Ohio Workers’ Compensation Claim Denied? Here’s What You Need To Know

In this article, you can discover…

• The most common reasons for workers’ comp denials.
• What to do after receiving a denial notice.
• The benefits and process of filing for an appeal. 

What Are The Most Common Reasons For A Workers’ Comp Claim To Be Denied?

Taking too long to report an injury to an employer is a common reason. Within 24 hours of being injured on the job, always report your injury to an employer and get medical attention from a Workers’ Comp Bureau-approved doctor for the injury. 

Pre-existing conditions may also be used as a reason to deny your claim, and insurance companies may claim that your injury is related to a previous condition and not to a workplace accident. In both cases, thorough and rapid medical documentation of your injury can go a long way in making approval more likely.

What Should Be My First Step After Receiving A Denial Notice?

Get in touch with an attorney. You and your attorney will have 14 days to file an appeal of the denial. It is critical to be sure that your request is filed in a timely manner; this allows your claim to go through the formal appeal process and possibly to a hearing. 

If you attempt to appeal beyond this 14-day timeframe, the denial of your claim can not be contested and will be final. 

What Documentation Do I Need To Gather For The Appeal?

An attorney can assist you, but you will need every medical record from every visit to any doctor. You’ll need more than discharge papers or an after-visit summary; be sure to have complete and official medical records in hand. 

Your formal medical records must include a doctor’s assessment as to the cause of your injury so that the board can verify that, in the doctor’s opinion, your injury was caused by a workplace accident. Without that clarification, your appeal may be turned down.

Attorney Michael Weber is a seasoned, hard-working lawyer serving Ohio. For over 30 years, he’s helped injured workers navigate workers’ comp denials and successfully appeal for full compensation.

Are you concerned about the denial of your workers’ comp claim? Reach out to Weber Worker's Comp at (513) 450-4405 for an initial consultation today.

How Long Does This Appeal Process Usually Take?

Once a workers’ comp claim is appealed, it usually takes four to eight weeks to get in front of a judge and conduct a hearing. The hearing process can run for up to two months, after which a decision will be handed down. 

If One Is Eventually Approved, Would They Be Eligible For Any Back Pay Compensation?

Yes. A judge has the ability to award back pay for any time that your doctor has certified off work. If you’ve had time off work due to your injury or faced restrictions that an employer could not meet, you can receive back pay for those wages. 

Can You Describe A Memorable Case Where You Were Able To Find A Positive Outcome Despite Challenging Odds?

In many cases, I’ve dealt with medical records that are incomplete or wherein a doctor failed to find a causal relationship between the accident and the injury. My office has been able to get second, approved opinions on these injuries and present this evidence at hearings. 

I’ve had great success and full approval, even in cases where the odds were considerable. I would strongly urge anyone who’s been turned down for workers’ compensation to contact an attorney and review the possibility of an appeal. 

For more information on What To Do If Your Ohio Workers’ Compensation Claim Is Denied, an initial consultation is your next best step. Get the information and legal answers you are seeking by calling (513) 450-4405 today.