Workers’ compensation in Ohio serves as a critical safety net for employees who suffer injuries or illnesses directly related to their job duties. This state-mandated system ensures that workers receive medical care and compensation for lost wages until they can go back to work.
While the system normally provides ongoing weekly benefits, in some cases the Bureau of Workers’ Compensation (BWC), the employer, and the injured worker will reach a settlement agreement that results in a lump sum payment. In this article, we explain the claims process, how these settlements are calculated, and how an Ohio workers’ comp lawyer can help.
Understanding Ohio Workers’ Compensation
Ohio’s workers’ compensation system operates under a no-fault principle, meaning that you can receive injury benefits without the need to prove that your employer was at fault for your workplace accident. This system ensures timely assistance and eliminates the need to analyze fault, but it also means that workers can’t sue their employers for negligence in most cases.
The benefits provided by the Ohio Bureau of Workers’ Compensation (BWC) cover several key areas:
- Medical Benefits: These workers’ comp benefits cover all necessary medical treatments related to the work injury, including hospital stays, medications, and rehabilitative services like physical therapy.
- Temporary Total/Wage Loss Compensation: If an on-the-job injury results in a temporary inability to work, weekly benefits are available to compensate for lost earnings. These benefits are usually a percentage of the worker’s pre-injury earnings and subject to a maximum as determined by law.
- Disability Benefits: For injuries resulting in long-term or permanent disability, workers may receive payments to compensate for their lost earning capacity.
- Death Benefits: In the unfortunate event of a fatality, the system provides death benefits, funeral costs, and burial expenses to the deceased worker’s dependents.
Types of Settlements in Ohio Workers’ Comp
In Ohio, there are two main types of workers’ comp settlements to consider, each with distinct implications for your ongoing rights and benefits.
Full Settlements
Opting for a full settlement means agreeing to resolve your workers’ compensation claim entirely in exchange for a specified lump sum amount. This type of settlement concludes your case, and you relinquish all future claims related to your injury. This includes forfeiting ongoing medical benefits and any further compensation for lost wages that might arise due to the injury. It’s a final decision that requires careful consideration of your current and future medical needs as well as your financial circumstances.
In situations where your work-related injury qualifies under Medicare, a Medicare Set-Aside (MSA) may also be established as part of your settlement. An MSA is a financial arrangement that allocates a portion of the settlement to cover future medical expenses related to the injury. This ensures that Medicare will not be billed for these future costs, which are instead paid out of the settlement funds.
Indemnity-Only Settlements
This type of settlement is less comprehensive and focuses solely on the compensation aspect of your claim. With an indemnity-only settlement, you receive a lump sumpayment intended to compensate for your lost wages and other compensation you may be entitled to, but you retain the right to claim future medical benefits. This option is particularly beneficial if you need to address potential obligations related to Medicare benefits.
Choosing the right type of settlement requires a thorough evaluation of your specific situation, including your financial needs, potential future medical treatments, and your overall long-term well-being. Consulting with a skilled workers’ compensation attorney can provide crucial guidance in making an informed decision.
Structured vs. Lump Sum Settlements
In some situations, settlements can be structured in two primary ways:
- Structured Settlements: This arrangement involves regular payments made over a specified period of time. This type of settlement can provide a steady income stream for the injured employee and help manage long-term financial needs, especially if the worker’s ability to earn an income has been impacted. It offers the security of regular, predictable income, is federally insured, and can be tailored to address anticipated future medical costs or living expenses.
- Lump Sum Settlements: This option provides the injured worker with a one-time payment. A lump sum might be preferable for those who need immediate access to funds to pay for large expenses such as medical bills, debt reduction, or significant life changes necessitated by their workplace injury. It also allows individuals the flexibility to invest or manage the money as they see fit.
Factors Influencing Settlement Amounts
When determining a workers’ compensation settlement in Ohio, several factors play vital roles in shaping the amount that you can expect to receive. Understanding these key factors can help in anticipating the settlement outcome and in preparing for negotiations.
Severity of Injuries
The type of injury and its severity are among the most important factors affecting settlement amounts. More severe injuries typically result in higher settlements due to potentially increased future medical costs and a greater impact on your ability to earn an income. Chronic or permanent injuries, such as a brain injury or loss of limb or function, generally result in higher compensation amounts than those expected to heal completely over time.
Medical Expenses Incurred and Future Medical Needs
Settlements often include reimbursement for all medical expenses related to the injury. This not only covers past and current medical bills but also estimated future medical costs. If an injury requires ongoing treatments, surgeries, or rehabilitation, these potential expenses will be considered in a fair settlement to ensure that you receive adequate care moving forward.
Wage Loss and Ability to Work
Monetary compensation for lost wages is calculated based on your earnings at the time of the injury and how long you are expected to be out of work. In cases where your capacity to earn is permanently affected, settlements might include calculations for future lost earnings. The more an injury impacts your ability to do your job or to gain employment elsewhere, the higher the potential settlement.
Age and Occupational Factors
The worker’s age and job role are also considered. Younger workers may receive larger settlements for severe injuries due to the longer impact on their working life. Workers in highly specialized or physically demanding jobs may also receive higher settlements if their injuries prevent them from returning to similar employment.
Having experienced legal representation can significantly influence the outcome of a workers’ comp settlement. An experienced lawyer can negotiate with insurers and employers, argue for a fair assessment of all associated costs, and ensure that the settlement reflects the full extent of the impact on your life.
Calculating Your Workers’ Compensation Settlement
This calculator is a reference tool only. It uses the Ohio compensation maximum weekly rates you entered (and, for % Permanent Partial, the simple formula “% granted × 2 weeks × PPD max rate”) to give an informal estimate of potential benefits. It does not account for every statutory rule, offset, or case‑specific factor, and it is not legal or financial advice. The Ohio Bureau of Workers’ Compensation and/or the Industrial Commission make the final, binding determinations—always verify your figures with them or with a qualified attorney.
In Ohio, there is no predefined formula or schedule of benefits that explicitly dictates fair compensation amounts. Instead, the settlement process involves an in-depth assessment of each individual case as no two are the same.
The BWC or self-insured employer evaluates what benefits they believe you might need in the future and weighs these against the probability and timing of these needs. For instance, a worker who is expected to require surgery will likely be considered for a higher settlement amount compared to a worker where there is uncertainty about the necessity of the surgery.
It is important to remember that workers’ compensation settlements in Ohio do not include compensation for intangible losses, such as pain and suffering. The system strictly covers tangible economic losses like medical expenses and lost wages. This limitation shapes the nature of the negotiations and the final settlement amount.
How Long Does it Take to Settle a Workers’ Compensation Claim?
How long it takes to settle a workers’ compensation claim can vary widely based on factors like the severity of the work-related injury, your prognosis, and how soon you can reach a settlement with the BWC or self-insured employer. Unfortunately, in some instances both parties do not desire to settle a claim and no settlement is possible. Ultimately neither party is required to consider settlement.
In cases involving serious injuries, it’s generally advisable not to rush into settlement negotiations. You should allow some time to get a clearer understanding of your prognosis and how it may affect your earning ability. Acting too quickly can result in a less favorable settlement.
After a settlement agreement is reached, formally executed, and the order is published, Ohio law mandates a 30-day waiting period. During this time, either party has the opportunity to reconsider and withdraw from the agreement if necessary. This waiting period is designed to allow both you and your employer (or their insurance carrier) to reflect on the terms of the settlement and ensure that it truly reflects the interests and needs of both parties.
Speak to an Ohio Workers’ Compensation Lawyer Today
Given the potential challenges involved in calculating and negotiating these settlements, it may be in your best interests to work with an Ohio workers’ compensation attorney. At Plevin & Gallucci, our legal team can provide the guidance and advocacy needed to navigate Ohio’s workers’ compensation system. Our experienced attorneys understand the critical importance of securing a settlement that meets your immediate medical expenses and addresses any long-term financial needs resulting from workplace injuries.
If you or someone you know is thinking about settling a workers’ comp claim, we can help ensure that your settlement reflects the true cost of your job-related injury. Contact our law firm today to discuss your injury claim and learn more about how we can achieve the best results in your case.
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How Much Does Workers’ Compensation Pay in Ohio?
