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.