The workers’ compensation claim process can be burdensome and confusing, but having a disputed claim can add even more stress. Under workers’ compensation law in Cincinnati, common reasons employers dispute a claim include: no actual injury, an injury that did not occur at work, unnecessary medical treatment, or an injury that did not require time off work.
If this has happened to you, do not panic or try to fight this decision alone. You can work with a Cincinnati-based workplace accident lawyer who understands the nuances of workers’ compensation and will advocate for you if your claim is disputed or denied.
Can a Work Injury Lawyer Increase My Settlement Award?
Yes, an experienced work accident law firm can usually help you secure a much larger settlement than if you handled the claim process on your own. An attorney knows what evidence and documentation you need to maximize your injury award. Many workers receive an unfair offer not because they aren’t eligible for a large settlement, but because they fail to provide adequate documentation. They may also not seek the appropriate medical treatment and diagnoses that insurance companies need to take their claims seriously.
What to Do If Your Claim Is Denied
If your workers’ comp claim has been denied, contact the Ohio Bureau of Workers’ Compensation (BWC) or your employer’s workers’ compensation administrator to learn the reason for the denial and the deadline to file an appeal. Next, hire a workers’ comp lawyer to prepare your case. If you need to take the issue to court, contact Clements, Taylor, Butkovich & Cohen, LPA, Co. for a free consultation with a workers’ compensation attorney.
The reality is that a substantial percentage of initial workers’ comp claim filings are rejected. Given the limited budget of the workers’ compensation funding pool, the BWC can fund only a certain percentage of claims. Furthermore, the BWC personnel reviewing claim applications are notoriously detail-oriented. Even the slightest error or missing form can cause an entire claim to be thrown out.
The good news is that many claims the BWC initially rejects are ultimately awarded on appeal. Therefore, do not lose hope if your claim was not approved right away. With the help of a skilled attorney familiar with the details of workers’ comp benefit funding, you can submit an appeal that has a better chance of passing the BWC’s scrutiny.
Was Your Workers’ Comp Claim Denied? Let Us Help.
If your workers’ compensation claim has been denied or disputed, you are not alone. However, the biggest mistake you can make at this point is to simply accept the initial ruling, pay the hefty medical bills, and try to recover from lost wages. Instead, get a Cincinnati workers’ comp lawyer on your side to defend your claim.
Remember that certain injuries fall into categories that are generally not covered by Ohio workers’ compensation law. Here is a list and brief summary of each:
- Psychiatric conditions. A mental health concern is covered by workers’ comp when it arises from a sexual assault at work. In all other circumstances, a mental health problem is covered only if it’s caused by a separate, covered injury.
- Natural deterioration. The law excludes coverage of “injury or disability caused primarily by the natural deterioration of tissue, an organ, or part of the body.” This is why workers’ compensation is not insurance against aging, an example of natural deterioration. In some cases, determining coverage may require a thorough medical examination and analysis to determine whether a condition is the result of natural deterioration or a workplace-related cause.
- Pre-existing conditions. Only injuries sustained at work are covered. Workers’ comp is not insurance for injuries that existed before the employee arrived at work. However, if a workplace injury substantially aggravates a pre-existing condition, the injury may be covered. To prevent anyone from taking unfair advantage of this rule, the law requires that the substantial aggravation “must be documented by objective diagnostic findings, objective clinical findings, or objective test results.”
- Company team building, organized games, etc. Many employers encourage employees to participate in company-sponsored recreational and fitness activities and require them to sign a waiver. As stated in the waiver, any injuries sustained during the activity will not be covered by workers’ comp.
Cincinnati Workers’ Comp Attorneys Advocating for Your Rights
Workers’ comp laws were established to protect workers. At Clements, Taylor, Butkovich & Cohen, LPA, Co., we understand your legal rights, and we will fight for them. Our workers’ comp attorneys have been recognized by U.S. News & World Report as among the Best Lawyers® in Cincinnati. This recognition is evidence of our extensive knowledge of workers’ compensation and our experience in helping injured workers obtain the compensation they need.
Your attorney will be your primary point of contact and guide you through every stage of the legal process, including appeals of denied claims. Most of our personal injury work is handled on a contingency basis, so we only win when you do. We have decades of experience and have secured substantial awards for our clients. After reviewing our testimonials page, contact us today to schedule your initial consultation.