Though you cannot sue your employer for a work related injury, your workers’ comp claim can end up in court. Under the Ohio Revised Code, an injured worker or an employer can appeal a final decision of the Industrial Commission to common pleas court in limited circumstances. If a medical condition is denied under a claim by the Industrial Commission, the injured worker has the right to file an appeal to the common pleas court and ask for a jury trial. An employer, likewise, can appeal if a medical condition is allowed under a claim filed against it.
Regardless of who appeals, the injured worker must meet the burden of proof by presenting evidence to the jury establishing the circumstances of the injury and his or her medical condition. The injured worker testifies to the jury about the facts of the injury, about his or her job duties, and usually about his or her treatment after the injury. The court requires that a medical expert testify about the diagnosis of the condition and the causal relationship between the injury and the condition. Typically, that medical expert is the injured worker’s treating doctor. The employer can also present testimony from coworkers or human resource managers, as well as from doctors of its choosing. The employer’s doctor is typically a doctor who only did a one time evaluation of the injured worker and who is paid by the employer to do it.
In addition to hearing the testimony from the individuals involved, the jury has the opportunity to review records such as accident reports and medical records. The jury must then decide, based upon the evidence presented, whether the medical condition was caused by the injury. The jury considers the credibility of the injured worker, of the doctors and of any witnesses. The jury at a workers’ comp trial is the same as in any civil proceeding: a collection of individuals chosen from the community to serve as jurors. Those jurors bring their own beliefs, experiences and attitudes to the decision making process. When an injured worker takes a case to court, they put the final decision in the hands of that jury.
Unlike other civil cases, the jury in a workers’ compensation trial does not have the power to award benefits or pay medical bills (damages in a personal injury lawsuit). The jury only decides whether the claim should be allowed for a specific medical condition or not. If the jury approves a condition, the injured worker must return to the administrative process at the Bureau of Workers’ Compensation and Industrial Commission to request and receive disability pay or medical treatment for the condition.
The courts generally set a trial date out about one year from when a workers’ compensation case is filed into court. It is a long wait. And it can be very expensive. Trial costs for a routine workers’ compensation case can range from $5000 to $10,000 depending on court costs and the costs of deposing doctors and other witnesses. Nowhere in this system is the financial imbalance between an injured worker and an employer more obvious and more unfair than in court.
For these reasons, most court cases settle. Sometimes, employers use the strategy of a court appeal to force settlement on claims because they know it is difficult to impossible for an injured worker to wait the year for trial and to come up with the money necessary to go forward.
Many times, though, a settlement is in the best interests of both the injured worker and the employee. Settlement amounts vary depending on the type of injury and the type and amounts of benefits available. No two cases are alike, so each case must be assessed individually. The credibility of witnesses and the strength of the medical evidence also figure into the valuation of a case.
This lesser known step in the process can be time consuming and cost prohibitive in some cases, but in others it allows us an extra opportunity to get injured workers some of the compensation to which we believe they are entitled. It is important to know that this option is available to you, and to have experienced lawyers that can properly advise on your rights in court.