In Ohio, when a worker sustains a work-related accident or a workplace injury, they reserve the right to claim for workers’ compensation. However, if you’ve filed a workers’ comp claim only to have it denied, chances are you are looking for a way to appeal the decision. If that’s the case, then you’ve come to the right place for help with your Columbus workers’ compensation dispute.
At Ohio Workers’ Compensation Lawyers, we’ve helped hundreds of people over the years resolve their workers’ compensation disputes, and can help you too! Mistakes can sometimes be made after filing a claim, hampering the chances of an injured worker receiving the benefits they deserve and need. However, most initial denials can be easily overturned when a professional workers’ compensation dispute lawyer gets involved – that’s why you are advised to seek legal counsel immediately after receiving a benefits denial letter.
The attorneys at Workers’ Compensation Lawyers in Columbus can help you clear up any misunderstandings that may have affected your claim to ensure that you receive the benefits you deserve. However, if the reason for the denial is because your employer or the insurer just doesn’t want to pay you for your injuries, then our Columbus workers’ compensation dispute attorneys are ready and willing to aggressively fight the decision and ensure you get well compensated for your injuries.
For more information on how we can be of assistance, contact us by calling (833) 406-0060 to book a consultation with our attorneys for a free case review and professional legal counsel.
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Causes of Columbus Workers’ Compensation Disputes
Employers and their insurers are always looking for reasons to deny workers’ compensation claims. However, for them to deny a claim, they have to ensure that the reason is a valid one and within the confines of the law. Common acceptable reasons why disputes are denied include:
For you to receive workers’ compensation benefits as an injured worker, you must ensure that you report your illness or injury to your employer immediately it happens or becomes apparent. After that, make sure you file a workers’ compensation claim with the Bureau of Workers’ Compensation or your employer’s Managed Care Organization.
Keep in mind that the time limit for filing a workers’ comp claim in Ohio is one year. If you fail to file your claim before this period ends, chances are your claim will be denied.
Disputes about Whether Your Injury/Injuries Are Work-Related
Your employer could say that you were not working when you got injured, that your current predicament is not actually due to a workplace accident, or that your injuries are a result of some type of misconduct. Whatever reason they give to dispute your work-related injuries means that you will need to gather evidence to prove that your injuries are work-related. That might call for you to undergo medical examinations to bring more medical evidence of your injuries.
Your Injuries Do Not Meet State Guidelines
Each state in the U.S. has its own set of laws that govern/define what an injury is and some have special restrictions on workers’ compensation claims for psychological conditions or cumulative trauma. For instance, in some states, workers’ compensation benefits do not apply to illnesses brought about by long-term, work-related emotional stress.
Another thing that insurers and employers might dispute is the severity of the injuries; they might argue that your injuries aren’t severe enough to warrant a workers’ compensation claim.
You Filed Your Claim After You’d Left Your Job
Insurance companies sometimes deny claims filed after the worker quit, was fired, or was laid off. However, in most cases, the victim had a good reason why they took so long. It might be because they got injured in the period after they had given or were given notice, but before their last day, or because they reported their injuries while they were still employed, but soon got laid off.
While it’s illegal to fire a worker for reporting an injury in Ohio, it may happen in some cases. Whatever the case is, you can still contest the denial with the help of a Columbus workers’ compensation dispute attorney who’s well versed in Ohio Workers’ Comp laws.
Need assistance with your workers’ comp claim in Columbus? Get in touch with Workers’ Compensation Lawyers now for a case review and counsel.
What To Do If Your Workers’ Compensation Claim is Denied in Ohio?
If your workers’ comp claim is denied, your next step should be to appeal the decision. The denial letter you received should have a deadline date for filing your appeal. In Ohio, injured workers have 14-days to file their appeal, so make sure you do not waste any time. If you have any concerns or don’t know what to do, consult the workers’ compensation attorneys at Workers’ Compensation Lawyers for help navigating workers’ compensation ever-complex issues and bureaucracy.
Types of Workers’ Compensation Disputes
Workers’ compensation disputes can arise over a number of issues.
These disputes often arise when the insurer disputes your claim’s liability. The insurer could argue that you are not a “worker” as per the state’s legislation, or that your employment wasn’t a contributing factor to your injury.
Permanent Impairment Disputes
Sometimes, workers and insurers disagree on how much should be paid as compensation for injuries experienced. This usually happens when insurers and injured workers have both had a permanent impairment evaluation performed, but the assessments seem to have varying extents of assessed permanent impairment.
Injury Management Disputes
These often involve claims that don’t have an injury management plan, or which had a management plan but wasn’t supported or followed. It may be there was no suitable work provided for the injured worker, there’s no recover-at-work plan or one was present but wasn’t followed, or the worker’s capacity to work is disputed.
Work-Capacity Decision Disputes
These often arise when the victim does not agree with the insurance company’s decision about how much they’ll receive every week after a work-related illness or injury.
Workers’ Compensation Dispute and Appeals Process in Ohio
If you had your claim denied, you can file an appeal through the Industrial Commission Online Network’s official website. You can also file your appeal in writing using a Notice of Appeal form. Once you have filed your appeal, what follows is a hearing set up by the BWC – expect a message from the Industrial Commission notifying you of the location, date, and time within a week of filing your appeal.
The first hearing will be before an Ohio district officer within forty-five days of filing the appeal. If you appeal the district officer’s decision, your case is then heard by a staff hearing officer. If you decide to appeal the decision, the matter then goes before the Industrial Commission Commissioners’ Panel.
If none of the channels above work out for you, the next step is to appeal to the courts. When that’s the case, your case will be taken to court and heard in the county you got injured. This process is a lot more formal and a lawyer will be needed to ensure that you meet all procedural rules and that your evidence is compliant. Your success at this point of the case is entirely dependent on having an experienced and knowledgeable workers’ compensation dispute attorney representing you.
Contact Our Columbus Workers’ Compensation Dispute Lawyers
The knowledgeable and professional workers’ compensation attorneys at Ohio Workers’ Compensation Lawyers are skilled and experienced in matters related to workers’ compensation disputes. We have, over the years, helped hundreds of injured workers get the compensation they deserve after a claim denial and can help you too!