OHIO WORKERS' COMPENSATION

DO YOU NEED A LAWYER?

The BWC has its' lawyers Your Employer has its' lawyers If a workers' comp claim was really something you could do yourself, why does everyone have a lawyer? You should have a     lawyer too. And your lawyer should     be a Certified Specialist     Attorney!

THINK ABOUT THIS!

Your family doctor sends you to a specialist  when you need complex surgery on your spine.  So, wouldn't you want a specialist attorney to represent you in your workers' comp claim? Mike Gruhin is a certified specialist attorney.

Ohio Workers' Compensation Laws are designed to protect injured workers.  Workers' compensation in Ohio is a No-fault law.  This means that any time a worker is injured in the course and scope of employment, workers' compensation coverage may be available.  As an example, if you are driving the company truck and fall asleep at the wheel and you sustain an injury you will be covered under Ohio Workers' compensation. But, if you intentionally drive the company truck into a tree in order to cause self inflicted injury, there is no workers' compensation coverage.  Self inflicted or intentionally caused injuries are not covered.

In order to take advantage of the law, you must protect your rights. As against your employer, Workers' compensation benefits are usually an employee's exclusive remedy. This means that, usually, you can seek to receive only workers' compensation benefits and are barred from suing your employer, even if the injury was the employer's fault.

However, you may have a claim against other persons in addition to receiving workers' compensation benefits from your employer. Additionally, in some instances, you may have an additional claim against the employer for an intentional tort. You must consult with an attorney to determine if you may have an intentional tort claim against your employer!

It is essential in any workers' compensation accident to build a proper foundation under for claim so that you can best protect your rights to receive benefits and other compensation.

If you have been injured on the job, you should immediately tell a co-worker, supervisor, your boss, or the personnel department immediately. Make a written incident report and always ask for a copy. Try to get the names of any co-workers that may have witnessed the incident or who assisted you immediately after the incident.

Get medical attention - and make sure you tell the doctor and anyone who is rendering medical treatment to you that you were hurt on the job and all of the body parts you injured and then seek legal advice from a certified Ohio Workers' Compensation Specialist Attorney.

Don't rely on the your employer, your employer's workers' compensation representative, your employer's attorney or your workers' compensation claims examiner. None of these people represent your legal interests!!

Your lawyer works for you and has your legal interests at heart.  You want someone representing you, not someone who is being paid by "the other guy" whose interests most likely are not the same as your interests.

As with all things legal in nature, in order to take advantage of the benefits available to you, you should take the necessary steps to protect your rights to workers' compensation benefits.

There are many benefits to which you may be entitled under Ohio Worker's Comepnsation Law.
It is important for you to discuss these benefits and your right to compensation with an experienced certified workers' compensation specialist attorney. You need an experienced lawyer working for you and not a lawyer who is being paid by your employer or some other third party.

It is essential that you build a proper foundation for your claim. Should you require benefits or compensation over a long period of time do not be afraid to enforce your legal rights and obtain the proper legal help to assist you with your claim.

  If you have suffered a work-related injury you should seek legal advice from an attorney who specializes in Ohio workers' compensation law.

Mike Gruhin is a Certified Ohio Workers' Compensation Specialist Attorney. Gruhin & Gruhin's workers' compensation specialist would like to manage your workers' compensation claim.

State Fund/Public Employee
  Claim Time Frames

This chart provides the maximum administrative times for processing a state fund/public employer workers' compensation claim in Ohio.

The process starts with the receipt of a state fund claim application for workers' compensation benefits by the administrator of The Bureau of Workers' Compensation.

7 days	for the administrator to contact both sides
28 days	for the administrator to investigate and issue an order
14 days	after receipt of the administrator's order for the parties to file an appeal from that order
7 days	after receipt of the appeal for the administrator to send the file to the DHO
45 days	from the date the appeal is filed for the District Hearing Officer to hear the appeal
7 days	from the date the appeal is heard for the District Hearing Officer to decide the appeal
14 days	after the DHO's order for the parties to file an appeal from that order
45 days	from the date the appeal is filed for the Staff Hearing Officer to hear the appea;
7 days	from the date the appeal is heard for the Staff Hearing Officer to decide the appeal
14 days	after the SHO's order for the parties to file an appeal from that order
45 days	after the appeal for the Industrial Commission to hear the appeal. [However, refusals to hear an appeal are to be made within 14 days.]
7 days	from the date the appeal is heard for the Industrial Commission to decide the appeal
60 days	from the date of the Commission's order for the parties to appeal to court pursuant to R.C. Section 4123.512

Self Insured Employer Hearing Track

This chart provides the maximum administrative times for processing a Self-Insured Employer workers' compensation claim in Ohio.

30 days	from the filing of the claim for the self-insurer to inform the claimant and Bureau in writing as to what conditions it has recognized or refuses to recognize, according to Rule 4123-19-03(L)(10)
7 days	for the administrator to send the file to the DHO
45 days	from the date the appeal is filed for the District Hearing Officer to hear the appeal
7 days	from the date the appeal is heard for the District Hearing Officer to decide the appeal
14 days	after the DHO's order for the parties to file an appeal from that order
45 days	from the date the appeal is filed for the Staff Hearing Officer to hear the appeal
7 days	from the date the appeal is heard for the Staff Hearing Officer to decide the appeal
14 days	after the SHO's order for the parties to file an appeal from that order
45 days	after the appeal for the Industrial Commission to hear the appeal. [However, refusals to hear an appeal are to be made within 14 days.]
7 days	from the date the appeal is heard for the Industrial Commission to decide the appeal
60 days	from the date of the Commission's order for the parties to appeal to court pursuant to R.C. Section 4123.512.

Temporary Total Disability

Compensation paid when you are unable to work as a result of an allowed Ohio BWC claim.  Workers' Compensation pays 72% of your Full Weekly Wage for the first 12 weeks you are unable to return to your job. From week 13 and on, you are paid at the rate of 66.66667% (2/3) of your Average Weekly Wage.  It is extremely important that your FWW and AWW are correctly set. If they are not, you will not receive the correct amount of weekly compensation payments. 

Wage Loss 

Wage loss compensation is payable when, as a result of the allowed medical conditions in a claim, an employee is either unable to find work within his physical capacities or has returned to a less strenuous or alternative job which pays less then the job which resulted in the industrial injury. The restrictions must be certified by the claimant's treating doctor.

There are two (2) types of wage loss that are available to injured workers when they are unable to return to their former positions of employment and their doctor has returned them to work with restrictions.

The first type of wage loss is the Non-working wage loss. In this situation, the worker looks for work but is unable to secure employment. The worker is able to submit job search forms to the BWC for compensation. There are specific requirements that must be met to obtain this compensation benefit.

The second type of wage loss is the working wage loss. In this situation, the injured worker secures employment, within the job restrictions placed by the doctor but suffers a wage loss. The worker can submit the paystubs from the lower paying job to seek compensation from the BWC in the amount of 66.66667% (2/3) of the difference of pay.  There are specific requirements that must be met to obtain this compensation benefit.

Workers' compensation wage loss is payable for a maximum period of 200 weeks.

In the event that an injured worker first receives wage loss through the BWC Rehabilitation Division, which is available for 200 weeks, then, at the end of that 200 week period, an injured worker may be eligible to receive an additional 200 weeks of wage loss through regular BWC compensation.

Facial Disfigurement

Facial disfigurement awards are paid to injured workers who have sustained severe injuries to their faces. 

The Following Injuries are subject to a Statutory    Compensation Schedule:

Loss of Arm
Loss of Hand
Loss of Fingers
Loss of Leg
Loss of Foot
Loss of Toes
Loss of Eye
Loss of Teeth

Ankylosis Awards
Contracture Awards

In some cases, a severe hand injury which damages the joints of the hand and/or fingers and renders them useless may qualify for an award for the "total loss" of finger(s) or even the whole hand. If you have frozen or stiff joints as a result of a severe work related hand injury, you should consult with a workers' compensation attorney. Usually, the attorney will need to look at your finger(s) and hand to make an assessment as to whether this award is available.

Permanent Partial Disability

This is the award for the permanent, but partial disability (damage done to your body) that you suffer as a result of your work injury. Unlike compensation you receive from a personal injury claim, Workers' compensation does not pay for "pain and suffering". Workers' compensation pays for the limitations in the range of motion in your injured body parts.

The usual examination inspects your ability to twist, bend, flex, etc. This is known as rotation, extension, flexion. There are other factors which are taken into consideration in the physical examinations.

Currently, Ohio Workers' Compensation relies on the American Medical Association's Guideline to the Evaluation of Permanent Impairment in setting the percentage rating of permanent partial impairment, which the hearing officers then convert into permanent partial disability ratings.

If a claimant's permanent partial disability increases over time, an application seeking an increase to the prior Permanent Partial Disability award may be filed.

Permanent Total Disability

This award is given in circumstances where a person can no longer perform sustained remunerative employment as a result of the allowed workers' compensation injury conditions.

Separate from the above, permanent total disability is granted statutorily to a person who loses both eyes, both hands, both arms, both legs, or both feet, or any combination of each in an industrial accident.

The Industrial Commission considers a claimant’s individual vocational factors including the claimant’s age, education, and work record as well as physical, psychological and sociological factors in considering a claim for permanent total disability compensation.

Death Claims

If the deceased worker has no dependents, no compensation is payable; however, bills for medical services, hospital services, etc. will be paid along with funeral expenses not to exceed $3,200 to anyone who pays them, whether dependent, volunteer or otherwise.

Wholly dependent persons are presumed to be the following:

(1) Surviving spouse living with employee at time of death, or separated due to the aggression of the decedent;

(2) a child under the age of 18 or 25 if pursuing a full-time educational program or over 25 if physically or mentally incapacitated from earning and is receiving more than half of his support from decedent with whom he is living or for whose maintenance decedent was legally liable.

When more than one person is wholly dependent, the Administrator shall apportion the benefits.

Payments shall continue to the dependent surviving spouse from date of the employee's death to date of death or remarriage of the surviving spouse. If the surviving spouse remarries, an amount equal to two years shall be paid in a lump sum.

Payment of Medical Bills

Medical bills are paid upon approval by the medical care organization in an amount which is set by the bureau of workers' compensation. If the doctor charges more for his/her services than is allowed by BWC schedule, the injured worker is not responsible to make any additional payments to the doctor.

Likewise, prescription expenses are paid by the BWC for medications related to your allowed condition(s). If you have paid for prescriptions "out of pocket" you are entitled to reimbursement from the BWC. However, you must have the pharmacist complete the appropriate form for submission to the BWC.

Full Weekly Wage (FWW)  Recalculations

Often, errors are made in the calculation of your FWW. It is important to make certain your rate is properly calculated because you are paid 72% of the FWW for the first 12 weeks you are unable to work (as certified by your doctor of record for allowed conditions). If your rate is wrong, your compensations payments will also be incorrect.

There is a simple formula to calculate the FWW under one of three circumstances. A workers' compensation specialist will know how to calculate your FWW under each circumstance.

Average Weekly Wage (AWW)
         Recalculations

Often, errors are made in the calculation of your AWW. It is important to make certain your rate is properly calculated because you are paid 2/3 of your AWW from the 13th week and onward while you are unable to work (as certified by your doctor of record for allowed conditions). If your rate is wrong, your compensations payments will also be incorrect.

There is a simple formula to calculate the AWW but in many instances certain statutory exceptions may apply.

For example, if you were unable to work a full 52 weeks prior to your injury due to illness, layoff, or other reasons beyond your control, you may be entitled to a higher AWW. If you are injured on your first job and are of a young age, you may qualify for a special AWW rate..

If you fall under the above exceptions, you should consult with a workers' compensation lawyer for the preparation of a wage affidavit seeking a higher AWW, based upon the special circumstances statutes. This may entail a hearing before the Industrial Commission.

Lump Sum Settlements

A claimant is entitled to settle his workers' compensation claim for a lump sum and close the claim. The employer must agree to a settlement. If the employer refuses to agree to settle the claim, the BWC has no power to settle the claim.

If you have been hurt on the job in OHIO - call Gruhin & Gruhin.

Mike Gruhin would like to evaluate and manage your workers' compensation claim.

THE RIGHT CALL TO MAKE  WHEN THINGS GO WRONG.