Injuries on the job are, though unfortunate, commonplace. According to the Bureau for Labor Statistics, 2021 alone saw over 2.6 million instances of workers becoming injured or ill while on the job. In many of these cases, employees obtained payment for their medical services — and in some cases, lost wages — through a workers’ compensation claim.
Workers’ compensation (or simply “workers’ comp”) is meant to be a quick and simple way for hurt or sick workers to pay for necessary medical treatment. If your injury or illness keeps you away from your job for a period, workers’ comp benefits can address the associated losses.
If workers’ compensation benefits are meant to be easily accessible for workers, though, you may wonder why you would need a workers’ comp lawyer. As it turns out, the workers’ compensation process can present several obstacles that get in the way of you getting the payment you deserve.
How Ohio Workers’ Compensation Is Supposed to Work
In Ohio, most employers are required to either pay into the state’s workers’ compensation fund or to obtain and carry adequate assets to address workplace injuries. The Bureau of Workers’ Compensation (BWC) is ultimately responsible for paying the claims of injured or ill workers unless the employer’s assets are sufficient enough that they can self-insure.
Following an injury or illness that takes place or manifests on the job, respectively, a notification is made to the BWC, and a claim is initiated. The first report of injury or sickness must be made within one year of its occurrence, though it should be made as quickly as possible.
The BWC will then investigate the claim by speaking with the worker, their employer, and their medical providers, and approximately 28 days after the claim is opened, the BWC will inform the worker whether their claim has been approved or denied.
Why Your Workers’ Comp Claim Got Denied
It may be surprising to learn that a workers’ compensation claim can very well be denied. Nevertheless, the BWC has the authority to deny claims that it believes do not meet the requirements for receiving benefits.
There are several reasons why your claim may be delayed or denied entirely, and any of them can be more than just cause to speak to a workers’ comp lawyer:
Your Claim Was Not Filed on Time
If you did not file your first report of injury within a year of your accident, the BWC can deem your claim “untimely” and deny it. However, not every delay toward opening a claim with the BWC may be due to your own negligence.
The issue at hand may be, for example, that you believed your employer, your doctor, or some other person would file the necessary paperwork on your behalf. Perhaps you did not know where to find the necessary paperwork and could not find someone to help you.
The one-year statute of limitations can be a harsh barrier if exceeded, but there are some limited exceptions that could extend it, including difficulty in determining the precise date you were injured or became ill. A workers’ compensation lawyer in Ohio can examine your situation and see if any of these exceptions apply.
Your Injury or Illness Was Not Work-Related
Workers’ comp claims are routinely approved when you can show that you were specifically injured or fell ill while clocked in on the job site. Claims can quickly become complicated, however, and they may be denied if any of the following factors come into play:
- You were away from the job site but still arguably “on the clock.”
- Your illness developed over a long period of time as opposed to a sudden onset of symptoms.
- Your injuries were caused by repetitive actions over months or years, such as typing or using small hand tools.
- You had a pre-existing injury, like a back injury, that was exacerbated and made worse by work
Determining whether an injury or illness was caused by work-related activities can require careful medical documentation from one or more occupational specialists. An experienced worker’s comp lawyer will be able to spot cases such as these and advise you where you should go to obtain a thorough evaluation.
Your Medical Records Do Not Match Your Claim
If there is a clear discrepancy between your injuries as you report them to the BWC and how your doctor sees them, your claim may be denied. Such a situation can also arise if you initially claim your injuries are severe but then disregard your doctor’s orders or restrictions. In either case, questions about how serious your injuries are can lead the BWC to deny your claim, especially if they believe you are trying to game the system.
Your workers’ comp lawyer will guide you to the appropriate medical professionals for evaluation and treatment if you do not receive adequate care from the first doctor who treats you. Your lawyer will also remind you of the need to follow your doctor’s orders and abide by any limitations placed upon you. If your employer tries to encourage you to return to work when you have not yet been cleared to do so, your lawyer can address that as well.
The Right Time to Seek Legal Counsel Is Now
If your workers’ compensation claim is rejected, you only have 14 days from its denial to file an appeal. If you do not take that important step, the denial becomes final, and you cannot reopen your claim. Two weeks does not give you much time at all to seek legal counsel if you wait until then to get help with your claim.
Instead, after notifying your employer and receiving medical aid, contact a workers’ comp lawyer in Ohio as soon as you can. Doing so will give your lawyer time to familiarize themselves with your case, review your medical records, and be prepared to respond quickly in the event of a denial.
Retaining counsel even before making your initial report of your injury to the BWC can also help identify early issues with your claim. Your attorney may be able to respond to these issues before your report is submitted, heading off a potential denial and saving you time.
Your Ohio Workers’ Comp Lawyer Is Waiting to Hear from You
You deserve prompt and fair compensation for your work-related injuries, and Schiff & Associates is here to help you get it. Just because workers’ compensation is meant to address your needs does not mean it is a user-friendly process. It can be intimidating, and the path to obtaining compensation can be especially frustrating if you receive a denial.
Contact Schiff & Associates right away after a workplace accident, and we will help ensure your claim is filed timely, and your legitimate claim is approved.