Every year in the Ohio Workers’ Compensation system, many people are injured in non-fatal accidents. In 2019, there were 110,500 injured workers reported in Ohio that were not fatal. This is nearly 2.6 cases per 100 full time equivalent (FTE) workers, which is tied for the 34th state for rate of injuries. Every year in the US, an estimated 4 million employees sustain workplace injuries. These injuries vary from those that are acute to those that are chronic. The spine, brain, back, neck, arms, hands and legs are the organs that are most frequently affected by work injuries. Injuries sustained on the job can happen anywhere, including factories and offices. Vulnerability to risks, physical handling of heavy objects, equipment misuse, poor biomechanics/ergonomics, failure of machinery, and mistakes made by coworkers are all potential contributors to injuries sustained on the job.
As an injured worker in Ohio, the present system of worker’s compensation can be challenging to comprehend and manage. At Harmony Chiropractic, our medical providers are board-certified by the Ohio Bureau of Workers’ Compensation. As qualified providers, we are accepting new and existing cases of injured workers. Depending on your situation, we may be a treating provider, or we may serve as your Physician of Record. The POR helps to coordinate your care and ensure that proper care is being requested and rendered in a timely manner. Unfortunately, many primary care providers and specialists have discontinued serving as POR for Ohio BWC patients due to a myriad of reasons. Because of this, many injured workers are left without a method to receive the appropriate treatment, have the requisite documentation filled out, or complete the necessary compensation forms.
Patients seeking treatment for Ohio workers’ compensation issues are welcome to seek treatment at our office. Even if it is not a condition that requires chiropractic therapy, we can manage your case as POR as Certified Ohio BWC physicians and still provide you the care and treatment that is appropriate and required. This is the case even when it is not a condition that requires chiropractic care. If your case calls for medical treatment or if you need to visit a specialist, we have a great working interaction with lots of experts and medical professionals.
You do not require a referral to meet us; a pre-certification is not required for an initial consultation and examination. We have highly qualified personnel that can assist you with the appropriate documentation, ensure that your case is handled correctly, and receive the necessary therapy to heal your injuries and return to work effectively.
Accidents at work can cause serious injuries and taking care of them promptly is important to prevent issues from becoming chronic. In and around the Toledo region, going to Harmony Chiropractic is the best decision one can make for their health. Due to our extensive training and expertise, we can assist patients in recovering from the majority of injuries sustained in workplace accidents. Dr. Royer is the only Board-Certified Chiropractic Neurologist in the Toledo area, which means that he is specially qualified to address mild Traumatic Brain Injury, concussion, post-concussion syndrome and nerve injuries. Dr. Royer has training in sports medicine as well which has prepared him to deal with a myriad of injuries better than a typical chiropractor. If you want to be treated in the best place to diagnose and treat your workplace injury, look no further.
Services Relating to Worker’s Compensation
After an accident, getting back to work may be challenging. To return to full capability at work, obstacles must be surmounted on all fronts, including the physical, the mental, and the emotional. We want to help you make the transition back to work as safe and seamless as possible. Harmony Chiropractic is responsible for coordinating the care and communicating with all parties involved from the time involving First Report of Injury until the case is closed. This helps to guarantee that the injured worker can make a good recovery and return to work.
We believe that assisting workers so that they may perform to the best of their abilities enable them to be more productive and satisfied with their lives. Because of this, Harmony Chiropractic provides extensive treatment plans for injuries sustained on the job, enabling patients to recover from their previous performance at work or improve upon it. We put into practice the most recent approaches developed in physical medicine and industrial rehabilitation. Our services are individualized, high-quality programs that provide the wounded worker with the power, stamina, and self-assurance necessary to make a successful transition back to work.
Basic Steps in an Ohio Workers’ Comp Claim
File Initial Paperwork with your employer and BWC
Be sure that your supervisor knows that you were injured at work and follow your company policies. Be sure to fill out the forms for your workplace and the First Report of Injury (FROI) Form for the BWC. Some employers may fill this out for you but you should sign it if it is accurate. Some dishonest employers try to avoid filing this form, which could lead to difficulties for you in the future if you have been seriously seriously injured. If you seek treatment, your treating provider can file a claim as well.
This must be approved and your employer or their MCO can fight the claim in court. They have the right to two appeals which may result in you needing to appear for them. Your claim must be allowed first for anything to proceed. Having a claim number does NOT mean the claim is allowed.
Proper Allowed Conditions on Claim
The Ohio Workers’ Compensation system works based on allowed conditions that are decided based on medical records and other administrative and legal avenues. An incomplete or even inaccurate listing of allowed condition frequently occurs when seen in the ER or urgent care. An injured worked with an allowed condition of lumbar strain may have made a complaint of upper back pain that may not have been documented and needs to be added. Later, the lumbar strain may be found to be a herniated disc and surgery cannot be scheduled until it is added as an allowed condition.
Request Appropriate Treatment
Almost all treatments in the Ohio workers’ compensation need to be requested and approved in order for treatment to occur. Once a phase of treatment has completed, more treatment must be requested to continue care. This is similar to how most insurances require pre-approval for certain testing, like MRIs. Medical provider must file a form for you to receive medical treatment and then the treatment must be approved. Sometimes, the employer or MCO will deny the requested care and the injured worker’s attorney must request a hearing to get it approved. The hearing can be appealed by the MCO or employer and usually is.
Get an Ohio Workers' Compensation Attorney
You need a workers’ comp attorney to help you whenever something in your claim is being disputed. Each of the steps listed above can be disputed which may lead to appeals on the part of the injured worker, your employer or their MCO each has the right to two appeals. Time can be eaten up waiting for each of these hearing dates so you need people on your side that know what they are doing. Your attorney is not paid for by the state but is paid for by the injured worker. Some firms require payments as you go through the process and other attorneys will work out a deal on getting paid later. Depending on your injury, there may be a small lump sum compensation that an attorney can use for payment.
Expert in Ohio Workers’ Compensation
Injured workers who chose Harmony Chiropractic have an advantage that may not be apparent, but it is sizable. Dr. Royer is one of the few chiropractors in the state of Ohio who is on the Ohio Bureau of Workers’ Compensation Disability Evaluator Panel (DEP). This means that the State of Ohio has ensured Dr. Royer meets additional qualifications to review claim files and provide injured worker medical examination services. The DEP has the following types of healthcare providers credentialed: Doctors of Medicine (MD), Doctors of Osteopathy (DO), Doctors of Chiropractic (DC), Doctors of Podiatric Medicine (DPM), Doctors of Dental Surgery (DDS) and psychologists (PhD). All of the above must maintain Board Certification in a specialty within their profession, so a board-certified orthopedic surgeon would be qualified.
Dr. Royer’s status as a Diplomate of the American Chiropractic Neurology Board allows him to serve on the DEP. Other diplomate-level chiropractic specialties, like sports medicine, orthopedics, rehabilitation, occupational disorders or internal disorders, qualify, but it is rare for chiropractors to attain diplomate specialization. Providers on the Disability Evaluators Panel must receive training on the Ohio Bureau of Workers’ Compensation (BWC) system. They also must review files of other providers regularly, so they know what documentation is necessary to get claims allowed, additional allowed conditions added, or treatment approved. This means that the State of Ohio uses Dr. Royer to provide expert opinion on certain cases.
The Rights of Ohio Injured Workers
Workers who sustain injuries in Ohio are eligible for various benefits and protections. We are open to accepting new and existing injured worker claims to serve as physician of record (POR). Harmony Chiropractic has been certified by the Bureau of Worker’s Compensation to treat injured workers in Ohio, and we are happy to help them return to work and their lives. Ohio injured workers have some rights concerning how and where they are treated that you should know about.
Below we will be listing the Ohio Injured Workers’ Bill of Rights and will be detailing some information under each one for explanation. Keep in mind that we are a chiropractic office and not lawyers so be sure to check with your workers’ compensation attorney if you have any questions. One of the reasons that we will go more in-depth in explaining each of the rights is because employers and MCOs often try to use the system against an injured worker. Some workplaces try to make it enough of a burden for an injured worker to use the system that many injuries go unclaimed since employees know it may be frustrating and unpleasant. This, unfortunately, leads to many injuries becoming chronic and long-lasting since the problems are not dealt with in an appropriate time frame. Your attorney will be invaluable in the process, but the more you understand about the process, the less frustrated that you will get.
The Ohio Injured Workers’ Bill of Rights is as follows and was compiled initially by the Ohio State Chiropractic Association. Be sure to click the down arrow to get further information.
1. Right to Freedom of Choice in Provider Type
Injured workers in Ohio have the freedom to pick whatever doctor they want to treat their condition, whether it be a chiropractor, an osteopath, or a medical doctor. Injured workers may also choose any of these provider types to be their Physician of Record (POR).
2. Right to Treatment Choice Allowed, but Employer Steerage Permitted
It is your choice as to who treats you for your workplace injuries, but your employer has the authority to steer you to a facility of their choosing for evaluation. Often, Ohio injured workers are directed to see an occupational health facility at a hospital or at their workplace facility. These facilities may also have the final say on allowing you back to work. Because these occupational facilities receive referrals from companies for injured workers, there can be a financial pressure on the healthcare business and the medical providers to be more helpful to the employer. While it is not all of these facilities, money talks and often the injured worker does not receive proper treatment.
3. Right to Change Treating Physician
The injured worker can select a new attending physician during their treatment. This can happen at any time regardless of what provider you started seeing. If you initially went to an occupational health facility, you can change your Provider of Record (POR) to any your favorite chiropractor, if you wish. You can keep your POR as your Primary Care Provider (PCP) if they will serve in that role and treat with a chiropractic physician, if you wish. Ask your POR to send you to physical therapy if that is appropriate.
4. Right to File Injury Claim
An injured worker has the primary right to bring a claim for compensation for an injury received as a result of, and in the course of performing, their job responsibilities.
As stated previously, some employers illegally try to stop workers from filing workers’ compensation claims. It is your right to file a claim.
5. Right to Payment of Medical Bills
The person hurt on the job has the legal right to get full payment for any medical treatments connected to their work injury. This means that the injured worker does not go through their health insurance and there are no bills for co-pays or deductibles for chiropractic care, physical therapy, medications, injection or even surgeries as long as the treatment is pre-approved on an allowed claim.
6. Right to Reimbursement for Lost Work
According to the laws of Ohio, the injured worker has the legal right to be reimbursed for any time missed or lost at work that is eight (8) days or more. This is accomplished through your workers’ compensation attorney.
7. Right to Protection from Retaliation
The injured worker has the legal right to submit a claim for worker’s compensation without worrying about being punished or discriminated against by their employer. The employer may not retaliate against the worker for the claim. If it did occur, it would be handled by your attorney.
8. Right to Appeal Decisions
The injured worker has a right to appeal and follow the proper procedure for any decisions made by the managed care organization that influence their choice of care.
9. Right to Representation
The worker who was hurt has the right to seek legal assistance to have their case argued on their behalf by a lawyer at your own expense.
10. Right of Choice with BWC Rehab Programs
The worker who was hurt has the choice to participate in any rehabilitation programs made accessible via the workers’ compensation system or not participate at all.
11. Right to Fair Independent Medical Exam
When it is necessary for your claim, the harmed worker has the right to an independent and high-quality medical evaluation.
12. Right to Supportive Care
The injured worker has the legal right to continue receiving supportive care in chiropractic, osteopathic, or medical treatment, which may be therapeutically appropriate to preserve some functional mobility.