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Skilled Help With Appeals And Mandamus Actions

Last updated on September 16, 2024

If you believe your compensation claim for workers’ comp was wrongfully denied, you still have options. Don’t give up merely because the system said no the first time.

At the Philip J. Fulton Law Office, in Columbus, we can help you challenge a claim denial and pursue the compensation benefits you deserve under Ohio law.

What Options Do You Have For Challenging A Denial Of Your Claim?

It is important to be clear about the terminology concerning the options available for challenging a denial of your workers’ comp claim. This is because – depending on the facts of your case – there is more than one type of compensation appeal possible.

The first type is an appeal to the Ohio Industrial Commission (IC). If the Ohio Bureau of Workers’ Compensation (BWC) sends you a written notice about denying your claim, you can request an administrative hearing before the IC. The IC is a separate agency from the BWC.

But in some cases, it is also possible to appeal to the court system, namely the Court of Common Pleas. There is also a procedure called a “mandamus action” that can be used in certain cases.

Appealing To The Court System

If you believe the Industrial Commission wrongfully denied your claim for workers’ compensation benefits, you can appeal this decision to the court system. In Ohio, the appropriate court is called the Court of Common Pleas. The procedure is set forth in the Ohio Statutes at Section 4123.512.

Under this law, you are not allowed to appeal a decision of the Industrial Commission regarding the extent of your disability. The only way to challenge that decision is through a procedure called “writ of mandamus.” But if there is a question about your eligibility for workers’ comp in the first place – such as whether a certain type of workplace injury or occupational disease is covered by the system – an appeal to the Court of Common Pleas is possible.

Our attorneys have many years of experience in handling these compensation appeals. We will make sure yours is filed in a timely manner, within 60 days after the adverse decision of the Industrial Commission. We know the steps to take to put your best case forward for the compensation benefits you have coming after getting hurt on the job.

Mandamus Actions

If you disagree with a decision made by the Industrial Commission about the extent of your disability, we can use a procedure called a mandamus action. This involves a review by the courts of whether the commission committed an abuse of discretion in the decision it made in your case.

For example, there may be an issue about whether you were entitled to receive temporary total disability or permanent total disability. The writ of mandamus offers a way to challenge the Industrial Commission’s decision about how badly you were hurt.

We are skilled at handling these actions and will use them appropriately to challenge wrongful denials of the compensation benefits you deserve.

Understanding Workers’ Compensation Appeals

When your workers’ compensation claim is denied in Ohio, it’s important to understand the appeals process. You have 14 days from the denial notice to request an administrative hearing before the Ohio Industrial Commission (IC). The IC will review your case, allowing you to present additional evidence and arguments. If the IC upholds the denial, you can further appeal to the Court of Common Pleas within 60 days. For disputes about the extent of your disability, a “writ of mandamus” can be filed to seek a higher court’s review. At the Philip J. Fulton Law Office, we guide you through each step to secure the compensation benefits you deserve.

Types Of Denial In Workers’ Compensation Claims

Understanding the reasons behind the denial of your workers’ compensation claim is crucial for effectively challenging it. Generally, denials fall into two main categories: medical treatment denials and benefit payment denials. Each type presents unique challenges and requires specific strategies to address.

Medical Treatment Denials

Medical treatment denials occur when the Ohio BWC or your employer’s insurer refuses to cover specific medical treatments or procedures recommended by your health care provider. These denials can significantly impact your recovery and well-being. Common reasons for denial include questioning the necessity of the treatment or disputing its relation to your workplace injury. If your medical treatment is denied, it’s essential to gather comprehensive medical evidence and expert opinions to support your case. At the Philip J. Fulton Law Office, we are experienced in challenging these denials to ensure you receive the medical care you need.

Benefit Payment Denials

Benefit payment denials involve the refusal to provide financial compensation for lost wages or other benefits you are entitled to under workers’ compensation. These denials can arise from disputes over the severity of your injury, your ability to work or the calculation of your benefits. Without these payments, you may struggle to cover your living expenses during your recovery. To contest a benefit payment denial, you must present strong evidence demonstrating your entitlement to these benefits. Our attorneys at the Philip J. Fulton Law Office are skilled in addressing benefit payment denials and will work tirelessly to secure the compensation benefits you deserve.