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After You Meet the Criteria for Claim Allowance in Ohio Workers' Comp

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You were hurt on the job. You filed a claim for Ohio workers’ compensation benefits.

And your claim was allowed by the Ohio Bureau of Workers’ Compensation (BWC) or your employer. That’s good. It means the workers’ compensation system has started your claim for an injury that disrupted your life.

But it may not be the end of your effort to get financial assistance to maintain your livelihood.

Workers’ compensation in Ohio has multiple types of benefits. Receiving a claim allowance doesn’t mean you’ll get all the benefits, or enough of them, or the full amount you truly deserve.

An experienced workers’ compensation lawyer can step in and fight for your rights in the workers’ compensation process.

On this page, the Ohio work injury lawyers at Horenstein, Nicholson & Blumenthal (HNB) lay out what happens next after a claim allowance.

And for legal guidance on your individual situation, you can call and talk to us directly.

Horenstein, Nicholson & Blumenthal has secured over $500,000,000.00 in benefits, awards and settlements for our injury clients over the years. We help workers in any occupation who were hurt at workin Cincinnati, Cleveland, Columbus, Dayton and all over Ohio.

“Helping me, that’s HNB.”

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    Qualifications for Getting an Ohio Workers’ Compensation Claim Allowed: How Is It Decided?

    After you experience a life-altering workplace injury, you or your employer file an Ohio workers’ compensation First Report of Injury (FROI-1) form. Filing the FROI-1 form starts the application process for an Ohio BWC claim.

    This is the main criteria for a claim allowance:

    • Your injury must have occurred within the course and scope of employment and your injury must have arisen from your employment.

    Workers’ compensation cases don’t require proving anyone was at fault in your accident on the job. They’re supposed to provide support when you’re hurt at work, and that’s it. But you can be denied if claims examiners decide your injury didn’t really happen on the job.

    This seems like it should be simple, but numerous Ohio state laws, administrative rules and past trial court, appellate court and Ohio Supreme Court decisions on workers’ compensation cases affect how the Ohio BWC and the Ohio Industrial Commission that hears appeals determine whether your injury can be compensated under Ohio law.

    Here are the steps in the claim denial vs. claim allowance process:

    • The Bureau of Workers’ Compensation (BWC) decides whether to deny your work injury claim or issue a claim allowance.
    • If you’re denied, you appeal your claim to the Ohio Industrial Commission, which has the power to allow or deny your claim.

    But getting your claim allowed is just the beginning. Now decisions must be made about what type of benefits you will receive and how much.

    This is a particularly important time to get a work injury lawyer to look at your case. You deserve the maximum possible benefits, but the state workers’ compensation system— or your employer itself if it is self-insured—may be more focused on saving themselves money.

    It costs nothing for you talk to a workers’ compensation attorney from HNB and learn how to protect your rights.

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    What Benefits Are Decided in the Workers’ Compensation Process after Your Claim Allowance?

    These are perhaps the most important benefits to be decided once you’ve met the criteria for claim allowance:

    • Medical Benefits: All the medical care you need because of your accident and injury at work should be covered by your workers’ compensation claim.
    • Wage Replacement: If you miss work because of your injury, you should receive payment for a portion of your lost wages through Temporary Total Disability Compensation (TTDC.) You should also receive payment of working wage loss (WWL) compensation if you can return to work but your injury leaves you unable to earn as much as before.

    But even after your claim is allowed, the Ohio Bureau of Workers’ Compensation or your employer could deny your request for medical treatment, TTD or WWL.

    They may say you don’t need certain treatments, or didn’t have to miss work.

    First you contest these decisions with your employer or the Ohio BWC. If that doesn’t provide the result you need, you appeal the decision to the Ohio Industrial Commission and go to district level or staff level hearings there.

    While it’s not exactly like going into a courtroom, the Ohio Industrial Commission hearing process is a highly legalistic process with legally binding ramifications on your BWC claim.

    For your appeal of a workers’ compensation benefits denial and your Industrial Commission hearing, you’ll want a skilled Ohio workers’ compensation lawyer by your side.

    Your lawyer explains your rights to you, gathers evidence to support your claim, highlights the laws that should get your claim allowed, and makes arguments on your behalf before the Industrial Commission.

    Don’t hesitate to pursue the fullest workers’ compensation benefits you can get, because after a major setback from a job injury, these benefits are crucial to stabilizing your situation and securing your future.

    Call HNB Now