Workers' compensation benefits in Ohio include medical treatment, lost wages, and compensation for permanent impairments. Workers' compensation in Ohio is administered by the Ohio Bureau of Workers' Compensation. Individuals working in Ohio who suffer an industrial injury or illness are likely to have a workers' compensation claim under Ohio law.
Any injury or illness that occurs during the course and scope of employment in Ohio is covered by workers' compensation. Negligence (carelessness) on the part of the employer is irrelevant; with very limited exceptions, there is no consideration of fault in determining whether an injured worker is eligible for workers' compensation benefits. (For more information, see What Injuries Aren't Covered by Workers' Comp?)
Your first step should be reporting your injury or illness to your employer as soon as possible. You will also need to file an official workers' compensation claim with the Ohio Bureau of Workers' Compensation (BWC). To do so, you must complete a First Report of an Injury, Occupational Disease, or Death (FROI) form. Your employer will likely either give you this form to complete or will complete it and submit it for you. You can also complete the form online or download a copy of the form at the BWC's website. Your treating doctor may also help you complete the FROI form.
There are strict deadlines for filing your claim. You must make sure that the FROI form is filed with the BWC within one year of the date of your injury. For occupational diseases that develop over time, you must file within:
Within 28 days of submitting the FROI form, the BWC will inform you of whether your workers' compensation claim was allowed or denied.
Workers' compensation pays for medical bills and provides benefits for wage loss and permanent impairments.
All proper and necessary medical treatment for conditions related to your industrial injury or illness will be covered under your claim. Your doctors should bill workers' comp directly; you should not receive a bill for any medical treatment. Covered treatment includes doctors' visits, physical therapy, surgery, prescriptions, and more. New or experimental treatment will not be covered under your claim, however.
You can see any doctor approved by the BWC for treatment related to your workers' compensation claim. Your primary care physician might be certified by the Bureau; if not, your doctor can likely provide you with names of doctors who are certified by the BWC to treat injured workers.
You should inform all of your doctors and pharmacies that you are receiving treatment for a workers' compensation claim, to ensure that the bills are directed properly.
Another form of workers' compensation benefits you are eligible for is temporary total compensation. This benefit is available to those who cannot work for seven or more days due to their injury or illness. Your doctor will provide the BWC with a form detailing your physical inability to work and will give the BWC frequent updates on your condition and ability to return to work.
For the first twelve weeks, temporary total compensation benefits are 72% of your full weekly wage. After that, the benefit will be two-thirds of your average weekly wage, up to the state maximum. In 2018, you cannot receive more than $932 per week.
If you return to work in a lower paying job or reduced hours due to your physical restrictions while recovering from the injury or illness, you can receive two-thirds of the difference in your wages.
If you are permanently disabled as a result of your workplace injury or disease, you will receive additional monetary compensation. For a partial impairment, called residual damage, you will receive an amount determined by state law, based on your degree of permanent impairment. Your doctor will determine your permanent impairment rating. Permanent partial disability benefits are two-thirds of your average weekly wage, subject to a maximum of $310.67 (for 2018).
If you are unable to perform any type of continuous, gainful employment as a result of your work injury, the Ohio Industrial Commission will declare you permanently and totally disabled. (The Industrial Commission, sometimes known as the IC, is the appeals board of the Ohio workers' comp system.) If you are determined to be totally and permanently disabled, you will receive monetary payments for the remainder of your life (unless you are able to return to work). The amount of your payment is dependent upon your wages at the time of injury, subject to certain maximums. In 2018, the most you can receive is $932 per week. (To learn more, see How Are Permanent Partial Disability Benefits Calculated?)
The BWC will send written notification as to whether your claim is allowed or denied. If your claim is denied, the letter will include instructions on appealing the decision. It is important to note that if your claim is accepted, your employer may also appeal the decision.
You must file your appeal with the Industrial Commission of Ohio within 14 days of the BWC Order. To file the appeal, you may complete an online form through the Industrial Commission Online Network (ICON). Or, you may file your appeal in written form using the Notice of Appeal (Form IC-12). Send this form to the Industrial Commission service office nearest to your residence. (You can find the office locations at the Industrial Commission's website. The Industrial Commission will then send you notice of the place, date, and time of your hearing. The initial hearing will be a District Level Hearing.
Within 45 days of your initial appeal request, you will have a District Level Hearing. An Officer of the Commission will preside over the hearing. Before the hearing, written witness affidavits, deposition transcripts, and other evidence should be submitted to the Officer for review. The Commission may require you to attend an independent medical examination while your case is pending at the District Level. You are required to attend this examination, but you have a right to review the examiner's report.
During the hearing, you and your employer (or its insurance company) may present witness testimony. You should be prepared to testify yourself, as well as present witnesses who can support your claim, such as, your treating doctor and coworkers who witnessed the incident.
The Officer will send a written decision to you and your employer no later than seven days after the hearing. Either party may appeal the decision to the Staff Level.
No later than 45 days after appeal decision from the District Level Hearing, the Staff Hearing Officer will conduct another hearing. The Officer will review the evidence presented and issue a written decision that will be sent to each party. If you lose, you can appeal to the Commission Level.
Unlike the first two levels of appeal, the Commission Level is not guaranteed. The Commission will review your appeal request and the staff hearing officer's decision to decide whether or not to grant the appeal.
If the Commission accepts the appeal, the Commission will conduct a hearing within 45 days of the appeal from the staff level. The Commission will issue a written decision no later than seven days after the hearing.
An order by the Commission may be appealed within 60 days to the state courts of Ohio. However, either party may file a notice of intention to settle within 30 days of the order. Unless the other party objects within 14 days, the time to file an appeal is extended to 150 days.
The appeals process is a legal process that can be very difficult to navigate without the help of an experienced workers' compensation attorney. Your employer will have experienced legal counsel, and you will be served by having an attorney to advocate on your behalf. (For more information, see Do I Need a Lawyer to Get Workers' Compensation Benefits?)