Workers' Compensation

Appealing a Workers’ Compensation Claim Decision

Chelsea Bikner
Appealing a Workers’ Compensation Claim Decision
Reading time 4 Mins
Published on Oct 30
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After you or your employee submit a workers’ compensation claim in Ohio, the Bureau of Workers’ Compensation (BWC) issues an initial order with a decision on the claim.

If you or your injured worker disagree with the decision, either of you may file an appeal with the Industrial Commission of Ohio (IC). This process ensures that all parties have the opportunity to present any mitigating information or documents that support their claim.

Read on to learn more about the workers’ compensation claim appeal process.

Right to appeal

A Claims Service Specialist with the BWC issues a letter stating the initial decision on the claim, kickstarting the 14-day appeal period. If you or your employee disagrees with the decision, you have 14 calendar days from the date of receipt of the letter to file an appeal with the IC.

The Notice of Appeal or a written notice must be sent to the original claims service specialist who issued the original decision by mail, fax, or in person, making sure to include the following information:

  • Injured worker and employer name;
  • The claim number;
  • The date of the order being appealed;
  • The reason why the order is being appealed;
  • A signature and date on the appeal.

Appeal levels

Once you file an appeal, the IC will hear the dispute. The IC will notify all involved parties about the date, time, and location of the hearing, generally two weeks in advance of the date. Injured workers and employers may either represent themselves in the process or hire a lawyer at their own expense.

The IC has three possible levels of appeal for workers’ compensation disputes:

  • District level hearings are held in the 12 IC district offices across the state. Your appeal will be heard at the nearest district office to your employees’ residence. All district hearings are held within 45 days of the initial appeal filing. After hearing evidence from each party and speaking to any witnesses, the district hearing officer will issue a written notice of their decision within seven days of the hearing and send the notice to all involved parties.
    • If you or your employee are not satisfied with the outcome, you may appeal to the staff hearing officer with 14 days of the receipt of the district hearing officer’s order by filing a Notice of Appeal.
  • Staff hearings are held within 45 days of the appeal of the district level decision and the process is very much the same as the district level appeal. The staff hearing officer will issue a written notice of their decision within seven days of the hearing and send the notice to all involved parties. If you disagree with the staff level decision, you may a Notice of Appeal requesting to present your case directly to the commission.
  • Commission level hearings are not guaranteed. The commission will review all information presented in the appeals process and either agree or refuse to hear the claim. All accepted appeals are heard within 45 days of the appeal and a written notice of the decision is issued within seven days of the hearing.

Legal representation at commission hearings is not required, however, you or your employee may choose to represent yourself or have an attorney present. You and your injured worker should bring two copies of any evidence related to the claim, including witness statements, medical records, video footage, or other documentation and evidence with you to the hearing. You are required to submit this information both to the hearing officer and to the opposing side in your appeal.

Claims appeals and Sheakley

Workers’ compensation can be a tricky enough topic all on its own and the claims appeal process even more so, but you don’t have to go it alone. The Workers’ Compensation experts at Sheakley can help to give you guidance and information on the claims appeal process, making sure that you understand how the process works and helping to protect your business.

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