If you have been injured in the job, you likely have questions about the processes you are about to undertake. Filing a work injury claim is comparatively straightforward. But what happens after you file your claim? What if the state denies your claim? What is the next step?
After filing a work injury claim in Ohio, the Ohio Bureau of Worker’s Compensation (BWC) is required to make its decision to allow or deny the claim within 28 days. This is done through written notification known as the BWC order. If your claim is denied, you may appeal the decision by filing a claim with the Industrial Commission of Ohio within two weeks of the BWC Order. The commission will then schedule a District Level Hearing to be held within 45 days of your initial appeal request.
As you can see, these processes move quickly. 28 + 14 + 45 = 87 days total, from your initial claim filing until the District Level Hearing regarding your appeal. The timing is crucial. Not a day can be wasted. You need to dot every “i” and cross every “t.” The details of the case presentation cannot be stressed enough. It is easy for the Ohio BWC to deny a claim, and of course they would prefer to save money by not paying a denied claim. Do not give them any reason to make your claim even slightly questionable, or they will jump at the case. You need to make your claim airtight and waterproof. A qualified Worker’s Comp lawyer can guide you through the process, and can inspect your cases for holes — and if there are not holes, this lawyer can help you predict where the BWC will try to push air through it anyhow.
Preparing for the District Level Hearing
The District Level Hearing will be presided over by the Officer of the Commission, who reviews any written witness affidavits, and deposition transcripts submitted by your worker’s compensation attorney and your employer’s legal counsel prior to the hearing. You should be prepared to testify and present witnesses on your behalf such as your doctor and any co-workers that witnessed the incident. Preparing for your testimony is something an attorney can assist you with.
No later than 45 days after the District Level Hearing, the Commission will conduct another hearing, where he or she reviews the evidence with both parties and their workmen’s comp attorneys, and issue a written decision that will be sent to both parties.
Having this evidence presented in such a way that it will convince the BWC — and, if needed, the Officer of the Commission — calls for some professional assistance. Being able to call and question witnesses, including people who saw the original injury occur as well as the health care professionals who dealt with the recovery, is something a workers’ comp attorney can do smoothly and clearly.
Your attorney will know what language to avoid. He or she will also know the ways in which the BWC can mark a claim invalid. There are certain red flags that testimonies or evidence can raise, and you want to either avoid those red flags or be prepared to counter them proactively, rather than react to the BWC’s claim rejection. If you can predict what issues the BWC may have with your claim, then you are one step ahead of them.
A free consultation with the workers’ comp experts at Clements, Taylor, Butkovich & Cohen can address any questions you may have about the process, or about the specifics of your injury and your claim. Knowing your rights, and knowing precisely what you need to prove to win over the BWC, is not always easy in these situations. The friendly advice of a legal professional can save you a great deal of time and effort.
What Happens if the District-Level Appeal is Denied?
In the unfortunate situation that your worker’s comp appeal got denied at the district level, you can submit an appeal at the staff level. Keep in mind that your employer can also appeal the decision to staff level. Another hearing will be held within 45 days and the decision will be made by a staff hearing officer. Staff decisions can also be appealed to the commission level. Further appeals must be brought before Ohio state courts. Because appealing is a legal process, you should consider hiring an attorney to guide you through the process.
If you plan to appeal a workmens comp claim, contact the Cincinnati law firm of Clements, Taylor, Butkovich & Cohen, L.P.A., Co. for a free consultation.