If you've ever performed a job that required you to repeat the same motion over and over again, then you may not have realized that you could have seriously damaged your muscles and connective tissue in the process. Called repetitive motion injuries, the damage associated with such injuries can take a long time before symptoms present themselves. But in some cases, when symptoms -- such as pain or numbness -- do present themselves, it may be too late to fully correct the damage.
Knowing what to expect at your first workers' compensation hearing is important in helping to understand how the workers' compensation process works. When a hearing is scheduled, it is scheduled because the parties to the claim (the injured worker, the Bureau of Workers' compensation, or the employer) do not agree over some aspect of the claim. The dispute can be a large issue (for example, should the claim be allowed in the first place?) or a smaller issue (for example, should a specific doctor's bill be processed under workers' compensation?).
A tight, burning and stabbing sensation. Muscles spasms and tingling. The feeling of being electrocuted in the same spot repeatedly. Back pain comes in many forms. Millions of people experience the agony of back pain and while the pain is often bearable at first, bearable doesn't cut it forever. For some people, surgery might feel like the only option.
A Court of Appeals has held that injuries sustained by the claimant while traveling to or from a Bureau medical examination are compensable "as being directly and proximately caused by circumstances that arose out of employment as the original injuries and obligations necessitated by those injuries in order to participate in the Workers' compensation fund, directly resulted in the new injuries."
Until recently, medical treatment in workers compensation claims have been limited to treatment of conditions that are "allowed" in the claim.1 Allowed conditions are medical conditions that are proven to have resulted from a compensable work-related injury or occupational disease.2 The BWC has now taken steps to address cognitive, emotional, behavioral, social and psychological issues in a claim that are not directly related to the allowed conditions.3 Instead, these issues are believed to have arisen after the allowed condition, and these issues are believed to prolong pain and disability of the allowed condition. This does not include mental illness and psychological disorders, but instead, normal emotional responses that many people experience following a serious injury.4 The idea of this new rule is to allow injured workers to get the guidance they need, before these issues turn into something more serious such as depression or opioid addiction, hindering the ability for the injured worker to heal.
According to the book, Ohio Workers' Compensation Law, written by Phillip Fulton, under R.C. § 4123.651 injured workers are entitled to freely choose a physician to treat a covered injury. This includes both the initial choice of physician and any decision by the injured worker to change physicians. The Bureau of Workers Compensation may require the injured worker to give notice of change in treating physician and the reason for change. Once a claimant goes to a private physician for treatment other than on an emergency basis, the claimant is generally regarded as having chosen that physician. Before 1959 employees didn't have a choice of physician. Choosing a treating physician and notifying the Bureau of your choice is important because authorized payment for treatment is only allowed by one physician. According to O.A.C. § 4123-7-05, the Bureau will not approve payment of medical fees for treatment rendered by more than one physician for the same condition over the same period of time. There is however one exception. If the BWC or self-insurer has authorized treatment where a consultant, anesthetist or assistant is required, or it is necessary for treatment to be seen by a specialist, then the BWC can authorize payment for medical fees. Not all licensed practitioners are qualified as treating physicians. Revised code § 1737.01 (A) defines "licensed physicians and surgeons" as persons certified under R.C. § 4731.14, which certification is limited to medical doctors and doctors of osteopathy. A medical doctor or osteopath may therefore be the treating physician. A chiropractor may also be the treating physician, because R.C. § 4734.09 specifically provides that the chiropractor is a physician for the purpose of chapter 4123.
In addition to reporting the injury, seeking medical care after the injury is perhaps one of the most important things to do at the beginning of workers' compensation claims. Obtaining medical care creates documentation of the diagnosis and the injury that was sustained. In many situations, the medical care provided just after the injury can help direct the injured worker to more specialized care or therapy if such treatment is deemed necessary. It is also the first opportunity for a medical expert to offer an opinion on whether there is a cause and effect connection between the injury and the diagnosis.
The settlement of a workers' compensation claim can be a way for an injured worker to receive a final monetary payment under the claim. Once a claim is settled, no further costs (medical or monetary benefits) are payable under the claim.
A lot of people, after suffering a work-related injury or realizing that they have an occupational disease, will immediately file a claim for workers' compensation benefits. For a lot of these people, there is no fear of losing their job or facing retaliation from their employer because they know that this isn't allowed by Ohio law.
The answer to this question is "it depends". It is an important question, however, because compensation as well as medical benefits cannot be paid if the claim has expired.