What Does Workers' Compensation Cover? | Ohio BWC Benefits!

An injury or illness at the workplace can adversely impact the affected worker. From burgeoning medical costs to lost wages and other damages, injured employees may struggle to make ends meet, facing long-term financial hardship. While the law allows individuals to recover out-of-pocket expenses, most people are unaware of their rights, which can lead to lower compensation.

At Larrimer & Larrimer, LLC, our attorneys have over 90 years of combined experience handling claims through Ohio's workers' comp system. We have the skills and knowledge to help navigate the complex legal waters, build a strong case, or even file an appeal to ensure maximum compensation. We can help answer questions such as Are contractors covered by workers' compensation?

Those struggling to file a workers' comp application or receive cash benefits in Columbus, Ohio, should reach out to us to discuss their case and learn more about their rights.

Understanding Workers' Compensation

Workers' compensation is mandatory for all employers with one or more employees in Ohio. Insurance coverage kicks in when a worker suffers injuries from an accident while carrying out their roles and responsibilities.

Employers in Ohio must pay for workers' compensation, which means that employees are not required to make contributions. When a workplace accident causes injuries to a worker, it can lead to medical expenses, lost wages, and other damages. Fortunately, this type of insurance provides cash benefits to the affected party.

After suffering injuries in a workplace accident, the injured worker can file a workers' compensation claim with their employer to recover the damages. Unlike a personal injury case, the affected party receives cash benefits or medical care regardless of who is at fault.

However, injured workers need to understand that the employer's insurance company only agrees to pay the workers' compensation claim after determining that the injuries are work-related.

A key thing to remember is that the workers' compensation is not only there to make the affected employee "whole" again but also to protect the employer legally and financially.

When the injured worker files a claim and accepts the cash benefits offered by the insurance company, they agree to forego their right to sue the company to seek further damages down the road.

What Does Workers' Compensation Cover?

A workplace accident can lead to hefty medical bills depending on the severity of the injuries. It can also prevent employees from returning to work (temporarily or permanently), resulting in lost wages.

Fortunately, workers' compensation coverage pays for the following damages:

Medical Expenses

Most workers' compensation covers only necessary and reasonable medical expenses related to work-related injuries. If an employee has a slip and fall accident at the workplace, the insurance will pay for their hospital bills.

However, if a worker gets into a motor vehicle accident while driving to a construction site, they may not be eligible for workers' compensation coverage.

Lost Wages

When an employee suffers injuries, they may be unable to return to work for a certain period of days or weeks. This is referred to as temporary total disability and can result in lost wages, placing a substantial financial burden on the injured worker.

While workers' compensation covers lost income during a period of medical recovery, the policy pays compensation at a reduced amount. In Ohio, affected employees can seek two-thirds of their average weekly wage for the days they are absent from work.

A workplace accident can also lead to permanent disabilities, preventing injured workers from ever resuming employment. In such cases, workers' compensation provides disability benefits and lost income for longer periods.

Death Benefits

If a worker dies due to a work-related accident, their dependents may be able to bring a workers' compensation claim to receive death benefit payments for as long as they are eligible.

What Is Temporary Total Disability and Permanent Total Disability in Ohio?

According to the Ohio Bureau of Workers' Compensation (BWC), a temporary total disability refers to disabilities that affect the injured employee's temporary ability to return to work or their former position.

Suppose the worker can perform their duties in a modified environment and their employer fails to provide such conditions. In that case, they may also be eligible for these types of benefits.

The amount an injured employee receives for their temporary total disability (TTD) varies from one case to another. Typically, they'll get 72% of their full weekly wage for the first 12 weeks, which decreases to two-thirds of the average weekly salary thereafter.

On the other hand, the Ohio BWC defines a permanent total disability (PTD) as an injured worker who is unable to perform sustained remunerative employment, meaning that the employee's disabilities prevent them from ever returning to work.

The affected party will continue to receive benefits for as long as the injury exists. These may equal two-thirds of their average weekly wage prior to the injuries sustained.

In Ohio, workers' compensation payments are determined by the number of days missed, according to the following schedule:

• Seven or fewer days: No compensation is offered for lost income.

• Eight to 14 days: Payment starts on the eighth day of missed work, and the injured worker receives compensation for each day missed but will not be compensated for the first seven days.

• More than 14 days: Payment starts on the eighth day and covers each day missed. Compensation includes the initial seven missed days if the worker is out for more than 14 days.

  
  

What Is the Process of Filing an Ohio Workers' Compensation Insurance Claim?

There are certain workers' compensation requirements that injured workers must fulfill before they can receive benefits. These vary from one state to another.

Here are the steps that an injured worker must follow if they wish to have a greater chance at securing compensation for the damages incurred due to a workplace accident in Ohio:

1. The affected party must report the work-related injury immediately. While there is no law that places a time limit on when injured workers should inform their employers of the injuries sustained, it's essential to act quickly.

2. Once the injured worker reports the accident, they may receive an incident form that they need to fill out to the best of their ability. It all depends on the company's policy, as an employer may initiate the claims process via email. Affected parties should keep copies of all reports and communication to avoid any legal hurdles along the way.

3. In Ohio, employers work with managed care organizations (MCO) that are responsible for filing workers' comp claims. An employee selects a medical provider from an approved panel of hospitals to begin treatment, while the doctors provide details to the MCO for further processing.

4. The MCO will send the workers' comp claim to the BWC, which has 28 days to respond. If approved, the affected party will receive cash benefits for the medical expenses and lost wages incurred. Upon denial, the claimant can file an appeal.

5. Injured workers have 14 days to file an appeal, which they must do in writing using an IC-12 form. The workers' compensation board will arrange a hearing for the affected party to attend and send a written decision within seven days. Even if the BWC denies cash benefits, the affected party may be able to file another appeal.

   
   

Do Injured Workers Need to Work with an Experienced Workers' Comp Attorney in Ohio?

While it may seem easy to receive workers' compensation benefits following an injury or illness at work, insurance companies may create hurdles throughout the entire process to reduce payouts. In some cases, insurers may argue that the injuries are not work-related and deny claims.

Injured private and federal employees must seek legal representation when a workplace accident occurs. An experienced attorney can help build a strong case, adhere to the necessary guidelines, and tackle the insurance company to ensure maximum workers' comp coverage. For more information, a Columbus workers compensation lawyer may be able to help.

Need Help with Ohio Workers' Compensation Insurance Claim? Larrimer & Larrimer Has Injured Workers Covered!

Whether it's a slip-and-fall incident at the workplace or a construction site accident, Larrimer & Larrimer, LLC, and our experienced workers' compensation attorneys have protected the rights of injured workers in Ohio since 1929. We have the expertise and skills to assess your case and ensure that you receive the best possible legal advice.

If you've suffered work-related injuries in Columbus, Ohio, call us to schedule a free consultation to discuss your workers' compensation insurance claim and receive maximum benefits!