Understandably, the process by which one obtain benefits from the Ohio Bureau of Worker's Compensation is a long and confusing process for many injured workers. In order to ensure that your better educated on the subject, we've posted the most common questions that our clients direct to our staff.
- How do they figure my average weekly wage?
- Can I see my own doctor?
- How do I report a work-related injury?
- Does my private health insurance take the place of workers' compensation?
- Who pays for my prescriptions?
- Can I settle my case?
- What medical coverage will I receive if I am injured at work?
- Can I receive money for scarring that related to my injury?
- If my claim is denied, what options do I have for having my medical bills covered?
- What if there are objections?
- What if my injury prevents me from returning to my job?
- How can I review my claim?
How do they figure my average weekly wage?
Average weekly wage is determined by dividing your total earnings for the year before the injury by 52 weeks.
Can I see my own doctor?
This depends on whether or not your carrier is using a managed care program. If they are, you must choose a doctor within there network. If you are not subject to managed care, the choice may ultimately be your own.
How do I report a work-related injury?
First, make sure that your employer is aware of your injury. Your employer may fill out your claim papers on the job or they may ask you or your medical provider to do so at the time of your initial treatment date. If you require a claim form, visit the Ohio Bureau of Worker's Compensation web page and download a claim form.
Does my private health insurance take the place of workers' compensation?
No. Workers' Compensation is required by law for all employers in the state of Ohio. If your injured at work, your employers Compensation insurance will pay for the bills associated with treatment and care of your work related injury.
Who pays for my prescriptions?
Your employers insurance carrier will reimburse you for any prescriptions relating to your injury. They have 30 days from receipt of your bills to reimburse you for the expenditures relating to your medication.
Can I settle my case?
Yes. A "negotiation settlement" between the injured worker or his/her attorney and the insurance company must come to agreement to a monetary figure that adequately compensates you for closing the claim. If a case settles then you giving up all monetary rights for his injury. Many times a worker's right to future medical treatment is kept open. In addition, the worker's right to be considered for retraining can remain open for two years post-settlement.
What medical coverage will I receive if I am injured at work?
As long as your medical treatment is deemed necessary and related to your industrial injury, then you are entitled to full payment for all medical treatment. However, there are bureau guidelines which may limit the extent to which you can receive treatment if the treatment is not considered medically necessary to aid in your recovery. Generally speaking, you should be able to obtain coverage for most if not all of your treatment.
Can I receive money for scarring that related to my injury?
As long as the scarring or disfigurement is on your face, neck or hands then you have a legit right to receive compensation as a part of the management of your claim.
If my claim is denied, what options do I have for having my medical bills covered?
If your claim is fully denied, then your Bureau of Worker's Compensation is telling you that they do not consider your injury work related and thus, you will not be compensated for any treatment relating to that injury. You can submit a copy of the denial letter to your health insurance carrier along with copies of your medical bills for reimbursement.
If your claim is only partially denied, then you need to obtain guidance from your Benefits Department to determine what bills they will pay and what bills should be submitted to your health insurance carrier.
What if there are objections?
If your claim is contested by your employer/insurer, it will be scheduled for a hearing before a Commissioner of the Bureau of Worker's Compensation. The commission will hear from all parties involved and determine if the objections are meritorious.
What if my injury prevents me from returning to my job?
If you are not capable of returning to your job or some other comparable job for which you have been trained, then you may be eligible for vocational rehabilitation and training.
The Bureau of Worker's Compensation will refer you to a Vocational Rehabilitationist, who will provide the necessary training and guidance to assist you in becoming gainfully employed in your new field of employment.
You may be a candidate for vocational rehabilitation if and only if, your injury prevents your from holding the occupation you held at the time of the injury. A doctor must make the determination that you are medically incapable of returning to your former job and that provider refers you to vocational training.
How can I review my claim?
The Ohio Bureau of Worker's Compensation allows all injured workers, their employers as well as their representatives to review that status on any claim online. You can enter your social security number to determine the status of all of your claims or simply input a specific claim number to review individual
