As Reported by the House Finance and Appropriations Committee 1
122nd General Assembly 4
Regular Session Sub. H.B. No. 363 5
1997-1998 6
REPRESENTATIVES THOMPSON-JOHNSON-AMSTUTZ-O'BRIEN-CORE-CATES-VESPER 7
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A B I L L
To amend sections 121.03, 2317.45, 4121.12, 11
4121.121, 4121.125, 4123.511, 4123.512, and 12
4123.57 of the Revised Code to make
appropriations for the Bureau of Workers' 13
Compensation for the biennium beginning July 1,
1997, and ending June 30, 1999, and to provide 14
authorization and conditions for the operation of 15
Bureau of Workers' Compensation programs.
BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF OHIO: 16
Section 1. That sections 121.03, 2317.45, 4121.12, 18
4121.121, 4121.125, 4123.511, 4123.512, and 4123.57 of the 19
Revised Code be amended to read as follows: 20
Sec. 121.03. The following administrative department heads 31
shall be appointed by the governor, with the advice and consent 32
of the senate, and shall hold their offices during the term of 33
the appointing governor, except as provided in division (W) of 35
this section, and are subject to removal at the pleasure of the 36
governor.
(A) The director of budget and management; 38
(B) The director of commerce; 40
(C) The director of transportation; 42
(D) The director of agriculture; 44
(E) The director of human services; 47
(F) Until July 1, 1997, the director of liquor control; 49
(G) The director of public safety; 51
(H) The superintendent of insurance; 53
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(I) The director of development; 55
(J) The tax commissioner; 57
(K) The director of administrative services; 59
(L) The administrator of the bureau of employment 61
services; 62
(M) The director of natural resources; 64
(N) The director of mental health; 66
(O) The director of mental retardation and developmental 68
disabilities; 69
(P) The director of health; 71
(Q) The director of youth services; 73
(R) The director of rehabilitation and correction; 75
(S) The director of environmental protection; 77
(T) The director of aging; 79
(U) The director of alcohol and drug addiction services; 81
(W)(V) The administrator of workers' compensation who 83
meets the qualifications required under division (A) of section 84
4121.121 of the Revised Code, who shall serve as administrator, 85
subject to removal at the pleasure of the governor, until the 86
date the workers' compensation oversight commission appoints the 87
administrator as provided in division (F)(10) of section 4121.12 88
of the Revised Code.
Sec. 2317.45. (A) As used in this section: 97
(1) "Collateral benefits" means benefits that are paid by 99
any source, including workers' compensation benefits, to or on 101
behalf of the plaintiff as a result of an injury or loss to
person or property, regardless of whether there is an obligation 102
to pay back the money or other benefits, in whole or in part, 103
upon recovery in a tort action. "Collateral benefits" does not 104
include life insurance proceeds.
(2) "Tort action" means a civil action for damages for 107
injury, death, or loss to person or property. "Tort action" 108
includes a product liability claim but does not include a civil 109
action for damages for a breach of contract or another agreement 110
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between persons.
(3) "Trier of fact" means the jury or, in a nonjury 112
action, the court.
(B) In determining the amount of the compensatory damages 115
that are recoverable by the plaintiff in a tort action, the trier 117
of fact shall consider, if presented in the tort action, relevant
collateral benefits that have been paid, or that the source of 118
the benefits has acknowledged are payable, from insurance other 119
than insurance for which the plaintiff, spouse of the plaintiff, 120
or parent of the plaintiff if the plaintiff is a minor, has paid 121
a premium, insurance that is subject to a right of subrogation, 122
WORKERS' COMPENSATION BENEFITS THAT ARE SUBJECT TO A RIGHT OF 123
SUBROGATION, or insurance that has any other obligation of 125
repayment, including, but not limited to, evidence of the amount 126
of the collateral benefit and of the costs, premiums, or charges
for the collateral benefits. 127
(C) This section does not apply as follows: 129
(1) In tort actions against the state in the court of 131
claims. Division (D) of section 2743.02 or division (B)(2) of 133
section 3345.40 of the Revised Code applies to collateral 134
recoveries or sources of plaintiffs in those tort actions.
(2) In tort actions against political subdivisions of this 136
state that are commenced under or are subject to Chapter 2744. of 137
the Revised Code. Division (B) of section 2744.05 of the Revised 139
Code applies to collateral sources of plaintiffs in those tort
actions. 140
(D) This section shall be considered to be purely remedial 142
in operation and shall be applied in a remedial manner in any 143
civil action commenced on or after the effective date of the 144
amendment to this section JANUARY 27, 1997, in which this section 145
is relevant, regardless of when the cause of action accrued and 146
notwithstanding any other section of the Revised Code or prior 147
rule of law of this state, but shall not be construed to apply to 148
any civil action pending prior to the effective date of the 149
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amendment to this section JANUARY 27, 1997. 150
Sec. 4121.12. (A) There is hereby created the workers' 160
compensation oversight commission consisting of nine members, of 161
which members the governor shall appoint five with the advice and 162
consent of the senate. Of the five members the governor 164
appoints, two shall be individuals who, on account of their 166
previous vocation, employment, or affiliations, can be classed as 168
representative of employees, at least one of whom is
representative of employees who are members of an employee 170
organization; two shall be individuals who, on account of their 172
previous vocation, employment, or affiliations, can be classed as 174
representative of employers, one of whom represents self-insuring 175
employers and one of whom has experience as an employer in 176
compliance with section 4123.35 of the Revised Code other than a 178
self-insuring employer, and one of those two representatives also
shall represent employers whose employees are not members of an 179
employee organization; and one shall represent the public and 180
also be an individual who, on account of the individual's 181
previous vocation, employment, or affiliations, cannot be classed 182
as either predominantly representative of employees or of 183
employers. The governor shall select the chairperson of the 184
commission who shall serve as chairperson at the pleasure of the 185
governor. No more than three members appointed by the governor 188
shall belong to or be affiliated with the same political party. 189
Each of these five members shall have at least three years' 191
experience in the field of insurance, finance, workers' 192
compensation, law, accounting, actuarial, personnel, investments, 193
or data processing, or in the management of an organization whose 194
size is commensurate with that of the bureau of workers' 195
compensation. At least one of these five members shall be an 196
attorney licensed under Chapter 4705. of the Revised Code to 197
practice law in this state. 198
(B) Of the initial appointments made to the commission, 201
the governor shall appoint one member who represents employees to 202
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a term ending one year after September 1, 1995, one member who 203
represents employers to a term ending two years after the 205
effective date of this section, the member who represents the 206
public to a term ending three years after September 1, 1995, one 209
member who represents employees to a term ending four years after 210
September 1, 1995, and one member who represents employers to a 212
term ending five years after September 1, 1995. Thereafter, 214
terms of office shall be for five years, with each term ending on 215
the same day of the same month as did the term that it succeeds. 217
Each member shall hold office from the date of his appointment 218
until the end of the term for which the member was appointed. 219
The governor shall not appoint any person to more than two 221
full terms of office on the commission. This restriction does 222
not prevent the governor from appointing a person to fill a 223
vacancy caused by the death, resignation, or removal of a 224
commission member and also appointing that person twice to full 225
terms on the commission, or from appointing a person previously 226
appointed to fill less than a full term twice to full terms on 227
the commission. Any member appointed to fill a vacancy occurring 228
prior to the expiration date of the term for which the member's 230
predecessor was appointed shall hold office as a member for the
remainder of that term. A member shall continue in office 231
subsequent to the expiration date of the member's term until a 233
successor takes office or until a period of sixty days has 234
elapsed, whichever occurs first. 235
(C) In making appointments to the commission, the governor 238
shall select the members from the list of names submitted by the 241
workers' compensation oversight commission nominating committee 242
pursuant to this division. Within fourteen days after the 243
governor calls the initial meeting of the nominating committee
pursuant to division (C) of section 4121.123 of the Revised Code, 244
the nominating committee shall submit to the governor, for the 247
initial appointments, a list containing four separate names for 249
each of the members on the commission. Within fourteen days 251
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after the submission of the list, the governor shall appoint 252
individuals from the list.
For the appointment of the member who is representative of 254
employees who are members of an employee organization, both for 255
initial appointments and for the filling of vacancies, the list 256
of four names submitted by the nominating committee shall be 257
comprised of four individuals who are members of the executive 258
committee of the largest statewide labor federation.
Thereafter, within sixty days after a vacancy occurring as 262
a result of the expiration of a term and within thirty days after 263
other vacancies occurring on the commission, the nominating 264
committee shall submit a list containing four names for each 266
vacancy. Within fourteen days after the submission of the list, 268
the governor shall appoint individuals from the list. With 270
respect to the filling of vacancies, the nominating committee 271
shall provide the governor with a list of four individuals who 272
are, in the judgment of the nominating committee, the most fully 273
qualified to accede to membership on the commission. The 274
nominating committee shall not include the name of an individual 275
upon the list for the filling of vacancies if the appointment of
that individual by the governor would result in more than three 276
members of the commission belonging to or being affiliated with 277
the same political party. The committee shall include on the 278
list for the filling of vacancies only the names of attorneys 279
admitted to practice law in this state if, to fulfill the
requirement of division (A) of section 4121.12 of the Revised 280
Code, the vacancy must be filled by an attorney. 281
In order for the name of an individual to be submitted to 283
the governor under this division, the nominating committee shall 285
approve the individual by an affirmative vote of a majority of 287
its members.
(D) The remaining four members of the commission shall be 290
the chairperson and ranking minority member of the standing 291
committees of the house of representatives and of the senate to
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which legislation concerning this chapter and Chapters 4123., 292
4127., and 4131. of the Revised Code normally are referred, or a 294
designee of the chairperson or ranking minority member, provided 295
that the designee is a member of the standing committee. 296
Legislative members shall serve during the session of the general 297
assembly to which they are elected and for as long as they are 298
members of the general assembly. Legislative members shall serve 299
in an advisory capacity to the commission and shall have no 301
voting rights on matters coming before the commission. 303
Membership on the commission by legislative members shall not be 304
deemed as holding a public office. 305
(E) All members of the commission shall receive their 308
reasonable and necessary expenses pursuant to section 126.31 of 309
the Revised Code while engaged in the performance of their duties 311
as members. Legislative members also shall receive fifty dollars 312
per meeting that they attend. Members appointed by the governor 313
also shall receive an annual salary as follows:
(a)(1) On and before August 31, 1998, not to exceed six 316
thousand dollars payable at the rate of five hundred dollars per 317
month. A member shall receive the monthly five hundred dollar 318
salary only if the member has attended at least one meeting of 320
the commission during that month. A member may receive no more
than the monthly five hundred dollar salary regardless of the 322
number of meetings held by the commission during a month or the 323
number of meetings in excess of one within a month that the 324
member attends.
(b)(2) After August 31, 1998, not to exceed eighteen 326
thousand dollars payable at the rate of fifteen hundred dollars 327
per month. A member shall receive the monthly fifteen hundred 328
dollar salary only if the member has attended at least one 329
meeting of the commission during that month. A member may 330
receive no more than the monthly fifteen hundred dollar salary
regardless of the number of meetings held by the commission 331
during the month or the number of meetings in excess of one 332
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within a month that the member attends. 333
The administrator of workers' compensation shall provide 335
professional and clerical assistance to the commission, as the 336
commission considers appropriate. 337
(F) The commission shall: 339
(1) Review progress of the bureau in meeting its cost and 342
quality objectives and in complying with this chapter and 343
Chapters 4123., 4127., and 4131. of the Revised Code; 344
(2) Issue an annual report on the cost and quality 346
objectives of the bureau to the president of the senate, the 348
speaker of the house of representatives, and the governor; 349
(3) Review all independent financial audits of the bureau. 351
The administrator shall provide access to records of the bureau 352
to facilitate the review required under this division. 353
(4) Study issues as requested by the administrator or the 355
governor;
(5) Contract with an independent actuarial firm to assist 357
the commission in making recommendations to the administrator 358
regarding premium rates;
(6) Establish objectives, policies, and criteria for the 361
administration of the investment program that include asset 363
allocation targets and ranges, risk factors, asset class
benchmarks, time horizons, total return objectives, and 364
performance evaluation guidelines, and monitor the 366
administrator's progress in implementing the objectives, 367
policies, and criteria on a quarterly basis. The commission
shall publish the objectives, policies, and criteria no less than 369
annually and shall make copies available to interested parties. 370
The commission shall prohibit, on a prospective basis, specific 372
investment activity it finds to be contrary to its investment
objectives, policies, and criteria. 373
The investment policy in existence on the effective date of 375
this amendment shall continue until the commission approves 376
objectives, policies, and criteria for the administration of the 377
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investment program pursuant to this section. 378
(7) Advise and consent on all of the following: 380
(a) Administrative rules the administrator submits to it 383
pursuant to division (B)(5) of section 4121.121 of the Revised
Code for the classification of occupations or industries, for 385
premium rates and contributions, for the amount to be credited to 386
the surplus fund, for rules and systems of rating, rate 387
revisions, and merit rating;
(b) The overall policy of the bureau of workers' 390
compensation as set by the administrator;
(c) The duties and authority conferred upon the 392
administrator pursuant to section 4121.37 of the Revised Code; 393
(d) Rules the administrator adopts for the health 395
partnership program and the qualified health plan system, as 396
provided in sections 4121.44, 4121.441, and 4121.442 of the 397
Revised Code.
(8) Perform all duties required under section 4121.125 of 399
the Revised Code; 400
(9) After August 31, 1998, appoint an administrator who 402
meets the qualifications required under section 4121.121 of the 403
Revised Code and fix the salary of the administrator, the amount 405
of which the commission shall base upon the experience of the 407
administrator and the responsibilities and duties of the
administrator pursuant to this chapter and Chapters 4123., 4127., 408
and 4131. of the Revised Code. 409
(G) The commission may enter into an employment contract 411
with an administrator it appoints, provided that the contract 412
does not exceed two years in length. 414
(H) As used in this section, "employee organization" means 416
any labor or bona fide organization in which employees 417
participate and which exists for the purpose, in whole or in 419
part, of dealing with employers concerning grievances, labor 420
disputes, wages, hours, terms and other conditions of employment. 421
Sec. 4121.121. (A) There is hereby created the bureau of 430
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workers' compensation, which shall be administered by the 431
administrator of workers' compensation. A person appointed to 432
the position of administrator shall possess significant 433
management experience in effectively managing an organization or 434
organizations of substantial size and complexity. Before
September 1, 1998, the THE governor shall appoint the 435
administrator as provided in section 121.03 of the Revised Code, 437
and the administrator shall serve at the pleasure of the 439
governor. The governor shall fix the administrator's salary on 441
the basis of the administrator's experience and the
administrator's responsibilities and duties under this chapter 443
and Chapters 4123., 4127., and 4131. of the Revised Code. The 444
governor shall not appoint to the position of administator any 445
person who has, or whose spouse has, given a contribution to the 446
campaign committee of the governor in an amount greater than one 447
thousand dollars during the two-year period immediately preceding 448
the date of the appointment of the administrator. After August 450
31, 1998, the workers' compensation oversight commission shall 451
appoint the administrator as provided in division (F)(9) of 452
section 4121.12 of the Revised Code, and the administrator shall 453
serve at the pleasure of the oversight commission. The oversight 455
commission shall fix the administrator's salary on the basis of 456
the administrator's experience and the administrator's 457
responsibilities and duties under this chapter and Chapters 458
4123., 4127., and 4131. of the Revised Code. 459
The administrator shall hold no other public office and 461
shall devote full time to the duties of administrator. Before 463
entering upon the duties of the office, the administrator shall 464
take an oath of office as required by sections 3.22 and 3.23 of 465
the Revised Code, and shall file in the office of the secretary 466
of state, a bond signed by the administrator and by surety 467
approved by the governor, for the sum of fifty thousand dollars 469
payable to the state, conditioned upon the faithful performance 470
of the administrator's duties.
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(B) The administrator is responsible for the management of 473
the bureau of workers' compensation and for the discharge of all 474
administrative duties imposed upon the administrator in this 475
chapter and Chapters 4123., 4127., and 4131. of the Revised Code, 477
and in the discharge thereof shall do all of the following: 478
(1) Establish the overall administrative policy of the 481
bureau for the purposes of this chapter and Chapters 4123.,
4127., and 4131. of the Revised Code, and perform all acts and 482
exercise all authorities and powers, discretionary and otherwise 484
that are required of or vested in the bureau or any of its 485
employees in this chapter and Chapters 4123., 4127., and 4131. of 486
the Revised Code, except the acts and the exercise of authority 487
and power that is required of and vested in the oversight 488
commission or the industrial commission pursuant to those 489
chapters. The treasurer of state shall honor all warrants signed 490
by the administrator, or by one or more of the administrator's 491
employees, authorized by the administrator in writing, or bearing 493
the facsimile signature of the administrator or such employee 494
under sections 4123.42 and 4123.44 of the Revised Code. 495
(2) Employ, direct, and supervise all employees required 497
in connection with the performance of the duties assigned to the 498
bureau by this chapter and Chapters 4123., 4127., and 4131. of 499
the Revised Code, and may establish job classification plans and 500
compensation for all employees of the bureau provided that this 501
grant of authority shall not be construed as affecting any 502
employee for whom the state employment relations board has 503
established an appropriate bargaining unit under section 4117.06 504
of the Revised Code. All positions of employment in the bureau 505
are in the classified civil service except those employees the 506
administrator may appoint to serve at the administrator's 507
pleasure in the unclassified civil service pursuant to section 508
124.11 of the Revised Code. The administrator shall fix the 509
salaries of employees the administrator appoints to serve at the 511
administrator's pleasure, including the chief operating officer, 512
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staff physicians, and other senior management personnel of the
bureau AND SHALL ESTABLISH THE COMPENSATION OF STAFF ATTORNEYS OF 513
THE BUREAU'S LEGAL SECTION AND THEIR IMMEDIATE SUPERVISORS, AND 514
TAKE WHATEVER STEPS ARE NECESSARY TO PROVIDE ADEQUATE 515
COMPENSATION FOR OTHER STAFF ATTORNEYS. 516
(3) Reorganize the work of the bureau, its sections, 518
departments, and offices to the extent necessary to achieve the 519
most efficient performance of its functions and to that end may 520
establish, change, or abolish positions and assign and reassign 521
duties and responsibilities of every employee of the bureau. All 522
persons employed by the commission in positions that, after 524
November 3, 1989, are supervised and directed by the 525
administrator under this section are transferred to the bureau in 526
their respective classifications but subject to reassignment and 527
reclassification of position and compensation as the 528
administrator determines to be in the interest of efficient 529
administration. The civil service status of any person employed 530
by the commission is not affected by this section. Personnel 531
employed by the bureau or the commission who are subject to 532
Chapter 4117. of the Revised Code shall retain all of their 533
rights and benefits conferred pursuant to that chapter as it 534
presently exists or is hereafter amended and nothing in this 535
chapter or Chapter 4123. of the Revised Code shall be construed 536
as eliminating or interfering with Chapter 4117. of the Revised 537
Code or the rights and benefits conferred under that chapter to 538
public employees or to any bargaining unit. 539
(4) Provide offices, equipment, supplies, and other 541
facilities for the bureau. The administrator also shall provide 543
suitable office space in the service offices for the district 544
hearing officers, the staff hearing officers, and commission 545
employees as requested by the commission.
(5) Prepare and submit to the oversight commission 548
information the administrator considers pertinent or the 549
oversight commission requires, together with the administrator's 552
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recommendations, in the form of administrative rules, for the 553
advice and consent of the oversight commission, for 554
classifications of occupations or industries, for premium rates 555
and contributions, for the amount to be credited to the surplus 556
fund, for rules and systems of rating, rate revisions, and merit 557
rating. The administrator shall obtain, prepare, and submit any 558
other information the oversight commission requires for the 560
prompt and efficient discharge of its duties. 562
(6) Keep the accounts required by division (A) of section 564
4123.34 of the Revised Code and all other accounts and records 565
necessary to the collection, administration, and distribution of 566
the workers' compensation funds and shall obtain the statistical 567
and other information required by section 4123.19 of the Revised 568
Code. 569
(7) Exercise the investment powers vested in the 571
administrator by section 4123.44 of the Revised Code in 572
accordance with the investment objectives, policies, and criteria 574
established by the oversight commission pursuant to section 575
4121.12 of the Revised Code. The administrator shall not engage 576
in any prohibited investment activity specified by the oversight 577
commission pursuant to division (F)(6) of section 4121.12 of the 578
Revised Code. All business shall be transacted, all funds 579
invested, all warrants for money drawn and payments made, and all 580
cash and securities and other property held, in the name of the 581
bureau, or in the name of its nominee, provided that nominees are
authorized by the administrator solely for the purpose of 583
facilitating the transfer of securities, and restricted to the 584
administrator and designated employees. 585
(8) Make contracts for and supervise the construction of 588
any project or improvement or the construction or repair of 589
buildings under the control of the bureau. 590
(9) Purchase supplies, materials, equipment, and services; 592
make contracts for, operate, and superintend the telephone, other 593
telecommunication, and computer services for the use of the 594
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bureau; and make contracts in connection with office 595
reproduction, forms management, printing, and other services. 596
(10) Separately from the budget the industrial commission 599
submits, prepare and submit to the director of budget and 600
management a budget for each biennium. The budget submitted 601
shall include estimates of the costs and necessary expenditures 602
of the bureau in the discharge of any duty imposed by law as well 603
as the costs of furnishing office space to the district hearing 604
officers, staff hearing officers, and commission employees under 605
division (D) of this section. 606
(11) As promptly as possible in the course of efficient 608
administration, decentralize and relocate such of the personnel 609
and activities of the bureau as is appropriate to the end that 610
the receipt, investigation, determination, and payment of claims 611
may be undertaken at or near the place of injury or the residence 612
of the claimant and for that purpose establish regional offices, 613
in such places as the administrator considers proper, capable of 615
discharging as many of the functions of the bureau as is 616
practicable so as to promote prompt and efficient administration 617
in the processing of claims. All active and inactive lost-time 618
claims files shall be held at the service office responsible for 619
the claim. A claimant, at the claimant's request, shall be 620
provided with information by telephone as to the location of the 622
file pertaining to claim. The administrator shall ensure that 623
all service office employees report directly to the director for 624
their service office.
(12) Provide a written binder on new coverage where the 626
administrator considers it to be in the best interest of the 627
risk. The administrator, or any other person authorized by the 628
administrator, shall grant the binder upon submission of a 630
request for coverage by the employer. A binder is effective for 631
a period of thirty days from date of issuance and is 632
nonrenewable. Payroll reports and premium charges shall coincide 633
with the effective date of the binder. 634
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(13) Set standards for the reasonable and maximum handling 636
time of claims payment functions, ensure, by rules, the impartial 637
and prompt treatment of all claims and employer risk accounts, 638
and establish a secure, accurate method of time stamping all 639
incoming mail and documents hand delivered to bureau employees. 640
(14) Ensure that all employees of the bureau follow the 642
orders and rules of the commission as such orders and rules 643
relate to the commission's overall adjudicatory policy-making and 644
management duties under this chapter and Chapters 4123., 4127., 645
and 4131. of the Revised Code. 646
(15) Manage and operate a data processing system with a 648
common data base for the use of both the bureau and the 649
commission and, in consultation with the commission, using 650
electronic data processing equipment, shall develop a claims 651
tracking system that is sufficient to monitor the status of a 652
claim at any time and that lists appeals that have been filed and 653
orders or determinations that have been issued pursuant to 654
section 4123.511 or 4123.512 of the Revised Code, including the 655
dates of such filings and issuances. 656
(16) Establish and maintain a medical section within the 658
bureau. The medical section shall do all of the following: 659
(a) Assist the administrator in establishing standard 661
medical fees, approving medical procedures, and determining 662
eligibility and reasonableness of the compensation payments for 663
medical, hospital, and nursing services, and in establishing 664
guidelines for payment policies which recognize usual, customary, 665
and reasonable methods of payment for covered services; 666
(b) Provide a resource to respond to questions from claims 668
examiners for employees of the bureau; 669
(c) Audit fee bill payments; 671
(d) Implement a program to utilize, to the maximum extent 673
possible, electronic data processing equipment for storage of 674
information to facilitate authorizations of compensation payments 675
for medical, hospital, drug, and nursing services; 676
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(e) Perform other duties assigned to it by the 678
administrator. 679
(17) Appoint, as the administrator determines necessary, 681
panels to review and advise the administrator on disputes arising 683
over a determination that a health care service or supply 684
provided to a claimant is not covered under this chapter or 685
Chapter 4123. of the Revised Code or is medically unnecessary. 686
If an individual health care provider is involved in the dispute, 687
the panel shall consist of individuals licensed pursuant to the 688
same section of the Revised Code as such health care provider. 689
(18) Pursuant to section 4123.65 of the Revised Code, 691
approve applications for the final settlement of claims for 692
compensation or benefits under this chapter and Chapters 4123., 693
4127., and 4131. of the Revised Code as the administrator 694
determines appropriate, except in regard to the applications of 696
self-insuring employers and their employees; 697
(19) Comply with section 3517.13 of the Revised Code, and 699
except in regard to contracts entered into pursuant to the 702
authority contained in section 4121.44 of the Revised Code,
comply with the competitive bidding procedures set forth in the 704
Revised Code for all contracts into which the administrator 705
enters provided that those contracts fall within the type of 706
contracts and dollar amounts specified in the Revised Code for 707
competitive bidding and further provided that those contracts are 708
not otherwise specifically exempt from the competitive bidding 709
procedures contained in the Revised Code. 710
(20) Adopt, with the advice and consent of the oversight 712
commission, rules for the operation of the bureau. No rule 713
adopted by the administrator shall be construed as barring the 714
participation of a person who is not admitted to the practice of 715
law as a representative of a party for the purposes of any matter 716
arising under this chapter and Chapters 4123., 4127., and 4131. 717
of the Revised Code, provided that the representative of the
party complies with rules of the administrator. 718
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(21) Prepare and submit to the oversight commission 720
information the administrator considers pertinent or the 721
oversight commission requires, together with the administrator's 722
recommendations, in the form of administrative rules, for the 723
advice and consent of the oversight commission, for the health 724
partnership program and the qualified health plan system, as
provided in sections 4121.44, 4121.441, and 4121.442 of the 725
Revised Code.
(C) The administrator, with the advice and consent of the 727
senate, shall appoint a chief operating officer who has 729
significant experience in the field of workers' compensation 730
insurance or other similar insurance industry experience if the
administrator does not possess such experience. The chief 731
operating officer shall not commence the chief operating 732
officer's duties until after the senate consents to the chief 733
operating officer's appointment. The chief operating officer 734
shall serve in the unclassified civil service of the state. 735
Sec. 4121.125. (A) The workers' compensation oversight 745
commission may contract with one or more outside actuarial firms 746
and other professional persons, as the oversight commission 747
determines necessary, to assist the oversight commission in 748
measuring the performance of Ohio's workers' compensation system 749
and in comparing Ohio's workers' compensation system to other 750
state and private workers' compensation systems. The oversight 751
commission, actuarial firm or firms, and professional persons 752
shall make such measurements and comparisons using accepted 753
insurance industry standards, including, but not limited to, 754
standards promulgated by the National Council on Compensation 756
Insurance.
(B) The oversight commission may contract with one or more 758
outside firms to conduct management and financial audits of the 760
workers' compensation system, including audits of the reserve 761
fund belonging to the state insurance fund, and to establish 762
objective quality management principles and methods by which to 763
18
review the performance of the workers' compensation system.
(C) The oversight commission shall include any actuarial, 765
managerial, or financial report completed under its authority 767
pursuant to division (A) or (B) of this section in the next 768
regularly published report of the oversight commission. 769
(D) The oversight commission shall publish monthly reports 771
that include, but are not limited to, all of the following: 772
(1) Comparative and competitive data concerning Ohio's 774
workers' compensation system and the workers' compensation system 775
of other states on all of the following subjects: 777
(a) Average length of time to process contested and 780
uncontested claims;
(b) Length of time to investigate claims that raise 782
suspicion of fraudulent activity; 783
(c) Average indemnity cost of claims; 785
(d) Average medical costs of claims reported according to 787
the types of awards and separately reported according to the 788
types of injuries; 789
(e) Comparisons of Ohio classification manual rates with 792
comparable rates in other states, and after the administrator of 793
workers' compensation classifies occupations and industries and 794
determines risks of different classes according to the National 795
Council on Compensation Insurance, comparisons of rates in Ohio 797
with rates of other states that use National Council on 798
Compensation Insurance codes;
(f) Effectiveness of rehabilitation, both private and 800
within the state's workers' compensation system, including the 801
number of individuals referred, the percentage completing a 802
rehabilitation program, and the percentage of those finding 803
employment after successful completion of a rehabilitation 804
program.
(2) Data concerning Ohio's workers' compensation system 806
concerning all of the following: 807
(a) Performance of the investments of the bureau of 809
19
workers' compensation; 810
(b) Effectiveness of the bureau in collecting delinquent 813
payments that are due from employers pursuant to Chapters 4121., 814
4123., 4127., and 4131. of the Revised Code, including a
crosscheck with other state agencies to which employers are 816
required under law to make payments;
(c) Effectiveness of the bureau in subrogation claims; 819
(d) Performance measurements of managed care organizations 822
within the health partnership program and the qualified health 823
plan system;
(e) Return-to-work rates, medical outcome measures, and 826
other measures that the oversight commission or general assembly
determines; 827
(f) Adequacy of the reserve fund to cover indemnity costs 830
of the state insurance fund;
(g) The total number of claims filed in the time period 832
occurring subsequent to publication of the report that 833
immediately precedes publication of the report for which the 834
information is being compiled according to the type of claim, 836
employer classification, and claim result;
(h) The effectiveness of the bureau in identifying and 838
eliminating fraud in the workers' compensation system and in 839
recovering workers' compensation resources. 840
The reports published under this division shall include 842
data from the bureau and the industrial commission regarding 843
state fund, self-insuring, and public employers. 844
(E) The administrator and the industrial commission shall 846
compile information and provide access to records of the bureau 847
and the industrial commission to the oversight commission to the 848
extent necessary for fulfillment of all BOTH of the following 849
requirements: 850
(1) Conduct of the measurements and comparisons described 853
in division (A) of this section; 854
(2) Conduct of the management and financial audits and 856
20
establishment of the principles and methods described in division 857
(B) of this section; 858
(3) Publishing of the reports described in divisions (C) 861
and (D) of this section.
(F)(D) The administrator shall pay the expenses incurred 864
by the oversight commission to effectively fulfill its duties and 865
exercise its powers under this section as the administrator pays 866
other operating expenses of the bureau. 867
Sec. 4123.511. (A) Within seven days after receipt of any 878
claim under this chapter, the bureau of workers' compensation
shall notify the claimant and the employer of the claimant of the 879
receipt of the claim and of the facts alleged therein. If the 880
bureau receives from a person other than the claimant written or 881
telecommunicated information indicating that an injury or 882
occupational disease has occurred or been contracted which may be 883
compensable under this chapter, the bureau shall notify the 884
employee and the employer of the information. If the information 885
is provided by any method of telecommunication, the person 886
providing the information shall provide written verification of 887
the information to the bureau according to division (E) of 888
section 4123.84 of the Revised Code. The receipt of the 889
information in writing, or if by a method of telecommunications, 890
the written verification, and the notice by the bureau shall be 891
considered an application for compensation under section 4123.84 892
or 4123.85 of the Revised Code provided that the conditions of 893
division (E) of section 4123.84 of the Revised Code apply to 894
information provided by a method of telecommunication. Upon 895
receipt of a claim, the bureau shall advise the claimant of the 896
claim number assigned and the claimant's right to representation 897
in the processing of a claim or to elect no representation. If 898
the bureau determines that a claim is determined to be a 899
compensable lost time claim, the bureau shall notify the claimant 900
and the employer of the availability of rehabilitation services. 901
No bureau or industrial commission employee shall directly or 902
21
indirectly convey any information in derogation of this right. 903
This section shall in no way abrogate the bureau's responsibility 904
to aid and assist a claimant in the filing of a claim and to 905
advise the claimant of the claimant's rights under the law. 906
The administrator of workers' compensation shall assign all 908
claims and investigations to the bureau service office from which 909
investigation and determination may be made most expeditiously. 910
The bureau shall investigate the facts concerning an injury 912
or occupational disease and ascertain such facts in whatever 913
manner is most appropriate and may obtain statements of the 914
employee, employer, attending physician, and witnesses in 915
whatever manner is most appropriate. 916
(B)(1) Except as provided in division (B)(2) of this 918
section, in claims other than those in which the employer is a 919
self-insuring employer, if the administrator determines under 920
division (A) of this section that a claimant is or is not 921
entitled to an award of compensation or benefits, the 922
administrator shall issue an order, no sooner than twenty-one 923
days but no later than twenty-eight days after the sending of the 925
notice under division (A) of this section, granting or denying 926
the payment of the compensation or benefits, or both as is 927
appropriate to the claimant. Notwithstanding the time limitation 928
specified in this division for the issuance of an order, if a 929
medical examination of the claimant is required by statute, the 930
administrator promptly shall schedule the claimant for that
examination and shall issue an order no later than twenty-eight 931
days after receipt of the report of the examination. The 932
administrator shall notify the claimant and the employer of the 934
claimant and their respective representatives in writing of the 935
nature of the order and the amounts of compensation and benefit 936
payments involved. The employer or claimant may appeal the order 937
pursuant to division (C) of this section within fourteen days 938
after the date of the receipt of the order. The employer and 939
claimant may waive, in writing, their rights to an appeal under 940
22
this division.
(2) Notwithstanding the time limitation specified in 942
division (B)(1) of this section for the issuance of an order, if 943
the employer certifies a claim for payment of compensation or 944
benefits, or both, to a claimant, and the administrator has 945
completed the investigation of the claim, the payment of benefits 947
or compensation, or both, as is appropriate, shall commence upon 948
the later of the date of the certification or completion of the 949
investigation and issuance of the order by the administrator, 950
provided that the administrator shall issue the order no later 951
than the time limitation specified in division (B)(1) of this 952
section. 953
(3) If an appeal is made under division (B)(1) or (2) of 955
this section, the administrator shall forward the claim file to 956
the appropriate district hearing officer within seven days of the 957
appeal. In contested claims other than state fund claims, the 958
administrator shall forward the claim within seven days of the 959
administrator's receipt of the claim to the commission, which 961
shall refer the claim to an appropriate district hearing officer 962
for a hearing in accordance with division (C) of this section. 963
(C) If an employer or claimant timely appeals the order of 965
the administrator issued under division (B) of this section or in 966
the case of other contested claims other than state fund claims, 967
the commission shall refer the claim to an appropriate district 968
hearing officer according to rules the commission adopts under 969
section 4121.36 of the Revised Code. The district hearing 970
officer shall notify the parties and their respective 971
representatives of the time and place of the hearing. 972
The district hearing officer shall hold a hearing on a 974
disputed issue or claim within forty-five days after the filing 976
of the appeal under this division and issue a decision within 977
seven days after holding the hearing. The district hearing 978
officer shall notify the parties and their respective
representatives in writing of the order. Any party may appeal an 980
23
order issued under this division pursuant to division (D) of this 981
section within fourteen days after receipt of the order under 982
this division. 983
(D) Upon the timely filing of an appeal of the order of 985
the district hearing officer issued under division (C) of this 986
section, the commission shall refer the claim file to an 987
appropriate staff hearing officer according to its rules adopted 988
under section 4121.36 of the Revised Code. The staff hearing 989
officer shall hold a hearing within forty-five days after the 990
filing of an appeal under this division and issue a decision 991
within seven days after holding the hearing under this division. 994
The staff hearing officer shall notify the parties and their 995
respective representatives in writing of his THE STAFF HEARING
OFFICER'S order. Any party may appeal an order issued under this 997
division pursuant to division (E) of this section within fourteen 998
days after receipt of the order under this division. 999
(E) Upon the filing of a timely appeal of the order of the 1,001
staff hearing officer issued under division (D) of this section, 1,002
the commission or a designated staff hearing officer, on behalf 1,003
of the commission, shall determine whether the commission will 1,005
hear the appeal. If the commission or the designated staff
hearing officer decides to hear the appeal, the commission or the 1,007
designated staff hearing officer shall notify the parties and 1,008
their respective representatives in writing of the time and place 1,009
of the hearing. The commission shall hold the hearing within 1,010
forty-five days after the filing of the notice of appeal and, 1,011
within seven days after the conclusion of the hearing, the 1,012
commission shall issue its order affirming, modifying, or 1,013
reversing the order issued under division (D) of this section. 1,014
The commission shall notify the parties and their respective 1,015
representatives in writing of the order. If the commission or 1,016
the designated staff hearing officer determines not to hear the 1,017
appeal, within fourteen days after the filing of the notice of 1,018
appeal, the commission or the designated staff hearing officer 1,019
24
shall issue an order to that effect and notify the parties and
their respective representatives in writing of that order. 1,020
Except as otherwise provided in this chapter and Chapters 1,022
4121., 4127., and 4131. of the Revised Code, any party may appeal 1,023
an order issued under this division to the court pursuant to 1,024
section 4123.512 of the Revised Code within sixty days after 1,025
receipt of the order, subject to the limitations contained in 1,026
that section. 1,027
(F) Every notice of an appeal from an order issued under 1,029
divisions (B), (C), (D), and (E) of this section shall state the 1,030
names of the claimant and employer, the number of the claim, the 1,031
date of the decision appealed from, and the fact that the 1,032
appellant appeals therefrom. 1,033
(G) All of the following apply to the proceedings under 1,035
divisions (C), (D), and (E) of this section: 1,036
(1) The parties shall proceed promptly and without 1,038
continuances except for good cause; 1,039
(2) The parties, in good faith, shall engage in the free 1,041
exchange of information relevant to the claim prior to the 1,042
conduct of a hearing according to the rules the commission adopts 1,043
under section 4121.36 of the Revised Code; 1,044
(3) The administrator is a party and may appear and 1,046
participate at all administrative proceedings on behalf of the 1,047
state insurance fund. However, in cases in which the employer is 1,048
represented, the administrator shall neither present arguments 1,049
nor introduce testimony that is cumulative to that presented or 1,050
introduced by the employer or the employer's representative. The 1,051
administrator may file an appeal under this section on behalf of
the state insurance fund; however, except in cases arising under 1,052
section 4123.343 of the Revised Code, the administrator only may 1,053
appeal questions of law or issues of fraud when the employer 1,054
appears in person or by representative.
(H) Except as provided in division (J) of this section, 1,056
payments of compensation to a claimant or on behalf of a claimant 1,057
25
as a result of any order issued under this chapter shall commence 1,058
upon the earlier of the following: 1,059
(1) Fourteen days after the date the administrator issues 1,061
an order under division (B) of this section, unless that order is 1,062
appealed; 1,063
(2) The date when the employer has waived the right to 1,065
appeal a decision issued under division (B) of this section; 1,066
(3) If no appeal of an order has been filed under this 1,068
section or to a court under section 4123.512 of the Revised Code, 1,069
the expiration of the time limitations for the filing of an 1,070
appeal of an order; 1,071
(4) The date of receipt by the employer of an order of a 1,073
district hearing officer, a staff hearing officer, or the 1,076
industrial commission issued under division (C), (D), or (E) of 1,077
this section. 1,078
(I) No medical benefits payable under this chapter or 1,080
Chapter 4121., 4127., or 4131. of the Revised Code are payable 1,081
until the earlier of the following: 1,082
(1) The date of the issuance of the staff hearing 1,084
officer's order under division (D) of this section; 1,085
(2) The date of the final administrative or judicial 1,087
determination. 1,088
(J) Upon the final administrative or judicial 1,090
determination UNDER THIS SECTION OR SECTION 4123.512 OF THE 1,091
REVISED CODE OF AN APPEAL OF AN ORDER TO PAY COMPENSATION, if a 1,092
claimant is found to have received compensation PURSUANT to A 1,093
PRIOR ORDER which the claimant was not entitled IS REVERSED UPON 1,094
SUBSEQUENT APPEAL, the claimant's employer, if a self-insuring 1,095
employer, or the bureau, shall withhold from any amount to which 1,097
the claimant becomes entitled pursuant to any claim, past, 1,098
present, or future, under Chapter 4121., 4123., 4127., or 4131. 1,099
of the Revised Code, the amount OF PREVIOUSLY PAID COMPENSATION 1,100
to which the claimant was WHICH, DUE TO REVERSAL UPON APPEAL, THE 1,101
CLAIMANT IS not entitled, pursuant to the following criteria: 1,102
26
(1) No withholding for the first twelve weeks of temporary 1,104
total disability compensation pursuant to section 4123.56 of the 1,105
Revised Code shall be made; 1,106
(2) Forty per cent of all awards of compensation paid 1,108
pursuant to sections 4123.56 and 4123.57 of the Revised Code, 1,109
until the amount overpaid is refunded; 1,110
(3) Twenty-five per cent of any compensation paid pursuant 1,112
to section 4123.58 of the Revised Code until the amount overpaid 1,113
is refunded; 1,114
(4) If, pursuant to an appeal under section 4123.512 of 1,116
the Revised Code, the court of appeals or the supreme court 1,117
reverses the allowance of the claim, then no amount of any 1,118
compensation will be withheld. 1,119
THE ADMINISTRATOR AND SELF-INSURING EMPLOYERS, AS 1,121
APPROPRIATE, ARE SUBJECT TO THE REPAYMENT SCHEDULE OF THIS 1,122
DIVISION ONLY WITH RESPECT TO AN ORDER TO PAY COMPENSATION THAT 1,123
WAS PROPERLY PAID UNDER A PREVIOUS ORDER, BUT WHICH IS
SUBSEQUENTLY REVERSED UPON AN ADMINISTRATIVE OR JUDICIAL APPEAL. 1,124
THE ADMINISTRATOR AND SELF-INSURING EMPLOYERS ARE NOT SUBJECT TO, 1,125
BUT MAY UTILIZE, THE REPAYMENT SCHEDULE OF THIS DIVISION, OR ANY 1,126
OTHER LAWFUL MEANS, TO COLLECT PAYMENT OF COMPENSATION MADE TO A 1,127
PERSON WHO WAS NOT ENTITLED TO THE COMPENSATION DUE TO FRAUD OR 1,128
HUMAN ERROR.
(K) If a staff hearing officer or the commission fails to 1,130
issue a decision or the commission fails to refuse to hear an 1,131
appeal within the time periods required by this section, payments 1,132
to a claimant shall cease until the staff hearing officer or 1,133
commission issues a decision or hears the appeal, unless the 1,134
failure was due to the fault or neglect of the employer or the 1,135
employer agrees that the payments should continue for a longer 1,136
period of time. 1,137
(L) Except as provided in section 4123.522 of the Revised 1,139
Code, no appeal is timely filed under this section unless the 1,140
appeal is filed with the time limits set forth in this section. 1,141
27
(M) No person who is not an employee of the bureau or 1,143
commission or who is not by law given access to the contents of a 1,144
claims file shall have a file in the person's possession. 1,145
Sec. 4123.512. (A) The claimant or the employer may 1,154
appeal an order of the industrial commission made under division 1,155
(E) of section 4123.511 of the Revised Code in any injury or 1,156
occupational disease case, other than a decision as to the extent 1,157
of disability or impairment, or percentage of impairment 1,158
determined pursuant to division (A) of section 4123.57 of the 1,159
Revised Code, to the court of common pleas of the county in which 1,162
the injury was inflicted or in which the contract of employment 1,163
was made if the injury occurred outside the state, or in which 1,164
the contract of employment was made if the exposure occurred 1,165
outside the state. If no common pleas court has jurisdiction for 1,166
the purposes of an appeal by the use of the jurisdictional 1,167
requirements described in this division, the appellant may use 1,168
the venue provisions in the Rules of Civil Procedure to vest 1,169
jurisdiction in a court. If the claim is for an occupational 1,170
disease the appeal shall be to the court of common pleas of the 1,171
county in which the exposure which caused the disease occurred. 1,172
Like appeal may be taken from an order of a staff hearing officer 1,173
made under division (D) of section 4123.511 of the Revised Code 1,174
from which the commission has refused to hear an appeal. The 1,175
appellant shall file the notice of appeal with a court of common 1,176
pleas within sixty days after the date of the receipt of the 1,177
order appealed from or the date of receipt of the order of the 1,178
commission refusing to hear an appeal of a staff hearing 1,179
officer's decision under division (D) of section 4123.511 of the 1,180
Revised Code. The filing of the notice of the appeal with the 1,181
court is the only act required to perfect the appeal.
If an action has been commenced in a court of a county 1,183
other than a court of a county having jurisdiction over the 1,184
action, the court, upon notice by any party or upon its own 1,185
motion, shall transfer the action to a court of a county having 1,186
28
jurisdiction. 1,187
Notwithstanding anything to the contrary in this section, 1,189
if the commission determines under section 4123.522 of the 1,190
Revised Code that an employee, employer, or their respective 1,191
representatives have not received written notice of an order or 1,192
decision which is appealable to a court under this section and 1,193
which grants relief pursuant to section 4123.522 of the Revised 1,194
Code, the party granted the relief has sixty days from receipt of 1,195
the order under section 4123.522 of the Revised Code to file a 1,196
notice of appeal under this section. 1,197
(B) The notice of appeal shall state the names of the 1,199
claimant and the employer, the number of the claim, the date of 1,200
the order appealed from, and the fact that the appellant appeals 1,201
therefrom. 1,202
The administrator, the claimant, and the employer shall be 1,204
parties to the appeal and the court, upon the application of the 1,205
commission, shall make the commission a party. The administrator 1,206
shall notify the employer that, if the employer fails to become 1,209
an active party to the appeal, the administrator may act on 1,210
behalf of the employer and the results of the appeal could have 1,211
an adverse effect upon the employer's premium rates. 1,212
(C) The attorney general or one or more of the attorney 1,214
general's assistants or special counsel designated by the 1,216
attorney general shall represent the administrator and the 1,218
commission. If the attorney general or the attorney general's 1,219
designated assistants or special counsel are absent, the 1,221
administrator or the commission shall select one or more of the 1,222
attorneys in the employ of the administrator or the commission as 1,223
the administrator's attorney or the commission's attorney in the 1,224
appeal. Any attorney so employed shall continue the 1,226
representation during the entire period of the appeal and in all 1,227
hearings thereof except where the continued representation 1,228
becomes impractical.
(D) Upon receipt of notice of appeal the clerk of courts 1,230
29
shall provide notice to all parties who are appellees and to the 1,231
commission. 1,232
The claimant, within thirty days after the filing of the 1,235
notice of appeal, shall file a petition containing a statement of
facts in ordinary and concise language showing a cause of action 1,236
to participate or to continue to participate in the fund and 1,237
setting forth the basis for the jurisdiction of the court over 1,238
the action. Further pleadings shall be had in accordance with 1,239
the Rules of Civil Procedure, provided that service of summons on 1,240
such petition shall not be required. The clerk of the court, 1,241
upon receipt thereof, shall transmit by certified mail a copy 1,243
thereof to each party named in the notice of appeal other than 1,244
the claimant. Any party may file with the clerk prior to the 1,245
trial of the action a deposition of any physician taken in 1,246
accordance with the provisions of the Revised Code, which 1,247
deposition may be read in the trial of the action even though the 1,248
physician is a resident of or subject to service in the county in 1,249
which the trial is had. The bureau of workers' compensation 1,250
shall pay the cost of the STENOGRAPHIC deposition filed in court 1,251
and of copies of the STENOGRAPHIC deposition for each party from 1,253
the surplus fund and charge the costs thereof against the 1,255
unsuccessful party if the claimant's right to participate or 1,256
continue to participate is finally sustained or established in 1,257
the appeal. In the event the deposition is taken and filed, the 1,258
physician whose deposition is taken is not required to respond to 1,259
any subpoena issued in the trial of the action. The court, or 1,260
the jury under the instructions of the court, if a jury is 1,261
demanded, shall determine the right of the claimant to 1,262
participate or to continue to participate in the fund upon the 1,263
evidence adduced at the hearing of the action. 1,264
(E) The court shall certify its decision to the commission 1,266
and the certificate shall be entered in the records of the court. 1,267
Appeals from the judgment are governed by the law applicable to 1,268
the appeal of civil actions. 1,269
30
(F) The cost of any legal proceedings authorized by this 1,271
section, including an attorney's fee to the claimant's attorney 1,272
to be fixed by the trial judge, based upon the effort expended, 1,273
in the event the claimant's right to participate or to continue 1,274
to participate in the fund is established upon the final 1,275
determination of an appeal, shall be taxed against the employer 1,276
or the commission if the commission or the administrator rather 1,277
than the employer contested the right of the claimant to 1,278
participate in the fund. The attorney's fee shall not exceed 1,279
twenty-five hundred dollars. 1,280
(G) If the finding of the court or the verdict of the jury 1,282
is in favor of the claimant's right to participate in the fund, 1,283
the commission and the administrator shall thereafter proceed in 1,284
the matter of the claim as if the judgment were the decision of 1,285
the commission, subject to the power of modification provided by 1,286
section 4123.52 of the Revised Code. 1,287
(H) An appeal from an order issued under division (E) of 1,289
section 4123.511 of the Revised Code or any action filed in court 1,290
in a case in which an award of compensation has been made shall 1,291
not stay the payment of compensation under the award or payment 1,292
of compensation for subsequent periods of total disability or 1,293
impairment during the pendency of the appeal. If, in a final 1,295
administrative or judicial action, it is determined that payments 1,296
of compensation or benefits, or both, made to or on behalf of a 1,297
claimant should not have been made, the amount thereof shall be 1,298
charged to the surplus fund under division (B) of section 4123.34 1,299
of the Revised Code. In the event the employer is a state risk, 1,300
the amount shall not be charged to the employer's experience. In 1,301
the event the employer is a self-insuring employer, the 1,302
self-insuring employer shall deduct the amount from the paid 1,303
compensation he reports to the administrator under division (K) 1,304
of section 4123.35 of the Revised Code. All actions and 1,305
proceedings under this section which are the subject of an appeal 1,306
to the court of common pleas or the court of appeals shall be 1,307
31
preferred over all other civil actions except election causes, 1,308
irrespective of position on the calendar. 1,309
This section applies to all decisions of the commission or 1,311
the administrator on November 2, 1959, and all claims filed 1,312
thereafter are governed by sections 4123.511 and 4123.512 of the 1,313
Revised Code. 1,314
Any action pending in common pleas court or any other court 1,316
on January 1, 1986, under this section is governed by former 1,317
sections 4123.514, 4123.515, 4123.516, and 4123.519 and section 1,318
4123.522 of the Revised Code. 1,319
Sec. 4123.57. (A)(1) Except as provided in division 1,328
(A)(2) of this section, not earlier than forty weeks after the 1,330
date of termination of the latest period of payments under 1,331
section 4123.56 of the Revised Code, or not earlier than forty 1,332
weeks after the date of the injury or the date of first diagnosis 1,333
of an occupational disease by a licensed physician in the absence 1,334
of payments under section 4123.56 of the Revised Code, an 1,335
employee may file an application with the bureau of workers' 1,336
compensation for the determination of the percentage of the 1,338
employee's permanent partial impairment resulting from an injury 1,340
or occupational disease. 1,341
(2) An employee may file the application specified in 1,344
division (A)(1) of this section without waiting forty weeks when 1,346
either of the following occurs:
(a) The receipt of payments under division (A) of section 1,349
4123.56 of the Revised Code is terminated by a hearing officer 1,351
because the employee has reached maximum medical improvement. 1,353
(b) The receipt of benefits under division (A) of section 1,356
4123.56 of the Revised Code is terminated because the employee's 1,357
attending physician certifies that the employee has reached 1,358
maximum medical improvement.
(3) Whenever an application is filed under division (A)(1) 1,361
or (2) of this section, the bureau shall send a copy of the 1,362
application to the employee's employer or the employer's 1,363
32
representative and, except when the option provided in division 1,364
(A)(7) of this section is chosen, shall schedule the employee for 1,365
a medical examination by the bureau medical section. The bureau 1,366
shall send a copy of the report of the medical examination to the 1,367
employee, the employer, and their representatives. The report of 1,368
the medical examination shall contain a statement of the 1,371
examiner's finding on the employee's percentage of permanent 1,372
partial impairment resulting from allowed conditions in the claim 1,373
under the most recent edition of the American medical 1,374
association's guides to the evaluation of permanent impairment. 1,375
After receiving the report of the medical examination, the 1,376
administrator of workers' compensation shall make a tentative 1,377
order finding that the employee's percentage of permanent partial 1,379
impairment is the same percentage shown by the report of the 1,380
medical examination, unless the administrator determines that the 1,381
report clearly is erroneous. If the administrator determines 1,382
that the report clearly is erroneous, the administrator shall
disregard the report, schedule the employee for another 1,384
examination by the bureau medical section, and issue a tentative 1,385
order that finds that the employee's percentage of permanent 1,386
partial impairment is the same percentage shown by the second 1,387
medical examination report. 1,388
(4) The administrator shall notify the employee, the 1,390
employer, and their representatives, in writing, of the tentative 1,391
order and of the parties' right to request a hearing. Within 1,393
fourteen days after receipt of the tentative order, the employee, 1,394
the employer, or their representatives, may file with the bureau 1,395
an objection to the tentative order. The opposing party must be 1,397
served by the filing party with a copy of the objection to the 1,398
tentative order not later than the day of filing. Proper mailing 1,399
of the objection to the tentative order to the opposing party 1,401
constitutes service. If an objection to the tentative order is 1,402
not filed by a party by the deadline established by division 1,403
(A)(4) of this section, the order becomes final. 1,404
33
(5) If the employee, the employer, or their 1,406
representatives timely notify the administrator of an objection 1,407
to the tentative order, either party, within fourteen days after 1,410
the date of filing or of receipt of an objection, whichever is
later, may request another examination by the bureau medical 1,412
section. The party requesting that examination shall pay the 1,413
cost of that examination. Upon that request, the bureau shall 1,414
schedule the employee for another medical examination by the 1,416
bureau medical section. All provisions of division (A)(3) of 1,417
this section applicable to the first medical examination apply to 1,418
a subsequent medical examination requested pursuant to division 1,419
(A)(5) of this section. The bureau shall send a copy of the 1,420
report of the medical examination to the employee, the employer, 1,421
and their representatives.
Upon the filing of an objection to the tentative order or 1,423
upon the completion of the medical examination requested pursuant 1,424
to division (A)(5) of this section, whichever is later, the 1,427
matter shall be referred to a district hearing officer who shall 1,428
set the application for hearing with written notices to all 1,429
interested persons. At the hearing, the district hearing officer 1,430
first shall make a finding as to whether any of the following has 1,431
occurred: 1,432
(a) The bureau medical section based its report, at least 1,435
in part, on conditions not allowed in the claim;
(b) The bureau medical section failed to consider all of 1,438
the allowed conditions in the claim;
(c) The bureau medical section's examiner was prejudiced 1,441
against the employer or the employee;
(d) The bureau medical section failed to properly apply 1,444
the most recent edition of the American medical association's 1,445
guides to the evaluation of permanent impairment in determining 1,446
the employee's percentage of permanent impairment; 1,447
(e) The tentative order provides for the payment of 1,449
compensation under a circumstance in which that compensation is 1,450
34
barred by this section or any other provision of law. 1,451
If the district hearing officer finds one of the situations 1,454
described in division (A)(5)(a), (b), (c) or (d) of this section, 1,456
the district hearing officer shall issue an order rejecting the 1,458
report of the medical examination and requiring the bureau 1,459
medical section to perform a new medical examination. All 1,460
provisions of this division applicable to the first medical 1,461
examination and the determination of the percentage of permanent 1,462
partial impairment apply to any subsequent medical examination 1,463
that is ordered under this division. If the district hearing 1,464
officer finds the situation described in division (A)(5)(e) of 1,465
this section, the district hearing officer shall issue an order 1,466
denying the application. If the district hearing officer finds 1,468
none of the situations described in division (A)(5)(a), (b), (c), 1,469
(d), or (e) of this section, the district hearing officer shall 1,471
issue an order finding that the employee's percentage of 1,472
permanent partial impairment is the same percentage shown by 1,473
either the first or any subsequent bureau medical examination 1,474
report.
(6) An employee may file an application for a subsequent 1,477
determination of the percentage of the employee's permanent 1,478
impairment. No application for subsequent percentage 1,480
determinations on the same claim for injury or occupational
disease shall be accepted unless supported by substantial 1,481
evidence of new and changed circumstances developing since the 1,482
time of the last determination. If an application is filed under 1,484
division (A)(6) of this section, the bureau shall treat the 1,485
application as though it was an original application for the 1,486
determination of the percentage of permanent partial impairment, 1,487
EXCEPT THAT THE BUREAU MAY REQUIRE EITHER A MEDICAL EXAMINATION 1,488
OR A MEDICAL REVIEW OF THE EMPLOYEE. In no instance shall the 1,490
former award be modified unless it is found from medical or 1,491
clinical findings that the condition of the employee resulting 1,492
from the injury or occupational disease has so progressed as to 1,494
35
have increased the percentage of permanent partial impairment. 1,495
All provisions of this division applicable to an original
application apply to an application for subsequent determination. 1,496
The decision of a district hearing officer on an employee's 1,498
application filed under division (A)(1), (2), and (6) of this 1,500
section is final. 1,501
(7) Notwithstanding divisions (A)(3) through (6) of this 1,504
section, the determination of an employee's percentage of 1,505
permanent partial impairment shall be made in accordance with 1,506
division (A)(7) of this section, upon the written agreement by an 1,508
employee and employer to utilize the alternative method of 1,509
determination provided in division (A)(7) of this section. 1,511
Within seven days after receipt of the written agreement, the 1,512
administrator shall assign a physician from the impairment 1,513
evaluation panel within the bureau medical section to conduct a 1,514
medical examination of the employee and send written notice to 1,515
the employee and employer of that assignment. The employee and 1,516
employer each shall select a physician from the impairment 1,517
evaluation panel who shall serve as consultants to the assigned 1,518
physician if the employee or employer objects to the assigned 1,519
physician's determination.
Within twenty-one days after assignment, the assigned 1,521
physician shall conduct a medical examination of the employee and 1,523
provide to the administrator a report of the medical examination 1,524
stating the employee's percentage of permanent partial impairment 1,525
resulting from the allowed conditions in the claim under the most 1,526
recent edition of the American medical association's guides to 1,528
the evaluation of permanent impairment. Immediately upon receipt 1,529
of the report, the administrator shall send a copy of the report 1,530
to the employee and employer.
Within twenty-one days after receipt of the report, an 1,532
employee or employer may send written notice to the administrator 1,534
objecting to the report. If a written notice of objection is not 1,535
timely received, the assigned physician's determination of the 1,536
36
percentage of permanent partial impairment of an employee is 1,537
final, notwithstanding section 4123.511 of the Revised Code. If 1,539
a written notice of objection is timely received, the 1,540
administrator shall provide a copy of the assigned physician's 1,541
report to the consulting physicians selected by the employee and 1,542
employer, within seven days after receipt of the objection. 1,543
Within twenty-one days after receipt of the report, both 1,545
consulting physicians shall confer with the assigned physician 1,546
and jointly, on the basis of the opinion of a majority of the 1,547
physicians, issue a final report stating the employee's 1,548
percentage of permanent partial impairment resulting from the 1,549
allowed conditions in the claim under the most recent edition of 1,550
the American medical association's guides to the evaluation of 1,552
permanent impairment. Within fourteen days after receipt of the 1,553
final report, the administrator shall send a copy of the final 1,554
report to the employee and employer. Notwithstanding section 1,555
4123.511 of the Revised Code, the percentage of permanent partial 1,557
impairment of an employee stated in the final report issued 1,558
pursuant to division (A)(7) of this section is final. 1,560
(8) Compensation payable under division (A) of this 1,563
section accrues and is payable to the employee from the date of 1,564
last payment of compensation, or, in cases where no previous 1,565
compensation has been paid, from the date of the injury or, for 1,566
occupational diseases, the date of disease. The employee shall 1,568
receive sixty-six and two-thirds per cent of the employee's 1,569
average weekly wage, but not more than a maximum of thirty-three 1,570
and one-third per cent of the statewide average weekly wage as 1,571
defined in division (C) of section 4123.62 of the Revised Code, 1,573
per week regardless of the average weekly wage for the number of 1,574
weeks that equals the percentage of two hundred weeks. If the 1,576
percentage of the permanent impairment of the employee equals or 1,577
exceeds ninety per cent, compensation for permanent partial
impairment shall be paid for two hundred weeks. No award shall 1,578
be made under division (A) of this section based upon a 1,579
37
percentage of impairment that, when taken with all other 1,580
percentages of permanent impairment, exceeds one hundred per 1,581
cent. Notwithstanding division (H) of section 4123.511 of the 1,583
Revised Code, the bureau or a self-insuring employer shall pay a 1,585
permanent partial impairment award within twenty-one days after
the date on which an order fixing the employee's percentage of 1,587
permanent partial impairment becomes final. 1,588
As used in this division, "date of disease" means the date 1,591
an occupational disease is first diagnosed by a licensed
physician, or for an occupational disease described in divisions 1,592
(A) through (AA) of section 4123.68 of the Revised Code or other 1,596
occupational disease that results from exposure to 1,597
fibrosis-producing or toxic dusts, fumes, mists, vapors, gases, 1,598
or liquids, or other toxic materials, or a combination of those, 1,599
the date that the employee first misses work as a result of the 1,600
occupational disease. 1,601
(9) When an award under division (A) of this section has 1,605
been made prior to the death of an employee, all unpaid 1,606
installments accrued or to accrue under the provisions of the 1,607
award are payable to the surviving spouse, or if there is no 1,608
surviving spouse, to the dependent children of the employee, and 1,609
if there are no children surviving, then to other dependents as 1,610
the administrator determines. 1,611
(B) In cases included in the following schedule the 1,613
compensation payable per week to the employee is the statewide 1,614
average weekly wage as defined in division (C) of section 4123.62 1,615
of the Revised Code per week and shall continue during the 1,616
periods provided in the following schedule: 1,617
For the loss of a thumb, sixty weeks. 1,619
For the loss of a first finger, commonly called index 1,621
finger, thirty-five weeks. 1,622
For the loss of a second finger, thirty weeks. 1,624
For the loss of a third finger, twenty weeks. 1,626
For the loss of a fourth finger, commonly known as the 1,628
38
little finger, fifteen weeks. 1,629
The loss of a second, or distal, phalange of the thumb is 1,631
considered equal to the loss of one half of such thumb; the loss 1,632
of more than one half of such thumb is considered equal to the 1,633
loss of the whole thumb. 1,634
The loss of the third, or distal, phalange of any finger is 1,636
considered equal to the loss of one-third of the finger. 1,637
The loss of the middle, or second, phalange of any finger 1,639
is considered equal to the loss of two-thirds of the finger. 1,640
The loss of more than the middle and distal phalanges of 1,642
any finger is considered equal to the loss of the whole finger. 1,643
In no case shall the amount received for more than one finger 1,644
exceed the amount provided in this schedule for the loss of a 1,645
hand. 1,646
For the loss of the metacarpal bone (bones of the palm) for 1,648
the corresponding thumb, or fingers, add ten weeks to the number 1,649
of weeks under this division. 1,650
For ankylosis (total stiffness of) or contractures (due to 1,652
scars or injuries) which makes any of the fingers, thumbs, or 1,653
parts of either useless, the same number of weeks apply to the 1,654
members or parts thereof as given for the loss thereof. 1,655
If the claimant has suffered the loss of two or more 1,657
fingers by amputation or ankylosis and the nature of the 1,658
claimant's employment in the course of which the claimant was 1,660
working at the time of the injury or occupational disease is such 1,661
that the handicap or impairment resulting from the loss of 1,662
fingers, or loss of use of fingers, exceeds the normal handicap 1,664
or impairment resulting from the loss of fingers, or loss of use 1,666
of fingers, the administrator may take that fact into 1,667
consideration and increase the award of compensation accordingly, 1,668
but the award made shall not exceed the amount of compensation 1,669
for loss of a hand. 1,670
For the loss of a hand, one hundred seventy-five weeks. 1,672
For the loss of an arm, two hundred twenty-five weeks. 1,674
39
For the loss of a great toe, thirty weeks. 1,676
For the loss of one of the toes other than the great toe, 1,678
ten weeks. 1,679
The loss of more than two-thirds of any toe is considered 1,681
equal to the loss of the whole toe. 1,682
The loss of less than two-thirds of any toe is considered 1,684
no loss, except as to the great toe; the loss of the great toe up 1,685
to the interphalangeal joint is co-equal to the loss of one-half 1,686
of the great toe; the loss of the great toe beyond the 1,687
interphalangeal joint is considered equal to the loss of the 1,688
whole great toe. 1,689
For the loss of a foot, one hundred fifty weeks. 1,691
For the loss of a leg, two hundred weeks. 1,693
For the loss of the sight of an eye, one hundred 1,695
twenty-five weeks. 1,696
For the permanent partial loss of sight of an eye, the 1,698
portion of one hundred twenty-five weeks as the administrator in 1,699
each case determines, based upon the percentage of vision 1,700
actually lost as a result of the injury or occupational disease, 1,701
but, in no case shall an award of compensation be made for less 1,702
than twenty-five per cent loss of uncorrected vision. "Loss of 1,703
uncorrected vision" means the percentage of vision actually lost 1,704
as the result of the injury or occupational disease. 1,705
For the permanent and total loss of hearing of one ear, 1,707
twenty-five weeks; but in no case shall an award of compensation 1,708
be made for less than permanent and total loss of hearing of one 1,709
ear. 1,710
For the permanent and total loss of hearing, one hundred 1,712
twenty-five weeks; but, except pursuant to the next preceding 1,713
paragraph, in no case shall an award of compensation be made for 1,714
less than permanent and total loss of hearing. 1,715
In case an injury or occupational disease results in 1,717
serious facial or head disfigurement which either impairs or may 1,718
in the future impair the opportunities to secure or retain 1,719
40
employment, the administrator shall make an award of compensation 1,720
as the administrator deems proper and equitable, in view of the 1,722
nature of the disfigurement, and not to exceed the sum of five 1,723
thousand dollars. For the purpose of making the award, it is not 1,724
material whether the employee is gainfully employed in any 1,725
occupation or trade at the time of the administrator's 1,726
determination.
When an award under this division has been made prior to 1,728
the death of an employee all unpaid installments accrued or to 1,729
accrue under the provisions of the award shall be payable to the 1,730
surviving spouse, or if there is no surviving spouse, to the 1,731
dependent children of the employee and if there are no such 1,732
children, then to such dependents as the administrator 1,733
determines. 1,734
When an employee has sustained the loss of a member by 1,736
severance, but no award has been made on account thereof prior to 1,737
the employee's death, the administrator shall make an award in 1,739
accordance with this division for the loss which shall be payable 1,740
to the surviving spouse, or if there is no surviving spouse, to 1,741
the dependent children of the employee and if there are no such 1,742
children, then to such dependents as the administrator 1,743
determines. 1,744
(C) Compensation for partial impairment under divisions 1,747
(A) and (B) of this section is in addition to the compensation 1,748
paid the employee pursuant to section 4123.56 of the Revised 1,749
Code. A claimant may receive compensation under divisions (A) 1,750
and (B) of this section. No employee may receive compensation 1,752
under division (A) of this section or receive a medical 1,753
examination provided for by this section during the time in which 1,754
that employee is receiving compensation under section 4123.58 of 1,756
the Revised Code in any claim or is receiving compensation under 1,758
section 4123.56 of the Revised Code on the same claim in which 1,759
the employee is seeking compensation under this section. The 1,760
employee shall list on the application specified in divisions 1,761
41
(A)(1) and (2) of this section the claim numbers of all other 1,762
claims for which the employee is a claimant. 1,763
In all cases arising under division (B) of this section, if 1,765
it is determined by any one of the following: (1) the amputee 1,766
clinic at University hospital, Ohio state university; (2) the 1,767
rehabilitation services commission; (3) an amputee clinic or 1,768
prescribing physician approved by the administrator or the 1,769
administrator's designee, that an injured or impaired employee is 1,771
in need of an artificial appliance, or in need of a repair 1,773
thereof, regardless of whether the appliance or its repair will 1,774
be serviceable in the vocational rehabilitation of the injured 1,775
employee, and regardless of whether the employee has returned to 1,776
or can ever again return to any gainful employment, the bureau 1,777
shall pay the cost of the artificial appliance or its repair out 1,778
of the surplus created by division (B) of section 4123.34 of the 1,779
Revised Code.
In those cases where a rehabilitation services commission 1,781
recommendation that an injured or impaired employee is in need of 1,783
an artificial appliance would conflict with their state plan, 1,784
adopted pursuant to the "Rehabilitation Act of 1973," 87 Stat. 1,785
355, 29 U.S.C.A. 701, the administrator or the administrator's 1,787
designee or the bureau may obtain a recommendation from an 1,788
amputee clinic or prescribing physician that they determine 1,789
appropriate.
(D) If an employee makes application for a finding and is 1,792
found to have contracted silicosis as defined in division (X), or 1,793
coal miners' pneumoconiosis as defined in division (Y), or 1,794
asbestosis as defined in division (AA) of section 4123.68 of the 1,795
Revised Code, and it is found that a change of such employee's 1,796
occupation is medically advisable in order to decrease 1,798
substantially further exposure to silica dust, asbestos, or coal 1,799
dust and if the employee, after the finding, has changed or shall 1,800
change the employee's occupation to an occupation in which the 1,802
exposure to silica dust, asbestos, or coal dust is substantially 1,803
42
decreased, the employee shall receive an amount equal to fifty 1,804
per cent of the statewide average weekly wage per week for a 1,806
period of thirty weeks, commencing as of the date of the 1,807
discontinuance or change, and for a period of one hundred weeks 1,808
immediately following the expiration of the period of thirty 1,809
weeks, the employee shall receive sixty-six and two-thirds per 1,811
cent of the loss of wages resulting directly and solely from the 1,812
change of occupation but not to exceed a maximum of an amount 1,813
equal to fifty per cent of the statewide average weekly wage per 1,814
week. No such employee is entitled to receive more than one 1,815
allowance on account of discontinuance of employment or change of 1,816
occupation and benefits shall cease for any period during which 1,817
the employee is employed in an occupation in which the exposure 1,818
to silica dust, asbestos, or coal dust is not substantially less 1,819
than the exposure in the occupation in which the employee was 1,820
formerly employed or for any period during which the employee may 1,822
be entitled to receive compensation or benefits under section 1,823
4123.68 of the Revised Code on account of disability from 1,824
silicosis, asbestosis, or coal miners' pneumoconiosis. An award 1,825
for change of occupation for a coal miner who has contracted coal 1,826
miners' pneumoconiosis may be granted under this division even 1,827
though the coal miner continues employment with the same 1,829
employer, so long as the coal miner's employment subsequent to 1,831
the change is such that the coal miner's exposure to coal dust is 1,833
substantially decreased and a change of occupation is certified 1,834
by the claimant as permanent. Medical and other benefits shall 1,835
be paid to the employee in accordance with section 4123.66 of the 1,837
Revised Code.
(E) If a firefighter or police officer makes application 1,840
for a finding and the administrator finds that the firefighter or 1,841
police officer has contracted a cardiovascular and pulmonary 1,843
disease as defined in division (W) of section 4123.68 of the 1,844
Revised Code, and that a change of the firefighter's or police 1,845
officer's occupation is medically advisable in order to decrease 1,847
43
substantially further exposure to smoke, toxic gases, chemical 1,848
fumes, and other toxic vapors, and if the firefighter, or police 1,849
officer, after the finding, has changed or changes occupation to 1,851
an occupation in which the exposure to smoke, toxic gases, 1,852
chemical fumes, and other toxic vapors is substantially 1,853
decreased, the administrator shall allow to the firefighter or 1,854
police officer an amount equal to fifty per cent of the statewide 1,856
average weekly wage per week for a period of thirty weeks, 1,857
commencing as of the date of the discontinuance or change, and 1,858
for a period of seventy-five weeks immediately following the 1,859
expiration of the period of thirty weeks the administrator shall 1,860
allow the firefighter or police officer sixty-six and two-thirds 1,862
per cent of the loss of wages resulting directly and solely from 1,863
the change of occupation but not to exceed a maximum of an amount 1,864
equal to fifty per cent of the statewide average weekly wage per 1,865
week. No such firefighter or police officer is entitled to 1,867
receive more than one allowance on account of discontinuance of 1,868
employment or change of occupation and benefits shall cease for 1,869
any period during which the firefighter or police officer is 1,870
employed in an occupation in which the exposure to smoke, toxic 1,872
gases, chemical fumes, and other toxic vapors is not 1,873
substantially less than the exposure in the occupation in which 1,874
the firefighter or police officer was formerly employed or for 1,875
any period during which the firefighter or police officer may be 1,877
entitled to receive compensation or benefits under section 1,878
4123.68 of the Revised Code on account of disability from a 1,879
cardiovascular and pulmonary disease. The administrator may 1,880
accord to the firefighter or police officer medical and other 1,882
benefits in accordance with section 4123.66 of the Revised Code. 1,883
(F) An order issued under division (B), (D), or (E) of 1,886
this section is appealable pursuant to section 4123.511 of the 1,887
Revised Code but is not appealable to court under section 1,888
4123.512 of the Revised Code.
Section 2. That existing sections 121.03, 2317.45, 1,890
44
4121.12, 4121.121, 4121.125, 4123.511, 4123.512, and 4123.57 of 1,891
the Revised Code are hereby repealed. 1,892
Section 3. The Administrator of Workers' Compensation 1,894
shall submit a series of reports to the Workers' Compensation 1,895
Oversight Commission, the Office of Budget and Management, the 1,896
Legislative Budget Office of the Legislative Service Commission, 1,897
and the General Assembly semiannually during the 1997-1999 1,899
biennium, beginning on or before October 1, 1997, containing
information relative to all of the following: 1,901
(A) The premium cost per worker, which reports the average 1,903
annual cost a state fund employer pays to provide workers' 1,904
compensation coverage for its employees. The premium cost per 1,905
worker is calculated by adding together an employer's total 1,906
amounts of premiums and assessments paid during a calendar year 1,907
and dividing that sum by the employer's average number of 1,908
workers. 1,909
(B) The claims cost per worker, which reports the average 1,911
annual benefit cost paid for each worker who is employed by a 1,912
state fund employer during the preceding twelve months. The 1,913
claims cost per worker is calculated by dividing an employer's 1,914
total claim expenses paid during the preceding twelve months by 1,915
the employer's average number of workers. 1,916
(C) The administrative cost per claim, which reports the 1,918
average annual administrative expense a state fund employer pays 1,919
to process a claim. The administrative cost per claim is 1,920
calculated by dividing an employer's total amount of 1,921
administrative expenses incurred during the preceding twelve 1,922
months by the total number of claims the employer processed. 1,923
(D) The direct loss ratio, which measures the relationship 1,925
between an employer's revenues and workers' compensation benefits 1,927
paid to an injured worker during the preceding twelve months; 1,928
(E) The rate of return generated by investments of the 1,930
Bureau of Workers' Compensation; 1,931
(F) The customer service index, which accounts for various 1,933
45
statistical measures reflecting the Bureau's customer service 1,934
levels; 1,935
(G) The Health Partnership Program performance index, 1,937
which measures the effectiveness of managed care organizations 1,938
working for the Bureau and reflects the quality of care, customer 1,939
satisfaction, and cost of care provided by the managed care 1,940
organizations; 1,941
(H) The rate of injury in the state per 1,000 workers; 1,943
(I) The average number of days the Bureau takes to 1,945
adjudicate an injured worker's medical bill fee; 1,946
(J) The return-to-work rate of state fund employers' 1,948
injured workers who do not receive workers' compensation benefits 1,949
for at least ninety days following their injury, which reports 1,950
the number of injured workers who returned to work as a 1,951
percentage of total injuries; 1,952
(K) The average number of days it takes for an employer or 1,954
injured worker to report an injury to the Bureau, which is 1,955
calculated by taking the average number of days between the date 1,956
of injury and the date the claim was filed with the Bureau; 1,957
(L) The percentage of indemnity claims adjudicated by the 1,959
Bureau within fourteen days of the injury. 1,960
Section 4. All items in this section are hereby 1,962
appropriated out of any moneys in the state treasury to the 1,963
credit of the designated fund. For all appropriations made in 1,964
this act, those in the first column are for fiscal year 1998, and 1,965
those in the second column are for fiscal year 1999.
BWC BUREAU OF WORKERS' COMPENSATION 1,966
FND ALI ALI TITLE FY 1998 FY 1999 1,969
Workers' Compensation Fund Group 1,971
023 855-401 William Green Lease 1,974
Payments to OBA $ 14,665,000 $ 15,465,000 1,976
4Y6 855-611 J.L. Camera Center 1,978
Rent $ 1,592,800 $ 1,681,997 1,980
4Y6 855-612 J.L. Camera Center 1,982
46
Operating $ 7,381,302 $ 7,345,026 1,984
023 855-407 Claims, Risk & 1,986
Medical Management $ 129,400,786 $ 123,784,337 1,988
023 855-408 Fraud Prevention $ 8,200,705 $ 8,111,383 1,992
023 855-409 Administrative 1,994
Services $ 111,629,196 $ 114,654,976 1,996
023 855-410 Attorney General 1,998
Payments $ 3,017,914 $ 3,227,422 2,000
825 855-605 DWRF $ 635,629 $ 651,961 2,004
822 855-606 Coal Workers' Fund $ 73,684 $ 75,545 2,008
823 855-608 Marine Industry $ 42,536 $ 43,599 2,012
826 855-609 Safety & Hygiene $ 17,981,552 $ 17,991,764 2,016
TOTAL WCF Workers' Compensation 2,017
Fund Group $ 294,621,104 $ 293,033,010 2,020
TOTAL ALL BUDGET FUND GROUPS $ 294,621,104 $ 293,033,010 2,023
Safety and Hygiene 2,026
Notwithstanding section 4121.37 of the Revised Code, the 2,028
Administrator of the Bureau of Workers' Compensation shall 2,029
transfer monies from the State Insurance Fund so that 2,030
appropriation line item 855-609, Safety and Hygiene, is provided
$17,981,552 in fiscal year 1998 and $17,991,764 in fiscal year 2,031
1999.
Workers' Compensation Fraud Unit 2,033
The Workers' Compensation Section Fund (Fund 195) shall 2,035
receive payments from the Bureau of Workers' Compensation at the 2,036
beginning of each quarter of each fiscal year to fund expenses of 2,037
the Workers' Compensation Fraud Unit of the Attorney General's 2,038
Office. Of the foregoing appropriation item 855-410, Attorney 2,039
General Payments, $659,151 in fiscal year 1998 and $676,002 in
fiscal year 1999 shall be used to provide such payments. 2,040
William Green Lease Payments 2,042
The foregoing appropriation item 855-401, William Green 2,044
Lease Payments to OBA, shall be used for lease payments to the 2,045
Ohio Building Authority, and these appropriations shall be used 2,046
47
to meet all payments at the times they are required to be made 2,047
during the period from July 1, 1997, to June 30, 1999, by the 2,048
Bureau of Workers' Compensation to the Ohio Building Authority
pursuant to leases and agreements made under Chapter 152. of the 2,049
Revised Code and Section 6 of Am. Sub. H.B. 743 of the 118th 2,050
General Assembly. Of the amounts received in Fund 023, 2,051
appropriation line item 855-401, up to $30,130,000 shall be
restricted for lease rental payments to the Ohio Building 2,052
Authority. If it is determined that additional appropriations 2,053
are necessary for such purpose, such amounts are hereby 2,054
appropriated.
Notwithstanding any other provision of law to the contrary, 2,056
all tenants of the William Green Building not funded by the 2,057
Workers' Compensation Fund (Fund 023) shall pay their fair share 2,058
of the costs of lease payments to the Workers' Compensation Fund 2,059
(Fund 023) by intrastate transfer voucher.
Camera Center 2,061
The Camera Center Fund (Fund 4Y6) created in division (F) 2,063
of section 4121.62 of the Revised Code shall receive revenues 2,064
raised by the fees Camera Center charges for its services and 2,065
rent paid by tenants of the Center's facilities. The foregoing 2,066
appropriation item 855-611, J.L. Camera Center Rent, shall be
used to pay rent, including building operating expenses, of the 2,067
J. Leonard Camera Rehabilitation Center in Columbus. The 2,068
foregoing appropriation item 855-612, J.L. Camera Center 2,069
Operating, shall be used for all other expenses for the Center. 2,070
The Bureau of Workers' Compensation shall not consider 2,072
appropriations made to the Camera Center Fund (Fund 4Y6) when 2,073
establishing administrative cost rates.
Balances 2,075
Notwithstanding any provision of law to the contrary, the 2,077
Director of Budget and Management shall make any transfers of 2,078
cash balances between funds made necessary by the creation of new 2,079
funds, or the consolidation of funds as authorized by the General 2,080
48
Assembly. Within the first five days after the effective date of 2,081
this section, the administering agency head shall certify to the 2,082
Director an estimate of the amount of the cash balance to be
transferred to the receiving fund. The Director may transfer the 2,083
estimated amount when needed to make payments. Within thirty 2,084
days after the effective date of this section, the administering 2,085
agency head shall certify the final amount to the Director. The 2,086
Director shall transfer the difference between any estimated
amount previously transferred and such certified final amount. 2,087
To implement such funding changes as described above 2,089
pertaining to prior year encumbrance balances and commensurate 2,090
appropriation authority, in fiscal year 1998 the Director of 2,091
Budget and Management may cancel encumbrances outstanding on June 2,092
30, 1997, and reestablish such prior year encumbrances or parts 2,093
of encumbrances as needed in fiscal year 1998 in the appropriate
fund or appropriation line item as authorized in this act for the 2,094
same purpose and to the same vendor. As determined by the 2,095
Director, the appropriation authority necessary to reestablish 2,096
such prior year encumbrances in fiscal year 1998 in a different 2,097
fund or appropriation line item within an agency or between
agencies is hereby authorized. The Director shall reduce each 2,098
prior year's appropriation authority by the amount of the 2,099
encumbrances canceled in their respective funds and appropriation 2,100
line items.
Vocational Rehabilitation 2,102
The Bureau of Workers' Compensation and the Rehabilitation 2,104
Services Commission shall enter into an interagency agreement for 2,105
the provision of vocational rehabilitation services and staff to 2,106
mutually eligible clients. The Bureau shall provide $519,608 in 2,107
fiscal year 1998 and $534,157 in fiscal year 1999 from the State 2,108
Insurance Fund to fund vocational rehabilitation services and 2,109
staff in accordance with the interagency agreement. 2,110
Fund Balance 2,112
Any unencumbered cash balance in excess of $45,000,000 in 2,114
49
the Workers' Compensation Fund (Fund 023) on the thirtieth day of 2,115
June of each fiscal year shall be used to reduce the 2,116
administrative cost rate charged to employers to cover 2,117
appropriations for Bureau of Workers' Compensation and Industrial 2,118
Commission operations. 2,119
Section 5. Accounting 2,121
Within the limits set forth in this act, the Director of 2,124
Budget and Management shall establish accounts indicating the 2,125
source and amount of funds for each appropriation made in this
act, and shall determine the form and manner in which 2,126
appropriation accounts shall be maintained. 2,127
The appropriations made in this act are subject to all 2,129
provisions of the main operating appropriations act of the 122nd 2,130
General Assembly that are generally applicable to such 2,131
appropriations.
Section 6. Reissuance of Voided Warrants 2,133
In order to provide funds for the reissuance of voided 2,135
warrants pursuant to section 117.47 of the Revised Code, there is 2,136
hereby appropriated, out of moneys in the state treasury from the 2,137
fund credited as provided in section 117.47 of the Revised Code, 2,138
that amount sufficient to pay such warrants when approved by the 2,139
Office of Budget and Management. 2,140
Section 7. Judgments Against State 2,142
Any appropriations contained in this act, except those to 2,144
be applied to or used for payment of guarantees by or on behalf 2,145
of the state or for debt service on bonds, notes, or certificates 2,146
of participation, may be used pursuant to section 2743.15, 2,147
2743.19, or 2743.191 of the Revised Code for the purpose of 2,148
satisfying judgments, settlements, or administrative awards 2,149
ordered or approved by the Court of Claims in connection with 2,150
civil actions against the state. 2,151
Section 8. Reappropriation of Unexpended Balances 2,153
Notwithstanding section 131.33 of the Revised Code, 2,155
unexpended balances of appropriations and reappropriations 2,156
50
against which encumbrances have been lawfully incurred by a state 2,157
agency are, at the close of fiscal year 1997, to the extent of 2,158
such encumbrances, hereby reappropriated from the funds from 2,159
which they were originally appropriated and reappropriated and, 2,160
except for encumbrances for items of special order manufacture 2,161
not available on term contract or open market, made available for 2,162
the purpose of discharging such encumbrances for a period of five 2,163
months from the end of the fiscal year. Unexpended balances of 2,164
appropriations and reappropriations against which encumbrances 2,165
for items of special order manufacture not available on term 2,166
contract or in the open market have been lawfully incurred are, 2,167
at the close of the fiscal year, to the extent of such 2,168
encumbrances, hereby reappropriated and made available for the
purpose of discharging such encumbrances for a period of five 2,169
months from the end of the fiscal year or, if the Director of 2,170
Budget and Management approves, for a period of not more than 2,171
twelve months from the end of the fiscal year. 2,172
Any items for which unexpended balances are reappropriated 2,174
beyond a five-month period from the end of the fiscal year shall 2,175
be reported to the Controlling Board by the Director of Budget 2,176
and Management. The report on each such item shall include the 2,177
item, the cost of the item, the vendor involved, and the delivery 2,178
date. Such reports to the board shall be updated on a quarterly 2,179
basis while the encumbrance remains open. 2,180
After any such period, reappropriations made for the 2,182
purpose of discharging encumbrances for operating expenses, 2,183
defined as those encumbrances incurred for personal services, 2,184
maintenance, and equipment, are canceled. Reappropriations for 2,185
encumbrances other than operating expenses or items of special 2,186
manufacture not available on term contract or in the open market 2,187
may be extended by obtaining the approval of the Director of 2,188
Budget and Management.
Section 9. The administrator of the Bureau of Workers' 2,190
Compensation shall conduct a cost analysis study of all doctors 2,191
51
under contract or subcontract to the Bureau of Workers' 2,192
Compensation during the 1995-1997 biennium. The cost analysis 2,193
study excludes those doctors involved with the Health Partnership
Program and excludes those doctors with the Qualified Health 2,194
Plan. The administrator shall report the findings of this study 2,195
to the Speaker of the House of Representatives, the Minority 2,196
Leader of the House of Representatives, the President of the 2,197
Senate, and the Minority Leader of the Senate by July 1, 1998. 2,198
Section 10. If any item of law that constitutes the whole 2,200
or part of a codified or uncodified section of law contained in 2,201
this act, or if any application of any item of law that 2,202
constitutes the whole or part of a codified or uncodified section 2,204
of law contained in this act, is held invalid, the invalidity 2,205
does not affect other items of law or applications of items of 2,206
law that can be given effect without the invalid item of law or 2,207
application. To this end, the items of law of which the codified 2,208
and uncodified sections contained in this act are composed, and 2,209
their applications, are independent and severable.
Section 11. Except as otherwise specifically provided in 2,211
this act, the codified and uncodified sections of law contained 2,212
in this act, and the items of law of which the codified and 2,213
uncodified sections of law contained in this act are composed, 2,214
are not subject to the referendum. Therefore, under Ohio 2,215
Constitution, Article II, Section 1d and section 1.471 of the 2,216
Revised Code, the codified and uncodified sections of law 2,217
contained in this act, and the items of law of which the codified 2,219
and uncodified sections of law contained in this act are 2,220
composed, except as otherwise specifically provided in this act, 2,221
go into immediate effect when this act becomes law.
Section 12. Sections 121.03, 2317.45, 4121.12, 4121.121, 2,223
4121.125, 4123.511, and 4123.512 of the Revised Code, as amended 2,224
or enacted by this act, and Section 13 of this act; and the items 2,225
of law of which such sections, as amended or enacted by this act, 2,226
are composed, are subject to the referendum. Therefore, under 2,227
52
Ohio Constitution, Article II, Section 1c and section 1.471 of 2,228
the Revised Code, such sections as amended or enacted by this 2,229
act, and the items of law of which such sections as amended or 2,230
enacted by this act are composed, take effect on the ninety-first 2,232
day after this act is filed with the Secretary of State. If, 2,233
however, a referendum petition is filed against any such section 2,234
as amended or enacted by this act, or against any item of law of 2,235
which any such section as amended or enacted by this act is 2,236
composed, the section as amended or enacted, or item of law, 2,237
unless rejected at the referendum, takes effect at the earliest 2,238
time permitted by law.
Section 13. Sections 4121.121, 4123.512, and 4123.57 of 2,241
the Revised Code are amended by this act and also by Am. Sub. 2,242
S.B. 45 of the 122nd General Assembly, effective July 22, 1997. 2,243
The amendments of Am. Sub. S.B. 45 are included in this act to 2,244
confirm the intention to retain them, but are not intended to be 2,245
effective until July 22, 1997. 2,246
Section 14. Section 121.03 of the Revised Code is 2,248
presented in this act as a composite of the section as amended by 2,249
both Am. Sub. H.B. 7 and Am. Sub. S.B. 162 of the 121st General 2,250
Assembly, with the new language of neither of the acts shown in 2,252
capital letters. This is in recognition of the principle stated 2,253
in division (B) of section 1.52 of the Revised Code that such 2,254
amendments are to be harmonized where not substantively 2,255
irreconcilable and constitutes a legislative finding that such is 2,256
the resulting version in effect prior to the effective date of 2,257
this act.