Workers’ Compensation FAQs
What on-the-job injuries does workers’ compensation cover?
Three types of workers’ compensation claims may be filed — injury claims, occupational disease claims and death claims. An injury claim occurs when an injured worker suffers a physical injury on the job. An occupational disease claim may be filed if a worker is exposed during employment to conditions or substances that are detrimental to health. Death claims are filed where a worker has died due to the employment. Eligible dependents are entitled to an award known as death benefits.
Who pays my workers’ compensation benefits?
Ohio law requires that all employers either insure themselves or purchase workers’ compensation insurance coverage from the state fund. Therefore, if you have an allowed claim, either the state fund or your employer will be responsible for paying your compensation and/or medical benefits.
Will I get the same benefits if my employer is self-insured?
Yes. Injured workers will receive the same compensation and benefits whether they work for a state fund or self-insured employer. The claim process varies slightly, however, depending on the employer type.
State fund employers do not pay compensation and benefits directly to the injured worker. State fund claims are initially processed by the Bureau of Workers’ Compensation (BWC). No payment can be made in state fund claims without an order from the BWC or the Industrial Commission of Ohio. If the BWC denies your claim, an appeal may be filed and the claim will be referred to the Industrial Commission for a hearing.
Self-insured employers fund their own insurance and pay all compensation and benefits directly to the injured worker. Self-insurers make the initial decision on whether to accept or deny a claim and they can pay compensation or benefits without an order from the BWC or Industrial Commission. If a self-insurer chooses to deny a claim, the issue will be referred for a hearing before the Industrial Commission of Ohio.
How long will it take to get benefits after my injury?
This depends on the specifics of your injury, whether your employer is self-insured or state funded and many other factors. At Fox & Fox Co. L.P.A., our goal is to help you receive benefits as soon as possible, by obtaining and filing all the necessary paperwork to process your claim.
Do I have to continue treatment with the doctor that the employer sent me to after my injury?
No. When you suffer an injury on the job, your employer or your employer’s third-party administrator may suggest that you seek treatment with a specific doctor. However, you are free to consult with any doctor who is certified by the Bureau of Workers’ Compensation (BWC) for the conditions that are allowed in your claim.
What should I do if the self-insured employer or BWC denies my workers’ compensation claim?
If your self-insured employer denies your claim, it will be referred to the Industrial Commission for a hearing. Similarly, if the BWC issues an order denying your claim, we will appeal the decision and the claim will be referred to the Industrial Commission for a hearing. There are three levels of hearings at the Industrial Commission — the district hearing (first level), the staff hearing (second level) and the full Industrial Commission (third level, discretionary).
Following the Industrial Commission hearings, the injured worker or the employer may have further appeal options to the Court of Common Pleas or Court of Appeals, depending upon the issues involved.
Do I have to go back to work before I am ready?
Ultimately, your doctor determines when you can go back to work. If you receive a phone call or letter from your employer concerning your return to work (either full duty or with restrictions), contact our office immediately to discuss your return to work.
What kind of workers’ compensation benefits can I recover?
Eligible injured employees are entitled to medical care through a BWC-certified provider for treatment of the allowed conditions in the claim. Workers unable to return to work for eight or more days are paid a percentage of the wages lost as a result of their work-related injury. Injured workers may be entitled to participate in a vocational rehabilitation program and/or seek wage loss benefits if they have restrictions as a result of their injury that render them incapable of returning to their former job. If an injured worker suffers permanent residual damage as a result of the injury or is unable to return to the workforce entirely, additional benefits may be available.
Why do I need an attorney?
Workers’ compensation is a difficult and often frustrating system. Our job is to take the hassle out of the process, do the work needed for you to recover your benefits and provide counsel and advice to help you navigate the process.
How do I pay for your services?
Our initial consultation with you is free. All other work is done on a contingency basis. This means we do not get paid unless you win your claim. We do not charge hourly fees or ask for a retainer. To arrange a consultation at one of our offices in Amelia or Cincinnati, call 513-961-6644 or send us an email.