Types of Workers' Compensation in Ohio
Learn from our Columbus Workers' Comp Lawyers
If you have been injured on the job, you may be eligible for workers' compensation. Because there are numerous benefits that vary from case to case, it is important to consult with a Columbus workers' comp attorney directly about your circumstances. Depending on your employment status or insurance coverage, you could be looking at a wide-range of coverage to virtually none at all. Turn to Charles Zamora Co., L.P.A. for the experienced representation you need during this time.
Temporary Total Disability Compensation - AWW & FWW Explained
Jeremy was injured on July 1, 2019 when he slipped and fell while working at USA Market. His doctor diagnosed him with a lumbar sprain and a left knee sprain, and completed a MEDCO-14, certifying him off work for 30 days. He filed a workers' compensation claim online once he got home from his doctor's office and he notified USA Market that he would be off work.
Jeremy is entitled to receive temporary total disability (TTD) compensation for the 30 days that he will be off work. The law provides he is entitled to receive 72% of his "full weekly wage" (FWW) for the first 12 weeks that he misses from work. In his case, he will not be off work quite that long. Before Jeremy receives TTD, his FWW needs to be calculated. The workman's compensation law provides that the FWW is determined by averaging the employee's six (6) weeks of earnings immediately before the work injury. In Jeremy's case, he made $3,000.00 in the six weeks before his July 1, 2016 injury. Therefore, his FWW is $500.00 ($3,000.00 divided by 6 weeks). Jeremy will receive $360.00 per week in temporary total disability compensation (i.e. 72% of $500.00).
Renee works at American Crane as a crane operator. On September 15, 2019, the crane she was operating experienced a catastrophic failure and collapsed. Fortunately, she survived; however, she sustained multiple fractures, concussion with loss of consciousness (coma), and various other contusions and lacerations. She began working for American Crane on January 1, 2019 and had been earning $35.00 per hour for the past two (2) years. Her doctor completed a MEDCO-14, certifying her as being temporarily and totally disabled through an estimated date of March 15, 2017.
Renee is entitled to receive TTD from September 15, 2016 and continuing. For the first 12 weeks she is off work, she will receive 72% of her FWW. However, in Renee's case, 72% of her FWW would equal $1,008.00 ($35.00 x 40 hours per week x 72%). The maximum weekly TTD rate for 2016 workers' compensation injuries is $950.00. Therefore, Renee will receive $950.00 for the first 12 weeks that she misses from work. For the 13th week that she misses, and for the remainder of the life of her workers' compensation claim, she will receive 66 2/3% of her "average weekly wage" (AWW).
The AWW is calculated based upon the average of her earnings for the one-year time period before the industrial accident. In Renee's case, she was earning $35.00 per hour for two years before the September 15, 2019 accident. Therefore, her AWW is $1,008.00 ($35.00 multiplied by 40 hours per week, divided by 52 weeks). Again, however, her AWW rate would be higher than the maximum for a 2019 injury, which is $950.00 per week. For this reason, she would receive $885.00 for the 13th week she is temporarily and totally disabled, for the remainder of the time she is off work for the life of her claim.
Maximum Medical Improvement
Tyrell was delivering 5-gallon water bottles to a business in downtown Columbus when he slipped on the ice and snow on March 1, 2019. He completed his shift and notified his employer, Clear Springs. He sought treatment immediately afterwards at Grant Hospital. The emergency room doctor diagnosed Tyrell with a lumbar sprain, gave him a Toradol injection and a two-day off-work slip, and instructed him to follow up with his family doctor for further care. He saw his family doctor, James Wright, M.D., the next day. Tyrell had significant loss of range of motion of the low back, severe muscle spasms, and radiating pain down his right leg. Dr. Wright completed a C-9 for an MRI of the low back and also a MEDCO-14, certifying Tyrell off work through October 15, 2019.
Clear Springs did not oppose Tyrell's workers' compensation claim. The Ohio BWC issued an Order, allowing the claim for "lumbar sprain," and also awarded temporary total disability (TTD) beginning March 1, 2019 and continuing. After three (3) months of being off work, the Ohio BWC scheduled Tyrell for an exam with Juan Martinez, M.D. The workers' compensation law permits the the Ohio BWC and self-insured employers the opportunity to have the injured worker examined every ninety (90) days that he or she is receiving TTD. Tyrell attended the exam with Dr. Martinez, who issued a report on July 11, 2019, opening that Tyrell had reached "maximum medical improvement," which is a treatment plateau at which no further functional or physiological improvement is expected to occur.
Immediately, the Ohio BWC issued a "Notice of Referral" letter to the parties, notifying them that the Industrial Commission of Ohio would be scheduling a hearing to determine whether Tyrell's TTD should continue. Tyrell has not had an attorney and doesn't understand what this means. He calls Charles Zamora, a workers' compensation specialist, who advises him that the opinion of Dr. Martinez "is not the final word."
Ultimately, Dr. Wright has the opportunity to explain why Tyrell has not yet reached MMI, which Tyrell can present to the Industrial Commission, along with his testimony as to what treatment has been taking place, and the gains he has experienced in the improvement of his symptoms. Of course, his employer, Clear Springs, will be present at the hearing, as well, to argue that TTD should be terminated. Clear Springs may also schedule Tyrell for an examination with a physician of its own choice on the issue of MMI.
Permanent Partial Disability Compensation
Brittany was injured on July 3, 2019, while stopped at a temporary road closing for the popular Red, White and Boom fireworks display in Central Ohio. She is a city police officer and her cruiser was rear-ended when a driver failed to follow the posted road closure signs. Her workers' compensation claim was allowed for "cervical sprain, and herniated disc at C5-6." Although she missed work from July 3, 2019 through December 1, 2019, she never received temporary total disability compensation. Instead, she received "injury leave" from the city for the entire time she was off work.
Brittany has ongoing neck problems due to this workers' compensation injury and she qualifies for a permanent partial disability (PPD). PPD is an award that is intended to compensate an injured worker for an impairment of earning capacity. The injured worker must have residual symptoms due to the allowed conditions in the claim. The workers' compensation law requires the injured worker to wait the later of 26 weeks from the injury date, or the date that the injured last received either temporary total disability compensation or wage loss (WL) compensation.
In Brittany's case, she did not receive either TTD or WL. Therefore, she can file for her PPD award on January 3, 2020 (26 weeks from her injury date of July 3, 2019).
The PPD award is calculated based upon the injured worker's "whole person impairment." For instance, a neck sprain and a herniated disc may justify a whole person impairment (WPI) rating of 10%. The workers' compensation law provides a formula to convert a percentage of impairment to a monetary amount. The formula is as follows: % multiplied by 2, multiplied by the rate of compensation for the year of injury. In Brittany's case, if her WPI is 10%, she would receive $6,333.40 (10 x 2 x $316.67). The maximum permanent partial disability rate for a 2019 injury is $316.67.
It is possible for an injured worker to pursue further increases in PPD as the claim continues, particularly if additional conditions are recognized in the claim. A PPD award is not a settlement of the claim. In fact, receiving a PPD award in the claim serves to extend the life of the claim an additional five (5) years from the payment of the award.
Wage Loss Compensation
Jason was injured on February 9, 2014 while employed with the Metro City School District. He was employed as a high school teacher, earning $45,000.00 per year. He suffered serious burns when a beaker exploded and sulfuric acid penetrated his protective clothing during a classroom experiment. His workers' compensation claim was allowed for third degree chemical burns to his bilateral upper extremities and post-traumatic stress disorder. His attending physician, Bharat Singh, M.D., and attending psychologist, Sigmund Franz, Ph.D., both opined he should not work as a school teacher anymore because of significant residual upper extremity impairments and ongoing PTSD symptoms.
However, both of his doctors opined he could work in a sedentary capacity with a lifting capacity of no more than 10 pounds and a low-stress work environment. His doctors stated he could return to work with these limitations effective June 15, 2016. He resigned his employment with the Metro City School District because of this work accident. He then began searching for new employment within the restrictions provided by his doctors. He made it a full time effort to find new employment, and made between ten to fifteen in-person contacts per week with prospective new employers, in addition to searching online. He was offered a position as a Recreational Program Assistant at a local nursing home facility, White Pines, which he accepted on October 15, 2016.
This was a low stress position, which required no lifting. Jason's new salary was $10.00 per hour. Recall that his salary at Metro City School District was $21.63 per hour ($45,000.00 divided by 52 weeks divided by 40 hours). His average weekly wage (AWW) at Metro City was $865.38. His new weekly earnings were $400.00 ($10.00 x 40 hours). This means he was effective suffering a wage loss of $465.38 ($865.38 minus $400.00).
Jason will qualify for two (2) types of wage loss compensation, and two (2) periods of wage loss compensation. The first type of wage loss compensation is called "non-working" wage loss compensation, when he was searching for work from June 15, 2016 through October 14, 2016. As long as Jason made a good faith effort to find suitable employment within his restrictions, he qualifies for non-working wage loss compensation. Since he had no earnings during that time period, he would receive a weekly non-working wage loss award of $576.92 (2/3 of his AWW).
When Jason began his new job at White Pines on October 16, 2016, he would then receive "working wage loss compensation." His weekly working wage loss compensation would be $310.25 (2/3 of his AWW of $865.38 minus his current earnings of $400.00 per week).
The maximum working and non-working wage loss compensation per week for 2014 injuries is $849.00. For 2016 injuries, the maximum weekly WL rate is $950.00.
Permanent Partial "Scheduled Loss" Awards
Rebecca worked as punch press operator for Massillon Fabricators. On December 2, 2019, she was performing a routine repair when another employee bypassed the safety lock, which caused the press to perform a cycle. This resulted in Rebecca's left thumb being severed. Rebecca qualifies for a "loss" award of $57,000.00 (60 weeks multiplied by the maximum 2019 rate of $950.00). This is not a settlement of her claim. Instead, this is one of the benefits that Rebecca receives as part of her open and ongoing workers' compensation claim.
She would also be entitled to receive temporary total disability compensation for the time period that her doctor had her off work following the accident, while her injury healed. In addition, if Rebecca eventually lost her punch press operator job because of this industrial injury, she may qualify for wage loss compensation.
Armando was involved in a serious automobile accident while working as a driver for Rocket Pizza Delivery in Wapakoneta, Ohio, on June 15, 2016. Unfortunately, Armando suffered a significant crushing injury to his entire left upper extremity, rendering it useless for all practical purposes. Armando qualifies for a "loss of use" permanent partial award, even though he still has the upper extremity. His award will equal $213,750.00 (225 weeks multiplied by the maximum rate for 2019, $950.00).
Call attorney Charles Zamora for more information if you have suffered a loss or "loss of use" of any body part, including vision and hearing loss.
Permanent Total Disability Compensation
Nathan had two separate injuries while employed as an Equipment Operator with the City of Charleston. The first injury occurred on May 15, 2008 and his claim is allowed for "tear of the left medial meniscus, right ankle fracture, and herniated disc at L5-S1." His second injury occurred on March 1, 2015 and the claim is allowed for "cervical sprain, disc protrusion at C3-4, C4-5 and C5-6, SLAP tear of the right shoulder, AC joint arthritis of the right shoulder, and major depression." Nathan has been off work since the second accident.
On June 30, 2016, Nathan's doctors, Ahmad Sethna, D.O., and Angel Barnett, Ph.D., both opine he is permanently incapable of performing any form of sustained remunerative employment and he should be declared permanently and totally disabled. Nathan qualifies to pursue permanent total disability compensation based upon his doctors' reports. Nathan worked for the City of Charleston for 21 years and was earning $66,000.00. Assuming the Industrial Commission's examining physicians agree that Nathan is PTD, he will receive PTD compensation for the rest of his life. The Industrial Commission will determine the portion of PTD compensation that will apply to each claim. Since the maximum rates of compensation are different for each year, and one claim may be more significant than another, the Industrial Commission will determine the appropriate apportionment of compensation for each claim.
If an injured worker sustains a loss of two (2) body parts, such as a hand and a foot, or both hands, or both feet, etc., the injured worker qualifies for "statutory" permanent total disability compensation. With this type of award, the injured worker is actually permitted to work and still receive statutory PTD for his or her lifetime. However, if an individual receives regular PTD, he or she is not permitted to work in any capacity, or to perform services for which he or she could be paid (assuming he or she is not receiving pay).
For further information about these benefits, or for other types of compensation not mentioned on this page (e.g. Violation of a Specific Safety Requirement; Death Benefits; Living Maintenance; Living Maintenance Wage Loss Compensation; Facial Disfigurement; and Change of Occupation), please call Charles Zamora as soon as possible. Please be aware that if you delay in requesting compensation, your award may be limited or denied.
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