As Passed by the House 1
122nd General Assembly 4
Regular Session Am. Sub. H. B. No. 363 5
1997-1998 6
REPRESENTATIVES THOMPSON-JOHNSON-AMSTUTZ-O'BRIEN-CORE-CATES- 7
VESPER-CORBIN-GARCIA-BRADING 8
10
A B I L L
To amend sections 121.03, 2317.45, 4121.12, 12
4121.121, 4121.125, 4123.511, 4123.512, and 13
4123.57 of the Revised Code to make 14
appropriations for the Bureau of Workers' 15
Compensation for the biennium beginning July 1, 16
1997, and ending June 30, 1999, and to provide 17
authorization and conditions for the operation of 18
Bureau of Workers' Compensation programs. 19
BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF OHIO: 20
Section 1. That sections 121.03, 2317.45, 4121.12, 22
4121.121, 4121.125, 4123.511, 4123.512, and 4123.57 of the 23
Revised Code be amended to read as follows: 24
Sec. 121.03. The following administrative department heads 35
shall be appointed by the governor, with the advice and consent 36
of the senate, and shall hold their offices during the term of 37
the appointing governor, except as provided in division (W) of 39
this section, and are subject to removal at the pleasure of the 40
governor.
(A) The director of budget and management; 42
(B) The director of commerce; 44
(C) The director of transportation; 46
(D) The director of agriculture; 48
(E) The director of human services; 51
(F) Until July 1, 1997, the director of liquor control; 53
(G) The director of public safety; 55
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(H) The superintendent of insurance; 57
(I) The director of development; 59
(J) The tax commissioner; 61
(K) The director of administrative services; 63
(L) The administrator of the bureau of employment 65
services; 66
(M) The director of natural resources; 68
(N) The director of mental health; 70
(O) The director of mental retardation and developmental 72
disabilities; 73
(P) The director of health; 75
(Q) The director of youth services; 77
(R) The director of rehabilitation and correction; 79
(S) The director of environmental protection; 81
(T) The director of aging; 83
(U) The director of alcohol and drug addiction services; 85
(W)(V) The administrator of workers' compensation who 87
meets the qualifications required under division (A) of section 88
4121.121 of the Revised Code, who shall serve as administrator, 89
subject to removal at the pleasure of the governor, until the 90
date the workers' compensation oversight commission appoints the 91
administrator as provided in division (F)(10) of section 4121.12 92
of the Revised Code.
Sec. 2317.45. (A) As used in this section: 101
(1) "Collateral benefits" means benefits that are paid by 103
any source, including workers' compensation benefits, to or on 105
behalf of the plaintiff as a result of an injury or loss to
person or property, regardless of whether there is an obligation 106
to pay back the money or other benefits, in whole or in part, 107
upon recovery in a tort action. "Collateral benefits" does not 108
include life insurance proceeds.
(2) "Tort action" means a civil action for damages for 111
injury, death, or loss to person or property. "Tort action" 112
includes a product liability claim but does not include a civil 113
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action for damages for a breach of contract or another agreement 114
between persons.
(3) "Trier of fact" means the jury or, in a nonjury 116
action, the court.
(B) In determining the amount of the compensatory damages 119
that are recoverable by the plaintiff in a tort action, the trier 121
of fact shall consider, if presented in the tort action, relevant
collateral benefits that have been paid, or that the source of 122
the benefits has acknowledged are payable, from insurance other 123
than insurance for which the plaintiff, spouse of the plaintiff, 124
or parent of the plaintiff if the plaintiff is a minor, has paid 125
a premium, insurance that is subject to a right of subrogation, 126
WORKERS' COMPENSATION BENEFITS THAT ARE SUBJECT TO A RIGHT OF 127
SUBROGATION, or insurance that has any other obligation of 129
repayment, including, but not limited to, evidence of the amount 130
of the collateral benefit and of the costs, premiums, or charges
for the collateral benefits. 131
(C) This section does not apply as follows: 133
(1) In tort actions against the state in the court of 135
claims. Division (D) of section 2743.02 or division (B)(2) of 137
section 3345.40 of the Revised Code applies to collateral 138
recoveries or sources of plaintiffs in those tort actions.
(2) In tort actions against political subdivisions of this 140
state that are commenced under or are subject to Chapter 2744. of 141
the Revised Code. Division (B) of section 2744.05 of the Revised 143
Code applies to collateral sources of plaintiffs in those tort
actions. 144
(D) This section shall be considered to be purely remedial 146
in operation and shall be applied in a remedial manner in any 147
civil action commenced on or after the effective date of the 148
amendment to this section JANUARY 27, 1997, in which this section 149
is relevant, regardless of when the cause of action accrued and 150
notwithstanding any other section of the Revised Code or prior 151
rule of law of this state, but shall not be construed to apply to 152
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any civil action pending prior to the effective date of the 153
amendment to this section JANUARY 27, 1997. 154
Sec. 4121.12. (A) There is hereby created the workers' 164
compensation oversight commission consisting of nine members, of 165
which members the governor shall appoint five with the advice and 166
consent of the senate. Of the five members the governor 168
appoints, two shall be individuals who, on account of their 170
previous vocation, employment, or affiliations, can be classed as 172
representative of employees, at least one of whom is
representative of employees who are members of an employee 174
organization; two shall be individuals who, on account of their 176
previous vocation, employment, or affiliations, can be classed as 178
representative of employers, one of whom represents self-insuring 179
employers and one of whom has experience as an employer in 180
compliance with section 4123.35 of the Revised Code other than a 182
self-insuring employer, and one of those two representatives also
shall represent employers whose employees are not members of an 183
employee organization; and one shall represent the public and 184
also be an individual who, on account of the individual's 185
previous vocation, employment, or affiliations, cannot be classed 186
as either predominantly representative of employees or of 187
employers. The governor shall select the chairperson of the 188
commission who shall serve as chairperson at the pleasure of the 189
governor. No more than three members appointed by the governor 192
shall belong to or be affiliated with the same political party. 193
Each of these five members shall have at least three years' 195
experience in the field of insurance, finance, workers' 196
compensation, law, accounting, actuarial, personnel, investments, 197
or data processing, or in the management of an organization whose 198
size is commensurate with that of the bureau of workers' 199
compensation. At least one of these five members shall be an 200
attorney licensed under Chapter 4705. of the Revised Code to 201
practice law in this state. 202
(B) Of the initial appointments made to the commission, 205
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the governor shall appoint one member who represents employees to 206
a term ending one year after September 1, 1995, one member who 207
represents employers to a term ending two years after the 209
effective date of this section, the member who represents the 210
public to a term ending three years after September 1, 1995, one 213
member who represents employees to a term ending four years after 214
September 1, 1995, and one member who represents employers to a 216
term ending five years after September 1, 1995. Thereafter, 218
terms of office shall be for five years, with each term ending on 219
the same day of the same month as did the term that it succeeds. 221
Each member shall hold office from the date of his appointment 222
until the end of the term for which the member was appointed. 223
The governor shall not appoint any person to more than two 225
full terms of office on the commission. This restriction does 226
not prevent the governor from appointing a person to fill a 227
vacancy caused by the death, resignation, or removal of a 228
commission member and also appointing that person twice to full 229
terms on the commission, or from appointing a person previously 230
appointed to fill less than a full term twice to full terms on 231
the commission. Any member appointed to fill a vacancy occurring 232
prior to the expiration date of the term for which the member's 234
predecessor was appointed shall hold office as a member for the
remainder of that term. A member shall continue in office 235
subsequent to the expiration date of the member's term until a 237
successor takes office or until a period of sixty days has 238
elapsed, whichever occurs first. 239
(C) In making appointments to the commission, the governor 242
shall select the members from the list of names submitted by the 245
workers' compensation oversight commission nominating committee 246
pursuant to this division. Within fourteen days after the 247
governor calls the initial meeting of the nominating committee
pursuant to division (C) of section 4121.123 of the Revised Code, 248
the nominating committee shall submit to the governor, for the 251
initial appointments, a list containing four separate names for 253
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each of the members on the commission. Within fourteen days 255
after the submission of the list, the governor shall appoint 256
individuals from the list.
For the appointment of the member who is representative of 258
employees who are members of an employee organization, both for 259
initial appointments and for the filling of vacancies, the list 260
of four names submitted by the nominating committee shall be 261
comprised of four individuals who are members of the executive 262
committee of the largest statewide labor federation.
Thereafter, within sixty days after a vacancy occurring as 266
a result of the expiration of a term and within thirty days after 267
other vacancies occurring on the commission, the nominating 268
committee shall submit a list containing four names for each 270
vacancy. Within fourteen days after the submission of the list, 272
the governor shall appoint individuals from the list. With 274
respect to the filling of vacancies, the nominating committee 275
shall provide the governor with a list of four individuals who 276
are, in the judgment of the nominating committee, the most fully 277
qualified to accede to membership on the commission. The 278
nominating committee shall not include the name of an individual 279
upon the list for the filling of vacancies if the appointment of
that individual by the governor would result in more than three 280
members of the commission belonging to or being affiliated with 281
the same political party. The committee shall include on the 282
list for the filling of vacancies only the names of attorneys 283
admitted to practice law in this state if, to fulfill the
requirement of division (A) of section 4121.12 of the Revised 284
Code, the vacancy must be filled by an attorney. 285
In order for the name of an individual to be submitted to 287
the governor under this division, the nominating committee shall 289
approve the individual by an affirmative vote of a majority of 291
its members.
(D) The remaining four members of the commission shall be 294
the chairperson and ranking minority member of the standing 295
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committees of the house of representatives and of the senate to
which legislation concerning this chapter and Chapters 4123., 296
4127., and 4131. of the Revised Code normally are referred, or a 298
designee of the chairperson or ranking minority member, provided 299
that the designee is a member of the standing committee. 300
Legislative members shall serve during the session of the general 301
assembly to which they are elected and for as long as they are 302
members of the general assembly. Legislative members shall serve 303
in an advisory capacity to the commission and shall have no 305
voting rights on matters coming before the commission. 307
Membership on the commission by legislative members shall not be 308
deemed as holding a public office. 309
(E) All members of the commission shall receive their 312
reasonable and necessary expenses pursuant to section 126.31 of 313
the Revised Code while engaged in the performance of their duties 315
as members. Legislative members also shall receive fifty dollars 316
per meeting that they attend. Members appointed by the governor 317
also shall receive an annual salary as follows:
(a)(1) On and before August 31, 1998, not to exceed six 320
thousand dollars payable at the rate of five hundred dollars per 321
month. A member shall receive the monthly five hundred dollar 322
salary only if the member has attended at least one meeting of 324
the commission during that month. A member may receive no more
than the monthly five hundred dollar salary regardless of the 326
number of meetings held by the commission during a month or the 327
number of meetings in excess of one within a month that the 328
member attends.
(b)(2) After August 31, 1998, not to exceed eighteen 330
thousand dollars payable at the rate of fifteen hundred dollars 331
per month. A member shall receive the monthly fifteen hundred 332
dollar salary only if the member has attended at least one 333
meeting of the commission during that month. A member may 334
receive no more than the monthly fifteen hundred dollar salary
regardless of the number of meetings held by the commission 335
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during the month or the number of meetings in excess of one 336
within a month that the member attends. 337
The administrator of workers' compensation shall provide 339
professional and clerical assistance to the commission, as the 340
commission considers appropriate. 341
(F) The commission shall: 343
(1) Review progress of the bureau in meeting its cost and 346
quality objectives and in complying with this chapter and 347
Chapters 4123., 4127., and 4131. of the Revised Code; 348
(2) Issue an annual report on the cost and quality 350
objectives of the bureau to the president of the senate, the 352
speaker of the house of representatives, and the governor; 353
(3) Review all independent financial audits of the bureau. 355
The administrator shall provide access to records of the bureau 356
to facilitate the review required under this division. 357
(4) Study issues as requested by the administrator or the 359
governor;
(5) Contract with an independent actuarial firm to assist 361
the commission in making recommendations to the administrator 362
regarding premium rates;
(6) Establish objectives, policies, and criteria for the 365
administration of the investment program that include asset 367
allocation targets and ranges, risk factors, asset class
benchmarks, time horizons, total return objectives, and 368
performance evaluation guidelines, and monitor the 370
administrator's progress in implementing the objectives, 371
policies, and criteria on a quarterly basis. The commission
shall publish the objectives, policies, and criteria no less than 373
annually and shall make copies available to interested parties. 374
The commission shall prohibit, on a prospective basis, specific 376
investment activity it finds to be contrary to its investment
objectives, policies, and criteria. 377
The investment policy in existence on the effective date of 379
this amendment shall continue until the commission approves 380
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objectives, policies, and criteria for the administration of the 381
investment program pursuant to this section. 382
(7) Advise and consent on all of the following: 384
(a) Administrative rules the administrator submits to it 387
pursuant to division (B)(5) of section 4121.121 of the Revised
Code for the classification of occupations or industries, for 389
premium rates and contributions, for the amount to be credited to 390
the surplus fund, for rules and systems of rating, rate 391
revisions, and merit rating;
(b) The overall policy of the bureau of workers' 394
compensation as set by the administrator;
(c) The duties and authority conferred upon the 396
administrator pursuant to section 4121.37 of the Revised Code; 397
(d) Rules the administrator adopts for the health 399
partnership program and the qualified health plan system, as 400
provided in sections 4121.44, 4121.441, and 4121.442 of the 401
Revised Code.
(8) Perform all duties required under section 4121.125 of 403
the Revised Code; 404
(9) After August 31, 1998, appoint an administrator who 406
meets the qualifications required under section 4121.121 of the 407
Revised Code and fix the salary of the administrator, the amount 409
of which the commission shall base upon the experience of the 411
administrator and the responsibilities and duties of the
administrator pursuant to this chapter and Chapters 4123., 4127., 412
and 4131. of the Revised Code. 413
(G) The commission may enter into an employment contract 415
with an administrator it appoints, provided that the contract 416
does not exceed two years in length. 418
(H) As used in this section, "employee organization" means 420
any labor or bona fide organization in which employees 421
participate and which exists for the purpose, in whole or in 423
part, of dealing with employers concerning grievances, labor 424
disputes, wages, hours, terms and other conditions of employment. 425
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Sec. 4121.121. (A) There is hereby created the bureau of 434
workers' compensation, which shall be administered by the 435
administrator of workers' compensation. A person appointed to 436
the position of administrator shall possess significant 437
management experience in effectively managing an organization or 438
organizations of substantial size and complexity. Before
September 1, 1998, the THE governor shall appoint the 439
administrator as provided in section 121.03 of the Revised Code, 441
and the administrator shall serve at the pleasure of the 443
governor. The governor shall fix the administrator's salary on 445
the basis of the administrator's experience and the
administrator's responsibilities and duties under this chapter 447
and Chapters 4123., 4127., and 4131. of the Revised Code. The 448
governor shall not appoint to the position of administator any 449
person who has, or whose spouse has, given a contribution to the 450
campaign committee of the governor in an amount greater than one 451
thousand dollars during the two-year period immediately preceding 452
the date of the appointment of the administrator. After August 454
31, 1998, the workers' compensation oversight commission shall 455
appoint the administrator as provided in division (F)(9) of 456
section 4121.12 of the Revised Code, and the administrator shall 457
serve at the pleasure of the oversight commission. The oversight 459
commission shall fix the administrator's salary on the basis of 460
the administrator's experience and the administrator's 461
responsibilities and duties under this chapter and Chapters 462
4123., 4127., and 4131. of the Revised Code. 463
The administrator shall hold no other public office and 465
shall devote full time to the duties of administrator. Before 467
entering upon the duties of the office, the administrator shall 468
take an oath of office as required by sections 3.22 and 3.23 of 469
the Revised Code, and shall file in the office of the secretary 470
of state, a bond signed by the administrator and by surety 471
approved by the governor, for the sum of fifty thousand dollars 473
payable to the state, conditioned upon the faithful performance 474
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of the administrator's duties.
(B) The administrator is responsible for the management of 477
the bureau of workers' compensation and for the discharge of all 478
administrative duties imposed upon the administrator in this 479
chapter and Chapters 4123., 4127., and 4131. of the Revised Code, 481
and in the discharge thereof shall do all of the following: 482
(1) Establish the overall administrative policy of the 485
bureau for the purposes of this chapter and Chapters 4123.,
4127., and 4131. of the Revised Code, and perform all acts and 486
exercise all authorities and powers, discretionary and otherwise 488
that are required of or vested in the bureau or any of its 489
employees in this chapter and Chapters 4123., 4127., and 4131. of 490
the Revised Code, except the acts and the exercise of authority 491
and power that is required of and vested in the oversight 492
commission or the industrial commission pursuant to those 493
chapters. The treasurer of state shall honor all warrants signed 494
by the administrator, or by one or more of the administrator's 495
employees, authorized by the administrator in writing, or bearing 497
the facsimile signature of the administrator or such employee 498
under sections 4123.42 and 4123.44 of the Revised Code. 499
(2) Employ, direct, and supervise all employees required 501
in connection with the performance of the duties assigned to the 502
bureau by this chapter and Chapters 4123., 4127., and 4131. of 503
the Revised Code, and may establish job classification plans and 504
compensation for all employees of the bureau provided that this 505
grant of authority shall not be construed as affecting any 506
employee for whom the state employment relations board has 507
established an appropriate bargaining unit under section 4117.06 508
of the Revised Code. All positions of employment in the bureau 509
are in the classified civil service except those employees the 510
administrator may appoint to serve at the administrator's 511
pleasure in the unclassified civil service pursuant to section 512
124.11 of the Revised Code. The administrator shall fix the 513
salaries of employees the administrator appoints to serve at the 515
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administrator's pleasure, including the chief operating officer, 516
staff physicians, and other senior management personnel of the
bureau AND SHALL ESTABLISH THE COMPENSATION OF STAFF ATTORNEYS OF 517
THE BUREAU'S LEGAL SECTION AND THEIR IMMEDIATE SUPERVISORS, AND 518
TAKE WHATEVER STEPS ARE NECESSARY TO PROVIDE ADEQUATE 519
COMPENSATION FOR OTHER STAFF ATTORNEYS. 520
(3) Reorganize the work of the bureau, its sections, 522
departments, and offices to the extent necessary to achieve the 523
most efficient performance of its functions and to that end may 524
establish, change, or abolish positions and assign and reassign 525
duties and responsibilities of every employee of the bureau. All 526
persons employed by the commission in positions that, after 528
November 3, 1989, are supervised and directed by the 529
administrator under this section are transferred to the bureau in 530
their respective classifications but subject to reassignment and 531
reclassification of position and compensation as the 532
administrator determines to be in the interest of efficient 533
administration. The civil service status of any person employed 534
by the commission is not affected by this section. Personnel 535
employed by the bureau or the commission who are subject to 536
Chapter 4117. of the Revised Code shall retain all of their 537
rights and benefits conferred pursuant to that chapter as it 538
presently exists or is hereafter amended and nothing in this 539
chapter or Chapter 4123. of the Revised Code shall be construed 540
as eliminating or interfering with Chapter 4117. of the Revised 541
Code or the rights and benefits conferred under that chapter to 542
public employees or to any bargaining unit. 543
(4) Provide offices, equipment, supplies, and other 545
facilities for the bureau. The administrator also shall provide 547
suitable office space in the service offices for the district 548
hearing officers, the staff hearing officers, and commission 549
employees as requested by the commission.
(5) Prepare and submit to the oversight commission 552
information the administrator considers pertinent or the 553
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oversight commission requires, together with the administrator's 556
recommendations, in the form of administrative rules, for the 557
advice and consent of the oversight commission, for 558
classifications of occupations or industries, for premium rates 559
and contributions, for the amount to be credited to the surplus 560
fund, for rules and systems of rating, rate revisions, and merit 561
rating. The administrator shall obtain, prepare, and submit any 562
other information the oversight commission requires for the 564
prompt and efficient discharge of its duties. 566
(6) Keep the accounts required by division (A) of section 568
4123.34 of the Revised Code and all other accounts and records 569
necessary to the collection, administration, and distribution of 570
the workers' compensation funds and shall obtain the statistical 571
and other information required by section 4123.19 of the Revised 572
Code. 573
(7) Exercise the investment powers vested in the 575
administrator by section 4123.44 of the Revised Code in 576
accordance with the investment objectives, policies, and criteria 578
established by the oversight commission pursuant to section 579
4121.12 of the Revised Code. The administrator shall not engage 580
in any prohibited investment activity specified by the oversight 581
commission pursuant to division (F)(6) of section 4121.12 of the 582
Revised Code. All business shall be transacted, all funds 583
invested, all warrants for money drawn and payments made, and all 584
cash and securities and other property held, in the name of the 585
bureau, or in the name of its nominee, provided that nominees are
authorized by the administrator solely for the purpose of 587
facilitating the transfer of securities, and restricted to the 588
administrator and designated employees. 589
(8) Make contracts for and supervise the construction of 592
any project or improvement or the construction or repair of 593
buildings under the control of the bureau. 594
(9) Purchase supplies, materials, equipment, and services; 596
make contracts for, operate, and superintend the telephone, other 597
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telecommunication, and computer services for the use of the 598
bureau; and make contracts in connection with office 599
reproduction, forms management, printing, and other services. 600
(10) Separately from the budget the industrial commission 603
submits, prepare and submit to the director of budget and 604
management a budget for each biennium. The budget submitted 605
shall include estimates of the costs and necessary expenditures 606
of the bureau in the discharge of any duty imposed by law as well 607
as the costs of furnishing office space to the district hearing 608
officers, staff hearing officers, and commission employees under 609
division (D) of this section. 610
(11) As promptly as possible in the course of efficient 612
administration, decentralize and relocate such of the personnel 613
and activities of the bureau as is appropriate to the end that 614
the receipt, investigation, determination, and payment of claims 615
may be undertaken at or near the place of injury or the residence 616
of the claimant and for that purpose establish regional offices, 617
in such places as the administrator considers proper, capable of 619
discharging as many of the functions of the bureau as is 620
practicable so as to promote prompt and efficient administration 621
in the processing of claims. All active and inactive lost-time 622
claims files shall be held at the service office responsible for 623
the claim. A claimant, at the claimant's request, shall be 624
provided with information by telephone as to the location of the 626
file pertaining to claim. The administrator shall ensure that 627
all service office employees report directly to the director for 628
their service office.
(12) Provide a written binder on new coverage where the 630
administrator considers it to be in the best interest of the 631
risk. The administrator, or any other person authorized by the 632
administrator, shall grant the binder upon submission of a 634
request for coverage by the employer. A binder is effective for 635
a period of thirty days from date of issuance and is 636
nonrenewable. Payroll reports and premium charges shall coincide 637
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with the effective date of the binder. 638
(13) Set standards for the reasonable and maximum handling 640
time of claims payment functions, ensure, by rules, the impartial 641
and prompt treatment of all claims and employer risk accounts, 642
and establish a secure, accurate method of time stamping all 643
incoming mail and documents hand delivered to bureau employees. 644
(14) Ensure that all employees of the bureau follow the 646
orders and rules of the commission as such orders and rules 647
relate to the commission's overall adjudicatory policy-making and 648
management duties under this chapter and Chapters 4123., 4127., 649
and 4131. of the Revised Code. 650
(15) Manage and operate a data processing system with a 652
common data base for the use of both the bureau and the 653
commission and, in consultation with the commission, using 654
electronic data processing equipment, shall develop a claims 655
tracking system that is sufficient to monitor the status of a 656
claim at any time and that lists appeals that have been filed and 657
orders or determinations that have been issued pursuant to 658
section 4123.511 or 4123.512 of the Revised Code, including the 659
dates of such filings and issuances. 660
(16) Establish and maintain a medical section within the 662
bureau. The medical section shall do all of the following: 663
(a) Assist the administrator in establishing standard 665
medical fees, approving medical procedures, and determining 666
eligibility and reasonableness of the compensation payments for 667
medical, hospital, and nursing services, and in establishing 668
guidelines for payment policies which recognize usual, customary, 669
and reasonable methods of payment for covered services; 670
(b) Provide a resource to respond to questions from claims 672
examiners for employees of the bureau; 673
(c) Audit fee bill payments; 675
(d) Implement a program to utilize, to the maximum extent 677
possible, electronic data processing equipment for storage of 678
information to facilitate authorizations of compensation payments 679
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for medical, hospital, drug, and nursing services; 680
(e) Perform other duties assigned to it by the 682
administrator. 683
(17) Appoint, as the administrator determines necessary, 685
panels to review and advise the administrator on disputes arising 687
over a determination that a health care service or supply 688
provided to a claimant is not covered under this chapter or 689
Chapter 4123. of the Revised Code or is medically unnecessary. 690
If an individual health care provider is involved in the dispute, 691
the panel shall consist of individuals licensed pursuant to the 692
same section of the Revised Code as such health care provider. 693
(18) Pursuant to section 4123.65 of the Revised Code, 695
approve applications for the final settlement of claims for 696
compensation or benefits under this chapter and Chapters 4123., 697
4127., and 4131. of the Revised Code as the administrator 698
determines appropriate, except in regard to the applications of 700
self-insuring employers and their employees;. 701
(19) Comply with section 3517.13 of the Revised Code, and 703
except in regard to contracts entered into pursuant to the 706
authority contained in section 4121.44 of the Revised Code,
comply with the competitive bidding procedures set forth in the 708
Revised Code for all contracts into which the administrator 709
enters provided that those contracts fall within the type of 710
contracts and dollar amounts specified in the Revised Code for 711
competitive bidding and further provided that those contracts are 712
not otherwise specifically exempt from the competitive bidding 713
procedures contained in the Revised Code. 714
(20) Adopt, with the advice and consent of the oversight 716
commission, rules for the operation of the bureau. No rule 717
adopted by the administrator shall be construed as barring the 718
participation of a person who is not admitted to the practice of 719
law as a representative of a party for the purposes of any matter 720
arising under this chapter and Chapters 4123., 4127., and 4131. 721
of the Revised Code, provided that the representative of the
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party complies with rules of the administrator. 722
(21) Prepare and submit to the oversight commission 724
information the administrator considers pertinent or the 725
oversight commission requires, together with the administrator's 726
recommendations, in the form of administrative rules, for the 727
advice and consent of the oversight commission, for the health 728
partnership program and the qualified health plan system, as
provided in sections 4121.44, 4121.441, and 4121.442 of the 729
Revised Code.
(C) The administrator, with the advice and consent of the 731
senate, shall appoint a chief operating officer who has 733
significant experience in the field of workers' compensation 734
insurance or other similar insurance industry experience if the
administrator does not possess such experience. The chief 735
operating officer shall not commence the chief operating 736
officer's duties until after the senate consents to the chief 737
operating officer's appointment. The chief operating officer 738
shall serve in the unclassified civil service of the state. 739
Sec. 4121.125. (A) The workers' compensation oversight 749
commission may contract with one or more outside actuarial firms 750
and other professional persons, as the oversight commission 751
determines necessary, to assist the oversight commission in 752
measuring the performance of Ohio's workers' compensation system 753
and in comparing Ohio's workers' compensation system to other 754
state and private workers' compensation systems. The oversight 755
commission, actuarial firm or firms, and professional persons 756
shall make such measurements and comparisons using accepted 757
insurance industry standards, including, but not limited to, 758
standards promulgated by the National Council on Compensation 760
Insurance.
(B) The oversight commission may contract with one or more 762
outside firms to conduct management and financial audits of the 764
workers' compensation system, including audits of the reserve 765
fund belonging to the state insurance fund, and to establish 766
18
objective quality management principles and methods by which to 767
review the performance of the workers' compensation system.
(C) The oversight commission shall include any actuarial, 769
managerial, or financial report completed under its authority 771
pursuant to division (A) or (B) of this section in the next 772
regularly published report of the oversight commission. 773
(D) The oversight commission shall publish monthly reports 775
that include, but are not limited to, all of the following: 776
(1) Comparative and competitive data concerning Ohio's 778
workers' compensation system and the workers' compensation system 779
of other states on all of the following subjects: 781
(a) Average length of time to process contested and 784
uncontested claims;
(b) Length of time to investigate claims that raise 786
suspicion of fraudulent activity; 787
(c) Average indemnity cost of claims; 789
(d) Average medical costs of claims reported according to 791
the types of awards and separately reported according to the 792
types of injuries; 793
(e) Comparisons of Ohio classification manual rates with 796
comparable rates in other states, and after the administrator of 797
workers' compensation classifies occupations and industries and 798
determines risks of different classes according to the National 799
Council on Compensation Insurance, comparisons of rates in Ohio 801
with rates of other states that use National Council on 802
Compensation Insurance codes;
(f) Effectiveness of rehabilitation, both private and 804
within the state's workers' compensation system, including the 805
number of individuals referred, the percentage completing a 806
rehabilitation program, and the percentage of those finding 807
employment after successful completion of a rehabilitation 808
program.
(2) Data concerning Ohio's workers' compensation system 810
concerning all of the following: 811
19
(a) Performance of the investments of the bureau of 813
workers' compensation; 814
(b) Effectiveness of the bureau in collecting delinquent 817
payments that are due from employers pursuant to Chapters 4121., 818
4123., 4127., and 4131. of the Revised Code, including a
crosscheck with other state agencies to which employers are 820
required under law to make payments;
(c) Effectiveness of the bureau in subrogation claims; 823
(d) Performance measurements of managed care organizations 826
within the health partnership program and the qualified health 827
plan system;
(e) Return-to-work rates, medical outcome measures, and 830
other measures that the oversight commission or general assembly
determines; 831
(f) Adequacy of the reserve fund to cover indemnity costs 834
of the state insurance fund;
(g) The total number of claims filed in the time period 836
occurring subsequent to publication of the report that 837
immediately precedes publication of the report for which the 838
information is being compiled according to the type of claim, 840
employer classification, and claim result;
(h) The effectiveness of the bureau in identifying and 842
eliminating fraud in the workers' compensation system and in 843
recovering workers' compensation resources. 844
The reports published under this division shall include 846
data from the bureau and the industrial commission regarding 847
state fund, self-insuring, and public employers. 848
(E) The administrator and the industrial commission shall 850
compile information and provide access to records of the bureau 851
and the industrial commission to the oversight commission to the 852
extent necessary for fulfillment of all BOTH of the following 853
requirements: 854
(1) Conduct of the measurements and comparisons described 857
in division (A) of this section; 858
20
(2) Conduct of the management and financial audits and 860
establishment of the principles and methods described in division 861
(B) of this section; 862
(3) Publishing of the reports described in divisions (C) 865
and (D) of this section.
(F)(D) The administrator shall pay the expenses incurred 868
by the oversight commission to effectively fulfill its duties and 869
exercise its powers under this section as the administrator pays 870
other operating expenses of the bureau. 871
Sec. 4123.511. (A) Within seven days after receipt of any 882
claim under this chapter, the bureau of workers' compensation
shall notify the claimant and the employer of the claimant of the 883
receipt of the claim and of the facts alleged therein. If the 884
bureau receives from a person other than the claimant written or 885
telecommunicated information indicating that an injury has 886
occurred or an occupational disease that may be compensable under 888
this chapter has been diagnosed by a licensed physician, the
bureau shall notify the employee and the employer of the 890
information. If the information is provided by any method of 891
telecommunication, the person providing the information shall 892
provide written verification of the information to the bureau 893
according to division (E) of section 4123.84 of the Revised Code. 894
The receipt of the information in writing, or if by a method of 895
telecommunications, the written verification, and the notice by 896
the bureau shall be considered an application for compensation 897
under section 4123.84 or 4123.85 of the Revised Code provided 898
that the conditions of division (E) of section 4123.84 of the 899
Revised Code apply to information provided by a method of 900
telecommunication. Upon receipt of a claim, the bureau shall 901
advise the claimant of the claim number assigned and the 902
claimant's right to representation in the processing of a claim 903
or to elect no representation. If the bureau determines that a 904
claim is determined to be a compensable lost time claim, the 905
bureau shall notify the claimant and the employer of the 906
21
availability of rehabilitation services. No bureau or industrial 907
commission employee shall directly or indirectly convey any 908
information in derogation of this right. This section shall in no 909
way abrogate the bureau's responsibility to aid and assist a 910
claimant in the filing of a claim and to advise the claimant of 911
the claimant's rights under the law.
The administrator of workers' compensation shall assign all 913
claims and investigations to the bureau service office from which 914
investigation and determination may be made most expeditiously. 915
The bureau shall investigate the facts concerning an injury 917
or occupational disease and ascertain such facts in whatever 918
manner is most appropriate and may obtain statements of the 919
employee, employer, attending physician, and witnesses in 920
whatever manner is most appropriate. 921
(B)(1) Except as provided in division (B)(2) of this 923
section, in claims other than those in which the employer is a 924
self-insuring employer, if the administrator determines under 925
division (A) of this section that a claimant is or is not 926
entitled to an award of compensation or benefits, the 927
administrator shall issue an order, no later than twenty-eight 930
days after the sending of the notice under division (A) of this 931
section, granting or denying the payment of the compensation or 932
benefits, or both as is appropriate to the claimant. 933
Notwithstanding the time limitation specified in this division
for the issuance of an order, if a medical examination of the 934
claimant is required by statute, the administrator promptly shall 935
schedule the claimant for that examination and shall issue an 936
order no later than twenty-eight days after receipt of the report 937
of the examination. The administrator shall notify the claimant 938
and the employer of the claimant and their respective 939
representatives in writing of the nature of the order and the 940
amounts of compensation and benefit payments involved. The 941
employer or claimant may appeal the order pursuant to division 942
(C) of this section within fourteen days after the date of the 943
22
receipt of the order. The employer and claimant may waive, in 944
writing, their rights to an appeal under this division. 945
(2) Notwithstanding the time limitation specified in 947
division (B)(1) of this section for the issuance of an order, if 948
the employer certifies a claim for payment of compensation or 949
benefits, or both, to a claimant, and the administrator has 950
completed the investigation of the claim, the payment of benefits 952
or compensation, or both, as is appropriate, shall commence upon 953
the later of the date of the certification or completion of the 954
investigation and issuance of the order by the administrator, 955
provided that the administrator shall issue the order no later 956
than the time limitation specified in division (B)(1) of this 957
section. 958
(3) If an appeal is made under division (B) of this 961
section, the administrator shall forward the claim file to the 962
appropriate district hearing officer within seven days of the
appeal. In contested claims other than state fund claims, the 963
administrator shall forward the claim within seven days of the 964
administrator's receipt of the claim to the commission, which 966
shall refer the claim to an appropriate district hearing officer 967
for a hearing in accordance with division (C) of this section. 968
(C) If an employer or claimant timely appeals the order of 970
the administrator issued under division (B) of this section or in 971
the case of other contested claims other than state fund claims, 972
the commission shall refer the claim to an appropriate district 973
hearing officer according to rules the commission adopts under 974
section 4121.36 of the Revised Code. The district hearing 975
officer shall notify the parties and their respective 976
representatives of the time and place of the hearing. 977
The district hearing officer shall hold a hearing on a 979
disputed issue or claim within forty-five days after the filing 981
of the appeal under this division and issue a decision within 982
seven days after holding the hearing. The district hearing 983
officer shall notify the parties and their respective
23
representatives in writing of the order. Any party may appeal an 985
order issued under this division pursuant to division (D) of this 986
section within fourteen days after receipt of the order under 987
this division. 988
(D) Upon the timely filing of an appeal of the order of 990
the district hearing officer issued under division (C) of this 991
section, the commission shall refer the claim file to an 992
appropriate staff hearing officer according to its rules adopted 993
under section 4121.36 of the Revised Code. The staff hearing 994
officer shall hold a hearing within forty-five days after the 995
filing of an appeal under this division and issue a decision 996
within seven days after holding the hearing under this division. 999
The staff hearing officer shall notify the parties and their 1,000
respective representatives in writing of the staff hearing 1,001
officer's order. Any party may appeal an order issued under this 1,002
division pursuant to division (E) of this section within fourteen 1,003
days after receipt of the order under this division. 1,004
(E) Upon the filing of a timely appeal of the order of the 1,006
staff hearing officer issued under division (D) of this section, 1,007
the commission or a designated staff hearing officer, on behalf 1,008
of the commission, shall determine whether the commission will 1,010
hear the appeal. If the commission or the designated staff
hearing officer decides to hear the appeal, the commission or the 1,012
designated staff hearing officer shall notify the parties and 1,013
their respective representatives in writing of the time and place 1,014
of the hearing. The commission shall hold the hearing within 1,015
forty-five days after the filing of the notice of appeal and, 1,016
within seven days after the conclusion of the hearing, the 1,017
commission shall issue its order affirming, modifying, or 1,018
reversing the order issued under division (D) of this section. 1,019
The commission shall notify the parties and their respective 1,020
representatives in writing of the order. If the commission or 1,021
the designated staff hearing officer determines not to hear the 1,022
appeal, within fourteen days after the filing of the notice of 1,023
24
appeal, the commission or the designated staff hearing officer 1,024
shall issue an order to that effect and notify the parties and
their respective representatives in writing of that order. 1,025
Except as otherwise provided in this chapter and Chapters 1,027
4121., 4127., and 4131. of the Revised Code, any party may appeal 1,028
an order issued under this division to the court pursuant to 1,029
section 4123.512 of the Revised Code within sixty days after 1,030
receipt of the order, subject to the limitations contained in 1,031
that section. 1,032
(F) Every notice of an appeal from an order issued under 1,034
divisions (B), (C), (D), and (E) of this section shall state the 1,035
names of the claimant and employer, the number of the claim, the 1,036
date of the decision appealed from, and the fact that the 1,037
appellant appeals therefrom. 1,038
(G) All of the following apply to the proceedings under 1,040
divisions (C), (D), and (E) of this section: 1,041
(1) The parties shall proceed promptly and without 1,043
continuances except for good cause; 1,044
(2) The parties, in good faith, shall engage in the free 1,046
exchange of information relevant to the claim prior to the 1,047
conduct of a hearing according to the rules the commission adopts 1,048
under section 4121.36 of the Revised Code; 1,049
(3) The administrator is a party and may appear and 1,051
participate at all administrative proceedings on behalf of the 1,052
state insurance fund. However, in cases in which the employer is 1,053
represented, the administrator shall neither present arguments 1,054
nor introduce testimony that is cumulative to that presented or 1,055
introduced by the employer or the employer's representative. The 1,056
administrator may file an appeal under this section on behalf of
the state insurance fund; however, except in cases arising under 1,057
section 4123.343 of the Revised Code, the administrator only may 1,058
appeal questions of law or issues of fraud when the employer 1,059
appears in person or by representative.
(H) Except as provided in division (J) of this section, 1,061
25
payments of compensation to a claimant or on behalf of a claimant 1,062
as a result of any order issued under this chapter shall commence 1,063
upon the earlier of the following: 1,064
(1) Fourteen days after the date the administrator issues 1,066
an order under division (B) of this section, unless that order is 1,067
appealed; 1,068
(2) Twenty-one days after the date when the employer has 1,070
waived the right to appeal a decision issued under division (B) 1,071
of this section;
(3) If no appeal of an order has been filed under this 1,073
section or to a court under section 4123.512 of the Revised Code, 1,074
the expiration of the time limitations for the filing of an 1,075
appeal of an order; 1,076
(4) The date of receipt by the employer of an order of a 1,078
district hearing officer, a staff hearing officer, or the 1,081
industrial commission issued under division (C), (D), or (E) of 1,082
this section. 1,083
(I) No medical benefits payable under this chapter or 1,085
Chapter 4121., 4127., or 4131. of the Revised Code are payable 1,086
until the earlier of the following: 1,087
(1) The date of the issuance of the staff hearing 1,089
officer's order under division (D) of this section; 1,090
(2) The date of the final administrative or judicial 1,092
determination. 1,093
(J) Upon the final administrative or judicial 1,095
determination UNDER THIS SECTION OR SECTION 4123.512 OF THE 1,096
REVISED CODE OF AN APPEAL OF AN ORDER TO PAY COMPENSATION, if a 1,097
claimant is found to have received compensation PURSUANT to A 1,098
PRIOR ORDER which the claimant was not entitled IS REVERSED UPON 1,099
SUBSEQUENT APPEAL, the claimant's employer, if a self-insuring 1,100
employer, or the bureau, shall withhold from any amount to which 1,102
the claimant becomes entitled pursuant to any claim, past, 1,103
present, or future, under Chapter 4121., 4123., 4127., or 4131. 1,104
of the Revised Code, the amount OF PREVIOUSLY PAID COMPENSATION 1,105
26
to which the claimant was WHICH, DUE TO REVERSAL UPON APPEAL, THE 1,106
CLAIMANT IS not entitled, pursuant to the following criteria: 1,107
(1) No withholding for the first twelve weeks of temporary 1,109
total disability compensation pursuant to section 4123.56 of the 1,110
Revised Code shall be made; 1,111
(2) Forty per cent of all awards of compensation paid 1,113
pursuant to sections 4123.56 and 4123.57 of the Revised Code, 1,114
until the amount overpaid is refunded; 1,115
(3) Twenty-five per cent of any compensation paid pursuant 1,117
to section 4123.58 of the Revised Code until the amount overpaid 1,118
is refunded; 1,119
(4) If, pursuant to an appeal under section 4123.512 of 1,121
the Revised Code, the court of appeals or the supreme court 1,122
reverses the allowance of the claim, then no amount of any 1,123
compensation will be withheld. 1,124
THE ADMINISTRATOR AND SELF-INSURING EMPLOYERS, AS 1,126
APPROPRIATE, ARE SUBJECT TO THE REPAYMENT SCHEDULE OF THIS 1,127
DIVISION ONLY WITH RESPECT TO AN ORDER TO PAY COMPENSATION THAT 1,128
WAS PROPERLY PAID UNDER A PREVIOUS ORDER, BUT WHICH IS
SUBSEQUENTLY REVERSED UPON AN ADMINISTRATIVE OR JUDICIAL APPEAL. 1,129
THE ADMINISTRATOR AND SELF-INSURING EMPLOYERS ARE NOT SUBJECT TO, 1,130
BUT MAY UTILIZE, THE REPAYMENT SCHEDULE OF THIS DIVISION, OR ANY 1,131
OTHER LAWFUL MEANS, TO COLLECT PAYMENT OF COMPENSATION MADE TO A 1,132
PERSON WHO WAS NOT ENTITLED TO THE COMPENSATION DUE TO FRAUD OR 1,133
HUMAN ERROR.
(K) If a staff hearing officer or the commission fails to 1,135
issue a decision or the commission fails to refuse to hear an 1,136
appeal within the time periods required by this section, payments 1,137
to a claimant shall cease until the staff hearing officer or 1,138
commission issues a decision or hears the appeal, unless the 1,139
failure was due to the fault or neglect of the employer or the 1,140
employer agrees that the payments should continue for a longer 1,141
period of time. 1,142
(L) Except as provided in section 4123.522 of the Revised 1,144
27
Code, no appeal is timely filed under this section unless the 1,145
appeal is filed with the time limits set forth in this section. 1,146
(M) No person who is not an employee of the bureau or 1,148
commission or who is not by law given access to the contents of a 1,149
claims file shall have a file in the person's possession. 1,150
Sec. 4123.512. (A) The claimant or the employer may 1,159
appeal an order of the industrial commission made under division 1,160
(E) of section 4123.511 of the Revised Code in any injury or 1,161
occupational disease case, other than a decision as to the extent 1,162
of disability or impairment, or percentage of impairment 1,163
determined pursuant to division (A) of section 4123.57 of the 1,164
Revised Code, to the court of common pleas of the county in which 1,167
the injury was inflicted or in which the contract of employment 1,168
was made if the injury occurred outside the state, or in which 1,169
the contract of employment was made if the exposure occurred 1,170
outside the state. If no common pleas court has jurisdiction for 1,171
the purposes of an appeal by the use of the jurisdictional 1,172
requirements described in this division, the appellant may use 1,173
the venue provisions in the Rules of Civil Procedure to vest 1,174
jurisdiction in a court. If the claim is for an occupational 1,175
disease the appeal shall be to the court of common pleas of the 1,176
county in which the exposure which caused the disease occurred. 1,177
Like appeal may be taken from an order of a staff hearing officer 1,178
made under division (D) of section 4123.511 of the Revised Code 1,179
from which the commission has refused to hear an appeal. The 1,180
appellant shall file the notice of appeal with a court of common 1,181
pleas within sixty days after the date of the receipt of the 1,182
order appealed from or the date of receipt of the order of the 1,183
commission refusing to hear an appeal of a staff hearing 1,184
officer's decision under division (D) of section 4123.511 of the 1,185
Revised Code. The filing of the notice of the appeal with the 1,186
court is the only act required to perfect the appeal.
If an action has been commenced in a court of a county 1,188
other than a court of a county having jurisdiction over the 1,189
28
action, the court, upon notice by any party or upon its own 1,190
motion, shall transfer the action to a court of a county having 1,191
jurisdiction. 1,192
Notwithstanding anything to the contrary in this section, 1,194
if the commission determines under section 4123.522 of the 1,195
Revised Code that an employee, employer, or their respective 1,196
representatives have not received written notice of an order or 1,197
decision which is appealable to a court under this section and 1,198
which grants relief pursuant to section 4123.522 of the Revised 1,199
Code, the party granted the relief has sixty days from receipt of 1,200
the order under section 4123.522 of the Revised Code to file a 1,201
notice of appeal under this section. 1,202
(B) The notice of appeal shall state the names of the 1,204
claimant and the employer, the number of the claim, the date of 1,205
the order appealed from, and the fact that the appellant appeals 1,206
therefrom. 1,207
The administrator, the claimant, and the employer shall be 1,209
parties to the appeal and the court, upon the application of the 1,210
commission, shall make the commission a party. The administrator 1,211
shall notify the employer that, if the employer fails to become 1,214
an active party to the appeal, the administrator may act on 1,215
behalf of the employer and the results of the appeal could have 1,216
an adverse effect upon the employer's premium rates. 1,217
(C) The attorney general or one or more of the attorney 1,219
general's assistants or special counsel designated by the 1,221
attorney general shall represent the administrator and the 1,223
commission. If the attorney general or the attorney general's 1,224
designated assistants or special counsel are absent, the 1,226
administrator or the commission shall select one or more of the 1,227
attorneys in the employ of the administrator or the commission as 1,228
the administrator's attorney or the commission's attorney in the 1,229
appeal. Any attorney so employed shall continue the 1,231
representation during the entire period of the appeal and in all 1,232
hearings thereof except where the continued representation 1,233
29
becomes impractical.
(D) Upon receipt of notice of appeal the clerk of courts 1,235
shall provide notice to all parties who are appellees and to the 1,236
commission. 1,237
The claimant, within thirty days after the filing of the 1,240
notice of appeal, shall file a petition containing a statement of
facts in ordinary and concise language showing a cause of action 1,241
to participate or to continue to participate in the fund and 1,242
setting forth the basis for the jurisdiction of the court over 1,243
the action. Further pleadings shall be had in accordance with 1,244
the Rules of Civil Procedure, provided that service of summons on 1,245
such petition shall not be required. The clerk of the court, 1,246
upon receipt thereof, shall transmit by certified mail a copy 1,248
thereof to each party named in the notice of appeal other than 1,249
the claimant. Any party may file with the clerk prior to the 1,250
trial of the action a deposition of any physician taken in 1,251
accordance with the provisions of the Revised Code, which 1,252
deposition may be read in the trial of the action even though the 1,253
physician is a resident of or subject to service in the county in 1,254
which the trial is had. The bureau of workers' compensation 1,255
shall pay the cost of the STENOGRAPHIC deposition filed in court 1,256
and of copies of the STENOGRAPHIC deposition for each party from 1,258
the surplus fund and charge the costs thereof against the 1,260
unsuccessful party if the claimant's right to participate or 1,261
continue to participate is finally sustained or established in 1,262
the appeal. In the event the deposition is taken and filed, the 1,263
physician whose deposition is taken is not required to respond to 1,264
any subpoena issued in the trial of the action. The court, or 1,265
the jury under the instructions of the court, if a jury is 1,266
demanded, shall determine the right of the claimant to 1,267
participate or to continue to participate in the fund upon the 1,268
evidence adduced at the hearing of the action. 1,269
(E) The court shall certify its decision to the commission 1,271
and the certificate shall be entered in the records of the court. 1,272
30
Appeals from the judgment are governed by the law applicable to 1,273
the appeal of civil actions. 1,274
(F) The cost of any legal proceedings authorized by this 1,276
section, including an attorney's fee to the claimant's attorney 1,277
to be fixed by the trial judge, based upon the effort expended, 1,278
in the event the claimant's right to participate or to continue 1,279
to participate in the fund is established upon the final 1,280
determination of an appeal, shall be taxed against the employer 1,281
or the commission if the commission or the administrator rather 1,282
than the employer contested the right of the claimant to 1,283
participate in the fund. The attorney's fee shall not exceed 1,284
twenty-five hundred dollars. 1,285
(G) If the finding of the court or the verdict of the jury 1,287
is in favor of the claimant's right to participate in the fund, 1,288
the commission and the administrator shall thereafter proceed in 1,289
the matter of the claim as if the judgment were the decision of 1,290
the commission, subject to the power of modification provided by 1,291
section 4123.52 of the Revised Code. 1,292
(H) An appeal from an order issued under division (E) of 1,294
section 4123.511 of the Revised Code or any action filed in court 1,295
in a case in which an award of compensation has been made shall 1,296
not stay the payment of compensation under the award or payment 1,297
of compensation for subsequent periods of total disability or 1,298
impairment during the pendency of the appeal. If, in a final 1,300
administrative or judicial action, it is determined that payments 1,301
of compensation or benefits, or both, made to or on behalf of a 1,302
claimant should not have been made, the amount thereof shall be 1,303
charged to the surplus fund under division (B) of section 4123.34 1,304
of the Revised Code. In the event the employer is a state risk, 1,305
the amount shall not be charged to the employer's experience. In 1,306
the event the employer is a self-insuring employer, the 1,307
self-insuring employer shall deduct the amount from the paid 1,308
compensation he reports to the administrator under division (K) 1,309
of section 4123.35 of the Revised Code. All actions and 1,310
31
proceedings under this section which are the subject of an appeal 1,311
to the court of common pleas or the court of appeals shall be 1,312
preferred over all other civil actions except election causes, 1,313
irrespective of position on the calendar. 1,314
This section applies to all decisions of the commission or 1,316
the administrator on November 2, 1959, and all claims filed 1,317
thereafter are governed by sections 4123.511 and 4123.512 of the 1,318
Revised Code. 1,319
Any action pending in common pleas court or any other court 1,321
on January 1, 1986, under this section is governed by former 1,322
sections 4123.514, 4123.515, 4123.516, and 4123.519 and section 1,323
4123.522 of the Revised Code. 1,324
Sec. 4123.57. (A)(1) Except as provided in division 1,333
(A)(2) of this section, not earlier than forty weeks after the 1,335
date of termination of the latest period of payments under 1,336
section 4123.56 of the Revised Code, or not earlier than forty 1,337
weeks after the date of the injury or the date of first diagnosis 1,338
of an occupational disease by a licensed physician in the absence 1,339
of payments under section 4123.56 of the Revised Code, an 1,340
employee may file an application with the bureau of workers' 1,341
compensation for the determination of the percentage of the 1,343
employee's permanent partial impairment resulting from an injury 1,345
or occupational disease. 1,346
(2) An employee may file the application specified in 1,349
division (A)(1) of this section without waiting forty weeks when 1,351
either of the following occurs:
(a) The receipt of payments under division (A) of section 1,354
4123.56 of the Revised Code is terminated by a hearing officer 1,356
because the employee has reached maximum medical improvement. 1,358
(b) The receipt of benefits under division (A) of section 1,361
4123.56 of the Revised Code is terminated because the employee's 1,362
attending physician certifies that the employee has reached 1,363
maximum medical improvement.
(3) Whenever an application is filed under division (A)(1) 1,366
32
or (2) of this section, the bureau shall send a copy of the 1,367
application to the employee's employer or the employer's 1,368
representative and, except when the option provided in division 1,369
(A)(7) of this section is chosen, shall schedule the employee for 1,370
a medical examination by the bureau medical section. The bureau 1,371
shall send a copy of the report of the medical examination to the 1,372
employee, the employer, and their representatives. The report of 1,373
the medical examination shall contain a statement of the 1,376
examiner's finding on the employee's percentage of permanent 1,377
partial impairment resulting from allowed conditions in the claim 1,378
under the most recent edition of the American medical 1,379
association's guides to the evaluation of permanent impairment. 1,380
After receiving the report of the medical examination, the 1,381
administrator of workers' compensation shall make a tentative 1,382
order finding that the employee's percentage of permanent partial 1,384
impairment is the same percentage shown by the report of the 1,385
medical examination, unless the administrator determines that the 1,386
report clearly is erroneous. If the administrator determines 1,387
that the report clearly is erroneous, the administrator shall
disregard the report, schedule the employee for another 1,389
examination by the bureau medical section, and issue a tentative 1,390
order that finds that the employee's percentage of permanent 1,391
partial impairment is the same percentage shown by the second 1,392
medical examination report. 1,393
(4) The administrator shall notify the employee, the 1,395
employer, and their representatives, in writing, of the tentative 1,396
order and of the parties' right to request a hearing. Within 1,398
fourteen days after receipt of the tentative order, the employee, 1,399
the employer, or their representatives, may file with the bureau 1,400
an objection to the tentative order. The opposing party must be 1,402
served by the filing party with a copy of the objection to the 1,403
tentative order not later than the day of filing. Proper mailing 1,404
of the objection to the tentative order to the opposing party 1,406
constitutes service. If an objection to the tentative order is 1,407
33
not filed by a party by the deadline established by division 1,408
(A)(4) of this section, the order becomes final. 1,409
(5) If the employee, the employer, or their 1,411
representatives timely notify the administrator of an objection 1,412
to the tentative order, either party, within fourteen days after 1,415
the date of filing or of receipt of an objection, whichever is
later, may request another examination by the bureau medical 1,417
section. The party requesting that examination shall pay the 1,418
cost of that examination. Upon that request, the bureau shall 1,419
schedule the employee for another medical examination by the 1,421
bureau medical section. All provisions of division (A)(3) of 1,422
this section applicable to the first medical examination apply to 1,423
a subsequent medical examination requested pursuant to division 1,424
(A)(5) of this section. The bureau shall send a copy of the 1,425
report of the medical examination to the employee, the employer, 1,426
and their representatives.
Upon the filing of an objection to the tentative order or 1,428
upon the completion of the medical examination requested pursuant 1,429
to division (A)(5) of this section, whichever is later, the 1,432
matter shall be referred to a district hearing officer who shall 1,433
set the application for hearing with written notices to all 1,434
interested persons. At the hearing, the district hearing officer 1,435
first shall make a finding as to whether any of the following has 1,436
occurred: 1,437
(a) The bureau medical section based its report, at least 1,440
in part, on conditions not allowed in the claim;
(b) The bureau medical section failed to consider all of 1,443
the allowed conditions in the claim;
(c) The bureau medical section's examiner was prejudiced 1,446
against the employer or the employee;
(d) The bureau medical section failed to properly apply 1,449
the most recent edition of the American medical association's 1,450
guides to the evaluation of permanent impairment in determining 1,451
the employee's percentage of permanent impairment; 1,452
34
(e) The tentative order provides for the payment of 1,454
compensation under a circumstance in which that compensation is 1,455
barred by this section or any other provision of law. 1,456
If the district hearing officer finds one of the situations 1,459
described in division (A)(5)(a), (b), (c) or (d) of this section, 1,461
the district hearing officer shall issue an order rejecting the 1,463
report of the medical examination and requiring the bureau 1,464
medical section to perform a new medical examination. All 1,465
provisions of this division applicable to the first medical 1,466
examination and the determination of the percentage of permanent 1,467
partial impairment apply to any subsequent medical examination 1,468
that is ordered under this division. If the district hearing 1,469
officer finds the situation described in division (A)(5)(e) of 1,470
this section, the district hearing officer shall issue an order 1,471
denying the application. If the district hearing officer finds 1,473
none of the situations described in division (A)(5)(a), (b), (c), 1,474
(d), or (e) of this section, the district hearing officer shall 1,476
issue an order finding that the employee's percentage of 1,477
permanent partial impairment is the same percentage shown by 1,478
either the first or any subsequent bureau medical examination 1,479
report.
(6) An employee may file an application for a subsequent 1,482
determination of the percentage of the employee's permanent 1,483
impairment. No application for subsequent percentage 1,485
determinations on the same claim for injury or occupational
disease shall be accepted unless supported by substantial 1,486
evidence of new and changed circumstances developing since the 1,487
time of the last determination. If an application is filed under 1,489
division (A)(6) of this section, the bureau shall treat the 1,490
application as though it was an original application for the 1,491
determination of the percentage of permanent partial impairment, 1,492
EXCEPT THAT THE BUREAU MAY REQUIRE EITHER A MEDICAL EXAMINATION 1,493
OR A MEDICAL REVIEW OF THE EMPLOYEE. In no instance shall the 1,495
former award be modified unless it is found from medical or 1,496
35
clinical findings that the condition of the employee resulting 1,497
from the injury or occupational disease has so progressed as to 1,499
have increased the percentage of permanent partial impairment. 1,500
All provisions of this division applicable to an original
application apply to an application for subsequent determination. 1,501
The decision of a district hearing officer on an employee's 1,503
application filed under division (A)(1), (2), and (6) of this 1,505
section is final. 1,506
(7) Notwithstanding divisions (A)(3) through (6) of this 1,509
section, the determination of an employee's percentage of 1,510
permanent partial impairment shall be made in accordance with 1,511
division (A)(7) of this section, upon the written agreement by an 1,513
employee and employer to utilize the alternative method of 1,514
determination provided in division (A)(7) of this section. 1,516
Within seven days after receipt of the written agreement, the 1,517
administrator shall assign a physician from the impairment 1,518
evaluation panel within the bureau medical section to conduct a 1,519
medical examination of the employee and send written notice to 1,520
the employee and employer of that assignment. The employee and 1,521
employer each shall select a physician from the impairment 1,522
evaluation panel who shall serve as consultants to the assigned 1,523
physician if the employee or employer objects to the assigned 1,524
physician's determination.
Within twenty-one days after assignment, the assigned 1,526
physician shall conduct a medical examination of the employee and 1,528
provide to the administrator a report of the medical examination 1,529
stating the employee's percentage of permanent partial impairment 1,530
resulting from the allowed conditions in the claim under the most 1,531
recent edition of the American medical association's guides to 1,533
the evaluation of permanent impairment. Immediately upon receipt 1,534
of the report, the administrator shall send a copy of the report 1,535
to the employee and employer.
Within twenty-one days after receipt of the report, an 1,537
employee or employer may send written notice to the administrator 1,539
36
objecting to the report. If a written notice of objection is not 1,540
timely received, the assigned physician's determination of the 1,541
percentage of permanent partial impairment of an employee is 1,542
final, notwithstanding section 4123.511 of the Revised Code. If 1,544
a written notice of objection is timely received, the 1,545
administrator shall provide a copy of the assigned physician's 1,546
report to the consulting physicians selected by the employee and 1,547
employer, within seven days after receipt of the objection. 1,548
Within twenty-one days after receipt of the report, both 1,550
consulting physicians shall confer with the assigned physician 1,551
and jointly, on the basis of the opinion of a majority of the 1,552
physicians, issue a final report stating the employee's 1,553
percentage of permanent partial impairment resulting from the 1,554
allowed conditions in the claim under the most recent edition of 1,555
the American medical association's guides to the evaluation of 1,557
permanent impairment. Within fourteen days after receipt of the 1,558
final report, the administrator shall send a copy of the final 1,559
report to the employee and employer. Notwithstanding section 1,560
4123.511 of the Revised Code, the percentage of permanent partial 1,562
impairment of an employee stated in the final report issued 1,563
pursuant to division (A)(7) of this section is final. 1,565
(8) Compensation payable under division (A) of this 1,568
section accrues and is payable to the employee from the date of 1,569
last payment of compensation, or, in cases where no previous 1,570
compensation has been paid, from the date of the injury or, for 1,571
occupational diseases, the date of disease. The employee shall 1,573
receive sixty-six and two-thirds per cent of the employee's 1,574
average weekly wage, but not more than a maximum of thirty-three 1,575
and one-third per cent of the statewide average weekly wage as 1,576
defined in division (C) of section 4123.62 of the Revised Code, 1,578
per week regardless of the average weekly wage for the number of 1,579
weeks that equals the percentage of two hundred weeks. If the 1,581
percentage of the permanent impairment of the employee equals or 1,582
exceeds ninety per cent, compensation for permanent partial
37
impairment shall be paid for two hundred weeks. No award shall 1,583
be made under division (A) of this section based upon a 1,584
percentage of impairment that, when taken with all other 1,585
percentages of permanent impairment, exceeds one hundred per 1,586
cent. Notwithstanding division (H) of section 4123.511 of the 1,588
Revised Code, the bureau or a self-insuring employer shall pay a 1,590
permanent partial impairment award within twenty-one days after
the date on which an order fixing the employee's percentage of 1,592
permanent partial impairment becomes final. 1,593
As used in this division, "date of disease" means the date 1,596
an occupational disease is first diagnosed by a licensed
physician, or for an occupational disease described in divisions 1,597
(A) through (AA) of section 4123.68 of the Revised Code or other 1,601
occupational disease that results from exposure to 1,602
fibrosis-producing or toxic dusts, fumes, mists, vapors, gases, 1,603
or liquids, or other toxic materials, or a combination of those, 1,604
the date that the employee first misses work as a result of the 1,605
occupational disease. 1,606
(9) When an award under division (A) of this section has 1,610
been made prior to the death of an employee, all unpaid 1,611
installments accrued or to accrue under the provisions of the 1,612
award are payable to the surviving spouse, or if there is no 1,613
surviving spouse, to the dependent children of the employee, and 1,614
if there are no children surviving, then to other dependents as 1,615
the administrator determines. 1,616
(B) In cases included in the following schedule the 1,618
compensation payable per week to the employee is the statewide 1,619
average weekly wage as defined in division (C) of section 4123.62 1,620
of the Revised Code per week and shall continue during the 1,621
periods provided in the following schedule: 1,622
For the loss of a thumb, sixty weeks. 1,624
For the loss of a first finger, commonly called index 1,626
finger, thirty-five weeks. 1,627
For the loss of a second finger, thirty weeks. 1,629
38
For the loss of a third finger, twenty weeks. 1,631
For the loss of a fourth finger, commonly known as the 1,633
little finger, fifteen weeks. 1,634
The loss of a second, or distal, phalange of the thumb is 1,636
considered equal to the loss of one half of such thumb; the loss 1,637
of more than one half of such thumb is considered equal to the 1,638
loss of the whole thumb. 1,639
The loss of the third, or distal, phalange of any finger is 1,641
considered equal to the loss of one-third of the finger. 1,642
The loss of the middle, or second, phalange of any finger 1,644
is considered equal to the loss of two-thirds of the finger. 1,645
The loss of more than the middle and distal phalanges of 1,647
any finger is considered equal to the loss of the whole finger. 1,648
In no case shall the amount received for more than one finger 1,649
exceed the amount provided in this schedule for the loss of a 1,650
hand. 1,651
For the loss of the metacarpal bone (bones of the palm) for 1,653
the corresponding thumb, or fingers, add ten weeks to the number 1,654
of weeks under this division. 1,655
For ankylosis (total stiffness of) or contractures (due to 1,657
scars or injuries) which makes any of the fingers, thumbs, or 1,658
parts of either useless, the same number of weeks apply to the 1,659
members or parts thereof as given for the loss thereof. 1,660
If the claimant has suffered the loss of two or more 1,662
fingers by amputation or ankylosis and the nature of the 1,663
claimant's employment in the course of which the claimant was 1,665
working at the time of the injury or occupational disease is such 1,666
that the handicap or impairment resulting from the loss of 1,667
fingers, or loss of use of fingers, exceeds the normal handicap 1,669
or impairment resulting from the loss of fingers, or loss of use 1,671
of fingers, the administrator may take that fact into 1,672
consideration and increase the award of compensation accordingly, 1,673
but the award made shall not exceed the amount of compensation 1,674
for loss of a hand. 1,675
39
For the loss of a hand, one hundred seventy-five weeks. 1,677
For the loss of an arm, two hundred twenty-five weeks. 1,679
For the loss of a great toe, thirty weeks. 1,681
For the loss of one of the toes other than the great toe, 1,683
ten weeks. 1,684
The loss of more than two-thirds of any toe is considered 1,686
equal to the loss of the whole toe. 1,687
The loss of less than two-thirds of any toe is considered 1,689
no loss, except as to the great toe; the loss of the great toe up 1,690
to the interphalangeal joint is co-equal to the loss of one-half 1,691
of the great toe; the loss of the great toe beyond the 1,692
interphalangeal joint is considered equal to the loss of the 1,693
whole great toe. 1,694
For the loss of a foot, one hundred fifty weeks. 1,696
For the loss of a leg, two hundred weeks. 1,698
For the loss of the sight of an eye, one hundred 1,700
twenty-five weeks. 1,701
For the permanent partial loss of sight of an eye, the 1,703
portion of one hundred twenty-five weeks as the administrator in 1,704
each case determines, based upon the percentage of vision 1,705
actually lost as a result of the injury or occupational disease, 1,706
but, in no case shall an award of compensation be made for less 1,707
than twenty-five per cent loss of uncorrected vision. "Loss of 1,708
uncorrected vision" means the percentage of vision actually lost 1,709
as the result of the injury or occupational disease. 1,710
For the permanent and total loss of hearing of one ear, 1,712
twenty-five weeks; but in no case shall an award of compensation 1,713
be made for less than permanent and total loss of hearing of one 1,714
ear. 1,715
For the permanent and total loss of hearing, one hundred 1,717
twenty-five weeks; but, except pursuant to the next preceding 1,718
paragraph, in no case shall an award of compensation be made for 1,719
less than permanent and total loss of hearing. 1,720
In case an injury or occupational disease results in 1,722
40
serious facial or head disfigurement which either impairs or may 1,723
in the future impair the opportunities to secure or retain 1,724
employment, the administrator shall make an award of compensation 1,725
as the administrator deems proper and equitable, in view of the 1,727
nature of the disfigurement, and not to exceed the sum of five 1,728
thousand dollars. For the purpose of making the award, it is not 1,729
material whether the employee is gainfully employed in any 1,730
occupation or trade at the time of the administrator's 1,731
determination.
When an award under this division has been made prior to 1,733
the death of an employee all unpaid installments accrued or to 1,734
accrue under the provisions of the award shall be payable to the 1,735
surviving spouse, or if there is no surviving spouse, to the 1,736
dependent children of the employee and if there are no such 1,737
children, then to such dependents as the administrator 1,738
determines. 1,739
When an employee has sustained the loss of a member by 1,741
severance, but no award has been made on account thereof prior to 1,742
the employee's death, the administrator shall make an award in 1,744
accordance with this division for the loss which shall be payable 1,745
to the surviving spouse, or if there is no surviving spouse, to 1,746
the dependent children of the employee and if there are no such 1,747
children, then to such dependents as the administrator 1,748
determines. 1,749
(C) Compensation for partial impairment under divisions 1,752
(A) and (B) of this section is in addition to the compensation 1,753
paid the employee pursuant to section 4123.56 of the Revised 1,754
Code. A claimant may receive compensation under divisions (A) 1,755
and (B) of this section. No employee may receive compensation 1,757
under division (A) of this section or receive a medical 1,758
examination provided for by this section during the time in which 1,759
that employee is receiving compensation under section 4123.58 of 1,761
the Revised Code in any claim or is receiving compensation under 1,763
section 4123.56 of the Revised Code on the same claim in which 1,764
41
the employee is seeking compensation under this section. The 1,765
employee shall list on the application specified in divisions 1,766
(A)(1) and (2) of this section the claim numbers of all other 1,767
claims for which the employee is a claimant. 1,768
In all cases arising under division (B) of this section, if 1,770
it is determined by any one of the following: (1) the amputee 1,771
clinic at University hospital, Ohio state university; (2) the 1,772
rehabilitation services commission; (3) an amputee clinic or 1,773
prescribing physician approved by the administrator or the 1,774
administrator's designee, that an injured or impaired employee is 1,776
in need of an artificial appliance, or in need of a repair 1,778
thereof, regardless of whether the appliance or its repair will 1,779
be serviceable in the vocational rehabilitation of the injured 1,780
employee, and regardless of whether the employee has returned to 1,781
or can ever again return to any gainful employment, the bureau 1,782
shall pay the cost of the artificial appliance or its repair out 1,783
of the surplus created by division (B) of section 4123.34 of the 1,784
Revised Code.
In those cases where a rehabilitation services commission 1,786
recommendation that an injured or impaired employee is in need of 1,788
an artificial appliance would conflict with their state plan, 1,789
adopted pursuant to the "Rehabilitation Act of 1973," 87 Stat. 1,790
355, 29 U.S.C.A. 701, the administrator or the administrator's 1,792
designee or the bureau may obtain a recommendation from an 1,793
amputee clinic or prescribing physician that they determine 1,794
appropriate.
(D) If an employee makes application for a finding and is 1,797
found to have contracted silicosis as defined in division (X), or 1,798
coal miners' pneumoconiosis as defined in division (Y), or 1,799
asbestosis as defined in division (AA) of section 4123.68 of the 1,800
Revised Code, and it is found that a change of such employee's 1,801
occupation is medically advisable in order to decrease 1,803
substantially further exposure to silica dust, asbestos, or coal 1,804
dust and if the employee, after the finding, has changed or shall 1,805
42
change the employee's occupation to an occupation in which the 1,807
exposure to silica dust, asbestos, or coal dust is substantially 1,808
decreased, the employee shall receive an amount equal to fifty 1,809
per cent of the statewide average weekly wage per week for a 1,811
period of thirty weeks, commencing as of the date of the 1,812
discontinuance or change, and for a period of one hundred weeks 1,813
immediately following the expiration of the period of thirty 1,814
weeks, the employee shall receive sixty-six and two-thirds per 1,816
cent of the loss of wages resulting directly and solely from the 1,817
change of occupation but not to exceed a maximum of an amount 1,818
equal to fifty per cent of the statewide average weekly wage per 1,819
week. No such employee is entitled to receive more than one 1,820
allowance on account of discontinuance of employment or change of 1,821
occupation and benefits shall cease for any period during which 1,822
the employee is employed in an occupation in which the exposure 1,823
to silica dust, asbestos, or coal dust is not substantially less 1,824
than the exposure in the occupation in which the employee was 1,825
formerly employed or for any period during which the employee may 1,827
be entitled to receive compensation or benefits under section 1,828
4123.68 of the Revised Code on account of disability from 1,829
silicosis, asbestosis, or coal miners' pneumoconiosis. An award 1,830
for change of occupation for a coal miner who has contracted coal 1,831
miners' pneumoconiosis may be granted under this division even 1,832
though the coal miner continues employment with the same 1,834
employer, so long as the coal miner's employment subsequent to 1,836
the change is such that the coal miner's exposure to coal dust is 1,838
substantially decreased and a change of occupation is certified 1,839
by the claimant as permanent. Medical and other benefits shall 1,840
be paid to the employee in accordance with section 4123.66 of the 1,842
Revised Code.
(E) If a firefighter or police officer makes application 1,845
for a finding and the administrator finds that the firefighter or 1,846
police officer has contracted a cardiovascular and pulmonary 1,848
disease as defined in division (W) of section 4123.68 of the 1,849
43
Revised Code, and that a change of the firefighter's or police 1,850
officer's occupation is medically advisable in order to decrease 1,852
substantially further exposure to smoke, toxic gases, chemical 1,853
fumes, and other toxic vapors, and if the firefighter, or police 1,854
officer, after the finding, has changed or changes occupation to 1,856
an occupation in which the exposure to smoke, toxic gases, 1,857
chemical fumes, and other toxic vapors is substantially 1,858
decreased, the administrator shall allow to the firefighter or 1,859
police officer an amount equal to fifty per cent of the statewide 1,861
average weekly wage per week for a period of thirty weeks, 1,862
commencing as of the date of the discontinuance or change, and 1,863
for a period of seventy-five weeks immediately following the 1,864
expiration of the period of thirty weeks the administrator shall 1,865
allow the firefighter or police officer sixty-six and two-thirds 1,867
per cent of the loss of wages resulting directly and solely from 1,868
the change of occupation but not to exceed a maximum of an amount 1,869
equal to fifty per cent of the statewide average weekly wage per 1,870
week. No such firefighter or police officer is entitled to 1,872
receive more than one allowance on account of discontinuance of 1,873
employment or change of occupation and benefits shall cease for 1,874
any period during which the firefighter or police officer is 1,875
employed in an occupation in which the exposure to smoke, toxic 1,877
gases, chemical fumes, and other toxic vapors is not 1,878
substantially less than the exposure in the occupation in which 1,879
the firefighter or police officer was formerly employed or for 1,880
any period during which the firefighter or police officer may be 1,882
entitled to receive compensation or benefits under section 1,883
4123.68 of the Revised Code on account of disability from a 1,884
cardiovascular and pulmonary disease. The administrator may 1,885
accord to the firefighter or police officer medical and other 1,887
benefits in accordance with section 4123.66 of the Revised Code. 1,888
(F) An order issued under division (B), (D), or (E) of 1,891
this section is appealable pursuant to section 4123.511 of the 1,892
Revised Code but is not appealable to court under section 1,893
44
4123.512 of the Revised Code.
Section 2. That existing sections 121.03, 2317.45, 1,895
4121.12, 4121.121, 4121.125, 4123.511, 4123.512, and 4123.57 of 1,896
the Revised Code are hereby repealed. 1,897
Section 3. The Administrator of Workers' Compensation 1,899
shall submit a series of reports to the Workers' Compensation 1,900
Oversight Commission, the Office of Budget and Management, the 1,901
Legislative Budget Office of the Legislative Service Commission, 1,902
and the General Assembly semiannually during the 1997-1999 1,904
biennium, beginning on or before October 1, 1997, containing
information relative to all of the following: 1,906
(A) The premium cost per worker, which reports the average 1,908
annual cost a state fund employer pays to provide workers' 1,909
compensation coverage for its employees. The premium cost per 1,910
worker is calculated by adding together an employer's total 1,911
amounts of premiums and assessments paid during a calendar year 1,912
and dividing that sum by the employer's average number of 1,913
workers. 1,914
(B) The claims cost per worker, which reports the average 1,916
annual benefit cost paid for each worker who is employed by a 1,917
state fund employer during the preceding twelve months. The 1,918
claims cost per worker is calculated by dividing an employer's 1,919
total claim expenses paid during the preceding twelve months by 1,920
the employer's average number of workers. 1,921
(C) The administrative cost per claim, which reports the 1,923
average annual administrative expense a state fund employer pays 1,924
to process a claim. The administrative cost per claim is 1,925
calculated by dividing an employer's total amount of 1,926
administrative expenses incurred during the preceding twelve 1,927
months by the total number of claims the employer processed. 1,928
(D) The direct loss ratio, which measures the relationship 1,930
between an employer's revenues and workers' compensation benefits 1,932
paid to an injured worker during the preceding twelve months; 1,933
(E) The rate of return generated by investments of the 1,935
45
Bureau of Workers' Compensation; 1,936
(F) The customer service index, which accounts for various 1,938
statistical measures reflecting the Bureau's customer service 1,939
levels; 1,940
(G) The Health Partnership Program performance index, 1,942
which measures the effectiveness of managed care organizations 1,943
working for the Bureau and reflects the quality of care, customer 1,944
satisfaction, and cost of care provided by the managed care 1,945
organizations; 1,946
(H) The rate of injury in the state per 1,000 workers; 1,948
(I) The average number of days the Bureau takes to 1,950
adjudicate an injured worker's medical bill fee; 1,951
(J) The return-to-work rate of state fund employers' 1,953
injured workers who do not receive workers' compensation benefits 1,954
for at least ninety days following their injury, which reports 1,955
the number of injured workers who returned to work as a 1,956
percentage of total injuries; 1,957
(K) The average number of days it takes for an employer or 1,959
injured worker to report an injury to the Bureau, which is 1,960
calculated by taking the average number of days between the date 1,961
of injury and the date the claim was filed with the Bureau; 1,962
(L) The percentage of indemnity claims adjudicated by the 1,964
Bureau within fourteen days of the injury. 1,965
Section 4. All items in this section are hereby 1,967
appropriated out of any moneys in the state treasury to the 1,968
credit of the designated fund. For all appropriations made in 1,969
this act, those in the first column are for fiscal year 1998, and 1,970
those in the second column are for fiscal year 1999.
BWC BUREAU OF WORKERS' COMPENSATION 1,971
FND ALI ALI TITLE FY 1998 FY 1999 1,974
Workers' Compensation Fund Group 1,976
023 855-401 William Green Lease 1,979
Payments to OBA $ 14,665,000 $ 15,465,000 1,981
4Y6 855-611 J.L. Camera Center 1,983
46
Rent $ 1,592,800 $ 1,681,997 1,985
4Y6 855-612 J.L. Camera Center 1,987
Operating $ 7,381,302 $ 7,345,026 1,989
023 855-407 Claims, Risk & 1,991
Medical Management $ 129,400,786 $ 123,784,337 1,993
023 855-408 Fraud Prevention $ 8,200,705 $ 8,111,383 1,997
023 855-409 Administrative 1,999
Services $ 111,629,196 $ 114,654,976 2,001
023 855-410 Attorney General 2,003
Payments $ 3,017,914 $ 3,227,422 2,005
825 855-605 DWRF $ 635,629 $ 651,961 2,009
822 855-606 Coal Workers' Fund $ 73,684 $ 75,545 2,013
823 855-608 Marine Industry $ 42,536 $ 43,599 2,017
826 855-609 Safety & Hygiene $ 17,981,552 $ 17,991,764 2,021
TOTAL WCF Workers' Compensation 2,022
Fund Group $ 294,621,104 $ 293,033,010 2,025
TOTAL ALL BUDGET FUND GROUPS $ 294,621,104 $ 293,033,010 2,028
Safety and Hygiene 2,031
Notwithstanding section 4121.37 of the Revised Code, the 2,033
Administrator of the Bureau of Workers' Compensation shall 2,034
transfer moneys from the State Insurance Fund so that 2,035
appropriation line item 855-609, Safety and Hygiene, is provided
$17,981,552 in fiscal year 1998 and $17,991,764 in fiscal year 2,036
1999.
Workers' Compensation Fraud Unit 2,038
The Workers' Compensation Section Fund (Fund 195) shall 2,040
receive payments from the Bureau of Workers' Compensation at the 2,041
beginning of each quarter of each fiscal year to fund expenses of 2,042
the Workers' Compensation Fraud Unit of the Attorney General's 2,043
Office. Of the foregoing appropriation item 855-410, Attorney 2,044
General Payments, $659,151 in fiscal year 1998 and $676,002 in
fiscal year 1999 shall be used to provide such payments. 2,045
William Green Lease Payments 2,047
The foregoing appropriation item 855-401, William Green 2,049
47
Lease Payments to OBA, shall be used for lease payments to the 2,050
Ohio Building Authority, and these appropriations shall be used 2,051
to meet all payments at the times they are required to be made 2,052
during the period from July 1, 1997, to June 30, 1999, by the 2,053
Bureau of Workers' Compensation to the Ohio Building Authority
pursuant to leases and agreements made under Chapter 152. of the 2,054
Revised Code and Section 6 of Am. Sub. H.B. 743 of the 118th 2,055
General Assembly. Of the amounts received in Fund 023, 2,056
appropriation line item 855-401, up to $30,130,000 shall be
restricted for lease rental payments to the Ohio Building 2,057
Authority. If it is determined that additional appropriations 2,058
are necessary for such purpose, such amounts are hereby 2,059
appropriated.
Notwithstanding any other provision of law to the contrary, 2,061
all tenants of the William Green Building not funded by the 2,062
Workers' Compensation Fund (Fund 023) shall pay their fair share 2,063
of the costs of lease payments to the Workers' Compensation Fund 2,064
(Fund 023) by intrastate transfer voucher.
Camera Center 2,066
The Camera Center Fund (Fund 4Y6) created in division (F) 2,068
of section 4121.62 of the Revised Code shall receive revenues 2,069
raised by the fees Camera Center charges for its services and 2,070
rent paid by tenants of the Center's facilities. The foregoing 2,071
appropriation item 855-611, J.L. Camera Center Rent, shall be
used to pay rent, including building operating expenses, of the 2,072
J. Leonard Camera Rehabilitation Center in Columbus. The 2,073
foregoing appropriation item 855-612, J.L. Camera Center 2,074
Operating, shall be used for all other expenses for the Center. 2,075
The Bureau of Workers' Compensation shall not consider 2,077
appropriations made to the Camera Center Fund (Fund 4Y6) when 2,078
establishing administrative cost rates.
Balances 2,080
Notwithstanding any provision of law to the contrary, the 2,082
Director of Budget and Management shall make any transfers of 2,083
48
cash balances between funds made necessary by the creation of new 2,084
funds, or the consolidation of funds as authorized by the General 2,085
Assembly. Within the first five days after the effective date of 2,086
this section, the administering agency head shall certify to the 2,087
Director an estimate of the amount of the cash balance to be
transferred to the receiving fund. The Director may transfer the 2,088
estimated amount when needed to make payments. Within thirty 2,089
days after the effective date of this section, the administering 2,090
agency head shall certify the final amount to the Director. The 2,091
Director shall transfer the difference between any estimated
amount previously transferred and such certified final amount. 2,092
To implement such funding changes as described above 2,094
pertaining to prior year encumbrance balances and commensurate 2,095
appropriation authority, in fiscal year 1998 the Director of 2,096
Budget and Management may cancel encumbrances outstanding on June 2,097
30, 1997, and reestablish such prior year encumbrances or parts 2,098
of encumbrances as needed in fiscal year 1998 in the appropriate
fund or appropriation line item as authorized in this act for the 2,099
same purpose and to the same vendor. As determined by the 2,100
Director, the appropriation authority necessary to reestablish 2,101
such prior year encumbrances in fiscal year 1998 in a different 2,102
fund or appropriation line item within an agency or between
agencies is hereby authorized. The Director shall reduce each 2,103
prior year's appropriation authority by the amount of the 2,104
encumbrances canceled in their respective funds and appropriation 2,105
line items.
Vocational Rehabilitation 2,107
The Bureau of Workers' Compensation and the Rehabilitation 2,109
Services Commission shall enter into an interagency agreement for 2,110
the provision of vocational rehabilitation services and staff to 2,111
mutually eligible clients. The Bureau shall provide $519,608 in 2,112
fiscal year 1998 and $534,157 in fiscal year 1999 from the State 2,113
Insurance Fund to fund vocational rehabilitation services and 2,114
staff in accordance with the interagency agreement. 2,115
49
Fund Balance 2,117
Any unencumbered cash balance in excess of $45,000,000 in 2,119
the Workers' Compensation Fund (Fund 023) on the thirtieth day of 2,120
June of each fiscal year shall be used to reduce the 2,121
administrative cost rate charged to employers to cover 2,122
appropriations for Bureau of Workers' Compensation and Industrial 2,123
Commission operations. 2,124
Section 5. Accounting 2,126
Within the limits set forth in this act, the Director of 2,129
Budget and Management shall establish accounts indicating the 2,130
source and amount of funds for each appropriation made in this
act, and shall determine the form and manner in which 2,131
appropriation accounts shall be maintained. 2,132
The appropriations made in this act are subject to all 2,134
provisions of the main operating appropriations act of the 122nd 2,135
General Assembly that are generally applicable to such 2,136
appropriations.
Section 6. Reissuance of Voided Warrants 2,138
In order to provide funds for the reissuance of voided 2,140
warrants pursuant to section 117.47 of the Revised Code, there is 2,141
hereby appropriated, out of moneys in the state treasury from the 2,142
fund credited as provided in section 117.47 of the Revised Code, 2,143
that amount sufficient to pay such warrants when approved by the 2,144
Office of Budget and Management. 2,145
Section 7. Judgments Against State 2,147
Any appropriations contained in this act, except those to 2,149
be applied to or used for payment of guarantees by or on behalf 2,150
of the state or for debt service on bonds, notes, or certificates 2,151
of participation, may be used pursuant to section 2743.15, 2,152
2743.19, or 2743.191 of the Revised Code for the purpose of 2,153
satisfying judgments, settlements, or administrative awards 2,154
ordered or approved by the Court of Claims in connection with 2,155
civil actions against the state. 2,156
Section 8. Reappropriation of Unexpended Balances 2,158
50
Notwithstanding section 131.33 of the Revised Code, 2,160
unexpended balances of appropriations and reappropriations 2,161
against which encumbrances have been lawfully incurred by a state 2,162
agency are, at the close of fiscal year 1997, to the extent of 2,163
such encumbrances, hereby reappropriated from the funds from 2,164
which they were originally appropriated and reappropriated and, 2,165
except for encumbrances for items of special order manufacture 2,166
not available on term contract or open market, made available for 2,167
the purpose of discharging such encumbrances for a period of five 2,168
months from the end of the fiscal year. Unexpended balances of 2,169
appropriations and reappropriations against which encumbrances 2,170
for items of special order manufacture not available on term 2,171
contract or in the open market have been lawfully incurred are, 2,172
at the close of the fiscal year, to the extent of such 2,173
encumbrances, hereby reappropriated and made available for the
purpose of discharging such encumbrances for a period of five 2,174
months from the end of the fiscal year or, if the Director of 2,175
Budget and Management approves, for a period of not more than 2,176
twelve months from the end of the fiscal year. 2,177
Any items for which unexpended balances are reappropriated 2,179
beyond a five-month period from the end of the fiscal year shall 2,180
be reported to the Controlling Board by the Director of Budget 2,181
and Management. The report on each such item shall include the 2,182
item, the cost of the item, the vendor involved, and the delivery 2,183
date. Such reports to the board shall be updated on a quarterly 2,184
basis while the encumbrance remains open. 2,185
After any such period, reappropriations made for the 2,187
purpose of discharging encumbrances for operating expenses, 2,188
defined as those encumbrances incurred for personal services, 2,189
maintenance, and equipment, are canceled. Reappropriations for 2,190
encumbrances other than operating expenses or items of special 2,191
manufacture not available on term contract or in the open market 2,192
may be extended by obtaining the approval of the Director of 2,193
Budget and Management.
51
Section 9. The administrator of the Bureau of Workers' 2,195
Compensation shall conduct a cost analysis study of all doctors 2,196
under contract or subcontract to the Bureau of Workers' 2,197
Compensation during the 1995-1997 biennium. The cost analysis 2,198
study excludes those doctors involved with the Health Partnership
Program and excludes those doctors with the Qualified Health 2,199
Plan. The administrator shall report the findings of this study 2,200
to the Speaker of the House of Representatives, the Minority 2,201
Leader of the House of Representatives, the President of the 2,202
Senate, and the Minority Leader of the Senate by July 1, 1998. 2,203
Section 10. If any item of law that constitutes the whole 2,205
or part of a codified or uncodified section of law contained in 2,206
this act, or if any application of any item of law that 2,207
constitutes the whole or part of a codified or uncodified section 2,209
of law contained in this act, is held invalid, the invalidity 2,210
does not affect other items of law or applications of items of 2,211
law that can be given effect without the invalid item of law or 2,212
application. To this end, the items of law of which the codified 2,213
and uncodified sections contained in this act are composed, and 2,214
their applications, are independent and severable.
Section 11. Except as otherwise specifically provided in 2,216
this act, the codified and uncodified sections of law contained 2,217
in this act, and the items of law of which the codified and 2,218
uncodified sections of law contained in this act are composed, 2,219
are not subject to the referendum. Therefore, under Ohio 2,220
Constitution, Article II, Section 1d and section 1.471 of the 2,221
Revised Code, the codified and uncodified sections of law 2,222
contained in this act, and the items of law of which the codified 2,224
and uncodified sections of law contained in this act are 2,225
composed, except as otherwise specifically provided in this act, 2,226
go into immediate effect when this act becomes law.
Section 12. Sections 121.03, 2317.45, 4121.12, 4121.121, 2,228
4121.125, 4123.511, and 4123.512 of the Revised Code, as amended 2,229
or enacted by this act, and Section 13 of this act; and the items 2,230
52
of law of which such sections, as amended or enacted by this act, 2,231
are composed, are subject to the referendum. Therefore, under 2,232
Ohio Constitution, Article II, Section 1c and section 1.471 of 2,233
the Revised Code, such sections as amended or enacted by this 2,234
act, and the items of law of which such sections as amended or 2,235
enacted by this act are composed, take effect on the ninety-first 2,237
day after this act is filed with the Secretary of State. If, 2,238
however, a referendum petition is filed against any such section 2,239
as amended or enacted by this act, or against any item of law of 2,240
which any such section as amended or enacted by this act is 2,241
composed, the section as amended or enacted, or item of law, 2,242
unless rejected at the referendum, takes effect at the earliest 2,243
time permitted by law.
Section 13. Sections 4121.121, 4123.511, 4123.512, and 2,246
4123.57 of the Revised Code are amended by this act and also by 2,248
Am. Sub. S.B. 45 of the 122nd General Assembly, effective July 2,249
22, 1997. The amendments of Am. Sub. S.B. 45 are included in 2,250
this act to confirm the intention to retain them, but are not 2,251
intended to be effective until July 22, 1997. 2,252
Section 14. Section 121.03 of the Revised Code is 2,254
presented in this act as a composite of the section as amended by 2,255
both Am. Sub. H.B. 7 and Am. Sub. S.B. 162 of the 121st General 2,256
Assembly, with the new language of neither of the acts shown in 2,258
capital letters. This is in recognition of the principle stated 2,259
in division (B) of section 1.52 of the Revised Code that such 2,260
amendments are to be harmonized where not substantively 2,261
irreconcilable and constitutes a legislative finding that such is 2,262
the resulting version in effect prior to the effective date of 2,263
this act.