When Does Workers Comp Stop Paying?

Workers’ compensation is a crucial safety net for injured employees, offering financial support and medical coverage during recovery. But when do workers comp benefits end? In Ohio, like most states, the answer hinges on the specifics of your case and relevant laws.

This blog dives deep into the legalities surrounding workers’ compensation termination in the Buckeye State, empowering you with knowledge and resources. Don’t hesitate to reach out to our Ohio workers’ compensation lawyers for help with your claim.

How Long Do Workers Comp Benefits Last?

Ohio’s workers’ compensation system hinges on a critical distinction: temporary total disability (TTD) and permanent total disability (PTD). Each type comes with its own set of rules regarding benefit termination, as outlined by the Ohio Revised Code (ORC).

Temporary Total Disability (TTD): Support While You Heal

If you’re injured at work and can’t work, Temporary Total Disability offers two-thirds of your average weekly wage until you reach certain milestones.

  • Return to Work: Even if it’s modified duty, stepping back into any employment ends TTD benefits.
  • Maximum Medical Improvement (MMI): This point, determined by your doctor, signifies your condition has stabilized and won’t significantly improve. It’s crucial to understand MMI, and you can contest it if you disagree.
  • 70% Earning Capacity: If your earnings reach 70% of your pre-injury level, TTD might cease, even if you’re not fully recovered.
  • Benefit Exhaustion: There’s a maximum of 2,600 weeks for TTD. After that, benefits stop, regardless of your recovery status.

Permanent Total Disability (PTD): A Lifelong Lifeline

When a workplace injury leaves you permanently unable to work, permanent total disability offers two-thirds of your average weekly wage for life. It’s a safety net for severe, long-term injuries.

However, PTD can also end under certain circumstances:

  • Change in Circumstances: If your earning capacity significantly improves, your PTD benefits may be reviewed or even terminated.
  • Refusal of Medical Treatment: Unreasonably refusing necessary medical care can impact your eligibility for continued benefits.

workers comp will stop paying when you are declared healed

Termination of Workers’ Compensation

Several other situations can lead to termination of workers’ compensation, as outlined in the Ohio Administrative Code (OAC) Chapter 4123-18.

  • Claim Denial or Closure: If your claim is denied or closed due to ineligibility, actively seeking work, or incarceration, benefits naturally stop.
  • Fraudulent Activity: Misrepresenting information or intentionally causing injury can lead to not only benefit termination but also legal repercussions.

How Can an Ohio Workers’ Compensation Attorney Help?

The primary objective of a workers’ compensation attorney representing the claimant (the injured worker) is to help them secure benefits. Here are some of the key tasks that a workers’ compensation attorney can perform.

  • Compile Medical Evidence: One of the most common reasons for the rejection of workers’ compensation claims is insufficient medical evidence. An attorney can help compile the necessary medical documentation to substantiate the severity of your injuries.
  • Calculate Compensation Value: Based on your physical condition, the nature of your injuries, anticipated medical expenses, and other owed payments, the attorney can estimate the approximate value of the compensation you should receive.
  • Negotiate Settlements: The attorney can assist you in formulating and negotiating a favorable settlement agreement.
  • Represent You in Court: If a settlement cannot be reached with the insurer, the workers’ compensation attorney will represent you in court before the Appeals Board.

Remember, understanding how long workers comp benefits last and when they can be terminated is critical. Don’t hesitate to seek guidance and clarification if you have questions by contacting Ohio Workers Compensation Lawyers at 833-406-0060.

We are here to help you get the benefits you deserve. Call us today for a free consultation.