Frequently Asked Questions

Answers to common questions about disability benefits

Vanderhorst & Burgy, LLC is dedicated to representing clients in Social Security Disability hearings in Ohio and Southeast Michigan and Workers' Compensation proceedings throughout Ohio.  We help you, the injured and disabled, to navigate the legal system.  For your reference, we have provided some answers to a few frequently asked questions below, but caution that there is no substitute for legal advice tailored to the circumstances of your case.  We invite you to call or contact us with questions or to schedule a free initial consultation for advice tailored to you.

Representation

Benefits

Parties

Representation

 Do I need an attorney?
The law does not require you to be represented by an attorney, but almost all workers would benefit by being represented by an attorney experienced in workers' compensation matters.

Is there an initial consultation fee?
Vanderhorst & Burgy does NOT charge a consultation fee. We will meet with you and review your claim without charge.

What fees am I responsible for?
Vanderhorst & Burgy, like most other attorneys who represent injured clients, charge a fee only if and when successful in getting some benefit for our clients. Generally speaking, we charge 1/3 of any recovery. We also charge a fee if we are successful in either keeping your weekly benefits going (a fee equal to up to two weeks of compensation) or a fee ($300) for getting action approved in your claim that that does not put money in your pocket such as getting a costly surgery approved. We will thoroughly explain our fee contract before signing and we will give you a copy for your records if you decide to hire our firm.

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Benefits

What is salary continuation?
Salary continuation is where your employer pays you your regular wages with all the usual deductions while you are off work.

Does workers' compensation pay for "Pain and Suffering"?
No, unlike other personal injury claims, workers' compensation does not pay you for your "Pain and Suffering." It also does not pay your spouse for his or her loss of your services.

What are Temporary Total (TT) disability benefits?
TT is a benefit paid to an injured worker for time lost from work due to a work injury or occupational disease. For the first 12 weeks of TT you are paid 72% of your wage, subject to a maximum and minimum. If you are off work longer than 12 weeks, the TT rate drops to 66 and 2/3% percent.

Can I be working and collecting TT?
No, you cannot be working for any period where you collect TT. However, you can work and be paid Wage Loss benefits, Permanent Partial Disability benefits, Loss of Use benefits and in very limited circumstances Statutory Permanent Total Disability benefits. (See below.)

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What are wage loss benefits?
Wage loss benefits are for injured workers who are released to go back to work with restrictions but who are unable to earn as much because of restrictions in either how many hours they can work or how heavy a work they can perform.

What are Permanent Partial Disability benefits?
Permanent Partial Disability (PPD) or Percentage PPD is a benefit under Ohio’s workers’ compensation system that compensates the injured worker for loss of function such as restricted movement due to strains, sprains, surgery, fractures and even lacerations. Nearly all injuries qualify for a PPD award.

What is a "Scheduled Loss Of" or "Loss of Use" award?
In Ohio, there is a schedule of awards for loss of body parts through either amputation, ankylosis (frozen joint) or loss of use due to paralysis or muscle wasting. The scheduled loss award is given in weeks paid at the maximum rate for the year of injury. This includes loss of fingers, toes, hands, arms, feet, legs, eyes and hearing.

What is Permanent Total Disability (PTD)?
Permanent Total Disability (PTD) is a lifetime benefit for the injured worker who is unable to return to any work and unable to be retrained for any work. You cannot work and receive PTD benefits. The only exception to this strict rule is if you qualify for "Statutory PTD" because of the loss of two hands, two arms two feet or two legs or both eyes or any two of these. IF, and only if, you qualify for "Statutory PTD" are you allowed to work and receive PTD benefits.

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Parties

The injured worker (IW)
Injured workers include workers who are injured or who contract occupational diseases on the job.

Dependent
Dependents include a surviving spouse of a worker who has died as a result of a work injury or occupational disease. It also includes the workers’ minor children, children under the age of 25 who are enrolled in full-time college and physically and mentally dependent adult children.

The employer
There are two types of employers under the Ohio Workers' Compensation system:

  • State-Fund Employers basically buy insurance for work related injuries, occupational diseases and deaths from the State of Ohio Bureau of Workers' Compensation.
  • Self-Insuring Employers are larger employers who pay compensation and benefits directly to injured and disabled workers.

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Physician of record
Physician of Record is the doctor you choose to treat you. Under Ohio law, you have free choice of physician and as long as that physician is an approved BWC provider, the BWC (or the Self-Insuring employer) pays the provider with no co-pays or balance billing to you.

Bureau of Workers' Compensation (BWC)
The BWC is a state agency that administers Ohio's Workers' Compensation claims. Sometimes the BWC makes the initial determination in a claim, but you may appeal the BWC’s determination to the Industrial Commission of Ohio.

Industrial Commission of Ohio (IC)
The Industrial Commission or IC is composed of attorney hearing officers who are trained decision makers when disputes arise between the injured worker and either the employer or the BWC. There are three levels of hearings at the IC:

  1. DHO or District Hearing Officers are the first level hearing officers on all matters except Permanent Total Disability hearings and Additional Award hearings on VSSRs.
  2. SHO or Staff Hearing Officers hear all appeals from DHOs and hear PTD and Additional Award hearings on VSSRs.
  3. The Industrial Commissioners hear only very limited number of appeals from SHOs.

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Managed Care Organization (MCO)
A Managed Care Organization is selected by state fund employers to manage the medical care of a Workers' Compensation claim. The MCO is paid by the BWC to do this.

Third party administrator (TPA)
A TPA helps both state fund and self insuring employers make initial decisions regarding Workers' Compensation claims.

From offices located in Toledo, Vanderhorst & Burgy, LLC proudly serves clients throughout Lucas, Ottawa, Sandusky, Wood, Fulton and Henry counties in Ohio and Monroe and Lenawee counties in Michigan.