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A workers' compensation claim will be scheduled for hearing any time a determination is made in a claim, and any party to the claim disagrees and files and appeal. The Bureau of Workers' Compensation (BWC) may also refer certain matters to the Industrial Commission of Ohio (ICO) for a hearing for adjudication, regardless of whether an appeal has been filed. Many issues are appealed to the ICO such as initial allowance of a claim, payment of compensation, additional allowances, wage calculations and appropriate medical treatment.
COSE encourages employers to attend hearings. It is helpful to have an employer at the hearing to give crucial testimony or ensure accurate information is being testified to by the employee. Your attendance can be a reflection of your company's core values. It lets the Hearing Officer see that you care about your business and, even your employees.
Evidence and documentation are also crucial in defending your claims. We may ask for copies of your employee handbook, witness statements, prior disciplinary documentation, security video, employment applications, etc. in order to prepare a successful defense.
The Industrial Commission hearing process is very informal and last approximately 15 minutes. Hearing Officers preside at the hearings. Many are former workers' compensation attorneys that have legal expertise in claims. They will review a file before the hearing, and then allow testimony from both sides of the issue. In most circumstances, the hearing officer will take a matter under advisement and issue their decision within 14 days.
There are 3 levels of hearing at the ICO. The first level of hearing is heard by a District Hearing Officer. These hearings are commonly referred to as DHO hearings. When the order is received, in the majority of cases, there is a 14 day appeal period for either side to appeal if they disagree with the ruling. Once the appeal is filed, the claim is scheduled for hearing before a Staff Hearing Officer for an SHO hearing.
At the SHO level of hearing, new evidence may be submitted, but routinely arguments are repeated from the DHO level. These hearing officers will issue their decisions within 14 days as well. If any party disagrees with the decision of the Staff Hearing Officer, an appeal can be filed within 14 days from the date the order is received. This appeal is made to the Industrial Commission in Columbus. There is no guarantee that this appeal will be accepted and these hearings are uncommon.
Like the U.S. Supreme Court, the Industrial Commissioners can only hear specific issues such as fraud or mistakes made by the lower level hearing officers. However, this is not the last stop for employers and injured workers to argue their cases. Once notified that the Industrial Commission has refused the appeal, each party has 60 days to appeal most issues into the Court of Common Pleas.
Since an appeal into your local Court system is very rare, and can be extremely expensive, it is imperative that thorough preparation is done from the very beginning. Evidence should be gathered from the onset of the claim and employers must work closely with the Account Manager to ensure all documentation and testimony will be available in a timely manner.
It's important to remember that every case has its own set of unique circumstances - so what was critical in one claim, may not have any impact on another. For this reason, it is important that you remain involved and informed throughout the process. While we can't guarantee the outcome of a hearing, our collaboration with you and our legal experts leads to the best possible representation.
Submitted by Vicki Allford -COSE Compensation Services 216-592-2214 vallford@cose.org