The best way to answer the question “Does my rehabilitation plan qualify me for workers’ compensation?” seems to be to quote Reverend Lovejoy from the Simpsons episode titled “Hurricane Neddy”: “Oh, short answer, ‘yes’ with an ‘if.’ Long answer, ‘no’ with a ‘but.’”
Trust us, this is no intention to be dismissive or just funny for funny’s sake. Rules interpreted and enforced by the Ohio Bureau of Workers’ Compensation (BWC) almost always require people applying for benefits to complete a rehabilitation plan. Agreeing to do so keeps a person eligible for benefits, but doing rehab by itself does not qualify a person to receive any temporary or permanent disability payments.
Sorting through that explanation and its real-world implications often requires an expertise employees hurt on the job do not possess. This is especially true when approval or denial of a workers’ comp claim comes down to decisions regarding the appropriateness of a rehabilitation plan, the quality and completeness of medical records, or a hurt worker’s compliance with rehab requirements. In addition to reviewing the overview presented here, consider contacting a disability benefits lawyer with Agee Clymer Mitchell & Portman to request a free consultation.
The Ohio BWC emphasizes rehabilitation because the program operates on the assumption that almost every person hurt at work can return to the workforce. In fact, the first sentence of the bureau’s Handbook for Injured Workers reads, “Helping people get back on their feet and back to work after an on-the-job injury is what BWC is all about.”
In pursuit of that goal, the BWC requires workers’ comp applicants to get confirmed diagnoses of work-related injuries, progress through several rounds of review, engage with a group of medical professionals and employment specialists called a managed care organization, and do rehab. The rehabilitation plan must be approved by the MCO and the bureau, and it can include physical therapy, mental and emotional counseling, and retraining. Importantly, rehab is almost never optional, and participation can be required even after an employee has returned to work.
A BWC rehabilitation plan can last a week, a few months, or a year or more. Qualifying for permanent disability under the Ohio workers’ compensation program requires proving that no amount of ongoing rehab will allow a former employee to return to gainful employment. Fully defining “gainful employment” would require a whole other article. Suffice it to say here that the determination is made by BWC case reviewers and based on degree of disability, former earnings, financial and health care needs, and extent of employability for one’s old job or for tasks different from those performed prior to the injury. Often, people who only recover somewhat from a workplace accident qualify for partial disability, meaning they receive supplemental income from the Ohio BWC while also having to take a new job at a lower annual salary.
Having a skilled and experienced attorney on your side while you go through the workers’ compensation application, review, and appeals process can make all the difference between receiving the benefits you need to live the best life possible and struggling to pay for housing, food, medical care, and other necessities. Satisfying requests for addition medical evidence, documenting compliance with a rehabilitation plan, establishing financial hardships, and proving the existence of an ongoing disability caused by an on-the-job injury are not simple, straightforward procedures. Even understanding what the BWC is asking to see in the form of evidence to support a workers’ comp claim can be confusing.
Agee Clymer Mitchell & Portman has attorneys at each of its nine offices throughout Ohio who know the ins and outs of the state’s workers’ compensation system. Call us today at (800) 678-3318 or check out the rest of our website to get the answers you need to avoid going without the benefits you qualify to receive.