In many states, if you are injured on the job, your employer is expected to arrange workers’ compensation benefits for you.
The Ohio workers’ compensation system is different. It is up to the injured or ill worker to apply for workers’ compensation benefits in Ohio. You can do this by:
- Applying for benefits online through the Ohio Bureau of Workers’ Compensation (BWC)
- Downloading forms from the BWC site and mailing them in after you have completed them
- Visiting a claims office for assistance
- Our office – we file many claims for our clients.
Information You Need to Apply for Workers’ Comp
The first thing you will need to access is the First Report of Injury, Occupational Disease or Death (FROI). This is the first form you submit to begin to apply for benefits.
The FROI requires:
- Injured Worker’s Name
- Injured Worker’s SSN
- Injured Worker’s Mailing Address
- Injured Worker’s Home or Work Phone Number
- Date of Birth
- Date of Injury/Disease
- Occupation or Job Title
- Description of Accident
- Type of Injury/Disease and Part(s) of Body Affected
- Employer Policy Number (available through BWC online)
Submitting these two forms registers your claim for benefits. In return, you will receive a claim card, which includes a claim number that serves as your claim ID. It should also provide contact information for the claims service specialist (CSS) assigned to your case.You must also complete and submit the Authorization to Release Medical Information.
You should soon hear from the CSS, who will request additional information from you, including medical records from each doctor, hospital or other care provider who treated your injury. Keep in mind that any medical provider who treats you and who you expect to provide information to support your workers’ comp claim must be registered as an Ohio BWC-certified provider.
The CSS will also want you to have completed at least three additional BWC forms (some cases require additional information):
- The Request for Temporary Total Compensation (Form C-84) if your injury has or will keep you out of work for more than seven calendar days.
- The Physician’s Report of Work Ability (MEDCO-14) or equivalent documentation that describes your physical capabilities and limitations, maximum medical improvement expected, vocational rehabilitation and the dates of disability being certified, including an anticipated or actual return-to-work date.
- The Employer Report of Employee Earnings for Wage Loss Compensation (C-142), which provides documentation from any of your employers for the 52 weeks prior to the date of your injury. Your employer(s) may complete this for you. If you complete the form yourself, it must be notarized. This information is used to set the full and average weekly wages in your claim to determine future benefit rates.
Decisions in a Workers’ Comp Claim
Once the CSS has the necessary information, he or she is to provide written notice of a decision to you within 28 days. This notice may tell you your claim has been:
- Allowed. Make sure you read the full explanation to make sure that what has been allowed is everything you believe you deserve. If it is not, you may appeal by completing the Notice of Appeal (IC-12) form or writing to your CSS with an explanation of your reason for appealing within 14 days of receiving the CSS’ decision. If some conditions are denied it is usually best to appeal the order.
- Denied. The notice should provide a specific reason for the denial. If the reason is improper or something you can correct (such as failure to provide certain information), you have 14 days to appeal. Appeal by completing the Notice of Appeal (IC-12) form or writing to your CSS to explain the reason for your appeal.
- Dismissed. If you withdraw your claim before receiving a decision, your CSS will confirm dismissal of your case in writing. If, for example, you withdrew your claim because you realized a form you submitted contained errors, you have two years from the date of your injury to refile. If your injury occurred after September 29, 2017, you have only one year to file.
If your claim has been allowed, you will be granted the “right to participate.” This means you may now request benefits. The Request for Temporary Total Compensation (Form C-84) is the instrument for obtaining benefits. You must complete this form every time you want to request temporary total disability compensation benefits, whether it’s for an initial period or the extension of an existing period.
Meanwhile, your treating physician should have submitted the Physician’s Report of Work Ability (MEDCO-14). You will not be eligible for temporary total disability benefits unless you were disabled for 14 or more consecutive days. Once you’ve missed 14 work days or more, you qualify to be compensated for the total number of days of work you miss.
Ohio Workers’ Compensation Temporary Total Compensation Benefits
In addition to reimbursing you for all medical costs related to your injury, workers’ compensation pays a portion of your wages while you are out of work.
Temporary total disability compensation consists of:
- Payments at the full weekly wage (FWW) rate — not your full wages — for the first 12 weeks after the date of injury. This rate is based on your earnings for the six weeks and/or seven days prior to the date of injury. An average of these earnings is calculated, and temporary total compensation is paid at 72 percent of this average.
- Payments at the average weekly wage (AWW) rate after you have missed 12 weeks of work. This rate is based on your earnings for the 52 weeks prior to the date of injury. An average of these earnings is calculated, and temporary total compensation is paid at 66 2/3 percent of this average.
- Workers’ Compensation benefits are NOT taxable income!
Need Help Applying for Ohio Workers’ Compensation Benefits?
If the process above sounds burdensome and complex to you, we agree. What’s worse is that, if you work your way through it successfully, you could still receive a workers’ compensation benefit that is less than you truly deserve. Our workers’ compensation lawyers see it all the time.
Additionally, the process above only describes a claim for a temporary injury. Workers who are permanently disabled or who have irregularities in their claim face not only a more complex benefits application system, but the very real likelihood that their employer will dispute their claim. After all, the cost of expensive workers’ compensation claims is eventually passed on to the employer through higher insurance premiums.
The workers’ compensation lawyers of Heller, Maas, Moro & Magill Co., LPA, help workers in Northeastern Ohio apply for workers’ compensation and demand all of the benefits they deserve.
We urge you to reach out for help and let us take the burden off you.