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How We Can Help You. 

We obtain the necessary evidence to support your workers’ compensation claim from physicians, witnesses, etc. 

We file your claim, motions, appeals, forms and any other documentation required in your claim.  

We explain the complex issues and Ohio workers compensation system, and make sure you are aware of your rights under Ohio law.  

We work to protect your rights and vigorously pursue all compensation and benefits you are entitled to.

We review your medical records from your injury and make sure you workers’ compensation claim is allowed for all medical conditions caused by your injury/occupational disease.  

We review your rate of compensation to ensure your are being paid the maximize the amount of compensation you are paid 

We represent you at hearings.We help to ensure you get the medical treatment you need and your medical bills are paid.We assist you in your transition back to work and try to get you vocational rehabilitation if you are unable to return to work at the job where you were injured.  

We negotiate a lump sum settlements. 

About the Attorneys: 

Michael Dorf received a Bachelor’s Degree from the University of Toledo in 1962.  Mr. Dorf graduated from University of Toledo College of Law in 1966.  Mr. Dorf has been practicing law for 44 years and has been practicing in the area of Ohio workers’ compensation law virtually full-time since 1972.  Mr. Dorf was listed at least once in the Best Lawyer’s of America and Who’s Who in America.  Mr. Dorf is a member of the Ohio State Bar Association and the Ohio Association for Justice.   

Steven Kalniz received a Bachelor of Music from Berklee College of Music (1991), received a paralegal certificate from The University of California Los Angeles (1994).  Mr. Kalniz graduated magna cum laude from the University of Toledo College of Law (2003) on a full scholarship.  Mr. Kalniz has worked in the field of Ohio workers’ compensation law for over 15 years.  Mr. Kalniz is a member of the Ohio State Bar Association, the Ohio Association for Justice, and the Lucas County Bar Association. 

 

About Ohio Workers’ Compensation: 

Workers’ Compensation: 

Ohio workers’ compensation is a state managed workers’ compensation system that provides compensation and medical benefits to employees who are injured at work.  The Ohio Bureau of Workers’ Compensation (Ohio BWC) administrates the claims.  If a dispute arises, the claim is set for a hearing which is adjudicated by the Industrial Commission of Ohio.   Claims can be filed for injuries or occupational diseases.   

Filing a Claim: 

Claims are filed on an FROI-1 form.  (First Report of Occupational Injury form)  The FROI form is filed at the Ohio BWC.  The form can be downloaded from the Ohio BWC website.  Once the claim is filed, the claim will be assigned a claim number.  There are time limits on when a claim must be filed.  Generally, a claim must be filed within two years from the date of injury.  In an occupational disease claim the required filing date is more complicated and the advice of counsel is recommended to ensure the claim is timely filed.    

No Fault System: 

Ohio’s workers’ compensation system is a no-fault system.  This means that the fault, or negligence of the worker or the employer is not an issue in the allowance of the claim and the injured worker will be paid compensation and medical benefits regardless as to any party’s negligence.  An exception to the no fault rule is for injuries resulting from horseplay which are not covered.    Also, self-inflicted injuries and injuries caused by intoxication are not covered.   

State Fund and Self-Insured Employers: 

Employers in Ohio can either be state-funded or self-insured.  If the employer is state-funded, the workers’ compensation claim is managed by the Ohio BWC.  The Ohio BWC makes the initial decisions regarding the allowance of claims and payment of compensation.   Payments are made to the injured worker by the Ohio BWC rather than the employer.   

State fund employers also have managed care organizations that oversee the approval and payment of medical treatment and medical bills.  Disputes regarding medical treatment are referred to the alternative dispute resolution program and later to the Ohio BWC if a disagreement remains.   

If the claim is self-insured, it is managed by the self-insured employer or their representative.  In self-insured claims, initial decisions to allow the claim and pay compensation are made by the self-insured employer.  The self-insured employer does not pay premiums to the Ohio BWC like a state fund employer.  The self-insured employer makes payments of compensation directly to the injured worker.  The self-insured employer manages approval and payment of treatment without a managed care organization.   

In either case, when there is a dispute, the issue is referred to the Industrial Commission of Ohio for a hearing.   

Appeals to Court 

If either party is dissatisfied with an Industrial Commission order regarding the allowance of the claim or any additional condition, an appeal can be filed into the Common Pleas court in the county where the injury occurred.  Other issues are appealed by filing a mandamus action in the Tenth District Court in Franklin County.   

Injuries/Occupational Diseases: 

Occupational Diseases 

Occupational diseases are diseases contracted in the course of employment.  Examples are asbestosis and silicosis.  Some occupational diseases are scheduled diseases and are specifically listed in the statute.  For occupational diseases that are not scheduled diseases an injured worker must show that the hazard to which the injured worker was exposed is greater than that to which the general public is exposed.     

Wear and Tear Claims/Repetitive Use Claims 

A claim can be compensable when there is not a single incident but the injured worker repetitively uses a body part and develops an injury.  An example may be carpal tunnels syndrome due to heavy, repetitive use of the hands.   

Aggravation of a Pre-Existing Condition: 

Even though an injured worker has a pre-existing condition, if the condition was aggravated by the injury, that condition still may be covered in the claim.  The legal standard for the aggravation of the pre-existing condition depends on the date of injury.   

For claims prior to 8/25/06, an injured worker must show that the pre-existing condition was worsened by the injury.  This could be an asymptomatic individual who became symptomatic as a result of the injury.  

For claims 8/25/06 forward, an injured worker must show that the pre-existing condition was substantially aggravated.  The injured worker must prove the aggravation by documented objective diagnostic findings, objective clinical findings, or objective test results.  Subjective evidence, such as an increase in pain, is insufficient to prove a substantial aggravation.   

An injury or disability that is caused primarily by the natural deterioration of tissue, an organ, or part of the body is not covered.  The issue with an aggravation of a pre-existing condition usually is whether there is a documented aggravation or whether the diagnosis is due to the natural deterioration of tissue.   

Psychological Conditions: 

A psychological injury must be related to a physical injury to be compensable in Ohio.  Psychological diagnoses alone due to issues such as workplace stress are not covered under Ohio law.  However, psychological conditions due to an injury can be included in a claim.   

Rate of Compensation: 

For each year there is a maximum amount of compensation payable weekly for all types of compensation.  This rate is set annually by the Ohio BWC.   

Full Weekly Wage: 

The full weekly wage is generally calculated using the higher of the actual wages earned in the one week prior to injury or the average of the wages earned in the six weeks prior to injury.  The full weekly wage is only used to calculate payment of temporary total disability for the first 12 weeks of compensation.  The first 12 weeks of temporary total disability is paid at 72% of the full weekly wage.   

Average Weekly Wage 

The average weekly wage is generally calculated using the earnings for the calendar year prior to injury.  The total earnings are divided by 52 weeks.  Under certain circumstances, weeks of unemployment can be excluded form the calculation yielding a higher rate.  The average weekly wage is used to calculate payment of all types of lost time compensation other than the first 12 weeks of disability.   

Types of Compensation: 

Disabled Worker Relief Fund (DWRF) 

These benefits are available in very limited circumstances.   The injured worker must be receiving permanent total disability and the injured worker’s combined permanent and total disability benefits and social security disability benefits when combined must be below a threshold dollar amount adjusted each year by the Ohio BWC.  If the combined benefits are below the threshold dollar amount, the injured worker is paid DWRF benefits to make up the difference up to the threshold dollar amount.   

Living Maintenance Benefits: 

Living Maintenance benefits are paid to an injured worker while participating in a vocational rehabilitation program.  There is an advantage in receiving living maintenance benefits rather than temporary total disability or wage loss compensation in claims where the injured worker’s average weekly wage is low, as living maintenance is paid at a minimum of 50% of the statewide maximum average weekly wage.   

Permanent Partial Disability 

Permanent partial disability is compensation for residual impairment that is a result of the allowed conditions from an allowed injury or occupational disease.  This award can be for physical or psychological conditions allowed in the claim.   

An injured worker must wait a period of time after other types of workers’ compensation payments end prior to filing for permanent partial disability.  For injuries prior to 6/30/06, the injured worker must wait 40 weeks after compensation ends to file the application.  (C92 form)  For injuries 6/30/06 and forward, the injured worker must wait 26 weeks after compensation ends to file the application.   

The permanent partial disability award is calculated based on the percentage of impairment due to the injury.  The higher the percentage an individual is found to be impaired, the higher the award.   

Permanent and Total Disability 

Permanent Total Disability is compensation paid for the life of the injured worker if the injured worker is unable to perform any sustained remunerative employment due to the allowed condition(s) in the claim.  Compensation is paid bi-weekly.   

An injured worker must demonstrate that he/she is incapable of performing any sustained remunerative employment due to the allowed conditions in the claim.    

If the injured worker has some residual capacity to work, the Industrial Commission will consider the injured worker’s age, education and prior work experience in determining whether the injured worker is employable.  The Industrial Commission requires the injured worker to make every effort to attempt vocational rehabilitation to acquire new job skills which will enable re-entry in the workforce if possible.   

Scheduled Losses 

An injured worker is entitled to a scheduled loss award for certain types of injuries which result in a loss of a body part or loss of use of the body part.   The scheduled loss can awarded for amputations, loss of use of a body part for all practical purposes, and for ankylosis (complete loss of motion of the affected body party).  There are also scheduled loss awards for loss of vision, total loss of hearing and facial disfigurement awards.   

Temporary Total Disability:  

Temporary total disability is compensation paid to an injured worker who is unable to return to his/her former position of employment due to the allowed conditions in the claim.   

Temporary total disability is terminated when the injured worker returns to work.  Temporary total disability can also be terminated if the injured worker is offered a light duty job in writing that is within the injured worker’s restrictions and he/she refuses to accept that light duty job offer.  Lastly, temporary total disability can be terminated when the injured worker is found to have reached maximum medical improvement.  (maximum medical improvement is a treatment plateau at which no functional physiological or psychological improvement is expected) 

Settlements: 

An alternative to receiving compensation and benefits under a claim is to reach a full and final settlement of the claim.  A settlement must be mutually agreed to be all parties and this issue cannot be taken to a hearing or forced on any party.  Injured workers must be very careful when settling a claim to make sure the settlement adequately covers the cost of future lost time from work and future medical bills.   

Also, if an injured worker has an expectation of being a Medicare beneficiary within the next thirty months, Medicare requires money to be set aside out of the settlements to cover future medical bills related to the injury.  Also, the injured worker must reimburse Medicare for any medical bills related to the injury that were conditionally paid by Medicare prior to the settlement of the claim.  Ultimately, Medicare does not want to pay any medical bills related to the injury.  This has become a very complex issue and requires competent legal advice to make sure the injured worker is protected.   

The Ohio BWC policies regarding settlement are constantly changing.  The Ohio BWC has recently changed its settlement policy and larger value settlements are currently backlogged.  In some cases, the Ohio BWC may be undervaluing claims for settlement purposes.  The Ohio BWC is currently requiring funds to be set-aside for Medicare purposes in some cases where the injured worker is not Medicare eligible and has not filed for social security disability.  The advice of competent legal counsel is recommended for any settlement of a worker’s compensation claim.   

Wage Loss Compensation 

Wage loss compensation is payable to an injured worker who is unable to return the former position of employment and suffers a loss of wages as a result.  The inability to return to work must be due to physical or psychological restrictions/limitations as outlined by a physician that are due to the injury.  The date of injury must be after 8/22/86 for wage loss compensation to be an available benefit.   

An injured worker can collect wage loss compensation while looking to find another job and performing a “good faith” job search.  This is called non-working wage loss compensation.  An injured worker is generally required to prove that he/she has spent the same amount of time and effort looking for work as they spent actually working prior to the injury.   

An injured worker must contact the employer of record and make sure that no work is available.  An injured worker must also register with the Ohio Department of Job and Family Services for the job search program in order to be entitled to wage loss compensation.   

An injured worker can also collect wage loss compensation if another job is found and the injured worker is making less at the new job than he/she was making on average in the year prior to the injury. This is called working wage loss compensation. In this scenario the injured worker is paid two-thirds 2/3 the difference between the earnings at the new job and the average weekly wage in the claim.   

The number of weeks that an injured worker can collect wage loss compensation depends on the date of injury.  For injuries prior to 8/25/06, an injured worker can collect up to 200 weeks of wage loss compensation in any combination of non-working and working wage loss.  Injuries after 8/25/06 are limited to 52 weeks of non-working wage loss compensation, however, the total number of weeks of wage loss compensation is 226.    

Violation of Specific Safety Requirement Awards 

An injured worker can receive additional compensation if he/she can prove that the injury was a direct and proximate result of the employer’s failure to adhere to a safety standard in the Ohio Administrative Code.  An OSHA violation is insufficient, as the injured worker must prove that the employer violated a comparable Ohio Administrative Code section.  If a violation is found to have caused the injury, a penalty will be applied to all past and future lost time compensation at a rate of 15% to 50% to be set by the Industrial Commission hearing officer.   

Forms and Motions: 

Ohio workers’ compensation requires the use of numerous forms for different types of requests.  Some common examples are listed below.  These forms are downloadable and printable from the Ohio BWC website.   

C9 forms: 

A C9 form is the form submitted by the physician to request approval for medical treatment.  The managed care organization (in state fund claims) or the self-insured employer makes the initial decision on the approval or denial of treatment. 

C86 motions: 

A C86 motion is submitted whenever a request is made for issues such as additional conditions, adjustments in compensation rates, requests for new periods of temporary total disability, scheduled loss awards, etc.   

C84 Forms: 

C84 forms are submitted to request temporary total disability compensation.  The front page of the form is completed by the injured worker.  The second page of the form is completed by the physician.  The Ohio BWC will not pay compensation unless both pages are complete.   

C92 Forms: 

C92 forms are applications for permanent partial disability.   

C140 Forms: 

C140 forms are used to request wage loss compensation.  The injured worker completes the first page and the physician completes the second page outlining the restrictions that prevent the injured worker from returning to his/her former position of employment.   

Miscellaneous Issues: 

Child Support 

Workers’ compensation benefits can be reduced if there is an outstanding child support order.   

Continuing Jurisdiction: 

How long your claim remains viable depends on the date of injury and what types of compensation have been paid.   The payment of compensation and medical bills extends the statute of limitations on claims.   

Medical Treatment: 

Medical treatment is covered under the claim for the allowed conditions in the claim.  Medical conditions are allowed by ICD-9 codes.  For each disease or diagnosis in the human body there is a corresponding ICD-9 code.  For medical treatment to be payable, this code must be allowed in your claim and the medical bills must be submitted using these allowed codes.   

Medical treatment also must be medically reasonable and necessary for the allowed conditions in the claim.  This issue is often disputed as managed care organizations deny care based upon reviews by their own physicians.   

Taxes: 

Ohio workers’ compensation benefits are not taxable.   

Vocational Rehabilitation: 

An injured worker may be entitled to vocational rehabilitation as part of a workers’ compensation claim if the injured worker is unable to return to the former position of employment as a result of restrictions from the allowed conditions in the claim.  In theory, vocational rehabilitation is designed to provide job retraining to enhance the injured worker’s ability to re-enter the workforce at an earnings level equivalent to the wages earned prior to injury.  Unfortunately, vocational rehabilitation often does not involve much more than a job search coach.   

Disclaimer:

The foregoing is not legal advice and should not be considered to be legal advice.  These summaries are for general information only.  The summaries are incomplete and every workers’ compensation claim presents its own unique set of facts and application of the law.  Please consult a qualified attorney for competent legal advice. 

• My son was injured in an accident. He was working for the city driving
  one of their trucks.  To be honest, he shouldn't have walked away from
  that accident.  They took him to the ER, He recieved stitches and the
  dr. told him he couldn't work.  Gave him painkillers.  Should he have
  been eligible for workers compensation?  The people told him they
  could give him light duty but he was unable to drive anywhere because
  of the pills he was having to take for pain. Please let me know.  He
  was without work up until last week.  They never did put him back to
  work and the city didn't allow him to return to the job he was doing.
  He was driving one of the large water trucks. The load shifted and it
  rolled several times down an embankment and crushed the truck cab
  flat.
  
• My father is a delivery driver and was injured on the job.  He
  received workers comp benefits up unitl March 12th .  The doctor says
  he is able to return to work, but ever since the injury he has
  developed other health complications and he can't drive. or
  concentrate to perform his job.  The doctor keeps saying his health
  complications are not related to the injury but it all happened as a
  result of the stress he had when he got injured.  Is there any
  recourse for him?
  
• I have Carpal Tunnel in both my wrist and I had surgery in one wrist
  already and about to have surgery on the other one. My question is do
  you know how much of a compensation settlement I can expect to get for
  Carpal Tunnel in both wrists?   I really do not trust my company to be
  fair in how much of a settlement they will pay out.  Is there a set
  amount for a compensation pay out?   Also can my company ask me to
  resign in a condition to getting my workers compensation settlement
  In the past?   I know that the company has made people resign in order
  to get their money I just want to know if that is legal.
• I was wondering about a previous claim. I started seeing my regular
  doctor about neck pain. At first I thought it was unrelated to a
  Toledo workers comp injury from two years previous. However I know
  think that it is a residual effect from the accident at work. I want
  to know if I can reopen the workmans comp case and if I do do I have
  to repay my insurance company  for treatment I have already recieved.
• I hurt my back at work and filed a workers comp claim.   I was cleared
  to go back to work and then was laid off by my employer. I am still
  trying to get paid from the workers comp insurance company. They have
  had all of the info needed to pay this claim and be done with it for
  about 3 weeks now.   I am up against a wall here...im about to lose my
  home and i dont know what , if anything, I can do. I need help
  Thats the short of it ...obviously there is more to it.
  

*Always consult a legal professional in person before taking any legal action related to your case or situation.