In theory, the Ohio workers’ compensation system is supposed to eliminate – or, at least, tone down – the adversarial nature of pursuing compensation after an injury in the workplace. Unlike a personal injury lawsuit, a workers’ compensation claim doesn’t require a showing of negligence. So the injured employee doesn’t have to show that the employer was negligent. And, with limited exceptions, the employer has nothing to gain by trying to prove the employee caused or contributed to his own injury.
Despite the goal of making it quicker and easier for an injured worker to access critical compensation like medical benefits and replacement income benefits, most of the time the system falls short. That’s true not only in catastrophic cases, but also in traditional cases, where a worker sustains an injury that may require medical care and some time off of work, or even when there is no lost time at all. Unfortunately, over the years the system has changed with a goal in mind of being more employer-friendly. The other side of that unfortunately is that the system provides less protection and service for the injured workers.
This is the reason why you need a workers’ compensation attorney:
Employers are almost always represented by legal counsel, whose objective is to minimize the cost of your claim and the Bureau of Workers’ Compensation will rely on various guidelines to deny you treatment and benefits. The fact is that you need legal representation, too, to be sure you receive all the benefits to which you are entitled. One study even found that injured workers who were represented by a workers’ comp attorney received substantially more than those who were unrepresented.
The situation is often more complicated when the injury is serious, requires ongoing care and / or involves long-term or permanent disability. In this blog, we highlight why it’s so important to have an experienced workers’ compensation lawyer in your corner when a workplace injury occurs, from the very beginning of the claims process.
You Should Always Talk to a Workers’ Compensation Attorney!
At Plevin & Gallucci, we recommend partnering with our experienced workers’ compensation team from the start to protect your rights and avoid potential pitfalls. Many workers’ compensation law firms, including ours, offer free consultations. Even claims that appear straightforward can take an unexpected turn or be more complex than they initially appear, creating unnecessary stress and delays. Having the right legal guidance from the beginning can help ensure you’re ready for any challenges that might arise, including those below.
1. Your Claim Isn’t Moving Forward
One of the intended advantages of workers’ compensation is that you’ll be able to swiftly get the medical care and replacement income benefits you need in the aftermath of a work injury. If your claim isn’t being processed or insurance companies are raising obstacles that prevent you from receiving those benefits promptly–especially necessary medical treatment–an experienced workers’ compensation attorney can provide vital help.
2. Your Employer Claims the Injury Didn’t Occur in the Course of Employment
Usually, it’s pretty clear whether an injury happened on the job. But there are some gray areas, such as when an employee is on the premises but not working, or is engaged in “horseplay.” If the on-the-job injury wasn’t sustained in the course of employment, workers’ compensation insurance companies won’t cover the claim. So if this suggestion is raised, it’s in your best interests to speak with an Ohio workers’ compensation lawyer right away.
3. The Injury Aggravated a Pre-Existing Condition
Demonstrating that a pre-existing condition was aggravated by a work-related injury and should be covered by workers’ compensation benefits can be complicated, and many employers will attempt to separate out anything related to the underlying condition, minimizing the payout and leaving the injured worker without adequate compensation. In this situation, expert legal representation is essential.
4. You’re Being Pushed to Enter Into a Quick Settlement
It may seem that a quick offer of settlement is a good thing, especially if you’ve been seriously injured and require compensation. But settling a workers’ compensation claim too quickly can be a costly mistake.
5. Your Ability to Work is Temporarily Limited and You’re Not Getting Appropriate Compensation or Accommodation
Once you settle your claim, you typically can’t receive any additional compensation. That means that if you discover you need additional surgeries or other major medical care or find that you are unable to return to work as expected, you will usually have to absorb those expenses on your own. Employers and the Bureau of Workers’ Compensation (BWC) know this and may push to close out a claim before those additional losses are discovered. Your attorney can make sure this doesn’t happen.
Workers’ compensation is designed to use a combination of replacement income and alternative work assignments to keep your income stable as you recover from a workplace injury. But employers don’t always provide alternatives that are appropriate to the worker’s restrictions and may deny benefits if an employee declines work that is too strenuous. A workers’ compensation lawyer can help enforce your rights.
6. It Appears You May Have a Permanent Injury
If an on-the-job accident has left you unable to work or unable to perform the type of work you previously performed, you may need compensation that will support you or supplement your income for many years. In this situation, there’s a powerful incentive for the employer to minimize the payout. But accepting a lower settlement may leave you struggling later in life. An experienced workers’ comp lawyer will know how to properly value your claim and fight for fair compensation.
7. A Third Party Caused the Workplace Injury
Though workers’ compensation is meant to be an exclusive remedy as to the employer–meaning you typically can’t sue your employer for a work-related injury–you may have a third-party claim against someone outside the company who caused the workplace accident or contributed to your injury. The compensation available in a personal injury claim or product liability case may be more extensive than the maximum benefits available through workers’ compensation. An experienced workers’ compensation lawyer can help determine whether legal action is advisable.
Workers’ Compensation in Ohio: an Overview
If you’ve been injured on the job in Ohio, workers’ comp insurance is intended to provide financial support and medical benefits while you recover. It’s a no-fault system, meaning you don’t have to prove your employer was negligent to qualify for benefits.
Here’s a quick breakdown of the workers’ comp benefits available in Ohio:
Medical Coverage: Workers’ comp covers all necessary medical evaluations and treatments related to your workplace injury or illness. This includes doctor visits, hospital stays, prescriptions, surgeries, and even physical therapy. The goal is simple: to help you recover without worrying about mounting medical bills.
- Loss of Income: If your injury prevents you from working, workers’ comp provides wage replacement in the form of weekly payments. This is typically a percentage of your average weekly wage, capped at a limit set by the Ohio Bureau of Workers’ Compensation (BWC). Wage replacement falls into a few categories:
- Temporary Total Disability Benefits (TTD): These disability payments are for job-related injuries that temporarily keep you out of work.
- Permanent Partial Disability Benefits (PPD): For injuries and medical conditions that cause lasting but partial impairment.
- Permanent Total Disability Benefits (PTD): For injuries and medical issues that prevent you from ever returning to work.
- Vocational Rehabilitation: In cases where you can’t return to your previous job, workers’ comp may cover vocational rehabilitation. This includes training programs or job placement services to help you transition into a new role that accommodates your physical limitations.
- Death Benefits: If a workplace injury or illness results in death, workers’ compensation coverage provides benefits to surviving family members. These benefits help with funeral expenses and offer financial support to dependents, such as a spouse or children.
Filing for workers’ compensation in Ohio involves several steps, and overlooking a detail can delay your benefits. After your injury, report it to your employer promptly and seek medical attention from a BWC-certified provider. We recommend always working with an attorney from the outset to ensure your claim is filed correctly and your rights are protected. While your employer or you can file a claim with the Ohio BWC, having legal guidance to represent YOU helps prevent issues. Once approved, your benefits will begin. If denied or complications arise, our attorneys can help you take the next steps.
An Experienced Workers’ Compensation Attorney Can Help
If you were injured on the job and find yourself facing an uphill battle, it can be extremely stressful. Should you be concerned about how your workers’ comp claim is being handled or whether you’re being offered a fair settlement, talk with an experienced Ohio workers’ compensation attorney right away.
At Plevin & Gallucci, our legal team offers free initial case evaluations so you can gather the information you need to make good decisions about your next steps. You can schedule yours right now by calling 855-4PLEVIN, filling out the contact form on this page, or clicking in the bottom right-hand corner of the page to chat with an agent. Let us help you level the playing field and help you secure the outcome you need to recover.
Related:
Workers’ Compensation for Back Injuries
Understanding Workers’ Compensation for Construction Site Accidents
Understanding Workers’ Compensation for Repetitive Stress Injuries
Maximum Medical Improvement for Workers’ Compensation in Ohio
