How Does Workers’ Compensation Work?
by Jacob Brandt | Oct 11, 2022 | General Information
One of the best tools you have during any legal process is information. As Ohio workers’ compensation lawyers, one of our primary jobs is to make sure you have the information and context you need to make the right decision about your workers’ compensation claim.
And one of the most important questions to answer is the simplest one: What is workers’ compensation? So here is a high-level overview and history of Ohio workers’ compensation from the attorneys at the Bainbridge Law Firm.
The Ohio Workers’ Compensation Claims Process
When employees are injured on the job, they file a workers’ compensation claim with the Ohio Bureau of Workers’ Compensation (BWC).
The BWC will investigate the claim and respond with a decision within 28 days. If the BWC denies the claim, employees have an opportunity to appeal the decision several times, a process that can be helped along by an Ohio workers’ compensation lawyer. If the BWC approves the claim, the employee may be awarded monetary benefits to compensate for their injury.
Common compensation includes medical expenses and lost wages. The BWC may also cover medication and transportation.
If you are injured on the job, it is important to take the following steps:
- inform a supervisor as quickly as possible
- prepare a detailed report of the incident
- seek medical treatment
- file a claim quickly
Once an initial decision has been made, an automatic 14-day appeals period begins. Either the employer or the employee can file an appeal with the Industrial Commission of Ohio (IC). Appeals can be submitted online or on paper, and an Ohio workers’ compensation attorney can help with the process. On appeal, the IC will then hold a hearing to determine if the prior decision was correct. A decision can be appealed up to three times. If you need assistance filing an appeal, our Ohio workers’ compensation attorneys can help.
Benefits From a Successful Workers’ Compensation Claim
Workers’ compensation benefits are awarded according to how necessary and reasonable they are, which is a determination that can be argued with the assistance of a workers’ compensation attorney. Employees will generally receive payments to cover medical expenses and to cover some wages.
Injuries are categorized as either partial or total and as either temporary or permanent. The amount of benefits an employee is entitled to depends, in part, on how their injury is categorized.
Employees are entitled to medical benefits for as long as they need them so long as the treatment is “reasonable” and “necessary” and supported by medical evidence within the file. However, proving that the benefits are reasonable and necessary is not always easy. This is where an Ohio workers’ compensation attorney can help.
Where Workers’ Compensation Money Comes From
All employers in Ohio are required to purchase workers’ compensation insurance. This means that each employer pays money into a state fund. As employees make claims with the BWC, the BWC will give deserving claimants benefits from the fund. Just like in an insurance system, employers that have more injuries are required to pay more money into the fund.
Some employers waive the Ohio governmental fund and choose to pay workers’ compensation claims themselves. These employers are called self-insured employers. They are usually large companies that have the manpower and money to operate their own workers’ compensation systems. Although self-employers work a little differently, employees are still entitled to the same benefits and can still appeal a decision through the Industrial Commission of Ohio.
Employees are still entitled to benefits even if an employer fails to fund workers’ compensation. The BWC has money in the reserve to fund all Ohio workers that are entitled to benefits. If you were injured at work, and your employer did not carry workers’ compensation coverage, you may still be entitled to benefits. Talk to one of our workers’ compensation attorneys to find out what your options are.
The History of Workers’ Compensation in Ohio
Workers’ compensation was born out of the Industrial Revolution. With the rise of mechanization in the United States, workers were sustaining injuries in factories at a rapid rate.
At the time, the only remedy these workers had was to sue their employers through the tort system. The tort system is inefficient and requires demonstrating various legal elements in court. To improve the process, states created the modern workers’ compensation system.
The Ohio workers’ compensation system is a no-fault system. That means that employees no longer needed to go through all the legal hoops of the tort system. Now, injured workers only have to prove that 1) they are employees 2) they have sustained an injury or occupational disease 3) are in the course of their employment, and 4) the injury arose from the employment.
Most people easily fall within the categories above. Ohio has set forth a long definition of “employee” in the Ohio code. Despite its complexity, the definition covers most workers. The definitions of “injury” and “what is an occupational illness” are also broad.
Most injuries, including accidental ones, are covered by the code. For an injury to be within the course of employment, there must be a causal connection between work and the injury. If an employee is injured on her commute, she is unlikely to be covered. However, an employee does not necessarily have to be working to be covered. Employees on a bathroom or lunch break at the office oftentimes receive benefits.
If you’re looking for more information on whether you qualify, our Ohio workers’ compensation attorneys give a detailed breakdown of the general rules in Ohio.
What to Expect from the Workers’ Compensation System
Employees should be detailed and patient. The workers’ compensation system requires employees to be very specific when providing evidence of an injury, and any amendments to a claim will elongate the process. Meeting deadlines is also paramount.
Oftentimes, the BWC will simply “go through the motions,” so it is important to advocate for your position. A qualified Ohio workers’ compensation attorney can ensure that the claims process goes as quickly and as positively as possible.
If you sustained a workplace injury, contact the Bainbridge Firm to speak with one of our experienced Ohio Workers’ Compensation Attorneys. Schedule a free consultation at our Columbus, Marion, Portsmouth, Waverly, Cambridge, and Springfield or Ironton law offices. Please call 800-762-1612 or contact us online.