Workers Comp.

What is workers’ compensation?

If you are unable to work because of a job injury or a work-related illness, the Workers’ Compensation Act in Ohio provides for your medical expenses and wage-loss compensation benefits until you’re able to go back to work.

The Ohio Bureau of Worker’s Compensation has the charge of administrating all Ohio worker’s compensation claims and paying out on approved claims. The BWC has set out standards for serving its customers – injured Ohio workers and their employers – in the Pledge of Service. The Pledge of Service outlines an injured Ohio worker’s rights, including:

  1. The right to worker’s compensation benefits after a workplace injury or diagnosis of an occupational disease;
  2. The right to choose a BWC-certified health care provider and access to treatment promptly after the injury;
  3. The right to the BWC’s payment of approved medical bills;
  4. The right to customer service by BWC employees that is “prompt, professional and courteous”;
  5. The right to online or in-person access to personal records;
  6. The right to prompt payment for approved claims;
  7. The right to consideration for all benefits that the injured worker is eligible for;
  8. The right to an independent medical examination, when needed;
  9. The right to appeal an adverse decision;
  10. The right to hire an attorney and the right to self-representation.

Common Questions Asked about Workers Compensation

My employer is making me go to a company doctor. Do I have the right to choose the doctor who will treat my new injury?

Answer: The laws says that the selection of a doctor is the patient’s choice. This include doctors of chiropractic. You are not required to see a doctor your employer (authorizes i.e. “company doctor”) makes you go to. You can however see any chiropractic physician or medical physician certified by the Ohio Bureau of Workers’ Compensation (BWC). (Note: There is one exception to this rule: If you work for an employer who is self-insured under the QHP program, you are required to see their doctor for your initial visit only. After that, you may select any BWC certified medical doctor or chiropractic physician.)

I injured myself at work. What should I do?

Answer: You should immediately report the injury to your supervisor, and should ask to complete a written incident report. Be sure to obtain a copy of this report for yourself. Note the names of any witnesses. Then seek medical attention from a chiropractic physician of your choice (See Question #4) as early as possible. When you do so, provide a detailed description of your job and the manner in which you were injured.

Should I file a workers’ compensation claim? Why can’t I bill my private insurance?

Answer: Yes, you should file a workers’ compensation claim. Your private insurance will not cover injuries that appear to be work related. If you change jobs, your insurance is likely to change. A new insurance carrier may not cover problems that appear to be pre-existing. A workers’ compensation claim will remain open, however, even if you change jobs.

How do I file a claim?

Answer: You should obtain a First Report of Injury (FROI) form from your employer, your chiropractor or from the Ohio Bureau of Workers’ Compensation (BWC). Fill out the sections titled “Injured Worker Info” and “Injury/Disease/Death Info.” Ask your chiropractor to complete the “Treatment Info” section. Provide your employer with a copy of this form. In Ohio, you must file a claim within two years of your date of Injury.

It is the injured worker’s responsibility to provide the BWC with sufficient information to approve your claim. Failure to do so will result in a denial of your claim. You should be prepared to provide all of your medical records and a statement from your chiropractic physician stating the history of your injury, your diagnosis, a treatment plan, and most importantly, whether your chiropractic physician feels that your injuries are related to your employment.

Do not make the mistake of believing that your claims manager, the hearing officer, or your employer’s attorney will try to protect your rights. If you have questions about your rights, you should seek the advice of an attorney who is familiar with the worker’s compensation system. Generally, workers’ compensation attorneys offer a free initial consultation and will not charge you an attorney fee unless you receive an award under your claim.

My employer told me that I have to go to “their” doctor. Is this true? Can’t I see a chiropractor of my choice?

Answer: Do not allow your employer to mislead you. In Ohio, you have the right to seek treatment from any Ohio Bureau of Workers’ Compensation (BWC) certified medical doctor or the chiropractor of your choice (Note: exception for self-insured employer under the QHP program, previously discussed). There are limits, however, on what types of treatment you can receive. Your workers’ compensation claim is like having medical and disability insurance only for the conditions allowed in your BWC claim.

If your chiropractic physician diagnoses a condition or problem that is not included in your claim allowance, this a major issue that must be addressed by filing a motion. Further, your workers’ compensation claim will be medically managed by an MCO, who may seek to contain costs in your claim by limiting treatment. An attorney who is familiar with workers’ compensation will understand these medical and legal issues and can assist you in getting your treatment authorized and your bills paid.

How do I find an attorney who is familiar with the workers’ compensation system?

Answer: We can refer you to several attorneys in the area that specialize in Workers’ Compensation Claims and who have assisted our patients in the past.

For detailed information about your Ohio Workers Compensation Claim
you can Click here: www.ohiobwc.com

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