More than 1 in 6 employees in the Buckeye State worked in the healthcare and social assistance job sectors in the past decade (16.17%). Home to major employers like Intel, Honda, Whirlpool, and General Electric (GE), Ohio also has the largest manufacturing workforce in the United States. Add in construction (4.54%), and more than 1 in 3 Ohioans work in jobs most likely to result in a work-related injury or illness. But if you’re hurt on the job, how do you know whether you’ll qualify for Ohio workers’ compensation benefits? And what must you do to get your employer to cover the cost of medical care?
Our guide below explains what benefits may be available to you if your employer has workers’ compensation insurance coverage.
Understanding How Ohio Workers’ Compensation Insurance Works: Key Takeaways
- Ohio workers who get sick or injured on the job may qualify for workers’ compensation benefits from their employer’s insurance plan.
- The Ohio Bureau of Workers’ Compensation (BWC) is the state’s exclusive insurance provider for employers that do not choose to self-insure.
- Employees who accept workers’ compensation benefits cannot sue their employers for issues like workplace safety violations.
- It’s illegal in all 50 states for employers to fire employees who apply for workers’ compensation benefits, including Ohio.
- State law says if you any doctor not explicitly authorized to treat you by the BMC, you must pay those medical bills yourself.
- If you refuse to accept part time or light duty work with restrictions from your doctor, you may lose workers’ comp benefits.
- Workers’ compensation does not pay for pain and suffering, harassment, wrongful termination, assault by a coworker, or self-inflicted injuries.
Which Ohio Employers Must Carry Workers’ Compensation Insurance Coverage?
All businesses with at least one part-time or full-time employee in this state must carry Ohio workers’ compensation insurance. State law says employers must either self-insure or purchase coverage through the Ohio Bureau of Workers’ Compensation (BWC). However, certain types of employees are automatically exempt from this coverage requirement under Ohio Revised Code Section 4123.01, like:
- Corporate officers for family farm businesses
- Domestic workers that earn less than $160 per calendar quarter from a single employer (babysitters, for example)
- Federal employees, including railroad workers, postal carriers, and shipyard dock workers
- Independent contractors that do not hire additional employees or subcontractors
- Most unpaid volunteers
- Religious organization ministers
- Sole proprietors, partners, and limited liability corporation (LLC) members
How to File Your Ohio Workers’ Compensation Claim
According to Ohio law under Revised Code Section 4123.84, you have one year to apply for workers’ comp benefits. This is called the statute of limitations, and every state has its own reporting and filing deadlines for workers’ compensation benefits.
Generally, sick or injured employees in Ohio will follow the process outlined below to file a claim:
1. If you need urgent medical care, go to the nearest emergency room or hospital and tell them you have a work-related injury or illness.
If the doctor you see for emergency medical care is a BWC-certified provider, you can keep that physician. Otherwise, you must see a BWC-authorized healthcare provider to avoid paying any medical bills out of your own pocket.
Important: Use the BWC's online search tool to find a state-certified medical provider who can treat your workplace injury.
2. Notify your employer (preferably in writing) about your injury and the incident that caused it.
You should always do this as soon as possible and include important facts about your accident, like:
- Time, date, and location where your work accident occurred
- Any witnesses that saw your accident and how to contact them (name, job title, phone number and email address, if possible)
- If you’re filing an occupational illness claim, list the date you received your disease diagnosis or began medical treatment
3. Confirm whether your employer is self-insured or has coverage through the Ohio Bureau of Workers’ Compensation (BWC).
If you work for a business that is self-insured, you’ll need to submit your workers’ compensation claim through your employer. Otherwise, you’ll need to file form FROI-1, “First Report of Injury” online directly with the BWC to start your claim.
Pro Tip: You can download any form in PDF format directly from the Ohio BWC website to fill out at home at your convenience.
4. The BWC or your employer then has 28 days to review your Ohio workers’ comp claim.
You’ll receive a letter in the mail explaining whether you’re approved or denied, and how to dispute the BWC’s decision (if applicable).
5. If approved, you must miss at least 7 work shifts before you can qualify for lost-wage benefits.
The first week of missed work after a job accident counts as unpaid time off under Ohio state law. However, payments for lost wages become available on your eight day of missed work due to injury.
If your doctor says you don’t need time off to recover from your injury or illness, workers’ comp only covers your medical bills. This means you can still receive any ongoing treatment you need without paying anything out of your own pocket. However, your employer has the right to demand you return to work, even if it’s just part time or on light duty.
6. You have 14 days to appeal a denied workers’ comp claim or resolve any disputes with the Ohio Industrial Commission.
To request an administrative hearing to resolve any disputes, fill out Form IC-12, Notice of Appeal, and submit it directly to the IC. You should then receive a notification letter two weeks before your hearing date listing the time, date, and location to appear.
What Ohio Workers’ Compensation Benefits Are Available to Eligible Injured Employees?
Eligible injured or sick employees can receive different types of workers’ compensation benefits in Ohio after claim approval. See the descriptions below to understand all your potential options.
Medical Benefits
You can receive unlimited medical benefits for approved work injuries and illnesses from Ohio workman’s comp insurance. This includes paying your healthcare provider directly or reimbursing you for the following approved costs:
- Doctor’s visits
- Medical imaging (i.e., x-rays, MRIs, CT scans)
- Prescription medications
- Physical therapy
- Travel expenses required to receive necessary treatment (i.e., mileage, hotel stays, etc.)
Wage Replacement Benefits to Help Cover Lost Wages
Ohio workman’s comp cannot cover lost wages unless a doctor orders you to take more than a week off to recover. Once you’re forced to miss 15+ work shifts, the BMC pays benefits at the TTC rate for your first week off.
Important: See current state maximum weekly benefit rates from the BMC.
Temporary Total Compensation (TTC)
If approved and you cannot temporarily work, you can receive temporary total disability benefits from workers’ comp. For the first 12 weeks, your TTC compensation rate equals 72% of your full weekly wage (FWW) amount. The BMC uses your paychecks from the six weeks prior to your claim submission to calculate that compensation. So, if you normally receive $1,000 per week, workers’ comp pays you $720 instead for the first 12 weeks.
After that, your compensation rate changes to 66 2/3% of your average weekly wage (AWW) from the past 12 months.
You can receive TTC payments for no more than 200 weeks, but they automatically stop when you:
- Return to work at your current job, even if it means working fewer hours or earning less than usual
- Get caught working for any Ohio employer while drawing TTC payments
- Reach Maximum Medical Improvement (MMI) and your doctor determines additional treatment will not benefit you
- Voluntarily quit your job
- Go to jail
Permanent Partial Disability Compensation (PPD)
After 26 weeks on TTC benefits, your doctor may schedule an independent medical exam to check your progress. That’s the soonest you may become eligible for permanent partial disability (PPD) payments. There are two types of PPD payments you can receive from Ohio workers’ compensation insurance:
- Percentage-based PPD benefits. You can receive two weeks’ worth of TTC income for every 1% of disability your doctor assigns you for no more than 200 weeks.
- Scheduled loss award. If you suffer a permanent injury that affects your work abilities for life, you may receive a lump-sum settlement. Injuries that count in this category include amputations, total loss of hearing, vision, or use of a body part, and ankylosis.
Permanent Total Disability Compensation (PTD)
If your workplace accident injures you so you can never work in any job again, you may qualify for PTD benefits. To determine if you may qualify for PTD payments, you must:
- File an Application for Compensation for Permanent Total Disability form
- Attend an Ohio Industrial Commission hearing and additional examination
The BWC uses your AWW from the year of your accident to determine your PTD rate. You can receive weekly PTD benefits until you start drawing Social Security retirement income. At that time (normally your 67th birthday), Ohio state law reduces your PTD payments to offset Social Security.
Death Benefits
Families of deceased workers killed on the job may qualify for death benefits, which can include:
- Up to $5,500 for funeral and burial costs
- Weekly TTD benefits paid at two-thirds of the deceased worker’s AWW rate
Eligible dependent spouses can receive weekly death benefits from the BMC until they die or remarry. Remarriage triggers a lump-sum payment to the dependent spouse equal to two years of TTC benefits. Children of deceased workers can receive benefits until they turn 18 years old. The BMC will continue death benefit payments to children who attend an accredited school full time until age 25.
How LegalASAP Helps Injured Workers Get Workers’ Compensation Claim Help Nationwide
We can connect you with a workers’ comp attorney in your area for a free, confidential claim consultation today. Every legal professional in our national network is happy to discuss your case and answer your questions, free of charge.
Denied workers’ comp benefits you believe your employer owes you? An attorney can help you appeal it on contingency. This means you only pay legal fees if your attorney helps you receive a cash settlement. But if you never get benefits, then you pay $0 in legal fees to your attorney.
Want to know how much your work injury may be worth? Click the button below to start your free claim evaluation and get the help you need today:
Lori Polemenakos is Director of Consumer Content and SEO strategist for LeadingResponse, a legal marketing company. An award-winning journalist, writer and editor based in Dallas, Texas, she's produced articles for major brands such as Match.com, Yahoo!, MSN, AOL, Xfinity, Mail.com, and edited several published books. Since 2016, she's published hundreds of articles about Social Security disability, workers' compensation, veterans' benefits, personal injury, mass tort, auto accident claims, bankruptcy, employment law and other related legal issues.
