Workers sustain serious occupational injuries every day. While some industries are more dangerous than others are, serious injuries can occur in any industry at any time. In fact, in 2014, over 900,000 workers sustained injuries serious enough to result in missed days from work, according to the Bureau of Labor Statistics (BLS). Downtime can create a financial burden for many families. If you sustained an injury or occupational illness, you are entitled to certain workers’ compensation benefits provided by your employer.
For help filing a claim and obtaining the maximum benefits allowable, call our workers’ compensation attorney at Levy Law Offices in Cincinnati for a free consultation: 513-587-1323.
What types of workers’ compensation benefits can I obtain?
Below are some of the benefits that are available for qualified employees in Ohio:
- Medical benefits: Your employer’s insurance company will pay all of your necessary and reasonable work injury-related needs. You do not have to worry about these benefits running out; you are entitled to them until you have reached “maximum medical improvement,” or the point at which your medical condition stabilizes and you no longer require treatment.
- Temporary total compensation: When you are completely unable to work for more than seven days, you can receive temporary wage replacement benefits, paid bi-weekly. For the first 12 weeks, you will receive 72 percent of your average weekly wages, and then 66.67 percent thereafter.
- Living maintenance wage loss: If you have to get a lesser paying job because of your work injury, you may qualify for living maintenance wage loss compensation.
- Permanent disability: If your injuries are permanently disabling, you can receive one of three income replacement benefits: permanent total disability, statutory permanent total disability, or permanent partial/scheduled loss disability.
- Disabled Workers’ Relief Fund: If your combined workers’ compensation benefits are less than the cost of living, you can receive an additional benefit under the Disabled Workers’ Relief Fund (DWRF). The Bureau of Workers’ Compensation (BWC) will evaluate your case and determine if you qualify for DWRF.
- Facial disfigurement: BWC gives this $10,000, one-time award to workers who sustain a work-related facial or head disfigurement injury that impairs opportunities.
- Death benefits: BWC provides a death award to the deceased worker’s dependents.
Compensation benefits available after work injury claims?
Workers’ compensation is pretty straightforward: if you are an employee and sustain a work-related injury, you are entitled to benefits. Fault (whether yours or the employer’s) has no bearing on eligibility. As simple as eligibility is though, it is not uncommon for workers to find that the insurer has denied their claim. The question is, “Why?” Why do so many insurers deny workers the benefits they so desperately need?
As a law firm that has handled numerous workers’ compensation cases for people all over Ohio, we can vouch that many denials result from technical errors. Not reporting your injury/illness to your employer straightaway, not filing your claim in time, and not responding the insurer’s requests for evidence will quickly thwart your claim.
Other common reasons (some justified, others not) insurers deny claims include the following:
- The insurer argues that the worker fabricated or is exaggerating the injury.
- The worker fails to stick to the doctor’s recommendations. (If your doctor says you should not lift any heavy objects, but your insurer hires a private investigator and catches you lifting your toddler, the insurer can refute your claim.)
- The injury was self-imposed or was the result of horseplay or intoxication.
- Not submitting to the BWC’s request for an Independent Medical Exam (IME)
- The doctor has given you the green light to work.
- The doctor has okayed you for light duty, but you do not go back to work (If you think your disability rating is too low, speak to a lawyer from Levy Law Offices.)
What do I do if my employer’s insurer denied my claim?
If your employer’s insurer denies your workers’ compensation claim, you can appeal the decision to the Industrial Commission of Ohio (IC). There are three levels of appeals:
- District level hearing: A district hearing officer will hear your case and issue you a decision within seven days.
- Staff level hearing : If the IC upholds the insurer’s denial, you have 14 days to appeal to the next level. This is where the staff hearing officer hears your case and issues you a decision. You will receive a decision via mail within seven days, just like with the district level hearing.
- Commission level: If the staff officer denies your claim, the Commission will either hear your case or refuse to authorize any further appeals. If it agrees to review your file, you will receive a decision within seven days. (If the Commission refuses any further appeals, you may be able to appeal that decision. Contact an attorney for help.)
IMPORTANT: If your employer’s insurer has denied your claim, you need to act quickly; there are time limits on requesting an appeal. Also, if you have yet to consult a lawyer, now would be the time to do so. Levy Law Offices can help you gather the proof you need to substantiate your claim and take the necessary steps to protect your right to benefits.
Call Levy Law Offices Now
Workers’ compensation is one of our primary areas of practice. We have a passion for helping injured workers get the benefits they need and deserve when a workplace accident renders them unable to support their families.
We can review your case and determine how much compensation you are eligible to receive, and help you take the required steps to receive your benefits. For help filing a claim, appealing a denial, handling matters when an insurer prematurely shuts off your benefits, or for general workers’ compensation questions, call Levy Law Offices in Cincinnati today.
Contact us today at 513-587-1323.