|
FREQUENTLY ASKED QUESTIONS ABOUT
WORKERS' COMPENSATION
Q: My employer denied my claim for workers' compensation benefits. Do I really
need an attorney to get benefits?
A: Although the law allows you to represent yourself, under most
circumstances you should hire an an attorney experienced in workers'
compensation to handle hearings before the Industrial Commission. Your
employer and their representative will always have an experienced attorney
representing their interests. Therefore, you will have a better chance of
winning your case if you hire an experienced attorney to represent your
interest.
Q: Since I am not working due to my work injury, and am not currently receiving
benefits, how can I hire an attorney if I have no money?
A: If we choose to represent you in your claim with the Ohio
BWC/IC, you do not have to pay any fees unless we recover benefits for you.
If we are successful, the attorney fee will be deducted from the benefits that
are recovered.
Q: I've been receiving benefits for my work related injury for a while and then
suddenly my benefits were stopped out of the blue. Is BWC allowed to do this?
A: The BWC or self-insured employer is not allowed to stop your
workers' compensation check without one of the following: 1)you return to work;
2) you reach Maximum Medical Improvement (MMI). You should consult an attorney
if you believe your benefits were improperly stopped.
Top of
Page
Q: I just received
a notice in the mail from
the BWC/employer stating that my benefits should be terminated as of the date I
attended an independent medical exam. How can they say I am fully recovered when
their doctor only examined me for ten minutes. Does this mean my benefits are
going to stop?
A: You have received a order for termination of your workers'
compensation benefits. The BWC believes that you have recovered
from your injury, or have reached Maximum Medical Improvement (MMI) as a result
of the findings of the doctor who performed the independent medical exam (IME)
and that you are no longer entitled to receive your workers' compensation
benefits. However, the employer cannot stop your benefits without an order from
the Industrial Commission. This Motion will be litigated before an Industrial
Commission Hearing Officer, and he or she will make a determination as to
whether or not you shall continue to receive your checks.
Top of
Page
Q: If I cannot work due to my work injury, how much will my benefits be?
A: In every workers’ compensation claim, before any compensation can be paid, the
Bureau of Workers’ Compensation (BWC) or self-insured employer must determine
the injured worker’s average weekly wage (AWW) and full weekly wage (FWW).
The AWW is the average of the earnings the injured worker received in the
one-year period immediately before the industrial accident. The FWW is the
average of the 6 weeks of earnings the injured worker received immediately
before the industrial accident.
These are the general methods used to calculate the AWW & FWW. There are
alternative methods the BWC and self-insured employer may employ to calculate
wages based on principles of “substantial justice.” It is generally the injured
worker’s responsibility to articulate the basis for a deviation from the
standard AWW & FWW calculations.
The workers’ compensation law places a maximum rate at which compensation may be
paid. The maximum rate is calculated yearly and is based upon a percentage of
the Statewide Average Weekly Wage of all workers in Ohio. For 2006, $704.00 is
the weekly maximum rate that may be paid for temporary total disability
compensation (TTD), wage loss compensation (WL), living maintenance
compensation (LM), living maintenance wage loss compensation (LMWL), and
permanent total disability (PTD) compensation.
Top of Page
Q: Is there a waiting period before I can collect my Temporary Total
Compensation? A: Temporary total compensation is not payable for
the first 7 days of total disability, unless the injured worker is off work at
least 14 consecutive days. This is the so-called “one week waiting period.” If
the injured worker is off work 10 straight days, for instance, the injured
worker would receive temporary total compensation for 3 days only. However, if
the injured worker is off work for 14 or more straight days, then the one-week
waiting period does not apply and the injured worker is entitled to be paid for
every day of missed work.
Top of Page
Q: Is there any other monetary benefit I may be entitled to receive?
A: Yes, under ORC §4123.57, you may be entitled
to receive Permanent Partial Disability (PPD) compensation. If the injury
occurred before June 30, 2006 and 40 weeks have passed from the later of the
date of injury or the date of last payment of temporary total or wage loss
compensation (or if the injury occurred on or after June 30, 2006 and 26 weeks
have passed), the injured worker may pursue a permanent partial disability
(“permanent partial”) award. This award is intended to compensate the injured
worker for an impairment of earning capacity due to the industrial injury. Once
the application for permanent partial disability is filed with the Bureau of
Workers’ Compensation, the customer service specialist schedules the injured
worker for a medical examination with a physician of the BWC’s choice. The BWC
physician then issues a report as to the injured worker’s whole person
impairment using the American Medical Association’s (“AMA”) Guides to the
Evaluation of Permanent Impairment, Fifth Edition. The BWC thereafter issues a
Tentative Order, to which the parties may file written objections. If objections
are filed, additional medical evidence must be obtained, as the Industrial
Commission of Ohio will schedule and hold a hearing to determine whether the
additional medical evidence warrants an increase or decrease from the BWC’s
Order. An additional appeal is permitted from the Industrial Commission’s Order.
Top of Page
Q: If my employer is based in Michigan and I was injured while working in
Ohio, can I recover workers' compensation benefits in Ohio?
A: Yes.
Top of
Page
Q: If I am injured in a state other than Ohio but my employer is based
in Ohio, can I recover workers' compensation benefits in Ohio?
A: Yes. If your employment is principally localized in Ohio you are
entitled to benefits even though your injury occurred out of state.
Also, if your employment is not principally localized in any one state and you
were hired in Ohio, you are entitled to workers' compensation benefits
in Ohio even though your injury occurred in another state.
Top of
Page
Q: Can I receive workers' compensation benefits if my injury did not occur on
my employer's premises?
A: Yes. You are entitled to workers' compensation benefits as long as
your injury occurred while you were in the "course and scope of your employment"
even though you are not specifically on the employer's premises when the injury
occurs. For example, if you performing your job duties “on the road” at a
customers place of business when you sustain your injury, your employer could be
liable for your workers' compensation benefits.
Top of Page
Q: Can I recover workers' compensation benefits even if my work injury is my
own fault?
A: Yes. The law provides for workers' compensation benefits regardless
of fault, even if it was no ones fault but your own. You are entitled to
workers' compensation benefits as long as your injury occurred while in the
course of your employment.
Top of
Page
Q: Can I recover workers' compensation benefits if my work injury is caused by
a co-worker or a third party?
A: Yes. As long as your injury occurred in the course and scope of your
employment, you are entitled to medical benefits and to wage loss benefits if
you cannot work due to your injury. For example, if you suffer injuries as a
result of your co-worker not utilizing proper lifting techniques while you were
making a delivery. Also, if your injury was caused by a “third party” such as
another driver striking your car while you were making a delivery for your
employer, you may also be entitled to sue the other driver in addition to your
workers' compensation benefits. You should consult an attorney to receive all of
the benefits to which you are entitled.
Top of Page
Q: Can I sue my co-worker if he or she caused my injury?
A: No. Under Ohio Workers' Compensation law you are barred from suing a
co-worker who negligently caused your injuries. You also can not sue
your employer for your co-workers' negligence.
However, you may have a claim if your employer or a co-worker intentionally
injured you.
Top of Page
Q: I have been receiving workers' compensation benefits for an injury I
suffered at work last year. Although I can't return to my old job I think I can
perform another job that does not require me to do the heavy lifting required by
my pre-injury job. If I return to work, will that affect my weekly benefits?
A: Yes. If you return to work and are earning wages greater than or equal
to what you earned at the time you suffered your work injury, your
benefits will be suspended. You will still be entitled to receive medical
treatment for your injuries; however your workers' compensation check will stop.
If you return to work and are earning less than you earned at the time of your
injury, due to your restrictions, you are entitled to “working wage loss" benefits (WWL). WWL benefits are
equal to 2/3 of the difference between your current earnings and your pre-injury
average weekly wage and cannot exceed the maximum compensation rate for the year
of your injury.
Top of
Page
Q: Can I apply for and receive Social Security benefits if I am receiving
workers' compensation benefits?
A: You can receive both benefits simultaneously. However, Social Security
will be reduced by the amount you are receiving in workers' compensation,
although this offset only applies to the money you actually receive and not the
money you are paying to your workers' compensation attorney. You should consult
an attorney to determine if it is in your best interest to apply Social Security
benefits or wait until your workers' compensation claim is resolved.
Top of
Page
The above information is intended solely as an overview and was accurate
when written. lease keep in mind that the law can change and often does.
Therefore, you should always discuss the merits of your individual claim with an
attorney. Please call us at 800-362-1674 to discuss the specifics of your claim
with a law firm dedicated to protecting the rights of injured workers.
|
