Ohio Workers’ Comp Appeals Lawyer

Steps in Appealing a Denied Workers’ Compensation Claim

Both injured workers and employers have the right to appeal a decision issued by the Ohio Bureau of Workers’ Compensation (BWC) or a ruling made by a district or staff hearing officer from the Ohio Industrial Commission.

Below are the various steps in appealing a denied claim through the workers’ compensation system:

First Hearing at District Level

If your Ohio workers’ compensation claim is contested, the first step in the appeals process is a hearing before a district hearing officer (DHO) at the Industrial Commission of Ohio (IC). This hearing provides both the injured worker and the employer an opportunity to present evidence and arguments regarding the claim. A DHO, an impartial official, will review the facts of the case, including medical records, witness statements, and other supporting evidence.

The DHO may uphold, modify, or overturn the original decision made by the BWC. If the DHO grants the claim, the injured worker may begin receiving benefits for medical bills, lost wages, or other applicable compensation. If the claim is denied or partially approved, the injured worker has the right to challenge the ruling. The case will then be escalated to a staff hearing officer (SHO) for further review.

Second Hearing at Staff Level

The SHO hearing serves as a second review of the case, allowing both parties to present additional evidence or arguments. The SHO is a higher-level official within the Industrial Commission and has the authority to affirm, modify, or overturn the previous decision. If either party is still dissatisfied, they may request a further appeal at the Commission Level, but this appeal is not automatically granted and must show a compelling reason for review.

Further Appeal at Commission Level

The third appeal at the Commission Level must include a clear explanation of why the decision should be reconsidered and any new evidence or legal arguments supporting the case.

The request is submitted to three commissioners of the IC, who will determine whether the appeal warrants further review. The commissioners will review the appeal request and decide whether to accept or deny the case for a hearing. If the Commission agrees to hear the case, a hearing will be scheduled where both parties can present arguments, but if they refuse to hear the appeal, the decision made by the SHO becomes final, leaving court appeal as the only remaining legal option.

Appealing to Court

This is the final stage in the appeals process and takes the dispute out of the Industrial Commission system and into the judicial system for review. Unlike previous hearings within the IC, a court appeal is a more formal legal process and may involve a full review of evidence and testimony presented in previous hearings as well as legal arguments from both the injured worker (or their attorney) and the employer (or their legal representatives).

The court may either rule in favor of the injured worker, overturning or modifying the IC’s decision and granting the workers’ compensation benefits that were previously denied OR uphold the IC decision, meaning the worker or employer must accept the ruling.