When an injured worker files a workers’ compensation claim with the Ohio Bureau of Workers’ Compensation (BWC), the BWC will evaluate the available evidence and issue an Order either allowing the claim, denying the claim, or allowing certain conditions while denying other conditions.
If the Ohio BWC Order denies the claim in its entirety, or allows the claim but denies specific conditions, the IW can appeal that decision.
If an appeal is timely filed, the matter will be referred to the Industrial Commission of Ohio and a hearing will be set. All parties involved will receive notice from the Industrial Commission of the hearing date, time, and location.
The first hearing is set at the District Hearing level and is heard by a District Hearing Officer. During the hearing, the injured worker will be given the opportunity to make the case as to why the claim should be allowed or why the specific denied conditions should be allowed. The employer will also have an opportunity to be heard on the issues. Upon conclusion of the hearing, the Hearing Officer will likely take the matter under advisement (meaning the Hearing Officer will not tell you on the spot whether you won or not) and issue a written Order with the decision.
Approximately 7-10 business days after the hearing, the injured worker will receive a copy of the District Hearing Officer’s Order in the mail. If the Order is unfavorable, the injured worker will be able to file another written appeal. If a written appeal is timely filed, the Industrial Commission will set the matter for a second hearing.
The second level hearing is set at the Staff Hearing level and will be heard by a Staff Hearing Officer. The Staff Hearing Officer will consider the issues as if it had not been heard before, and the injured worker will get a fresh shot at convincing the Industrial Commission to grant what is being requested. At the conclusion, the Hearing Officer will likely take the matter under advisement and the injured worker will get a written Order mailed to the address on file with the BWC.
If the Order from the Staff Hearing is also unfavorable, the injured worker can again file a written appeal. However, unlike the first two hearings, this appeal is a discretionary appeal meaning that the Industrial Commission will choose whether a third hearing will be granted. Third level appeals are granted on a very limited basis and only for specific issues. It is more likely that the claim will not receive a third hearing. The IW will likely receive an Order in the mail refusing the appeal.
When an injured worker receives the refusal Order from the Industrial Commission, the injured worker has the right to file a written Notice of Appeal into the Court of Common Pleas where the injury occurred. The Notice of Appeal must be filed within 60 days of receipt of the final Order.
Once the Notice of Appeal is filed, your case will be assigned to a judge and the court will provide guidance on how the case will proceed. This process can take up to 12 months to conclude. Filing a Notice of Appeal and Complaint into the court of common pleas requires particularized knowledge and skill and I would always advise contacting a competent workers’ compensation attorney to assist you.
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