Behind the Scenes Look at the Workers’ Comp Process

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Have you started to look into the workers comp claim process after your injury? In Ohio, workers’ comp is a form of employment insurance that is required by law. Workers’ comp reimburses an employee for any injuries they suffer while at work. Worker’s comp offers wage replacement and reimbursement for medical expenses. As a whole, workers’ comp intends to protect workers and minimize litigation against employers. 

Unfortunately, there are instances in which a workman’s compensation claim is denied. Agencies offering coverage to employers with workers’ comp are very strict with their rulings and may reject a workman’s compensation claim. This rejection holds especially true when injuries are present prior to any harm sustained at work. 

Let’s Begin.

What is the Workers Comp Claim Process? 

Workers’ comp identifies two primary requirements before disbursement. Employees must be a part of a business that has workers’ comp, and it must be clear that the harm sustained is work-related. Once these factors are proven, there should be no limitations during the workers’ comp claim process and in receiving workers’ comp. 

What is a workers’ compensation claim? Filing a workman’s compensation claim is not simple. A workman’s compensation claim is a report or declaration that indicates that an injury occurred while working, and you are seeking payment for these work-related damages. 

Your claim documents the incident and the damages, including your injuries, treatments, and work-related challenges such as being unable to perform your previous job. 

How Does the Workers Comp Claim Process Work?

The workers’ comp claim process is stringent. There are strict guidelines in filing a workman’s compensation claim, and there are deadlines to follow. 

The only exceptions to this ruling are conditions or sicknesses that result from exposure to chemicals in the workplace. These are known as occupational illnesses. For these types of injuries, a workman’s compensation claim must be filed within six months of the diagnosis. Otherwise, a workman’s compensation claim must be filed within a year of the sustained injuries. 

However, before filing, you must seek medical care, and your employer must be made aware of the injuries. Once they have recognized your injuries, the Ohio Bureau of Workers’ Compensation (BWC) must receive a First Report of an Injury, Occupational Disease, or Death (FROI) form. This record is typically completed as a part of the workers comp claim process by your employer and submitted directly to BWC. However, if not completed, you can complete it independently and send the workers’ comp claim on your own behalf. 

If you don’t want to risk delays or denial, the forms must be accurate. You must fill out the forms and supply the additional records for the workers’ comp claim. Failure to do so can lead to setbacks with the workers’ comp claim process. 

When Should You File into the Workers Comp Claim Process?

As iterated, injuries should be filed for a workman’s compensation claim within a year of its occurrence, minus the exclusion of other physical grievances. Nonetheless, you should present the workers’ comp claim promptly. Doing so will help to minimize any difficulties and ensure that you receive compensation as soon as possible. 

Failure to initiate the workers’ comp claim process on time can lead to a complete dismissal or reduction of your workers’ comp benefits. So, you need to be proactive by making your employer aware of the incident right away, submitting the necessary forms, and beginning the workers’ comp claim process without delay. 

What Does the Workers Comp Claim Process Look Like? 

There is a waiting period after the preliminary steps for a workers’ comp claim. After submission, it takes approximately 14 to 30 days before a decision is made during the workers comp claim process. 

If the workman’s compensation claim is denied, it is generally due to a lack of information. Or, as mentioned previously, due to late filing. Other reasons for denial of a workman’s compensation claim can include: 

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  • There are inconsistencies between the accident report and the injuries reported. 
  • You have pre-existing injuries.
  • The injury is not work-related. 
  • You sustained a non-major injury.
  • You did not seek medical treatment.
  • The suggested doctor was not used as instructed.

You will receive a comprehensive explanation with your denied workman’s compensation claim. So, applicants can be aware of the issues that led to the refusal of their workers’ comp claim. The process for an appeal, as well as its limitations, is also stated in the letter. For a workers’ comp appeal and to help with the workers comp claim process, you should seek the counsel of a qualified personal injury or workers’ comp lawyer. 

What Doesn’t Workers’ Comp Cover?

For the most part, workers’ comp covers various work-related injuries. However, there are instances in which physical damages occurring at work are overlooked during the workers comp claim process. For example, those with injuries resulting from misconduct, inebriation, or unauthorized use of drugs are likely to have their application for workers’ comp denied. 

Further examples of things not covered by workers’ comp include: 

  • Harms caused due to misconduct or wrongdoing (e.g., initiating a physical altercation) 
  • Injuries sustained while not at work 
  • Physical damages due to violation of company policy 
  • Injuries stemming from breaking the law 

If your physical grievances are similar to the situations listed, your workers comp claim process will not be successful. Instead, you will have to consider dealing with treatments and alternative measures independently. 

However, if you’ve been injured at work through no fault of your own, you have a case for workers’ comp. Even if you have pre-existing conditions or other complications to your claim, an experienced workers’ compensation lawyer can help you build a better case to get approved. 


Quick Answers

What is the Workers Comp Claim Process?

Your claim documents the incident and the damages, including your injuries, treatments, and work-related challenges such as being unable to perform your previous job. 

What Doesn’t Workers’ Comp Cover?

– Harms caused due to misconduct or wrongdoing (e.g., initiating a physical altercation) 
– Injuries sustained while not at work 
– Physical damages due to violation of company policy 
– Injuries stemming from breaking the law 


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