You were injured on the job. The Bureau of Workers’ Compensation or the Self-Insured Employer has acknowledged your injuries. So, what does that mean exactly?
Logically, one would think it means you can get the treatment you need, that it would be covered, and that you would be compensated accordingly for your injuries. Makes sense, doesn’t it?
But, having an established claim does not guarantee treatment or compensation without a fight. In fact, all it means is that your injuries have been acknowledged as having occurred on the job. It does not guarantee treatment or compensation for your injuries. For every treatment request, for every condition requested, for every request of compensation, the Bureau of Workers’ Compensation, the Managed Care Organization and/or the Self-Insured Employer have the ability to make an initial decision. In a state funded claim, the Bureau of Workers’ Compensation will make the initial decision on the claim. Once the claim is established, the Managed Care Organization will make the initial determination on any treatment requests that are submitted. The Bureau will address compensation and any additional conditions that are diagnosed. In self-insured claims, it is the self-insured employer that addresses all requests. While it certainly does not make sense, there are times where injured workers will find themselves with an established workers’ compensation claim and yet still not able to get the treatment or compensation they are rightfully entitled to and desperately need.
There is good news, however. While the Bureau, the MCO and the Self-Insured Employers have the initial decision making ability, none of them have the final say. You have the right to appeal a denial and request a hearing before the Industrial Commission of Ohio.
To say that maneuvering through the workers’ compensation system in Ohio is difficult is an understatement. That is why we are here to help. If you have been injured on the job, do not hesitate to contact the attorneys at Gallon, Takacs, Boissoneault & Schaffer Co., L.P.A. We will fight for you to get the benefits you deserve.