Ohio Workers’ Compensation

Employers get it!  Document.  Document.  Document.  It has been drilled into their heads for years.  Clear and accurate employment manuals.  Work Rules.  Safety Training.  Injury reporting.  Safety Training.  Alcohol/Drug Testing.  Do it.  Make sure your records show you did it and that your employees attended.

So, you do all the right things and you still end up at the Industrial Commission.  A hearing officer holds your fate in his/her hands.  What matters to them?  What should you do to maximize your opportunity to prevail?  I talked with some of those that represent you at hearings.  Here is what they have to say:

1. The most believable person is the one acting in a reasonable fashion.  No eye rolling.  No exhaling in disgust.  These tactics will weaken your position.  If you want to make a statement, keep it concise and to the point.  Do not come off as if this is a personal issues and please, please do not complain about the high cost of your premiums-the hearing officers do not set them and most do not understand them.
2. All hearing officers are human (some less than others!).  They are liberal, conservative, employer oriented, claimant oriented and some are biased between the people who take the hearings.
3. On additional allowance hearings, they are looking at how long into the treatment did the claimant begin to new symptoms or have new complaints.
4. Sometimes the claimant/patient has been telling the doctor all along about pain (say, in the knee) when they have had a back injury but the doctor continues to treat only the back and ignore the knee complaints.  Five or six monthly into the claim there is a meniscus tear but if there have been no complaints for six months and they are suddenly alleging a tear equals a whole different story.  The employer needs to understand the difference, putting personal feelings aside.
5. Think of hearing officers as if they have blinders on.  They are generally not interested that the claimant did not follow your policy in reporting the injury right away.  They are only looking for a description of injury, date of injury and medical which supports the injury.  Say a severe injury is not reported promptly (like herniated disc).  The hearing officer’s ears will perk up if your proof through timecards, payroll records and supervisors/coworkers statements (notarized, please) that the claimant continued to work without complaint right after the injury.
6. “Workers’ Comp Docs,” especially the chiropractors, take advantage of the system (I know you are shocked!)  ADR rightfully questions the retro chiropractic diagnoses but the hearing officers are reluctant to deny retro diagnoses as they do not want the claimant to get stuck with the bills.
7. Pick and choose your battles wisely.  Hearing officers remember those employers they see in hearings all the time on every issue.  That works against you.  Run a good program.  Hearing officers will listen more closely than some other EER’s on the same issue because they know what a quality program they run.
8. Hearing officer does not want to hear about your other employee who suffered the same injury and came back to work right away.  Everyone is different and we all heal differently.
9. Hearing officer does not want to hear about rumors about the second job they have which is where you think they really got hurt.
10. Hearing officer does not want to know how many times the claimant has been arrested or if their whole family is on workers’ compensation.

Remember, your representatives only have as general rule five minutes to present your position on a claim-they have to hit hard on what the hearing officers are looking for.  So do not insist on asking to add points that are not relevant to the issue at hand, such as returning to the allowance in the claim when the issue is on a new period of compensation.

Let me leave you with a quote from one of my sources that represents employers.  I believe her simple statement speaks volumes:  “Is that fair?  No, but neither is the system.”
 

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