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Workers' compensation is difficult to navigate and difficulties start shortly after you leave the emergency room, urgent care, or the doctor’s appointment that exposed your injury. Some of these injuries are so apparent that they’re impossible to argue.
Imagine slipping near a floor drain and shattering your ankle with the result of two plates, and multiple pins put into place. Now, what if the argument was that you had weak ankles and didn't need workers' compensation? That all seems like a little bit of a stretch, but in truth, many people are told that they probably got hurt somewhere else. That's when everything starts to fall apart. After that, you have to go through a long and complicated process to resolve your claim.
Many people confuse Social Security Disability with Worker's Compensation. Now, if you're injured enough that you'll be out of work for 12 months, then you may qualify for state disability. But, there are many other situations that come into play, and that frequently means that you're only dealing with your employer's private worker's compensation insurance.
Worker's compensation is a private insurance company that opens the huge issue that these companies want to keep money in their accounts, not yours. Now there are a ton of different ways that private insurance can deny a claim.
Your employer can dispute the claim saying that they never received notice of your workplace injury. Or, your medical team wasn’t on the approved network of doctors that the insurance company works with for diagnosis and treatment. There are also other elements, such as missing filing deadlines and more. Together these result in about an 11% denial rate of worker’s compensation claims in Ohio.
As an employer, they probably don't want you to worry, but they also shouldn't stand in the way of handling your medical care. After a denied claim, your employer may shrug it off as if it's no big deal. After all, they pay for the worker's compensation insurance coverage and expect the company to handle the claims fairly.
When an employer tells someone not to worry, they're not actually giving any advice. What an employer should do in these situations is to provide you with contact numbers or to connect you with the right people to get an answer — learning why your claim was denied could a cause to restart the claim or to clear up any issues which is where an Ohio workers' comp lawyer can help.
Many injuries on the job don’t know how to start a claim, and they don't know they need to file a First Report of Injury or which office to mail it to. And when you look at the injuries that come into action for injured workers, it's easy to say, "oh, it's not worth the hassle."
The most common injury is a strain or sprain. Someone throwing out the trash, or lifting a box is more likely an experience to lead to an injury than an electric shift or even fractures. Of the total claims, strains and sprains make up about 30% of all claims. It's easy for an employer or an insurance provider to say that you're just a little sore or that it's not a real injury. You just pulled something.
A lot of these can happen over time from repetitive motion and cause substantial damage if it's not treated. Treating strains and sprains is a huge issue because if this employee misses the opportunity to recover now, it may lead to a disability that prevents them from working later.
The next most common injury is cuts and punctures, which are exceptionally common in restaurants, warehouses, and construction sites. Often these are genuine accidents, but managers on the job site often let employees bandage themselves up and don't take a report.
When you're facing a denied worker's compensation claim, you need complete guidance throughout the process. Many employers will try to downplay the availability of using a lawyer or finding a second opinion because they're happy with the outcome. The issue is that if you were hurt, then you are the victim in this situation. Your employer failed in providing a safe environment, and the result of that failure was that you were injured.
Involved an Ohio worker’s compensation attorney is the best way to have some control over the system and process. When looking for the right attorney for you, start by talking with Young, Reverman, and Mazzei.