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Do You Need An Attorney for a Workers’ Compensation Claim in Ohio or Kentucky?

Posted on Wednesday, December 5th, 2018 at 8:23 am    

The following post is part of our Law Student Blog Writing Project, and is authored by Joe Trammell, a 2020 Juris Doctorate Candidate at The Ohio State University Michael E. Moritz College of Law.

Attorneys have learned in law school to be honest, even if it may seem to put them at a disadvantage. It is always better to be truthful, and if there is a good case it won’t matter that some of the law or facts are not favorable.

So here is the concession: you do not have to hire a workers’ compensation attorney to receive workers’ compensation. You are legally allowed to file for it on your own.

agreementThat may seem like a strange way to start a blog post for a law firm that does workers’ compensation, but do not worry. The rest of the article will detail why in many cases you should hire a workers’ compensation attorney.

There is a reason why there are many law firms that deal with this area. Laws are complicated, and workers’ compensation laws are a great example of that. Attorneys go through three years of law school (if they go full-time and do not do a dual-degree program) learning how to interpret them. At Ohio State’s law school, it is one of the first things taught to new students, and the process never stops. Add to it the need to interpret the exact meanings of parts of laws through reading cases decided by courts, and it is a very complicated process.

This is also why criminal trials guarantee a right to counsel. The landmark Supreme Court case, Gideon v. Wainwright, decided this. Mr. Gideon was not given representation in a burglary case, and faced a prosecutor who was in the courtroom for a living. Mr. Gideon lost his case, but after he won his Supreme Court appeal, he was retried—this time with representation—and was acquitted. Nothing had changed in Mr. Gideon’s case. He just had someone that knew how to take the facts and ask the right questions.

Unfortunately, the government does not provide counsel for workers’ compensation. But the point to sharing this is to illustrate how difficult it can be for people to understand the law and advocate for their rights when they have not been trained. That is not an indication of anyone’s intelligence or abilities; it just means that law is a specialized field and requires specialized training, the same way a doctor or pharmacist needs specialized training.

When you receive representation for your claims, you gain the benefit of that attorney’s education and experience not only practicing law, but practicing that specific kind of law. This may be pretty new to you, but the attorney is used to it. He or she knows what the laws say, what strategies to implement and what arguments to make, how to provide proof for your case, how to file the necessary paperwork, and how to answer the questions that will be asked. This relieves the burden on you and puts it on the shoulders of someone who does this for a career.

How Can An Attorney Help Me Win an Ohio or Kentucky Workers’ Compensation Claim?

One complexity in workers’ compensation laws is the list of exempted employees. Both Ohio and Kentucky cover most employees. But both exempt agriculture workers, domestic workers, and anyone who voluntarily rejects workers’ compensation coverage. Kentucky exempts nonprofit workers who make their living through the nonprofit, while Ohio exempts volunteer nonprofit officers.

Another is the statute of limitations. Statutes of limitation prevent claims from being filed after a certain length of time has passed. In Kentucky, an employee has two years from the date of the injury to file for workers compensation (or, if the employer initially paid voluntarily and then stopped, two years from the last payment). In Ohio, it is only one year. But, if you were not keeping up on the law, you might think it is two years. The statute of limitations was changed to one year in 2017 after decades of being two. But, to further complicate, this change only applies to injuries and death from injuries. The statute of limitations for occupational diseases and death from occupational diseases remains two years.

Ohio also has something known as “subrogation,” which allows the Bureau of Workers’ Compensation to recover from the injured person being compensated if the injured person has recovered twice. An example of this would be if the person receives workers’ compensation and then sues the person responsible (which could not be his or her employer) and receives money from the lawsuit as well. The Bureau of Workers’ Compensation would be able to recover some of the money from the lawsuit. Kentucky has similar provisions, although subrogation is calculated very differently in the two states.

Kentucky has a specific law that allows coal miners suffering from Black Lung (which this author’s great-grandfather died from) to recover extra, although this law continues to fluctuate.

These examples demonstrate a portion of the complexities of workers’ compensation laws. There are many deadlines and forms to keep track of, and the laws continue to change. With the state elections taking place this year, the possibility remains strong that more changes are coming. It is possible for you to track this yourself, but attorneys have more experience dealing with these claims and better resources available to research and help with the case.

There are some situations in which an attorney is especially needed. One, representation is more needed when the employer does not cooperate. Perhaps the employer denies the claim, refuses to fully compensate you, or you are retaliated against. It can also help to have an attorney if there is something else complicating your claim, such as if you are receiving other government benefits or have a preexisting condition, or if your injury is serious and affects your work. It is also advisable to have an attorney with you when you have a workers’ compensation hearing.

If you are in this unfortunate situation or find yourself in it in the future, keep this in mind. You can go it alone, but it might be a more effective claim with some assistance from workers’ compensation attorneys.

Do you need help with a Workers’ Compensation claim? Call Lawrence & Associates and let one of our experienced attorneys help. We’re Working Hard for the Working Class, and we want to help you!


Workers’ Compensation Death Benefits in Kentucky and Ohio

Posted on Wednesday, October 17th, 2018 at 8:35 am    

The following post is part of our Law Student Blog Writing Project, and is authored by Dayna Wilson, a law clerk at Lawrence and Associates, who is pursuing her Juris Doctorate at Chase College of Law.

girlA loved one suffering a death on the job can be painful and extremely traumatizing. Determining which benefits a family is entitled to can be a rigorous and complex process. This process can be can be made significantly easier if you have an experienced workers’ compensation attorney who can thoroughly explain and guide your through the procedures.

Lawrence & Associates will strive to ensure that you receive the compensation you deserve after a fatal death of a loved one. In Kentucky and Ohio there are slightly different benefits that loved ones may recover. This blog is designed to provide you with a better understanding of workers’ compensation death benefits.

Who Can Recover Death Benefits in Kentucky?

Losing an income earner can be financially difficult for a family. When the death of a loved one would not have occurred but for an on the job injury, the deceased’s surviving family members may be entitled to benefits under the Workers’ Compensation System. First, the people who are eligible to recover benefits in Kentucky include: a surviving spouse, minor children of the deceased worker, mentally disabled adult children of the deceased worker, and the parent of the deceased worker, if he or she had no spouse and no children.

Under Kentucky law, there are two possible statutes that can apply when determining your ability to recover your deceased family member’s income benefits. First, Kentucky Revised Statute 342.750 tells us the amount of compensation a widow and widower may receive when an injured worker dies because of the workplace injury:

(a) If there is a widow or widower and no children of the deceased, the widow or widower may receive 50 percent of the average weekly wage of the deceased

(b)  To the widow or widower, if there is a child or children living with the widow or widower, 45 percent of the average weekly wage of the deceased, or 40 percent, if such child is not or such children are not living with a widow or widower, and in addition, 15 percent for each child. When there are more than two children involved, benefits shall be divided among the children.

According to Kentucky Guidebook to Worker’s Compensation, if an employee dies as a result of a work- related injury, a lump sum payment will be made to the deceased employee’s estate. If an employee’s death occurs within four years from the date of injury, as a direct result of the injury, a lump sum payment to the estate will be made from which burial expense are to be paid. The surviving spouse and certain defendants are also entitled to income benefits. Currently, Kentucky’s death benefit is $83,336.22. This amount is paid into the deceased worker’s estate.

The next statute that may apply to your situation is Kentucky Revised Statute 342.730 (3) when an employee, who has sustained disability dies from causes other than the injury but is otherwise still able to recover benefits.

(a) To a widow or widower, if there is no child under the age of 18 or incapable of self-support, benefits at 50% of the rate specified in the award; or

(b) If there are both a widow or widower and such a child or children to the widow or widower 45% of the benefits specified in the award. If a child is not living with a widow or widower then 40% of the benefits specified in the awards.

(c) If there is no widow or widower but such a child or children, then to then the children are entitled to 50 % of the benefits specified in the award.

As you can see, this process can be quite complex and complicated. Therefore, it is in your best interest to contact an experienced Workers’ Compensation attorney to assist you with your rights to recovery.

How do you become Eligible for Survivor Benefits in Ohio?

Similar to Kentucky, Ohio has strict rules set up to pay workers’ compensation benefits to the family of a fatally injured worker. If you are a surviving spouse, minor child of the deceased worker, or mentally disabled adult child of the deceased worker. In Ohio there are three types of benefits available to the family. The family may be eligible for a lump sum, payment of medical bills before death, and a benefit to dependents that is paid on a weekly or bi-weekly basis from the date of the worker’s death onward. Workers’ Compensation will pay 100% of your medical bills directly to the provider.

Unfortunately, Pursuant to Ohio Revised Code 4123.66 an individual may not recover more than $5,500 for funeral expenses. This statute puts many families in an unfortunate situation because it will often times provide inadequate relief for the suffering family. I am sure you can imagine; this number seems completely unreasonable for the amount of pain and suffering incurred by the deceased family.

Again, like Kentucky, if you are wanting to recover damages such as pain and suffering, loss of guidance or loss of consortium you would have to file a civil lawsuit. A spouse will receive death benefits until he or she dies or remarries. Upon remarriage, the spouse will receive a lump sum of two years’ worth of benefits.

If you are a dependent of the deceased worker, under ORC 4123.59, as long as you are a spouse or child, both can receive two-thirds of the “average weekly wage” the worker had before he or she died. A child is able to collect this benefit until the child turns eighteen. If a child is still in school, benefits will continue until the child turns 25 or unless the child is incapable of having a job for other reasons. For other family members, the Bureau decides how long benefits continue.

What are the Time Limits for a Death Claim?

Dependents must file a claim for death benefits with the Ohio Bureau of Workers’ Compensation within one year of the worker’s death. In Kentucky, for the death benefits provided by the Kentucky Workers’ Compensation Act, the time limitations period is two years, and begins to run from the time of death.

Why Choose Lawrence & Associates for Workers’ Compensation?

According to the Bureau of Labor Statistics in 2016 there were 164 fatal occupational injuries. Falls, slips, or trips was the third-most frequent work event with 29 fatalities, unchanged from the prior year. When a worker passes away from a work-related injury a worker’s surviving family is eligible for benefits. An experienced workers’ compensation attorney will help you receive your deserving benefits. Here at Lawrence & Associates we will handle your workers’ compensation claims and make this difficult process a little easier for you and your family. We’re Working Hard for the Working Class, and we want to help you!


Warnings to Injured Workers in the Ohio Workers’ Compensation System

Posted on Monday, June 11th, 2018 at 11:31 am    

Compensation: When most people hear the word “compensation” they think of monetary recovery. While there is monetary recovery involved in Ohio Worker’s Compensation, it is only one of several benefits available to injured workers. In fact, Ohio Workers’ Compensation provides many forms of recovery that are valuable, but do not come in the form of a check or monetary award. These valuable benefits are unique to Workers’ Compensation and are often times not available in civil lawsuits. However, these added benefits do come as somewhat of a “tradeoff” as some of the monetary recovery received via the Ohio Bureau of Worker’s Compensation is smaller in amount or may seem less significant at first glance when compared to the monetary recovery that can be common in civil litigation. This blog discusses some of the unique aspects of the Ohio Worker’s Compensation system; pointing out both the positives and the negatives for injured workers as compared to more typical civil litigation lawsuits.

In order to receive any Ohio Workers’ Compensation benefits, monetary or otherwise, a claim must first be allowed by the Ohio Bureau of Workers’ Compensation. Before wasting your time, energy, and resources spinning your wheels to see if your claim is allowed you will want to consult with an attorney who specializes in Ohio Workers’ Compensation. What they tell you may surprise you. For example – did you know that Ohio is a “no fault” state? This means that no showing of breach of duty on the part of the employer is required for the allowance of a claim. Unlike commonplace civil litigation the defendant need not do anything wrong, careless, or negligent. If an employee is hurt in the course of, and arising out of, the injured employee’s employment they are covered! The actions the employer took, or failed to take to prevent such an accident are most times irrelevant.

While this no fault system may lead an injured worker to believe it is easy to get their claim allowed and compensation awarded, there are many other hurtles the injured worker may be unaware of that will cause their claim to be denied if not handled correctly. For example, if an employee legitimately gets hurt at work, but hurts a part of their body that has been hurt previously, or may not be perfect to begin with due to the natural aging process, the allowance of such claim may be fought by several other parties at several levels on the basis that it was a preexisting condition. Another situation in which it is nearly impossible to get a claim allowed is for a psychological condition. While Ohio does recognize psychological conditions in certain situations, there are particular procedures and requirements which must be met to receive benefits for psychological injuries. Another quite common scenario is for a claim to be initially allowed for a very minor injury, such as a sprain or strain, but then to not be recognized for the true, but more expensive condition suffered such as radiculopathy or torn muscles and ligaments which will require surgery. Only an experienced Ohio Worker’s Compensation attorney can help overcome these common obstacles in receiving the benefits an Injured Worker may be entitled to.

Where’s the money?

Generally speaking there is a lot less monetary compensation paid to plaintiffs in Ohio Workers’ Compensation than would be recovered for the exact same injury in a Personal Injury lawsuit. The reason for this is twofold: First, there are benefits for plaintiffs hurt at the work place that are not available to plaintiffs in Personal Injury lawsuits; these benefits will be spelled out later on in this blog article. Secondly, as a counter balance to some of those benefits to the injured worker, there are no punitive damages (in other words no pain and suffering) imposed on the employers of a Workers’ Compensation claim, unless there is a special circumstance known as a VSSR.

So, now that we’ve established that plaintiffs tend to recover significantly less money through Workers’ Compensation as compared to other civil litigation, let’s talk about how much money is involved and when an injured worker can expect to receive it. There are usually two situations in which an injured worker can expect to receive monetary compensation in a typical Ohio Workers’ Compensation Claim. The first is known as Temporary Total Disability, or TTD for short. An Injured Worker becomes eligible for TTD when they miss eight or more consecutive days of work and a Doctor has taken them off of work via a form called a MEDCO14. Therefore, plaintiffs who have missed less than eight consecutive days or do not have a MEDCO14 completely filled out and clearly stating that they have work restrictions that prevent them from returning to work will not be eligible for TTD. This is one reason why it pays to have an attorney in your corner. Oftentimes Doctors who are unfamiliar with such required forms will fail to fill them out or fill these forms out riddled with errors. These mistakes can cost injured workers thousands of dollars in TTD, so you will want someone who is familiar with these requirements to advocate on your behalf to your doctor.

The next question you may have is, “how much TTD can I expect to get?”

This number is calculated by statute and is dependent on the wage you were earning prior to your workplace injury. This calculation is set out by the Ohio Revised Code and can be complex and confusing to understand. Therefore it is important to consult with an attorney to ensure you are not being shortchanged on the TTD you receive. One aspect of this type of wage loss recovery that differs from its civil litigation counterparts is that TTD is capped every year by state statute. For example, injured workers receiving TTD in 2018, can receive no more than 902 dollars per week, regardless of what they were earning prior to their injury.

The second major situation an injured worker is typically eligible for monetary compensation is much later on in their claim when they have been determined by a doctor to have reached Maximum Medical Improvement, or MMI. MMI is defined by Ohio statute as “a treatment plateau (static or well-stabilized) at which no fundamental functional or physiological change can be expected within reasonable medical probability in spite of continuing medical or rehabilitative procedures.” However, reaching MMI does not necessarily mean the injured worker is %100 recovered. Again the monetary compensation is set out by the Ohio Revised Code, which provides a calculation that is based on the Permanent Partial Disability the injured worker has sustained. By way of example, if an injured worker reaches MMI, but is determined to only be 90% recovered, their compensation will be based on the remaining 10% Permanent Partial Disability. Much like TTD, this calculation is confusing and the process for obtaining this award is complex. This is another component of Workers’ Compensation in which an attorney who specializes in Ohio Workers’ Compensation will add tremendous value to your claim.

Other possible, but far less common Workers’ Compensation monetary benefits can include: working wage loss, VSSR, death benefits, and living maintenance. Only an attorney with experience in Ohio Workers’ Compensation will be able to identify if these special benefits are entitled to a particular injury or claim.

Other than monetary compensation, Ohio Workers’ Compensation provides injured workers with medical treatment and rehabilitation that can often times far outweigh the value of compensation paid via TTD and Permanent Partial Disability. The Ohio Workers’ Compensation system is designed to enable Injured Workers to be treated and get back to work as soon as possible. Therefore if an injury or disease is determined to be work related, treatment for such aliment is covered through the Workers’ Compensation System. Such treatment can include, but is not limited to surgeries, diagnostic tests such as MRIs and x-rays, physical therapy, chiropractic treatment, and pain management. However, for this valuable treatment to be covered through your Workers’ Compensation claim, the treatment must be deemed reasonable and necessary to treat a condition that has been formally allowed in the claim. Again, getting both conditions and treatments allowed is confusing and time consuming. If a condition or treatment is denied an injured worker may only have a short amount of time to figure out how to appeal it. This is when an attorney with Ohio Workers’ Compensation experience can make a remarkable difference in your claim.

Due to the fact that so many of these benefits are received by the injured worker before the end of their claim, the payout at the end in the form of Permanent Partial Disability, is much less than what would be recovered for the same injury in civil litigation. In other words, if a person were to recover for an accident through a personal injury lawsuit, that person would have to front all of their own medical treatment, and come up with income during time missed from work, then at the end of their treatment they would recover all of the money spent on medical bills, lost on missed wages, and even be compensated for their pain and suffering. In Ohio Workers’ Compensation however, the Injured Worker will be receiving most of these benefits as they work through the claim, and because the Ohio Workers’ Compensation system is set up to get workers back to work rather than to punish employers the monetary sum at the end will almost always be quite less than the same injury would result in through a Personal Injury claim.

Many injured workers are surprised to find out that even after reaching MMI and getting a Permanent Partial Disability award, there may be further benefits an injured worker is entitled to, that only an attorney with Ohio Workers’ Compensation experience will be able to identify. These can include maintenance treatment, vocational rehabilitation, and even future increases in Permanent Partial Disability.

So the next question you might be asking yourself is, “Yes I can see that having an attorney who understands the complexities of the Ohio Workers’ Compensation system is important. But I am out of work and how am I supposed to pay an attorney?”

The good news is that most Workers’ Compensation Attorneys work on a contingency basis. Meaning, the attorney only gets paid a percentage of money they recover for you. Therefore, just as most injured workers are eligible for monetary awards twice during their claim, so also attorneys get paid for their work most commonly at these two junctures as well: when back due TTD is awarded, and at the resolution of the case upon reaching MMI. “What about when my attorney wins additional conditions, diagnostic tests, or treatment for me?” You might ask. Most attorneys will only charge a very small and nominal fee for this type of service if that attorney feels that the Injured Worker is not likely eligible for any of the monetary compensation to which they would collect a typical fee for. If the attorney is certain that there is lost time at issue in the claim, or a Permanent Partial Disability has been suffered by the injured worker, any work done to get treatment allowed will be done at no additional charge.

Last, but certainly not least are some time frames that injured workers should be well aware of. The first is that of a short 14 day appeal deadline. Oftentimes when an aspect of a claim, or a claim in its entirety is not allowed an Injured Worker may have only 14 days to appeal such a decision. Additionally, disputes over the allowance of benefits necessitate Injured Workers to appear at various hearings and medical exams on quite little notice. Thus, an injured worker does not want to delay in getting an attorney. In order to make sure you have representation at such hearings, and to ensure you do not miss appeal deadlines, it is in your own best interest to retain an attorney as early as possible.

In sum, Ohio Workers’ Compensation is a complex area of the law. Attorneys and non-attorneys alike may has some understanding of what to expect in a run of the mill civil lawsuit, but these understandings and expectations cannot be applied in the same way to Ohio Workers’ Compensation claims. Before you find yourself in over your head, or facing a deadline that you do not understand come in for a free consultation with one of our attorneys who specializes in Ohio Workers’ Compensation.


Why Is a Treating Doctor an Important Part of a Worker’s Compensation Case?

Posted on Tuesday, May 22nd, 2018 at 12:39 pm    

When a worker gets injured at work, they aren’t thinking about which doctor to go to. They are hurt and want medical attention and that’s about as far as the thought process goes. In contrast, the insurance company has already given the subject a lot of thought. Often insurance companies have pre-selected the doctor’s office they want an injured worker to treat with. While their medical treatment is not controlled by the insurance company directly, these offices are in long-standing relationships with the workers’ compensation carrier.

Under Kentucky workers’ compensation law, medical treatment is controlled by a “designated physician” this is a doctor the injured worker selects on what is known as a “Form 113”. Sometimes an insurance company will fill in the Form 113 with a physician’s office of their choosing. However, the injured worker has the right to pick their own doctor.

The selection of a Form 113 doctor is crucially important. This doctor is the “quarterback” of the injured worker’s medical team. They are the physician who calls the medical plays, so to speak. This doctor determines whether a referral to a specialist is necessary, and they often make a recommendation as to which specialist to see. This in turn determines whether an injured worker gets diagnostic testing such as MRIs and whether the injured worker gets surgical care.

For the selected doctor, the decision on medical care is actually twofold, not only are they determining whether they think there is a medical need for treatment, they are deciding whether or not the treatment is work-related. For example, let’s say you twisted your knee at work. If your doctor is of the mindset that you need surgery now but consider that part of that surgery is to treat an arthritic condition, they might determine that you cannot have the surgery under workers’ compensation coverage. This might be the case even though you 1) got hurt at work, 2) there were witnesses 3) you had never once received any kind of medical care for arthritis or for your knees in your entire life!

When a doctor makes this decision they are not necessarily following the law. In Kentucky it is well-established that if a worker has some kind of condition that pre-existed the work injury, but was dormant i.e. it never bothered them before the work injury so they weren’t under medical care for it and then the condition becomes problematic after the work injury then both the work injury itself AND the prior dormant condition can be treated under the workers compensation carrier coverage. If the injured worker is off work while this treatment is undertaken, they may qualify for income benefits.

This makes the doctor’s decision very important. If a doctor does not agree with the law, say, due to their political stance, or if the doctor simply is unaware of the law, the treatment and income benefits the injured worker is entitled to may get denied. As you can see, it is extremely important that an injured worker gets a treating physician that either already has an understanding of the legal ramifications of the decisions they make or is at least willing to listen and learn. Sadly, not all doctors are.

An understanding of the workers’ compensation system is not the only requirement for the right treating physician. An insurance company is in business to make money. They do not make money by paying for medical care or paying an injured worker income benefits. Therefore, they will do things to try and minimize the amount they pay out. One of the things the insurance company will do is challenge the medical treatment through a process called utilization review, or peer review. In these scenarios the insurance company has hired a doctor, or often a nurse, to review the records to see if they believe the injured worker should get the medical care their doctor asked for. The reviewer will not see the patient, not even once, they will often refer to what are called the Official Disability Guidelines, and commonly they will determine that the treatment is not compensable. In the denial they will often state that they attempted to call the treating doctor but could not get through. The treating doctor has the right to appeal the decision of the reviewer, but they have a limited amount of time. It is very important that the injured worker has a doctor who is willing to answer the call and to respond to the denial when it comes. If the doctor simply doesn’t bother, the injured worker may have to litigate just to get their medical care, and this can take months. If the injured worker gives up, then the insurance company saves a bunch of money.

The treating doctor has an important role to play in the amount of income benefits an injured worker receives. This is because these benefits are calculated using an impairment rating provided by the physician. Many times, a hired expert will give an opinion on the percentage of impairment, and a good attorney will know which experts to use. However, the Administrative Law Judges often consider the view of the treating physician to be very significant. If your treating doctor is unwilling to figure out your impairment, or if they are unfamiliar with the process, they will not be assisting your case.

The treating doctor will be the one who assesses work restrictions, in other words they determine whether an injured worker can go back to work. Often the insurance company will employ a nurse case manager who will question the doctor on this issue. The injured worker will want a physician that is willing and able to justify their decision on work restrictions under this kind of challenge.

At Lawrence & Associates we describe the physicians that do these things as “patient advocates”. While proper medical care is essential, patient advocacy is always very important too.


Employee Deaths on the Job: What Benefits Do Ohio and Kentucky Workers’ Compensation Provide?

Posted on Thursday, May 10th, 2018 at 8:15 am    

The saddest day at Lawrence & Associates is when our attorneys sit down with a grieving widow, widower, or family member to discuss the workplace death of a loved one. Injuries are bad enough – always painful, often debilitating – but injuries can heal. When a family member dies, however, we are left with the difficult task of explaining how the Workers’ Compensation law compensates for a death the cold math and dollars and cents. Often called “survivors’ benefits,” they do anything but make the survivor whole. However, since our firm is located in the Cincinnati area and therefore workers with deceased workers’ families in both Kentucky and Ohio, we have seen big differences in how the law handles compensation for employee’s deaths. The deficiencies in the Workers’ Compensation system for these tragedies may shock you.

Worker Deaths in Ohio – What Benefits are Owed to the Family?

Ohio’s Workers’ Compensation system has three types of benefits. There is a death benefit that is paid to the deceased workers’ estate in one lump sum, a provision for payment of all medical bills incurred before death, and a benefit to dependents that is paid on a weekly or bi-weekly basis from the date of the worker’s death onward. Of these three, the medical benefit is the easiest to describe – 100% of all medical bills must be paid directly to the provider. No money goes to the deceased’s estate or family related to the medical bills.

The death benefit in Ohio is truly shocking – Ohio Revised Code 4123.66 only allows $5,500 dollars for funeral expenses, and no other amount for the deceased workers’ pain and suffering or loss of future earnings. Compare this to a person that dies in a car accident, who can sometimes get millions of dollars for pain and suffering or loss of future earnings. Assume, for a moment, that a 40 year person earns $10/hour and is killed. Even if you only paid their family for their loss of future earnings going forward with no allowance for inflation or wage raises, that 40 year old would earn $561,600 before reaching social security retirement age. The $5,500 offered by Ohio’s Workers’ Compensation system is paltry by comparison, and many commenters have observed that it makes it cheaper for a company to kill a worker than to injure the worker. Unfortunately, until Ohio’s state legislature changes this law, Ohio workers are stuck with a $5,500 death benefit.

Ohio is friendlier to the dependents of the deceased worker, so long as those dependents are spouses or children. Under ORC 4123.59, both receive two-thirds of the “average weekly wage” the worker had before he or she died. Spouses receive this money until they re-marry, at which time they receive two years of this benefit as a lump sum and then cease receiving it. Children receive this benefit until they turn eighteen, unless they are in school (in which case the benefit continues until the child turns twenty-five), or unless the child is incapable of having a job for other reasons (such as a physical or mental disability). However, fully dependent parents or siblings of the deceased worker cannot receive any benefit whatsoever.

The failings of Ohio’s system are laid bare when you consider the example of June. June was a civil engineer. She worked her way through school and, by age 30, she had an excellent job with a construction company making $120,000 per year. She was responsible for caring for her younger brother, who had severe mental retardation, and who lived with her. (Her parents had died several years before.) But June was killed in an on-site accident at age 33. Because her brother is not provided for by statute, and because June’s small family did not have the resources to care for him, he was forced to go to an assisted living facility. And because Ohio’s laws provide such a poor death benefit, June’s death was compensated only by paying $5,500 – which covered only 75% of her funeral costs. Surely there has to be a better way.

Worker Deaths in Kentucky – What Benefits are Owed to the Family?

Much like Ohio, Kentucky’s system provides for full payment of all medical bills, a death benefit, and a weekly or bi-weekly benefit to the deceased worker’s dependents. However, Kentucky’s provisions are much more generous. First, Kentucky’s death benefit is updated every year to account for inflation, and as of 2018 is currently sits at $83,336.22. This amount is paid directly into the deceased workers’ estate. Kentucky’s Department of Workers’ Claims updates the death benefit on their website every year.

In addition, Kentucky Revised Code 342.750 provides benefits to more people than Ohio’s law does. General guidelines are as follows:

  1. In Kentucky, a surviving spouse with no children gets 50% of the deceased employee’s average weekly wage. Upon remarriage, the spouse also receives a two year lump sum.
  2. If there are surviving children and a surviving spouse, the spouse gets 45% if the kids live with him or her, and 40% if not. The children get 15% for each child, not to exceed 30% total. If there are more than two children, each child gets an equal share of 30% of the average weekly wage. The child’s benefit ends when the child turns eighteen, unless they are in school (in which case the benefit continues until the child turns twenty-two), or unless the child is incapable of having a job for other reasons (such as a physical or mental disability).
  3. Actually dependent siblings, parents, and grandparents can receive 25% of the deceased workers’ average weekly wage.

Considering June’s example, above, it is easy to see that Kentucky’s system is superior. The death benefit would have more than covered the funeral expenses, and would have created a nest egg for a family member to help take care of June’s brother. And the weekly benefit for June’s brother would have continued to provide June’s family a way to care for him going forward. While both Ohio’s and Kentucky’s systems could use some tweaking and updating, Kentucky does a far better job of taking care of its’ deceased workers’ families.

If you have any other questions about Survivor Benefits in Workers’ Compensation cases, please call our Fort Mitchell, Kentucky office at 859-371-5997 or our West Chester, Ohio office at 513-351-5997. We are one of the largest workers’ compensation firms in Greater Cincinnati and we have helped over 3,000 clients. We’re Working Hard for the Working Class, and we want to help you!


The Benefits Available Through Workers’ Compensation in Cincinnati, Ohio

Posted on Wednesday, May 2nd, 2018 at 10:13 am    

The following post is part of our Law Student Blog Writing Project, and is authored by Thomas Rovito, who is pursuing his Juris Doctorate at the Ohio State University.

When one thinks of workers’ compensation, a person may reasonably think of it as a monolithic concept. However, when the theory meets reality, Ohio workers’ compensation includes several varieties, such as medical care, temporary disability, partial disability, permanent total disability, and benefits in case of death, all with unique characteristics under Chapter 4123 of the Ohio Revised Code.

Before reaching the characteristics of the unique varieties of workers’ compensation in Ohio, it is important to take stock of readily available and free resources on this topic. First, the Ohio Bureau of Workers’ Compensation and the Ohio Attorney General’s Workers’ Compensation Section have free resources from the state on this topic. While the webpages of the state agencies can be hard to navigate, they do have in-depth publications for injured worker, such as BWC Basics for Injured Workers and Compensation Types. Third-party legal websites Nolo and Findlaw have great information on this topic available for free. In addition, professional groups like the Ohio State Bar Association maintain readily available pamphlets on this topic.

Now, let’s turn to the characteristics of the unique varieties of workers’ compensation in Ohio.

I. Medical Care (O.R.C. § 4123.66)

This benefit includes “the amounts for medical, nurse, and hospital services and medicine as the administrator deems proper” under O.R.C. § 4123.66(A). In addition, this section includes “reasonable funeral expenses in an amount not to exceed fifty-five hundred dollars” if “death ensues from the injury or occupational disease.” If the injury damages the “eyeglasses, artificial teeth or other denture, or hearing aid” of the worker, they will be entitled to “a reasonable amount to repair or replace the same.” This statute also outlines the counter of the first prescription drug refill and welfare plans, which are further fleshed out in administrative rules derived from the statute.

II. Temporary Disability (O.R.C. § 4123.56)

Under temporary disability, “an employee shall receive sixty-six and two-thirds per cent of the employee’s average weekly wage so long as such disability is total” with a few internal threshold caveats as described in Chapter 4123. If the injury persists and prevents the clamant from working in the professional opinion of a certified medical doctor, after two hundred weeks the clamant must report for a determination by the Bureau of Workers’ Compensation for a permanent disability status determination. In addition, if the employee suffers a wage loss “as a result of returning to employment other than the employee’s former position of employment due to an injury or occupational disease” or “as a result of being unable to find employment consistent with the employee’s disability resulting from the employee’s injury or occupational disease,” then the employee is entitled to “compensation at sixty-six and two-thirds per cent of the difference between the employee’s average weekly wage and the employee’s present earnings, not to exceed the statewide average weekly wage” which cannot go beyond two hundred and twenty-six weeks in total.

III. Partial Disability (O.R.C. § 4123.57)

Partial disability flows from “[t]he district hearing officer, upon the application, shall determine the percentage of the employee’s permanent disability . . . based upon that condition of the employee resulting from the injury or occupational disease and causing permanent impairment evidenced by medical or clinical findings reasonably demonstrable.” This statute also has a schedule for injuries. For instance, the loss of a little finger is 15 weeks, whereas the loss of a leg is 200 weeks.

IV. Permanent Total Disability (O.R.C. § 4123.58)

If a worker is permanently and totally disabled, then “the employee shall receive an award to continue until the employee’s death in the amount of sixty-six and two-thirds per cent of the employee’s average weekly wage” with limited caveats. If the employee is also receiving Social Security disability benefits, and those benefits are reduced or terminated, then “the workers’ compensation award shall be recomputed to pay the maximum amount permitted under this division.” Very importantly, O.R.C. § 4123.58(C)-(D) distinguishes between what constitutes permanent total disability, and what does not constitute permanent total disability. Permanent total disability includes when “[t]he claimant has lost… the use of both hands or both arms, or both feet or both legs, or both eyes, or of any two thereof,” or “[t]he impairment resulting from the employee’s injury or occupational disease prevents the employee from engaging in sustained remunerative employment utilizing the employment skills that the employee has or may reasonably be expected to develop” under O.R.C. § 4123.58(C). However, permanent total disability does not cover “[i]mpairments of the employee that are not the result of an allowed injury or occupational disease,” “[s]olely the employee’s age or aging,” “[t]he employee retired or otherwise voluntarily abandoned the workforce for reasons unrelated to the allowed injury or occupational disease,” and “[t]he employee has not engaged in educational or rehabilitative efforts to enhance the employee’s employability, unless such efforts are determined to be in vain” under O.R.C. § 4123.58(D).

V. Benefits in Case of Death (O.R.C. § 4123.59)

Ohio law distinguishes between benefits in case of death if the worker dies from an injury or occupational disease cause by their employment if the employee has any dependents or not. If the employee does not have any dependents, then “the disbursements from the state insurance fund is limited to the expenses provided for in section 4123.66 of the Revised Code.” On the other hand, if the decedent employee does have “wholly dependent persons at the time of death,” then “the weekly payment is sixty-six and two-thirds per cent of the average weekly wage” subject to state-established internal payment caps. If there is more than one “wholly dependent persons at the time of death,” then “the administrator of workers’ compensation shall promptly apportion the weekly amount of compensation payable under this section among the dependent persons.” Dependent spouses “shall continue from the date of death of an injured or disabled employee until the death or remarriage of such dependent spouse. If the dependent spouse remarries, an amount equal to two years of compensation benefits at the weekly amount determined to be applicable to and being paid to the dependent spouse shall be paid in a lump sum to such spouse and no further compensation shall be paid to such spouse.” Other dependents “shall continue from the date of death of an injured or disabled employee to a dependent as of the date of death, other than a spouse, at the weekly amount determined to be applicable and being paid to such dependent other than a spouse.” These payments cease when other dependents “[r]eaches eighteen years of age;” “[i]f pursuing a full time educational program while enrolled in an accredited educational institution and program, reaches twenty-five years of age;” or “[i]f mentally or physically incapacitated from having any earnings, is no longer so incapacitated.”

Thus, workers compensation in Ohio comes provides many different benefits, including medical care, temporary disability, total permanent disability, benefits in case of death, all with unique characteristics. If you have been injured on the job and have additional questions, Lawrence & Associates offers free, confidential consultations. We’re Working Hard for the Working Class, and we want to help you. Call today!


Cincinnati, Ohio Workers’ Compensation Awards for Permanent Partial Disability and Permanent Total Disability

Posted on Monday, April 23rd, 2018 at 1:59 pm    

The following post is part of our Law Student Blog Writing Project, and is authored by Jennifer Tressler, who is pursuing her Juris Doctorate at The Ohio State University Moritz College of Law.

Below is a case study used by law students to teach them about the difference between Permanent Partial Disability (PPD) and Permanent Total Disability (PTD). By reading it, you may learn which of these applies to your Workers’ Compensation claim!

What Injuries Led This Cincinnati Woman to File for Workers’ Compensation?

Sherry Redwine was injured at work on August 13, 2003. She filed a workers’ compensation claim for lumbosacral strain, radiculopathy right lower extremity, aggravation of pre-existing degenerative disc disease, depression, and ruptured disc at L4-5 with free disc fragment and applied for permanent-total disability compensation. It was determined that she was now unable to perform any sustainable employment due to the medical impairment caused by her psychological condition, and thus she was awarded benefits to continue until her death.

In August 2013, Ms. Redwine applied for permanent-partial disability compensation. While she admitted that she was not entitled permanent-partial disability compensation for her psychological condition (which she had already been awarded permanent-total disability compensation for), she stated that she was entitled to this award based on her physical conditions. Her application was denied by a district hearing officer, who noted that her physical and psychological impairments were a result of the same workplace injury, saying therefore that she would be unable to collect both permanent partial disability and permanent total disability for the same injury. A staff hearing officer reconsidered her case and decided that claimants would not be barred from collecting both types of compensation provided that the conditions for which s/he is seeking permanent-partial disability were not the basis for which the permanent-total disability had been awarded.

In response to this, Ms. Redwine’s employer, Ohio Presbyterian Retirement Services, Inc. (OPRS), filed a complaint alleging that there was no evidence or authority to base this decision upon, but their complaint was denied. OPRS then appealed this decision to the Supreme Court of Ohio. Their appeal contains references to three different Ohio statutes (O.R.C. 4123.95, O.R.C. 4123.58, O.R.C. 4123.57(A)). The Supreme Court was concerned with the Industrial Commission’s interpretation of these statutes. In the event that the Commission is found to have misinterpreted a statute, the Court has the authority to issue something called a writ of mandamus to correct the misinterpretation.

How Do Permanent Partial Disability (PPD) and Permanent Total Disability (PTD) Actually Work?

The Industrial Commission is authorized to pay permanent-partial disability compensation to employees who suffer an injury or disease that result in a permanent partial disability and is intended to cover employees who can still work. Permanent-partial disability compensation comes in two forms: (1) compensation for a specific loss and (2) compensation based on the percentage of permanent disability pursuant to O.R.C. 4123.57(A), which is the type of compensation at issue in Ms. Redwine’s case. For the latter type of compensation, a district hearing officer determines the percentage of disability based on evidence submitting at a hearing, with compensation based upon the employee’s wages.

Permanent-total disability is also calculated based upon an employee’s wages and lasts until the employee’s death. The purpose of this type of compensation is to provide injured workers with compensation for loss of earning potential resulting from their injury or disease. This type of compensation also has two categories: (1) compensation for loss of body parts and (2) compensation for a workplace injury that prevents the employee from obtaining future lucrative employment, which is the type of compensation at issue in Ms. Redwine’s case.

The rules of statutory interpretation that the Supreme Court of Ohio is bound by are that they must determine and attribute the legislative intent, that the legislative intent must be determined primarily from the language of the statute itself, and if the statute is unambiguous, they must apply the statute as written. It is also mandated that workers’ compensation laws be construed in favor of employees.

Keeping these rules in mind, the Supreme Court of Ohio’s main issue was to decide whether the Industrial Commission has the authority to grant concurrent compensation of permanent-partial disability and permanent-total disability under O.R.C. 4123.57(A) and O.R.C. 4123.58, respectively. They held that the Industrial Commission does not have this authority.

The Court’s reasoning is that the language of the statutes is so plain and unambiguous that they are forced to apply the language of the statutes as written. Since there is no language in the workers’ compensation statutes that specifically allow for concurrent payment of permanent-partial disability and permanent-total disability compensation, the Court was unable to find for Ms. Redwine. The Industrial Commission argued that the statutes do not specifically prohibit concurrent payments in the same claim, but the Court countered by pointing out precedent that an injured employee only has the right the recover workers’ compensation benefits allowed by statute. The Court says that if the legislature intended to allow injured workers to concurrently receive permanent-partial disability and permanent-total disability payments in the same claim, it could easily have included it in the statutes. The Industrial Commission maintained that the statutes neglecting to comment on the issue of concurrent payment creates an ambiguity in the statutory language that must be decided in the workers’ favor, but the Supreme Court of Ohio reasons that the omission was intentional. Per Ms. Redwine’s request, the Court reopened her case for further consideration, but after hearing oral arguments on both sides, the Court adhered to their decision.

How Can Greater Cincinnati Residents Get the Permanent Partial Disability (PPD) and Permanent Total Disability (PTD) They Deserve?

What does this mean for workers injured on the job? Being unable to concurrently collect both permanent-partial disability compensation and permanent-total disability compensation will reduce benefits able to be collected by the most severely injured workers on the job. Workers like Ms. Redwine, who suffered both extensive physical and extensive mental injuries during her employment, will need to choose whether to apply for permanent-partial disability compensation or permanent-total disability compensation, as they will be unable to successfully apply for and receive both types of compensation. This may sound overwhelming, or even scary, but do not be afraid to reach out for help!

If you have been injured on the job like Ms. Redwine, contact Lawrence & Associates today. We can help you explore options to get the workers’ compensation you deserve! Call today for a free consultation at (513) 351-5997. We’re Working Hard for the Working Class, and we want to help you!


Workers’ Compensation Benefits in Ohio

Posted on Friday, April 20th, 2018 at 10:04 am    

Attorneys Justin Lawrence & Marisa Dyson discuss the benefits that the Ohio Bureau of Workers’ Compensation (BWC) offers injured workers during and after a workers’ compensation claim.


The significance of Parker v. Webster County Coal LLC

Posted on Monday, April 9th, 2018 at 1:20 pm    

Parker v. Webster County Coal LLC (Dotiki Mine), 529 S.W.3d 759 (Ky. 2017) is one of the most impactful Supreme Court decisions on Kentucky workers’ compensation law in recent times. Members of the Kentucky Legislature are politicking over revisions to the law as a result of the decision and practitioners for plaintiffs and defendants are arguing over how to settle claims in light of the changing legal landscape. Injured workers are left uncertain as to what benefits they are entitled.

In a workers’ compensation claim, if an injured worker is not permanently totally disabled then they are entitled to either 425 weeks or 520 weeks’ worth of income benefits, as determined by their percentage of impairment. However, prior to Parker, benefits would cease upon the date that the employee qualifies for social security retirement benefits or two years after the employers injury, whichever last occurred, pursuant to KRS 342.730(4).

The state of the law was that if an older worker got hurt, they got less benefits than a younger worker with an identical injury. The logic of cutting off benefits to an injured worker who is older was to prevent duplicate benefits in the form of retirement income and to allow savings in the workers’ compensation system. Parker did not address the absurdity that not every employee ceases working at retirement age, nor did it comment as to whom such “savings” went (spoiler alert –it’s the insurance company). Parker determined the issue of whether there was a rational basis to support a statute that undisputedly treated older and younger workers differently, but it did so in a way that perhaps the parties did not expect.

Mr. Parker was born in October, 1939, and worked as an underground coal miner for Webster County Coal LLC since 1974. In September, 2008, he slipped trying to clamber over a conveyor belt, injuring his knee and back. The Defendant challenged the injury to the spine, but ultimately the Administrative Law Judge ordered both the back and knee were compensable. Mr. Parker was awarded 4% impairment for his knee and 22% impairment for his low back injury, a combination of 26% whole person impairment. Ordinarily this would have qualified someone for 425 weeks’ worth of benefits, but with Mr. Parker being 68 years old at the time of his injury he qualified for social security retirement benefits. The Administrative Law Judge found that because Parker had received two years of temporary total disability benefits he was not entitled to any additional income benefits for his permanent disability. The Administrative Law Judge based his reasoning on KRS 342.730(4).

Plaintiff appealed arguing the unconstitutionality of KRS 342.730(4) claiming infringement of his right to due process, abrogation of jural rights and violation of the equal protection clause. Defendant countered that based on precedent these arguments were without merit.

Indeed there had previously been a failed constitutional challenge to KRS 342.730 (see McDowell v. Jackson Energy RECC, 84 S.W. 3d. 71 (Ky. 2002) and Keith v. Hopple Plastics, 178 S,W. 3d 463 (Ky. 2005). The Court justified its reason to revisit in part on the 2011 case Vision Mining Inc. v. Gardner, 364 S.W.3d 455 (Ky. 2011) but ultimately the Court decided the issue on the distinction between teachers, who participate in a retirement program separate from Social Security Retirement, and other workers in the Commonwealth . Teachers who had not had outside employment and who suffered a work related injury were not subject to the limitation of KRS 342,730 because they never qualify for Social Security Retirement benefits. The Court framed the issue as being disparate treatment between older workers who qualify for Social Security Retirement and older workers who do not.

The Court applied a rational basis test, concluding that to be the correct standard for social legislation like the Workers’ Compensation Act. It found that treating all other workers differently than teachers did not have a rational basis. The Court found the logic of avoiding duplicate benefits failed muster in the teacher scenario and found that pursuant to Vision Mining financial savings did not constitute a rational basis either.

Following Parker, it appears the Department of Workers’ claims is falling back to the tier down provision of the 1994 Act. Pursuant to that statute, an award of benefits was reduced by 10% at age 65 for one year and then reduced again by 10% annually until age 70. Once an injured worker reached 70, the benefits were no longer tiered down and they would continue for the duration of the award. Under the 1994 statute, Mr. Parker would be entitled to 425 weeks’ worth of benefits, rather than none at all.

The Kentucky legislature appears to be entertaining a much more severe reduction for the elderly workers of Kentucky. As of writing, Defense attorneys are arguing that benefits are likely going to be capped at 67 regardless of retirement benefits. Workers compensation carriers are taking this position on claims in and out of litigation to try and reduce their exposure on claims where the injury is clearly compensable.

Increasingly, people do not retire at 65. Sometimes they wish to continue their work, perhaps more often they have no choice but to work, people are living longer and retirement benefits are often insufficient. Occasionally, older workers need to support grandchildren or other people dependent for a myriad of reasons. Our 2018 society does not support a bright line rule that income benefits injured people rely on should stop at 65, 67, or any other arbitrary age. It is perhaps significant to remember the purpose of act, to provide income benefits and medical treatment for the cure and relief of a work-related injury. The focus should not be how old, it should be how hurt. If we lose sight of that everybody potentially suffers.


Lawrence & Associates Help Cincinnati Firefighter Get Workers’ Compensation Benefits

Posted on Wednesday, April 4th, 2018 at 10:16 am    

The following post is part of our Law Student Blog Writing Project, and is authored by Joseph Lowe. Lowe is a law clerk here at Lawrence and Associates, and is pursuing his Juris Doctorate at NKU Salmon P. Chase College of Law.

Lawrence & Associates pays attention to the law. You probably read that and thought, “Well, I hope an experienced group of attorneys pays attention to the law!” But what you may not know is that over time the law changes. What separates the great attorneys from the rest is the amount of attention they pay to the ever changing law. Recently, Attorney Marisa A. Dyson exemplified what it means to pay attention to the new laws and the benefits they can provide injured workers.

Marisa has been practicing law since 2014. She desires to represent her clients to the best of her ability and that means keeping tabs on how the law may be changing. Marisa represents many clients with Workers’ Compensation claims. Recently, Marisa won a case for her client largely because she was paying attention to new changes in the law. Before April of 2016 a firefighter could not get Workers’ Compensation benefits if he could not prove that his cancer was caused by exposure to all of the various carcinogens that come with fighting fires. Obviously, as pinpointing the cause of cancer is nearly impossible, this was a very difficult burden for injured workers to satisfy.

This past year Marisa represented a client who may not have been able to get the benefits he desperately needed if this new law were not enacted. Marisa followed Ohio S.B. 27 and the corresponding new legislation which became effective in April of 2016 and used this brand new statute to gain Workers’ Compensation coverage for a firefighter. This law was specifically enacted for the protection of firefighters who are denied Workers’ Compensation when they are suffering from cancer that they have acquired from the risks of their job.

Marisa’s client had been a firefighter for almost 30 years and had developed cancer as a result of his service to his community. This new law lays out a rebuttable presumption that if a fire fighter contracts cancer before the age of 70, has completed 6 years of hazardous duty within the past 15 years, and develops cancer, such cancer is caused by and a result of his or her employment. Marisa argued the facts of her client’s case and fought to get him the benefits he deserves. Specifically, Marisa won the firefighter the benefits he is entitled under the new law by proving:

  1. Her client served as a firefighter in hazardous duty for the required 6 years,
  2. Her client was under 70,
  3. Her client was actively working for the fire department within the past 15 years,
  4. Her client was disabled because of his cancer, and
  5. Her client was exposed to a 1 or 2A carcinogen as a result of employment.

It is important to have an attorney who not only advocates for your cause, but is equipped with the proper knowledge of what the law is when it matters to you. Marisa and the attorneys at Lawrence and Associates pay attention to the law and how it is changing. They are experienced at representing a variety of clients and will provide expert legal representation to every client they serve. If you need help with a Workers’ Compensation claim, don’t go it alone. Call Lawrence & Associates for a 100% free consultation. We’re Working Hard for the Working Class, and we want to help you!

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