For a claim to be compensable an injury must occur within the course and scope of employment and arise out of employment. Generally speaking the injured worker has the burden of proof to establish that the injury was caused by the injured worker’s employment. The injury may not be due to horseplay, be self-inflicted or caused by pre-existing condition or the natural deterioration of tissue. However, pre-existing conditions can be aggravated. (see below) The injured worker must be an employee and not an independent contractor. (see O.R.C. § 4123.01)
Occupational diseases are diseases contracted in the course of employment. Examples are asbestosis and silicosis. Some occupational diseases are scheduled diseases and are specifically listed in the statute. (See O.R.C. § 4123.68) For occupational diseases that are not scheduled diseases an injured worker must show that the hazard to which the injured worker was exposed is greater than that to which the general public is exposed.
Wear and Tear Claims/Repetitive Use Claims:
A claim can be compensable when there is not a single incident but the injured worker repetitively uses a body part and develops inuries. An example may be carpal tunnel syndrome due to heavy, repetitive use of the hands.
Even though an injured worker has a pre-existing condition, if the condition was aggravated by the injury, that condition still may be covered in the claim. The legal standard for the aggravation of the pre-existing condition depends on the date of injury.
For claims prior to 8/25/06, an injured worker must show that the pre-existing condition was worsened by the injury. This could be an asymptomatic individual who became symptomatic as a result of the injury.
For claims 8/25/06 forward, an injured worker must show that the pre-existing condition was substantially aggravated. The injured worker must prove the aggravation by documented objective diagnostic findings, objective clinical findings, or objective test results. Subjective evidence, such as an increase in pain, is insufficient to prove a substantial aggravation.
An injury or disability that is caused primarily by the natural deterioration of tissue, an organ, or part of the body is not covered. The issue with an aggravation of a pre-existing condition usually is whether there is a documented aggravation or whether the diagnosis is due to the natural deterioration of tissue.
A psychological injury must be related to a physical injury to be compensable in Ohio. Psychological diagnoses alone due to issues such as workplace stress are not covered under Ohio law. However, psychological conditions due to an injury can be included in a claim.