The workers’ compensation system provides certain benefits to workers who are injured while on the job. In a similar way to your personal auto insurance, businesses pay premiums for workers’ compensation insurance that will provide medical and wage payments to the injured party and provide a layer of protection to the businesses themselves.

Like any insurance claim, the rules are complex. You have filed for benefits and your claim was denied. Meanwhile, your medical bills may be arriving and your income may be lost while you are off work. What now?

Why was my workers’ comp claim denied?

The most common reasons are:

• the injury didn’t occur while you were at work or performing a work-related task
• the injury was the result of a preexisting injury or condition
• if there is a dispute as to exactly when or where the injury occurred
• a health professional concluded that you aren’t disabled as a result of your work injury and are therefore still able to perform your work duties
• there is a dispute whether you sustained injuries at all

How can I appeal a denied workers comp claim?

While the exact methods of appealing the denial can vary among the states (unless you are a federal employee), there are a few things that everyone can do when seeking a review of a denied claim:

1. Hire a workers’ compensation attorney to handle the appeals process.
2. Don’t wait. In Ohio, you must file a formal appeal within 14 days of the receipt of the denial.
3. Contact the BWC.

How can a Workers’ Compensation lawyer help me?

Workers’ compensation is all we do. As your lawyer, I will determine the reasons for the denial of your claim and gather documentary evidence, including contacting possible witnesses to your injury and retaining experts from the medical field as well as your work industry if needed.

Most workers’ comp claims are denied based on medical issues. I will have your injury or disability evaluated by an independent medical specialist and/or review your specific case with your present health care provider to determine if a more detailed medical report should be drafted. I will also determine if any additional proof is needed to demonstrate a disability or directly related injury.

Don’t wait to fight for the benefits you deserve. Contact Workers’ Compensation Attorney Tom Marchese today.  Call now.

A seemingly normal day at work can quickly become the start of a nightmarish ordeal if you get injured. A slip and fall (read about the difference between slip and fall vs. trip and fall here), machinery accident, lifting injury, and more can deter your life in a matter of minutes and leave you wondering how you’ll pay your bills and provide for your family now that you’re unable to work. In this situation, having a worker’s compensation lawyer walk you through the steps of filing a claim is essential.

Let’s discuss three important things that you should know about a worker compensation claim.

1. You don’t need to prove your employer is at fault.

This is actually a very common misconception. The reality is that you don’t have to prove anything to be eligible for compensation as workers comp is regarded as a no-fault system in the US. In addition, the amount of compensation you’ll receive is not affected by your carelessness in performing your job, that is unless you were under the influence of drugs or alcohol when the injury occurred. In that instance, it’s important that you consult a professional compensation attorney before filing a claim.

It is also important to note that reporting your injury is not “punishing” your employer or jeopardizing your job. All employers pay into the Ohio state workers’ compensation system to make sure that anyone injured on the job can seek compensation to cover those and injuries, missed income, and related medical expenses.

2. Report your injury immediately.

This is extremely important. Don’t wait to report your injury, even if you don’t immediately think you’ve been badly injured. That slight tweak in your back could have you unable to get out of bed in a few days, and you can seriously hurt your case of getting compensation if you do not immediately report your injury to the employer.

In some cases, workers choose not to report an accident because they think the work either doesn’t fall within their scope of employment, or they weren’t on duty when the injury occurred. This conversation should be discussed with your lawyer to decide since things are not always that clear-cut when it comes to workers’ comp claims.

3. You can still file a negligence lawsuit.

While it’s true that filing a workers comp claim does mean you waive your right to sue your employer, this does not mean that you can’t file a negligence lawsuit against a third party. For example, suppose your injury occurred due to a defective piece of equipment, in this situation you can bring a case to court against the equipment manufacturer. Any amount you receive in this case will be in addition to the compensation received from your employer.

Hire a workers comp lawyer to guide you.
Getting injured on the job can result in serious consequences. You can greatly increase your chances of getting adequate compensation by hiring a workers comp lawyer. Thomas Marchese is a highly experienced workers’ compensation lawyer who can help you file a claim and fight for what you deserve. Give us a call today for a free consultation.

There’s no doubt, life has dramatically changed since the beginning of the pandemic. Businesses have been forced to change the way that they operate, some restaurants are relying solely on take-out and curbside service, there’s now a limit on the number people allowed to grocery shop at one time, and doctors are now evaluating patients using “Telehealth.”

If you’ve been injured on the job, and are seeking restitution for missed work and mounting medical bills, it is vital to have your injury and treatment diagnosed. Most medical practices have adapted to COVID restrictions by offering Telehealth appointments. Using your mobile phone, tablet, laptop, or computer, you and your doctor can see each other just as if you would in a face-to-face appointment. You explain how your injury happened, what your symptoms are, and any medical treatment that you have received for your work injury.

How can a doctor diagnose me through Tele-health?

The doctor is unable to physically touch you, but he/she can still conduct an examination. For example, if you’ve injured your back, the doctor might ask you to walk a few steps to watch for a limp, touch your toes to gauge your range of motion or lift your legs while sitting to see if you feel pain in your back or legs. Although the doctor can’t test your reflexes, he/she can still gain valuable information from this modified exam.

Your doctor may provide you with treatment recommendations, which could include physical therapy, medications, or order a more thorough diagnostic, like an MRI. Most medical facilities have remained open during this pandemic and have continued to operate on a modified schedule to allow for the proper precautions to be taken. Staff members wear masks and gloves, wipe down equipment, and enforce social distancing.

How important is it that I see a physician after an injury?

If you injure yourself at work, the Industrial Commission of Ohio will give great weight to the reports of your doctors and the results of your diagnostic studies when determining whether to accept or deny your claim. If your claim is denied, a lawyer can file a petition on your behalf which will be heard by a workers’ compensation judge. An Industrial Commission Hearing Officer then carefully considers what conditions your doctor’s diagnosed and referenced studies. So, if your doctor orders an MRI and it shows herniated discs at two levels of your spine, there is a much better chance that they will conclude that you are truly disabled and therefore are entitled to workers’ compensation benefits.

Here at Marchese Law, we can help you file to fight your denial. SInce 1985, defending the rights of Ohio workers is all we do. The business restrictions of the pandemic have added another layer of complexity. We fight the BWC on your behalf to get you paid. If you sustained an injury at work, call us.

As a medical professional you spend hours on your feet every day, and perform intricate tasks with your hands day in and day out. You may also routinely squat and stretch to reach tools and supplies, and spend hours typing inpatient data. These tasks put you at risk for repetitive stress injuries (RSI).

Repetitive stress injuries are common in the medical profession. You may assume that most job-related injuries occur on construction sites, factories, or warehouses. They do, but a significant percentage of on-the-job work injury claims involve wear and tear. When you are experiencing pain and physical limitations, you need to remember to take care of yourself while you are caring for others.

Seeking Workers’ Compensation Benefits for RSI

It is a misconception that only traumatic on-the-job injuries are eligible for workers’ comp payments. Repetitive stress injuries are often covered as well.

Common RSI injuries that are common among nurses, therapists, and other health care professionals include the following:

• Carpal tunnel syndrome
• Stenosing tenosynovitis (trigger finger)
• Osteoarthritis
• De Quervain’s tenosynovitis
• Degenerative conditions
• Disc abnormalities
• Rotator cuff injuries

Interesting facts about workers’ comp claims and medical professionals.

1. The “No-Fault” Nature of Workers’ Comp
In Ohio, workers’ compensation is a “no-fault” system. Employees can seek benefits for all injuries sustained within the scope of their employment, regardless of the cause. So, if you’re in pain because you are a devoted employee and you love doing what you do, you are within your rights to file a claim for benefits.

2. Provide Written Notice
In order to file for workers’ comp, you need to first provide written notice of your injury to your employer. Most employers have some kind of “Accident Form” that you fill out for this exact reason, but really you can use whatever form your employer provides you, even if it’s not considered an accident-related injury.

3. See the Company Doctor
One aspect of Ohio’s workers’ compensation system is that it gives employers the right to require employees to see their “company physician.” Once you’ve provided written notice of your injury, your employer should tell you where you need to go to seek a diagnosis and treatment. This won’t necessarily be your only option, but it’s where most employees need to start.

4. Thorough Documentation
Thorough documentation is key. You will need to be able to demonstrate that your injury developed at work rather than at home. Make note of when the pain began or when you first noticed symptoms. Document when the symptoms would flare (ex: after a long shift, when lifting a patient onto a gurney). Every detail can help with your claim.

5. Preparing for the Claims Process
Your case management will involve a review of workers’ compensation coverage including wages, medical coverage, work-related medical conditions, loss of function, and injuries that may not show up until years after you have left a job.

In this time of social isolation, staying connected is more important than ever. The New York Times reported that Facebook and Instagram have enjoyed a 50% increase in usage as a direct result of the coronavirus. The average user spends 58 minutes per day on social.

Chances are, you’re probably included in this statistic, and like most people you also likely use social media accounts to share details about what’s going on in your life. It’s understandable why so many people have grown to rely on social media. After all, it offers the benefits of keeping us up to date with what is new with our friends. However, if you’re in the middle of a workers’ compensation claim, it is likely a good idea to limit or avoid social media altogether. In this article, we’ll take a brief look at exactly how social media usage can negatively affect your workers’ compensation claim.

The Role of Workers’ Comp Insurance in Ohio

In Ohio, every employer is required to carry workers compensation insurance. If you are injured on the job, this insurance is designated to pay your medical bills, injury compensation, death benefit, amputation or loss of use benefit, temporary disability, permanent partial disability benefit, change of condition, vocational rehabilitation, and multiple injury compensation.

Some claimants seek to take advantage of the system through fraudulent activity. Studies show that 1- 2% of claims are fraudulent, which costs insurance carriers billions of dollars.

Preemptively, insurance carriers often perform detailed investigations of claims. This includes monitoring of social media accounts. If an investigator believes that you lied, faked, or exaggerated your injury to obtain compensation, you could be denied compensation coverage.

Realize What Investigators Might Find on Social Media

Even if your social media account settings are set to private, there are still methods that investigators use to see what you post.

Are there pictures or videos of you engaging in a physical activity (sports, playing with a child or pet, working on a home improvement project, etc) after filing a claim for a personal injury?

Were you on vacation during the time that you were supposed to be recovering from an on-the-job injury?

Don’t post to Social Media

Before sharing or commenting, stop and reflect on how your words and pictures might be viewed by either your employer or the applicable insurance carrier. Even if you believe that what you are posting is okay, know that social media posts create misunderstandings on a routine basis.

Speak With an Experienced Workers’ Compensation Lawyer

An ounce of prevention is worth a pound of cure; remember that?

The workers’ compensation process is complex. Let’s work together to make sure that your application to receive benefits is complete. If you have already filed and you have been denied, contact workers comp attorney Thomas Marchese now to start the appeal and get your benefits.

Under Ohio Workers Compensation laws, do not need to prove fault to bring a claim. Call today.