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Can I Appeal a Workers’ Compensation Claim Denial?

May 9, 2022

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Workers’ compensation is a lifeline for injured workers and their families in Ohio. However, it’s also a system that’s rife for abuse. To prevent people from getting benefits they don’t need, the Ohio Bureau of Workers’ Compensation (BWC) is notoriously strict when reviewing claims. That means many valid claims get denied because of minor oversights, mistakes, and omissions.

Some estimates claim that around 25% of first-time workers’ compensation applications are denied. If you recently applied to workers’ compensation or are thinking about doing so, you may be wondering what your options are if your application gets denied.

Thankfully, you CAN appeal the BWC’s decision if you or your attorney think it’s unfair. In fact, you can appeal their decision all the way to the Ohio Supreme Court, although that’s rarely necessary. Here’s what to know about this situation and the different levels of appeals.

Appeal Level 1: A District Hearing Officer Hears Your Appeal

If the BWC denies your initial workers’ compensation application and you want to appeal their decision, your appeal will end up in the hands of a district hearing officer (DHO) who will hear it within 45 days of it being filed. Your hearing will be held at the Industrial Commission office near your home, and it will conclude with a written decision within seven days of the hearing.

If you decide to appeal the DHO’s decision, you have 14 days to do so after receiving their order.

Appeal Level 2: A Staff Hearing Officer Hears Your Appeal

Within 45 days of appealing the DHO’s decision, a staff hearing officer (SHO) will hear your appeal. At this hearing, the injured worker and their employer may both be requested to present witnesses and evidence to bolster their claims concerning the workplace injury. Within seven days after the hearing, the SHO will issue a decision.

If you decide to appeal the SHO’s decision, you have 14 days to do so after receiving it.

Appeal Level 3: The Industrial Commission of Ohio Hears Your Appeal

Appealing the SHO’s decision elevates your appeal to the level of the Industrial Commission itself. If it decides to hear your appeal, it will be scheduled within 45 days of the appeal being filed.

The Industrial Commission doesn’t always approve these hearings, and it can be difficult to be granted a hearing without experienced legal representation on your side. Workers who attempt to proceed with appeals after the second level of the appeals process often find themselves being dismissed or ignored.

Appeal Level 4: The Ohio State Courts Hear Your Appeal

If the Industrial Commission denies your appeal or even refuses to grant you a hearing or review of your appeal, you can appeal their decision or the SHO’s decision to the Ohio State Courts. This process must be initiated within 60 days of receiving the Industrial Commission’s decision.

Appeal Level 5: The Ohio Supreme Court Hears Your Appeal

Although rare, it’s possible to escalate your appeal all the way to the Ohio Supreme Court. These hearings are discretionary, which means it’s likely that the Ohio Supreme Court will refuse to review your workers’ compensation application and appeal.

However, depending on the strength and circumstances of your case, you may be granted a hearing, especially with an aggressive law firm on your side.

Let Our Experienced Attorneys Build Your Application or Appeal

Whether you’re applying for workers’ compensation benefits for the first time, or you want to appeal the BWC’s decision, our Ohio workers’ compensation lawyers are here to help. We have decades of experience building successful applications and appeals for injured workers just like you, and we know what it takes.

Our tenacious, dedicated, and aggressive approach means we don’t give up when our clients’ applications and initial appeals are denied. We work hard to get them the benefits they’re owed after they’re hurt on the job. Contact Nurenberg, Paris, Heller & McCarthy today for a free consultation and to get started on your path to the benefits you need.

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