Workers’ compensation is a no-fault situation. You do not have to prove that your employer was at fault. However, this does not mean that every claim is valid. The insurer will still investigate to ensure that you were not to blame for the accident. In addition, the insurer requires specific adherence to deadlines and documents that you must provide.
If you fail to properly file your case or the insurer finds you to be fully at fault for your accident, then the insurer could deny your claim. In most cases, a denial is something you can negotiate. According to the Ohio Bureau of Workers’ Compensation, if you get a workers’ compensation claim denial, then you do have the right to appeal.
How to appeal
To appeal, you will file a written notice with the BWC. Your document must include an explanation of why you want to appeal, your claim number, your name, your employer’s name and the date of the original claim. You must sign and date the form before submitting it. You can bring it to the BWC local office, fax it to the office or mail it.
Things to keep in mind
Your appeal will go to the Industrial Commission of Ohio. The IC works with the BWC to review your claim, the denial and appeal. There is a hearing that you will attend where the IC conducts its investigation. You can present evidence at the hearing to back up your claim. The IC issues a written decision.
You can appeal within 14 days after you get the denial notice. You have the right to appeal any part of a claim denial with which you do not agree.