, if you get repetitive stress injuries from typing work documents, then you would be able to make a stronger argument that you were injured in the course of your work duties.
Ultimately, Workers’ Compensation depends on the specific facts of the case. Working with an experienced attorney can help ensure that you get the medical and wage compensation you need. Call Nager, Romaine, & Schneiberg Co. L.P.A. to schedule a free case evaluation today.
When you’re injured or contract an illness on the job, you may be eligible for workers’ compensation. Injuries and illnesses in the course and scope of your employment are covered under the state’s workers’ compensation program, whether you sprained your ankle or sustained a spinal injury.
Most people know that their workers’ compensation payments should cover medical costs. If you’re not fully familiar with all the benefits offered, how you can use them and how to get them, it’s worth talking to an attorney.
Why Workers’ Compensation Is Important
The state of Ohio sponsors the workers’ compensation program. It’s designed to support employees who have been injured or suffered illness on the job, so they can recover and return to work whenever possible.
Employers pay for workers’ compensation insurance, which covers the cost of injuries or illnesses. If they don’t pay their premiums on time, however, their coverage will lapse. At that point, they’re solely responsible for covering the cost of employee injuries “for the life of the claim, any unpaid premiums and possible penalties from BWC.” In short, you’ll still be eligible for compensation—but your employer will have to cover that full amount.
If your employer is resistant to the idea of you collecting workers’ compensation payments, contact an attorney right away.
What Workers’ Compensation Payments Can Be Used For
Once your claim has been filed, the Bureau of Workers’ Compensation (BWC) will classify your claim into one of two categories: medical-only or lost time. Medical-only claims are those in which you’ve been injured, but missed less than seven days of work. Lost time claims cover injuries and illness where you’ve missed eight or more days of work.
If you were unable to return to work promptly, you will likely be eligible for compensation for medical costs as well as lost wages during recovery. There are also a number of benefits that you may continue to collect, based on whether you have a permanent disability or other applicable situation.
Naturally, your first priority should be medical reimbursement. If you’re eligible for other types of benefits, such as lost wages, you can use them to help make up for your lack of regular income. Use them to pay for rent, your mortgage, food, childcare and other necessities—what you would normally use your paycheck to pay for.
If you have questions about what kind of workers’ compensation benefits you are eligible to receive, or how you can spend them, call Nager, Romaine, & Schneiberg Co. L.P.A. today.
2020 and 2021 have seen a considerable worker shortage. The effects of COVID-19 have affected every industry on the planet, from healthcare to long-haul truck driving. The worker shortage is disastrous on many levels—including the potential for accidents on the job.
When businesses are short staffed, the remaining workers are often overworked. As a result, many employees suffer from fatigue. When employees are exhausted, it’s easier for accidents to occur.
If you’re working at a short-staffed business, make sure to advocate for your right to rest. Employers need to support their employees’ health and well-being—or risk an influx of workers’ compensation claims.
How Fatigue Can Lead to Accidents
Healthcare workers have long made a case for getting adequate rest and reasonable hours. Over the course of the pandemic, this has been made more obvious than ever. Nurses and other healthcare professionals are working long, thankless hours and burning out faster than usual, thanks to the increased strain.
This 2014 study found that “[s]hift work and long work hours increase the risk for reduced performance on the job, obesity, injuries, and a wide range of chronic diseases. In addition, fatigue-related errors could harm patients. Fatigued nurses also endanger others during their commute to and from work.”
Of course, this applies to every industry. Whether you work in a bookstore or on a construction site, you’re much more likely to get injured—or sick—when you’re constantly tired. When businesses lack a full staff, the remaining employees tend to take on a heavier workload, longer shifts and more of them. When you’re tired, it affects your memory, perception, motor skills, judgment and your ability to deal with stress; you’re also far more likely to suffer an accident on the job. That can lead to serious injury, time off work, lost wages and, of course, needing to file a workers’ compensation claim.
Protect Yourself Against Fatigue
The best way to protect against fatigue is to get enough rest—but when a business is short staffed, that may not be possible. It is important to find and review the labor laws applicable to your job. If your employer is asking you to violate them by working more hours than legally allowed, or otherwise endangering your health, talk to an attorney about your options.
Your employer should have a vested interest in preventing fatigue-related accidents—the better rested their employees, the less likely they’ll file workers’ compensation claims.
For assistance with your claim, contact Nager, Romaine, & Schneiberg Co. L.P.A. today.
There are many myths surrounding workers’ compensation. One damaging myth is the idea that your workplace injury needs to be “serious” to receive workers’ compensation benefits. You might feel awkward asking your employer to pay for costs associated with a minor sprain, for example, but that’s why the program exists. It’s better to report a minor injury right away. If you wait for it to either go away or worsen, you risk your claim being denied. Since many injuries do worsen over time, play it safe: file your claim as soon as possible.
The Risk of Not Reporting within the Statute of Limitations
In 2017, the statute of limitations for reporting a workplace injury was reduced to one year. If you have an occupational disease, the statute of limitations is still two years. While that might seem like a lot of time, many workers wait too long to file. When their injuries persist and their medical bills pile up, they’re disheartened to find there’s no legal recourse.
Whether your injury is mild or serious, it is important to file your workers’ compensation claim as close to the date of injury as possible to ensure that your claim is taken seriously by the Ohio Bureau of Workers’ Compensation, and to prevent your injury from worsening.
Why Would Someone Delay Filing?
- Employer pressure and fear of retaliation. Although retaliation is illegal, many employees fear that filing for workers’ compensation will make them a company target. Others are pressured to use their own health insurance for their medical bills. Employers might use guilt as an approach, claiming that their premiums will go up too high and put them out of business. These are red flags. Talk to an attorney right away—and make sure you file for the benefits you are due.
- Fear of missing work and lost income. Some employees worry that filing a claim and missing work will mean that they can’t make ends meet in the short term. Unfortunately, working during your recovery period could make your injuries worse.
- Hoping they’ll get better without treatment. Finally, some people forego the doctor simply because they don’t like them. They hope that they’ll get better on their own. It’s always best to see a doctor right away—with any luck, your first appointment will be the only one you need. If the injuries get worse, you’ll be glad you went when you did.
For assistance with your claim, contact one of the worker’s compensation attorneys at Nager, Romaine, & Schneiberg Co. L.P.A. today.
