If you’ve suffered a work-related injury, you’re likely wondering how workers’ compensation settlements work in Ohio. What are your rights? How much money could you receive? How do you ensure you get a fair settlement?
The Ohio workers’ compensation system is here to help employees by covering medical bills and lost wages after a job-related injury. In some cases, living maintenance costs and permanent total disability may also be payable. The question is: How are settlements determined?
Knowing the amount you could receive isn’t just about getting a check; it’s important to make sure you have what you need to get better, access ongoing medical care, and adjust to any changes in how you live and work because of your injury. This post explains how settlements are calculated, what factors play a role in determining the amount, and how an Ohio workers’ comp lawyer can help when it comes time to negotiate.
Understanding Workers’ Compensation Settlements in Ohio
A workers’ compensation settlement is an agreement between an injured worker and their employer’s insurer to resolve a claim. This settlement concludes the claim by providing the worker with a sum of money in exchange for closing the case. The idea behind a settlement is to give the injured employee the financial support they need to cover medical bills, lost wages, and other expenses related to their work injury or illness.
In Ohio, there are mainly two types of settlements that you can consider. Each has its own implications for your rights and benefits moving forward.
Full Settlements
A full settlement means you agree to close your workers’ compensation claim in exchange for a specified amount of money. This is typically paid out as a lump sum. By choosing a full settlement, you’re agreeing to give up your rights to any future benefits related to your injury. This includes both medical benefits and compensation for lost wages.
In some cases, as part of the settlement, you may also need to set up a Medicare Set-Aside (MSA) account. This account is specifically for future medical expenses related to your work injury, ensuring that Medicare isn’t billed for costs that should be covered by the settlement funds.
Indemnity-Only Settlement
An indemnity-only settlement is more of a partial settlement. It focuses on settling the compensation part of your claim but leaves the door open for future medical coverage. This means you receive a lump sum or installment payments for the compensation aspect, but you can still claim medical benefits for your injury in the future. This type of settlement can be beneficial if you anticipate needing ongoing medical treatment but are ready to settle the compensation portion of your claim.
Most workers’ comp settlements in Ohio are paid as a one-time lump sum, providing the injured worker with immediate financial relief. However, in some cases, receiving compensation in installments over a period of time might be more suitable, depending on your personal financial situation and future needs.
Settling a workers’ compensation claim allows both the injured worker and the employer to move forward. For the worker, it means receiving guaranteed funds without the need for further legal disputes. For the employer and their insurance company, it means a resolution to the claim without the possibility of future unexpected costs related to the injury.
Factors Influencing Settlement Amounts
Several factors can influence the workers’ compensation settlement you might receive in Ohio. They include:
- Severity and Nature of the Injury: The type of injury you’ve suffered and how severe it is play a significant role in determining your settlement amount. Generally speaking, injuries that result in longer recovery times or permanent disabilities tend to lead to higher settlements.
- Pre-Injury Wages: Workers’ compensation benefits, including settlements, usually aim to partially replace lost wages. Therefore, if you had a higher salary before your injury, your settlement might be larger to reflect the change in your earning capacity.
- Medical Expenses: Settlements also take into account the medical expenses you’ve already incurred due to your injury. If you require ongoing treatment, rehabilitation, or any form of long-term care, these anticipated costs will be considered in the settlement.
- Impact on Earning Capacity: If your injury affects your ability to work, either by reducing the number of hours you can work or by forcing you into a lower-paying job, this loss of earning capacity is an important factor.
How is a Workers’ Compensation Settlement Calculated in Ohio?
Calculating a workers’ compensation settlement in this state isn’t as straightforward as applying a simple formula or referring to a set schedule of values. The Ohio Bureau of Workers’ Compensation (BWC) evaluates the potential future benefits that might be owed under the claim. This evaluation includes considering:
- The likelihood and extent of future medical treatments;
- The potential for lost wages due to time off work.
For instance, if you’ve been told you’ll definitely need follow-up surgery in 12 months and will be out of work for eight weeks to recover, your settlement is likely to be higher. This is because there’s a clear expectation of future medical expenses and a definite period of lost wages. On the other hand, if there’s only a chance you’ll need that surgery, your settlement might be lower. The uncertainty around whether you’ll incur those medical expenses and suffer lost wages plays an important role in the calculation.
It’s important to note that workers’ compensation settlements in Ohio are designed to cover tangible losses. This means they aim to compensate for actual financial impacts, like medical bills and lost earnings. They don’t account for intangible damages such as pain and suffering. The focus is squarely on the financial repercussions of work-related injuries or illnesses.
How to File a Workers’ Compensation Settlement
The way you file a workers’ compensation settlement in Ohio varies slightly depending on whether your employer is state-funded or self-insured. It’s essential to follow the correct steps to ensure your settlement is filed properly and reviewed by the appropriate authorities.
For Self-Insured Employers
If your employer is self-insured (meaning they manage their own workers’ compensation claims rather than using the state insurance system), you’ll need to file your settlement documents directly with the Ohio Industrial Commission. Once you submit them, the Industrial Commission reviews them to ensure the settlement is fair and appropriate given the circumstances. If they approve, they will notify you and your employer, finalizing the settlement agreement.
For State-Funded Employers
If your employer is insured through the state system, the process involves the Ohio Bureau of Workers’ Compensation (BWC). Either you (the injured worker) or your employer can initiate the settlement process by submitting the necessary documents. Form C-240 outlines the details of your claim and the proposed settlement. After receiving the documents, the BWC will typically get in touch with your workers’ comp attorney to discuss and negotiate the settlement terms.
Regardless of whether your employer is self-insured or state-funded, the submitted documents undergo a review process to ensure that the proposed settlement is fair. If the reviewing body agrees that the terms are reasonable, they will approve your workers’ compensation settlement. You, your employer, and any other involved parties must agree to the terms.
How Long Does It Take to Settle a Workers’ Compensation Claim?
The time it takes to settle a workers’ compensation claim isn’t set in stone; it varies widely depending on several factors. Understanding the general timeline can help set realistic expectations for how your claim might progress.
If you’ve suffered a serious injury at work, jumping straight into settlement negotiations might not be the best course of action. It’s crucial first to understand your long-term medical needs and how your injury could affect your ability to earn a living in the future. Rushing into a settlement without this information could result in agreeing to terms that don’t fully cover your needs.
Once you have a clearer picture of your future medical requirements and earning capacity, settlement negotiations can begin. Finalizing a settlement can take anywhere from a few months to around a year. This timeframe includes negotiating the settlement amount, agreeing on terms, and drafting and executing the settlement agreement.
After the settlement agreement is signed, Ohio law requires a 30-day waiting period for a settlement to be deemed final. During this time, either party involved in the settlement—the worker or the employer’s insurance company—has the option to withdraw from the agreement. This waiting period serves as a final reflection phase to ensure that both sides are confident in the settlement.
Do You Need an Attorney to Settle Your Workers’ Compensation Claim?
You’re not legally required to engage counsel to handle your settlement. However, having an experienced workers’ compensation attorney by your side can make a big difference in the outcome of your claim.
The workers’ compensation process in Ohio can be tricky, especially when it comes to getting a fair settlement. A skilled attorney who knows the ins and outs of the system can help in several ways:
- They’re great at figuring out how much your claim is really worth. This isn’t just about the immediate costs; it’s also about future medical care, lost wages, and how your injury might affect your ability to work down the line.
- They’ve got the experience to negotiate on your behalf and deal with any legal issues or disputes that might come up.
- Having someone who knows the workers’ comp system can relieve you of the stress of dealing with paperwork and legal procedures, allowing you to focus on your recovery.
While you don’t have to hire an attorney to settle your workers’ compensation claim, doing so can increase your chances of getting a settlement that truly reflects the impact of your injury on your life and livelihood.
Speak to a Cleveland Workers’ Comp Lawyer Today
Choosing to settle is a major decision and can involve extensive negotiations between the injured worker, their attorney, the employer, and the insurance company. It’s important for workers to understand their rights and the value of their claim to ensure the settlement fairly compensates them for their injury and its impact on their lives.If you’re feeling overwhelmed by the prospect of filing a workers’ comp claim or negotiating a settlement, the worker’s compensation lawyers at Plevin & Gallucci are here to support you. Our team of experienced workers’ compensation attorneys will strive to achieve the fair settlement you need to support your recovery and safeguard your financial future. To schedule a free consultation, call (216) 861-0804 or contact us online. We have offices in Cleveland, Columbus, and Waverly to better serve you.
Related:
How to Calculate Your Ohio Workers Compensation Settlement
