Frequently Asked Questions

 
 

Workers’ Compensation FAQ

Q. When DO I Need an attorney?

A. Whether you need an attorney to represent you after you’re injured and have a workers’ compensation claim depends on a number of factors, including the severity of your injuries, the existence of pre-existing disabilities, the need to dispute an adverse decision or denied medical benefits, and more. It also may provide you additional comfort to have an expert represent your interests throughout the workers' comp process. Regardless of the circumstances of your claim, you have the right to retain an attorney. 

Q. Why am I not getting paid by workers’ compensation?

A. There could be a number of reasons why the Bureau of Workers’ Compensation (BWC) is not paying expected monetary benefits, including missing, incorrect, or expired medical forms. The unique facts of each case determine whether a stoppage of payments is appropriate. 

Q. Why was my medical treatment denied?

A. In a workers' compensation claim, all benefits must be based on allowed conditions in the claim. If your doctor files a request for specific medical treatment, it may only be approved if it’s medically necessary and reasonably related to the allowed conditions. We work with your doctors to secure medical evidence to support your claim and the need for treatment.  

 

Q. Why was I billed for medical care?

A. Receiving an unexpected medical bill can be unsettling, especially when it should have been covered by workers’ compensation. There are a few reasons this can happen. Regardless of the reason, it's important to address the issue immediately to alleviate further frustration down the road.

 

Q. Why do I need a physician of record?

A. An important part of any workers’ compensation claim, the physician of record directs treatment and certifies disability. The physician of record can help an injured worker secure necessary diagnostic testing, new allowances in the claim, and disability benefits. 

Social Security Disability FAQ

Q. What’s the difference between SSD and SSI?

A. Social Security Disability (SSD) benefits are administered through the Social Security Disability Insurance (SSDI) program, which pays benefits to you and certain family members if you worked long enough and paid Social Security taxes.

The Supplemental Security Income (SSI) program pays benefits to disabled adults and children who have limited income and resources. 

Q. How do I apply for SSD benefits?

A. You should apply for disability benefits as soon as you become disabled. If you’re ready to apply now, you can:

Q. What happens after I apply for disability benefits?

A. Your claim will be processed by the Opportunity for Ohioans with Disabilities’ Division of Disability Determination. It’s important to fill out any paperwork from the State Agency or the Social Security Administration (SSA) as thoroughly and quickly as possible. Once you apply, it typically takes 30 to 90 days for a decision to be made at the initial level.

Q. How long does it take to receive benefits?

A. Once you have applied for SSD or SSI, the SSA typically takes two to six months to make its initial determination. If denied, the appeals process can take as little as one to three months, or as long as two to three years. 

Q. What do I need to win my case?

A. The most important factor in being approved for disability benefits is consistent medical treatment. The SSA can only approve disability benefits if there is medical documentation that proves your conditions are present and disabling. There are many other things you can do to help get your application approved as quickly as possible.

Q. How soon will I get paid once I’m awarded benefits?

A. Unfortunately, there is no set time frame for when you will receive benefits once the SSA finds you are disabled. Some claimants receive benefits within just a couple of weeks following a favorable decision, while others wait several months.

Q. How are monthly disability benefits calculated?

A. SSD benefits are calculated based upon prior earnings and how much you have paid into the program through taxes. Learn more about the formula the SSA uses, and note that the maximum disability payment someone can receive in 2018 is $2,788 per month.

Q. How do I appeal my denial?

A. If you are denied SSD or SSI benefits, you generally must file an appeal within 60 days. There are forms dependent on the level at which you were denied, as well as a Disability Report and records release. All forms should be provided by the SSA with your denial, or can be found online.