by Jacob Brandt | Dec 14, 2020 | Workers' Compensation
Typically, a claim will remain open and viable for five years from the last medical bill or compensation payment. However, there are instance where claims close well before the expiration of that five-year statutory period.
Really there are three ways by which an Ohio workers’ comp case closes. First, a claim can be closed through the initial adjudication of an individual’s application for benefits that results in denial. Often the Ohio workers’ compensation system rejects an individual’s initial application for benefits. Nonetheless before that rejection a claim is “opened.” If an application is never approved through the initial adjudication the claim becomes closed.
The second way by which a claim can close is through settlement. The parties to a workers’ compensation claim are free to work together and reach a settlement agreement. Settlements vary from case to case but put simply, in instances of settlement the workers compensation system agrees to pay out an injured worker’s claims for benefits in exchange for the injured worker agreeing to close their claim and no longer seek benefits for the injury or illness they suffered. Once a settlement agreement is reached and the injured worker signs documents attesting their acceptance the claim is closed.
As aforementioned, the third way a claim can close is by the expiration of the five-year statutory period. Every time there is a new payment made for medical services approved in a claim or payment of compensation approved in the claim the five-year period starts over. For example, take injured worker who is hurt at work on January 1, 2015. That individual suffers very minor injuries and only has one treatment at an emergency care facility on January 1, 2015. The BWC pays for that individual’s emergency care visit on January 15, 2015. In that case, if the individual receives no further treatment that is covered by the claim and does not receive any compensation through his claim, the claim will expire and close on January 15, 2020, five years from the date of last medical payment.
Keep in mind, the date on which the individual was hurt is very important to determining the proper expiration date. For injuries that occur on or after July 1, 2020, the five-year period for expiration starts not on the date medical treatment is paid for but, rather, the date on which the last medical treatment was rendered. So, in relation to the prior example, if that injury occurred on January 1, 2021, the proper date of expiration would be January 1, 2026, exactly five years from the last date of treatment rendered that was paid for in the claim.
Keep in mind that the five-year period restarts with the payment compensation through a claim as well, not just payment for medical services. So, each time an individual is paid compensation through their claim the life of the claim is extended five years from the date of that compensation payment.
To summarize, if a claim application is not initially denied and the claim is never settled, a workers’ compensation claim can stay open forever so long as the injured worker continues to have medical treatment covered through the claim or compensation paid through the claim.
If you need assistance keeping your claim open don’t hesitate to contact the team of talented and caring attorneys at The Bainbridge Firm. We have decades of experience helping workers in Ohio with their workers’ compensation claim. If you are wondering how to keep your workers’ compensation claim open schedule a consultation with us today!
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