At Plevin & Gallucci, we believe in empowering injured workers with knowledge about their rights and options. This guide covers everything from estimated benefit payments and types of compensation to factors that could increase your settlement, so you know what to expect if you’re injured on the job or suffer an occupational disease. The goal at our law firm is to help Ohio workers understand the workers’ compensation system and access the benefits and support they deserve.
How Much Does Workers’ Compensation Pay?
In Ohio, workers’ compensation benefits vary based on the type and severity of the injury. Generally speaking, here’s what you can expect after filing a workers’ comp claim:
- Temporary Total Disability (TTD): If you’re unable to work temporarily, TTD benefits cover 72% of your wages for the first 12 weeks and then 66.67% thereafter, subject to state maximum limits.
- Permanent Partial Disability (PPD): If you have a lasting impairment but can still work, you may receive a percentage of your wages as determined by the Bureau of Workers’ Compensation (BWC) based on the impairment rating.
- Permanent Total Disability (PTD): If you’re permanently unable to work, PTD benefits provide ongoing payments based on 66.67% of your wages up to the state’s maximum rate.
- Wage Loss Benefits: If you can return to work but earn less due to your injury, wage loss benefits cover up to 66.67% of the difference in earnings.
Keep in mind that Ohio caps these payments at certain maximums, which are updated annually. It’s always a good idea to consult with an experienced workers’ compensation attorney to understand your eligibility and maximize your benefits.
How Long Does Workers’ Compensation Last?
The duration of workers’ compensation benefits depends on the type and extent of the injury:
- Temporary Total Disability (TTD): These benefits continue until you either return to work or reach maximum medical improvement (MMI) – the point at which your condition is stable and not expected to improve further.
- Permanent Partial Disability (PPD): PPD benefits are paid based on an impairment rating and may continue for a set number of weeks or an even longer period of time, depending on the severity of your injury.
- Permanent Total Disability (PTD): If you’re permanently unable to work, PTD benefits can last for life, as long as the disability prevents you from working.
- Wage Loss Benefits: Wage loss benefits can last up to 200 weeks if you’re earning less due to restrictions from your injury, or up to 226 weeks if you’re seeking new employment within your capabilities.
- Medical Benefits: Medical benefits can continue as long as the treatment is related to your work injury and deemed necessary.
Each case is different, so working with an attorney can help ensure you receive the benefits you’re entitled to for the right period of time.
Can I Quit My Job While on Workers’ Compensation?
Yes, you can quit your job while receiving workers’ compensation in Ohio, but it may impact certain benefits. Here’s what you’ll need to consider:
- Medical Benefits: You’ll still be eligible for ongoing medical benefits related to your injury, as long as the treatment is necessary and approved by the Bureau of Workers’ Compensation.
- Temporary Total Disability (TTD): If you quit voluntarily while receiving TTD benefits, these wage replacement benefits may end because they’re tied to your inability to work for your employer. The BWC or your employer’s insurance company may view quitting as a voluntary decision rather than a result of the injury.
- Permanent Partial Disability (PPD) and Permanent Total Disability (PTD): If you qualify for these benefits based on the injury’s impact, quitting doesn’t necessarily affect them, as they are determined by your impairment level rather than your current employment.
Before making any decisions, consult with our workers’ compensation attorneys to understand how quitting could affect your specific benefits and rights under Ohio law.
Does My Employer Have to Hold My Job While I’m on Workers’ Compensation?
No, Ohio law does not require employers to hold your job open while you’re on workers’ compensation. However, many employers have a company policy in place or may be willing to work with employees to hold positions for a certain period.
Whether your job is held often depends on the employer’s policies, the length of your recovery, and the type of work. Under the Family and Medical Leave Act (FMLA), if you’re eligible, you may be entitled to up to 12 weeks of unpaid, job-protected leave, which could coincide with your workers’ comp leave. But after FMLA or any applicable leave period expires, employers are generally not obligated to keep your position open.
For specific guidance on your situation, it’s often helpful to consult with an Ohio workers’ compensation attorney to understand your rights and any options you may have for returning to work.
Does Ohio Workers’ Compensation Pay for Pain and Suffering?
No, an Ohio workers’ comp claim does not cover pain and suffering. The workers’ compensation system is designed to provide benefits for medical expenses, lost wages, and disability related to workplace injuries, but it does not include compensation for non-economic damages like pain and suffering or emotional distress.
If you have suffered severe pain or emotional distress due to a workplace injury, consult with a Plevin & Gallucci workers’ compensation attorney to explore other potential legal options, especially if a third party (outside your employer) contributed to the injury.
What Happens if My Boss Doesn’t Report an Injury to Workers’ Compensation?
If your employer fails to report your work injury to the BWC, you can still file a workers’ compensation claim directly. Here’s what you need to do:
- File Your Injury Claim: This form is available on the BWC website, and you can submit it online, by phone, or by mail. You can file a First Report of Injury (FROI) directly with the BWC, but it is in your best interest to have your workers’ compensation attorney help with this process.
- Document Everything: Keep records of your injury, medical visits, and any communication with your employer about the injury. These details will help support your workers’ compensation claim.
- Medical Provider Filing: Some medical providers may file the FROI for you if they know your injury is work-related, helping initiate the benefits application process.
Employers are legally required to report workplace injuries, and failure to do so may be investigated by the BWC. However, you don’t have to rely solely on your employer’s action to get the benefits you need. If you encounter challenges, speak to an Ohio workers’ comp attorney.
Can You Sue Your Employer for an Injury?
Workers’ compensation is generally the exclusive remedy for workplace injuries, which means you typically cannot sue your employer for an on-the-job injury. However, there are a few exceptions where a lawsuit may be possible:
- Intentional Torts: If your employer intentionally caused harm or was aware that their actions would likely cause serious injury, you may be able to file a lawsuit for an intentional tort. This is a high threshold to meet, but it applies in cases where employers have acted with extreme disregard for safety.
- Third-Party Claims: If a third party (someone other than your employer) contributed to your injury – such as a contractor or equipment manufacturer – you may be able to sue that third party while still receiving workers’ comp benefits from your employer.
If you believe one of these exceptions applies or have additional questions, a free consultation with Plevin & Gallucci can help you understand your options and evaluate the strength of a potential case.
Who Pays Your Health Insurance While on Workers’ Compensation?
Workers’ compensation does not cover the cost of your health insurance premiums. While you’re on workers’ comp, the responsibility for maintaining health insurance typically depends on your employer’s policies and any applicable employment agreements or benefits.
Here are some common scenarios:
- Employer Policy: Some employers may choose to continue covering health insurance premiums while you’re on workers’ comp, though they are generally not required by law to do so.
- COBRA Coverage: If your employer discontinues your health insurance, you may be eligible for COBRA, which allows you to continue your health insurance coverage by paying the full premium yourself. This can be costly but helps maintain coverage while you’re off work.
- Union or Contract Agreements: If you’re part of a union or have a contract that specifies health insurance coverage during workers’ comp leave, those terms would apply.
Since every situation is different, it’s a good idea to review your employer’s policies or consult with HR to understand your health insurance options while on workers’ comp.
Can You Work While on Workers’ Compensation?
Whether you can work while receiving workers’ compensation depends on the type of benefits you’re receiving and the nature of your injury:
- Temporary Total Disability (TTD): If you’re receiving TTD benefits, which are meant for those completely unable to work due to injury, you generally cannot work. Earning wages while on TTD could result in a suspension of benefits and may even lead to penalties.
- Light-Duty or Modified Work: If your doctor approves you for light-duty work that fits within your restrictions, you may return to work with your employer’s agreement. In these cases, your workers’ comp benefits may be adjusted if your light-duty job pays less than your pre-injury wages.
- Permanent Partial Disability (PPD): For those who receive PPD benefits due to a lasting impairment, you can work if you’re able. These benefits compensate for the impairment itself and aren’t dependent on whether you’re actively working.
- Wage Loss Benefits: If you return to work but earn less due to injury-related limitations, you may qualify for wage loss benefits, which cover a portion of the difference between your pre- and post-injury wages.
If you’re considering employment while on workers’ comp, it’s best to consult with your doctor and potentially an Ohio workers’ compensation attorney to ensure that any employment doesn’t impact your benefits or violate Ohio’s workers’ compensation rules.
How Long Can You Stay on Workers’ Compensation?
In Ohio, the duration of workers’ compensation benefits varies based on the type of injury and benefits you’re receiving:
- Temporary Total Disability (TTD): TTD benefits last until you reach maximum medical improvement (MMI)—the point at which your condition stabilizes and isn’t expected to improve further. After reaching MMI, TTD benefits end, and you may be evaluated for other benefits, like Permanent Partial Disability (PPD), if you have a lasting impairment.
- Permanent Partial Disability (PPD): PPD benefits are paid for a set number of weeks based on the degree of impairment. The Bureau of Workers’ Compensation (BWC) determines the amount of compensation as well as the duration based on your impairment rating.
- Permanent Total Disability (PTD): If your injury leaves you unable to work permanently, PTD benefits can continue for life, as long as the disability persists.
- Wage Loss Benefits: These benefits, which are intended for those who return to work but earn less due to injury-related restrictions, can be paid for up to 200 weeks if you’re working in a reduced capacity or up to 226 weeks if you’re actively seeking work within your capabilities.
- Medical Benefits: Medical benefits for work-related injuries can continue as long as treatment is necessary and related to the injury.
Each case is different, so it’s wise to consult with a workers’ compensation lawyer or representative at the Ohio BWC to understand the specific duration of your benefits based on your situation.
What Is Maximum Medical Improvement?
Maximum Medical Improvement (MMI) is the point at which an injured worker’s condition has stabilized and is not expected to improve further with additional medical treatment. This doesn’t necessarily mean a full recovery or the absence of symptoms, but rather that the condition is as improved as it’s likely to get with current medical intervention.
Once an injured worker reaches MMI, their Temporary Total Disability (TTD) benefits typically end, since TTD is intended to support workers who are still recovering. After reaching MMI, a worker may be evaluated for other benefits, such as Permanent Partial Disability (PPD) if there’s a lasting impairment, or Permanent Total Disability (PTD) if they’re unable to return to any form of work.
How Are Temporary Disability Benefits Calculated?
Temporary Total Disability (TTD) benefits are calculated as a percentage of your average weekly wage (AWW) before the injury. Here’s how it breaks down:
- For the first 12 weeks of disability, you receive 72% of your full wages (AWW), subject to Ohio’s maximum weekly benefit limits.
- After the initial 12 weeks, TTD benefits adjust to 66.67% (or two-thirds) of your AWW, up to the state’s maximum weekly cap.
Ohio also has a minimum weekly benefit based on 33.33% of the statewide AWW to ensure support for low-wage earners. It’s always a good idea to confirm your specific benefit rate with the BWC or consult an attorney if you have questions about your TTD benefit calculation.
How Many Employees are Required for an Employer to Carry Workers’ Compensation?
In Ohio, all employers with one or more employees are required to carry workers’ compensation coverage. This includes full-time, part-time, seasonal, and even some contract workers. Ohio operates a state-funded workers’ compensation system, which means that most employers obtain coverage directly through the Ohio Bureau of Workers’ Compensation (BWC) rather than private insurance.
Certain exceptions may apply to sole proprietors, partnerships, and family farm corporate officers who do not employ outside workers, but in general, coverage is mandatory for any business with employees.
Is Workers’ Compensation Mandatory?
Yes, workers’ compensation is mandatory in Ohio for most employers. Ohio law requires all employers with one or more employees to carry workers’ compensation insurance through the Ohio Bureau of Workers’ Compensation (BWC). This coverage is required for full-time, part-time, seasonal, and even some contract workers.
Ohio is a monopolistic state for workers’ compensation insurance coverage, meaning that employers must purchase it directly from the BWC rather than through a private insurance company. This system ensures that employees are protected if they’re injured on the job and that employers comply with state regulations for workplace injury coverage.
Can You Work Another Job While on Workers’ Compensation?
In Ohio, working another job while on workers’ compensation is generally not allowed if you’re receiving Temporary Total Disability (TTD) benefits. TTD is intended for workers who are fully unable to work due to their injury. Earning income from another job while receiving TTD benefits could lead to the suspension of benefits and potential penalties, as it may be considered fraudulent.
However, if you’re receiving other types of benefits that don’t require total disability, like Permanent Partial Disability (PPD) or wage loss compensation benefits, you may be able to work within certain restrictions. Before taking another job while on workers’ comp, it’s best to consult with your doctor and possibly an attorney to ensure it won’t affect your benefits or violate Ohio’s workers’ comp regulations.
Does Surgery Increase a Workers’ Comp Settlement?
Yes, having surgery for a work-related injury can increase the value of a workers’ compensation settlement, as it typically indicates a more severe injury that may require extended recovery time, additional medical care, and potentially more permanent impairment. Here’s how surgery might impact a workers’ comp settlement:
- Increased Medical Costs: Surgery adds significant medical expenses, which can raise the total settlement amount to cover current and anticipated medical bills.
- Higher Disability Ratings: If surgery leads to lasting impairment, you may qualify for a Permanent Partial Disability (PPD) or Permanent Total Disability (PTD) rating, which often increases the value of a settlement.
- Lost Wages and Future Treatment: Surgery often results in longer periods of disability and may require follow-up treatment, physical therapy, or ongoing medical care. These costs are typically factored into settlement negotiations.
- Pain and Limitation Considerations: While Ohio workers’ comp doesn’t cover pain and suffering, limitations or physical restrictions resulting from surgery can increase a settlement by accounting for future wage loss or diminished earning capacity.
If surgery is recommended or you’re considering a settlement, consulting with a workers’ compensation attorney can help you understand how surgery could influence your settlement’s value and ensure you receive fair compensation for injuries that leave you with long-term needs.
