Getting injured and needing medical attention can be a scary thing. It can be even scarier if it happens in your workplace. While this is not a relatively common event, when it does, it can lead to a lot of uncertainty as to what will happen next.
Joe Hahn, Self-Employed Contractor and Workers’ Compensation Lawyer at Elk & Elk; David Steiger owner and managing partner of Karp Steiger in Woodmere; and Ben Wiborg, partner at Nurenberg, Paris, Heller & McCarthy in Cleveland, said there are some vital steps an employee should take after an injury on the job.
Often, employers will require an injured worker to complete an incident report, Wiborg said.
But if that’s not an option, communicate in writing as soon as possible that an injury has occurred or an incident has occurred, he said.
“There is no law in Ohio requiring this, but many employers require it according to their handbook,” he said. “And a good way to lose favor with the employer is to fail to comply with the recommendations in the employee-employer manual.”
Hahn said an early pitfall of work-related injuries didn’t signal it at all. Maybe it’s because most people brush their teeth and think they’ll be fine. But often there will be no witnesses to what happened, he added, and if something becomes much worse than on the first day of the injury, it becomes extremely difficult to get the claim accepted. at a later date.
Another mistake Hahn cites is when injured workers will think they are doing the right thing by not giving an accurate description of what happened in order to protect their employer.
“These claims are extremely difficult to make because a worker injured early on is nervous and thinks his employer will be angry with him,” Hahn said. “And then we have to attend a hearing later and find out the real story. And employers, more often than not, will deny this claim. “
Including, but not limited to, these reasons are why Steiger said claims are often denied by the self-insured employer or the Ohio Bureau of Workers’ Compensation. This is where a lawyer would step in and help injured workers throughout the appeal process, he said.
“Sometimes claims are denied because the description of what the employer thinks happened is different from what is in the medical records,” Steiger said. “Sometimes claims are denied because the incident may not be an incident that occurred within the scope and scope of the injured worker’s job.”
The entity known as the Ohio Industrial Commission is the adjudicative arm for workers’ compensation decisions. So when a party disagrees with a decision of the Ohio Bureau of Workers’ Compensation and files an appeal, that appeal is heard by the Ohio Industrial Commission, which is essentially the litigation judge in matters of compensation for industrial accidents.
“So my job is to help the injured worker get a positive result in these industry commission hearings,” Steiger said. “The way we do this is to make sure that we have sufficient medical evidence and that we are aware of any legal issues that may arise regarding the dispute that is being considered by the industrial commission. And we must be prepared to plead both the medical and legal aspects of our client’s case before the industrial commission.
So what happens when an employee wins a claim? Wiborg said the workers’ compensation system covers two main elements, the first of which is medical costs. Any treatment for a workplace injury should be covered by the workers’ compensation system and not by medicare, he said. Moreover, he said, the treatment is good indefinitely, as long as it is considered reasonable and necessary. These treatments may include the initial emergency room visit, subsequent consultation, diagnostic tests such as x-rays, MRIs and CT scans, physiotherapy, injections, and surgery. One thing to note, Wiborg said, would be that this must be done with prior authorization, unless it is an emergency.
The other element of a claim is the element of financial compensation. If someone cannot work because of an accident at work, that person is eligible for temporary total disability benefits, or “working allowances.” And these benefits are intended to replace lost income resulting from the inability to work due to injury. These benefits would continue until the injured worker can return to work or their condition has plateaued. After that, the checks would stop, but that’s not the end of the investigation, Wiborg said.
Injured workers who are able to return to work would later be eligible for permanent partial disability compensation. This is a one-time benefit intended to compensate an injured worker for limitations they have due to an authorized condition.
“For example, if someone tears an ACL and it is surgically repaired, that person can go back to work, but the knee may never be the same again,” Wiborg said.
The system created a Permanent Partial Disability Award to provide some type of compensation for this injury, and it’s as close as the system gets close to pain and suffering, but it’s not technically that. , he added.
Wiborg said that if someone is injured and cannot return to work in any capacity, a lawyer could apply for permanent total disability benefits, which are a control for the rest of the injured worker’s life. ‘it can show that the injury renders the injured worker incapable of any sustained employment.
Hahn said employees should always provide an accurate and detailed medical history to a caregiver. Sometimes people don’t give out pre-existing issues and they don’t indicate that they have ever had some kind of injury.
“You can get a compensation claim for the substantial worsening of a pre-existing injury,” Hahn said. “For example, a back problem or a tear in the meniscus. Something that hasn’t bothered you for a while and then that’s hurt. And your employer will often go back and find something in the past that would prevent a new claim.