Nowhere is it more important that an injured worker have the right to submit their case to an impartial judge for determination rather than allowing the Bureau of Workers’ Compensation and/or your employer to make such determinations.
Under workers’ compensation law, you have the right to present any issue with regard to your workers’ compensation claim to a hearing officer assigned by the Industrial Commission of Ohio. The Industrial Commission of Ohio is an agency created by the state to make determinations in disputed Workers’ Compensation claims.
Under the law, where your employer has Workers’ Compensation insurance through the state, the Bureau will make an initial determination on the issue of the allowance of your claim, or any disputed issue that arises on your allowed claim. The Bureau determination is subject to your right to appeal. Please note that appeals from Bureau determinations are required to be filed within 14 days of the receipt of that determination. In most cases, if you do not appeal within those 14 days, the Bureau determination becomes a final decision, thus barring you from the opportunity to allow a hearing officer to make a determination on your claim. Consequently, it is absolutely essential that your appeal any order generated by the Bureau. It is also our strong recommendation that you seek our assistance to ensure that your issue is properly presented to a hearing officer.
Where your employer is self-insured, your employer, or employer’s representative, makes the issue determination on your case. Thus, your employer “stands in the shoes” of the Bureau of Workers’ Compensation in administering your claim. Your employer is required to abide by all the laws of the Bureau and Industrial Commission. One requirement for a self-insuring employer is to advise you when they are denying your claim, or denying a benefit in your existing claim. As in cases where your employer has insurance through the state, any and all determinations are subject to hearing before a hearing officer, where you have the opportunity to present all relevant evidence in support of your claim.
The first hearing on your case is determined by a District Hearing Officer. Such hearings are usually scheduled for 15 minutes, which give you limited time to present your case. You, as the injured worker, your employer, or employer representative, as well as the Bureau of Workers’ Compensation can present before the hearing officer. Typically, a decision is not announced at the conclusion of the hearing. Under law, the hearing is obligated to render a written decision, sent to all parties, within 7 days.
Any party can appeal the District Hearing Officer’s order. As with initial Bureau determinations, any appeal must be filed within 14 days of receipt of the order. If an appeal is not filed, the District Hearing Officer’s determination is final. Also with regard to Bureau orders, once the determination is final, typically you are forever barred from relitigating the issue.
Any timely appeal automatically allows a second hearing before a Staff Hearing Officer. At these hearings, the party that appealed the decision presents their case first. After the party that appealed the order presents their case, the other party presents their case. As with hearings before District Hearing Officers, the Staff Hearing Officer is required to issue their determination within 7 days.
Any party can appeal the Staff Hearing Officer’s order, requesting an additional hearing. However, the Industrial Commission determines whether an additional hearing is necessary. In most cases, the Industrial Commission refuses to hear the issue further. If the Industrial Commission refuses an additional hearing, an order is issue advising all parties that further hearing is refused.
Where the underlying issue being determined relates to whether your claim should be allowed, or whether an additional condition should be allowed in an existing claim, you have a right to appeal to the common pleas court of the county whether the injury occurred, requesting a jury trial on the issue of the allowance of your claim, or an additional condition in an allowed claim. An appeal to common pleas court must be filed within 60 days of receipt of the order from the Industrial Commission refusing further appeal. If there is no appeal within this 60 day time period, the determination made by the Industrial Commission is final.
In all court cases, it is absolutely essential that you have the assistance of an attorney. Court cases are very complicated as there are rules of evidence and certain documents must be filed in a timely manner.
The attorneys at the law firm of Gallon Takacs Boissoneault & Schaffer have years of experience representing injured workers before the Industrial Commission and in court. We are committed to assisting you in preparing and presenting your case to ensure that you receive the compensation and medical treatment you are entitled to, and deserve, in your workers’ compensation claim. If you are considering representation, please call our office at 1-567-455-5470 or visit our web site at www.gallonlaw.com to request a free consultation.
Thomas J. Schaffer, Esq.
Partner and Administrative Attorney
Workers’ Compensation Section