Have you been denied workers’ compensation in Ohio? You’re not alone. Every year, thousands of workers comp claims are denied in Ohio. The good news is that you have the right to appeal your denial.
The bad news is that battling a workers’ compensation claim denial can be complicated—even more so if you don’t know where to start. That’s why it’s important to understand how to appeal a denied Ohio workers compensation claim.
This article will explain what you need to know about appealing your claim, including when and how to submit an appeal and what documents you’ll need. Let’s get started!
Reasons for Denial
There are a few common reasons you may have been denied, such as missing a filing deadline, lack of medical evidence to support your claim, or the employer believing that your injury was pre-existing before the date of the accident.
Another common reason for denial is misconduct on your behalf, including intoxication or an unsafe working environment. Lastly, the state board might deny your claim if there’s a dispute over causation for your injury.
Review Your Workers Comp Claim
It’s possible that the denial of your Ohio workers comp claim was a result of a mistake or oversight. That’s why reviewing the Ohio Bureau of Workers’ Compensation (BWC) documents is important to ensure everything is in order.
When you receive the BWC decision, read it thoroughly and review all the dates, details, and descriptions in your initial claim. Make sure that any information included in the claim is accurate and complete. If any part is wrong, dispute it immediately and submit additional documentation as needed.
Notify Your Employer
You must notify the employer in writing that you are filing a claim for Ohio workers’ compensation and the reason for the claim. This must be done within two years from the date of injury or when you first knew or should have known that your injury was work-related. You’ll also need to provide your employer with medical records related to the claim.
Your employer is required to have a “notice of injuries,” which is available from the Ohio Bureau of Workers’ Compensation, so make sure your employer has one handy so you can provide all the necessary information for your claim.
File a Notice of Appeal
You have one more step in appealing your denied Ohio workers comp claim. The good news is it can be done quickly and without much hassle. The bad news is that you only have a limited time to do it.
The Notice of Appeal must be filed within 30 days after the Ohio Bureau of Workers’ Compensation’s order date. Within those 30 days, you must begin the appeal process by filing a Notice of Appeal with the BWC Office of Appeals.
You will need to include the following in your notice:
- Your name
- Your Social Security number
- The date of the Ohio Bureau of Workers’ Compensation’s order
- The name of the court or administrative agency with which you are appealing and any case number assigned by that court or agency
- A brief summary of your dispute and why you are appealing.
Once your Notice of Appeal has been received, you will receive a copy back from the appeals court, which will let you know that your appeal has been officially accepted and is being considered by the Ohio Bureau of Workers’ Compensation for review and further action.
Request a Hearing
You can request a hearing with the Bureau of Workers Compensation if your Ohio workers comp claim is denied. Here’s what you need to do to make it happen.
- Get a formal written response from your employer or their insurer.
- Set up an appointment with the Bureau of Workers Compensation. You can do this online or by calling 800-OHIOBWC (800-644-6292).
- Fill out the “Application for Adjudication of Claim” form on the website and have it delivered to the Ohio Bureau of Workers’ Compensation at least 14 days before your hearing date.
- Ensure you bring all relevant evidence, medical records, and any documentation regarding your claim and injury to your hearing.
- If applicable, bring along witnesses who can speak to your injuries and work environment.
A panel of commissioners will review any evidence presented on both sides and then decide whether or not you are entitled to workers’ compensation benefits. If they decide in favor of you receiving benefits, they will issue an order that outlines them in detail, including wage replacement payments, medical care, and more.
Prepare for the Hearing
Once your appeal is accepted, it’s time to prepare for the hearing. This part of the process can be intimidating, but if you follow a few simple steps, you can show your case in a way that gives you the best chance of success.
Here’s what you need to do to prepare for the hearing.
- Ensure all medical records and documents related to your workers’ compensation claim are up-to-date and organized.
- Research Ohio workers’ compensation laws so you know your rights and responsibilities.
- Get a qualified attorney specializing in Ohio workers’ compensation law to represent you at the hearing, if possible – or qualify for free or discounted legal services from non-profit organizations like Legal Aid or Ohio Center for Law-Related Education (OCLRE) if funds are tight.
- Consider seeking testimony from an expert witness who can provide credible evidence that backs up your case and explains complex medical information understandably, if necessary.
- Rehearse what you’ll say at the hearing before it takes place so that you can present yourself confidently and give clear answers when questioned by the judge or mediator presiding over your case.
Attend the Hearing
The process of appealing a denied Ohio Workers’ Compensation claim can be daunting—but you’re almost there. The next step is to attend the hearing scheduled by the Bureau of Workers’ Compensation and follow the steps outlined below.
Schedule an Appointment
The Ohio Bureau of Workers’ Compensation is usually responsible for scheduling hearings. Get in contact with them and set up a time for your hearing. It’s important to do this as soon as possible—it can take anywhere from months to over a year for your hearing date to be set, and you don’t want to miss out on getting any time-sensitive evidence ready.
It’s best to bring someone with you with experience in appealing Ohio Workers’ Compensation claims, as they’ll know what kind of questions the administrative law judge might ask and what kind of evidence they might need. They’ll also be able to represent you better than if you were on your own.
Our Ohio Workers’ Compensation Lawyers Are Here To Help You With Your Appeal
If your Ohio workers’ compensation claim has been denied, don’t despair. You can still appeal the decision to get connected with the resources and help you need. Our Ohio workers’ compensation lawyers are here to help you with your claim, providing personalized advice and guidance for success.
We provide legal representation for all stages of a denied workers comp claim in Ohio and can provide the insight and experience necessary to mount an effective appeal case before the Bureau of Workers Compensation. Our team is committed to helping employees get the benefits they deserve, no matter how complicated their situation may be.
Don’t wait to seek medical attention or advice. Call us today at (833) 406-0060, and let us help put you on the path toward financial security while recovering from an injury.