THE MONTHLY HMMM...Does Ohio Workers’ Comp Cover Long-Term Problems and Illnesses?
In contrast to most other states, private insurance companies do not provide workers’ compensation benefits in Ohio. Instead, injured workers who suffer from long-term illnesses and other problems which arose from their work must apply to the Bureau of Workers’ Compensation for workers’ compensation. Even though private insurers do not handle these claims, it does not mean that benefits are always easy to obtain.
If you face any difficulties with your workers’ compensation claim, our attorneys at Heller, Maas, Moro & Magill Co., LPA, can deliver the care and knowledge you need while, at the same time, understanding and supporting all aspects of your injury. Our goal is to get you back to work on your own terms and secure the benefits you deserve. When you have been injured at work, do not file a claim on your own. Instead, contact us today for a free consultation about your case.
What Benefits Does Workers’ Compensation Provide?
It is natural to wonder what benefits you will receive if your workers’ compensation claim is approved. These benefits can cover certain medical expenses, and they can make up a portion of an injured worker’s wages. The benefits provided will depend on the nature and severity of the injury.
Workers’ compensation benefits can provide for any medical treatment that is deemed necessary and reasonable. In most cases, injured workers must see their employer to determine how to get medical treatment through workers’ compensation for their injuries.
If you have sustained a temporary total disability, you will undergo a medical exam to determine if you reached maximum medical improvement (MMI). MMI refers to the point in treatment when your condition or illness has been determined it will not get any better.
If your hands, arms, feet, legs, eyes or any combination of at least two of these body parts can no longer function, your injury is considered a permanent and total disability. When this is the case, you may receive workers’ compensation benefits at the rate of temporary total disability for the remainder of your life.
Sometimes, an injury is considered permanent but not total, meaning you still have some function in certain body parts. These benefits are calculated as either a scheduled loss, percentage loss or disfigurement. Scheduled losses include amputations or a loss of an eye or extremity. If you have suffered this type of injury, you will receive benefits for a certain number of weeks depending on the schedule for that body part.
A percentage loss is considered a permanent impairment that does not include the loss of a scheduled body part. In these cases, a doctor will assign a percentage for the permanent partial disability, which can be appealed if you think it is too low.
How Long Can You Receive Medical Benefits?
Generally speaking, you can receive medical benefits from workers’ compensation for the entire time you need them as long as the expenses are considered reasonable and necessary. Obtaining these benefits is not always simple.
When the Bureau of Workers’ Compensation approves your claim, your doctor or other healthcare provider will submit the medical invoice to the managed care organization (MCO). When the MCO receives the invoice, it will forward the bills to the Bureau. The Bureau will evaluate the expenses to determine if they are reasonable and necessary. If so, the Bureau will send the payment to the MCO, and the MCO will redirect it to the health care provider. But if not, appeals need to be filed. Also, there could be several hearings to help you obtain this necessary treatment.
How Long Can You Receive Disability Benefits?
Injured employees can receive benefits for a total temporary disability for the entire time they miss work or until a doctor states that they have reached maximum medical improvement. If you return to work, you will stop receiving benefits.
If you stop receiving benefits for a total temporary disability, you may still be eligible for permanent total disability benefits. These benefits can provide you with compensation for your lost earning capacity for the remainder of your life.
The length of time you will receive disability benefits for a scheduled loss depends on the injury as these time periods are included within the schedule. The maximum weekly payments for these injuries include:
- Eye: 125 weeks
- Total hearing loss: 125 weeks
- Foot: 150 weeks
- Hand: 175 weeks
- Leg: 200 weeks
- Arm: 225 weeks
If you suffer the loss of more than one body part according to the schedule, you may be able to receive benefits for longer than the schedule provides.
What Happens If You Have an Occupational Disease?
An occupational disease is any illness that is contracted through employment. Typically, it is caused by the tasks which a worker had to perform while on the job. Also, exposure to dust, gases, fumes, chemicals, toxic substances, radiation and physical vibrations could cause an occupational disease.
Keep in mind that mere exposure to toxic substances is not enough to qualify for workers’ compensation benefits. A person must contract an occupational disease due to that exposure. In other words, a connection to your employment must exist. The Bureau also has a schedule of these diseases that qualify for benefits. They include:
- Anthrax poisoning
- Lead poisoning
- Mercury poisoning
- Arsenic poisoning
- Illnesses from asbestos and benzene
- Skin ulcerations infections
Sometimes, certain conditions that are not on the schedule may also entitle you to workers’ compensation benefits. Some diseases that may qualify include certain cancers, chronic bronchitis and emphysema. The Bureau may also consider certain repetitive motion injuries such as carpal tunnel as an occupational disease.
Get Help from Our Ohio Workers’ Compensation Lawyers
When you get hurt at work, we understand it is more than just physical harm. Our team is here to ease your worries and fears, pursue the financial support you need during this difficult time and get you back to work on your own terms with the goal of securing all the benefits you need. If you have been injured, contact our Ohio workers’ compensation lawyers at Heller, Maas, Moro & Magill Co., LPA, today to schedule a free case evaluation. We will review your claim and explain the legal options available to you.