Ohio’s workers’ compensation system provides benefits to employees who are injured at work. This system is typically an injured worker’s only recourse for getting compensation from the employer. (To learn about the exceptions, see Workplace Injury: When You Can Sue Outside of Workers’ Compensation.) This article explains how to start a workers’ comp claim if you were injured at work.
All private employers in Ohio must have workers’ compensation coverage for their employees. In many other states, employers secure coverage through private insurance companies. However, in Ohio, employers are insured through the state (unless they meet the financial criteria to self-insure). The Ohio Bureau of Workers’ Compensation (BWC) reviews workers’ comp claims and pays benefits on accepted claims.
Workers’ compensation covers injuries that happen in the course of employment. Most injuries that occur at work, or while the employee is performing work-related tasks, are covered. For example, if you get hurt while walking through the company warehouse or while running a work errand off-site, your injury will likely be covered.
Because workers’ comp is a no-fault system, you can usually collect compensation regardless of who was at fault for the injury. However, certain injuries—such as those caused by the employee’s participation in horseplay or practical jokes—are typically not covered.
The first step to making a workers’ comp claim is to report your injury to your employer. There is no specific deadline for giving notice, but it is best to notify your employer as soon as possible. If you wait more than a day or two to report it, your employer or the BWC might question the legitimacy of your claim.
You should also get medical treatment right away. If you need emergency treatment, you can go to the nearest emergency room or urgent care. You can also see any doctor you wish for your first office visit.
Your workers’ compensation claim officially starts when a First Report of Injury is filed with the BWC. When you first get medical treatment for your injury, tell the doctor that your injury is work-related. The doctor should fill out the first report of injury form and file it with the BWC on your behalf. Your employer can also file it on your behalf.
Your workers’ comp claim must be filed within one year of your accident or injury. You should confirm that your doctor or employer filed the first report of injury for you. If neither has, you should file the form yourself. The BWC has an online portal where you can file your claim.
Once the BWC receives your claim, it will assign a claim number and send you an informational packet about your rights and responsibilities. The BWC will then evaluate your claim, usually by talking to you, your employer, and your doctors. You will receive a decision in the mail within 28 days of filing your claim. If your claim is accepted, you will begin to receive medical coverage and wage loss benefits.
Workers’ compensation should pay for all necessary medical treatment related to your work injury. This includes the cost of doctors’ visits, hospital stays, prescriptions, and medical equipment. Except for your initial treatment, all medical care must be provided by a doctor who is certified by the BWC. You can search for certified providers at the BWC’s provider look-up page.
If the BWC denies your claim, you can challenge its decision with the Industrial Commission of Ohio. (For common grounds for a denial, see Denied Workers’ Compensation Claims.) To do so, you must request a workers’ compensation hearing within 14 days of the BWC’s order denying benefits. At your hearing, a hearing officer will review evidence, listen to testimony, and make a decision in your case.
Most workers can handle the initial workers’ comp claim process on their own. If the BWC readily accepts your claim and pays your benefits, you probably will not need to hire a lawyer. However, if the BWC denies your claim or disputes the amount of benefits you are entitled to, you should consider hiring a lawyer. This is especially true if you need to attend a workers’ comp hearing, which follow complex procedural rules. For more information, see Should I Hire a Workers’ Comp Attorney or Can I Handle My Own Case?