As Introduced 1
122nd General Assembly 4
Regular Session S. B. No. 45 5
1997-1998 6
SENATORS CUPP-GILLMOR-SUHADOLNIK-NEIN-LATTA-WHITE 8
10
A B I L L
To amend sections 2913.48, 4121.32, 4121,34, 12
4121.35, 4121.36, 4121.38, 4121.47, 4121.65, 14
4121.67, 4123.01, 4123.032, 4123.033, 4123.07, 15
4123.25, 4123.27, 4123.28, 4123.343, 4123.35,
4123.352, 4123.411, 4123.412, 4123.413, 4123.414, 16
4123.416, 4123.419, 4123.511, 4123.512, 4123.52, 17
4123.54, 4123.541, 4123.55, 4123.56, 4123.57, 18
4123.58, 4123.59, 4123.60, 4123.61, 4123.62,
4123.64, 4123.65, 4123.651, 4123.66, 4123.68, 19
4123.70, 4123.80, 4123.82, 4123.84, 4123.85, 20
4123.90, 4127.03, 4127.06, and 4141.31 and to 21
enact sections 4121.444, 4123.061, 4123.15,
4123.531, and 4123.86 of the Revised Code to make 23
various changes in the structure, payment, and
determination of benefits, to reduce the number 24
of weeks an employee can receive nonworking wage 26
loss, to permit an employer to have an employee
excepted from the Workers' Compensation Laws for 28
religious reasons, to change the duration of the
continuing jurisdiction of the Industrial 29
Commission to three years, to require hearing
officers to report suspected fraudulent activity, 30
to limit recovery for aggravation of a 31
preexisting condition, to change the definition
of occupational disease, to permit certain 32
nonattorneys to represent parties in hearings 33
before the Industrial Commission, to create the
presumption concerning alcohol or a controlled 35
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substance as the cause of an employee's injury,
to except buildings and land used for 36
agricultural production from safety rules that
apply to workshops and factories, to provide 38
criminal penalties for employers who
intentionally misclassify their employees for 39
workers' compensation purposes, to prohibit
kickbacks from health care providers under the 40
Workers' Compensation Law, to prohibit health
care providers from receiving payments for false 41
claims under the Workers' Compensation Law, to 42
provide that records kept by the Division of 43
Safety and Hygiene are confidential, to specify 44
that records produced by an attorney in
connection with a workers' compensation claim are 45
the property of the claimant, and to make other
changes in the Workers' Compensation Law. 46
BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF OHIO: 48
Section 1. That sections 2913.48, 4121.32, 4121.34, 50
4121.35, 4121.36, 4121.38, 4121.47, 4121.65, 4121.67, 4123.01, 52
4123.032, 4123.033, 4123.07, 4123.25, 4123.27, 4123.28, 4123.343, 53
4123.35, 4123.352, 4123.411, 4123.412, 4123.413, 4123.414, 54
4123.416, 4123.419, 4123.511, 4123.512, 4123.52, 4123.54, 55
4123.541, 4123.55, 4123.56, 4123.57, 4123.58, 4123.59, 4123.60, 56
4123.61, 4123.62, 4123.64, 4123.65, 4123.651, 4123.66, 4123.68, 57
4123.70, 4123.80, 4123.82, 4123.84, 4123.85, 4123.90, 4127.03, 58
4127.06, and 4141.31 be amended and sections 4121.444, 4123.061, 59
4123.15, 4123.531, and 4123.86 of the Revised Code be enacted to 60
read as follows: 61
Sec. 2913.48. (A) No person, with purpose to defraud or 70
knowing that the person is facilitating a fraud, shall do any of 71
the following: 72
(1) Receive workers' compensation benefits to which the 74
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person is not entitled; 75
(2) Make or present or cause to be made or presented a 77
false or misleading statement with the purpose to secure payment 78
for goods or services rendered under Chapter 4121., 4123., 4127., 79
or 4131. of the Revised Code or to secure workers' compensation 80
benefits; 81
(3) Alter, falsify, destroy, conceal, or remove any record 83
or document that is necessary to fully establish the validity of 84
any claim filed with, or necessary to establish the nature and 85
validity of all goods and services for which reimbursement or 86
payment was received or is requested from, the bureau of workers' 87
compensation, or a self-insuring employer under Chapter 4121., 88
4123., 4127., or 4131. of the Revised Code; 89
(4) Enter into an agreement or conspiracy to defraud the 91
bureau or a self-insuring employer by making or presenting or 92
causing to be made or presented a false claim for workers' 93
compensation benefits; 94
(5) MAKE OR PRESENT OR CAUSE TO BE MADE OR PRESENTED A 96
FALSE OR MISLEADING STATEMENT OR OTHER MISREPRESENTATION 97
CONCERNING MANUAL CODES, CLASSIFICATION OF EMPLOYEES, PAYROLL, OR 98
NUMBER OF PERSONNEL, WHEN INFORMATION OF THAT NATURE IS NECESSARY 99
TO DETERMINE THE ACTUAL WORKERS' COMPENSATION PREMIUM OR 100
ASSESSMENT OWED TO THE BUREAU BY AN EMPLOYER; 101
(6) SOLICIT, OFFER, OR RECEIVE ANY REMUNERATION IN CASH OR 103
IN KIND, INCLUDING, BUT NOT LIMITED TO, A KICKBACK OR REBATE, IN 104
CONNECTION WITH A REFERRAL FOR THE FURNISHING OF GOODS OR 105
SERVICES FOR WHICH REIMBURSEMENT MAY BE MADE PURSUANT TO CHAPTER 106
4121., 4123., 4127., OR 4131. OF THE REVISED CODE. DIVISION 107
(A)(6) OF THIS SECTION DOES NOT APPLY TO ANY CONTRACT TO PROVIDE 108
SERVICES UNDER THE BUREAU'S HEALTH CARE PARTNERSHIP PROGRAM 109
ENTERED INTO BETWEEN A MANAGED CARE ORGANIZATION AND AN
ORGANIZATION FORMED PURSUANT TO DIVISION (A)(4) OF SECTION 110
4123.29 OF THE REVISED CODE. 111
(7) ALTER A WORKERS' COMPENSATION CERTIFICATE TO FALSELY 113
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SHOW CURRENT OR CORRECT WORKERS' COMPENSATION COVERAGE; 114
(8) KNOWINGLY FAIL TO SECURE OR MAINTAIN WORKERS' 116
COMPENSATION COVERAGE AS REQUIRED BY CHAPTER 4123. OF THE REVISED 117
CODE.
(B) Whoever violates this section is guilty of workers' 119
compensation fraud. Except as otherwise provided in this 121
division, a violation of this section is a misdemeanor of the 122
first degree. If the value of the PREMIUMS AND ASSESSMENTS 124
UNPAID PURSUANT TO ACTIONS DESCRIBED IN DIVISION (A)(5) OR (8) OF 125
THIS SECTION, OR OF goods, services, property, or money stolen is 128
five hundred dollars or more and is less than five thousand 129
dollars, a violation of this section is a felony of the fifth 130
degree. If the value of the PREMIUMS AND ASSESSMENTS UNPAID 132
PURSUANT TO ACTIONS DESCRIBED IN DIVISION (A)(5) OR (8) OF THIS 133
SECTION, OR OF goods, services, property, or money stolen is five 135
thousand dollars or more and is less than one hundred thousand 136
dollars, a violation of this section is a felony of the fourth 137
degree. If the value of the PREMIUMS AND ASSESSMENTS UNPAID 139
PURSUANT TO ACTIONS DESCRIBED IN DIVISION (A)(5) OR (8) OF THIS 140
SECTION, OR OF goods, services, property, or money stolen is one 142
hundred thousand dollars or more, a violation of this section is 143
a felony of the third degree. WHOEVER VIOLATES DIVISION (A)(7) 144
OF THIS SECTION IS GUILTY OF A FELONY OF THE FIFTH DEGREE. 145
(C) Upon application of the governmental body that 147
conducted the investigation and prosecution of a violation of 148
this section, the court shall order the person who is convicted 149
of the violation to pay the governmental body its costs of 150
investigating and prosecuting the case. These costs are in 151
addition to any other costs or penalty provided in the Revised 152
Code or any other section of law. 153
(D) The remedies and penalties provided in this section 155
are not exclusive remedies and penalties and do not preclude the 156
use of any other criminal or civil remedy or penalty for any act 157
that is in violation of this section. 158
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(E) As used in this section: 160
(1) "False" means wholly or partially untrue or deceptive. 162
(2) "Goods" includes, but is not limited to, medical 164
supplies, appliances, rehabilitative equipment, and any other 165
apparatus or furnishing provided or used in the care, treatment, 166
or rehabilitation of a claimant for workers' compensation 167
benefits. 168
(3) "Services" includes, but is not limited to, any 170
service provided by any health care provider to a claimant for 171
workers' compensation benefits AND ANY AND ALL SERVICES PROVIDED 172
BY THE BUREAU AS PART OF WORKERS' COMPENSATION INSURANCE 174
COVERAGE.
(4) "Claim" means any attempt to cause the bureau, an 176
independent third party with whom the administrator or an 177
employer contracts under section 4121.44 of the Revised Code, or 178
a self-insuring employer to make payment or reimbursement for 179
workers' compensation benefits. 180
(5) "Employment" means participating in any trade, 182
occupation, business, service, or profession for substantial 183
gainful remuneration. 184
(6) "Employer," "employee," and "self-insuring employer" 186
have the same meanings as in section 4123.01 of the Revised Code. 187
(7) "Remuneration" includes, but is not limited to, wages, 189
commissions, rebates, and any other reward or consideration. 190
(8) "Statement" includes, but is not limited to, any oral, 192
written, electronic, electronic impulse, or magnetic 193
communication notice, letter, memorandum, receipt for payment, 194
invoice, account, financial statement, OR bill for services; a 196
diagnosis, prognosis, prescription, hospital, medical, or dental
chart or other record; and a computer generated document. 197
(9) "Records" means any medical, professional, financial, 199
or business record relating to the treatment or care of any 200
person, to goods or services provided to any person, or to rates 201
paid for goods or services provided to any person, or any record 202
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that the administrator of workers' compensation requires pursuant 203
to rule. 204
(10) "Workers' compensation benefits" means any 206
compensation or benefits payable under Chapter 4121., 4123., 207
4127., or 4131. of the Revised Code. 208
Sec. 4121.32. (A) The rules covering operating procedure 216
and criteria for decision-making that the administrator of 217
workers' compensation and the industrial commission are required 218
to adopt pursuant to section 4121.31 of the Revised Code shall be 219
supplemented with operating manuals setting forth the procedural 220
steps in detail for performing each of the assigned tasks of each 221
section of the bureau of workers' compensation and commission. 222
The administrator and commission jointly shall adopt such 223
manuals. No employee may deviate from manual procedures without 224
authorization of the section chief. 225
(B) Manuals shall set forth the procedure for the 227
assignment and transfer of claims within sections and be designed 228
to provide performance objectives and may require employees to 229
record sufficient data to reasonably measure the efficiency of 230
functions in all sections. The bureau's division of research and 231
statistics shall perform periodic cost-effectiveness analyses 232
which shall be made available to the general assembly, the 233
governor, and to the public during normal working hours. 234
(C) The bureau and commission jointly shall develop, 236
adopt, and use a policy manual setting forth the guidelines and 237
bases for decision-making for any decision which is the 238
responsibility of the bureau, district hearing officers, staff 239
hearing officers, or the commission. Guidelines shall be set 240
forth in the policy manual by the bureau and commission to the 241
extent of their respective jurisdictions for deciding at least 242
the following specific matters: 243
(1) Reasonable ambulance services; 245
(2) Relationship of drugs to injury; 247
(3) Awarding lump-sum advances for creditors; 249
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(4) Awarding lump-sum advances for attorney's fees; 251
(5) Placing a claimant into rehabilitation; 253
(6) Transferring costs of a claim from employer costs to 255
the statutory surplus fund pursuant to section 4123.343 of the 256
Revised Code; 257
(7) Utilization of physician specialist reports; 259
(8) Determining the percentage of permanent partial 261
disability, temporary IMPAIRMENT IN ACCORDANCE WITH THE MOST 262
RECENT EDITION OF THE AMERICAN MEDICAL ASSOCIATION'S GUIDES TO 263
THE EVALUATION OF PERMANENT IMPAIRMENT; 264
(9) DETERMINING THE PERCENTAGE OF TEMPORARY partial 266
disability, temporary total disability, violations of specific 269
safety requirements, an award under division (B) of section 270
4123.57 of the Revised Code, and permanent total disability 271
IMPAIRMENT.
(D) The bureau shall establish, adopt, and implement 273
policy guidelines and bases for decisions involving reimbursement 274
issues including, but not limited to, the adjustment of invoices, 275
the reduction of payments for future services when an internal 276
audit concludes that a health care provider was overpaid or
improperly paid for past services, reimbursement fees, or other 277
adjustments to payments. These policy guidelines and bases for 278
decisions, and any changes to the guidelines and bases, shall be 279
set forth in a reimbursement manual and provider bulletins. 280
Neither the policy guidelines nor the bases set forth in 282
the reimbursement manual or provider bulletins referred to in 283
this division is a rule as defined in section 119.01 of the 284
Revised Code.
(E) With respect to any determination of disability OR 286
IMPAIRMENT under Chapter 4123. of the Revised Code, when the 288
physician makes a determination based upon statements or 289
information furnished by the claimant or upon subjective 290
evidence, he THE PHYSICIAN shall clearly indicate this fact in 292
his THE PHYSICIAN'S report.
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(F) The administrator shall publish the manuals and make 294
copies of all manuals available to interested parties at cost. 295
Sec. 4121.34. (A) The industrial commission shall appoint 304
a sufficient number of district hearing officers for the purpose 305
of hearing the matters listed in division (B) of this section. 306
District hearing officers are in the classified civil service of 307
the state, are full-time employees of the commission, and shall 308
be persons admitted to the practice of law in this state. 310
District hearing officers shall not engage in any other activity
that interferes with their full-time employment by the commission 311
during normal working hours. 312
(B) District hearing officers shall have original 314
jurisdiction on all of the following matters: 315
(1) Determinations under section 4123.57 of the Revised 317
Code; 318
(2) All appeals from a decision of the administrator of 320
workers' compensation under division (B) of section 4123.511 of 321
the Revised Code; 322
(3) All other contested claims matters under this chapter 324
and Chapters 4123., 4127., and 4131. of the Revised Code, except 325
those matters over which staff hearing officers have original 326
jurisdiction. 327
(C) The administrator of workers' compensation shall make 329
available to each district hearing officer the facilities and 330
assistance of bureau employees and furnish all information 331
necessary to the performance of the district hearing officer's 332
duties. 333
(D) A DISTRICT HEARING OFFICER SHALL REPORT TO THE 335
INSPECTION DIVISION OF THE BUREAU OF WORKERS' COMPENSATION 336
SUSPECTED FRAUDULENT ACTIVITY PERTAINING TO THE OPERATION OF THE 337
WORKERS' COMPENSATION SYSTEM AND ITS SEVERAL INSURANCE FUNDS AS 338
EVIDENCED DURING ANY HEARING IN WHICH THE HEARING OFFICER IS 339
PRESENT OR AS EVIDENCED BY ANY MATERIAL SUBMITTED FOR USE IN A
HEARING. A DISTRICT HEARING OFFICER SHALL BE HELD HARMLESS FOR 340
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SUBMITTING A REPORT UNDER THIS DIVISION. THE INSPECTION DIVISION 341
SHALL MAINTAIN IN CONFIDENCE THE IDENTITY OF ANY HEARING OFFICER 342
WHO SUBMITS A REPORT UNDER THIS DIVISION. 343
Sec. 4121.35. (A) The industrial commission shall appoint 352
staff hearing officers to consider and decide all matters 353
specified in division (B) of this section. All staff hearing 354
officers are full-time employees of the commission and shall be 355
admitted to the practice of law in this state. Staff hearing 356
officers shall not engage in any other activity that interferes 358
with their full-time employment by the commission during normal 359
working hours.
(B) Except as provided in division (D) of this section, 361
staff hearing officers have original jurisdiction to hear and 362
decide the following matters: 363
(1) Applications for permanent, total disability 365
IMPAIRMENT awards pursuant to section 4123.58 of the Revised 367
Code;
(2) Appeals from an order of a district hearing officer 369
issued under division (C) of section 4123.511 of the Revised 370
Code; 371
(3) Applications for additional awards for violation of a 373
specific safety rule of the administrator of workers' 374
compensation pursuant to Section 35 of Article II of the Ohio 375
Constitution; 376
(4) Applications for reconsideration pursuant to division 378
(A) of section 4123.57 of the Revised Code. Decisions of the 379
staff hearing officers on reconsideration pursuant to division 380
(A) of section 4123.57 of the Revised Code are final. 381
(5) Reviews of settlement agreements pursuant to section 383
4123.65 of the Revised Code. Decisions of the staff hearing 384
officer under that section are final and not appealable to the 385
commission or to court under section 4123.511 or 4123.512 of the 386
Revised Code. 387
(C) The decision of a staff hearing officer under division 389
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(D) of section 4123.511 of the Revised Code is the decision of 390
the commission for the purposes of section 4123.512 of the 391
Revised Code unless the commission hears an appeal under division 392
(E) of section 4123.511 of the Revised Code. 393
(D) Staff hearing officers shall hold hearings on all 395
matters referred to them for hearing. Hearing procedures shall 396
conform to the rules the commission adopts pursuant to section 397
4121.36 of the Revised Code. 398
(E) A STAFF HEARING OFFICER SHALL REPORT TO THE INSPECTION 401
DIVISION OF THE BUREAU OF WORKERS' COMPENSATION SUSPECTED 402
FRAUDULENT ACTIVITY PERTAINING TO THE OPERATION OF THE WORKERS'
COMPENSATION SYSTEM AND ITS SEVERAL INSURANCE FUNDS AS EVIDENCED 403
DURING ANY HEARING IN WHICH THE HEARING OFFICER IS PRESENT OR AS 404
EVIDENCED BY ANY MATERIAL SUBMITTED FOR USE IN A HEARING. A 405
STAFF HEARING OFFICER SHALL BE HELD HARMLESS FOR SUBMITTING A 406
REPORT UNDER THIS DIVISION. THE INSPECTION DIVISION SHALL 407
MAINTAIN IN CONFIDENCE THE IDENTITY OF ANY HEARING OFFICER WHO
SUBMITS A REPORT UNDER THIS DIVISION. 408
Sec. 4121.36. (A) The industrial commission shall adopt 417
rules as to the conduct of all hearings before the commission and 418
its staff and district hearing officers and the rendering of a 419
decision and shall focus such rules on managing, directing, and 420
otherwise ensuring a fair, equitable, and uniform hearing 421
process. These rules shall provide for at least the following 422
steps and procedures: 423
(1) Adequate notice to all parties and their 425
representatives to ensure that no hearing is conducted unless all 426
parties have the opportunity to be present and to present 427
evidence and arguments in support of their positions or in 428
rebuttal to the evidence or arguments of other parties; 429
(2) A public hearing; 431
(3) Written decisions; 433
(4) Impartial assignment of staff and district hearing 435
officers and assignment of appeals from a decision of the 436
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administrator of workers' compensation to a district hearing 437
officer located at the commission service office that is the 438
closest in geographic proximity to the claimant's residence; 440
(5) Publication of a docket; 442
(6) The securing of the attendance or testimony of 444
witnesses; 445
(7) Prehearing rules, including rules relative to 447
discovery, the taking of depositions, and exchange of information 448
relevant to a claim prior to the conduct of a hearing; 449
(8) The issuance of orders by the district or staff 451
hearing officer who renders the decision. 452
NOTHING IN DIVISION (A) OF THIS SECTION SHALL BE CONSTRUED 454
AS BARRING THE PARTICIPATION OF A PERSON WHO IS NOT ADMITTED TO 455
THE PRACTICE OF LAW AS A REPRESENTATIVE OF A PARTY. 456
(B) Every decision by a staff or district hearing officer 458
or the commission shall be in writing and contain all of the 459
following elements: 460
(1) A concise statement of the order or award; 462
(2) A notation as to notice provided and as to appearance 464
of parties; 465
(3) Signatures of each commissioner or appropriate hearing 467
officer on the original copy of the decision only, verifying the 469
commissioner's or hearing officer's vote; 470
(4) Description of the part of the body and nature of the 472
disability recognized in the claim. 473
(C) The commission shall adopt rules that require the 475
regular rotation of district hearing officers with respect to the 476
types of matters under consideration and that ensure that no 477
district or staff hearing officer or the commission hears a claim 478
unless all interested and affected parties have the opportunity 479
to be present and to present evidence and arguments in support of 480
their positions or in rebuttal to the evidence or arguments of 481
other parties. 482
(D) All matters which, at the request of one of the 484
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parties or on the initiative of the administrator and any 485
commissioner, are to be expedited, shall require at least 486
forty-eight hours' notice, a public hearing, and a statement in 487
any order of the circumstances that justified such expeditious 488
hearings. 489
(E) All meetings of the commission and district and staff 491
hearing officers shall be public with adequate notice, including 492
if necessary, to the claimant, the employer, their 493
representatives, and the administrator. Confidentiality of 494
medical evidence presented at a hearing does not constitute a 495
sufficient ground to relieve the requirement of a public hearing, 496
but the presentation of privileged or confidential evidence shall 497
not create any greater right of public inspection of evidence 498
than presently exists. 499
(F) The commission shall compile all of its original 501
memorandums, orders, and decisions in a journal and make the 502
journal available to the public with sufficient indexing to allow 503
orderly review of documents. The journal shall indicate the vote 504
of each commissioner. 505
(G)(1) All original orders, rules, and memoranda, and 507
decisions of the commission shall contain the signatures of two 509
of the three commissioners and state whether adopted at a meeting 510
of the commission or by circulation to individual commissioners. 511
Any facsimile or secretarial signature, initials of 512
commissioners, and delegated employees, and any printed record of 513
the "yes" and "no" vote of a commission member or of a hearing 514
officer on such original is invalid. 516
(2) Written copies of final decisions of district or staff 518
hearing officers or the commission that are mailed to the 519
administrator, employee, employer, and their respective 520
representatives need not contain the signatures of the hearing 521
officer or commission members if the hearing officer or 522
commission members have complied with divisions (B)(3) and (G)(1) 523
of this section.
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(H) The commission shall do both of the following: 525
(1) Appoint an individual as a hearing officer trainer who 527
is in the unclassified civil service of the state and who serves 528
at the pleasure of the commission. The trainer shall be an 529
attorney registered to practice law in this state and have 530
experience in training or education, and the ability to furnish 531
the necessary training for district and staff hearing officers. 532
The hearing officer trainer shall develop and periodically 534
update a training manual and such other training materials and 535
courses as will adequately prepare district and staff hearing 536
officers for their duties under this chapter and Chapter 4123. of 537
the Revised Code. All district and staff hearing officers shall 538
undergo the training courses developed by the hearing officer 539
trainer, the cost of which the commission shall pay. The 540
commission shall make the hearing officer manual and all 541
revisions thereto available to the public at cost. 542
The commission shall have the final right of approval over 544
all training manuals, courses, and other materials the hearing 545
officer trainer develops and updates. 546
(2) Appoint a hearing administrator, who shall be in the 548
classified civil service of the state, for each bureau service 549
office, and sufficient support personnel for each hearing 550
administrator, which support personnel shall be under the direct 551
supervision of the hearing administrator. The hearing 552
administrator shall do all of the following: 553
(a) Assist the commission in ensuring that district 555
hearing officers comply with the time limitations for the holding 556
of hearings and issuance of orders under section 4123.511 of the 557
Revised Code. For that purpose, each hearing administrator shall 558
prepare a monthly report identifying the status of all claims in 559
its office and identifying specifically the claims which have not 560
been decided within the time limits set forth in section 4123.511 561
of the Revised Code. The commission shall submit an annual 562
report of all such reports to the standing committees of the 563
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house of representatives and of the state to which matters 564
concerning workers' compensation are normally referred. 565
(b) Provide information to requesting parties or their 567
representatives on the status of their claim; 568
(c) Issue compliance letters, upon a finding of good cause 570
and without a formal hearing in all of the following areas: 571
(i) Divisions (B) and (C) of section 4123.651 of the 573
Revised Code; 574
(ii) Requests for the taking of depositions of bureau and 576
commission physicians; 577
(iii) The issuance of subpoenas; 579
(iv) The granting or denying of requests for continuances; 581
(v) Matters involving section 4123.522 of the Revised 583
Code; 584
(vi) Requests for conducting telephone pre-hearing 586
conferences; 587
(vii) Any other matter that will cause a free exchange of 589
information prior to the formal hearing. 590
(d) Ensure that claim files are reviewed by the district 592
hearing officer prior to the hearing to ensure that there is 593
sufficient information to proceed to a hearing; 594
(e) Ensure that for occupational disease claims under 596
section 4123.68 of the Revised Code that require a medical 597
examination the medical examination is conducted prior to the 598
hearing; 599
(f) Take the necessary steps to prepare a claim to proceed 601
to a hearing where the parties agree and advise the hearing 602
administrator that the claim is not ready for a hearing. 604
(I) The commission shall permit any person direct access 606
to information contained in electronic data processing equipment 607
regarding the status of a claim in the hearing process. The 608
information shall indicate the number of days that the claim has 609
been in process, the number of days the claim has been in its 610
current location, and the number of days in the current point of 611
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the process within that location. 612
(J)(1) The industrial commission may establish an 614
alternative dispute resolution process for workers' compensation 615
claims that are within the commission's jurisdiction under 617
Chapters 4121., 4123., 4127., and 4131. of the Revised Code when 619
the commission determines that such a process is necessary. 620
Notwithstanding sections 4121.34 and 4121.35 of the Revised Code, 621
the commission may enter into personal service contracts with 622
individuals who are qualified because of their education and 623
experience to act as facilitators in the commission's alternative 624
dispute resolution process.
(2) The parties' use of the alternative dispute resolution 626
process is voluntary, and requires the agreement of all necessary 627
parties. The use of the alternative dispute resolution process 629
does not alter the rights or obligations of the parties, nor does 631
it delay the timelines set forth in section 4123.511 of the 632
Revised Code. 633
(3) The commission shall prepare monthly reports and 635
submit those reports to the governor, the president of the 636
senate, and the speaker of the house of representatives 637
describing all of the following:
(a) The names of each facilitator employed under a 639
personal service contract; 640
(b) The hourly amount of money and the total amount of 643
money paid to each facilitator;
(c) The number of disputed issues resolved during that 646
month by each facilitator;
(d) The number of decisions of each facilitator that were 649
appealed by a party;
(e) A certification by the commission that the alternative 652
dispute resolution process did not delay any hearing timelines as
set forth in section 4123.511 of the Revised Code for any 654
disputed issue.
(4) The commission may adopt rules in accordance with 656
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chapter 119. of the Revised Code for the administration of any 659
alternative dispute resolution process that the commission 660
establishes.
Sec. 4121.38. (A) The industrial commission shall DO ALL 669
OF THE FOLLOWING: 670
(1) Implement a program of impairment evaluation training 672
for its staff physicians; 673
(2) Issue a manual of commission policy as to impairment 675
evaluation so as to increase consistency of medical reports, 676
INCLUDING, BUT NOT LIMITED TO, A POLICY REQUIRING THE USE OF THE 677
MOST RECENT EDITION OF THE AMERICAN MEDICAL ASSOCIATION'S GUIDES 678
TO THE EVALUATION OF PERMANENT IMPAIRMENT FOR THE EVALUATION OF 679
PERMANENT PARTIAL IMPAIRMENT CLAIMS. This manual shall be 681
available to the public at cost but shall be provided free to all 682
physicians who treat claimants or to whom claimants are referred 683
for evaluation. The commission shall take steps to ensure that 684
the manual receives the widest possible distribution to 685
physicians.
(3) Develop a method of peer review of medical reports 687
prepared by the commission referral doctors; 688
(4) Issue a policy manual as to the basis upon which 690
referrals to other than commission specialists will be made; 691
(5) Designate two hearing examiners and two medical staff 693
members who shall be specially trained in medical-legal analysis. 694
The specialists shall write evaluations of medical-legal problems 695
upon assignment by other hearing examiners or the commission. The 697
director of administrative services upon commission advice shall 698
assign such employees to a salary schedule commensurate with 699
expertise required of them.
(6) Require that prior to any examination, a physician to 701
whom a claimant is referred for examination receives all 702
necessary medical information in the claim file about the 703
claimant and a complete statement as to the purpose of the 704
examination. 705
17
(B) The commission may establish a medical section within 707
the commission to perform the duties assigned to the commission 708
under this section. 709
Sec. 4121.444. (A) NO HEALTH CARE PROVIDER, MANAGED CARE 711
ORGANIZATION, OR OWNER OF A HEALTH CARE PROVIDER OR MANAGED CARE 712
ORGANIZATION SHALL OBTAIN OR ATTEMPT TO OBTAIN PAYMENTS BY 713
DECEPTION UNDER CHAPTER 4121., 4123., 4127., OR 4131. OF THE 714
REVISED CODE TO WHICH THE HEALTH CARE PROVIDER, MANAGED CARE 715
ORGANIZATION, OR OWNER IS NOT ENTITLED UNDER RULES OF THE BUREAU 716
OF WORKERS' COMPENSATION ADOPTED PURSUANT TO SECTIONS 4121.441 717
AND 4121.442 OF THE REVISED CODE. 718
(B) ANY HEALTH CARE PROVIDER, MANAGED CARE ORGANIZATION, 720
OR OWNER THAT VIOLATES DIVISION (A) OF THIS SECTION IS LIABLE, IN 722
ADDITION TO ANY OTHER PENALTIES PROVIDED BY LAW, FOR ALL OF THE
FOLLOWING PENALTIES: 723
(1) PAYMENT OF INTEREST ON THE AMOUNT OF THE EXCESS 725
PAYMENTS AT THE MAXIMUM INTEREST RATE ALLOWABLE FOR REAL ESTATE 726
MORTGAGES UNDER SECTION 1343.01 OF THE REVISED CODE. THE 727
INTEREST SHALL BE CALCULATED FROM THE DATE THE PAYMENT WAS MADE 728
TO THE OWNER, HEALTH CARE PROVIDER, OR MANAGED CARE ORGANIZATION 730
THROUGH THE DATE UPON WHICH REPAYMENT IS MADE TO THE BUREAU OR
THE SELF-INSURING EMPLOYER. 732
(2) PAYMENT OF AN AMOUNT EQUAL TO THREE TIMES THE AMOUNT 734
OF ANY EXCESS PAYMENTS; 735
(3) PAYMENT OF A SUM OF NOT LESS THAN FIVE THOUSAND 737
DOLLARS AND NOT MORE THAN TEN THOUSAND DOLLARS FOR EACH ACT OF 738
DECEPTION;
(4) ALL REASONABLE AND NECESSARY EXPENSES THAT THE COURT 740
DETERMINES HAVE BEEN INCURRED BY THE BUREAU OR THE SELF-INSURING 741
EMPLOYER IN THE ENFORCEMENT OF THIS SECTION. 743
ALL MONEYS COLLECTED BY THE BUREAU PURSUANT TO THIS SECTION 745
SHALL BE DEPOSITED INTO THE BUREAU'S STATE INSURANCE FUND CREATED 746
IN SECTION 4123.30 OF THE REVISED CODE. ALL MONEYS COLLECTED BY 748
A SELF-INSURING EMPLOYER PURSUANT TO THIS SECTION SHALL BE 749
18
AWARDED TO THE SELF-INSURING EMPLOYER. 750
(C)(1) IN ADDITION TO THE MONETARY PENALTIES PROVIDED IN 753
DIVISION (B) OF THIS SECTION AND EXCEPT AS PROVIDED IN DIVISION 754
(C)(3) OF THIS SECTION, THE ADMINISTRATOR SHALL TERMINATE, FOR A 755
PERIOD NOT TO EXCEED FIVE YEARS FROM THE DATE OF CONVICTION, PLEA 756
OF GUILTY, OR JUDGMENT ENTRY, ANY AGREEMENT BETWEEN THE BUREAU 757
AND A HEALTH CARE PROVIDER OR MANAGED CARE ORGANIZATION OR ITS 758
OWNER AND CEASE REIMBURSEMENT TO THAT PROVIDER, ORGANIZATION, OR 759
OWNER FOR SERVICES RENDERED IF EITHER OF THE FOLLOWING APPLIES: 760
(a) THE HEALTH CARE PROVIDER, MANAGED CARE ORGANIZATION, 763
OR ITS OWNER, OR AN OFFICER, AUTHORIZED AGENT, ASSOCIATE,
MANAGER, OR EMPLOYEE OF A PROVIDER OR ORGANIZATION IS CONVICTED 764
OF OR PLEADS GUILTY TO A VIOLATION OF SECTIONS 2913.48 OR 2923.31 766
TO 2923.36 OF THE REVISED CODE.
(b) THERE EXISTS AN ENTRY OF JUDGMENT AGAINST THE HEALTH 769
CARE PROVIDER, MANAGED CARE ORGANIZATION, OR ITS OWNER, OR AN
OFFICER, AUTHORIZED AGENT, ASSOCIATE, MANAGER, OR EMPLOYEE OF A 770
PROVIDER OR ORGANIZATION IN A CIVIL ACTION BROUGHT PURSUANT TO 771
THIS SECTION OR SECTIONS 2923.31 TO 2923.36 OF THE REVISED CODE. 772
(2) NO HEALTH CARE PROVIDER OR MANAGED CARE ORGANIZATION 774
THAT HAS HAD ITS AGREEMENT WITH AND REIMBURSEMENT FROM THE BUREAU 775
TERMINATED BY THE ADMINISTRATOR PURSUANT TO DIVISION (C)(1) OF 776
THIS SECTION, OR AN OWNER, OFFICER, AUTHORIZED AGENT, ASSOCIATE, 778
MANAGER, OR EMPLOYEE OF THAT HEALTH CARE PROVIDER OR MANAGED CARE 779
ORGANIZATION SHALL DO ANY OF THE FOLLOWING:
(a) DIRECTLY PROVIDE SERVICES TO ANY OTHER BUREAU PROVIDER 782
OR HAVE AN OWNERSHIP INTEREST IN A PROVIDER OF SERVICES THAT
FURNISHES SERVICES TO ANY OTHER BUREAU PROVIDER; 784
(b) ARRANGE FOR, RENDER, OR ORDER SERVICES FOR CLAIMANTS 787
DURING THE PERIOD THAT THE AGREEMENT OF THE HEALTH CARE PROVIDER,
MANAGED CARE ORGANIZATION, OR ITS OWNER IS TERMINATED AS 788
DESCRIBED IN DIVISION (C)(1) OF THIS SECTION; 789
(c) RECEIVE REIMBURSEMENT IN THE FORM OF DIRECT PAYMENTS 792
FROM THE BUREAU OR INDIRECT PAYMENTS OF BUREAU FUNDS IN THE FORM
19
OF SALARIES, SHARED FEES, CONTRACTS, KICKBACKS, OR REBATES FROM 793
OR THROUGH ANY PARTICIPATING PROVIDER. 794
(3) THE ADMINISTRATOR SHALL NOT TERMINATE THE AGREEMENT OR 796
REIMBURSEMENT IF THE HEALTH CARE PROVIDER, MANAGED CARE 797
ORGANIZATION, OR OWNER DEMONSTRATES THAT THE PROVIDER, 798
ORGANIZATION, OR OWNER DID NOT DIRECTLY OR INDIRECTLY SANCTION 799
THE ACTION OF THE AUTHORIZED AGENT, ASSOCIATE, MANAGER, OR
EMPLOYEE THAT RESULTED IN THE CONVICTION, PLEA OF GUILTY, OR 801
ENTRY OF JUDGMENT AS DESCRIBED IN DIVISION (C)(1) OF THIS 802
SECTION.
(4) NOTHING IN DIVISION (C) OF THIS SECTION PROHIBITS AN 805
OWNER, OFFICER, AUTHORIZED AGENT, ASSOCIATE, MANAGER, OR EMPLOYEE 806
OF A HEALTH CARE PROVIDER OR MANAGED CARE ORGANIZATION FROM
ENTERING INTO AN AGREEMENT WITH THE BUREAU IF THE PROVIDER, 807
ORGANIZATION, OWNER, OFFICER, AUTHORIZED AGENT, ASSOCIATE, 808
MANAGER, OR EMPLOYEE DEMONSTRATES ABSENCE OF KNOWLEDGE OF THE 810
ACTION OF THE HEALTH CARE PROVIDER OR MANAGED CARE ORGANIZATION 811
WITH WHICH THAT INDIVIDUAL OR ORGANIZATION WAS FORMERLY
ASSOCIATED THAT RESULTED IN A CONVICTION, PLEA OF GUILTY, OR 813
ENTRY OF JUDGMENT AS DESCRIBED IN DIVISION (C)(1) OF THIS 814
SECTION.
(D) THE ATTORNEY GENERAL MAY BRING AN ACTION ON BEHALF OF 817
THE STATE AND A SELF-INSURING EMPLOYER MAY BRING AN ACTION ON ITS 818
OWN BEHALF TO ENFORCE THIS SECTION IN ANY COURT OF COMPETENT
JURISDICTION. THE ATTORNEY GENERAL MAY SETTLE OR COMPROMISE ANY 819
ACTION BROUGHT UNDER THIS SECTION WITH THE APPROVAL OF THE 821
ADMINISTRATOR.
NOTWITHSTANDING ANY OTHER LAW PROVIDING A SHORTER PERIOD OF 823
LIMITATIONS, THE ATTORNEY GENERAL OR A SELF-INSURING EMPLOYER MAY 824
BRING AN ACTION TO ENFORCE THIS SECTION AT ANY TIME WITHIN SIX 825
YEARS AFTER THE CONDUCT IN VIOLATION OF THIS SECTION TERMINATES. 826
(E) THE AVAILABILITY OF REMEDIES UNDER THIS SECTION AND 829
SECTIONS 2913.48 AND 2923.31 TO 2923.36 OF THE REVISED CODE FOR 830
RECOVERING BENEFITS PAID ON BEHALF OF CLAIMANTS FOR MEDICAL
20
ASSISTANCE DOES NOT LIMIT THE AUTHORITY OF THE BUREAU OR A 831
SELF-INSURING EMPLOYER TO RECOVER EXCESS PAYMENTS MADE TO AN 832
OWNER, HEALTH CARE PROVIDER, OR MANAGED CARE ORGANIZATION UNDER 834
STATE AND FEDERAL LAW.
(F) AS USED IN THIS SECTION: 836
(1) "DECEPTION" MEANS ACTING WITH ACTUAL KNOWLEDGE OF, IN 838
DELIBERATE IGNORANCE OF, OR RECKLESS DISREGARD OF THE TRUTH OR 839
FALSITY OF, ANY REPRESENTATION OR INFORMATION IN ORDER TO DECEIVE 840
ANOTHER OR CAUSE ANOTHER TO BE DECEIVED BY MEANS OF ANY OF THE 841
FOLLOWING:
(a) A FALSE OR MISLEADING REPRESENTATION; 843
(b) THE WITHHOLDING OF INFORMATION; 845
(c) THE PREVENTING OF ANOTHER FROM ACQUIRING INFORMATION; 848
(d) ANY OTHER CONDUCT, ACT, OR OMISSION THAT CREATES, 851
CONFIRMS, OR PERPETUATES A FALSE IMPRESSION AS TO A FACT, THE
LAW, THE VALUE OF SOMETHING, OR A PERSON'S STATE OF MIND. 853
FOR PURPOSES OF THIS SECTION, PROOF OF SPECIFIC INTENT TO 855
DEFRAUD IS NOT REQUIRED IN ORDER TO SHOW THAT AN OWNER, HEALTH 856
CARE PROVIDER, OR MANAGED CARE ORGANIZATION IS ENGAGING IN OR HAS 857
ENGAGED IN DECEPTION.
(2) "OWNER" MEANS ANY PERSON HAVING AT LEAST A FIVE PER 859
CENT OWNERSHIP INTEREST IN A HEALTH CARE PROVIDER OR MANAGED CARE 860
ORGANIZATION.
Sec. 4121.47. (A) No employer shall violate a specific 869
safety rule adopted by the administrator of workers' compensation 870
pursuant to section 4121.13 of the Revised Code or an act of the 872
general assembly to protect the lives, health, and safety of 873
employees pursuant to Section 35 of Article II, Ohio 874
Constitution. Chapter 4167. of the Revised Code and rules and 875
standards adopted thereunder UNDER THAT CHAPTER are not the rules 876
or enactment referred to in this division and shall not be 877
considered as such for purposes of this section. FOR PURPOSES OF 878
THIS SECTION, A SPECIFIC SAFETY RULE OF THE ADMINISTRATOR THAT 880
REFERS TO OR IS INTERPRETED AS APPLYING TO WORKSHOPS AND
21
FACTORIES SHALL NOT APPLY TO BUILDINGS OR STRUCTURES USED FOR 881
AGRICULTURAL PRODUCTION, OR TO ANY OF THE FIXTURES, MACHINERY, 882
EQUIPMENT, TOOLS, OR DEVICES UTILIZED IN THOSE BUILDINGS OR 883
STRUCTURES.
(B) If a staff hearing officer, in the course of his THE 885
HEARING OFFICER'S determination of a claim for an additional 886
award under Section 35 of Article II, Ohio Constitution, finds 887
the employer guilty of violating division (A) of this section, he 888
shall THE HEARING OFFICER, in addition to any award paid to the 889
claimant, SHALL issue an order to the employer to correct the 891
violation within the period of time he fixes FIXED BY THE HEARING 892
OFFICER. For any violation occurring within twenty-four months 893
of the last violation, the staff hearing officer shall assess 894
against the employer a civil penalty in an amount he THE HEARING 895
OFFICER determines up to a maximum of fifty thousand dollars for 897
each violation. In fixing the exact penalty, the staff hearing 898
officer shall base his THE decision upon the size of the employer 900
as measured by the number of employees, assets, and earnings of 901
the employer.
(C) An employer dissatisfied with the imposition of a 903
civil penalty pursuant to division (B) of this section may appeal 904
the staff hearing officer's decision, if the commission refuses 905
to hear the appeal under division (E) of section 4123.511 of the 906
Revised Code, or a decision of the commission, if the commission 907
hears the appeal under that division, to a court of common pleas 908
pursuant to the Rules of Civil Procedure. An appeal operates to 909
stay the payment of the fine pending the appeal. 910
(D) The administrator shall deposit all penalties 912
collected pursuant to this section in the occupational safety 913
loan program fund established pursuant to section 4121.48 of the 914
Revised Code. 915
Sec. 4121.65. Employers who provide compensation and 924
benefits pursuant to section 4123.35 OR 4123.46 of the Revised 925
Code also may be granted authority to furnish rehabilitation 927
22
services as long as the quality and content of the same is equal 928
to or greater than that provided by the bureau of workers'
compensation, and prior approval therefor has been given by the 929
bureau.
Sec. 4121.67. The administrator of workers' compensation, 937
with the advice and consent of the workers' compensation 939
oversight commission, shall adopt rules: 940
(A) For the encouragement of reemployment of claimants who 942
have successfully completed prescribed rehabilitation programs by 943
payment from the surplus fund established by section 4123.34 of 944
the Revised Code to employers who employ or reemploy the 945
claimants. The period or periods of payments shall not exceed 946
six months in the aggregate, unless the administrator or his THE 947
ADMINISTRATOR'S designee determines that the claimant will be 948
benefited by an extension of payments. 949
(B) Requiring payment, in the same manner as living 951
maintenance payments are made pursuant to section 4121.63 of the 952
Revised Code, to the claimant who completes a rehabilitation 953
training program and returns to employment, but who suffers a 954
wage loss compared to the wage the claimant was receiving at the 955
time of injury. Payments per week shall be sixty-six and 956
two-thirds per cent of the difference, if any, between the 957
claimant's weekly wage at the time of injury and the weekly wage 958
received while employed, up to a maximum payment per week equal 959
to the statewide average weekly wage. The payments may continue 960
for up to a maximum of two hundred weeks but shall be reduced by 961
the corresponding number of weeks in which the claimant receives 962
payments pursuant to division (B)(C) of section 4123.56 of the 963
Revised Code. 964
Sec. 4123.01. As used in this chapter: 973
(A)(1) "Employee" means: 975
(a) Every person in the service of the state, or of any 977
county, municipal corporation, township, or school district 978
therein, including regular members of lawfully constituted police 979
23
and fire departments of municipal corporations and townships, 980
whether paid or volunteer, and wherever serving within the state 981
or on temporary assignment outside thereof, and executive 982
officers of boards of education, under any appointment or 983
contract of hire, express or implied, oral or written, including 984
any elected official of the state, or of any county, municipal 985
corporation, or township, or members of boards of education; 986
(b) Every person in the service of any person, firm, or 988
private corporation, including any public service corporation, 989
that (i) employs one or more persons regularly in the same 990
business or in or about the same establishment under any contract 991
of hire, express or implied, oral or written, including aliens 992
and minors, household workers who earn one hundred sixty dollars 993
or more in cash in any calendar quarter from a single household 994
and casual workers who earn one hundred sixty dollars or more in 995
cash in any calendar quarter from a single employer, or (ii) is 996
bound by any such contract of hire or by any other written 997
contract, to pay into the state insurance fund the premiums 998
provided by this chapter. 999
(c) Every person who performs labor or provides services 1,002
pursuant to a construction contract, as defined in section 1,003
4123.79 of the Revised Code, if at least ten of the following
criteria apply:
(i) The person is required to comply with instructions 1,006
from the other contracting party regarding the manner or method 1,007
of performing services;
(ii) The person is required by the other contracting party 1,010
to have particular training;
(iii) The person's services are integrated into the 1,013
regular functioning of the other contracting party; 1,014
(iv) The person is required to perform the work 1,016
personally;
(v) The person is hired, supervised, or paid by the other 1,018
contracting party;
24
(vi) A continuing relationship exists between the person 1,021
and the other contracting party that contemplates continuing or 1,022
recurring work even if the work is not full time; 1,023
(vii) The person's hours of work are established by the 1,026
other contracting party;
(viii) The person is required to devote full time to the 1,029
business of the other contracting party;
(ix) The person is required to perform the work on the 1,032
premises of the other contracting party;
(x) The person is required to follow the order of work set 1,035
by the other contracting party;
(xi) The person is required to make oral or written 1,038
reports of progress to the other contracting party; 1,039
(xii) The person is paid for services on a regular basis 1,042
such as hourly, weekly, or monthly;
(xiii) The person's expenses are paid for by the other 1,044
contracting party;
(xiv) The person's tools and materials are furnished by 1,047
the other contracting party;
(xv) The person is provided with the facilities used to 1,049
perform services;
(xvi) The person does not realize a profit or suffer a 1,052
loss as a result of the services provided;
(xvii) The person is not performing services for a number 1,055
of employers at the same time;
(xviii) The person does not make the same services 1,057
available to the general public; 1,058
(xix) The other contracting party has a right to discharge 1,061
the person;
(xx) The person has the right to end the relationship with 1,064
the other contracting party without incurring liability pursuant 1,065
to an employment contract or agreement. 1,066
Every person in the service of any independent contractor 1,068
or subcontractor who has failed to pay into the state insurance 1,069
25
fund the amount of premium determined and fixed by the 1,070
administrator of workers' compensation for the person's 1,071
employment or occupation or if a self-insuring employer has 1,072
failed to pay compensation and benefits directly to the 1,073
employer's injured and to the dependents of the employer's killed 1,074
employees as required by section 4123.35 of the Revised Code, 1,076
shall be considered as the employee of the person who has entered 1,077
into a contract, whether written or verbal, with such independent 1,078
contractor unless such employees or their legal representatives 1,079
or beneficiaries elect, after injury or death, to regard such 1,080
independent contractor as the employer.
(2) "Employee" does not mean: 1,082
(a) A duly ordained, commissioned, or licensed minister or 1,084
assistant or associate minister of a church in the exercise of 1,085
ministry; or 1,086
(b) Any officer of a family farm corporation; 1,088
(c) AN INDIVIDUAL WHO SIGNS THE WAIVER AND AFFIDAVIT 1,090
PROVIDED FOR IN SECTION 4123.15 OF THE REVISED CODE, PROVIDED 1,091
THAT THE ADMINISTRATOR HAS GRANTED A WAIVER AND EXCEPTION TO THE 1,092
INDIVIDUAL'S EMPLOYER UNDER THAT SECTION.
Any employer may elect to include as an "employee" within 1,094
this chapter, any person excluded from the definition of 1,095
"employee" pursuant to division (A)(2) of this section. If an 1,096
employer is a partnership, sole proprietorship, or family farm 1,097
corporation, such employer may elect to include as an "employee" 1,098
within this chapter, any member of such partnership, the owner of 1,099
the sole proprietorship, or the officers of the family farm 1,100
corporation. In the event of an election, the employer shall 1,101
serve upon the bureau of workers' compensation written notice 1,102
naming the persons to be covered, include such employee's 1,103
remuneration for premium purposes in all future payroll reports, 1,104
and no person excluded from the definition of "employee" pursuant 1,105
to division (A)(2) of this section, proprietor, or partner shall 1,106
be deemed an employee within this division until the employer has 1,107
26
served such notice. 1,108
For informational purposes only, the bureau shall prescribe 1,110
such language as it considers appropriate, on such of its forms 1,111
as it considers appropriate, to advise employers of their right 1,112
to elect to include as an "employee" within this chapter a sole 1,113
proprietor, any member of a partnership, the officers of a family 1,114
farm corporation, or a person excluded from the definition of 1,115
"employee" under division (A)(2)(a) of this section, that they 1,116
should check any health and disability insurance policy, or other 1,117
form of health and disability plan or contract, presently 1,118
covering them, or the purchase of which they may be considering, 1,119
to determine whether such policy, plan, or contract excludes 1,120
benefits for illness or injury that they might have elected to 1,121
have covered by workers' compensation. 1,122
(B) "Employer" means: 1,124
(1) The state, including state hospitals, each county, 1,126
municipal corporation, township, school district, and hospital 1,127
owned by a political subdivision or subdivisions other than the 1,128
state; 1,129
(2) Every person, firm, and private corporation, including 1,131
any public service corporation, that (a) has in service one or 1,132
more employees regularly in the same business or in or about the 1,133
same establishment under any contract of hire, express or 1,134
implied, oral or written, or (b) is bound by any such contract of 1,135
hire or by any other written contract, to pay into the insurance 1,136
fund the premiums provided by this chapter. 1,137
All such employers are subject to this chapter. Any member 1,139
of a firm or association, who regularly performs manual labor in 1,140
or about a mine, factory, or other establishment, including a 1,141
household establishment, shall be considered an employee in 1,142
determining whether such person, firm, or private corporation, or 1,143
public service corporation, has in its service, one or more 1,144
employees and the employer shall report the income derived from 1,145
such labor to the bureau as part of the payroll of such employer, 1,146
27
and such member shall thereupon be entitled to all the benefits 1,147
of an employee. 1,148
(C) "Injury" includes any injury, whether caused by 1,150
external accidental means or accidental in character and result, 1,151
received in the course of, and arising out of, the injured 1,152
employee's employment. "Injury" does not include: 1,153
(1) Psychiatric conditions except where the conditions 1,155
have arisen from an injury or occupational disease; 1,156
(2) Injury, IMPAIRMENT, or disability caused primarily by 1,159
the natural deterioration of tissue, an organ, or part of the 1,160
body;
(3) Injury, IMPAIRMENT, or disability incurred in 1,162
voluntary participation in an employer-sponsored recreation or 1,164
fitness activity if the employee signs a waiver of the employee's 1,165
right to compensation or benefits under this chapter prior to 1,166
engaging in the recreation or fitness activity; 1,167
(4) INJURY, IMPAIRMENT, OR DISABILITY CAUSED BY A 1,169
PREEXISTING CONDITION, IMPAIRMENT, OR DISEASE PROCESS UNLESS THAT 1,171
PREEXISTING CONDITION OR IMPAIRMENT IS SUBSTANTIALLY WORSENED OR 1,172
THAT DISEASE PROCESS IS SUBSTANTIALLY ACCELERATED BY A 1,173
COMPENSABLE INJURY AS DOCUMENTED BY OBJECTIVE CLINICAL FINDINGS 1,174
AND TEST RESULTS. SUBJECTIVE COMPLAINTS WITHOUT THESE FINDINGS 1,175
AND RESULTS ARE INSUFFICIENT TO ESTABLISH A COMPENSABLE INJURY 1,176
UNDER DIVISION (C)(4) OF THIS SECTION; 1,177
(5) INJURY, IMPAIRMENT, OR DISABILITY RESULTING FROM 1,179
CUMULATIVE OR REPETITIVE TRAUMA. 1,180
(D) "Child" includes a posthumous child and a child 1,182
legally adopted prior to the injury. 1,183
(E) "Family farm corporation" means a corporation founded 1,185
for the purpose of farming agricultural land in which the 1,186
majority of the voting stock is held by and the majority of the 1,187
stockholders are persons or the spouse of persons related to each 1,188
other within the fourth degree of kinship, according to the rules 1,189
of the civil law, and at least one of the related persons is 1,190
28
residing on or actively operating the farm, and none of whose 1,191
stockholders are a corporation. A family farm corporation does 1,192
not cease to qualify under this division where, by reason of any 1,193
devise, bequest, or the operation of the laws of descent or 1,194
distribution, the ownership of shares of voting stock is 1,195
transferred to another person, as long as that person is within 1,196
the degree of kinship stipulated in this division. 1,197
(F) "Occupational disease" means a disease contracted in 1,199
the course of employment, which by its causes and the 1,200
characteristics of its manifestation or the condition of the 1,201
employment results in a hazard which distinguishes the employment 1,202
in character from employment generally, and the employment 1,203
creates a risk of contracting the disease in greater degree and 1,204
in a different manner from the public in general, INCLUDING A 1,205
DISEASE OR CONDITION THAT RESULTS FROM A CUMULATIVE OR REPETITIVE 1,207
TRAUMA, THAT IS CONTRACTED IN THE COURSE OF EMPLOYMENT, THAT 1,209
RESULTS IN DAMAGE OR HARM TO THE PHYSICAL STRUCTURE OF THE BODY, 1,210
AND THAT IS DUE TO CAUSES AND CONDITIONS THAT ARE CHARACTERISTIC 1,211
OF AND PECULIAR TO A PARTICULAR INDUSTRIAL PROCESS, TRADE, OR 1,212
OCCUPATION. "OCCUPATIONAL DISEASE" DOES NOT INCLUDE ANY OF THE 1,213
FOLLOWING:
(1) A DISEASE OR CONDITION TO WHICH THE GENERAL PUBLIC IS 1,215
EXPOSED OUTSIDE OF EMPLOYMENT ABSENT A SHOWING, BY A 1,216
PREPONDERANCE OF THE EVIDENCE, THAT THE DISEASE OR CONDITION IS 1,218
CHARACTERISTIC OF AND PECULIAR TO A PARTICULAR INDUSTRIAL 1,220
PROCESS, TRADE, OR OCCUPATION;
(2) A DISEASE OR CONDITION THAT WOULD HAVE ARISEN WITHOUT 1,222
THE OCCUPATIONAL EXPOSURE; 1,223
(3) A DISEASE OR CONDITION THAT RESULTS FROM AGGRAVATION 1,225
OF A PREEXISTING DISEASE, CONDITION, OR DISEASE PROCESS; 1,226
(4) A DISEASE OR CONDITION CAUSED PRIMARILY BY THE NATURAL 1,228
DETERIORATION OF THE TISSUE, ORGANS, OR OTHER PARTS OF THE BODY; 1,229
(5) PSYCHIATRIC CONDITIONS, EXCEPT WHERE THE CONDITIONS 1,231
HAVE ARISEN FROM AN OCCUPATIONAL DISEASE. 1,233
29
(G) "Self-insuring employer" means any of the following 1,235
categories of employers if granted the privilege of paying 1,236
compensation and benefits directly under section 4123.35 of the 1,237
Revised Code: 1,238
(1) Any employer mentioned in division (B)(2) of this 1,240
section; 1,241
(2) A board of county hospital trustees; 1,243
(3) A publicly owned utility. 1,245
Sec. 4123.032. Every emergency management worker shall, 1,254
with respect to the performance of his THE WORKER'S duties as 1,256
such AN emergency management worker, SHALL be in the employment 1,259
of the state or political subdivision for purposes of sections
4123.01 to 4123.94 of the Revised Code, and every emergency 1,260
management worker or, in case of death, his THE EMERGENCY 1,261
MANAGEMENT WORKERS' dependents shall be entitled to the benefits 1,262
payable on account of total disability OR IMPAIRMENT, loss of 1,263
member, or death as accorded by such sections to employees 1,265
covered by its THEIR provisions. No payment for such disability 1,267
OR IMPAIRMENT, loss of member, or death shall be made unless a 1,268
claim is filed within one year of the date of the accidental 1,269
injury causing the total disability OR IMPAIRMENT, loss of 1,270
member, or death. If an injury claim is filed within the said 1,272
THAT one-year period and the claimant subsequently dies, his THE 1,274
EMERGENCY MANAGEMENT WORKERS' dependents shall file any death 1,276
claim based on such injury within six months after the death or
be forever barred. 1,277
Sec. 4123.033. Any emergency management worker who suffers 1,286
an accidental injury while performing emergency management 1,287
duties, as defined herein, shall be compensated for any total 1,289
disability, IMPAIRMENT, or loss of member and his THE WORKERS' 1,290
dependents shall be compensated for any death resulting from such 1,291
an injury on the same basis as provided for workers, employees, 1,292
and their dependents under sections 4123.01 to 4123.94 of the 1,293
Revised Code. 1,294
30
This section shall not apply in the case of any person who 1,296
is otherwise entitled, under sections 4123.01 to 4123.94 of the 1,297
Revised Code, to receive workers' compensation benefits for such 1,298
accidental injury or death. 1,299
Sec. 4123.061. ANY RECORDS, FILES, PLEADINGS, OR DOCUMENTS 1,302
GENERATED BY A CLAIMANT'S ATTORNEY WITH RESPECT TO A CLIENT IN A 1,303
WORKERS' COMPENSATION CLAIM ARE THE PROPERTY OF THAT CLIENT. 1,304
UPON THE CLIENT'S REQUEST, THE ATTORNEY SHALL CONVEY TO THE 1,305
CLIENT COPIES OF ALL RECORDS, FILES, PLEADINGS, AND DOCUMENTS 1,306
RELATING TO THE CLIENT'S WORKERS' COMPENSATION CLAIM NO LATER 1,307
THAN FIFTEEN DAYS AFTER THE CLIENT'S REQUEST.
Sec. 4123.07. The administrator of the bureau of workers' 1,316
compensation shall prepare and furnish blank forms of application 1,317
for benefits or compensation from the state insurance fund, 1,318
reports of injury, disability, IMPAIRMENT, or occupational 1,320
disease, notices to employers and employees, proofs of injury, 1,321
disease, disability, IMPAIRMENT, or death, proofs of medical 1,323
attendance and hospital and nursing care, and proofs of 1,324
employment and wage earnings, and other necessary blanks, and 1,325
shall provide in his THE ADMINISTRATOR'S rules for their 1,326
preparation and distribution so that they may be readily
available and so prepared that the furnishing of information 1,327
required of any person with respect to any aspect of a claim 1,328
shall not be delayed by a requirement that information with 1,329
respect to another aspect of such claim shall be furnished on the 1,330
form by the same or another person. Insured employers shall keep 1,331
on hand a sufficient supply of such blanks. 1,332
Sec. 4123.15. (A) AN EMPLOYER WHO IS A MEMBER OF A 1,334
RECOGNIZED RELIGIOUS SECT OR DIVISION OF A RECOGNIZED RELIGIOUS 1,335
SECT AND WHO IS AN ADHERENT OF ESTABLISHED TENETS OR TEACHINGS OF 1,337
THAT SECT OR DIVISION BY REASON OF WHICH THE EMPLOYER IS
CONSCIENTIOUSLY OPPOSED TO ACCEPTANCE OF THE BENEFITS OF ANY 1,338
PUBLIC OR PRIVATE INSURANCE THAT MAKES PAYMENTS IN THE EVENT OF 1,339
DEATH, DISABILITY, IMPAIRMENT, OLD AGE, OR RETIREMENT OR MAKES 1,341
31
PAYMENTS TOWARD THE COST OF, OR PROVIDES SERVICES FOR, MEDICAL 1,342
BILLS, INCLUDING THE BENEFITS OF ANY INSURANCE SYSTEM ESTABLISHED
BY THE FEDERAL "SOCIAL SECURITY ACT," 42 U.S.C.A. 301, ET SEQ., 1,344
MAY APPLY TO THE ADMINISTRATOR OF WORKERS' COMPENSATION TO BE 1,345
EXCEPTED FROM PAYMENT OF PREMIUMS AND OTHER CHARGES ASSESSED 1,346
UNDER THIS CHAPTER AND CHAPTER 4121. OF THE REVISED CODE WITH 1,348
RESPECT TO, OR IF THE EMPLOYER IS A SELF-INSURING EMPLOYER, FROM 1,349
PAYMENT OF DIRECT COMPENSATION AND BENEFITS TO AND ASSESSMENTS 1,350
REQUIRED BY THIS CHAPTER AND CHAPTER 4121. OF THE REVISED CODE ON 1,351
ACCOUNT OF, AN INDIVIDUAL WHO MEETS THE REQUIREMENTS OF THIS 1,352
SECTION. THE APPLICATION SHALL BE ON FORMS PROVIDED BY THE 1,353
BUREAU OF WORKERS' COMPENSATION, WHICH FORMS MAY BE THOSE USED BY 1,354
OR SIMILAR TO THOSE USED BY THE INTERNAL REVENUE SERVICE FOR THE 1,355
PURPOSE OF GRANTING AN EXEMPTION FROM THE PAYMENT OF SOCIAL 1,356
SECURITY TAXES UNDER 26 U.S.C.A. 1402(g) OF THE INTERNAL REVENUE 1,358
CODE, AND SHALL INCLUDE A WRITTEN WAIVER, SIGNED BY THE 1,359
INDIVIDUAL TO BE EXCEPTED, OF ALL THE BENEFITS AND COMPENSATION 1,360
PROVIDED FOR IN THIS CHAPTER AND CHAPTER 4121. OF THE REVISED 1,362
CODE.
THE APPLICATION ALSO SHALL INCLUDE AFFIDAVITS SIGNED BY THE 1,365
EMPLOYER AND THAT INDIVIDUAL THAT THE EMPLOYER AND THE INDIVIDUAL 1,366
ARE MEMBERS OF A RECOGNIZED RELIGIOUS SECT OR DIVISION OF A 1,367
RECOGNIZED RELIGIOUS SECT AND ARE ADHERENTS OF ESTABLISHED TENETS 1,369
OR TEACHINGS OF THAT SECT OR DIVISION BY REASON OF WHICH THE 1,370
EMPLOYER AND THE INDIVIDUAL ARE CONSCIENTIOUSLY OPPOSED TO
ACCEPTANCE OF THE BENEFITS OF ANY PUBLIC OR PRIVATE INSURANCE 1,372
THAT MAKES PAYMENTS IN THE EVENT OF DEATH, DISABILITY, 1,373
IMPAIRMENT, OLD AGE, OR RETIREMENT OR MAKES PAYMENTS TOWARD THE 1,374
COST OF, OR PROVIDES SERVICES FOR, MEDICAL BILLS, INCLUDING THE 1,375
BENEFITS OF ANY INSURANCE SYSTEM ESTABLISHED BY THE FEDERAL 1,376
"SOCIAL SECURITY ACT," 42 U.S.C.A. 301, ET SEQ. IF THE 1,378
INDIVIDUAL IS A MINOR, THE GUARDIAN OF THE MINOR SHALL COMPLETE 1,379
THE WAIVER AND AFFIDAVIT REQUIRED BY THIS DIVISION. 1,380
(B) THE ADMINISTRATOR SHALL GRANT THE WAIVER AND EXCEPTION 1,383
32
TO THE EMPLOYER FOR A PARTICULAR INDIVIDUAL IF THE ADMINISTRATOR
FINDS THAT THE EMPLOYER AND THE INDIVIDUAL ARE MEMBERS OF A SECT 1,384
OR DIVISION HAVING THE ESTABLISHED TENETS OR TEACHINGS DESCRIBED 1,385
IN DIVISION (A) OF THIS SECTION, THAT IT IS THE PRACTICE, AND HAS 1,386
BEEN FOR A SUBSTANTIAL NUMBER OF YEARS, FOR MEMBERS OF THAT SECT 1,387
OR DIVISION OF THAT SECT TO MAKE PROVISION FOR THEIR DEPENDENT 1,388
MEMBERS WHICH IN THE ADMINISTRATOR'S JUDGMENT IS REASONABLE IN 1,389
VIEW OF THEIR GENERAL LEVEL OF HIRING, AND THAT THAT SECT OR 1,390
DIVISION OF THAT SECT HAS BEEN IN EXISTENCE AT ALL TIMES SINCE 1,391
DECEMBER 31, 1950. 1,392
(C) A WAIVER AND EXCEPTION UNDER DIVISION (B) OF THIS 1,395
SECTION IS EFFECTIVE ON THE DATE THE ADMINISTRATOR GRANTS THE 1,396
WAIVER AND EXCEPTION. AN EMPLOYER WHO COMPLIES WITH THIS CHAPTER 1,397
AND THE EMPLOYER'S EMPLOYEES, WITH RESPECT TO AN INDIVIDUAL FOR 1,398
WHOM THE ADMINISTRATOR GRANTS THE WAIVER AND EXCEPTION, ARE 1,399
ENTITLED, AS TO THAT INDIVIDUAL AND AS TO ALL INJURIES AND 1,400
OCCUPATIONAL DISEASES OF THAT INDIVIDUAL THAT OCCURRED PRIOR TO 1,401
THE EFFECTIVE DATE OF THE WAIVER AND EXCEPTION, TO THE 1,402
PROTECTIONS OF SECTIONS 4123.74 AND 4123.741 OF THE REVISED CODE. 1,403
ON AND AFTER THE EFFECTIVE DATE OF THE WAIVER AND EXCEPTION, THE 1,404
EMPLOYER IS NOT LIABLE FOR THE PAYMENT OF ANY PREMIUMS OR OTHER 1,405
CHARGES ASSESSED UNDER THIS CHAPTER OR CHAPTER 4121. OF THE 1,406
REVISED CODE, OR IF THE INDIVIDUAL IS A SELF-INSURING EMPLOYER, 1,407
THE EMPLOYER IS NOT LIABLE FOR THE PAYMENT OF ANY COMPENSATION OR 1,408
BENEFITS DIRECTLY OR OTHER CHARGES ASSESSED UNDER THIS CHAPTER OR 1,409
CHAPTER 4121. OF THE REVISED CODE, IN REGARD TO THAT INDIVIDUAL, 1,411
IS CONSIDERED A COMPLYING EMPLOYER UNDER THOSE CHAPTERS, AND THE 1,412
EMPLOYER AND THE EMPLOYER'S EMPLOYEES ARE ENTITLED TO THE 1,413
PROTECTIONS OF SECTIONS 4123.74 AND 4123.741 OF THE REVISED CODE, 1,414
AS TO THAT INDIVIDUAL, AND AS TO INJURIES AND OCCUPATIONAL 1,415
DISEASES OF THAT INDIVIDUAL THAT OCCUR ON AND AFTER THE EFFECTIVE 1,416
DATE OF THE WAIVER AND EXCEPTION. 1,417
(D) A WAIVER AND EXCEPTION GRANTED IN REGARD TO A SPECIFIC 1,420
INDIVIDUAL IS VALID FOR ALL FUTURE YEARS UNLESS THE ADMINISTRATOR 1,421
33
DETERMINES THAT THE EMPLOYER, INDIVIDUAL, OR SECT OR DIVISION
CEASES TO MEET THE REQUIREMENTS OF THIS SECTION. IF THE 1,422
ADMINISTRATOR MAKES THIS DETERMINATION, THE EMPLOYER IS LIABLE 1,423
FOR THE PAYMENT OF PREMIUMS AND OTHER CHARGES ASSESSED UNDER THIS 1,424
CHAPTER AND CHAPTER 4121. OF THE REVISED CODE, OR IF THE 1,426
INDIVIDUAL IS A SELF-INSURING EMPLOYER, THE EMPLOYER IS LIABLE 1,427
FOR THE PAYMENT OF COMPENSATION AND BENEFITS DIRECTLY AND OTHER 1,428
CHARGES ASSESSED UNDER THOSE CHAPTERS, IN REGARD TO THAT 1,429
INDIVIDUAL FOR ALL INJURIES AND OCCUPATIONAL DISEASES OF THAT 1,430
INDIVIDUAL THAT OCCUR ON AND AFTER THE DATE OF THE 1,431
ADMINISTRATOR'S DETERMINATION AND THE INDIVIDUAL IS ENTITLED TO 1,432
ALL OF THE BENEFITS AND COMPENSATION PROVIDED IN THOSE CHAPTERS 1,433
FOR AN INJURY OR OCCUPATIONAL DISEASE THAT OCCURS ON OR AFTER THE 1,434
DATE OF THE ADMINISTRATOR'S DETERMINATION.
Sec. 4123.25. (A) No employer shall KNOWINGLY 1,443
misrepresent to the bureau of workers' compensation the amount OR 1,444
CLASSIFICATION of payroll upon which the premium under this 1,446
chapter is based. Whoever violates this division shall be liable 1,447
to the state in FOR UP TO ten times the amount of the difference 1,449
in BETWEEN THE premium paid and the amount the employer should 1,450
have paid. THE ADMINISTRATOR OF WORKERS' COMPENSATION, WITH THE 1,451
ADVICE AND CONSENT OF THE WORKERS' COMPENSATION OVERSIGHT 1,452
COMMISSION, SHALL ADOPT RULES IN ACCORDANCE WITH CHAPTER 119. OF 1,453
THE REVISED CODE FOR THE ASSESSMENT OF A FINE OR PENALTY AGAINST 1,454
AN EMPLOYER FOR A VIOLATION OF THIS DIVISION. The liability to 1,455
the state under this division shall MAY be enforced in a civil 1,456
action in the name of the state, and all sums collected under 1,457
this division shall be paid into the state insurance fund. 1,458
(B) No self-insuring employer shall misrepresent the 1,460
amount of paid compensation paid by such employer for purposes of 1,461
the assessments provided under this chapter and Chapter 4121. of 1,462
the Revised Code as required by section 4123.35 of the Revised 1,463
Code. Whoever violates this division is liable to the state in 1,464
an amount assessed by the self-insuring employers evaluation 1,465
34
board ADMINISTRATOR pursuant to division (C)(B) of section 1,467
4123.352 of the Revised Code or UP TO ten times the amount of the 1,468
difference between the assessment paid and the amount of the 1,469
assessment that should have been paid along with any other 1,470
penalty as determined by the board. The liability to the state 1,471
under this division may be enforced in a civil action in the name 1,472
of the state and all sums collected under this division shall be 1,473
paid into the self-insurance assessment fund created pursuant to 1,474
division (J) of section 4123.35 of the Revised Code. 1,475
Sec. 4123.27. Information contained in the annual 1,483
statement provided for in section 4123.26 of the Revised Code, 1,484
and such other information as may be furnished to the bureau of 1,485
workers' compensation by employers in pursuance of that section, 1,486
is OR AS THE BUREAU DEVELOPS OR CREATES, AND RECORDS KEPT BY THE 1,488
DIVISION OF SAFETY AND HYGIENE PERTAINING TO WORKPLACE INJURIES 1,489
AND ILLNESSES OR OCCUPATIONAL SAFETY AND HEALTH CONDITIONS IN 1,490
SPECIFIC WORKPLACES, INCLUDING, BUT NOT LIMITED TO, INDUSTRIAL 1,491
HYGIENE REPORTS, ERGONOMIC SURVEY REPORTS, TEAM APPROACH REPORTS, 1,492
SAFETY CONSULTANT REPORTS, ACCIDENT INVESTIGATION REPORTS, LOSS 1,493
CONTROL ANALYSIS REPORTS, AND ILLNESS AND INJURY DATA PERTAINING 1,494
TO SPECIFIC WORKPLACES, ARE for the exclusive use and information 1,495
of the bureau in the discharge of its official duties, and shall 1,496
not be open to the public nor be used in any court in any action 1,497
or proceeding pending therein unless the bureau is a party to the 1,498
action or proceeding; but the information contained in the 1,499
statement may be tabulated and published by the bureau in 1,500
statistical form for the use and information of other state 1,501
departments and the public. No person in the employ of the 1,502
bureau, except those who are authorized by the administrator of 1,503
workers' compensation, shall divulge any information secured by 1,504
him THE PERSON while in the employ of the bureau in respect to 1,505
the transactions, property, claim files, records, or papers of 1,508
the bureau or in respect to the business or mechanical, chemical, 1,510
or other industrial process of any company, firm, corporation, 1,511
35
person, association, partnership, or public utility to any person 1,512
other than the administrator or to the superior of such employee
of the bureau. 1,513
Notwithstanding the restrictions imposed by this section, 1,515
the governor, select or standing committees of the general 1,516
assembly, the auditor of state, the attorney general, or their 1,517
designees, pursuant to the authority granted in this chapter and 1,518
Chapter 4121. of the Revised Code, may examine any records, claim 1,519
files, or papers in possession of the industrial commission or 1,520
the bureau. They also are bound by the privilege that attaches 1,521
to these papers. 1,522
The administrator shall report to the director of human 1,524
services or to the county director of human services the name, 1,525
address, and social security number or other identification 1,526
number of any person receiving workers' compensation whose name 1,527
or social security number or other identification number is the 1,528
same as that of a person required by a court or child support 1,529
enforcement agency to provide support payments to a recipient of 1,530
public assistance, and whose name is submitted to the 1,531
administrator by the director under section 5101.36 of the 1,532
Revised Code. The administrator also shall inform the director 1,533
of the amount of workers' compensation paid to the person during 1,534
such period as the director specifies. 1,535
Within fourteen days after receiving from the director of 1,537
human services a list of the names and social security numbers of 1,538
recipients of public assistance pursuant to section 5101.181 of 1,539
the Revised Code, the administrator shall inform the auditor of 1,540
state of the name, current or most recent address, and social 1,541
security number of each person receiving workers' compensation 1,542
pursuant to this chapter whose name and social security number 1,543
are the same as that of a person whose name or social security 1,544
number was submitted by the director. The administrator also 1,546
shall inform the auditor of state of the amount of workers'
compensation paid to the person during such period as the 1,547
36
director specifies. 1,548
The bureau and its employees, except for purposes of 1,550
furnishing the auditor of state with information required by this 1,551
section, shall preserve the confidentiality of recipients of 1,552
public assistance in compliance with division (A) of section 1,553
5101.181 of the Revised Code. 1,554
For the purposes of this section, "public assistance" means 1,556
medical assistance provided through the medical assistance 1,557
program established under section 5111.01 of the Revised Code, 1,558
aid to dependent children provided under Chapter 5107. of the 1,559
Revised Code, or disability assistance provided under Chapter 1,560
5115. of the Revised Code. 1,561
Sec. 4123.28. Every employer in this state shall keep a 1,570
record of all injuries and occupational diseases, fatal or 1,571
otherwise, received or contracted by his THE EMPLOYER'S employees 1,573
in the course of their employment and resulting in seven days or 1,574
more of total disability OR IMPAIRMENT. Within a week after 1,575
acquiring knowledge of an injury or death therefrom, and in the 1,577
event of occupational disease or death therefrom, within one week 1,578
after acquiring knowledge of or diagnosis of or death from an 1,579
occupational disease or of a report to the employer of the 1,580
occupational disease or death, a report thereof shall be made in 1,581
writing to the bureau of workers' compensation upon blanks to be 1,582
procured from the bureau for that purpose. The report shall 1,583
state the name and nature of the business of the employer, the 1,584
location of his THE EMPLOYER'S establishment or place of work, 1,586
the name, address, nature and duration of occupation of the 1,587
injured, disabled, IMPAIRED, or deceased employee and the time, 1,589
the nature, and the cause of injury, occupational disease, or 1,590
death, and such other information as is required by the bureau. 1,591
The employer shall give a copy of each report to the 1,593
employee it concerns or his THE EMPLOYEE'S surviving dependents. 1,595
No employer shall refuse or neglect to make any report 1,597
required by this section. 1,598
37
Each day that an employer fails to file a report required 1,600
by this section constitutes an additional day within the time 1,601
period given to a claimant by the applicable statute of 1,602
limitations for the filing of a claim based on the injury or 1,603
occupational disease, provided that a failure to file a report 1,604
shall not extend the applicable statute of limitations for more 1,605
than two additional years. 1,606
Sec. 4123.343. This section shall be construed liberally 1,615
to the end that employers shall be encouraged to employ and 1,616
retain in their employment handicapped employees as defined in 1,617
this section. 1,618
(A) As used in this section, "handicapped employee" means 1,620
an employee who is afflicted with or subject to any physical or 1,621
mental impairment, or both, whether congenital or due to an 1,622
injury or disease of such character that the impairment 1,623
constitutes a handicap in obtaining employment or would 1,624
constitute a handicap in obtaining reemployment if the employee 1,625
should become unemployed and whose handicap is due to any of the 1,626
following diseases or conditions: 1,627
(1) Epilepsy; 1,629
(2) Diabetes; 1,631
(3) Cardiac disease; 1,633
(4) Arthritis; 1,635
(5) Amputated foot, leg, arm, or hand; 1,637
(6) Loss of sight of one or both eyes or a partial loss of 1,639
uncorrected vision of more than seventy-five per cent 1,640
bilaterally; 1,641
(7) Residual disability OR IMPAIRMENT from poliomyelitis; 1,643
(8) Cerebral palsy; 1,645
(9) Multiple sclerosis; 1,647
(10) Parkinson's disease; 1,649
(11) Cerebral vascular accident; 1,651
(12) Tuberculosis; 1,653
(13) Silicosis; 1,655
38
(14) Psycho-neurotic disability OR IMPAIRMENT following 1,657
treatment in a recognized medical or mental institution; 1,658
(15) Hemophilia; 1,660
(16) Chronic osteomyelitis; 1,662
(17) Ankylosis of joints; 1,664
(18) Hyper insulinism; 1,666
(19) Muscular dystrophies; 1,668
(20) Arterio-sclerosis; 1,670
(21) Thrombo-phlebitis; 1,672
(22) Varicose veins; 1,674
(23) Cardiovascular, pulmonary, or respiratory diseases of 1,676
a fire fighter or police officer employed by a municipal 1,677
corporation or township as a regular member of a lawfully 1,678
constituted police department or fire department; 1,679
(24) Coal miners' pneumoconiosis, commonly referred to as 1,681
"black lung disease"; 1,682
(25) Disability OR IMPAIRMENT with respect to which an 1,684
individual has completed a rehabilitation program conducted 1,685
pursuant to sections 4121.61 to 4121.69 of the Revised Code. 1,686
(B) Under the circumstances set forth in this section all 1,688
or such portion as the administrator determines of the 1,689
compensation and benefits paid in any claim arising hereafter 1,690
shall be charged to and paid from the statutory surplus fund 1,691
created under section 4123.34 of the Revised Code and only the 1,692
portion remaining shall be merit-rated or otherwise treated as 1,693
part of the accident or occupational disease experience of the 1,694
employer. If the employer is a self-insuring employer, the 1,695
proportion of such costs whether charged to the statutory surplus 1,696
fund in whole or in part shall be by way of direct payment to 1,697
such employee or his THE EMPLOYEE'S dependents or by way of 1,698
reimbursement to the self-insuring employer as the circumstances 1,700
indicate. The provisions of this section apply only in cases of 1,701
death, TEMPORARY total disability, whether temporary or permanent 1,703
TOTAL IMPAIRMENT, and all disabilities IMPAIRMENTS compensated 1,705
39
under division (B) of section 4123.57 of the Revised Code. The 1,706
administrator shall adopt rules specifying the grounds upon which 1,707
charges to the statutory surplus fund are to be made. The rules 1,708
shall prohibit as a grounds any agreement between employer and 1,709
claimant as to the merits of a claim and the amount of the 1,710
charge.
(C) Any employer who advises the bureau of workers' 1,712
compensation prior to the occurrence of an injury or occupational 1,713
disease that it has in its employ a handicapped employee is 1,714
entitled, in the event the person is injured, to a determination 1,715
under this section. Any employer who fails to notify the bureau 1,716
but applies for a determination under this section is entitled to 1,717
a determination if the bureau finds that there was good cause for 1,718
the failure to give notice of the employment of the handicapped 1,719
employee. The bureau annually shall require employers to file an 1,720
inventory of current handicapped employees. 1,721
An employer shall file an application for a determination 1,723
with the bureau or commission in the same manner as other claims. 1,724
An application only may be made in cases where IN WHICH a 1,725
handicapped employee or his THE HANDICAPPED EMPLOYEE'S dependents 1,727
claim or is ARE receiving an award of compensation as a result of 1,728
an injury OCCURRING or AN occupational disease occurring or 1,730
contracted FIRST DIAGNOSED BY A LICENSED PHYSICIAN on or after 1,731
the date on which division (A) of this section first included the 1,733
handicap of such employee.
(D) The circumstances under and the manner in which an 1,735
apportionment under this section shall be made are AS FOLLOWS: 1,736
(1) Whenever a handicapped employee is injured, IMPAIRED, 1,739
or disabled or dies as the result of an injury or occupational 1,740
disease sustained in the course of and arising out of his THE 1,741
EMPLOYEE'S employment in this state and the administrator awards 1,743
compensation therefor and when it appears to the satisfaction of 1,744
the administrator that the injury or occupational disease or the 1,745
death resulting therefrom would not have occurred but for the 1,746
40
pre-existing physical or mental impairment of the handicapped 1,747
employee, all compensation and benefits payable on account of the 1,748
disability, IMPAIRMENT, or death shall be paid from the surplus 1,750
fund.
(2) Whenever a handicapped employee is injured, IMPAIRED, 1,753
or disabled or dies as a result of an injury or occupational 1,754
disease and the administrator finds that the injury or 1,755
occupational disease would have been sustained or suffered 1,756
without regard to the employee's pre-existing impairment but that 1,757
the resulting IMPAIRMENT, disability, or death was caused at 1,759
least in part through aggravation of the employee's pre-existing 1,760
disability IMPAIRMENT, the administrator shall determine in a 1,762
manner that is equitable and, reasonable, and based upon medical 1,764
evidence the amount of disability, IMPAIRMENT, or proportion of 1,765
the cost of the death award that is attributable to the 1,766
employee's pre-existing disability IMPAIRMENT and the amount 1,767
found shall be charged to the statutory surplus fund. 1,769
(E) The benefits and provisions of this section apply only 1,771
to employers who have complied with this chapter either through 1,772
insurance with the state fund or as a self-insuring employer. 1,773
(F) No employer shall in any year SHALL receive credit 1,775
under this section in an amount greater than the premium he THE 1,776
EMPLOYER paid if a state fund employer or greater than his THE 1,778
EMPLOYER'S assessments if a self-insuring employer. 1,780
(G) Self-insuring employers may, for all claims made after 1,782
January 1, 1987, for compensation and benefits under this 1,783
section, MAY pay the compensation and benefits directly to the 1,784
employee or the employee's dependents. If such an employer 1,785
chooses to pay compensation and benefits directly, he THE 1,786
EMPLOYER shall receive no money or credit from the surplus fund 1,788
for the payment under this section, nor shall he THE EMPLOYER be 1,789
required to pay any amounts into the surplus fund that otherwise 1,791
would be assessed for handicapped reimbursements for claims made 1,792
after January 1, 1987. Where IF a self-insuring employer elects 1,793
41
to pay for compensation and benefits pursuant to this section, he 1,795
THE EMPLOYER shall assume responsibility for compensation and 1,797
benefits arising out of claims made prior to January 1, 1987, and 1,798
shall not be required to pay any amounts into the surplus fund 1,799
and may not receive any money or credit from that fund on account 1,800
of this section. The election made under this division is 1,801
irrevocable.
(H) An order issued by the administrator pursuant to this 1,803
section is appealable under section 4123.511 of the Revised Code 1,804
but is not appealable to court under section 4123.512 of the 1,805
Revised Code. 1,806
Sec. 4123.35. (A) Except as provided in this section, 1,815
every employer mentioned in division (B)(2) of section 4123.01 of 1,816
the Revised Code, and every publicly owned utility shall pay 1,817
semiannually in the months of January and July into the state 1,819
insurance fund the amount of annual premium the administrator of 1,820
workers' compensation fixes for the employment or occupation of 1,821
the employer, the amount of which premium to be paid by each 1,822
employer to be determined by the classifications, rules, and 1,823
rates made and published by the administrator. The employer
shall pay semiannually a further sum of money into the state 1,824
insurance fund as may be ascertained to be due from the employer 1,827
by applying the rules of the administrator, and a receipt or 1,828
certificate certifying that payment has been made shall be mailed 1,830
immediately to the employer by the bureau of workers'
compensation. The receipt or certificate is prima facie evidence 1,831
of the payment of the premium. 1,832
The bureau of workers' compensation shall verify with the 1,834
secretary of state the existence of all corporations and 1,835
organizations making application for workers' compensation 1,836
coverage and shall require every such application to include the 1,837
employer's federal identification number. 1,838
An employer as defined in division (B)(2) of section 1,840
4123.01 of the Revised Code who has contracted with a 1,841
42
subcontractor is liable for the unpaid premium due from any 1,842
subcontractor with respect to that part of the payroll of the 1,843
subcontractor that is for work performed pursuant to the contract 1,845
with the employer.
Division (A) of section 4123.35 of the Revised Code 1,847
providing for the payment of premiums semiannually does not apply 1,848
to any employer who was a subscriber to the state insurance fund 1,849
prior to January 1, 1914, or who may first become a subscriber to 1,850
the fund in any month other than January or July. Instead, the 1,851
semiannual premiums shall be paid by those employers from time to 1,852
time upon the expiration of the respective periods for which 1,853
payments into the fund have been made by them.
The administrator shall adopt rules to permit employers to 1,855
make periodic payments of the semiannual premium due under this 1,856
division. The rules shall include provisions for the assessment 1,857
of interest charges, where appropriate, and for the assessment of 1,858
penalties when an employer fails to make timely premium payments. 1,860
An employer who timely pays the amounts due under this division 1,861
is entitled to all of the benefits and protections of this 1,862
chapter. Upon receipt of payment, the bureau immediately shall 1,863
mail a receipt or certificate to the employer certifying that
payment has been made, which receipt is prima-facie evidence of 1,865
payment. Workers' compensation coverage under this chapter 1,866
continues uninterrupted upon timely receipt of payment under this 1,867
division.
Every employer mentioned in division (B)(1) of section 1,869
4123.01 of the Revised Code, except boards of county hospital 1,870
trustees that are self-insuring employers under this section, 1,871
shall comply with sections 4123.38 to 4123.41, and 4123.48 of the 1,873
Revised Code in regard to the contribution of moneys to the 1,874
public insurance fund. 1,875
(B) Provided, that employers mentioned in division (B)(2) 1,877
of section 4123.01 of the Revised Code, boards of county hospital 1,878
trustees, and publicly owned utilities who will abide by the 1,879
43
rules of the administrator and who may be of sufficient financial 1,880
ability to render certain the payment of compensation to injured 1,881
employees or the dependents of killed employees, and the 1,882
furnishing of medical, surgical, nursing, and hospital attention 1,883
and services and medicines, and funeral expenses, equal to or 1,884
greater than is provided for in sections 4123.52, 4123.55 to 1,885
4123.62, and 4123.64 to 4123.67 of the Revised Code, and who do 1,886
not desire to insure the payment thereof or indemnify themselves 1,887
against loss sustained by the direct payment thereof, upon a 1,888
finding of such facts by the administrator, may be granted the 1,889
privilege to pay individually compensation, and furnish medical, 1,891
surgical, nursing, and hospital services and attention and 1,892
funeral expenses directly to injured employees or the dependents 1,893
of killed employees, thereby being granted status as a 1,895
self-insuring employer. The administrator may charge employers, 1,896
boards of county hospital trustees, or publicly owned utilities 1,897
who apply for the status as a self-insuring employer a reasonable 1,898
application fee to cover the bureau's costs in connection with 1,899
processing and making a determination with respect to an 1,900
application. All employers granted such status shall demonstrate 1,901
sufficient financial and administrative ability to assure that 1,902
all obligations under this section are promptly met. The 1,903
administrator shall deny the privilege where the employer is 1,904
unable to demonstrate the employer's ability to promptly meet all 1,905
the obligations imposed on the employer by this section. The 1,906
administrator shall consider, but is not limited to, the 1,908
following factors, where applicable, in determining the
employer's ability to meet all of the obligations imposed on the 1,909
employer by this section: 1,910
(1) The employer employs a minimum of five hundred 1,912
employees in this state; 1,913
(2) The employer has operated in this state for a minimum 1,915
of two years, provided that an employer who has purchased, 1,916
acquired, or otherwise succeeded to the operation of a business, 1,917
44
or any part thereof, situated in this state that has operated for 1,918
at least two years in this state, also shall qualify; 1,919
(3) Where the employer previously contributed to the state 1,921
insurance fund or is a successor employer as defined by bureau 1,922
rules, the amount of the buy-out, as defined by bureau rules; 1,923
(4) The sufficiency of the employer's assets located in 1,925
this state to insure the employer's solvency in paying 1,926
compensation directly; 1,927
(5) The financial records, documents, and data, certified 1,929
by a certified public accountant, necessary to provide the 1,930
employer's full financial disclosure. The records, documents, 1,931
and data include, but are not limited to, balance sheets and 1,932
profit and loss history for the current year and previous four 1,933
years. 1,934
(6) The employer's organizational plan for the 1,936
administration of the workers' compensation law; 1,937
(7) The employer's proposed plan to inform employees of 1,939
the change from a state fund insurer to a self-insuring employer, 1,940
the procedures the employer will follow as a self-insuring 1,941
employer, and the employees' rights to compensation and benefits; 1,942
and 1,943
(8) The employer has either an account in a financial 1,945
institution in this state, or if the employer maintains an 1,946
account with a financial institution outside this state, ensures 1,947
that workers' compensation checks are drawn from the same account 1,948
as payroll checks or the employer clearly indicates that payment 1,949
will be honored by a financial institution in this state. 1,950
The administrator may waive the requirements of divisions 1,952
(B)(1) and (2) of this section and the requirement of division 1,953
(B)(5) of this section that the financial records, documents, and 1,954
data be certified by a certified public accountant. The 1,955
administrator shall adopt rules establishing the criteria that an 1,956
employer shall meet in order for the administrator to waive the 1,957
requirement of division (B)(5) of this section. Such rules may 1,958
45
require additional security of that employer pursuant to division 1,959
(E) of section 4123.351 of the Revised Code. The administrator 1,960
shall not grant the status of self-insuring employer to any 1,961
public employer, other than publicly owned utilities and boards 1,962
of county hospital trustees. 1,963
(C) The administrator shall require a surety bond from all 1,965
self-insuring employers, issued pursuant to section 4123.351 of 1,966
the Revised Code, that is sufficient to compel, or secure to 1,967
injured employees, or to the dependents of employees killed, the 1,968
payment of compensation and expenses, which shall in no event be 1,969
less than that paid or furnished out of the state insurance fund 1,970
in similar cases to injured employees or to dependents of killed 1,971
employees whose employers contribute to the fund, except when an 1,972
employee of the employer, who has suffered the loss of a hand, 1,973
arm, foot, leg, or eye prior to the injury for which compensation 1,974
is to be paid, and thereafter suffers the loss of any other of 1,975
the members as the result of any injury sustained in the course 1,976
of and arising out of the employee's employment, the compensation 1,978
to be paid by the self-insuring employer is limited to the
disability OR IMPAIRMENT suffered in the subsequent injury, 1,979
additional compensation, if any, to be paid by the bureau out of 1,981
the surplus created by section 4123.34 of the Revised Code. 1,982
(D) In addition to the requirements of this section, the 1,984
administrator shall make and publish rules governing the manner 1,985
of making application and the nature and extent of the proof 1,986
required to justify a finding of fact by the administrator as to 1,987
granting the status of a self-insuring employer, which rules 1,988
shall be general in their application, one of which rules shall 1,989
provide that all self-insuring employers shall pay into the state 1,990
insurance fund such amounts as are required to be credited to the 1,991
surplus fund in division (B) of section 4123.34 of the Revised 1,992
Code. 1,993
Employers shall secure directly from the bureau central 1,995
offices application forms upon which the bureau shall stamp a 1,996
46
designating number. Prior to submission of an application, an 1,997
employer shall make available to the bureau, and the bureau shall 1,998
review, the information described in divisions (B)(1) to (8) of 1,999
this section. An employer shall file the completed application 2,000
forms with an application fee, which shall cover the costs of 2,001
processing the application, as established by the administrator, 2,002
by rule, with the bureau at least ninety days prior to the 2,003
effective date of the employer's new status as a self-insuring 2,004
employer. The application form is not deemed complete until all 2,005
the required information is attached thereto. The bureau shall 2,006
only accept applications that contain the required information. 2,007
(E) The bureau shall review completed applications within 2,009
a reasonable time. If the bureau determines to grant an employer 2,010
the status as a self-insuring employer, the bureau shall issue a 2,011
statement, containing its findings of fact, that is prepared by 2,012
the bureau and signed by the administrator. If the bureau 2,013
determines not to grant the status as a self-insuring employer, 2,014
the bureau shall notify the employer of the determination and 2,015
require the employer to continue to pay its full premium into the 2,016
state insurance fund. The administrator also shall adopt rules 2,017
establishing a minimum level of performance as a criterion for 2,018
granting and maintaining the status as a self-insuring employer 2,019
and fixing time limits beyond which failure of the self-insuring 2,020
employer to provide for the necessary medical examinations and 2,021
evaluations may not delay a decision on a claim. 2,022
(F) The administrator shall adopt rules setting forth 2,024
procedures for auditing the program of self-insuring employers. 2,025
The bureau shall conduct the audit upon a random basis or 2,026
whenever the bureau has grounds for believing that an employer is 2,027
not in full compliance with bureau rules or this chapter. 2,028
The administrator shall monitor the programs conducted by 2,030
self-insuring employers, to ensure compliance with bureau 2,031
requirements and for that purpose, shall develop and issue to 2,032
self-insuring employers standardized forms for use by the 2,033
47
employer in all aspects of the employers' direct compensation 2,034
program and for reporting of information to the bureau. 2,035
The bureau shall receive and transmit to the employer all 2,037
complaints concerning any self-insuring employer. In the case of 2,038
a complaint against a self-insuring employer, the administrator 2,039
shall handle the complaint through the self-insurance division of 2,040
the bureau. The bureau shall maintain a file by employer of all 2,041
complaints received that relate to the employer. The bureau 2,042
shall evaluate each complaint and take appropriate action. 2,043
The administrator shall adopt as a rule a prohibition 2,045
against any self-insuring employer from harassing, dismissing, or 2,046
otherwise disciplining any employee making a complaint, which 2,047
rule shall provide for a financial penalty to be levied by the 2,048
administrator payable by the offending employer. 2,049
(G) For the purpose of making determinations as to whether 2,051
to grant status as a self-insuring employer, the administrator 2,052
may subscribe to and pay for a credit reporting service that 2,053
offers financial and other business information about individual 2,054
employers. The costs in connection with the bureau's 2,055
subscription or individual reports from the service about an 2,056
applicant may be included in the application fee charged 2,057
employers under this section. 2,058
(H) The administrator, notwithstanding other provisions of 2,061
this chapter, may permit a self-insuring employer to resume 2,062
payment of premiums to the state insurance fund with appropriate 2,063
credit modifications to the employer's basic premium rate as such 2,064
rate is determined pursuant to section 4123.29 of the Revised 2,065
Code.
(I) On the first day of July of each year, the 2,067
administrator shall calculate separately each self-insuring 2,068
employer's assessments for the safety and hygiene fund, 2,069
administrative costs pursuant to section 4123.342 of the Revised 2,070
Code, and for the portion of the surplus fund under division (B) 2,071
of section 4123.34 of the Revised Code that is not used for 2,072
48
handicapped reimbursement, on the basis of the paid compensation 2,073
attributable to the individual self-insuring employer according 2,074
to the following calculation: 2,075
(1) The total assessment against all self-insuring 2,077
employers as a class for each fund and for the administrative 2,078
costs for the year that the assessment is being made, as 2,079
determined by the administrator, divided by the total amount of 2,080
paid compensation for the previous calendar year attributable to 2,081
all amenable self-insuring employers; 2,082
(2) Multiply the quotient in division (I)(1) of this 2,084
section by the total amount of paid compensation for the previous 2,085
calendar year that is attributable to the individual 2,086
self-insuring employer for whom the assessment is being 2,087
determined. Each self-insuring employer shall pay the assessment 2,088
that results from this calculation, unless the assessment 2,089
resulting from this calculation falls below a minimum assessment, 2,090
which minimum assessment the administrator shall determine on the 2,091
first day of July of each year with the advice and consent of the 2,092
workers' compensation oversight commission, in which event, the 2,093
self-insuring employer shall pay the minimum assessment. 2,094
In determining the total amount due for the total 2,096
assessment against all self-insuring employers as a class for 2,097
each fund and the administrative assessment, the administrator 2,098
shall reduce proportionately the total for each fund and 2,100
assessment by the amount of money in the self-insurance 2,101
assessment fund as of the date of the computation of the 2,102
assessment. 2,103
The administrator shall calculate the assessment for the 2,105
portion of the surplus fund under division (B) of section 4123.34 2,106
of the Revised Code that is used for handicapped reimbursement in 2,107
the same manner as set forth in divisions (I)(1) and (2) of this 2,108
section except that the administrator shall calculate the total 2,109
assessment for this portion of the surplus fund only on the basis 2,110
of those self-insuring employers that retain participation in the 2,111
49
handicapped reimbursement program and the individual 2,112
self-insuring employer's proportion of paid compensation shall be 2,113
calculated only for those self-insuring employers who retain 2,114
participation in the handicapped reimbursement program. The 2,115
administrator, as the administrator determines appropriate, may 2,117
determine the total assessment for the handicapped portion of the 2,118
surplus fund in accordance with sound actuarial principles. 2,119
The administrator shall calculate the assessment for the 2,121
portion of the surplus fund under division (B) of section 4123.34 2,122
of the Revised Code that under division (D) of section 4121.66 of 2,123
the Revised Code is used for rehabilitation costs in the same 2,124
manner as set forth in divisions (I)(1) and (2) of this section, 2,125
except that the administrator shall calculate the total 2,126
assessment for this portion of the surplus fund only on the basis 2,127
of those self-insuring employers who have not made the election 2,128
to make payments directly under division (D) of section 4121.66 2,129
of the Revised Code and an individual self-insuring employer's 2,130
proportion of paid compensation only for those self-insuring 2,131
employers who have not made that election. 2,132
An employer who no longer is a self-insuring employer in 2,134
this state or who no longer is operating in this state, shall 2,135
continue to pay assessments for administrative costs and for the 2,136
portion of the surplus fund under division (B) of section 4123.34 2,137
of the Revised Code that is not used for handicapped 2,138
reimbursement, based upon paid compensation attributable to 2,139
claims that occurred while the employer was a self-insuring 2,140
employer within this state. 2,141
(J) There is hereby created in the state treasury the 2,143
self-insurance assessment fund. All investment earnings of the 2,144
fund shall be deposited in the fund. The administrator shall use 2,145
the money in the self-insurance assessment fund only for 2,146
administrative costs as specified in section 4123.341 of the 2,147
Revised Code. 2,148
(K) Every self-insuring employer shall certify, in 2,150
50
affidavit form subject to the penalty for perjury, to the bureau 2,151
the amount of the self-insuring employer's paid compensation for 2,152
the previous calendar year. In reporting paid compensation paid 2,153
for the previous year, a self-insuring employer shall exclude 2,154
from the total amount of paid compensation any reimbursement the 2,155
employer receives in the previous calendar year from the surplus 2,156
fund pursuant to section 4123.512 of the Revised Code for any 2,157
paid compensation. The self-insuring employer also shall exclude 2,158
from the paid compensation reported any amount recovered under 2,159
section 4123.93 of the Revised Code and any amount that is 2,160
determined not to have been payable to or on behalf of a claimant 2,161
in any final administrative or judicial proceeding. The 2,162
self-insuring employer shall exclude such amounts from the paid 2,163
compensation reported in the reporting period subsequent to the 2,164
date the determination is made. The administrator shall adopt 2,165
rules, in accordance with Chapter 119. of the Revised Code, 2,166
establishing the date by which self-insuring employers must 2,167
submit such information and the amount of the assessments 2,168
provided for in division (I) of this section for employers who 2,169
have been granted self-insuring status within the last calendar 2,170
year. 2,171
The administrator shall include any assessment that remains 2,173
unpaid for previous assessment periods in the calculation and 2,174
collection of any assessments due under this division or division 2,175
(I) of this section. 2,176
(L) As used in this section, "paid compensation" means all 2,178
amounts paid by a self-insuring employer for living maintenance 2,179
benefits, all amounts for compensation paid pursuant to sections 2,180
4121.63, 4121.67, 4123.56, 4123.57, 4123.58, 4123.59, 4123.60, 2,181
and 4123.64 of the Revised Code, all amounts paid as wages in 2,182
lieu of such compensation, all amounts paid in lieu of such 2,183
compensation under a nonoccupational accident and sickness 2,184
program fully funded by the self-insuring employer, and all 2,185
amounts paid by a self-insuring employer for a violation of a 2,186
51
specific safety standard pursuant to Section 35 of Article II, 2,187
Ohio Constitution and section 4121.47 of the Revised Code. 2,188
(M) Should any section of this chapter or Chapter 4121. of 2,190
the Revised Code providing for self-insuring employers' 2,191
assessments based upon compensation paid be declared 2,192
unconstitutional by a final decision of any court, then that 2,193
section of the Revised Code declared unconstitutional shall 2,194
revert back to the section in existence prior to November 3, 2,195
1989, providing for assessments based upon payroll. 2,196
(N) The administrator may grant a self-insuring employer 2,198
the privilege to self-insure a construction project entered into 2,199
by the self-insuring employer that is scheduled for completion 2,200
within six years after the date the project begins, and the total 2,201
cost of which is estimated to exceed one hundred million dollars. 2,203
The administrator may waive such cost and time criteria and grant 2,204
a self-insuring employer the privilege to self-insure a
construction project regardless of the time needed to complete 2,205
the construction project and provided that the cost of the 2,206
construction project is estimated to exceed fifty million 2,207
dollars. A self-insuring employer who desires to self-insure a 2,209
construction project shall submit to the administrator an
application listing the dates the construction project is 2,210
scheduled to begin and end, the estimated cost of the 2,212
construction project, the contractors and subcontractors whose
employees are to be self-insured by the self-insuring employer, 2,213
the provisions of a safety program that is specifically designed 2,214
for the construction project, and a statement as to whether a 2,215
collective bargaining agreement governing the rights, duties, and 2,216
obligations of each of the parties to the agreement with respect 2,217
to the construction project exists between the self-insuring 2,218
employer and a labor organization. 2,219
A self-insuring employer may apply to self-insure the 2,221
employees of either of the following: 2,222
(1) All contractors and subcontractors who perform labor 2,224
52
or work or provide materials for the construction project; 2,225
(2) All contractors and, at the administrator's 2,227
discretion, a substantial number of all the subcontractors who 2,228
perform labor or work or provide materials for the construction 2,229
project.
Upon approval of the application, the administrator shall 2,231
mail a certificate granting the privilege to self-insure the 2,232
construction project to the self-insuring employer. The 2,233
certificate shall contain the name of the self-insuring employer 2,234
and the name, address, and telephone number of the self-insuring 2,235
employer's representatives who are responsible for administering
workers' compensation claims for the construction project. The 2,236
self-insuring employer shall post the certificate in a 2,237
conspicuous place at the site of the construction project. 2,238
The administrator shall maintain a record of the 2,240
contractors and subcontractors whose employees are covered under 2,241
the certificate issued to the self-insured employer. A 2,242
self-insuring employer immediately shall notify the administrator 2,243
when any contractor or subcontractor is added or eliminated from 2,244
inclusion under the certificate.
Upon approval of the application, the self-insuring 2,246
employer is responsible for the administration and payment of all 2,247
claims under this chapter and Chapter 4121. of the Revised Code 2,248
for the employees of the contractor and subcontractors covered 2,249
under the certificate who receive injuries or are killed in the 2,250
course of and arising out of employment on the construction 2,252
project, or who contract an occupational disease in the course of 2,253
employment on the construction project. For purposes of this
chapter and Chapter 4121. of the Revised Code, a claim that is 2,255
administered and paid in accordance with this division is
considered a claim against the self-insuring employer listed in 2,256
the certificate. A contractor or subcontractor included under 2,257
the certificate shall report to the self-insuring employer listed 2,258
in the certificate, all claims that arise under this chapter and 2,259
53
Chapter 4121. of the Revised Code in connection with the 2,261
construction project for which the certificate is issued. 2,262
A self-insuring employer who complies with this division is 2,264
entitled to the protections provided under this chapter and 2,265
Chapter 4121. of the Revised Code with respect to the employees 2,267
of the contractors and subcontractors covered under a certificate 2,268
issued under this division for death or injuries that arise out 2,269
of, or death, injuries, or occupational diseases that arise in
the course of, those employees' employment on that construction 2,271
project, as if the employees were employees of the self-insuring 2,272
employer, provided that the self-insuring employer also complies 2,273
with this section. No employee of the contractors and
subcontractors covered under a certificate issued under this 2,274
division shall be considered the employee of the self-insuring 2,275
employer listed in that certificate for any purposes other than 2,276
this chapter and Chapter 4121. of the Revised Code. Nothing in 2,277
this division gives a self-insuring employer authority to control 2,278
the means, manner, or method of employment of the employees of 2,279
the contractors and subcontractors covered under a certificate 2,280
issued under this division. 2,281
The contractors and subcontractors included under a 2,283
certificate issued under this division are entitled to the 2,284
protections provided under this chapter and Chapter 4121. of the 2,285
Revised Code with respect to the contractor's or subcontractor's 2,286
employees who are employed on the construction project which is 2,287
the subject of the certificate, for death or injuries that arise 2,288
out of, or death, injuries, or occupational diseases that arise 2,289
in the course of, those employees' employment on that 2,290
construction project.
The contractors and subcontractors included under a 2,292
certificate issued under this division shall identify in their 2,293
payroll records the employees who are considered the employees of 2,294
the self-insuring employer listed in that certificate for 2,295
purposes of this chapter and Chapter 4121. of the Revised Code, 2,297
54
and the amount that those employees earned for employment on the 2,298
construction project that is the subject of that certificate. 2,299
Notwithstanding any provision to the contrary under this chapter
and Chapter 4121. of the Revised Code, the administrator shall 2,302
exclude the payroll that is reported for employees who are 2,303
considered the employees of the self-insuring employer listed in
that certificate, and that the employees earned for employment on 2,304
the construction project that is the subject of that certificate, 2,305
when determining those contractors' or subcontractors' premiums 2,306
or assessments required under this chapter and Chapter 4121. of 2,307
the Revised Code. A self-insuring employer issued a certificate 2,308
under this division shall include in the amount of paid 2,309
compensation it reports pursuant to division (K) of this section, 2,310
the amount of paid compensation the self-insuring employer paid 2,311
pursuant to this division for the previous calendar year. 2,312
Nothing in this division shall be construed as altering the 2,314
rights of employees under this chapter and Chapter 4121. of the 2,315
Revised Code as those rights existed prior to the effective date 2,317
of this amendment SEPTEMBER 17, 1996. Nothing in this division 2,318
shall be construed as altering the rights devolved under sections 2,319
2305.31 and 4123.82 of the Revised Code as those rights existed 2,321
prior to the effective date of this amendment SEPTEMBER 17, 1996. 2,322
As used in this division, "privilege to self-insure a 2,324
construction project" means privilege to pay individually 2,325
compensation, and to furnish medical, surgical, nursing, and 2,326
hospital services and attention and funeral expenses directly to 2,327
injured employees or the dependents of killed employees. 2,328
(O) A self-insuring employer whose application is granted 2,330
under division (N) of this section shall designate a safety 2,331
professional to be responsible for the administration and 2,332
enforcement of the safety program that is specifically designed 2,333
for the construction project that is the subject of the 2,334
application.
A self-insuring employer whose application is granted under 2,336
55
division (N) of this section shall employ an ombudsperson for the 2,337
construction project that is the subject of the application. The 2,338
ombudsperson shall have experience in workers' compensation or 2,339
the construction industry, or both. The ombudsperson shall 2,340
perform all of the following duties:
(1) Communicate with and provide information to employees 2,342
who are injured in the course of, or whose injury arises out of 2,343
employment on the construction project, or who contract an 2,344
occupational disease in the course of employment on the 2,345
construction project;
(2) Investigate the status of a claim upon the request of 2,347
an employee to do so; 2,348
(3) Provide information to claimants, third party 2,350
administrators, employers, and other persons to assist those 2,351
persons in protecting their rights under this chapter and Chapter 2,352
4121. of the Revised Code. 2,353
A self-insuring employer whose application is granted under 2,355
division (N) of this section shall post the name of the safety 2,357
professional and the ombudsperson and instructions for contacting
the safety professional and the ombudsperson in a conspicuous 2,358
place at the site of the construction project. 2,359
(P) The administrator may consider all of the following 2,362
when deciding whether to grant a self-insuring employer the 2,363
privilege to self-insure a construction project as provided under 2,364
division (N) of this section: 2,365
(1) Whether the self-insuring employer has an 2,367
organizational plan for the administration of the workers' 2,368
compensation law; 2,369
(2) Whether the safety program that is specifically 2,371
designed for the construction project provides for the safety of 2,372
employees employed on the construction project, is applicable to 2,374
all contractors and subcontractors who perform labor or work or 2,375
provide materials for the construction project, and has a
component, a safety training program that complies with standards 2,376
56
adopted pursuant to the "Occupational Safety and Health Act of 2,377
1970," 84 Stat. 1590, 29 U.S.C.A. 651, and provides for 2,378
continuing management and employee involvement; 2,379
(3) Whether granting the privilege to self-insure the 2,381
construction project will reduce the costs of the construction 2,382
project; 2,383
(4) Whether the self-insuring employer has employed an 2,385
ombudsperson as required under division (O) of this section; 2,387
(5) Whether the self-insuring employer has sufficient 2,389
surety to secure the payment of claims for which the 2,390
self-insuring employer would be responsible pursuant to the 2,391
granting of the privilege to self-insure a construction project 2,392
under division (N) of this section. 2,394
Sec. 4123.352. (A) There is hereby created the 2,403
self-insuring employers evaluation board consisting of three 2,404
members. The member of the industrial commission representing 2,405
the public shall be a member of the self-insuring employers 2,406
evaluation board and shall serve, ex officio, as chairman 2,407
CHAIRPERSON. The governor shall appoint the remaining two 2,408
members with the advice and consent of the senate. One member 2,409
shall be a member of the Ohio self-insurance association and one 2,410
member shall be a representative of labor. Not more than two of 2,411
the three members of the board may be of the same political 2,412
party.
Of the two members originally appointed by the governor 2,414
pursuant to this section, one shall serve an initial term of two 2,415
years and one an initial term of four years. Thereafter, terms 2,416
of office of the two members are for four years, each term ending 2,417
on the same date as the original date of appointment. Any member 2,418
appointed to fill a vacancy occurring prior to the expiration of 2,419
the term for which his THE MEMBER'S predecessor was appointed 2,420
shall hold office for the remainder of such term. Any member 2,421
shall continue in office subsequent to the expiration date of his 2,422
THE MEMBER'S term until his A successor takes office, or until a 2,423
57
period of sixty days has elapsed, whichever occurs first. A 2,425
vacancy in an unexpired term shall be filled in the same manner 2,426
as the original appointment. The governor may remove any member 2,427
pursuant to section 3.05 of the Revised Code. 2,428
The board member who also is a member of the commission 2,430
shall receive no additional compensation but shall be reimbursed 2,431
for actual and necessary expenses in the performance of his THE 2,432
MEMBER'S duties AS A MEMBER OF THE BOARD. The two remaining 2,433
members of the board shall receive per diem compensation fixed 2,434
pursuant to division (J) of section 124.15 of the Revised Code 2,435
and actual and necessary expenses incurred in the performance of 2,436
their duties.
For administrative purposes, the board is a part of the 2,438
bureau of workers' compensation, and the bureau shall furnish the 2,439
board with necessary office space, staff, and supplies. The 2,440
board shall meet as required by the administrator of workers' 2,441
compensation. 2,442
(B) In addition to the grounds listed in section 4123.35 2,444
of the Revised Code pertaining to criteria for being granted the 2,445
status as a self-insuring employer, the grounds upon which the 2,446
administrator may ASSESS A FINE OR PENALTY AGAINST, OR revoke or 2,447
refuse to renew the SELF-INSURING status includes OF A 2,448
SELF-INSURING EMPLOYER INCLUDE failure to comply with any rules 2,449
or orders of the administrator or to pay contributions to the 2,451
self-insuring employers' guaranty fund established by section 2,452
4123.351 of the Revised Code, continued failure to file medical 2,453
reports bearing upon the injury of the claimant, and failure to 2,454
pay compensation or benefits in accordance with law in a timely 2,455
manner. A deficiency in any of the grounds listed in this 2,456
division is sufficient to justify the administrator's ASSESSMENT 2,457
OF A FINE OR PENALTY AGAINST A SELF-INSURING EMPLOYER, OR THE 2,458
revocation or refusal to renew the employer's status as a 2,459
self-insuring employer. THE ADMINISTRATOR, OR THE
ADMINISTRATOR'S DESIGNEE, SHALL HOLD A HEARING, AFTER NOTICE TO 2,460
58
THE SELF-INSURING EMPLOYER OF THE HEARING, BEFORE ASSESSING A 2,461
FINE OR PENALTY AGAINST A SELF-INSURING EMPLOYER OR REVOKING OR 2,462
REFUSING TO RENEW AN EMPLOYER'S STATUS AS A SELF-INSURING 2,463
EMPLOYER. The administrator need not ASSESS A FINE OR PENALTY 2,465
AGAINST A SELF-INSURING EMPLOYER, OR revoke or refuse to renew an 2,466
employer's status as a self-insuring employer if adequate 2,467
corrective action is taken by the employer pursuant to division 2,468
(C) of this section. THE ADMINISTRATOR, WITH THE ADVICE AND 2,469
CONSENT OF THE WORKERS' COMPENSATION OVERSIGHT COMMISSION, SHALL 2,470
ADOPT RULES IN ACCORDANCE WITH CHAPTER 119. OF THE REVISED CODE 2,473
FOR THE ASSESSMENT OF A FINE OR PENALTY UNDER THIS SECTION 2,474
AGAINST A SELF-INSURING EMPLOYER. ALL SUMS COLLECTED UNDER THIS 2,475
DIVISION SHALL BE PAID INTO THE SELF-INSURANCE ASSESSMENT FUND 2,476
CREATED PURSUANT TO DIVISION (J) OF SECTION 4123.35 OF THE 2,478
REVISED CODE. 2,479
(C) The administrator shall refer to the board all 2,481
complaints or allegations of misconduct against a self-insuring 2,482
employer or questions as to whether a self-insuring employer 2,483
continues to meet minimum standards. The board shall investigate 2,484
and may order the employer to take corrective action in 2,485
accordance with the schedule the board fixes. The board's 2,486
determination in this regard need not be made by formal hearing 2,487
but shall be issued in written form and contain the signature of 2,488
at least two board members. If the board determines, after A 2,490
SELF-INSURING EMPLOYER MAY APPEAL THE ADMINISTRATOR'S ASSESSMENT 2,491
OF A FINE OR PENALTY AGAINST A SELF-INSURING EMPLOYER, OR THE 2,492
REVOCATION OF OR REFUSAL TO RENEW THE SELF-INSURING STATUS OF A 2,493
SELF-INSURING EMPLOYER UNDER THIS SECTION, WITHIN THIRTY DAYS 2,494
AFTER RECEIPT OF NOTICE OF THE FINE, PENALTY, REVOCATION, OR 2,495
RENEWAL REFUSAL, TO THE SELF-INSURING EMPLOYERS EVALUATION BOARD. 2,496
THE FILING OF AN APPEAL SHALL STAY THE ADMINISTRATOR'S ORDER. 2,497
AFTER a hearing conducted pursuant to Chapter 119. of the Revised 2,498
Code and the rules of the bureau, that the employer has failed to 2,499
correct the deficiencies within the time fixed by the board or is 2,500
59
otherwise in violation of this chapter, the board shall recommend 2,502
to the administrator revocation of an employer's status as a
self-insuring employer or such other penalty which may include, 2,503
but is not limited to, probation, or a civil penalty not to 2,504
exceed ten thousand dollars for each failure. A board 2,505
recommendation to revoke an employer's status as a self-insuring 2,506
employer shall be by unanimous vote. A recommendation for any 2,507
other penalty shall be by majority vote. Where the board makes 2,508
recommendations to the administrator for disciplining a 2,509
self-insuring employer, the administrator promptly and fully 2,510
shall implement the recommendations AFFIRM OR VACATE THE 2,512
ASSESSMENT OF A FINE OR PENALTY AGAINST A SELF-INSURING EMPLOYER 2,513
BY MAJORITY VOTE OF THE BOARD. IF THE ADMINISTRATOR DECIDES TO 2,514
REVOKE OR REFUSE TO RENEW THE EMPLOYER'S STATUS AS A 2,515
SELF-INSURING EMPLOYER, THE BOARD'S DECISION TO AFFIRM THE 2,516
ADMINISTRATOR'S DECISION SHALL BE BY UNANIMOUS VOTE. 2,517
Sec. 4123.411. (A) For the purpose of carrying out 2,526
sections 4123.412 to 4123.418 of the Revised Code, the 2,527
administrator of workers' compensation, with the advice and 2,529
consent of the workers' compensation oversight commission, shall 2,530
levy an assessment against all employers at a rate, of at least 2,532
five but not to exceed ten cents per one hundred dollars of 2,533
payroll, such rate to be determined annually for each employer 2,534
group listed in divisions (A)(1) to (3) of this section, which 2,535
will produce an amount no greater than the amount the 2,536
administrator estimates to be necessary to carry out such 2,537
sections for the period for which the assessment is levied. In 2,538
the event the amount produced by the assessment is not sufficient 2,539
to carry out such sections the additional amount necessary shall 2,540
be provided from the income produced as a result of investments 2,541
made pursuant to section 4123.44 of the Revised Code. 2,542
Assessments shall be levied according to the following 2,544
schedule: 2,545
(1) Private fund employers, except self-insuring 2,547
60
employers--in January and July of each year upon gross payrolls 2,548
of the preceding six months; 2,549
(2) Counties and taxing district employers therein, except 2,551
county hospitals that are self-insuring employers--in January of 2,552
each year upon gross payrolls of the preceding twelve months; 2,553
(3) The state as an employer--in January, April, July, and 2,555
October of each year upon gross payrolls of the preceding three 2,556
months. 2,557
Amounts assessed in accordance with this section shall be 2,559
collected from each employer as prescribed in rules the 2,560
administrator adopts. 2,561
The moneys derived from the assessment provided for in this 2,563
section shall be credited to the disabled workers' relief fund 2,564
created by section 4123.412 of the Revised Code. The 2,565
administrator shall establish by rule classifications of 2,566
employers within divisions (A)(1) to (3) of this section and 2,567
shall determine rates for each class so as to fairly apportion 2,568
the costs of carrying out sections 4123.412 to 4123.418 of the 2,569
Revised Code. 2,570
(B) For all injuries and disabilities occurring on or 2,573
after January 1, 1987, AND FOR ALL INJURIES, IMPAIRMENTS, AND 2,574
DISABILITIES ARISING ON OR AFTER THE EFFECTIVE DATE OF THIS 2,575
AMENDMENT, the administrator, for the purposes of carrying out 2,577
sections 4123.412 to 4123.418 of the Revised Code, shall levy an 2,578
assessment against all employers at a rate per one hundred 2,579
dollars of payroll, such rate to be determined annually for each 2,580
classification of employer in each employer group listed in 2,581
divisions (A)(1) to (3) of this section, which will produce an
amount no greater than the amount the administrator estimates to 2,582
be necessary to carry out such sections for the period for which 2,583
the assessment is levied. 2,584
Amounts assessed in accordance with this division shall be 2,586
billed at the same time premiums are billed and credited to the 2,587
disabled workers' relief fund created by section 4123.412 of the 2,588
61
Revised Code. The administrator shall determine the rates for 2,589
each class in the same manner as he THE ADMINISTRATOR fixes the 2,590
rates for premiums pursuant to section 4123.29 of the Revised 2,592
Code.
(C) For a self-insuring employer, the bureau of workers' 2,594
compensation shall pay to employees who are participants 2,595
regardless of the date of injury, any amounts due to the 2,596
participants under section 4123.414 of the Revised Code and shall 2,597
bill the self-insuring employer, semiannually, for all amounts 2,598
paid to a participant. 2,599
Sec. 4123.412. For the relief of persons who are 2,608
permanently and totally disabled IMPAIRED as the result of injury 2,610
or disease sustained in the course of their employment and who 2,611
are receiving workers' compensation which is payable to them by 2,612
virtue of and under the laws of this state in amounts, the total 2,613
of which, when combined with disability benefits received 2,614
pursuant to the Social Security Act is less than three hundred 2,615
forty-two dollars per month adjusted annually as provided in 2,616
division (B) of section 4123.62 of the Revised Code, there is 2,617
hereby created a separate fund to be known as the disabled 2,618
workers' relief fund, which fund shall consist of the sums that 2,619
are from time to time appropriated by the general assembly and 2,620
made available to the order of the bureau of workers' 2,621
compensation to carry out the objects and purposes of sections 2,622
4123.412 to 4123.418 of the Revised Code. The fund shall be in 2,623
the custody of the treasurer of the state. Disbursements from 2,624
the fund shall be made by the bureau to those persons entitled to 2,625
participate therein and in amounts to each participant as is 2,626
provided in section 4123.414 of the Revised Code. All investment 2,627
earnings of the fund shall be credited to the fund. 2,628
Sec. 4123.413. To be eligible to participate in said THE 2,637
DISABLED WORKERS' RELIEF fund, a participant must be permanently 2,639
and totally disabled IMPAIRED and be receiving workers' 2,640
compensation payments, the total of which, when combined with 2,641
62
disability benefits received pursuant to The THE Social Security 2,642
Act is less than three hundred forty-two dollars per month 2,644
adjusted annually as provided in division (B) of section 4123.62 2,645
of the Revised Code.
Sec. 4123.414. Each person determined eligible, pursuant 2,654
to section 4123.413 of the Revised Code, to participate in the 2,655
disabled workers' relief fund is entitled to receive payments, 2,656
without application, from the fund of a monthly amount equal to 2,657
the lesser of the difference between three hundred forty-two 2,658
dollars, adjusted annually pursuant to division (B) of section 2,659
4123.62 of the Revised Code, and: 2,660
(1)(A) The amount he THE PERSON is receiving per month as 2,663
the disability monthly benefits award pursuant to The Social 2,665
Security Act; or
(2)(B) The amount he THE PERSON is receiving monthly under 2,668
the workers' compensation laws for permanent and total disability 2,670
IMPAIRMENT. In determining such difference, a participant shall 2,672
be considered as receiving the amount of such participant's 2,673
compensation which shall have been commuted under the provisions 2,674
of section 4123.64 of the Revised Code. Such payments shall be 2,675
made monthly during the period in which such participant is 2,676
permanently and totally disabled IMPAIRED. 2,677
Sec. 4123.416. The administrator of workers' compensation 2,686
shall promptly require of each employer who has elected to pay 2,687
compensation direct under the provisions of section 4123.35 of 2,688
the Revised Code SELF-INSURING EMPLOYER a verified list of the 2,689
names and addresses of all persons to whom the employer is paying 2,691
workers' compensation on account of permanent and total 2,692
disability IMPAIRMENT and the evidence respecting such persons as 2,694
the administrator reasonably deems necessary to determine the 2,695
eligibility of any such person to participate in the disabled 2,696
workers' relief fund. The superintendent of insurance shall 2,697
promptly require of each insurance company which is organized or 2,698
licensed to do business in this state and which has at any time 2,699
63
written workers' compensation insurance in this state a like 2,700
verified list and like evidence respecting persons to whom the 2,701
insurance companies are paying workers' compensation under the 2,702
Ohio workers' compensation laws and contracts of insurance in 2,703
respect thereof; and the superintendent of insurance shall 2,704
promptly transmit all such lists and evidence to the bureau of 2,705
workers' compensation. Any person claiming the right to 2,706
participate in the fund may file his AN application therefor with 2,707
the bureau and shall be accorded a hearing thereon. 2,708
Sec. 4123.419. The assessment rate established pursuant to 2,717
section 4123.411 of the Revised Code, subject to the limits set 2,718
forth in that section, shall be adequate to provide the amounts 2,719
estimated as necessary by the administrator of workers' 2,720
compensation to carry out the provisions of sections 4123.412 to 2,721
4123.418 of the Revised Code, and in addition to provide moneys 2,722
to reimburse the general revenue fund for moneys appropriated by 2,723
Section 2 of H.B. No. 1131 of the 103rd general assembly or by 2,724
the 104th and succeeding general assemblies for disabled OR 2,725
IMPAIRED workers' relief. When the additional moneys are 2,727
available in whole or part for the purpose of making the 2,728
reimbursement, the director of budget and management shall 2,729
certify the amount to the bureau of workers' compensation which 2,730
shall thereupon cause the moneys to be paid to the general 2,731
revenue fund from the disabled workers' relief fund except that 2,732
any amounts due because of the state's obligation as an employer 2,733
pursuant to section 4123.411 of the Revised Code and not paid to 2,734
the disabled workers' relief fund shall be deducted from any such 2,735
reimbursement.
Sec. 4123.511. (A) Within seven days after receipt of any 2,745
claim under this chapter, the bureau of workers' compensation
shall notify the claimant and the employer of the claimant of the 2,746
receipt of the claim and of the facts alleged therein. If the 2,747
bureau receives from a person other than the claimant written or 2,748
telecommunicated information indicating that an injury HAS 2,749
64
OCCURRED or AN occupational disease has occurred or been 2,750
contracted which THAT may be compensable under this chapter HAS 2,752
BEEN DIAGNOSED BY A LICENSED PHYSICIAN, the bureau shall notify 2,753
the employee and the employer of the information. If the 2,754
information is provided by any method of telecommunication, the 2,755
person providing the information shall provide written 2,756
verification of the information to the bureau according to 2,757
division (E) of section 4123.84 of the Revised Code. The receipt 2,758
of the information in writing, or if by a method of 2,759
telecommunications, the written verification, and the notice by 2,760
the bureau shall be considered an application for compensation 2,761
under section 4123.84 or 4123.85 of the Revised Code provided 2,762
that the conditions of division (E) of section 4123.84 of the 2,763
Revised Code apply to information provided by a method of 2,764
telecommunication. Upon receipt of a claim, the bureau shall 2,765
advise the claimant of the claim number assigned and the 2,766
claimant's right to representation in the processing of a claim 2,767
or to elect no representation. If the bureau determines that a 2,768
claim is determined to be a compensable lost time claim, the 2,769
bureau shall notify the claimant and the employer of the 2,770
availability of rehabilitation services. No bureau or industrial 2,771
commission employee shall directly or indirectly convey any 2,772
information in derogation of this right. This section shall in no 2,773
way abrogate the bureau's responsibility to aid and assist a 2,774
claimant in the filing of a claim and to advise the claimant of 2,775
the claimant's rights under the law.
The administrator of workers' compensation shall assign all 2,777
claims and investigations to the bureau service office from which 2,778
investigation and determination may be made most expeditiously. 2,779
The bureau shall investigate the facts concerning an injury 2,781
or occupational disease and ascertain such facts in whatever 2,782
manner is most appropriate and may obtain statements of the 2,783
employee, employer, attending physician, and witnesses in 2,784
whatever manner is most appropriate. 2,785
65
(B)(1) Except as provided in division (B)(2) of this 2,787
section, in claims other than those in which the employer is a 2,788
self-insuring employer, if the administrator determines under 2,789
division (A) of this section that a claimant is or is not 2,790
entitled to an award of compensation or benefits, the 2,791
administrator shall issue an order, no sooner than twenty-one 2,792
days but no later than twenty-eight days after the sending of the 2,794
notice under division (A) of this section, granting or denying 2,795
the payment of the compensation or benefits, or both as is 2,796
appropriate to the claimant. Notwithstanding the time limitation 2,797
specified in this division for the issuance of an order, if a 2,798
medical examination of the claimant is required by statute, the 2,799
administrator promptly shall schedule the claimant for that
examination and shall issue an order no later than twenty-eight 2,800
days after receipt of the report of the examination. The 2,801
administrator shall notify the claimant and the employer of the 2,803
claimant and their respective representatives in writing of the 2,804
nature of the order and the amounts of compensation and benefit 2,805
payments involved. The employer or claimant may appeal the order 2,806
pursuant to division (C) of this section within fourteen days 2,807
after the date of the receipt of the order. The employer and 2,808
claimant may waive, in writing, their rights to an appeal under 2,809
this division.
(2) Notwithstanding the time limitation specified in 2,811
division (B)(1) of this section for the issuance of an order, if 2,812
the employer certifies a claim for payment of compensation or 2,813
benefits, or both, to a claimant, and the administrator has 2,814
completed the investigation of the claim, the payment of benefits 2,816
or compensation, or both, as is appropriate, shall commence upon 2,817
the later of the date of the certification or completion of the 2,818
investigation and issuance of the order by the administrator, 2,819
provided that the administrator shall issue the order no later 2,820
than the time limitation specified in division (B)(1) of this 2,821
section. 2,822
66
(3) If an appeal is made under division (B)(1) or (2) of 2,824
this section, the administrator shall forward the claim file to 2,825
the appropriate district hearing officer within seven days of the 2,826
appeal. In contested claims other than state fund claims, the 2,827
administrator shall forward the claim within seven days of the 2,828
administrator's receipt of the claim to the commission, which 2,830
shall refer the claim to an appropriate district hearing officer 2,831
for a hearing in accordance with division (C) of this section. 2,832
(C) If an employer or claimant timely appeals the order of 2,834
the administrator issued under division (B) of this section or in 2,835
the case of other contested claims other than state fund claims, 2,836
the commission shall refer the claim to an appropriate district 2,837
hearing officer according to rules the commission adopts under 2,838
section 4121.36 of the Revised Code. The district hearing 2,839
officer shall notify the parties and their respective 2,840
representatives of the time and place of the hearing. 2,841
The district hearing officer shall hold a hearing on a 2,843
disputed issue or claim within forty-five days after the filing 2,845
of the appeal under this division and issue a decision within 2,846
seven days after holding the hearing. The district hearing 2,847
officer shall notify the parties and their respective
representatives in writing of the order. Any party may appeal an 2,849
order issued under this division pursuant to division (D) of this 2,850
section within fourteen days after receipt of the order under 2,851
this division. 2,852
(D) Upon the timely filing of an appeal of the order of 2,854
the district hearing officer issued under division (C) of this 2,855
section, the commission shall refer the claim file to an 2,856
appropriate staff hearing officer according to its rules adopted 2,857
under section 4121.36 of the Revised Code. The staff hearing 2,858
officer shall hold a hearing within forty-five days after the 2,859
filing of an appeal under this division and issue a decision 2,860
within seven days after holding the hearing under this division. 2,863
The staff hearing officer shall notify the parties and their 2,864
67
respective representatives in writing of his THE STAFF HEARING
OFFICER'S order. Any party may appeal an order issued under this 2,866
division pursuant to division (E) of this section within fourteen 2,867
days after receipt of the order under this division. 2,868
(E) Upon the filing of a timely appeal of the order of the 2,870
staff hearing officer issued under division (D) of this section, 2,871
the commission or a designated staff hearing officer, on behalf 2,872
of the commission, shall determine whether the commission will 2,874
hear the appeal. If the commission or the designated staff
hearing officer decides to hear the appeal, the commission or the 2,876
designated staff hearing officer shall notify the parties and 2,877
their respective representatives in writing of the time and place 2,878
of the hearing. The commission shall hold the hearing within 2,879
forty-five days after the filing of the notice of appeal and, 2,880
within seven days after the conclusion of the hearing, the 2,881
commission shall issue its order affirming, modifying, or 2,882
reversing the order issued under division (D) of this section. 2,883
The commission shall notify the parties and their respective 2,884
representatives in writing of the order. If the commission or 2,885
the designated staff hearing officer determines not to hear the 2,886
appeal, within fourteen days after the filing of the notice of 2,887
appeal, the commission or the designated staff hearing officer 2,888
shall issue an order to that effect and notify the parties and
their respective representatives in writing of that order. 2,889
Except as otherwise provided in this chapter and Chapters 2,891
4121., 4127., and 4131. of the Revised Code, any party may appeal 2,892
an order issued under this division to the court pursuant to 2,893
section 4123.512 of the Revised Code within sixty days after 2,894
receipt of the order, subject to the limitations contained in 2,895
that section. 2,896
(F) Every notice of an appeal from an order issued under 2,898
divisions (B), (C), (D), and (E) of this section shall state the 2,899
names of the claimant and employer, the number of the claim, the 2,900
date of the decision appealed from, and the fact that the 2,901
68
appellant appeals therefrom. 2,902
(G) All of the following apply to the proceedings under 2,904
divisions (C), (D), and (E) of this section: 2,905
(1) The parties shall proceed promptly and without 2,907
continuances except for good cause; 2,908
(2) The parties, in good faith, shall engage in the free 2,910
exchange of information relevant to the claim prior to the 2,911
conduct of a hearing according to the rules the commission adopts 2,912
under section 4121.36 of the Revised Code; 2,913
(3) The administrator is a party and may appear and 2,915
participate at all administrative proceedings on behalf of the 2,916
state insurance fund. However, in cases in which the employer is 2,917
represented, the administrator shall neither present arguments 2,918
nor introduce testimony that is cumulative to that presented or 2,919
introduced by the employer or the employer's representative. The 2,920
administrator may file an appeal under this section on behalf of
the state insurance fund; however, except in cases arising under 2,921
section 4123.343 of the Revised Code, the administrator only may 2,922
appeal questions of law or issues of fraud when the employer 2,923
appears in person or by representative.
(H) Except as provided in division (J) of this section, 2,925
payments of compensation to a claimant or on behalf of a claimant 2,926
as a result of any order issued under this chapter shall commence 2,927
upon the earlier of the following: 2,928
(1) Fourteen days after the date the administrator issues 2,930
an order under division (B) of this section, unless that order is 2,931
appealed; 2,932
(2) The date when the employer has waived the right to 2,934
appeal a decision issued under division (B) of this section; 2,935
(3) If no appeal of an order has been filed under this 2,937
section or to a court under section 4123.512 of the Revised Code, 2,938
the expiration of the time limitations for the filing of an 2,939
appeal of an order; 2,940
(4) The TWENTY-ONE DAYS AFTER THE date of receipt by the 2,942
69
employer of an order of a district hearing officer, a staff 2,943
hearing officer, or the industrial commission issued under 2,945
division (C), (D), or (E) of this section. 2,946
(I) No medical benefits payable under this chapter or 2,948
Chapter 4121., 4127., or 4131. of the Revised Code are payable 2,949
until the earlier of the following: 2,950
(1) The date of the issuance of the staff hearing 2,952
officer's order under division (D) of this section; 2,953
(2) The date of the final administrative or judicial 2,955
determination. 2,956
(J) Upon the final administrative or judicial 2,958
determination, if a claimant is found to have received 2,959
compensation to which the claimant was not entitled, the 2,961
claimant's employer, if a self-insuring employer, or the bureau, 2,962
shall withhold from any amount to which the claimant becomes 2,963
entitled pursuant to any claim, past, present, or future, under 2,964
Chapter 4121., 4123., 4127., or 4131. of the Revised Code, the 2,965
amount to which the claimant was not entitled pursuant to the 2,966
following criteria:
(1) No withholding for the first twelve weeks of temporary 2,968
total disability compensation pursuant to section 4123.56 of the 2,969
Revised Code shall be made; 2,970
(2) Forty per cent of all awards of compensation paid 2,972
pursuant to sections 4123.56 and 4123.57 of the Revised Code, 2,973
until the amount overpaid is refunded; 2,974
(3) Twenty-five per cent of any compensation paid pursuant 2,976
to section 4123.58 of the Revised Code until the amount overpaid 2,977
is refunded; 2,978
(4) If, pursuant to an appeal under section 4123.512 of 2,980
the Revised Code, the court of appeals or the supreme court 2,981
reverses the allowance of the claim, then no amount of any 2,982
compensation will be withheld. 2,983
(K) If a staff hearing officer or the commission fails to 2,985
issue a decision or the commission fails to refuse to hear an 2,986
70
appeal within the time periods required by this section, payments 2,987
to a claimant shall cease until the staff hearing officer or 2,988
commission issues a decision or hears the appeal, unless the 2,989
failure was due to the fault or neglect of the employer or the 2,990
employer agrees that the payments should continue for a longer 2,991
period of time. 2,992
(L) Except as provided in section 4123.522 of the Revised 2,994
Code, no appeal is timely filed under this section unless the 2,995
appeal is filed with the time limits set forth in this section. 2,996
(M) No person who is not an employee of the bureau or 2,998
commission or who is not by law given access to the contents of a 2,999
claims file shall have a file in the person's possession. 3,000
Sec. 4123.512. (A) The claimant or the employer may 3,010
appeal an order of the industrial commission made under division 3,011
(E) of section 4123.511 of the Revised Code in any injury or 3,012
occupational disease case, other than a decision as to the extent 3,013
of disability OR IMPAIRMENT, to the court of common pleas of the 3,014
county in which the injury was inflicted or in which the contract 3,016
of employment was made if the injury occurred outside the state, 3,017
or in which the contract of employment was made if the exposure 3,018
occurred outside the state. If no common pleas court has 3,019
jurisdiction for the purposes of an appeal by the use of the 3,020
jurisdictional requirements described in this division, the 3,021
appellant may use the venue provisions in the Rules of Civil 3,022
Procedure to vest jurisdiction in a court. If the claim is for 3,023
an occupational disease the appeal shall be to the court of 3,024
common pleas of the county in which the exposure which caused the 3,025
disease occurred. Like appeal may be taken from an order of a 3,026
staff hearing officer made under division (D) of section 4123.511 3,027
of the Revised Code from which the commission has refused to hear 3,028
an appeal. The appellant shall file the notice of appeal with a 3,029
court of common pleas within sixty days after the date of the 3,030
receipt of the order appealed from or the date of receipt of the 3,031
order of the commission refusing to hear an appeal of a staff 3,032
71
hearing officer's decision under division (D) of section 4123.511 3,033
of the Revised Code. The filing of the notice of the appeal with 3,034
the court is the only act required to perfect the appeal. 3,035
If an action has been commenced in a court of a county 3,037
other than a court of a county having jurisdiction over the 3,038
action, the court, upon notice by any party or upon its own 3,039
motion, shall transfer the action to a court of a county having 3,040
jurisdiction. 3,041
Notwithstanding anything to the contrary in this section, 3,043
if the commission determines under section 4123.522 of the 3,044
Revised Code that an employee, employer, or their respective 3,045
representatives have not received written notice of an order or 3,046
decision which is appealable to a court under this section and 3,047
which grants relief pursuant to section 4123.522 of the Revised 3,048
Code, the party granted the relief has sixty days from receipt of 3,049
the order under section 4123.522 of the Revised Code to file a 3,050
notice of appeal under this section. 3,051
(B) The notice of appeal shall state the names of the 3,053
claimant and the employer, the number of the claim, the date of 3,054
the order appealed from, and the fact that the appellant appeals 3,055
therefrom. 3,056
The administrator, the claimant, and the employer shall be 3,058
parties to the appeal and the court, upon the application of the 3,059
commission, shall make the commission a party. The administrator 3,060
shall notify the employer that, if he THE EMPLOYER fails to 3,062
become an active party to the appeal, then the administrator may 3,064
act on behalf of the employer and the results of the appeal could 3,065
have an adverse effect upon the employer's premium rates. 3,066
(C) The attorney general or one or more of his THE 3,068
ATTORNEY GENERAL'S assistants or special counsel designated by 3,070
him THE ATTORNEY GENERAL shall represent the administrator and 3,072
the commission. In the event IF the attorney general or his THE 3,073
ATTORNEY GENERAL'S designated assistants or special counsel are 3,074
absent, the administrator or the commission shall select one or 3,075
72
more of the attorneys in the employ of the administrator or the 3,076
commission as his THE ADMINISTRATOR'S ATTORNEY or its THE 3,078
COMMISSION'S attorney in the appeal. Any attorney so employed 3,080
shall continue his THE representation during the entire period of 3,081
the appeal and in all hearings thereof except where the continued 3,082
representation becomes impractical.
(D) Upon receipt of notice of appeal the clerk of courts 3,084
shall provide notice to all parties who are appellees and to the 3,085
commission. 3,086
The claimant shall, within thirty days after the filing of 3,088
the notice of appeal, SHALL file a petition containing a 3,089
statement of facts in ordinary and concise language showing a 3,090
cause of action to participate or to continue to participate in 3,091
the fund and setting forth the basis for the jurisdiction of the 3,092
court over the action. Further pleadings shall be had in 3,093
accordance with the Rules of Civil Procedure, provided that 3,094
service of summons on such petition shall not be required. The 3,095
clerk of the court shall, upon receipt thereof, SHALL transmit by 3,096
certified mail a copy thereof to each party named in the notice 3,098
of appeal other than the claimant. Any party may file with the 3,099
clerk prior to the trial of the action a deposition of any 3,100
physician taken in accordance with the provisions of the Revised 3,101
Code, which deposition may be read in the trial of the action 3,102
even though the physician is a resident of or subject to service 3,103
in the county in which the trial is had. The bureau of workers' 3,104
compensation shall pay the cost of the deposition filed in court 3,105
and of copies of the deposition for each party from the surplus 3,106
fund and charge the costs thereof against the unsuccessful party 3,107
if the claimant's right to participate or continue to participate 3,108
is finally sustained or established in the appeal. In the event 3,109
the deposition is taken and filed, the physician whose deposition 3,110
is taken is not required to respond to any subpoena issued in the 3,111
trial of the action. The court, or the jury under the 3,112
instructions of the court, if a jury is demanded, shall determine 3,113
73
the right of the claimant to participate or to continue to 3,114
participate in the fund upon the evidence adduced at the hearing 3,115
of the action. 3,116
(E) The court shall certify its decision to the commission 3,118
and the certificate shall be entered in the records of the court. 3,119
Appeals from the judgment are governed by the law applicable to 3,120
the appeal of civil actions. 3,121
(F) The cost of any legal proceedings authorized by this 3,123
section, including an attorney's fee to the claimant's attorney 3,124
to be fixed by the trial judge, based upon the effort expended, 3,125
in the event the claimant's right to participate or to continue 3,126
to participate in the fund is established upon the final 3,127
determination of an appeal, shall be taxed against the employer 3,128
or the commission if the commission or the administrator rather 3,129
than the employer contested the right of the claimant to 3,130
participate in the fund. The attorney's fee shall not exceed 3,131
twenty-five hundred dollars. 3,132
(G) If the finding of the court or the verdict of the jury 3,134
is in favor of the claimant's right to participate in the fund, 3,135
the commission and the administrator shall thereafter proceed in 3,136
the matter of the claim as if the judgment were the decision of 3,137
the commission, subject to the power of modification provided by 3,138
section 4123.52 of the Revised Code. 3,139
(H) An appeal from an order issued under division (E) of 3,141
section 4123.511 of the Revised Code or any action filed in court 3,142
in a case in which an award of compensation has been made shall 3,143
not stay the payment of compensation under the award or payment 3,144
of compensation for subsequent periods of total disability OR 3,145
IMPAIRMENT during the pendency of the appeal. If, in a final 3,147
administrative or judicial action, it is determined that payments 3,148
of compensation or benefits, or both, made to or on behalf of a 3,149
claimant should not have been made, the amount thereof shall be 3,150
charged to the surplus fund under division (B) of section 4123.34 3,151
of the Revised Code. In the event the employer is a state risk, 3,152
74
the amount shall not be charged to the employer's experience. In 3,153
the event the employer is a self-insuring employer, the 3,154
self-insuring employer shall deduct the amount from the paid 3,155
compensation he reports to the administrator under division (K) 3,156
of section 4123.35 of the Revised Code. All actions and 3,157
proceedings under this section which are the subject of an appeal 3,158
to the court of common pleas or the court of appeals shall be 3,159
preferred over all other civil actions except election causes, 3,160
irrespective of position on the calendar. 3,161
This section applies to all decisions of the commission or 3,163
the administrator on November 2, 1959, and all claims filed 3,164
thereafter are governed by sections 4123.511 and 4123.512 of the 3,165
Revised Code. 3,166
Any action pending in common pleas court or any other court 3,168
on January 1, 1986, under this section is governed by former 3,169
sections 4123.514, 4123.515, 4123.516, and 4123.519 and section 3,170
4123.522 of the Revised Code. 3,171
Sec. 4123.52. (A)(1) The jurisdiction of the industrial 3,180
commission and the authority of the administrator of workers' 3,181
compensation over each case is continuing, and the commission may 3,182
make such modification or change with respect to former findings 3,183
or orders with respect thereto, as, in its opinion is justified. 3,184
No THE COMMISSION SHALL MAKE NO modification or, change nor any, 3,186
finding, or award in ANY CLAIM WITH respect of any claim shall be 3,188
made with respect to disability, compensation, dependency, or 3,189
MEDICAL benefits, after six THREE years from the date of injury 3,191
in the absence of the payment of medical benefits under this
chapter, in which event the modification, change, finding, or 3,192
award shall be made within six years after the payment of medical 3,194
benefits, or in the absence of payment of compensation under 3,195
section 4123.57, 4123.58, or division (A) or (B) of section 3,197
4123.56 of the Revised Code or wages in lieu of compensation in a 3,198
manner so as to satisfy the requirements of section 4123.84 of 3,199
the Revised Code, in which event the modification, change, 3,200
75
finding, or award shall be made within ten years from the date of 3,202
the last payment of compensation or from the date of death, nor 3,203
unless written notice of claim for the specific part or parts of 3,204
the body injured or disabled has been given as provided in 3,206
section 4123.84 or 4123.85 of the Revised Code, and the 3,207
commission shall not make any modification, change, finding, or 3,208
award which shall award compensation for a back period in excess 3,209
of two years prior to the date of filing application therefor OR 3,211
THE DATE OF FIRST DIAGNOSIS UNLESS COMPENSATION UNDER SECTION
4123.56 OF THE REVISED CODE, WAGES IN LIEU OF THAT COMPENSATION 3,212
IN A MANNER THAT SATISFIES THE REQUIREMENTS OF SECTION 4123.84 OF 3,213
THE REVISED CODE, COMPENSATION UNDER SECTION 4123.58 OR 4123.59 3,214
OF THE REVISED CODE, OR MEDICAL BENEFITS HAVE BEEN PAID. IN 3,215
CASES IN WHICH COMPENSATION OR WAGES IN LIEU OF THAT COMPENSATION 3,216
HAS BEEN PAID UNDER SECTION 4123.56 OF THE REVISED CODE, OR IN 3,217
CASES IN WHICH COMPENSATION HAS BEEN PAID UNDER DIVISION (B) OF 3,218
SECTION 4123.57 OR SECTION 4123.58 OR 4123.59 OF THE REVISED 3,219
CODE, THE COMMISSION MAY ONLY MAKE A MODIFICATION, CHANGE, 3,220
FINDING, OR AWARD IN A CLAIM WITH RESPECT TO COMPENSATION, 3,221
DEPENDENCY, OR MEDICAL BENEFITS WITHIN THREE YEARS AFTER THE DATE 3,222
OF THE LAST PAYMENT OF COMPENSATION UNDER SECTION 4123.56, 3,223
DIVISION (B) OF SECTION 4123.57, OR SECTION 4123.58 OR 4123.59 OF 3,224
THE REVISED CODE. 3,225
(2) NOTWITHSTANDING DIVISION (A)(1) OF THIS SECTION, THE 3,227
COMMISSION MAY MAKE A MODIFICATION, CHANGE, FINDING, OR AWARD IN 3,228
ANY CLAIM WITH RESPECT TO MEDICAL BENEFITS WITHIN THREE YEARS 3,229
AFTER THE DATE OF THE LAST TREATMENT FOR WHICH MEDICAL BENEFITS 3,230
HAVE BEEN PAID OR ORDERED TO BE PAID.
(B) UNLESS WRITTEN NOTICE HAS BEEN GIVEN AS PROVIDED IN 3,233
SECTION 4123.84 OR 4123.85 OF THE REVISED CODE, THE COMMISSION 3,235
SHALL MAKE NO MODIFICATION, CHANGE, FINDING, OR AWARD THAT AWARDS 3,236
COMPENSATION FOR A BACK PERIOD IN EXCESS OF TWO YEARS PRIOR TO
THE DATE OF FILING AN APPLICATION FOR THAT COMPENSATION. This 3,237
section does not affect the right of a claimant to compensation 3,239
76
accruing subsequent to the filing of any such application, 3,240
provided IF the application is filed within the time limit 3,241
provided in this section.
(C) This section does not deprive the commission of its 3,243
continuing jurisdiction to determine the questions raised by any 3,244
application for modification of award which has been filed with 3,245
the commission after June 1, 1932, and prior to the expiration of 3,246
the applicable period but in respect to which no award has been 3,247
granted or denied during the applicable period. 3,248
(D) The commission may, by general rules, MAY provide for 3,251
the destruction of files of cases in which no further action may 3,252
be taken. 3,253
The commission and administrator of workers' compensation 3,255
each may, by general rules, MAY provide for the retention and 3,256
destruction of all other records in their possession or under 3,257
their control pursuant to section 121.211 and sections 149.34 to 3,258
149.36 of the Revised Code. The bureau of workers' compensation 3,259
may purchase or rent required equipment for the document 3,260
retention media, as determined necessary to preserve the records. 3,261
Photographs, microphotographs, microfilm, films, or other direct 3,262
document retention media, when properly identified, have the same 3,263
effect as the original record and may be offered in like manner 3,264
and may be received as evidence in any court where the original 3,265
record could have been introduced. 3,266
(E) AS USED IN DIVISION (A) OF THIS SECTION, "MEDICAL 3,268
BENEFITS" MEANS PAYMENTS TO, OR ON BEHALF OF, AN EMPLOYEE FOR A 3,269
HOSPITAL BILL, MEDICAL BILL FOR A LICENSED PHYSICIAN OR HOSPITAL, 3,270
AN ORTHOPEDIC OR PROSTHETIC DEVICE, OR A PRESCRIPTION MEDICATION. 3,271
Sec. 4123.531. THE ADMINISTRATOR OF WORKERS' COMPENSATION 3,273
OR THE INDUSTRIAL COMMISSION MAY REQUIRE ANY EMPLOYEE CLAIMING 3,274
THE RIGHT TO RECEIVE COMPENSATION TO SUBMIT TO A VOCATIONAL 3,275
REHABILITATION EVALUATION. IF THE PERSON WHO CONDUCTS THE 3,276
EVALUATION RECOMMENDS A VOCATIONAL REHABILITATION PLAN FOR THE 3,277
EMPLOYEE, THE EMPLOYEE SHALL COMPLY WITH THE REHABILITATION PLAN. 3,279
77
IF AN EMPLOYEE REFUSES TO SUBMIT TO ANY VOCATIONAL 3,281
REHABILITATION EVALUATION SCHEDULED PURSUANT TO THIS SECTION OR 3,282
OBSTRUCTS THE EVALUATION, THE EMPLOYEE'S RIGHT TO HAVE THE 3,283
EMPLOYEE'S CLAIM FOR COMPENSATION CONSIDERED, IF THE CLAIM IS 3,284
PENDING BEFORE THE BUREAU OR COMMISSION, OR TO RECEIVE ANY 3,285
PAYMENT FOR COMPENSATION THAT HAS BEEN GRANTED, IS SUSPENDED 3,286
DURING THE PERIOD OF THE REFUSAL OR OBSTRUCTION. 3,287
Sec. 4123.54. Every employee, who is injured or who 3,296
contracts an occupational disease, and the dependents of each 3,297
employee who is killed, or dies as the result of an occupational 3,298
disease contracted in the course of employment, wherever such 3,299
injury has occurred or occupational disease has been contracted, 3,300
provided the same were not: 3,301
(A) Purposely self-inflicted; or 3,303
(B) Caused by the employee being intoxicated or under the 3,305
influence of a controlled substance not prescribed by a physician 3,306
where the intoxication or being under the influence of the 3,307
controlled substance not prescribed by a physician was the 3,308
proximate cause of the injury, is entitled to receive, either 3,309
directly from his THE EMPLOYEE'S self-insuring employer as 3,310
provided in section 4123.35 of the Revised Code, or from the 3,312
state insurance fund, the compensation for loss sustained on 3,313
account of the injury, occupational disease, or death, and the 3,314
medical, nurse, and hospital services and medicines, and the 3,315
amount of funeral expenses in case of death, as are provided by 3,316
this chapter.
FOR THE PURPOSE OF THIS DIVISION, IF THE EMPLOYEE, THROUGH 3,318
A CHEMICAL TEST OR A TEST OF THE EMPLOYEE'S BLOOD, BREATH, OR 3,320
URINE ADMINISTERED WITHIN A REASONABLE TIME AFTER THE OCCURRENCE 3,321
OF THE EMPLOYEE'S INJURY, IS DETERMINED TO HAVE AN ALCOHOL 3,323
CONTENT EQUAL TO OR IN EXCESS OF THAT SPECIFIED IN SECTION
4511.19 OF THE REVISED CODE OR HAVE A CONTROLLED SUBSTANCE NOT 3,324
PRESCRIBED BY THE EMPLOYEE'S PHYSICIAN FOR THE EMPLOYEE'S USE IN 3,325
THE EMPLOYEE'S SYSTEM, IT IS A REBUTTABLE PRESUMPTION THAT THE 3,326
78
EMPLOYEE WAS INTOXICATED OR UNDER THE INFLUENCE OF THE CONTROLLED 3,327
SUBSTANCE AND THAT THAT INTOXICATION OR BEING UNDER THE INFLUENCE
IS THE PROXIMATE CAUSE OF THE INJURY. AN EMPLOYEE'S REFUSAL TO 3,329
SUBMIT TO A CHEMICAL TEST OR A TEST OF THE EMPLOYEE'S BLOOD, 3,330
BREATH, OR URINE IS ADMISSIBLE AS EVIDENCE OF THE EMPLOYEE'S 3,331
INTOXICATION OR BEING UNDER THE INFLUENCE OF A CONTROLLED
SUBSTANCE NOT PRESCRIBED BY A PHYSICIAN AT ANY HEARING PURSUANT 3,332
TO SECTION 4123.511 OF THE REVISED CODE TO DETERMINE THE 3,333
ALLOWANCE OF THE EMPLOYEE'S CLAIM AND ON ANY APPEAL TO COURT 3,334
PURSUANT TO SECTION 4123.512 OF THE REVISED CODE.
IF AN INJURY AS DEFINED IN DIVISION (C)(4) OF SECTION 3,337
4123.01 OF THE REVISED CODE OCCURS, COMPENSATION AND MEDICAL 3,338
BENEFITS ARE PAYABLE ONLY FOR THE CONDITION OR IMPAIRMENT THAT 3,339
RESULTED FROM THE SUBSTANTIAL WORSENING OF THE PREEXISTING 3,340
CONDITION OR THE SUBSTANTIAL ACCELERATION OF THE DISABILITY OR 3,341
IMPAIRMENT FROM THAT CONDITION. NO COMPENSATION OR BENEFITS ARE 3,342
PAYABLE BECAUSE OF THE PREEXISTING CONDITION ONCE THAT CONDITION 3,343
AND RESULTING DISABILITY OR IMPAIRMENT HAVE RETURNED TO A LEVEL 3,344
THAT WOULD HAVE EXISTED WITHOUT THE INJURY. 3,345
Whenever, with respect to an employee of an employer who is 3,347
subject to and has complied with this chapter, there is 3,348
possibility of conflict with respect to the application of 3,349
workers' compensation laws because the contract of employment is 3,350
entered into and all or some portion of the work is or is to be 3,351
performed in a state or states other than Ohio, the employer and 3,352
the employee may agree to be bound by the laws of this state or 3,353
by the laws of some other state in which all or some portion of 3,354
the work of the employee is to be performed. The agreement shall 3,355
be in writing and shall be filed with the bureau of workers' 3,356
compensation within ten days after it is executed and shall 3,357
remain in force until terminated or modified by agreement of the 3,358
parties similarly filed. If the agreement is to be bound by the 3,359
laws of this state and the employer has complied with this 3,360
chapter, then the employee is entitled to compensation and 3,361
79
benefits regardless of where the injury occurs or the disease is 3,362
contracted and the rights of the employee and his THE EMPLOYEE'S 3,363
dependents under the laws of this state are the exclusive remedy 3,365
against the employer on account of injury, disease, or death in 3,366
the course of and arising out of his THE EMPLOYEE'S employment. 3,367
If the agreement is to be bound by the laws of another state and 3,369
the employer has complied with the laws of that state, the rights 3,370
of the employee and his THE EMPLOYEE'S dependents under the laws 3,372
of that state are the exclusive remedy against the employer on 3,373
account of injury, disease, or death in the course of and arising 3,374
out of his THE EMPLOYEE'S employment without regard to the place 3,376
where the injury was sustained or the disease contracted. 3,377
If any employee or his THE EMPLOYEE'S dependents are 3,379
awarded workers' compensation benefits or recover damages from 3,381
the employer under the laws of another state, the amount awarded 3,382
or recovered, whether paid or to be paid in future installments, 3,383
shall be credited on the amount of any award of compensation or 3,384
benefits made to the employee or his THE EMPLOYEE'S dependents by 3,385
the bureau. 3,386
If an employee is a resident of a state other than this 3,388
state and is insured under the workers' compensation law or 3,389
similar laws of a state other than this state, the employee and 3,390
his THE EMPLOYEE'S dependents are not entitled to receive 3,391
compensation or benefits under this chapter, on account of 3,393
injury, disease, or death arising out of or in the course of 3,394
employment while temporarily within this state and the rights of 3,395
the employee and his THE EMPLOYEE'S dependents under the laws of 3,396
the other state are the exclusive remedy against the employer on 3,398
account of the injury, disease, or death. 3,399
Compensation or benefits are not payable to a claimant 3,401
during the period of confinement of the claimant in any state or 3,402
federal correctional institution whether in this or any other 3,403
state for conviction of violation of any state or federal 3,404
criminal law.
80
Sec. 4123.541. In the event that IF any person who is 3,413
entitled to receive benefits for TEMPORARY total disability OR 3,415
PERMANENT TOTAL IMPAIRMENT, loss of member, or death through the 3,417
application of section 4123.033 of the Revised Code, receives, in 3,418
connection with the injury giving rise to such entitlement, 3,419
benefits under an act of congress or federal program providing 3,420
benefits for civil defense workers and their survivors, the 3,421
benefits payable hereunder, shall be reduced in proportion to the 3,422
benefits received under such other act or program.
Sec. 4123.55. No compensation shall be allowed for the 3,431
first week after an injury is received or occupational disease 3,432
contracted IS FIRST DIAGNOSED and no compensation shall be 3,435
allowed for the first week of total disability OR IMPAIRMENT,
whenever it may occur, unless and until the employee is totally 3,437
disable DISABLED OR IMPAIRED for a continuous period of two weeks 3,439
or more, in which event compensation for the first week of total 3,440
disability OR IMPAIRMENT, whenever it has occurred, shall be
paid, in addition to any other weekly benefits which are due, 3,442
immediately following the second week of total disability OR 3,443
IMPAIRMENT. There shall be no waiting period in connection with 3,444
the disbursements provided by section 4123.66 of the Revised 3,445
Code.
Sec. 4123.56. (A) Except as provided in division (D)(E) 3,454
of this section, in the case of temporary disability, an employee 3,455
shall receive sixty-six and two-thirds per cent of his THE 3,456
EMPLOYEE'S average weekly wage so long as such disability is 3,458
total, not to exceed a maximum amount of weekly compensation 3,459
which is equal to the statewide average weekly wage as defined in 3,460
division (C) of section 4123.62 of the Revised Code, and not less 3,461
than a minimum amount of compensation which is equal to 3,462
thirty-three and one-third per cent of the statewide average 3,463
weekly wage as defined in division (C) of section 4123.62 of the 3,464
Revised Code unless the employee's wage is less than thirty-three 3,465
and one-third per cent of the minimum statewide average weekly 3,466
81
wage, in which event he THE EMPLOYEE shall receive compensation 3,467
equal to his THE EMPLOYEE'S full wages; provided that for the 3,469
first twelve weeks of total disability the employee shall receive 3,470
seventy-two per cent of his THE EMPLOYEE'S full weekly wage, but 3,472
not to exceed a maximum amount of weekly compensation which is 3,473
equal to the lesser of the statewide average weekly wage as 3,474
defined in division (C) of section 4123.62 of the Revised Code or 3,475
one hundred per cent of the employee's net take home weekly wage. 3,476
In the case of a self-insuring employer, payments 3,477
AS USED IN THIS DIVISION, "NET TAKE HOME WEEKLY WAGE" MEANS 3,480
THE AMOUNT OBTAINED BY DIVIDING AN EMPLOYEE'S TOTAL REMUNERATION, 3,481
AS DEFINED IN SECTION 4141.01 OF THE REVISED CODE, PAID TO OR 3,483
EARNED BY THE EMPLOYEE DURING THE FIRST FOUR OF THE LAST FIVE 3,484
COMPLETED CALENDAR QUARTERS WHICH IMMEDIATELY PRECEDE THE FIRST 3,485
DAY OF THE EMPLOYEE'S ENTITLEMENT TO BENEFITS UNDER THIS 3,486
DIVISION, BY THE NUMBER OF WEEKS DURING WHICH THE EMPLOYEE WAS 3,487
PAID OR EARNED REMUNERATION DURING THOSE FOUR QUARTERS, LESS THE 3,488
AMOUNT OF LOCAL, STATE, AND FEDERAL INCOME TAXES DEDUCTED FOR 3,489
EACH SUCH WEEK. 3,490
(B)(1) IF THE PAYMENT OF COMPENSATION FOR TEMPORARY 3,493
DISABILITY IS COMMENCED VOLUNTARILY BY A SELF-INSURING EMPLOYER, 3,494
PAYMENTS OF COMPENSATION SHALL BE CONTINUED AT THE DISCRETION OF 3,496
THE SELF-INSURING EMPLOYER. WHEN A SELF-INSURING EMPLOYER MAKES 3,498
ITS FIRST PAYMENT OF COMPENSATION TO AN EMPLOYEE UNDER THIS 3,499
DIVISION, THE SELF-INSURING EMPLOYER SHALL NOTIFY THE EMPLOYEE, 3,500
IN WRITING, OF ALL OF THE FOLLOWING: 3,501
(a) THAT THE SELF-INSURING EMPLOYER VOLUNTARILY HAS 3,503
COMMENCED THE PAYMENTS; 3,504
(b) THAT THE SELF-INSURING EMPLOYER MAY TERMINATE THE 3,506
PAYMENTS AT ANY TIME; 3,507
(c) THAT THE EMPLOYEE HAS A RIGHT TO A HEARING ON THE 3,509
EMPLOYEE'S CLAIM; 3,510
(d) IF THE EMPLOYEE'S CLAIM THAT IS THE SUBJECT OF THE 3,512
PAYMENTS COMMENCED UNDER THIS DIVISION IS DETERMINED TO BE VALID, 3,514
82
THAT ANY COMPENSATION TO WHICH THE EMPLOYEE IS OR BECOMES
ENTITLED UNDER THIS SECTION FOR THAT CLAIM SHALL BE OFFSET BY THE 3,515
PAYMENTS THE EMPLOYEE RECEIVES FROM THE SELF-INSURING EMPLOYER 3,516
UNDER THIS DIVISION. 3,517
A SELF-INSURING EMPLOYER EITHER SHALL CERTIFY OR CONTEST 3,519
THE CLAIM FOR WHICH IT VOLUNTARILY IS MAKING PAYMENTS UNDER THIS 3,520
DIVISION WITHIN SEVENTY-FIVE DAYS AFTER THE SELF-INSURING 3,522
EMPLOYER MAKES THE FIRST PAYMENT OF COMPENSATION TO AN EMPLOYEE 3,523
UNDER THIS DIVISION. A CLAIM IS DEEMED CONTESTED IF THE 3,524
SELF-INSURING EMPLOYER FAILS EITHER TO CERTIFY OR CONTEST THE 3,525
CLAIM WITHIN SEVENTY-FIVE DAYS AFTER MAKING THE FIRST PAYMENT OF 3,526
COMPENSATION UNDER THIS DIVISION TO AN EMPLOYEE.
(2) PAYMENT OF COMPENSATION FOR ALL CLAIMS OTHER THAN 3,528
THOSE DESCRIBED IN DIVISION (B)(1) OF THIS SECTION, shall be for 3,529
a duration based upon the medical reports of the attending 3,531
physician. If the employer disputes the attending physician's 3,532
report, payments may be terminated only upon application and 3,533
hearing by a district hearing officer pursuant to division (C) of 3,534
section 4123.511 of the Revised Code. Payments shall continue 3,535
pending the determination of the matter, however, payment shall 3,536
not be made for the period when any employee has returned to 3,537
work, when an employee's treating physician has made a written 3,538
statement that the employee is capable of returning to his THE 3,539
EMPLOYEE'S former position of employment, when work within the 3,541
physical capabilities of the employee is made available by the 3,542
employer or another employer, or when the employee has reached 3,543
the maximum medical improvement. Where IF the employee is 3,545
capable of work activity, but his THE EMPLOYEE'S employer is 3,547
unable to offer him THE EMPLOYEE any employment, the employee 3,548
shall register with the bureau of employment services, which 3,550
shall assist the employee in finding suitable employment. The 3,551
(3) THE termination of temporary total disability, whether 3,554
by order or otherwise, does not preclude the commencement of 3,555
temporary total disability at another point in time if the 3,556
83
employee again becomes temporarily totally disabled.
(4) IF A DISTRICT HEARING OFFICER, STAFF HEARING OFFICER, 3,558
OR THE INDUSTRIAL COMMISSION DETERMINES, BASED UPON THE EVIDENCE, 3,560
THAT THE EMPLOYEE WAS NOT ENTITLED PURSUANT TO THIS CHAPTER OR 3,561
CHAPTER 4121., 4127., OR 4131. OF THE REVISED CODE TO RECEIVE 3,562
TEMPORARY TOTAL DISABILITY COMPENSATION PRIOR TO THE DATE OF THE 3,563
HEARING IN WHICH THAT DETERMINATION IS MADE, THE HEARING OFFICER
OR THE COMMISSION SHALL DECLARE AN OVERPAYMENT EFFECTIVE FROM THE 3,565
DATE THE CLAIMANT WAS NOT ENTITLED TO RECEIVE THAT COMPENSATION. 3,566
IF THE EMPLOYER PAYS PREMIUMS TO THE STATE INSURANCE FUND, THE 3,567
AMOUNT OF THE OVERPAYMENT SHALL NOT BE CHARGED TO THE EMPLOYER'S 3,568
EXPERIENCE. IF THE EMPLOYER IS A SELF-INSURING EMPLOYER, THE 3,569
SELF-INSURING EMPLOYER SHALL DEDUCT THE AMOUNT OF THE OVERPAYMENT 3,570
FROM THE PAID COMPENSATION IT REPORTS TO THE ADMINISTRATOR UNDER 3,571
DIVISION (K) OF SECTION 4123.35 OF THE REVISED CODE. THE 3,572
SELF-INSURING EMPLOYER OR THE BUREAU, AS APPROPRIATE, SHALL 3,573
WITHHOLD THE AMOUNT OF THE OVERPAYMENT FROM ANY AMOUNT TO WHICH 3,574
THE CLAIMANT BECOMES ENTITLED UNDER ANY CLAIM PAST, PRESENT, OR 3,575
FUTURE UNDER CHAPTER 4121., 4123., 4127., OR 4131. OF THE REVISED 3,576
CODE PURSUANT TO DIVISION (J) OF SECTION 4123.511 OF THE REVISED 3,577
CODE.
(5) After two hundred weeks of temporary total disability 3,579
benefits, the bureau medical section shall schedule the claimant 3,580
for an examination for an evaluation to determine whether or not 3,581
the temporary disability has become permanent. A self-insuring 3,582
employer shall notify the bureau of workers' compensation 3,583
immediately after payment of two hundred weeks of temporary total 3,584
disability and request that the bureau of workers' compensation 3,585
schedule the claimant for such an examination. 3,586
(6) When the employee is awarded compensation for 3,588
temporary total disability for a period for which he THE EMPLOYEE 3,589
has received benefits under Chapter 4141. of the Revised Code, 3,591
the bureau of workers' compensation shall pay an amount equal to 3,592
the amount received from the award to the bureau of employment 3,593
84
services and the administrator of employment services shall 3,594
credit the amount to the accounts of the employers to whose 3,595
accounts the payment of benefits was charged or is chargeable to 3,596
the extent it was charged or is chargeable. 3,597
(7) If any compensation under this section has been paid 3,599
for the same period or periods for which temporary 3,600
nonoccupational accident and sickness insurance is or has been 3,601
paid pursuant to an insurance policy or program to which the 3,602
employer has made the entire contribution or payment for 3,603
providing insurance or under a nonoccupational accident and 3,604
sickness program fully funded by the employer, compensation paid 3,605
under this section for the period or periods shall be paid only 3,606
to the extent by which the payment or payments exceeds the amount 3,607
of the nonoccupational insurance or program paid or payable. 3,608
Offset of the compensation shall be made only upon the prior 3,609
order of the bureau of workers' compensation or industrial 3,610
commission or agreement of the claimant. 3,611
As used in this division, "net take home weekly wage" means 3,613
the amount obtained by dividing an employee's total remuneration, 3,614
as defined in section 4141.01 of the Revised Code, paid to or 3,615
earned by the employee during the first four of the last five 3,616
completed calendar quarters which immediately precede the first 3,617
day of the employee's entitlement to benefits under this 3,618
division, by the number of weeks during which the employee was 3,619
paid or earned remuneration during those four quarters, less the 3,620
amount of local, state, and federal income taxes deducted for 3,621
each such week. 3,622
(B) Where (C)(1) IF an employee in a claim allowed under 3,625
this chapter suffers a wage loss as a DIRECT result of returning 3,626
to employment other than his THE EMPLOYEE'S former position of 3,627
employment or as a result of being unable to find employment 3,629
consistent with DUE TO A LIMITATION IN the claimant's physical 3,631
capabilities CAUSED SOLELY BY THE ALLOWED CONDITION OR CONDITIONS 3,632
IN THE EMPLOYEE'S CLAIM, he THE EMPLOYEE shall receive 3,633
85
compensation at sixty-six and two-thirds per cent of his THE 3,634
DIFFERENCE BETWEEN THE EMPLOYEE'S AVERAGE weekly wage loss AT THE 3,635
TIME OF THE INJURY AND THE EMPLOYEE'S PRESENT EARNINGS not to 3,637
exceed the statewide average weekly wage for a period not to
exceed two hundred weeks. THE PAYMENTS MAY CONTINUE FOR UP TO A 3,638
MAXIMUM OF TWO HUNDRED WEEKS, BUT THE PAYMENTS SHALL BE REDUCED 3,639
BY THE CORRESPONDING NUMBER OF WEEKS IN WHICH THE CLAIMANT 3,640
RECEIVES PAYMENTS PURSUANT TO DIVISION (B) OF SECTION 4121.67 OF 3,641
THE REVISED CODE.
(2) IF AN EMPLOYEE IN A CLAIM ALLOWED UNDER THIS CHAPTER 3,644
SUFFERS A WAGE LOSS AS A DIRECT RESULT OF BEING UNABLE TO FIND 3,645
EMPLOYMENT CONSISTENT WITH THE EMPLOYEE'S PHYSICAL CAPABILITIES 3,646
RESULTING FROM THE EMPLOYEE'S INJURY, THE EMPLOYEE SHALL RECEIVE
COMPENSATION AT SIXTY-SIX AND TWO-THIRDS PER CENT OF THE 3,648
DIFFERENCE BETWEEN THE EMPLOYEE'S AVERAGE WEEKLY WAGE AT THE TIME 3,649
OF THE INJURY AND THE EMPLOYEE'S PRESENT EARNINGS, NOT TO EXCEED 3,650
THE STATEWIDE AVERAGE WEEKLY WAGE. THE PAYMENTS MAY CONTINUE FOR 3,651
UP TO A MAXIMUM OF TWENTY-SIX WEEKS; HOWEVER, AN EMPLOYEE IN A 3,652
CLAIM ALLOWED UNDER THIS CHAPTER MAY RECEIVE COMPENSATION UNDER 3,653
DIVISION (C)(2) OF THIS SECTION FOR UP TO A MAXIMUM OF FIFTY-TWO 3,655
WEEKS IF THE ADMINISTRATOR OF EMPLOYMENT SERVICES EXTENDS THE 3,656
BENEFIT PERIOD FOR UNEMPLOYMENT COMPENSATION PURSUANT TO SECTION 3,657
4141.301 OF THE REVISED CODE. 3,658
(3) THE NUMBER OF WEEKS OF WAGE LOSS PAYABLE TO AN 3,660
EMPLOYEE UNDER DIVISIONS (C)(1) AND (2) OF THIS SECTION SHALL NOT 3,661
EXCEED TWO HUNDRED WEEKS IN THE AGGREGATE. 3,662
(C)(D) In the event an employee of a professional sports 3,664
franchise domiciled in this state is disabled OR IMPAIRED as the 3,665
result of an injury or occupational disease, the total amount of 3,667
payments made under a contract of hire or collective bargaining 3,668
agreement to the employee during a period of disability OR 3,669
IMPAIRMENT is deemed an advanced payment of compensation payable 3,671
under sections 4123.56 to 4123.58 of the Revised Code. The 3,672
employer shall be reimbursed the total amount of the advanced 3,673
86
payments out of any award of compensation made pursuant to 3,674
sections 4123.56 to 4123.58 of the Revised Code.
(D)(E) If an employee receives temporary total disability 3,676
benefits pursuant to division (A) of this section and social 3,677
security retirement benefits pursuant to the "Social Security 3,678
Act," the weekly benefit amount under division (A) of this 3,679
section shall not exceed sixty-six and two-thirds per cent of the 3,680
statewide average weekly wage as defined in division (C) of 3,681
section 4123.62 of the Revised Code. 3,682
(F) THE COMMENCEMENT OF THE PAYMENT OF COMPENSATION UNDER 3,685
DIVISION (B) OF THIS SECTION SHALL NOT CONSTITUTE A RECOGNITION 3,687
BY A SELF-INSURING EMPLOYER OF A CLAIM OR OF A CONDITION IN THE 3,688
CLAIM AS COMPENSABLE, BUT SHALL DO NO MORE THAN SATISFY THE 3,689
REQUIREMENTS OF SECTION 4123.84 OF THE REVISED CODE. 3,691
Sec. 4123.57. Partial disability compensation shall be 3,701
paid as follows.
(A)(1) Except as provided in DIVISION (A)(2) OF this 3,703
section, not earlier than forty weeks after the date of 3,705
termination of the latest period of payments under section 3,706
4123.56 of the Revised Code, or not earlier than forty weeks 3,707
after the date of the injury or contraction THE DATE OF FIRST 3,708
DIAGNOSIS of an occupational disease BY A LICENSED PHYSICIAN in 3,709
the absence of payments under section 4123.56 of the Revised 3,710
Code, the AN employee may file an application with the bureau of 3,711
workers' compensation for the determination of the percentage of 3,713
his THE EMPLOYEE'S permanent partial disability IMPAIRMENT 3,715
resulting from the AN injury or occupational disease. 3,716
(2) AN EMPLOYEE MAY FILE THE APPLICATION SPECIFIED IN 3,719
DIVISION (A)(1) OF THIS SECTION WITHOUT WAITING FORTY WEEKS WHEN 3,721
EITHER OF THE FOLLOWING OCCURS:
(a) THE RECEIPT OF PAYMENTS UNDER DIVISION (A) OF SECTION 3,724
4123.56 OF THE REVISED CODE IS TERMINATED BY A HEARING OFFICER 3,726
BECAUSE THE EMPLOYEE HAS REACHED MAXIMUM MEDICAL IMPROVEMENT. 3,728
(b) THE RECEIPT OF BENEFITS UNDER DIVISION (A) OF SECTION 3,731
87
4123.56 OF THE REVISED CODE IS TERMINATED BECAUSE THE EMPLOYEE'S 3,732
ATTENDING PHYSICIAN CERTIFIES THAT THE EMPLOYEE HAS REACHED 3,733
MAXIMUM MEDICAL IMPROVEMENT.
(3) NO EMPLOYEE MAY RECEIVE COMPENSATION UNDER THIS 3,735
SECTION OR RECEIVE A MEDICAL EXAMINATION PROVIDED FOR BY THIS 3,736
SECTION DURING THE TIME IN WHICH THAT EMPLOYEE IS RECEIVING 3,737
COMPENSATION UNDER SECTION 4123.58 OF THE REVISED CODE IN ANY 3,739
CLAIM OR IS RECEIVING COMPENSATION UNDER SECTION 4123.56 OF THE 3,741
REVISED CODE ON THE SAME CLAIM IN WHICH THE EMPLOYEE IS SEEKING 3,742
COMPENSATION UNDER THIS SECTION. THE EMPLOYEE SHALL LIST ON THE 3,743
APPLICATION SPECIFIED IN DIVISIONS (A)(1) AND (2) OF THIS SECTION 3,744
THE CLAIM NUMBERS OF ALL OTHER CLAIMS FOR WHICH THE EMPLOYEE IS A 3,745
CLAIMANT.
(4) UPON FILING AN APPLICATION PURSUANT TO DIVISION (A)(2) 3,747
OF THIS SECTION, AN APPLICATION FOR PERMANENT TOTAL IMPAIRMENT 3,748
COMPENSATION, AND A STATEMENT FROM THE EMPLOYEE'S ATTENDING 3,749
PHYSICIAN THAT THE IMPAIRMENT RESULTING FROM THE ALLOWED 3,750
CONDITIONS IN THE CLAIM RENDER THE EMPLOYEE UNABLE TO PARTICIPATE 3,751
IN ANY GAINFUL EMPLOYMENT, THE EMPLOYEE SHALL RECEIVE AN AWARD OF 3,752
PERMANENT PARTIAL IMPAIRMENT COMPENSATION PER WEEK EQUAL TO 3,754
SIXTY-SIX AND TWO-THIRDS PER CENT OF THE EMPLOYEE'S AVERAGE 3,755
WEEKLY WAGE, NOT TO EXCEED A MAXIMUM AMOUNT OF WEEKLY 3,756
COMPENSATION THAT IS EQUAL TO THE STATEWIDE AVERAGE WEEKLY WAGE 3,757
AS DEFINED IN DIVISION (C) OF SECTION 4123.62 OF THE REVISED 3,760
CODE, AND NOT LESS THAN A MINIMUM AMOUNT OF COMPENSATION THAT IS 3,761
EQUAL TO THIRTY-THREE AND ONE-THIRD PER CENT OF THE STATEWIDE 3,762
AVERAGE WEEKLY WAGE UNLESS THE EMPLOYEE'S WAGE IS LESS THAN 3,763
THIRTY-THREE AND ONE-THIRD PER CENT OF THE MINIMUM STATEWIDE 3,764
AVERAGE WEEKLY WAGE, IN WHICH EVENT THE EMPLOYEE SHALL RECEIVE 3,765
COMPENSATION EQUAL TO THE EMPLOYEE'S FULL WAGES. THIS 3,766
COMPENSATION SHALL BE PAID FOR SIXTY DAYS OR UNTIL THE DATE OF 3,767
ISSUANCE OF THE TENTATIVE ORDER ISSUED UNDER THIS SECTION,
WHICHEVER IS EARLIER. 3,768
(5) Whenever the AN application is filed UNDER DIVISION 3,771
88
(A)(1) OR (2) OF THIS SECTION, the bureau shall send a copy of 3,772
the application to the employee's employer or the employer's 3,773
representative and shall schedule the employee for a medical 3,774
examination by the bureau medical section. The bureau shall send 3,775
a copy of the report of the medical examination to the employee, 3,776
the employer, and their representatives. Thereafter, the 3,777
administrator of workers' compensation shall review the
employee's claim file and make a tentative order as the evidence 3,778
before him at the time of the making of the order warrants. If 3,779
the administrator determines that there is a conflict of 3,780
evidence, he shall send the application, along with the 3,781
claimant's file, to the district hearing officer who shall set 3,782
the application for a hearing THE REPORT OF THE MEDICAL 3,783
EXAMINATION SHALL CONTAIN A STATEMENT OF THE EXAMINER'S FINDING 3,785
ON THE EMPLOYEE'S PERCENTAGE OF PERMANENT PARTIAL IMPAIRMENT 3,786
RESULTING FROM ALLOWED CONDITIONS IN THE CLAIM UNDER THE MOST 3,787
RECENT EDITION OF THE AMERICAN MEDICAL ASSOCIATION'S GUIDES TO 3,789
THE EVALUATION OF PERMANENT IMPAIRMENT. AFTER RECEIVING THE 3,790
REPORT OF THE MEDICAL EXAMINATION, THE ADMINISTRATOR OF WORKERS' 3,791
COMPENSATION SHALL MAKE A TENTATIVE ORDER FINDING THAT THE 3,792
EMPLOYEE'S PERCENTAGE OF PERMANENT PARTIAL IMPAIRMENT IS THE SAME 3,793
PERCENTAGE SHOWN BY THE REPORT OF THE MEDICAL EXAMINATION, UNLESS 3,794
THE ADMINISTRATOR DETERMINES THAT THE REPORT CLEARLY IS 3,795
ERRONEOUS. IF THE ADMINISTRATOR SO DETERMINES, THE ADMINISTRATOR 3,796
SHALL DISREGARD THE REPORT, SCHEDULE THE EMPLOYEE FOR ANOTHER 3,797
EXAMINATION BY THE BUREAU MEDICAL SECTION, AND ISSUE A TENTATIVE 3,798
ORDER THAT FINDS THAT THE EMPLOYEE'S PERCENTAGE OF PERMANENT 3,799
PARTIAL IMPAIRMENT IS THE SAME PERCENTAGE SHOWN BY THE SECOND 3,800
MEDICAL EXAMINATION REPORT. 3,801
(6) The administrator shall notify the employee, the 3,803
employer, and their representatives, in writing, of the tentative 3,804
order and of the parties' right to request a hearing. Unless the 3,805
employee, the employer, or their representative notifies the 3,806
administrator, in writing, of an objection to the tentative order 3,807
89
within twenty days after receipt of the notice thereof, the 3,808
tentative order shall go into effect and the employee shall 3,809
receive the compensation provided in the order. In no event 3,810
shall there be a reconsideration of a tentative order issued 3,811
under this division WITHIN FOURTEEN DAYS AFTER RECEIPT OF THE 3,812
TENTATIVE ORDER, THE EMPLOYEE AND THE EMPLOYER, OR THEIR 3,813
REPRESENTATIVES, SHALL FILE WITH THE BUREAU EITHER A STATEMENT 3,815
ACCEPTING THE TENTATIVE ORDER OR AN OBJECTION TO THE TENTATIVE 3,816
ORDER. THE OPPOSING PARTY MUST BE SERVED BY THE FILING PARTY 3,817
WITH A COPY OF THE STATEMENT ACCEPTING THE TENTATIVE ORDER OR THE 3,818
OBJECTION TO THE TENTATIVE ORDER NOT LATER THAN THE DAY OF 3,819
FILING. PROPER MAILING OF THE STATEMENT ACCEPTING THE TENTATIVE 3,820
ORDER OR THE OBJECTION TO THE TENTATIVE ORDER TO THE OPPOSING 3,821
PARTY SHALL CONSTITUTE SERVICE. IF NEITHER A STATEMENT ACCEPTING 3,822
THE TENTATIVE ORDER OR AN OBJECTION TO THE TENTATIVE ORDER IS 3,823
FILED BY A PARTY BY THE DEADLINE ESTABLISHED BY THIS SECTION, THE 3,824
ORDER BECOMES FINAL. NOTWITHSTANDING DIVISION (H) OF SECTION 3,825
4123.511 OF THE REVISED CODE, THE EMPLOYER OR BUREAU SHALL PAY A 3,826
PERMANENT PARTIAL IMPAIRMENT AWARD WITHIN TWENTY-ONE DAYS AFTER 3,827
THE DATE ON WHICH AN ORDER FIXING THE EMPLOYEE'S PERCENTAGE OF 3,828
PERMANENT PARTIAL IMPAIRMENT BECOMES FINAL. 3,829
(7) If the employee, the employer, or their 3,831
representatives timely notify the administrator of an objection 3,832
to the tentative order, the matter shall be referred to a 3,833
district hearing officer who shall set the application for 3,834
hearing with written notices to all interested persons. Upon 3,835
referral to a district hearing officer, the employer may obtain a 3,836
medical examination of the employee, pursuant to rules of the 3,837
industrial commission AT THE HEARING, THE DISTRICT HEARING 3,838
OFFICER SHALL REVIEW THE REPORT OF THE MEDICAL EXAMINATION AND 3,839
SHALL MAKE A FINDING AS TO WHETHER ANY OF THE FOLLOWING HAS
OCCURRED: 3,840
(a) THE BUREAU MEDICAL SECTION BASED ITS REPORT, AT LEAST 3,843
IN PART, ON CONDITIONS NOT ALLOWED IN THE CLAIM;
90
(b) THE BUREAU MEDICAL SECTION FAILED TO CONSIDER ALL OF 3,846
THE ALLOWED CONDITIONS IN THE CLAIM;
(c) THE BUREAU MEDICAL SECTION'S EXAMINER WAS PREJUDICED 3,849
AGAINST THE EMPLOYER OR THE EMPLOYEE;
(d) THE TENTATIVE ORDER PROVIDES FOR THE PAYMENT OF 3,851
COMPENSATION UNDER A CIRCUMSTANCE IN WHICH THAT COMPENSATION IS 3,852
BARRED BY THIS SECTION OR ANY OTHER PROVISION OF LAW. 3,853
(A) The UNLESS THE district hearing officer, upon the 3,855
application, shall determine the percentage of the employee's 3,856
permanent disability, except as is subject to division (B) of 3,857
this section, based upon that condition of the employee resulting 3,858
from the injury or occupational disease and causing permanent 3,859
impairment evidenced by medical or clinical findings reasonably 3,860
demonstrable. The employee shall receive sixty-six and 3,861
two-thirds per cent of his average weekly wage, but not more than 3,862
a maximum of thirty-three and one-third per cent of the statewide 3,863
average weekly wage as defined in division (C) of section 4123.62 3,864
of the Revised Code, per week regardless of the average weekly 3,865
wage, for the number of weeks which equals the percentage of two 3,866
hundred weeks. Except on application for reconsideration, 3,867
review, or modification, which is filed within ten days after the 3,868
date of receipt of the decision of the district hearing officer, 3,869
in no instance shall the former award be modified unless it is 3,870
found from medical or clinical findings that the condition of the 3,871
claimant resulting from the injury has so progressed as to have 3,872
increased the percentage of permanent partial disability. A 3,873
staff hearing officer shall hear an application for 3,874
reconsideration filed and his decision is final. An FINDS ANY OF 3,876
THE SITUATIONS DESCRIBED IN DIVISION (A)(7)(a), (b), (c), OR (d) 3,878
OF THIS SECTION, THE DISTRICT HEARING OFFICER SHALL ENTER AN 3,879
ORDER FINDING THE PERCENTAGE OF THE EMPLOYEE'S PERMANENT PARTIAL 3,880
IMPAIRMENT TO BE THE PERCENTAGE OF PERMANENT PARTIAL IMPAIRMENT 3,881
IDENTIFIED IN THE REPORT OF THE MEDICAL EXAMINATION. IF THE 3,882
DISTRICT HEARING OFFICER FINDS ONE OF THE SITUATIONS DESCRIBED IN 3,884
91
DIVISION (A)(7)(a), (b), OR (c) OF THIS SECTION, THE DISTRICT 3,885
HEARING OFFICER SHALL ISSUE AN ORDER REJECTING THE REPORT OF THE 3,886
MEDICAL EXAMINATION AND REQUIRING THE BUREAU MEDICAL SECTION TO 3,887
PERFORM A NEW MEDICAL EXAMINATION. THE BUREAU MEDICAL SECTION 3,888
SHALL EXAMINE THE SAME ALLOWED CONDITIONS IN THE NEW MEDICAL 3,890
EXAMINATION AS IT EXAMINED IN THE FIRST EXAMINATION, AND ALL 3,891
PROVISIONS OF THIS SECTION APPLICABLE TO THE FIRST MEDICAL 3,892
EXAMINATION APPLY TO THE SUBSEQUENT EXAMINATION. IF THE DISTRICT 3,893
HEARING OFFICER FINDS THE SITUATION DESCRIBED IN DIVISION 3,894
(A)(7)(d) OF THIS SECTION, THE DISTRICT HEARING OFFICER SHALL 3,895
ISSUE AN ORDER DENYING THE APPLICATION. NO FINDING AS TO THE 3,896
PERCENTAGE OF AN EMPLOYEE'S PERMANENT PARTIAL IMPAIRMENT SHALL BE 3,897
MADE EXCEPT UNDER THIS SECTION. 3,898
(8) AN employee may file an application for a subsequent 3,901
determination of the percentage of his THE EMPLOYEE'S permanent 3,902
disability IMPAIRMENT. If such an application is filed, the 3,904
bureau shall send a copy of the application to the employer or 3,905
the employer's representative. No sooner than sixty days from 3,906
the date of the mailing of the application to the employer or the 3,907
employer's representative, the administrator shall review the 3,908
application. The administrator may require a medical examination 3,909
or medical review of the employee. The administrator shall issue 3,910
a tentative order based upon the evidence before him, provided 3,911
that if he requires a medical examination or medical review, the 3,912
administrator shall not issue the tentative order until the 3,913
completion of the examination or review TREAT THE APPLICATION AS 3,914
THOUGH IT WERE AN ORIGINAL APPLICATION FOR THE DETERMINATION OF 3,915
THE PERCENTAGE OF PERMANENT PARTIAL IMPAIRMENT. ALL PROVISIONS 3,916
OF THIS SECTION APPLICABLE TO AN ORIGINAL APPLICATION APPLY TO AN 3,917
APPLICATION FOR A SUBSEQUENT DETERMINATION. 3,918
The employer may obtain a medical examination of the 3,920
employee and may submit medical evidence at any stage of the 3,921
process up to a hearing before the district hearing officer, 3,922
pursuant to rules of the commission. The administrator shall 3,923
92
notify the employee, the employer, and their representatives, in 3,924
writing, of the nature and amount of any tentative order issued 3,925
on an application requesting a subsequent determination of the 3,926
percentage of an employee's permanent disability. An employee, 3,927
employer, or their representatives may object to the tentative 3,928
order within twenty days after the receipt of the notice thereof. 3,929
If no timely objection is made, the tentative order shall go into 3,930
effect. In no event shall there be a reconsideration of a 3,931
tentative order issued under this division. If an objection is 3,932
timely made, the application for a subsequent determination shall 3,933
be referred to a district hearing officer who shall set the 3,934
application for a hearing with written notice to all interested 3,935
persons. No application for subsequent percentage determinations 3,936
on the same claim for injury or occupational disease shall be 3,937
accepted for review by the district hearing officer unless 3,938
supported by substantial evidence of new and changed 3,939
circumstances developing since the time of the hearing on the 3,940
original or last determination. 3,941
(9) No award shall be made under this division (A) OF THIS 3,944
SECTION based upon a percentage of disability which IMPAIRMENT 3,945
THAT, when taken with all other percentages of permanent 3,946
disability IMPAIRMENT, exceeds one hundred per cent. If the 3,948
percentage of the permanent disability IMPAIRMENT of the employee 3,950
equals or exceeds ninety per cent, compensation for permanent 3,951
partial disability IMPAIRMENT shall be paid for two ONE hundred 3,953
weeks.
Compensation payable under this division (A) OF THIS 3,955
SECTION accrues and is payable to the employee from the date of 3,957
last payment of compensation, or, in cases where no previous 3,958
compensation has been paid, from the date of the injury or the 3,959
date of the diagnosis of the occupational disease. IF THE 3,960
TENTATIVE ORDER FINDS THAT THE PERCENTAGE OF THE EMPLOYEE'S 3,961
PERMANENT PARTIAL IMPAIRMENT IS LESS THAN NINETY PER CENT, THE 3,962
EMPLOYEE SHALL RECEIVE COMPENSATION EQUIVALENT TO SIXTY-SIX AND 3,963
93
TWO-THIRDS PER CENT OF THE EMPLOYEE'S AVERAGE WEEKLY WAGE SUBJECT 3,964
TO A MAXIMUM AMOUNT OF COMPENSATION EQUIVALENT TO SIXTY-SIX AND 3,965
TWO-THIRDS PER CENT OF THE STATEWIDE AVERAGE WEEKLY WAGE AS 3,966
DEFINED IN DIVISION (C) OF SECTION 4123.62 OF THE REVISED CODE 3,968
PER WEEK FOR THE NUMBER OF WEEKS THAT EQUALS THE EMPLOYEE'S 3,969
PERCENTAGE OF PERMANENT PARTIAL IMPAIRMENT AS DETERMINED UNDER 3,971
THIS SECTION.
When an award under this division (A) OF THIS SECTION has 3,974
been made prior to the death of an employee, all unpaid 3,975
installments accrued or to accrue under the provisions of the 3,976
award are payable to the surviving spouse, or if there is no 3,977
surviving spouse, to the dependent children of the employee, and 3,978
if there are no children surviving, then to other dependents as 3,979
the administrator determines. 3,980
(B) In cases included in the following schedule the 3,982
compensation payable per week to the employee is the statewide 3,983
average weekly wage as defined in division (C) of section 4123.62 3,984
of the Revised Code per week and shall continue during the 3,985
periods provided in the following schedule: 3,986
For the loss of a thumb, sixty weeks. 3,988
For the loss of a first finger, commonly called index 3,990
finger, thirty-five weeks. 3,991
For the loss of a second finger, thirty weeks. 3,993
For the loss of a third finger, twenty weeks. 3,995
For the loss of a fourth finger, commonly known as the 3,997
little finger, fifteen weeks. 3,998
The loss of a second, or distal, phalange of the thumb is 4,000
considered equal to the loss of one half of such thumb; the loss 4,001
of more than one half of such thumb is considered equal to the 4,002
loss of the whole thumb. 4,003
The loss of the third, or distal, phalange of any finger is 4,005
considered equal to the loss of one-third of the finger. 4,006
The loss of the middle, or second, phalange of any finger 4,008
is considered equal to the loss of two-thirds of the finger. 4,009
94
The loss of more than the middle and distal phalanges of 4,011
any finger is considered equal to the loss of the whole finger. 4,012
In no case shall the amount received for more than one finger 4,013
exceed the amount provided in this schedule for the loss of a 4,014
hand. 4,015
For the loss of the metacarpal bone (bones of the palm) for 4,017
the corresponding thumb, or fingers, add ten weeks to the number 4,018
of weeks under this division. 4,019
For ankylosis (total stiffness of) or contractures (due to 4,021
scars or injuries) which makes any of the fingers, thumbs, or 4,022
parts of either useless, the same number of weeks apply to the 4,023
members or parts thereof as given for the loss thereof. 4,024
If the claimant has suffered the loss of two or more 4,026
fingers by amputation or ankylosis and the nature of his THE 4,027
CLAIMANT'S employment in the course of which the claimant was 4,029
working at the time of the injury or occupational disease is such 4,030
that the handicap or disability IMPAIRMENT resulting from the 4,031
loss of fingers, or loss of use of fingers, exceeds the normal 4,033
handicap or disability IMPAIRMENT resulting from the loss of 4,035
fingers, or loss of use of fingers, the administrator may take 4,036
that fact into consideration and increase the award of 4,037
compensation accordingly, but the award made shall not exceed the 4,038
amount of compensation for loss of a hand. 4,039
For the loss of a hand, one hundred seventy-five weeks. 4,041
For the loss of an arm, two hundred twenty-five weeks. 4,043
For the loss of a great toe, thirty weeks. 4,045
For the loss of one of the toes other than the great toe, 4,047
ten weeks. 4,048
The loss of more than two-thirds of any toe is considered 4,050
equal to the loss of the whole toe. 4,051
The loss of less than two-thirds of any toe is considered 4,053
no loss, except as to the great toe; the loss of the great toe up 4,054
to the interphalangeal joint is co-equal to the loss of one-half 4,055
of the great toe; the loss of the great toe beyond the 4,056
95
interphalangeal joint is considered equal to the loss of the 4,057
whole great toe. 4,058
For the loss of a foot, one hundred fifty weeks. 4,060
For the loss of a leg, two hundred weeks. 4,062
For the loss of the sight of an eye, one hundred 4,064
twenty-five weeks. 4,065
For the permanent partial loss of sight of an eye, the 4,067
portion of one hundred twenty-five weeks as the administrator in 4,068
each case determines, based upon the percentage of vision 4,069
actually lost as a result of the injury or occupational disease, 4,070
but, in no case shall an award of compensation be made for less 4,071
than twenty-five per cent loss of uncorrected vision. "Loss of 4,072
uncorrected vision" means the percentage of vision actually lost 4,073
as the result of the injury or occupational disease. 4,074
For the permanent and total loss of hearing of one ear, 4,076
twenty-five weeks; but in no case shall an award of compensation 4,077
be made for less than permanent and total loss of hearing of one 4,078
ear. 4,079
For the permanent and total loss of hearing, one hundred 4,081
twenty-five weeks; but, except pursuant to the next preceding 4,082
paragraph, in no case shall an award of compensation be made for 4,083
less than permanent and total loss of hearing. 4,084
In case an injury or occupational disease results in 4,086
serious facial or head disfigurement which either impairs or may 4,087
in the future impair the opportunities to secure or retain 4,088
employment, the administrator shall make an award of compensation 4,089
as it THE ADMINISTRATOR deems proper and equitable, in view of 4,090
the nature of the disfigurement, and not to exceed the sum of 4,092
five thousand dollars. For the purpose of making the award, it 4,093
is not material whether the employee is gainfully employed in any 4,094
occupation or trade at the time of the administrator's 4,095
determination.
When an award under this division has been made prior to 4,097
the death of an employee all unpaid installments accrued or to 4,098
96
accrue under the provisions of the award shall be payable to the 4,099
surviving spouse, or if there is no surviving spouse, to the 4,100
dependent children of the employee and if there are no such 4,101
children, then to such dependents as the administrator 4,102
determines. 4,103
When an employee has sustained the loss of a member by 4,105
severance, but no award has been made on account thereof prior to 4,106
his THE EMPLOYEE'S death, the administrator shall make an award 4,107
in accordance with this division for the loss which shall be 4,109
payable to the surviving spouse, or if there is no surviving 4,110
spouse, to the dependent children of the employee and if there 4,111
are no such children, then to such dependents as the 4,112
administrator determines. 4,113
(C) Compensation for partial disability IMPAIRMENT under 4,115
divisions (A) and (B) of this section is in addition to the 4,117
compensation paid the employee pursuant to section 4123.56 of the 4,118
Revised Code. A claimant may receive compensation under 4,119
divisions (A) and (B) of this section. 4,120
In all cases arising under division (B) of this section, if 4,122
it is determined by any one of the following: (1) the amputee 4,123
clinic at University hospital, Ohio state university; (2) the 4,124
rehabilitation services commission; (3) an amputee clinic or 4,125
prescribing physician approved by the administrator or his THE 4,126
ADMINISTRATOR'S designee, that an injured or disabled IMPAIRED 4,128
employee is in need of an artificial appliance, or in need of a 4,130
repair thereof, regardless of whether the appliance or its repair 4,131
will be serviceable in the vocational rehabilitation of the 4,132
injured employee, and regardless of whether the employee has 4,133
returned to or can ever again return to any gainful employment, 4,134
the bureau shall pay the cost of the artificial appliance or its 4,135
repair out of the surplus created by division (B) of section 4,136
4123.34 of the Revised Code.
In those cases where a rehabilitation services commission 4,138
recommendation that an injured or disabled IMPAIRED employee is 4,139
97
in need of an artificial appliance would conflict with their 4,141
state plan, adopted pursuant to the "Rehabilitation Act of 1973," 4,142
87 Stat. 355, 29 U.S.C.A. 701, the administrator or his THE 4,143
ADMINISTRATOR'S designee or the bureau may obtain a 4,145
recommendation from an amputee clinic or prescribing physician 4,146
that they determine appropriate.
(D) If an employee of a state fund employer makes 4,148
application for a finding and the administrator finds that he THE 4,149
EMPLOYEE has contracted silicosis as defined in division (X), or 4,151
coal miners' pneumoconiosis as defined in division (Y), or 4,152
asbestosis as defined in division (AA) of section 4123.68 of the 4,153
Revised Code, and that a change of such employee's occupation is 4,154
medically advisable in order to decrease substantially further 4,155
exposure to silica dust, asbestos, or coal dust and if the 4,156
employee, after the finding, has changed or shall change his THE 4,157
EMPLOYEE'S occupation to an occupation in which the exposure to 4,159
silica dust, asbestos, or coal dust is substantially decreased, 4,160
the administrator shall allow to the employee an amount equal to 4,161
fifty per cent of the statewide average weekly wage per week for 4,162
a period of thirty weeks, commencing as of the date of the 4,163
discontinuance or change, and for a period of one hundred weeks 4,164
immediately following the expiration of the period of thirty 4,165
weeks the administrator shall allow the employee sixty-six and 4,166
two-thirds per cent of the loss of wages resulting directly and 4,167
solely from the change of occupation but not to exceed a maximum 4,168
of an amount equal to fifty per cent of the statewide average 4,169
weekly wage per week. No such employee is entitled to receive 4,170
more than one allowance on account of discontinuance of 4,171
employment or change of occupation and benefits shall cease for 4,172
any period during which the employee is employed in an occupation 4,173
in which the exposure to silica dust, asbestos, or coal dust is 4,174
not substantially less than the exposure in the occupation in 4,175
which he THE EMPLOYEE was formerly employed or for any period 4,177
during which the employee may be entitled to receive compensation 4,178
98
or benefits under section 4123.68 of the Revised Code on account 4,179
of disability from silicosis, asbestosis, or coal miners' 4,180
pneumoconiosis. An award for change of occupation for a coal 4,181
miner who has contracted coal miners' pneumoconiosis may be 4,182
granted under this division even though he THE COAL MINER 4,183
continues his employment with the same employer, so long as his 4,184
THE COAL MINER'S employment subsequent to the change is such that 4,186
his THE COAL MINER'S exposure to coal dust is substantially 4,188
decreased and a change of occupation is certified by the claimant 4,189
as permanent. The administrator may accord to the employee 4,190
medical and other benefits in accordance with section 4123.66 of 4,191
the Revised Code.
(E) If a fire fighter FIREFIGHTER or police officer makes 4,193
application for a finding and the administrator finds that he THE 4,195
FIREFIGHTER OR POLICE OFFICER has contracted a cardiovascular and 4,197
pulmonary disease as defined in division (W) of section 4123.68 4,198
of the Revised Code, and that a change of the fire fighter's 4,199
FIREFIGHTER'S or police officer's occupation is medically 4,200
advisable in order to decrease substantially further exposure to 4,201
smoke, toxic gases, chemical fumes, and other toxic vapors, and 4,202
if the fire fighter FIREFIGHTER, or police officer, after the 4,203
finding, has changed or changes his occupation to an occupation 4,205
in which the exposure to smoke, toxic gases, chemical fumes, and 4,206
other toxic vapors is substantially decreased, the administrator 4,207
shall allow to the fire fighter FIREFIGHTER or police officer an 4,208
amount equal to fifty per cent of the statewide average weekly 4,210
wage per week for a period of thirty weeks, commencing as of the 4,211
date of the discontinuance or change, and for a period of 4,212
seventy-five weeks immediately following the expiration of the 4,213
period of thirty weeks the administrator shall allow the fire 4,214
fighter FIREFIGHTER or police officer sixty-six and two-thirds 4,216
per cent of the loss of wages resulting directly and solely from 4,217
the change of occupation but not to exceed a maximum of an amount 4,218
equal to fifty per cent of the statewide average weekly wage per 4,219
99
week. No such fire fighter FIREFIGHTER or police officer is 4,221
entitled to receive more than one allowance on account of 4,222
discontinuance of employment or change of occupation and benefits 4,223
shall cease for any period during which the fire fighter 4,224
FIREFIGHTER or police officer is employed in an occupation in 4,226
which the exposure to smoke, toxic gases, chemical fumes, and
other toxic vapors is not substantially less than the exposure in 4,227
the occupation in which he THE FIREFIGHTER OR POLICE OFFICER was 4,228
formerly employed or for any period during which the fire fighter 4,230
FIREFIGHTER or police officer may be entitled to receive 4,232
compensation or benefits under section 4123.68 of the Revised 4,233
Code on account of disability from a cardiovascular and pulmonary 4,234
disease. The administrator may accord to the fire fighter 4,235
FIREFIGHTER or police officer medical and other benefits in 4,237
accordance with section 4123.66 of the Revised Code.
(F) An order issued under this section is appealable 4,239
pursuant to section 4123.511 of the Revised Code but is not 4,240
appealable to court under section 4123.512 of the Revised Code. 4,241
Sec. 4123.58. (A) In cases of permanent total disability 4,250
IMPAIRMENT, the employee shall receive an award to continue until 4,252
his death in the amount of sixty-six and two-thirds per cent of 4,253
his THE EMPLOYEE'S average weekly wage, but, except as otherwise 4,255
provided in division (B) of this section, not more than a maximum 4,256
amount of weekly compensation which is equal to sixty-six and 4,257
two-thirds per cent of the statewide average weekly wage as 4,258
defined in division (C) of section 4123.62 of the Revised Code, 4,259
nor not less than a minimum amount of weekly compensation which 4,260
is equal to fifty per cent of the statewide average weekly wage 4,261
as defined in division (C) of section 4123.62 of the Revised 4,262
Code, unless the employee's average weekly wage is less than 4,263
fifty per cent of the statewide average weekly wage at the time 4,264
of the injury, in which event he THE EMPLOYEE shall receive 4,265
compensation in an amount equal to his THE EMPLOYEE'S average 4,266
weekly wage.
100
PERMANENT TOTAL IMPAIRMENT MEANS THAT THE PHYSICAL OR 4,269
MENTAL LIMITATIONS THAT DIRECTLY RESULT FROM THE ALLOWED 4,270
CONDITIONS IN THE EMPLOYEE'S CLAIM OR CLAIMS PREVENT THE EMPLOYEE 4,271
FROM ENGAGING IN SUSTAINED REMUNERATIVE EMPLOYMENT. 4,272
THE INDUSTRIAL COMMISSION MAY CONSIDER THE EMPLOYEE'S AGE 4,274
IN DETERMINING WHETHER THE EMPLOYEE HAS THE CAPACITY TO ENGAGE IN 4,275
SUSTAINED REMUNERATIVE EMPLOYMENT OR MAY ACQUIRE THE CAPACITY TO 4,276
ENGAGE IN SUSTAINED REMUNERATIVE EMPLOYMENT THROUGH TRAINING, 4,277
REHABILITATION, EDUCATION, OR OTHER SIMILAR EFFORTS. HOWEVER, 4,278
THE EMPLOYEE IS NOT ENTITLED TO COMPENSATION FOR PERMANENT TOTAL 4,279
IMPAIRMENT IF THE EMPLOYEE'S AGE IS A SIGNIFICANT FACTOR 4,280
PREVENTING THE EMPLOYEE FROM ENGAGING IN OR ACQUIRING THE 4,282
CAPACITY TO ENGAGE IN SUSTAINED REMUNERATIVE EMPLOYMENT. 4,283
FOR CLAIMS FILED PURSUANT TO DIVISION (A)(2) OF SECTION 4,285
4123.57 OF THE REVISED CODE, AN EMPLOYEE WHO IS PERMANENTLY AND 4,286
TOTALLY IMPAIRED SHALL RECEIVE PERMANENT TOTAL IMPAIRMENT 4,288
COMPENSATION FROM THE DATE THE EMPLOYEE'S TEMPORARY TOTAL
DISABILITY COMPENSATION PURSUANT TO SECTION 4123.56 OF THE 4,289
REVISED CODE WAS TERMINATED SUBJECT TO SECTION 4123.52 OF THE 4,290
REVISED CODE. THE EMPLOYEE'S PERMANENT TOTAL IMPAIRMENT AWARD 4,291
SHALL BE REDUCED BY THE AMOUNT OF COMPENSATION THE EMPLOYEE 4,292
RECEIVED PURSUANT TO THE EMPLOYEE'S PERMANENT PARTIAL IMPAIRMENT 4,293
AWARD UNDER DIVISION (A) OF SECTION 4123.57 OF THE REVISED CODE.
(B) In the event the weekly workers' compensation amount 4,295
when combined with disability benefits received pursuant to the 4,296
Social Security Act is less than the statewide average weekly 4,297
wage as defined in division (C) of section 4123.62 of the Revised 4,298
Code, then the maximum amount of weekly compensation shall be the 4,299
statewide average weekly wage as defined in division (C) of 4,300
section 4123.62 of the Revised Code. At any time that social 4,301
security disability benefits terminate or are reduced, the 4,302
workers' compensation award shall be recomputed to pay the 4,303
maximum amount permitted under this division. 4,304
(C) The loss or loss of use of both hands or both arms, or 4,306
101
both feet or both legs, or both eyes, or of any two thereof, 4,307
constitutes total and permanent disability IMPAIRMENT, to be 4,308
compensated according to this section. Compensation payable 4,310
under this section for permanent total disability IMPAIRMENT is 4,311
in addition to benefits payable under division (B) of section 4,313
4123.57 of the Revised Code. 4,314
Sec. 4123.59. In case an injury to or an occupational 4,323
disease contracted by an employee causes his THE EMPLOYEE'S 4,324
death, benefits shall be in the amount and to the persons 4,326
following:
(A) If there are no dependents, the disbursements from the 4,328
state insurance fund is limited to the expenses provided for in 4,329
section 4123.66 of the Revised Code. 4,330
(B) If there are wholly dependent persons at the time of 4,332
the death, the weekly payment is sixty-six and two-thirds per 4,333
cent of the average weekly wage, but not to exceed a maximum 4,334
aggregate amount of weekly compensation which is equal to 4,335
sixty-six and two-thirds per cent of the statewide average weekly 4,336
wage as defined in division (C) of section 4123.62 of the Revised 4,337
Code, and not in any event less than a minimum amount of weekly 4,338
compensation which is equal to fifty per cent of the statewide 4,339
average weekly wage as defined in division (C) of section 4123.62 4,340
of the Revised Code, regardless of the average weekly wage; 4,341
provided however, that if the death is due to injury received or 4,342
occupational disease first diagnosed after January 1, 1976, the 4,343
weekly payment is sixty-six and two-thirds per cent of the 4,344
average weekly wage but not to exceed a maximum aggregate amount 4,345
of weekly compensation which is equal to the statewide average 4,346
weekly wage as defined in division (C) of section 4123.62 of the 4,347
Revised Code; provided that when any claimant is receiving total 4,348
disability OR IMPAIRMENT compensation at the time of death the 4,349
wholly dependent person is eligible for the maximum compensation 4,351
provided for in this section. Where there is more than one person 4,352
who is wholly dependent at the time of the death of the employee, 4,353
102
the administrator of workers' compensation shall promptly 4,354
apportion the weekly amount of compensation payable under this 4,355
section among the dependent persons as provided in division (D) 4,356
of this section. 4,357
(1) The payment as provided in this section shall continue 4,359
from the date of death of an injured, IMPAIRED, or disabled 4,361
employee until the death or remarriage of such dependent spouse. 4,363
If the dependent spouse remarries, an amount equal to two years 4,364
of compensation benefits at the weekly amount determined to be 4,365
applicable to and being paid to the dependent spouse shall be 4,366
paid in a lump sum to such spouse and no further compensation 4,367
shall be paid to such spouse. 4,368
(2) That portion of the payment provided in division (B) 4,370
of this section applicable to wholly dependent persons other than 4,371
a spouse shall continue from the date of death of an injured, 4,372
IMPAIRED, or disabled employee to a dependent as of the date of 4,374
death, other than a spouse, at the weekly amount determined to be 4,375
applicable and being paid to such dependent other than a spouse, 4,376
until he THE DEPENDENT: 4,377
(a) Reaches eighteen years of age; 4,379
(b) If pursuing a full time educational program while 4,381
enrolled in an accredited educational institution and program, 4,382
reaches twenty-five years of age; 4,383
(c) If mentally or physically incapacitated from having 4,385
any earnings, is no longer so incapacitated. 4,386
(C) If there are partly dependent persons at the time of 4,388
the death the weekly payment is sixty-six and two-thirds per cent 4,389
of the employee's average weekly wage, not to exceed sixty-six 4,390
and two-thirds per cent of the statewide average weekly wage as 4,391
defined in division (C) of section 4123.62 of the Revised Code, 4,392
and shall continue for such time as the administrator in each 4,393
case determines. 4,394
(D) The following persons are presumed to be wholly 4,396
dependent for their support upon a deceased employee: 4,397
103
(1) A surviving spouse who was living with the employee at 4,399
the time of death or a surviving spouse who was separated from 4,400
the employee at the time of death because of the aggression of 4,401
the employee; 4,402
(2) A child under the age of eighteen years, or 4,404
twenty-five years if pursuing a full-time educational program 4,405
while enrolled in an accredited educational institution and 4,406
program, or over said THAT age if physically or mentally 4,407
incapacitated from earning, upon only the one parent who is 4,409
contributing more than one-half of the support for such child and 4,410
with whom he THAT CHILD is living at the time of the death of 4,412
such parent, or for whose maintenance such parent was legally 4,413
liable at the time of his THE PARENT'S death. 4,415
It is presumed that there is sufficient dependency to 4,417
entitle a surviving natural parent or surviving natural parents, 4,418
share and share alike, with whom the decedent was living at the 4,419
time of his death, to a total minimum award of three thousand 4,420
dollars. 4,421
The administrator may take into consideration any 4,423
circumstances which, at the time of the death of the decedent, 4,424
clearly indicate prospective dependency on the part of the 4,425
claimant and potential support on the part of the decedent. No 4,426
person shall be considered a prospective dependent unless such 4,427
person is a member of the family of the deceased employee and 4,428
bears to him THE DECEDENT the relation of surviving spouse, 4,429
lineal descendant, ancestor, or brother, or sister. The total 4,431
award for any or all prospective dependency to all such 4,432
claimants, except to a natural parent or natural parents of the 4,433
deceased, shall not exceed three thousand dollars to be 4,434
apportioned among them as the administrator orders. 4,435
In all other cases, the question of dependency, in whole or 4,437
in part, shall be determined in accordance with the facts in each 4,438
particular case existing at the time of the injury resulting in 4,439
the death of such employee, but no person shall be considered as 4,440
104
dependent unless such person is a member of the family of the 4,441
deceased employee, or bears to him THE DECEDENT the relation of 4,442
surviving spouse, lineal descendant, ancestor, or brother, or 4,444
sister.
(E) An order issued by the administrator under this 4,446
section is appealable pursuant to sections 4123.511 to 4123.512 4,447
of the Revised Code. 4,448
Sec. 4123.60. (A) Benefits in case of death shall be paid 4,457
to such one or more of the dependents of the decedent, for the 4,458
benefit of all the dependents as the administrator of workers' 4,459
compensation determines. The administrator may apportion the 4,460
benefits among the dependents in such manner as he THE 4,461
ADMINISTRATOR deems just and equitable. Payment to a dependent 4,463
subsequent in right may be made, if the administrator deems it 4,464
proper, and operates to discharge all other claims therefor. The 4,465
dependents or person to whom benefits are paid shall apply the 4,466
same to the use of the several beneficiaries thereof according to 4,467
their respective claims upon the decedent for support, in 4,468
compliance with the finding and direction of the administrator. 4,469
In all cases of death where the dependents are a surviving 4,471
spouse and one or more children, it is sufficient for the 4,472
surviving spouse to apply to the administrator on behalf of the 4,473
spouse and minor children. In cases where all the dependents are 4,474
minors, a guardian or next friend of such minor dependents shall 4,475
apply. 4,476
In all cases where an award had been made on account of 4,478
temporary DISABILITY, or permanent partial IMPAIRMENT, or total 4,480
disability OR IMPAIRMENT, in which there remains an unpaid 4,482
balance, representing payments accrued and due to the decedent at 4,483
the time of his death, the administrator may, after satisfactory 4,484
proof has been made warranting such action, MAY award or pay any 4,485
unpaid balance of such award to such of the dependents of the 4,486
decedent, or for services rendered on account of the last illness 4,487
or death of such THAT decedent, as the administrator determines 4,488
105
in accordance with the circumstances in each such case. If the 4,489
decedent would have been lawfully entitled to have applied for an 4,490
award at the time of his death, the administrator may, after 4,491
satisfactory proof to warrant an award and payment, MAY award and 4,493
pay an amount, not exceeding the compensation which the decedent 4,494
might have received, but for his THE DECEDENT'S death, for the 4,496
period prior to the date of his death, to such of the dependents 4,497
of the decedent, or for services rendered on account of the last 4,498
illness or death of such decedent, as the administrator 4,499
determines in accordance with the circumstances in each such 4,500
case, but such payments may be made only in cases in which 4,501
application for compensation was made in the manner required by 4,502
this chapter, during the lifetime of such injured, IMPAIRED, or 4,503
disabled person, or within one year after the death of such THAT 4,504
injured, IMPAIRED, or disabled person. 4,505
An order issued by the administrator under this section 4,507
DIVISION is appealable pursuant to section 4123.511 of the 4,509
Revised Code but is not appealable to court under section 4,510
4123.512 of the Revised Code. 4,511
(B) THE DEATH OF A CLAIMANT WHO IS ENTITLED TO PAYMENT 4,513
UNDER A SETTLEMENT AGREED TO AND EFFECTIVE IN ACCORDANCE WITH 4,514
SECTION 4123.65 OF THE REVISED CODE DOES NOT ABATE THAT 4,515
SETTLEMENT. PAYMENT OF THAT SETTLEMENT SHALL BE MADE TO THE 4,516
CLAIMANT'S ESTATE.
Sec. 4123.61. The average weekly wage of an injured 4,525
employee at the time of the injury or at the time disability due 4,527
to the occupational disease begins is the basis upon which to
compute benefits. FOR OCCUPATIONAL DISEASE CLAIMS, THE AVERAGE 4,528
WEEKLY WAGE AT THE TIME OF FIRST DIAGNOSIS OF AN OCCUPATIONAL 4,529
DISEASE BY A LICENSED PHYSICIAN IS THE BASIS UPON WHICH TO 4,530
COMPUTE BENEFITS.
In cases of temporary total disability the compensation for 4,532
the first twelve weeks for which compensation is payable shall be 4,533
based on the full weekly wage of the claimant at the time of the 4,534
106
injury or at the time disability due to OF FIRST DIAGNOSIS OF AN 4,535
occupational disease begins BY A LICENSED PHYSICIAN; when a 4,536
factory, mine, or other place of employment is working short time 4,538
in order to divide work among the employees, the bureau of 4,539
workers' compensation shall take that fact into consideration 4,540
when determining the wage for the first twelve weeks of temporary 4,541
total disability.
Compensation for all further temporary total disability 4,543
shall be based as provided for permanent disability IMPAIRMENT 4,544
claims. 4,545
In death, permanent total disability IMPAIRMENT CLAIMS, 4,547
permanent partial disability IMPAIRMENT claims, and impairment of 4,550
earnings claims, the claimant's or the decedent's average weekly 4,552
wage for the year preceding the injury or AT the date the 4,553
disability due to the TIME OF FIRST DIAGNOSIS OF AN occupational 4,555
disease begins BY A LICENSED PHYSICIAN is the weekly wage upon 4,556
which compensation shall be based. In ascertaining the average 4,557
weekly wage for the year previous to the injury, or the date the 4,558
disability due to the OF FIRST DIAGNOSIS OF AN occupational 4,559
disease begins BY A LICENSED PHYSICIAN, any period of 4,560
unemployment due to sickness, industrial depression, strike, 4,561
lockout, or other cause beyond the employee's control shall be 4,562
eliminated. 4,563
In cases where there are special circumstances under which 4,565
the average weekly wage cannot justly be determined by applying 4,566
this section, the administrator of workers' compensation, in 4,567
determining the average weekly wage in such cases, shall use such 4,568
method as will enable him THE ADMINISTRATOR to do substantial 4,569
justice to the claimants. FOR PURPOSES OF THIS SECTION, "SPECIAL 4,572
CIRCUMSTANCES" DOES NOT INCLUDE AND THE ADMINISTRATOR SHALL NOT 4,573
ADJUST THE AVERAGE WEEKLY WAGE FOR A CLAIMANT FOR ANY PERIOD OF 4,574
TIME IN WHICH THE CLAIMANT IS ENROLLED AS A FULL- OR PART-TIME 4,575
STUDENT IN A PUBLIC OR PRIVATE COLLEGE OR UNIVERSITY, INCLUDING A 4,576
COMMUNITY COLLEGE AS DEFINED IN SECTION 3354.01 OF THE REVISED 4,579
107
CODE.
A DETERMINATION MADE BY THE ADMINISTRATOR UNDER THIS 4,581
SECTION IS APPEALABLE PURSUANT TO SECTION 4123.511 OF THE REVISED 4,582
CODE, BUT IT IS NOT APPEALABLE TO COURT UNDER SECTION 4123.512 OF 4,583
THE REVISED CODE.
Sec. 4123.62. (A) If it is established that an injured, 4,592
IMPAIRED, or disabled employee was of such age and experience 4,594
when injured, IMPAIRED, or disabled as that under natural 4,596
conditions his THE EMPLOYEE'S wages would be expected to 4,598
increase, the administrator of workers' compensation may consider 4,599
that fact in arriving at his THE EMPLOYEE'S average weekly wage, 4,600
EXCEPT THAT THE ADMINISTRATOR SHALL NOT CONSIDER AND SHALL NOT 4,602
ADJUST THE AVERAGE WEEKLY WAGE FOR AN EMPLOYEE FOR ANY PERIOD OF 4,603
TIME IN WHICH THE EMPLOYEE IS ENROLLED AS A FULL- OR PART-TIME 4,604
STUDENT IN A PUBLIC OR PRIVATE COLLEGE OR UNIVERSITY, INCLUDING A 4,605
COMMUNITY COLLEGE AS DEFINED IN SECTION 3354.01 OF THE REVISED 4,607
CODE.
(B) On each first day of January, the current maximum 4,609
monthly benefit amounts provided in sections 4123.412, 4123.413, 4,610
and 4123.414 of the Revised Code in injury cases shall be 4,611
adjusted based on the United States department of labor's 4,612
national consumer price index. The percentage increase in the 4,613
cost of living using the index figure for the first day of 4,614
September of the preceding year and the first day of September of 4,615
the year preceding that year shall be applied to the maximums in 4,616
effect on the preceding thirty-first day of December to obtain 4,617
the increase in the cost of living during that year. 4,618
In determining the increase in the maximum benefits for any 4,620
year after 1972, the base shall be the national consumer price 4,621
index on the first day of September of the preceding year. The 4,622
increase in the index for the applicable twelve-month period 4,623
shall be determined and shall be divided by the base used. The 4,624
resulting percentage shall be applied to the existing maximums to 4,625
arrive at the new maximums. 4,626
108
(C) Effective January 1, 1974, and each first day of 4,628
January thereafter, the current maximum weekly benefit amounts 4,629
provided in sections 4123.56, 4123.58, and 4123.59, and division 4,630
(B) of section 4123.57 of the Revised Code shall be adjusted 4,631
based on the increase or decrease in the statewide average weekly 4,632
wage. 4,633
"Statewide average weekly wage" means the average weekly 4,635
earnings of all workers in Ohio employment subject to Chapter 4,636
4141. of the Revised Code as determined as of the first day of 4,637
September for the four full calendar quarters preceding the first 4,638
day of July of each year, by the administrator of the bureau of 4,639
employment services. 4,640
The statewide average weekly wage to be used for the 4,642
determination of compensation for any employee who sustains an 4,643
injury, or death WHO DIES, or who contracts IS DIAGNOSED AS 4,645
HAVING an occupational disease during the subsequent calendar 4,646
year beginning with the first day of January, shall be the 4,647
statewide average weekly wage so determined as of the prior first 4,648
day of September adjusted to the next higher even multiple of one 4,649
dollar.
Any change in benefit amounts is effective with respect to 4,651
injuries sustained, occupational diseases contracted DIAGNOSED, 4,652
and deaths occurring during the calendar year for which 4,654
adjustment is made.
In determining the change in the maximum benefits for any 4,656
year after 1978, the base shall be the statewide average weekly 4,657
wage on the first day of September of the preceding year. 4,658
Sec. 4123.64. (A) The administrator of workers' 4,667
compensation, under special circumstances, and when the same is 4,668
deemed advisable for the purpose of rendering the injured, 4,669
IMPAIRED, or disabled employee financial relief or for the 4,671
purpose of furthering his THE EMPLOYEE'S rehabilitation, may 4,672
commute payments of compensation or benefits to one or more 4,674
lump-sum payments.
109
(B) The administrator shall adopt rules which set forth 4,676
the policy for awarding lump sum payments. The rules shall: 4,677
(1) Enumerate the allowable purposes for payments and the 4,679
conditions for making such awards; 4,680
(2) Enumerate the maximum reduction in compensation 4,682
allowable; 4,683
(3) Enumerate the documentation necessary to award a 4,685
lump-sum payment; 4,686
(4) Require that all checks include the claimant as a 4,688
payee, except where the check is for the payment of attorney's 4,689
fees in accordance with section 4123.06 of the Revised Code, in 4,690
which case the attorney shall be named as the only payee on the 4,691
check; 4,692
(5) Require a fully completed and current application 4,694
including notary and seal; and 4,695
(6) Specify procedures to make a claimant aware of the 4,697
reduction in amount of compensation which will occur. 4,698
(C) An order of the administrator issued under this 4,700
section is appealable pursuant to section 4123.551 of the Revised 4,701
Code but is not appealable to court under section 4123.512 of the 4,702
Revised Code. 4,703
Sec. 4123.65. (A) A state fund employer or the employee 4,712
of such an employer may file an application with the 4,713
administrator of workers' compensation for approval of a final 4,714
settlement of a claim under this chapter. The application shall 4,715
include the settlement agreement, AND EXCEPT AS OTHERWISE 4,716
PROVIDED IN THIS DIVISION, be signed by the claimant and 4,717
employer, and clearly set forth the circumstances by reason of 4,718
which the proposed settlement is deemed desirable and that the 4,719
parties agree to the terms of the settlement agreement provided 4,720
that the. A CLAIMANT MAY FILE AN APPLICATION FOR AN AGREEMENT 4,722
WITHOUT AN EMPLOYER'S SIGNATURE. IF A CLAIMANT FILES AN 4,723
AGREEMENT WITHOUT AN EMPLOYER'S SIGNATURE, AND THE EMPLOYER STILL 4,724
IS DOING BUSINESS IN THIS STATE, THE ADMINISTRATOR SHALL SEND 4,725
110
WRITTEN NOTICE OF THE APPLICATION TO THE EMPLOYER IMMEDIATELY 4,726
UPON RECEIPT OF THE APPLICATION. IF THE EMPLOYER FAILS TO 4,727
RESPOND TO THE NOTICE WITHIN SIXTY DAYS AFTER RECEIPT OF THE 4,728
NOTICE, THE AGREEMENT NEED NOT CONTAIN THE EMPLOYER'S SIGNATURE, 4,729
AND NO agreement need not be signed by the AN employer if the 4,730
employer WHO is no longer doing business in Ohio THIS STATE. If 4,732
a state fund employer or an employee of such an employer has not 4,733
filed an application for a final settlement under this division, 4,734
the administrator may file an application on behalf of the 4,735
employer or the employee, provided that the administrator gives 4,736
notice of the filing to the employer and the employee and to the 4,737
representative of record of the employer and of the employee 4,738
immediately upon the filing. An application filed by the 4,739
administrator shall contain all of the information and signatures 4,740
required of an employer or an employee who files an application 4,741
under this division. Every self-insuring employer that enters 4,742
into a final settlement agreement with an employee shall mail, 4,743
within seven days of executing the agreement, a copy of the 4,744
agreement to the administrator and the employee's representative. 4,745
The administrator shall place the agreement into the claimant's 4,746
file. 4,747
(B) Except as provided in divisions (C) and (D) of this 4,749
section, a settlement agreed to under this section is binding 4,750
upon all parties thereto and as to items, injuries, and 4,751
occupational diseases to which the settlement applies. 4,752
(C) No settlement agreed to under division (A) of this 4,754
section or agreed to by a self-insuring employer and the 4,755
self-insuring employer's employee shall take effect until thirty 4,756
days after the administrator approves the settlement for state 4,757
fund employees and employers, or after the self-insuring employer 4,758
and employee sign the final settlement agreement. During the 4,759
thirty-day period, the employer, employee, or administrator, for 4,760
state fund settlements, and the employer or employee, for 4,761
self-insuring settlements, may withdraw consent to the settlement 4,762
111
by an employer providing written notice to the employer's 4,763
employee and the administrator or by an employee providing 4,765
written notice to the employee's employer and the administrator, 4,766
or by the administrator providing written notice to the state 4,767
fund employer and employee.
(D) At the time of agreement to any final settlement 4,769
agreement under division (A) of this section or agreement between 4,770
a self-insuring employer and the self-insuring employer's 4,771
employee, IN CASES IN WHICH ONE OR MORE PARTIES TO THE AGREEMENT 4,772
ARE UNREPRESENTED, the administrator, for state fund settlements, 4,773
and the self-insuring employer, for self-insuring settlements, 4,775
immediately shall send a copy of the agreement to the industrial 4,776
commission who shall assign the matter to a staff hearing 4,777
officer. The staff hearing officer shall determine, within the 4,778
time limitations specified in division (C) of this section, 4,779
whether the settlement agreement is or is not a gross miscarriage 4,780
of justice CLEARLY UNFAIR. If the staff hearing officer 4,782
determines within that time period that the settlement agreement 4,783
is clearly unfair, the staff hearing officer shall issue an order
disapproving the settlement agreement. If the staff hearing 4,785
officer determines that the settlement agreement is not clearly 4,786
unfair or fails to act within those time limits, the settlement
agreement is approved. 4,787
(E) A settlement entered into under this section may 4,789
pertain to one or more claims of a claimant, or one or more parts 4,790
of a claim, or the compensation or benefits pertaining to either, 4,791
or any combination thereof, provided that nothing in this section 4,792
shall be interpreted to require a claimant to enter into a 4,793
settlement agreement for every claim that has been filed with the 4,794
bureau of workers' compensation by that claimant under Chapter 4,795
4121., 4123., 4127., or 4131. of the Revised Code. 4,796
(F) A settlement entered into under this section is not 4,798
appealable under section 4123.511 or 4123.512 of the Revised 4,799
Code. 4,800
112
(G) FOR PURPOSES OF DETERMINING WHETHER A PARTY IS 4,802
UNREPRESENTED AS SPECIFIED IN DIVISION (D) OF THIS SECTION, A 4,804
PARTY IS CONSIDERED REPRESENTED ONLY IF THE PARTY HAS THE 4,805
SERVICES OF ONE OF THE FOLLOWING PERSONS: 4,806
(1) AN ATTORNEY ADMITTED TO THE PRACTICE OF LAW IN THIS 4,808
STATE;
(2) A DULY AUTHORIZED REPRESENTATIVE OF AN EMPLOYEE 4,810
ORGANIZATION RECOGNIZED BY THE EMPLOYER FOR COLLECTIVE BARGAINING 4,812
PURPOSES;
(3) A PERSON REGULARLY ENGAGED IN THE BUSINESS OF 4,814
PROVIDING WORKERS' COMPENSATION-RELATED SERVICES TO EMPLOYERS; 4,815
(4) AN EMPLOYEE OF THE SELF-INSURING EMPLOYER WHOSE JOB 4,817
DUTIES OR RESPONSIBILITIES INCLUDE PARTICIPATION IN THE 4,818
ADMINISTRATION OF THE SELF-INSURING EMPLOYER'S WORKERS' 4,819
COMPENSATION PROGRAM.
Sec. 4123.651. (A) The employer of a claimant who is 4,828
injured, IMPAIRED, or disabled in the course of his THE 4,830
CLAIMANT'S employment may require, without the approval of the 4,831
administrator or the industrial commission, that the claimant be 4,832
examined by a physician of the employer's choice one time upon 4,833
any issue asserted by the employee or a physician of the 4,834
employee's choice or which is to be considered by the commission. 4,835
Any further requests for medical examinations shall be made to 4,836
the commission which shall consider and rule on the request. The 4,837
employer shall pay the cost of any examinations initiated by the 4,838
employer.
(B) The bureau of workers' compensation shall prepare a 4,840
form for the release of medical information, records, and reports 4,841
relative to the issues necessary for the administration of a 4,842
claim under this chapter. The claimant promptly shall provide a 4,843
current signed release of the information, records, and reports 4,844
when requested by the employer. The employer promptly shall 4,845
provide copies of all medical information, records, and reports 4,846
to the bureau and to the claimant or his THE CLAIMANT'S 4,847
113
representative upon request. 4,849
(C) If, without good cause, an employee refuses to submit 4,851
to any examination scheduled under this section or refuses to 4,852
release or execute a release for any medical information, record, 4,853
or report that is required to be released under this section and 4,854
involves an issue pertinent to the condition alleged in the 4,855
claim, his THE EMPLOYEE'S right to have his THE claim for 4,857
compensation or benefits considered, if his THE claim is pending 4,858
before the administrator, THE commission, or a district or staff 4,860
hearing officer, or to receive any payment for compensation or 4,861
benefits previously granted, is suspended during the period of 4,862
refusal.
(D) No bureau or commission employee shall alter any 4,864
medical report obtained from a health care provider the bureau or 4,865
commission has selected or cause or request the health care 4,866
provider to alter or change a report. The bureau and commission 4,867
shall make any request for clarification of a health care 4,868
provider's report in writing and shall provide a copy of the 4,869
request to the affected parties and their representatives at the 4,870
time of making the request. 4,871
Sec. 4123.66. (A) In addition to the compensation 4,879
provided for in this chapter, the administrator of workers' 4,880
compensation shall disburse and pay from the state insurance fund 4,881
the amounts for medical, nurse, and hospital services and 4,882
medicine as he THE ADMINISTRATOR deems proper, and, in case death 4,884
ensues from the injury or occupational disease, he THE 4,886
ADMINISTRATOR shall disburse and pay from the fund reasonable 4,888
funeral expenses in an amount not to exceed thirty-two hundred 4,889
dollars. The bureau of workers' compensation shall reimburse 4,890
anyone, whether dependent, volunteer, or otherwise, who pays the 4,891
funeral expenses of any employee whose death ensues from any 4,892
injury or occupational disease as provided in this section. The 4,893
administrator may adopt rules, with the advice and consent of the 4,894
workers' compensation oversight commission, with respect to 4,895
114
furnishing medical, nurse, and hospital service and medicine to 4,896
injured, IMPAIRED, or disabled employees entitled thereto, and 4,898
for the payment therefor. In case an injury or industrial 4,899
accident that injures an employee also causes damage to the 4,901
employee's eyeglasses, artificial teeth or other denture, or 4,902
hearing aid, or in the event an injury or occupational disease 4,903
makes it necessary or advisable to replace, repair, or adjust the 4,904
same, the bureau shall disburse and pay a reasonable amount to 4,905
repair or replace the same. 4,906
(B)(1) If an employer or a welfare plan has provided to or 4,908
on behalf of an employee any benefits or compensation for an 4,909
injury or occupational disease and that injury or occupational 4,910
disease is determined compensable under this chapter, the 4,911
employer or a welfare plan may request that the administrator 4,912
reimburse the employer or welfare plan for the amount the 4,913
employer or welfare plan paid to or on behalf of the employee in 4,914
compensation or benefits. The administrator shall reimburse the 4,915
employer or welfare plan for the compensation and benefits paid 4,916
if, at the time the employer or welfare plan provides the 4,917
benefits or compensation to or on behalf of employee, the injury 4,918
or occupational disease had not been determined to be compensable 4,919
under this chapter and if the employee was not receiving 4,920
compensation or benefits under this chapter for that injury or 4,921
occupational disease. The administrator shall reimburse the 4,922
employer or welfare plan in the amount that the administrator 4,923
would have paid to or on behalf of the employee under this 4,924
chapter if the injury or occupational disease originally would 4,925
have been determined compensable under this chapter. If the 4,926
employer is a merit-rated employer, the administrator shall 4,927
adjust the amount of premium next due from the employer according 4,928
to the amount the administrator pays the employer. The 4,929
administrator shall adopt rules, in accordance with Chapter 119. 4,930
of the Revised Code, to implement this division. 4,931
(2) As used in this division, "welfare plan" has the same 4,933
115
meaning as in division (1) of 29 U.S.C.A. 1002. 4,934
Sec. 4123.68. Every employee who is disabled OR IMPAIRED 4,943
because of the contraction of an occupational disease or the 4,944
dependent of an employee whose death is caused by an occupational 4,945
disease, is entitled to the compensation provided by sections 4,946
4123.55 to 4123.59 and 4123.66 of the Revised Code subject to the 4,947
modifications relating to occupational diseases contained in this 4,948
chapter. An order of the administrator issued under this section 4,949
is appealable pursuant to sections 4123.511 and 4123.512 of the 4,950
Revised Code. 4,951
The following diseases are occupational diseases and 4,953
compensable as such when contracted by an employee in the course 4,954
of the employment in which such employee was engaged and due to 4,955
the nature of any process described in this section. A disease 4,956
which meets the definition of an occupational disease is 4,957
compensable pursuant to this chapter EVEN though it is not 4,958
specifically listed in this section. 4,959
SCHEDULE 4,961
Description of disease or injury and description of 4,963
process: 4,964
(A) Anthrax: Handling of wool, hair, bristles, hides, and 4,966
skins. 4,967
(B) Glanders: Care of any equine animal suffering from 4,969
glanders; handling carcass of such animal. 4,970
(C) Lead poisoning: Any industrial process involving the 4,972
use of lead or its preparations or compounds. 4,973
(D) Mercury poisoning: Any industrial process involving 4,975
the use of mercury or its preparations or compounds. 4,976
(E) Phosphorous poisoning: Any industrial process 4,978
involving the use of phosphorous or its preparations or 4,979
compounds. 4,980
(F) Arsenic poisoning: Any industrial process involving 4,982
the use of arsenic or its preparations or compounds. 4,983
(G) Poisoning by benzol or by nitro-derivatives and 4,985
116
amido-derivatives of benzol (dinitro-benzol, anilin, and others): 4,986
Any industrial process involving the use of benzol or 4,987
nitro-derivatives or amido-derivatives of benzol or its 4,988
preparations or compounds. 4,989
(H) Poisoning by gasoline, benzine, naphtha, or other 4,991
volatile petroleum products: Any industrial process involving 4,992
the use of gasoline, benzine, naphtha, or other volatile 4,993
petroleum products. 4,994
(I) Poisoning by carbon bisulphide: Any industrial 4,996
process involving the use of carbon bisulphide or its 4,997
preparations or compounds. 4,998
(J) Poisoning by wood alcohol: Any industrial process 5,000
involving the use of wood alcohol or its preparations. 5,001
(K) Infection or inflammation of the skin on contact 5,003
surfaces due to oils, cutting compounds or lubricants, dust, 5,004
liquids, fumes, gases, or vapors: Any industrial process 5,005
involving the handling or use of oils, cutting compounds or 5,006
lubricants, or involving contact with dust, liquids, fumes, 5,007
gases, or vapors. 5,008
(L) Epithelion cancer or ulceration of the skin or of the 5,010
corneal surface of the eye due to carbon, pitch, tar, or tarry 5,011
compounds: Handling or industrial use of carbon, pitch, or tarry 5,012
compounds. 5,013
(M) Compressed air illness: Any industrial process 5,015
carried on in compressed air. 5,016
(N) Carbon dioxide poisoning: Any process involving the 5,018
evolution or resulting in the escape of carbon dioxide. 5,019
(O) Brass or zinc poisoning: Any process involving the 5,021
manufacture, founding, or refining of brass or the melting or 5,022
smelting of zinc. 5,023
(P) Manganese dioxide poisoning: Any process involving 5,025
the grinding or milling of manganese dioxide or the escape of 5,026
manganese dioxide dust. 5,027
(Q) Radium poisoning: Any industrial process involving 5,029
117
the use of radium and other radioactive substances in luminous 5,030
paint. 5,031
(R) Tenosynovitis and prepatellar bursitis: Primary 5,033
tenosynovitis characterized by a passive effusion or crepitus 5,034
into the tendon sheath of the flexor or extensor muscles of the 5,035
hand, due to frequently repetitive motions or vibrations, or 5,036
prepatellar bursitis due to continued pressure. 5,037
(S) Chrome ulceration of the skin or nasal passages: Any 5,039
industrial process involving the use of or direct contact with 5,040
chromic acid or bichromates of ammonium, potassium, or sodium or 5,041
their preparations. 5,042
(T) Potassium cyanide poisoning: Any industrial process 5,044
involving the use of or direct contact with potassium cyanide. 5,045
(U) Sulphur dioxide poisoning: Any industrial process in 5,047
which sulphur dioxide gas is evolved by the expansion of liquid 5,048
sulphur dioxide. 5,049
(V) Berylliosis: Berylliosis means a disease of the lungs 5,051
caused by breathing beryllium in the form of dust or fumes, 5,052
producing characteristic changes in the lungs and demonstrated by 5,053
x-ray examination, by biopsy or by autopsy. 5,054
This chapter does not entitle an employee or his THE 5,056
EMPLOYEE'S dependents to compensation, medical treatment, or 5,058
payment of funeral expenses for disability, IMPAIRMENT, or death 5,059
from berylliosis unless the employee has been subjected to 5,061
injurious exposure to beryllium dust or fumes in his THE 5,062
EMPLOYEE'S employment in this state preceding his THE EMPLOYEE'S 5,063
disablement OR IMPAIRMENT and only in the event of such 5,064
disability, IMPAIRMENT, or death resulting within eight years 5,067
after the last injurious exposure; provided that such eight-year 5,068
limitation does not apply to disability, IMPAIRMENT, or death 5,069
from exposure occurring after January 1, 1976. In the event of 5,071
death following continuous total disability OR IMPAIRMENT 5,072
commencing within eight years after the last injurious exposure, 5,074
the requirement of death within eight years after the last 5,075
118
injurious exposure does not apply.
Before awarding compensation for partial or total 5,077
disability OR IMPAIRMENT or death due to berylliosis, the 5,078
administrator of workers' compensation shall refer the claim to a 5,080
qualified MEDICAL SPECIALIST FOR EXAMINATION AND RECOMMENDATION 5,081
WITH REGARD to the diagnosis, the extent of the disability OR 5,082
IMPAIRMENT, the nature of the disability OR IMPAIRMENT, whether 5,083
permanent or temporary, the cause of death, and other medical 5,085
questions connected with the claim. An employee shall submit to 5,086
such examinations, including clinical and x-ray examinations, as 5,087
the administrator requires. In the event that an employee 5,088
refuses to submit to examinations, including clinical and x-ray 5,089
examinations, after notice from the administrator, or in the 5,090
event that a claimant for compensation for death due to 5,091
berylliosis fails to produce necessary consents and permits, 5,092
after notice from the administrator, so that such autopsy 5,093
examination and tests may be performed, then all rights for 5,094
compensation are forfeited. The reasonable compensation of such 5,095
specialist and the expenses of examinations and tests shall be 5,096
paid, if the claim is allowed, as part of the expenses of the
claim, otherwise they shall be paid from the surplus fund. 5,097
(W) Cardiovascular, pulmonary, or respiratory diseases 5,099
incurred by fire fighters FIREFIGHTERS or police officers 5,100
following exposure to heat, smoke, toxic gases, chemical fumes 5,102
and other toxic substances: Any cardiovascular, pulmonary, or 5,103
respiratory disease of a fire fighter FIREFIGHTERS or police 5,104
officer OFFICERS caused or induced by the cumulative effect of 5,106
exposure to heat, the inhalation of smoke, toxic gases, chemical 5,107
fumes and other toxic substances in the performance of his THEIR 5,108
duty constitutes a presumption, which may be refuted by 5,110
affirmative evidence, that such occurred in the course of and 5,111
arising out of his THEIR employment. For the purpose of this 5,113
section, "fire fighter FIREFIGHTER" means any regular member of a 5,114
lawfully constituted fire department of a municipal corporation 5,115
119
or township, whether paid or volunteer, and "police officer" 5,116
means any regular member of a lawfully constituted police 5,117
department of a municipal corporation, township or county, 5,118
whether paid or volunteer. 5,119
This chapter does not entitle a fire fighter FIREFIGHTER, 5,121
or police officer, or his THE FIREFIGHTER'S OR POLICE OFFICER'S 5,123
dependents to compensation, medical treatment, or payment of 5,125
funeral expenses for disability, IMPAIRMENT, or death from a 5,126
cardiovascular, pulmonary, or respiratory disease, unless the 5,127
fire fighter FIREFIGHTER or police officer has been subject to 5,128
injurious exposure to heat, smoke, toxic gases, chemical fumes, 5,130
and other toxic substances in his THE FIREFIGHTER'S OR POLICE 5,131
OFFICER'S employment in this state preceding his THE disablement 5,133
OR IMPAIRMENT, some portion of which has been after January 1, 5,134
1967, except as provided in division (E) of section 4123.57 of 5,135
the Revised Code. 5,136
Compensation on account of cardiovascular, pulmonary, or 5,138
respiratory diseases of fire fighters FIREFIGHTERS and police 5,139
officers is payable only in the event of temporary total 5,141
disability, permanent total disability IMPAIRMENT, or death, in 5,142
accordance with section 4123.56, 4123.58, or 4123.59 of the 5,144
Revised Code. Medical, hospital, and nursing expenses are 5,145
payable in accordance with this chapter. Compensation, medical, 5,146
hospital, and nursing expenses are payable only in the event of 5,147
such disability, IMPAIRMENT, or death resulting within eight 5,149
years after the last injurious exposure; provided that such 5,150
eight-year limitation does not apply to disability, IMPAIRMENT, 5,151
or death from exposure occurring after January 1, 1976. In the 5,153
event of death following continuous total disability OR 5,154
IMPAIRMENT commencing within eight years after the last injurious 5,155
exposure, the requirement of death within eight years after the 5,156
last injurious exposure does not apply. 5,157
This chapter does not entitle a fire fighter FIREFIGHTER or 5,159
police officer, or his THE dependents OF A FIREFIGHTER OR POLICE 5,161
120
OFFICER, to compensation, medical, hospital, and nursing 5,164
expenses, or payment of funeral expenses for disability, 5,165
IMPAIRMENT, or death due to a cardiovascular, pulmonary, or 5,166
respiratory disease in the event of failure or omission on the 5,167
part of the fire fighter FIREFIGHTER or police officer truthfully 5,169
to state, when seeking employment, the place, duration, and 5,170
nature of previous employment in answer to an inquiry made by the 5,171
employer.
Before awarding compensation for disability, IMPAIRMENT, or 5,174
death under this division, the administrator shall refer the 5,175
claim to a qualified medical specialist for examination and 5,176
recommendation with regard to the diagnosis, the extent of 5,177
disability OR IMPAIRMENT, the cause of death, and other medical 5,179
questions connected with the claim. A fire fighter FIREFIGHTER or 5,180
police officer shall submit to such examinations, including 5,182
clinical and x-ray examinations, as the administrator requires. 5,183
In the event that a fire fighter FIREFIGHTER or police officer 5,185
refuses to submit to examinations, including clinical and x-ray 5,186
examinations, after notice from the administrator, or in the 5,187
event that a claimant for compensation for death under this 5,188
division fails to produce necessary consents and permits, after 5,189
notice from the administrator, so that such autopsy examination 5,190
and tests may be performed, then all rights for compensation are 5,191
forfeited. The reasonable compensation of such specialists and 5,192
the expenses of examination and tests shall be paid, if the claim 5,193
is allowed, as part of the expenses of the claim, otherwise they 5,194
shall be paid from the surplus fund.
(X) Silicosis: Silicosis means a disease of the lungs 5,196
caused by breathing silica dust (silicon dioxide) producing 5,197
fibrous nodules distributed through the lungs and demonstrated by 5,198
x-ray examination, by biopsy or by autopsy. 5,199
(Y) Coal miners' pneumoconiosis: Coal miners' 5,201
pneumoconiosis, commonly referred to as "black lung disease," 5,202
resulting from working in the coal mine industry and due to 5,203
121
exposure to the breathing of coal dust, and demonstrated by x-ray 5,204
examination, biopsy, autopsy or other medical or clinical tests. 5,205
This chapter does not entitle an employee or his THE 5,207
EMPLOYEE'S dependents to compensation, medical treatment, or 5,209
payment of funeral expenses for disability, IMPAIRMENT, or death 5,210
from silicosis, asbestosis, or coal miners' pneumoconiosis unless 5,212
the employee has been subject to injurious exposure to silica 5,213
dust (silicon dioxide), asbestos, or coal dust in his THE 5,214
EMPLOYEE'S employment in this state preceding his THE disablement 5,216
OR IMPAIRMENT, some portion of which has been after October 12, 5,217
1945, except as provided in division (E) of section 4123.57 of 5,218
the Revised Code. 5,219
Compensation on account of silicosis, asbestosis, or coal 5,221
miners' pneumoconiosis are payable only in the event of temporary 5,222
total disability, permanent total disability IMPAIRMENT, or 5,223
death, in accordance with sections 4123.56, 4123.58, and 4123.59 5,225
of the Revised Code. Medical, hospital, and nursing expenses are 5,226
payable in accordance with this chapter. Compensation, medical, 5,227
hospital, and nursing expenses are payable only in the event of 5,228
such disability, IMPAIRMENT, or death resulting within eight 5,230
years after the last injurious exposure; provided that such 5,231
eight-year limitation does not apply to disability, IMPAIRMENT, 5,232
or death occurring after January 1, 1976, and further provided 5,234
that such eight-year limitation does not apply to any asbestosis 5,235
cases. In the event of death following continuous total 5,236
disability OR IMPAIRMENT commencing within eight years after the 5,238
last injurious exposure, the requirement of death within eight 5,239
years after the last injurious exposure does not apply. 5,240
This chapter does not entitle an employee or his THE 5,242
EMPLOYEE'S dependents to compensation, medical, hospital, and 5,244
nursing expenses, or payment of funeral expenses for disability, 5,245
IMPAIRMENT, or death due to silicosis, asbestosis, or coal 5,247
miners' pneumoconiosis in the event of the failure or omission on 5,248
the part of the employee truthfully to state, when seeking 5,249
122
employment, the place, duration, and nature of previous 5,250
employment in answer to an inquiry made by the employer. 5,251
Before awarding WHEN compensation IS REQUESTED for 5,253
disability, IMPAIRMENT, or death due to silicosis, asbestosis, or 5,256
coal miners' pneumoconiosis, the administrator shall refer MAY 5,257
DETERMINE WHETHER THERE IS SUFFICIENT LIKELIHOOD THAT ANY OF 5,258
THOSE DISEASES EXISTS, CAUSES DISABILITY OR IMPAIRMENT, OR CAUSED 5,260
DEATH TO WARRANT REFERRING the claim to a qualified medical
specialist for examination and recommendation with regard to the 5,261
diagnosis, the extent of disability OR IMPAIRMENT, the cause of 5,262
death, and other medical questions connected with the claim. IN 5,264
NO EVENT SHALL COMPENSATION FOR DISABILITY, IMPAIRMENT, OR DEATH 5,265
DUE TO SILICOSIS, ASBESTOSIS, OR COAL MINERS' PNEUMOCONIOSIS BE 5,266
AWARDED WITHOUT THE CLAIM BEING REFERRED TO A QUALIFIED MEDICAL 5,267
SPECIALIST FOR THAT EXAMINATION AND RECOMMENDATION. An employee 5,268
shall submit to such examinations, including clinical and x-ray 5,269
examinations, as the administrator requires. In the event that 5,270
an employee refuses to submit to examinations, including clinical 5,271
and x-ray examinations, after notice from the administrator, or 5,272
in the event that a claimant for compensation for death due to 5,273
silicosis, asbestosis, or coal miners' pneumoconiosis fails to 5,274
produce necessary consents and permits, after notice from the 5,275
commission, so that such autopsy examination and tests may be 5,276
performed, then all rights for compensation are forfeited. The 5,277
reasonable compensation of such specialist and the expenses of 5,278
examinations and tests shall be paid, if the claim is allowed, as 5,279
a part of the expenses of the claim, otherwise they shall be paid 5,280
from the surplus fund. 5,281
(Z) Radiation illness: Any industrial process involving 5,283
the use of radioactive materials. 5,284
Claims for compensation and benefits due to radiation 5,286
illness are payable only in the event death, IMPAIRMENT, or 5,288
disability occurred within eight years after the last injurious 5,289
exposure provided that such eight-year limitation does not apply 5,290
123
to disability, IMPAIRMENT, or death from exposure occurring after 5,292
January 1, 1976. In the event of death following continuous 5,293
disability OR IMPAIRMENT which commenced within eight years of 5,295
the last injurious exposure, the requirement of death within 5,296
eight years after the last injurious exposure does not apply. 5,297
(AA) Asbestosis: Asbestosis means a disease caused by 5,299
inhalation or ingestion of asbestos, demonstrated by x-ray 5,300
examination, biopsy, autopsy, or other objective medical or 5,301
clinical tests. 5,302
All conditions, restrictions, limitations, and other 5,304
provisions of this section, with reference to the payment of 5,305
compensation or benefits on account of silicosis or coal miners' 5,306
pneumoconiosis apply to the payment of compensation or benefits 5,307
on account of any other occupational disease of the respiratory 5,308
tract resulting from injurious exposures to dust. 5,309
The refusal to produce the necessary consents and permits 5,311
for autopsy examination and testing shall not result in 5,312
forfeiture of compensation provided the administrator finds that 5,313
such refusal was the result of bona fide religious convictions or 5,314
teachings to which the claimant for compensation adhered prior to 5,315
the death of the decedent. 5,316
Sec. 4123.70. No compensation shall be awarded on account 5,325
of disability, IMPAIRMENT, or death from disease suffered by an 5,327
employee who, at the time of entering into the employment from 5,328
which the disease is claimed to have resulted, willfully and 5,329
falsely represented himself THE EMPLOYEE as not having previously 5,330
suffered from such disease. Compensation shall not be awarded on 5,332
account of both injury and disease, except when the disability OR 5,333
IMPAIRMENT is caused by a disease and an injury, in which event 5,334
the administrator of workers' compensation may apportion the 5,335
payment of compensation provided for in sections 4123.56 to 5,336
4123.59 of the Revised Code between the funds as in his THE 5,337
ADMINISTRATOR'S judgment seems just and proper. 5,338
If an employee is suffering from both occupational disease 5,340
124
and an injury, and the administrator can determine which is 5,341
causing his THE EMPLOYEE'S disability OR IMPAIRMENT, the 5,342
administrator shall pay compensation therefor from the proper 5,344
fund.
Compensation for loss sustained on account of occupational 5,346
disease by an employee mentioned in division (A)(1) of section 5,347
4123.01 of the Revised Code, or the dependents of such employee, 5,348
shall be paid from the fund provided for in sections 4123.38 to 5,349
4123.41 and 4123.48 of the Revised Code. 5,350
Compensation for loss sustained on account of a disease by 5,352
an employee mentioned in division (A)(2) of section 4123.01 of 5,353
the Revised Code, or the dependents of the employee, shall be 5,354
paid from the occupational disease fund or by the employer of the 5,355
employee, if the employer is a self-insuring employer. 5,356
Sec. 4123.80. No agreement by an employee to waive his THE 5,364
EMPLOYEE'S rights to compensation under this chapter is valid, 5,366
except that:
(A) An employee who is blind may waive the compensation 5,368
that may become due him TO THE EMPLOYEE for injury, IMPAIRMENT, 5,370
or disability in cases where the injury, IMPAIRMENT, or 5,371
disability may be directly caused by or due to his THAT 5,373
blindness. The administrator of workers' compensation, with the 5,375
advice and consent of the workers' compensation oversight 5,377
commission, may adopt and enforce rules governing the employment 5,379
of such persons and the inspection of their places of employment. 5,380
(B) An employee may waive his THE EMPLOYEE'S rights to 5,382
compensation or benefits as authorized pursuant to division 5,383
(C)(3) of section 4123.01 OR SECTION 4123.15 of the Revised Code. 5,385
No agreement by an employee to pay any portion of the 5,387
premium paid by his THE EMPLOYEE'S employer into the state 5,389
insurance fund is valid.
Sec. 4123.82. (A) All contracts and agreements are void 5,398
which undertake to indemnify or insure an employer against loss 5,399
or liability for the payment of compensation to workers or their 5,400
125
dependents for death, injury, or occupational disease occasioned 5,401
in the course of the workers' employment, or which provide that 5,402
the insurer shall pay the compensation, or which indemnify the 5,403
employer against damages when the injury, disease, or death 5,404
arises from the failure to comply with any lawful requirement for 5,405
the protection of the lives, health, and safety of employees, or 5,406
when the same is occasioned by the willful act of the employer or 5,407
any of his THE EMPLOYER'S officers or agents, or by which it is 5,408
agreed that the insurer shall pay any such damages. No license 5,410
or authority to enter into any such agreements or issue any such 5,411
policies of insurance shall be granted or issued by any public 5,412
authority in this state. Any corporation organized or admitted 5,413
under the laws of this state to transact liability insurance as 5,414
defined in section 3929.01 of the Revised Code may by amendment 5,415
of its articles of incorporation or by original articles of 5,416
incorporation, provide therein for the authority and purpose to 5,417
make insurance in states, territories, districts, and counties, 5,418
other than the state of Ohio, and in the state of Ohio in respect 5,419
of contracts permitted by division (B) of this section, 5,420
indemnifying employers against loss or liability for payment of 5,421
compensation to workers and employees and their dependents for 5,422
death, injury, or occupational disease occasioned in the course 5,423
of the employment and to insure and indemnify employers against 5,424
loss, expense, and liability by risk of bodily injury or death by 5,425
accident, disability, IMPAIRMENT, sickness, or disease suffered 5,426
by workers and employees for which the employer may be liable or 5,428
has assumed liability. 5,429
(B) Notwithstanding division (A) of this section: 5,431
(1) No contract because of that division is void which 5,433
undertakes to indemnify a self-insuring employer against all or 5,434
part of such employer's loss in excess of at least fifty thousand 5,435
dollars from any one disaster or event arising out of the 5,436
employer's liability under this chapter, but no insurance 5,437
corporation shall, directly or indirectly, SHALL represent an 5,438
126
employer in the settlement, adjudication, determination, 5,439
allowance, or payment of claims. The superintendent of insurance 5,440
shall enforce this prohibition by such disciplinary orders 5,441
directed against the offending insurance corporation as the 5,442
superintendent of insurance deems appropriate in the 5,443
circumstances and the administrator of workers' compensation 5,444
shall enforce this prohibition by such disciplinary orders 5,445
directed against the offending employer as the administrator 5,446
deems appropriate in the circumstances, which orders may include 5,447
revocation of the insurance corporation's right to enter into 5,448
indemnity contracts and revocation of the employer's status as a 5,449
self-insuring employer. 5,450
(2) The administrator may enter into a contract of 5,452
indemnity with any such employer upon such terms, payment of such 5,453
premium, and for such amount and form of indemnity as the 5,454
administrator determines and the administrator may procure 5,455
reinsurance of the liability of the public and private funds 5,456
under this chapter, or any part of the liability in respect of 5,457
either or both of the funds, upon such terms and premiums or 5,458
other payments from the fund or funds as the administrator deems 5,459
prudent in the maintenance of a solvent fund or funds from year 5,460
to year. When making the finding of fact which the administrator 5,461
is required by section 4123.35 of the Revised Code to make with 5,462
respect to the financial ability of an employer, no contract of 5,463
indemnity, or the ability of the employer to procure such a 5,464
contract, shall be considered as increasing the financial ability 5,465
of the employer. 5,466
Sec. 4123.84. (A) In all cases of injury or death, claims 5,475
for compensation or benefits for the specific part or parts of 5,476
the body injured shall be forever barred unless, within two years 5,477
after the injury or death: 5,478
(1) Written notice of the specific part or parts of the 5,480
body claimed to have been injured has been made to the industrial 5,481
commission or the bureau of workers' compensation; 5,482
127
(2) The employer, with knowledge of a claimed compensable 5,484
injury or occupational disease, has paid wages in lieu of 5,485
compensation for total disability OR IMPAIRMENT; 5,486
(3) In the event the employer is a self-insuring employer, 5,488
one of the following has occurred: 5,489
(a) Written notice of the specific part or parts of the 5,491
body claimed to have been injured has been given to the 5,492
commission or bureau or the employer has furnished treatment by a 5,493
licensed physician in the employ of an employer, provided, 5,494
however, that the furnishing of such treatment shall not 5,495
constitute a recognition of a claim as compensable, but shall do 5,496
no more than satisfy the requirements of this section; 5,497
(b) Compensation or benefits have been paid or furnished 5,499
equal to or greater than is provided for in sections 4123.52, 5,500
4123.55 to 4123.62, and 4123.64 to 4123.67 of the Revised Code, 5,501
PROVIDED THAT THE PAYMENT OR FURNISHING OF THE COMPENSATION OR 5,502
BENEFITS SHALL NOT CONSTITUTE A RECOGNITION OF A CLAIM OR ANY 5,503
CONDITION IN A CLAIM AS COMPENSABLE. THAT PAYMENT, THAT 5,504
COMPENSATION, OR THOSE BENEFITS SHALL DO NO MORE THAN SATISFY THE 5,506
REQUIREMENTS OF THIS SECTION.
(4) Written notice of death has been given to the 5,508
commission or bureau.
(B) The bureau shall provide printed notices quoting in 5,510
full division (A) of this section, and every self-insuring 5,511
employer shall post and maintain at all times one or more of the 5,512
notices in conspicuous places in the workshop or places of 5,513
employment. 5,514
(C) The commission has continuing jurisdiction as set 5,516
forth in section 4123.52 of the Revised Code over a claim which 5,517
meets the requirement of this section, including jurisdiction to 5,518
award compensation or benefits for loss or impairment of bodily 5,519
functions developing in a part or parts of the body not specified 5,520
pursuant to division (A)(1) of this section, if the commission 5,521
finds that the loss or impairment of bodily functions was due to 5,522
128
and a result of or a residual of the injury to one of the parts 5,523
of the body set forth in the written notice filed pursuant to 5,524
division (A)(1) of this section. 5,525
(D) Any claim pending before the administrator, the 5,527
commission, or a court on December 11, 1967, in which the remedy 5,528
is affected by this section is governed by this section. 5,529
(E) Notwithstanding the requirement that the notice 5,531
required to be given to the bureau, commission, or employer under 5,532
this section is to be in writing, the bureau may accept, assign a 5,533
claim number, and process a notice provided by any method of 5,534
telecommunication. Immediately upon receipt of the 5,535
telecommunicated notice, the bureau shall send a written notice 5,536
to the employer of the bureau's receipt of the telecommunicated 5,537
notice. Within fifteen days after receipt of the notice, the 5,538
employer may in writing either MAY verify or not verify the 5,539
telecommunicated notice. If the bureau does not receive the 5,540
written notification from the employer or receives a written 5,541
notification verifying the telecommunicated notice within such 5,542
time period, the claim is validly filed and such telecommunicated 5,543
notice tolls the statute of limitations in regard to the claim 5,544
filed and is considered to meet the requirements of written 5,545
notice required by this section. 5,546
(F) As used in division (A)(3)(b) of this section, 5,548
"benefits" means payments by a self-insuring employer to, or on 5,549
behalf of, an employee for a hospital bill, a medical bill to a 5,550
licensed physician or hospital, or an orthopedic or prosthetic 5,551
device. 5,552
Sec. 4123.85. In all cases of occupational disease, or 5,561
death resulting from occupational disease, claims for 5,562
compensation or benefits are forever barred unless, within two 5,563
years after the disability due to the disease began, or within 5,565
such longer period as does not exceed six months after FIRST
diagnosis of the occupational disease by a licensed physician or 5,566
within two years after death occurs, application is made to the 5,567
129
industrial commission or the bureau of workers' compensation or 5,568
to the employer if he THE EMPLOYER is a self-insuring employer. 5,570
Sec. 4123.86. THE COMBINATION OF BENEFITS THAT A RETIRED 5,572
EMPLOYEE RECEIVES UNDER SECTION 4123.412, 4123.413, 4123.414, 5,573
4123.56, OR 4123.58 OF THE REVISED CODE AND BENEFITS A RETIRED 5,574
EMPLOYEE RECEIVES UNDER A RETIREMENT PLAN THAT IS AT LEAST EIGHTY 5,575
PER CENT FUNDED BY THE EMPLOYER OF RECORD IN THE EMPLOYEE'S CLAIM
SHALL NOT EXCEED THE STATEWIDE AVERAGE WEEKLY WAGE. ANY WORKERS' 5,576
COMPENSATION BENEFITS PAYABLE TO THE EMPLOYEE OR RETIRED EMPLOYEE 5,577
SHALL BE REDUCED SO THAT THE COMBINATION OF WORKERS' COMPENSATION 5,578
BENEFITS AND RETIREMENT BENEFITS DOES NOT EXCEED THE STATEWIDE 5,579
AVERAGE WEEKLY WAGE.
Sec. 4123.90. (A) The bureau ADMINISTRATOR of workers' 5,588
compensation, industrial commission WORKERS' COMPENSATION HEARING 5,589
OFFICERS, or any other PERSON OR body constituted by the statutes 5,591
of this state, or any court of this state, in awarding
compensation to the dependents of employees, or others killed in 5,592
Ohio THIS STATE, shall not make any discrimination against the 5,593
widows SURVIVING SPOUSES, children, or other dependents who 5,595
reside in a foreign country. The bureau ADMINISTRATOR, commission 5,596
HEARING OFFICER, or any other board, PERSON, or court, in 5,598
determining the amount of compensation to be paid to the 5,599
dependents of killed employees, shall pay to the alien dependents 5,600
residing in foreign countries the same benefits as to those 5,601
dependents residing in this state. 5,602
(B) No employer shall discharge, demote, reassign, or take 5,604
any punitive action against any employee because the employee 5,605
filed a claim or instituted, pursued, or testified in any 5,606
proceedings under the workers' compensation act THIS CHAPTER OR 5,607
CHAPTER 4126., 4127., OR 4131. OF THE REVISED CODE for an injury 5,608
or occupational disease which occurred in the course of and 5,609
arising out of his employment with that employer. Any such 5,610
AN employee AFFECTED BY A VIOLATION OF THIS DIVISION may 5,612
file an action in the COURT OF common pleas court of the county 5,613
130
of such employment in which the relief which may be granted shall 5,615
be limited to reinstatement with back pay, if the action is based 5,616
upon discharge, or an award for wages lost if based upon 5,617
demotion, reassignment, or punitive action taken, offset by 5,618
earnings subsequent to discharge, demotion, reassignment, or 5,619
punitive action taken, and payments received pursuant to section 5,620
4123.56 and Chapter 4141. of the Revised Code plus reasonable 5,621
attorney fees. The action shall be IS forever barred unless 5,622
filed within one hundred eighty days immediately following the 5,623
discharge, demotion, reassignment, or punitive action taken, and 5,624
no action may be instituted or maintained unless the employer has 5,625
received written notice of a claimed violation of this paragraph 5,626
within the ninety days immediately following the discharge, 5,627
demotion, reassignment, or punitive action taken. 5,628
Sec. 4127.03. Every work-relief employee who sustains an 5,637
injury and the dependents of such as are killed, in the course of 5,638
and arising out of employment, wheresoever such WHEREVER THAT 5,639
injury or death occurs, except when such injury or death is 5,641
caused by willful misconduct or intent to bring about such injury 5,642
or death, or when the use of intoxicating liquors or drugs is the 5,643
proximate cause of such injury or death, is entitled to receive 5,644
out of the public work-relief employees' compensation fund, 5,645
compensation, death benefits, medical, nurse, and hospital 5,646
services, medicine, and funeral expenses, for loss sustained on 5,647
account of such injury or death, as is provided for by Chapter 5,648
4123. of the Revised Code.
Except as provided in section 4127.06 of the Revised Code, 5,650
no compensation shall be paid from the work-relief employees' 5,651
compensation fund for or on account of any temporary disability 5,652
or partial disability IMPAIRMENT; except that in the cases 5,653
included in the schedule of loss of specific members or sight, 5,655
set forth in section 4123.57 of the Revised Code, the disability 5,656
OR IMPAIRMENT is deemed to continue for the periods mentioned for 5,658
each of such cases in that section. In cases where the injury 5,659
131
results in the total or partial loss of use of any such member, 5,660
the disability OR IMPAIRMENT is deemed to continue for such 5,662
proportion of the period fixed for the total loss of a member as 5,663
the administrator of workers' compensation finds that the actual 5,664
physical disability OR IMPAIRMENT bears to the total loss of such 5,666
members.
All compensation payable under this chapter shall be paid 5,668
on the basis of computation provided for in this chapter. 5,669
Sec. 4127.06. During periods of temporary disability and 5,678
partial disability IMPAIRMENT other than that resulting from loss 5,680
of a member or sight or total or partial loss of use of a member, 5,681
an injured work-relief employee shall be paid directly out of the 5,682
fund from which the employee was receiving relief, the amounts 5,683
required to meet the budgetary needs of the employee and his THE 5,684
EMPLOYEE'S dependents, and in the manner determined by the person 5,685
or agency having control over or supervision of the fund. 5,686
When all of the funds for relief purposes which are 5,688
available to any employer are exhausted, or when, disability OR 5,689
IMPAIRMENT as a result of the injury is continuous beyond a 5,692
period of six months, the injured work-relief employee shall be
compensated for temporary DISABILITY and partial disability 5,693
IMPAIRMENT out of the public work-relief employees' compensation 5,695
fund by the bureau of workers' compensation in the same manner 5,696
and amount as is provided in sections 4127.01 to 4127.14 of the
Revised Code for other disabilities AND IMPAIRMENTS. 5,697
Sec. 4141.31. (A) Benefits otherwise payable for any week 5,706
shall be reduced by the amount of remuneration a claimant 5,707
receives with respect to such week as follows: 5,708
(1) Remuneration in lieu of notice; 5,710
(2) Compensation for wage loss under division (B)(C) of 5,712
section 4123.56 of the Revised Code or temporary partial 5,713
disability under the workers' compensation law of any state or 5,714
under a similar law of the United States; 5,715
(3) Except as provided in section 4141.312 of the Revised 5,717
132
Code, payments in the form of retirement, or pension allowances 5,718
under a plan wholly financed by an employer which payments are 5,719
paid either directly by the employer, or indirectly through a 5,720
trust, annuity, insurance fund, or under an insurance contract 5,721
whether payable upon retirement, termination, or separation from 5,722
employment, provided that if the claimant has twenty-six weeks or 5,723
more of employment with a subsequent employer or employers who 5,724
are not paying him a pension or retirement allowance, then such 5,725
pension or retirement payments shall not reduce the benefits 5,726
payable for the week, and provided further that no benefits shall 5,727
thereafter be charged to the account of the employer who is 5,728
paying the pension, but instead such benefits shall be charged to 5,729
the mutualized account except as provided in division (B)(1)(b) 5,730
of section 4141.241 of the Revised Code if the claimant's 5,731
separation from the employer was disqualifying under division 5,732
(D)(2)(a) of section 4141.29 of the Revised Code. 5,733
(4) Remuneration in the form of separation or termination 5,735
pay paid to an employee at the time of his THE EMPLOYEE'S 5,736
separation from employment; 5,738
(5) Vacation pay or allowance payable under the terms of a 5,740
labor-management contract or agreement, or other contract of 5,741
hire, which payments are allocated to designated weeks. 5,742
If payments under this division are paid with respect to a 5,744
month then the amount of remuneration deemed to be received with 5,745
respect to any week during such month shall be computed by 5,746
multiplying such monthly amount by twelve and dividing the 5,747
product by fifty-two. If there is no designation of the period 5,748
with respect to which payments to an individual are made under 5,749
this section then an amount equal to such individual's normal 5,750
weekly wage shall be attributed to and deemed paid with respect 5,751
to the first and each succeeding week following his THE 5,752
EMPLOYEE'S separation or termination from the employment of the 5,754
employer making the payment until such amount so paid is 5,755
exhausted.
133
If benefits for any week, when reduced as provided in this 5,757
division, result in an amount not a multiple of one dollar, such 5,758
benefits shall be rounded to the next lower multiple of one 5,759
dollar. 5,760
Any payment allocated by the employer or the administrator 5,762
of the bureau of employment services to weeks under division 5,763
(A)(1), (4), or (5) of this section shall be deemed to be 5,764
remuneration for the purposes of establishing a qualifying week 5,765
and a benefit year under divisions (O)(1) and (R) of section 5,766
4141.01 of the Revised Code. 5,767
(B) Benefits payable for any week shall not be reduced by 5,769
the amount of remuneration a claimant receives with respect to 5,770
such week in the form of drill or reserve pay received by a 5,771
member of the Ohio national guard or the armed forces reserve for 5,772
attendance at a regularly scheduled drill or meeting. 5,773
(C) No benefits shall be paid for any week with respect to 5,775
which or a part of which an individual has received or is seeking 5,776
unemployment benefits under an unemployment compensation law of 5,777
any other state or of the United States, provided the 5,778
disqualifications shall not apply if the appropriate agency of 5,779
such other state or of the United States finally determines that 5,780
he is not entitled to such unemployment benefits. A law of the 5,781
United States providing any payment of any type and in any 5,782
amounts for periods of unemployment due to lack of work shall be 5,783
considered an unemployment compensation law of the United States. 5,784
(D) Notwithstanding any other provision in this chapter, 5,786
benefits otherwise payable shall not be reduced by payments that 5,787
were made to an individual on or after August 1, 1991, pursuant 5,788
to "The National Defense Authorization Act for Fiscal Years 1992 5,789
and 1993," Public Law 102-190, 105 Stat. 1394, 1396, 10 U.S.C.A. 5,790
1174a, 1175, in the form of voluntary separation incentive 5,791
payments and special separation pay. 5,792
Section 2. That existing sections 2913.48, 4121.32, 5,794
4121.34, 4121.35, 4121.36, 4121.38, 4121.47, 4121.65, 4121.67, 5,795
134
4123.01, 4123.032, 4123.033, 4123.07, 4123.25, 4123.27, 4123.28, 5,796
4123.343, 4123.35, 4123.352, 4123.411, 4123.412, 4123.413, 5,797
4123.414, 4123.416, 4123.419, 4123.511, 4123.512, 4123.52, 5,798
4123.54, 4123.541, 4123.55, 4123.56, 4123.57, 4123.58, 4123.59, 5,799
4123.60, 4123.61, 4123.62, 4123.64, 4123.65, 4123.651, 4123.66, 5,800
4123.68, 4123.70. 4123.80, 4123.82, 4123.84, 4123.85, 4123.90, 5,801
4127.03, 4127.06, and 4141.31 of the Revised Code are hereby 5,802
repealed. 5,803
Section 3. Section 4123.58 of the Revised Code, as amended 5,805
by this act, applies to all applications for compensation filed 5,806
on or after the effective date of this act regardless of when the 5,807
workers' compensation claim arose. 5,808
Section 4. The penalties provided for in divisions (B) and 5,810
(C) of section 4121.444 of the Revised Code apply to any 5,811
overpayment, billing, or falsification occurring on or after the 5,812
effective date of this act.