February 9, 2015 | Mark Newman, Ohio Certified Workers’ Compensation Specialist
Here are some basic things you should know to help you navigate the workers’ compensation system.
Know Your Rights:
Injured workers in Ohio, have the right to workers’ compensation benefits and high quality health care. Ohio laws require employers to provide workers’ compensation insurance for all employees. Your employer’s workers’ compensation insurance is state funded or self-insured. If your employer is state funded the claim will be managed by the Ohio Bureau of Workers’ Compensation and the managed care organizations that determine medical and return-to-work services. A self-insured employer manages its own claims and will pay worker’s compensation benefits directly to its employees.
Filing a Claim:
If you are injured on the job, you can simply fill out the First Report of Injury form and mail it in to any BWC office. You can also file your claim online or with your Managed Care Organization. In most cases, if you receive medical treatment at a hospital or urgent care, the facility will file a claim for you. You can check with the BWC to see if a claim has been filed. Your employer can notify the MCO to file a claim and your health care provider can also notify your MCO to file a claim. It is your responsibility to make sure a claim is filed.
Injured workers have the right to receive medical treatment from a doctor of your choice as long as the doctor is a BWC certified physician. If your employer is state funded, you can choose from a list of pre-approved physicians provided by your managed care organization. If your employer is self-insured, you can contact your employer to obtain information about choosing the right physician for you. You can also select a doctor on you own.
Do I Pay For My Medical Bills?
After the claim has been approved, your health care provider should submit their bills to your managed care organization. The MCO will review and pay the medial bills if the treatment is necessary and appropriate. If you receive a bill in the mail contact your health care provider and notify them the treatment was related to a workplace injury. Give the health care provider the name and billing address of your managed care organization.
If you are unable to work for more than seven days due to your work injury you will be entitled to temporary total disability compensation. The first seven days of lost time are not payable until you lose 14 consecutive days. Your compensation is based on your earnings during the year prior to the injury. Temporary total is paid bi-weekly. You will receive temporary total until you return to work or reach maximum medical improvement. If you miss more than 90 days of work a medical exam may be scheduled.