How Do I Know if I Qualify for Ohio Workers’ Compensation Benefits?
by Andrew Bainbridge | Aug 09, 2022 | Workers' Compensation
As Ohio workers compensation lawyers, one of the most common things we hear from clients is concern that they may not be covered by the Ohio workers’ compensation system.
While that concern is certainly understandable, it is often unfounded. Ohio’s workers’ compensation system is designed to cover most people who need it. There are three primary requirements to qualify for benefits within the state.
To qualify, a claimant must:
- Be an employee
- Be suffering from an injury or occupational disease
- Have sustained the injury or disease in the course of employment and arising from that employment
Ohio workers compensation attorneys know that some of these legal definitions can get a bit complicated, so let’s break down each part of that in more detail.
Who is Considered an Employee in Workers’ Compensation Claims?
Ohio has set forth a lengthy definition of “employee” that is filled with its own sub-definitions. Our Ohio workers’ compensation lawyers know the ins and outs of that definition and how it applies, but here’s the short version. Despite its daunting length, the definition is friendly to the average worker. Most people that are normally thought of as “employees” are covered by the law and can receive benefits.
The one major exception is independent contractors. Independent contractors are not considered employees under the law and will not be entitled to workers compensation benefits unless they purchase workers compensation insurance for themselves.
Sometimes employers mistakenly consider a worker to be an independent contractor and neglect to provide workers compensation coverage. This is something we look at very closely as workers’ compensation lawyers. If an employer controls the working hours, selection of materials, traveling routes and quality of performance of a worker, an employer-employee relationship exists, and the employer is required to provide workers compensation coverage for that employee.
Many workers’ compensation claims arise from arguments about whether an injured worker is legally considered an “employee,” and our Columbus workers’ compensation lawyers know how to handle those arguments.
If you have been injured at work and your employer claims you are not covered under the employer’s workers’ compensation policy because you are an “independent contractor,” contact an Ohio workers’ compensation attorney to review your case. A legal argument may prove you were acting as an employee and should be entitled to coverage.
What is an Occupational Illness, Disease, or Injury?
Much like with the term “employee,” Ohio has long definitions of both “injury” and “occupational disease” that our Ohio workers’ compensation attorneys can help you decode. For the most part, the two cover everything that one would normally think of. Almost all injuries and diseases are covered, including those that are sustained by accident.
An injury may be as minimal as a finger prick with a needle, or a torn thumbnail, and it may be as large as a severed extremity. An injury may also include a heart attack, cancer, or contagious disease if those are connected to your employment. Let’s discuss that designation next.
Injuries Considered “Sustained in the Course of Employment”
Generally, an employee must have been at work when the injury occurred to receive workers’ compensation benefits. However, an employee does not necessarily have to be actively working. Ohio has a “personal comfort doctrine” that covers employees who are involved in reasonable personal activities like taking a lunch or bathroom break when they sustain an injury.
The personal comfort doctrine does not apply to commutes or to activities outside the scope of acceptable employee behavior.
Likewise, the injury must arise from the employee’s employment. For example, if the employee was engaged in work activity at the direction of the employer at the time of the accident – regardless of the nature of the accident – the employee should meet the “arising from employment” prong and be entitled to an allowed claim.
An Ohio workers’ compensation attorney can help define this difference, and fight on your behalf when an employer tries to deny benefits on these grounds.
How Soon Must I File a Workers’ Compensation Claim?
As of 2017, the Ohio Statute of limitations for workers’ compensation was lowered to one year for acute injuries and two years for work-related diseases, or six months from the date of a diagnosis of a work-related disease.
This means that employees should talk to an Ohio workers compensation attorney and file a claim as soon as they are injured or made aware of a disease that was caused by their employment. Otherwise, you risk losing the benefits you deserve.
The process of acquiring benefits begins when a first report of injury is filed with the BWC or your self-insured employer. It is best to consult with a skilled workers’ compensation attorney before filing a claim to maximize both the chances of success and the potential payout.
Once the process begins, the initial statute of limitations no longer matters. New deadlines will be created, and a final ruling does not have to be made before the statute of limitations for an employee to receive benefits.
What If My Employer Is In Another State?
If you are an Ohio resident who was injured while working for a company from another state, you are still covered. Out-of-state employers with workers who are Ohio residents have liability for claims that arise in Ohio.
For payroll reporting purposes, employers must report wages and pay premiums to the Ohio Bureau of Workers’ Compensation for any work performed in Ohio. It is common for an out-of-state employer to hire a salesperson covering a geographical region, or a skilled worker to work remotely from their home in Ohio.
This type of employee is an Ohio employee under the workers’ compensation laws of Ohio with the wages for the employee reportable to BWC, and as such, an Ohio workers’ compensation lawyer can help with your claim.
This also applies to the inverse situation – if you are an Ohio worker who was injured outside the state of Ohio, you are also covered. Ohio has extraterritorial coverage. This means that Ohio workers that are temporarily outside the state will still be covered by Ohio workers’ compensation so long as the work remains incidental to the Ohio employment. Again, our workers’ compensation attorneys can help clarify this, as every case is different.
What If My Employer Doesn’t Have Workers’ Compensation Coverage?
The Ohio Bureau of Workers’ Compensation works like an insurance system with businesses across the state pooling money into a fund. When a worker is injured or suffers from an occupational disease, money is taken out of the fund and given to the employee.
Because the money is pooled into a state fund, employees will still be able to receive benefits even if their employer failed to make premium payments. If an employer fails to make payments, they may be in their own bit of legal trouble, but this trouble will not affect your ability to file a claim for workers’ compensation benefits. The BWC will take measures to acquire the money from your employer regardless.
So even if you are unsure if your employer has workers’ compensation insurance, you should still speak with a qualified Ohio workers’ compensation attorney and file a claim.