Ohio Workers’ Compensation laws exist to help workers who suffer an injury, occupational disease or death in the course and scope of their employment. Claims are initially filed with the Ohio Bureau of Workers’ Compensation or the self-insured employer.
Injured workers are entitled to multiple benefits; payment of temporary total compensation, wage loss compensation, permanent partial disability, permanent and total disability, scheduled loss awards, Violation of Specific Safety Requirements, medical treatment, therapy, diagnostic testing and surgery if necessary.
The process can involve hearings before the Industrial Commission of Ohio and even litigation. Don’t fight this battle alone. A. James Tsangeos will be happy to discuss your claim at a free consultation.
Under Ohio law, you are entitled to workers’ compensation benefits for an on-the-job injury, occupational disease or industrial injury resulting in death. Ohio is a no-fault work injury state, which means Ohio does not require you to your employer was negligent or at fault for causing your injury, occupational disease or death in order to receive benefits.
Temporary Total Compensation. This compensation is for a worker who is totally disabled and unable to work for a specific period of time due to a work-related injury or occupational disease. Generally, this is the initial award of compensation paid to compensate for lost wages.
Percentage of Permanent Partial Disability. Permanent Partial Disability (PPD) is offered to worker who experience residual damage after a work-related illness or injury. Residual damage is permanent injury that cannot be revolved; an employee has recovered as fully as is possible, but will not return to same physical state as before the injury. For example, consider a factory worker with a piece equipment falling on his arm, breaking his elbow. He receives proper treatment and heals. However, after the injury, he cannot extend his arm. While he may perform job functions and still work, he has suffered a permanent injury that could quality for PPD benefits. PPD benefits are awarded based on the extent of the injury. Injured workers must undergo an independent medical examination, and a physician will determine the level of the impairment. State law allows injured workers to file for PPD benefits within 6 months of the date of injury or last payment of compensation.
Medical Benefits. Medical coverage includes the cost of all necessary treatment related to your work-place injury or disability. Your workers’ compensation claim will also cover all deductibles and copays. Medical coverage may include compensation for medications, diagnostic testing, hospitalizations, nursing care, medical equipment, like wheelchairs or walkers, and other treatments.
Lump Sum Settlement. Many times, a workers’ compensation claim can be settled by reaching an agreement between the worker, employer and the BWC. A lump sum settlement forever resolves all past, present or future medical and compensation issues and liabilities in the claim, whether known or unknown. This means an injured worker cannot receive any additional compensation after agreeing to a lump sum settlement. An injured worker should consult with an experienced workers’ compensation attorney before agreeing to a lump sum settlement.
Scheduled Loss. This applies when a worker suffers amputations or loss of use of a body part, including vision and hearing. A scheduled loss award is based on the loss suffered by the injured worker prior to treatment, not on the injured workers’ condition after treatment.
Death Benefits. This type of claim is filed by the dependents of a worker who died as a result of an on-the-job injury. The amount paid to dependents depends on the level of support they received while the worker was alive. A death claim must be filed within two years of the workers’ death.
Retraining or Rehabilitation Benefits. Rehabilitation or retraining focuses on returning the injured worker to the original employer. If that is not possible, rehabilitation services can help the injured worker identify skills and abilities to secure a new job with another employer. The goal is to help restore the injured worker to the level of work and earnings they had prior to their injury.
Living Maintenance. This compensation is for injured workers who are activity participating in a rehabilitation plan. The BWC will issue this compensation for a period not to exceed a period of six (6) months, unless a review by the BWC finds the worker would benefit by an extension.
Living Maintenance Wage Loss. This compensation is only paid to an injured worker who has finished a rehabilitation plan and continues to have physical restrictions causing a wage loss upon return to work.
Permanent Total Disability (PTD). This form of compensation is for workers injured so severely they are permanently disabled and unable to work. The worker must attend an examination before the Industrial Commission of Ohio do determine if he/she meet the eligibility requirements. If approved, the injured worker can receive permanent total disability compensation for life.
Wage Loss. Applicants must prove they lost wages or their wages were decreased due to the work-related injury. There are two forms of wage loss compensation. The first type is Working Wage Loss which is paid when the injured worker returns to a job other than his/her former position, whether at the same or different employer, resulting in fewer hours and/or less pay due physical restrictions. The second type is Non-Working Wage Loss which is paid when the injured worker is released to return to work with restrictions but is unable to find suitable employment. The injured worker is required to show he/she is making a good faith effort to secure employment within his/her restrictions.
The employer / employee relationship: A recent trend is when employers claim a worker is actually a contractor, not an employee, and therefore not covered by workers’ compensation. This occurs often in the construction and trucking industries. In addition to falsely classifying employees as contractors, companies disputing claims may contest applications by workers attached to the company through labor leasing or professional employer organizations, or as temps or interns.
Injury is “accidental in character and result”: This phrase from state workers’ compensation statutes seems to place a qualifier on the no-fault nature of the program. However, courts have continued to say employers may not cite the workers’ contributory negligence as reason to deny a claim. In other words, lack of common sense, failure to follow work rules, inattention to detail, and other similar discrepancies on the part of the employee will not invalidate a claim. In most cases, a description of the accident that caused the employee’s injury is sufficient to meet this legal qualification.
Injury occurred “in the course of employment”: For a workers’ compensation claim to be allowed in Ohio, the injury must have occurred “in the course of employment,” or while on the job. In most cases, work records and witness statements make this easy to prove. However, an employer may object if an accident occurred while the worker was on a break, for example, or not yet on the job and in the parking lot, or while combining personal activities and business. The so-called “Coming and Going Rule” says that an employee’s commute to a fixed worksite does not count as “on the job.” There are exceptions to the Coming and Going Rule, one of which sets the rule aside if an accident happens in a parking lot the employer owns and controls, and the employee was required to park there, for example.
Injury occurred “arising out of the employment”: This portion of the law requires the worker to show that a risk or hazard directly related to their employment was the actual cause of the workplace injury. Disputes over this factor typically relate to:
Heart attack or stroke: Many lifestyle, genetic and general health factors may contribute to a heart attack or stroke, even if it occurs in the workplace
Repetitive motion injury (e.g., carpal tunnel syndrome or rotator cuff syndrome): Any kind of cumulative injury is subject to being questioned, with the employer pointing to previous employment or other activities as its cause.
Toxic exposure: Diseases caused by toxic exposure, such as silicosis or asbestosis, have lengthy periods before they show symptoms. Again, this allows employers to point at other potential causes.
Sometimes a work-related injury may be caused by the negligence of a person or company unrelated to your employer. Say you’re a delivery driver on your way to deliver an order to a customer. You’re driving at a lawful speed and another driver runs a red light and broadsides you. You end up hospitalized with a broken leg that leaves you unable to drive for a prolonged period of time while your leg is in a cast. In this scenario, you are entitled to workers’ compensation benefits if you can demonstrate that your injury happened in the course of your employment. Furthermore, you may be entitled to additional compensation from the driver who the crash.
Sometimes there comes a time during the process of workers’ compensation when it is necessary to decide whether or not you need an experienced workers’ compensation attorney to help you through the process. While this is by no means a complete list, the following situations would call for a workers’ compensation attorney:
The employer denies you were injured on the job or delays your benefits.
The insurance carrier has denied you benefits.
You cannot get the medical treatment and necessary testing you need.
You aren’t getting paid.
An insurance adjuster promises benefits or care that never arrives.
A lawyer for the insurance company wants you to take a deposition.
With more than 37 years of legal experience, our office will work to win your claim and successfully obtain all benefits you are entitled under the law. Schedule a free consultation to discuss your claim and learn how we can help.