Steps to Take After a Workers’ Comp Claim is Denied

Post by: Eric Jones | Posted Date: March 23rd, 2016 |


Appeal. Quickly, and with the assistance of an experienced Jones Law Group Ohio work injury lawyer.

Do not be shocked, feel discouraged, or give up on your claim. You applied for Ohio workers’ compensation because you needed the replacement wages and medical treatment. You have rights to challenge a denial. Exercise your rights to achieve the financial security you require.

This directly answers the question “What should I do after a workers’ comp claim is denied?” Explaining the appeals process and preparing you for what to expect takes a little more effort.

First, Ohio Bureau of Workers’ Compensation (BWC) denies many first-time claims. The agency’s annual report for the 2015 fiscal year indicates that about one-tenth of first-time applicants had their claims for workplace injuries, on-the-job deaths and occupational illnesses disallowed or dismissed. During that same year, though, OWC had nearly 800,00 claims under consideration for either the initial 60-day review period or in some stage of appeal.

BWC operates a three-tier appeals process. The first time an applicant is denied benefits, he or she can appeal to the office in their workers’ comp district. This must be done within 14 days of receiving the notification of BWC’s negative decision. The appeal must be filed in writing and state the grounds for appealing. Reason one to appeal with the help of a knowledgeable Ohio workers’ comp attorney is because your legal advocate will be able to interpret the agency’s reason for denying your claim and then be able to present evidence for why that decision was incorrect or unjust.

Should a district-level appeal also result in a workers’ compensation denial, you can appeal to agency staff. Each level of appeal will likely require you to present additional medical evidence, more proof that your injury or illness happened at work, and supporting testimony from experts who know that you were unable to work for some period due to a work-related injury or health problem. This is the second major reason to seek help from a dedicated Ohio work injury lawyer. Appeals can stretch out over years and require you to repeatedly rebuild your case.

If the BWC staff denies a workers’ comp claim, the case can be appealed to the Ohio Industrial Commission, or IC. While IC decisions are “final”—with refusals to hear appeals counting as affirmations of staff denials—injured and sick workers can also pursue workers’ compensation claims in state civil courts.

The attorney you hire to file and advise you on your workers’ comp appeal can also speak for you during hearings before BWC staff, the IC and a judge and jury. These services can be essential because applicants are rarely asked to testify on their own behalf while their claims are moving up the levels of appeal.

If you have received notice of an Ohio workers’ compensation benefits denial, contact Jones Law Group online or call us at (614) 545-9998 as soon as possible. With a two-week deadline to appeal, you cannot waste time. We can answer your immediate questions at no charge, and we may be able to help you contest the denial.



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