Workers’ Compensation Disability Explained by a Columbus Workers’ Compensation Attorney
Disability is one of the most important benefits provided by workers’ compensation. Unfortunately, determining what benefits you are entitled to isn’t easy. In addition, you will need to submit the correct forms and the necessary documentation in order to prove your claim, which can be overwhelming when you are sick or injured and concerned about keeping food on the table. If you need help, a Columbus workers’ compensation attorney at Malek & Malek Law Firm can help you apply for the benefits you need.
Disability Benefits Available Through Ohio Workers’ Compensation
There are four types of disability benefits available through workers’ compensation in Ohio:
- Working Wage Loss: These are benefits paid when you have suffered an injury that results when your injury eithers forces you to work less hours or a new job that pays less.s. For example, a welder may qualify for working wage loss if he cannot work as a welder but can work in the office or can only work on a part-time basis because of the physical limitations of the work injury. You must have some loss of income in order to qualify, and the onerous requirement for this type of compensation is that you must apply to approximately 15-20 jobs each week of the wage loss.
- Temporary Total Disability: These are benefits paid to you when you have suffered an injury that prevents you from working at all for a temporary period of time or have work restrictions but no corresponding light duty work. . For example, you would qualify for temporary total disability benefits if you cannot return to work or you have work restrictions but your employer cannot accommodate those work restrictions and you have not received a “written light-duty job offer.
- Permanent Partial Disability: A permanent partial disability award (ppd) or C92 award is a form of compensation you are entitled to for the allowed conditions in your claim. You or your attorney can file a C92 application about 26 weeks after the initial date of your work injury or 26 weeks after the last receipt of compensation, whichever is later. A PPD award recognizes the permanent residual impact of your allowed conditions. Imagine you are a character in a video game, prior to the work injury you have at 100%, after your work injury your health bar is now at 90%. You receive compensation for the 10% difference. This is not a settlement of your work injury claim.
- Permanent Total Disability: These are benefits paid when your injury or illness permanently prohibits you from returning to work in any capacity. You can receive social security disability and permanent total disability at the same time. (though comp received for one will offset the other)
Determining what category of benefits you qualify for is an important first step in the workers’ compensation process. You may eventually qualify for one or all forms of comp. There are other forms of compensation you may be entitled to beyond the forms mentioned above. You will need to submit your medical records that document your injury and it will need to be approved by the Ohio Bureau of Workers’ Compensation. If you are unsure what benefits you qualify for or how to make your claim, a Columbus workers’ compensation attorney at Malek Law Firm can help.
A Columbus Workers’ Compensation Lawyer Can Help You Apply
If you’ve been injured or became sick while on the job, the first thing you should do is report your injury or illness to your employer. This first step allows your employer to document your claim so they may file it on your behalf. If they do not, however, you should be prepared to file your own claim and consult with a Columbus workers’ compensation lawyer beforehand.
Claims can be filed with the Ohio Bureau of Workers’ Compensation (BWC) online, by mail, by fax. Once the initial paperwork has been received, you will receive an acknowledgment of your claim in the mail along with a BWC ID card. However, note that this acknowledgment does not mean that your claim has been approved – it only means that they have received it and opened a file.
The BWC will review your claim and make a determination. If your claim is denied, you have the right to appeal. You do not need a lawyer to file your claim, but a Columbus workers’ compensation lawyer can help you make sure your claim is approved. If your claim has been denied, you should speak with an attorney as soon as possible.
Who is Eligible for Workers Comp Benefits in Ohio?
There are three basic requirements to qualify for workers’ compensation benefits in Ohio:
- You are an employee;
- You have suffered an injury or occupational disease;
- Your injury or occupational disease was suffered in the course of your employment.
In order to qualify, you will need to prove all three requirements. The first element usually only comes up when there is a possibility an argument can be made that you are an independent contractor, rather than an employee. This is a common issue in work injuries suffered by folks working as roofers, dry wall framers, painters, landscapers, and truck drivers. These cases are very fact intensive.
To prove the second requirement, you will need to submit medical records that document your work injury and the diagnosis you will pursue through your claim. That is, if you injured your back, you will need the ER/Urgent Care/PCP records that document clinical findings related to your back and the specific condition the doctor is initially diagnosing.
The third element, proving that that your injury or occupational disease occurred while you were on the job can present its own set of challenges. In some cases it may be obvious because the injury was witnessed by your co-workers/employer and you sought medical treatment the same day as the injury. Other cases can be much more difficult because there is not a clear relationship how the injury relates to your work activity. For example if you had an unrelated injury to your knee in the months or weeks prior to twisting your knee at work, your employer will absolutely make the argument that your knee injury was due to the prior unrelated knee injury not an event at work.
Other difficult cases can include getting injured in a car accident away from the job site but traveling for work-related reasons. This is a tortured area of law involving something called the “going-and-coming rule”. Depending on any number of factors this rule may disqualify you from participating in the workers comp fund for your work injury.
Specific Disability Benefits Requirements
Once you have met the three requirements and you have an allowed claim, then you may be able to receive various forms of compensation.
- Working wage loss benefits is a form of compensation you may receive. You may be able to request working wage loss If you are unable to do your normal job or cannot work full time and are suffering a wage loss. The amount of benefits paid will be determined by the difference between your current wages and your pre-disability wages.
- Non-Working wage loss benefits is a form of compensation you may receive if you have been found to have reached “maximum medical improvement” (MMI), have work restrictions but still have not found gainful employment. The BWC requires that for every week of non-working wage loss you must submit documentation that you have applied to twenty different jobs each week.
- Temporary total disability benefits ( TTD ) are paid when you are unable to work at all, or you have work restrictions and your employer cannot accommodate those restrictions. Your BWC will certify your inability to work in a document called a Medco-14. Your benefits will be paid at a rate determined by dividing the income you made prior to your injury by fifity-two. The workers comp system does not pay you at 1:1 ratio, instead you’ll receive a percentage of your prior income based upon the wage rate.
- You will qualify for a Permanent partial disability award ( C92 Award ), twenty-six weeks after your last receipt of compensation or twenty-six weeks of the date of injury (if you had not received temporary total disability compensation, whichever is later. An independent medical examiner will determine the residual effects of your work injury and assign you a percentage. You will receive two weeks of compensation for every percentage you are assigned. This is not a settlement of your workers comp claim. Ohio BWC does compensate folks for their pain-and-suffering, but this type of compensation is analogous to a pain-and-suffering award.
- Permanent total disability benefits ( PTD )is a form of compensation where you are deemed incapable of returning to gainful remunerative employment. Each workers comp claim has a life cycle. If the initial injury is the birth of your workers compensation claim, then permanent total disability compensation or settlement can be seen as the end stage of your claim. In limited cases you may be found statutorily permanently and totally disabled at the outset of the claim. ( typically happens if the injured has lost multiple body parts or has become paralyzed). Otherwise the typical path to permanent total disability is that you suffered a work injury, have had surgery/whatever modalities are necessary to treat your injury, despite that surgery or treatment you still have significant issues. You have attempted to return to work either under your own volition, or vocational rehabilitation, and you have not been successful in this attempt.
- Loss of Use Award this is compensation you receive if you have actually lost a body part to amputation or for all intents and purposes the body is no longer function. Losing the function of an arm or hand is not an uncommon occurrence in the presence of CRPS or complex regional pain syndrome.
- Facial Disfigurement Award is a form of comp if you receive a significant disfigurement to your face due to your work injury.
- Living Maintenance is a benefit you receive if you participate in vocational rehabilitation. This is analogous to temporary total disability compensation, though it is not based off of your wage rate, but the living maintenance rate for the corresponding date of injury. Notice that it is a “benefit” and not compensation. First unlike most other forms of compensation, you will need to pay taxes on your living maintenance benefits. Second this form of compensation, because it is a benefit like unemployment, undocumented workers cannot receive it. Therefore by implication they cannot participate in vocational rehabilitation.
- VSSR Award (Violation of a Specific Safety Requirement) is a form of compensation granted where an employer is found to have violated a specific safety requirement. This is a form of compensation that is paid in addition to other forms of compensation you may receive. The employer is assessed a penalty up to 50%, all previously and future compensation is paid at the assessed percentage at the maximum rate of compensation for the year that the injury occurred. This can be a significant amount of money if you have and will receive compensation in your claim.A VSSR award is punitive, and taxed to your employer. Unlike, temporary total compensation or permanent total disability compensation which affect the employer’s premium, the employer pays this award directly.
Determining the benefits you may qualify for can be difficult and the process can be long and complicated. A Columbus workers’ compensation lawyer can help you successfully navigate the process so that you can get the benefits you need.
Contact a Columbus Workers’ Compensation Attorney at Malek Law Firm
At Malek Law Firm, we help injured workers get back on their feet. If you have questions about what benefits you are entitled to or simply don’t know what steps to take, we can help. We’re here to listen, advise and work with you to get you what you need to fully recover. To schedule a free consultation, call us at 888-444-7440 or contact us online to discuss your case with an experienced Columbus workers’ compensation lawyer today.