As Passed by the Senate 1
122nd General Assembly 4
Regular Session Sub. S. B. No. 45 5
1997-1998 6
SENATORS CUPP-GILLMOR-SUHADOLNIK-NEIN-LATTA-WHITE-B. JOHNSON- 8
DRAKE-RAY-SCHAFRATH-GAETH-DIX-FINAN-GARDNER-HORN 9
11
A B I L L
To amend sections 2913.48, 4121.32, 4121,34, 13
4121.35, 4121.36, 4121.38, 4121.47, 4121.61, 15
4121.67, 4123.01, 4123.032, 4123.033, 4123.07, 16
4123.25, 4123.27, 4123.28, 4123.343, 4123.35,
4123.352, 4123.411, 4123.412, 4123.413, 4123.414, 17
4123.416, 4123.419, 4123.511, 4123.512, 4123.52, 18
4123.54, 4123.541, 4123.55, 4123.56, 4123.57, 19
4123.58, 4123.59, 4123.60, 4123.61, 4123.62,
4123.64, 4123.65, 4123.651, 4123.66, 4123.68, 20
4123.70, 4123.80, 4123.82, 4123.84, 4123.85, 21
4123.90, 4127.03, 4127.06, and 4141.31 and to 22
enact sections 4121.361, 4121.444, 4123.061,
4123.15, and 4123.531 of the Revised Code to make 24
various changes in the structure, payment, and
determination of benefits, to reduce the number 25
of weeks an employee can receive nonworking wage 27
loss, to permit an employer to have an employee
excepted from the Workers' Compensation Laws for 29
religious reasons, to change the duration of the
continuing jurisdiction of the Industrial 30
Commission to three years, to require hearing
officers to report suspected fraudulent activity, 31
to limit recovery for aggravation of a 32
preexisting condition, to change the definition
of occupational disease, to permit certain 33
nonattorneys to represent parties in hearings 34
before the Industrial Commission, to create the
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presumption concerning alcohol or a controlled 36
substance as the cause of an employee's injury,
to except buildings and land used for 37
agricultural production from safety rules that
apply to workshops and factories, to provide 39
criminal penalties for employers who
intentionally misclassify their employees for 40
workers' compensation purposes, to prohibit
kickbacks from health care providers under the 41
Workers' Compensation Law, to prohibit health
care providers from receiving payments for false 42
claims under the Workers' Compensation Law, to 43
provide that records kept by the Division of 44
Safety and Hygiene are confidential, to specify 45
that records produced by an attorney in
connection with a workers' compensation claim are 46
the property of the claimant, and to make other
changes in the Workers' Compensation Law. 47
BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF OHIO: 49
Section 1. That sections 2913.48, 4121.32, 4121.34, 51
4121.35, 4121.36, 4121.38, 4121.47, 4121.61, 4121.67, 4123.01, 53
4123.032, 4123.033, 4123.07, 4123.25, 4123.27, 4123.28, 4123.343, 54
4123.35, 4123.352, 4123.411, 4123.412, 4123.413, 4123.414, 55
4123.416, 4123.419, 4123.511, 4123.512, 4123.52, 4123.54, 56
4123.541, 4123.55, 4123.56, 4123.57, 4123.58, 4123.59, 4123.60, 57
4123.61, 4123.62, 4123.64, 4123.65, 4123.651, 4123.66, 4123.68, 58
4123.70, 4123.80, 4123.82, 4123.84, 4123.85, 4123.90, 4127.03, 59
4127.06, and 4141.31 be amended and sections 4121.361, 4121.444, 60
4123.061, 4123.15, and 4123.531 of the Revised Code be enacted to 61
read as follows: 62
Sec. 2913.48. (A) No person, with purpose to defraud or 71
knowing that the person is facilitating a fraud, shall do any of 72
the following: 73
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(1) Receive workers' compensation benefits to which the 75
person is not entitled; 76
(2) Make or present or cause to be made or presented a 78
false or misleading statement with the purpose to secure payment 79
for goods or services rendered under Chapter 4121., 4123., 4127., 80
or 4131. of the Revised Code or to secure workers' compensation 81
benefits; 82
(3) Alter, falsify, destroy, conceal, or remove any record 84
or document that is necessary to fully establish the validity of 85
any claim filed with, or necessary to establish the nature and 86
validity of all goods and services for which reimbursement or 87
payment was received or is requested from, the bureau of workers' 88
compensation, or a self-insuring employer under Chapter 4121., 89
4123., 4127., or 4131. of the Revised Code; 90
(4) Enter into an agreement or conspiracy to defraud the 92
bureau or a self-insuring employer by making or presenting or 93
causing to be made or presented a false claim for workers' 94
compensation benefits; 95
(5) MAKE OR PRESENT OR CAUSE TO BE MADE OR PRESENTED A 97
FALSE OR MISLEADING STATEMENT OR OTHER MISREPRESENTATION 98
CONCERNING MANUAL CODES, CLASSIFICATION OF EMPLOYEES, PAYROLL, OR 99
NUMBER OF PERSONNEL, WHEN INFORMATION OF THAT NATURE IS NECESSARY 100
TO DETERMINE THE ACTUAL WORKERS' COMPENSATION PREMIUM OR 101
ASSESSMENT OWED TO THE BUREAU BY AN EMPLOYER; 102
(6) SOLICIT, OFFER, OR RECEIVE ANY REMUNERATION IN CASH OR 104
IN KIND, INCLUDING, BUT NOT LIMITED TO, A KICKBACK OR REBATE, IN 105
CONNECTION WITH A REFERRAL FOR THE FURNISHING OF GOODS OR 106
SERVICES FOR WHICH REIMBURSEMENT MAY BE MADE PURSUANT TO CHAPTER 107
4121., 4123., 4127., OR 4131. OF THE REVISED CODE. DIVISION 108
(A)(6) OF THIS SECTION DOES NOT APPLY TO ANY CONTRACT TO PROVIDE 109
SERVICES UNDER THE BUREAU'S HEALTH CARE PARTNERSHIP PROGRAM 110
ENTERED INTO BETWEEN A MANAGED CARE ORGANIZATION AND AN
ORGANIZATION FORMED PURSUANT TO DIVISION (A)(4) OF SECTION 111
4123.29 OF THE REVISED CODE. 112
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(7) ALTER A WORKERS' COMPENSATION CERTIFICATE TO FALSELY 114
SHOW CURRENT OR CORRECT WORKERS' COMPENSATION COVERAGE; 115
(8) KNOWINGLY FAIL TO SECURE OR MAINTAIN WORKERS' 117
COMPENSATION COVERAGE AS REQUIRED BY CHAPTER 4123. OF THE REVISED 118
CODE.
(B) Whoever violates this section is guilty of workers' 120
compensation fraud. Except as otherwise provided in this 122
division, a violation of this section is a misdemeanor of the 123
first degree. If the value of the PREMIUMS AND ASSESSMENTS 125
UNPAID PURSUANT TO ACTIONS DESCRIBED IN DIVISION (A)(5) OR (8) OF 126
THIS SECTION, OR OF goods, services, property, or money stolen is 129
five hundred dollars or more and is less than five thousand 130
dollars, a violation of this section is a felony of the fifth 131
degree. If the value of the PREMIUMS AND ASSESSMENTS UNPAID 133
PURSUANT TO ACTIONS DESCRIBED IN DIVISION (A)(5) OR (8) OF THIS 134
SECTION, OR OF goods, services, property, or money stolen is five 136
thousand dollars or more and is less than one hundred thousand 137
dollars, a violation of this section is a felony of the fourth 138
degree. If the value of the PREMIUMS AND ASSESSMENTS UNPAID 140
PURSUANT TO ACTIONS DESCRIBED IN DIVISION (A)(5) OR (8) OF THIS 141
SECTION, OR OF goods, services, property, or money stolen is one 143
hundred thousand dollars or more, a violation of this section is 144
a felony of the third degree. WHOEVER VIOLATES DIVISION (A)(7) 145
OF THIS SECTION IS GUILTY OF A FELONY OF THE FIFTH DEGREE. 146
(C) Upon application of the governmental body that 148
conducted the investigation and prosecution of a violation of 149
this section, the court shall order the person who is convicted 150
of the violation to pay the governmental body its costs of 151
investigating and prosecuting the case. These costs are in 152
addition to any other costs or penalty provided in the Revised 153
Code or any other section of law. 154
(D) The remedies and penalties provided in this section 156
are not exclusive remedies and penalties and do not preclude the 157
use of any other criminal or civil remedy or penalty for any act 158
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that is in violation of this section. 159
(E) As used in this section: 161
(1) "False" means wholly or partially untrue or deceptive. 163
(2) "Goods" includes, but is not limited to, medical 165
supplies, appliances, rehabilitative equipment, and any other 166
apparatus or furnishing provided or used in the care, treatment, 167
or rehabilitation of a claimant for workers' compensation 168
benefits. 169
(3) "Services" includes, but is not limited to, any 171
service provided by any health care provider to a claimant for 172
workers' compensation benefits AND ANY AND ALL SERVICES PROVIDED 173
BY THE BUREAU AS PART OF WORKERS' COMPENSATION INSURANCE 175
COVERAGE.
(4) "Claim" means any attempt to cause the bureau, an 177
independent third party with whom the administrator or an 178
employer contracts under section 4121.44 of the Revised Code, or 179
a self-insuring employer to make payment or reimbursement for 180
workers' compensation benefits. 181
(5) "Employment" means participating in any trade, 183
occupation, business, service, or profession for substantial 184
gainful remuneration. 185
(6) "Employer," "employee," and "self-insuring employer" 187
have the same meanings as in section 4123.01 of the Revised Code. 188
(7) "Remuneration" includes, but is not limited to, wages, 190
commissions, rebates, and any other reward or consideration. 191
(8) "Statement" includes, but is not limited to, any oral, 193
written, electronic, electronic impulse, or magnetic 194
communication notice, letter, memorandum, receipt for payment, 195
invoice, account, financial statement, OR bill for services; a 197
diagnosis, prognosis, prescription, hospital, medical, or dental
chart or other record; and a computer generated document. 198
(9) "Records" means any medical, professional, financial, 200
or business record relating to the treatment or care of any 201
person, to goods or services provided to any person, or to rates 202
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paid for goods or services provided to any person, or any record 203
that the administrator of workers' compensation requires pursuant 204
to rule. 205
(10) "Workers' compensation benefits" means any 207
compensation or benefits payable under Chapter 4121., 4123., 208
4127., or 4131. of the Revised Code. 209
Sec. 4121.32. (A) The rules covering operating procedure 217
and criteria for decision-making that the administrator of 218
workers' compensation and the industrial commission are required 219
to adopt pursuant to section 4121.31 of the Revised Code shall be 220
supplemented with operating manuals setting forth the procedural 221
steps in detail for performing each of the assigned tasks of each 222
section of the bureau of workers' compensation and commission. 223
The administrator and commission jointly shall adopt such 224
manuals. No employee may deviate from manual procedures without 225
authorization of the section chief. 226
(B) Manuals shall set forth the procedure for the 228
assignment and transfer of claims within sections and be designed 229
to provide performance objectives and may require employees to 230
record sufficient data to reasonably measure the efficiency of 231
functions in all sections. The bureau's division of research and 232
statistics shall perform periodic cost-effectiveness analyses 233
which shall be made available to the general assembly, the 234
governor, and to the public during normal working hours. 235
(C) The bureau and commission jointly shall develop, 237
adopt, and use a policy manual setting forth the guidelines and 238
bases for decision-making for any decision which is the 239
responsibility of the bureau, district hearing officers, staff 240
hearing officers, or the commission. Guidelines shall be set 241
forth in the policy manual by the bureau and commission to the 242
extent of their respective jurisdictions for deciding at least 243
the following specific matters: 244
(1) Reasonable ambulance services; 246
(2) Relationship of drugs to injury; 248
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(3) Awarding lump-sum advances for creditors; 250
(4) Awarding lump-sum advances for attorney's fees; 252
(5) Placing a claimant, INCLUDING A CLAIMANT WHOSE 254
EMPLOYER IS A SELF-INSURING EMPLOYER, into rehabilitation; 255
(6) Transferring costs of a claim from employer costs to 257
the statutory surplus fund pursuant to section 4123.343 of the 258
Revised Code; 259
(7) Utilization of physician specialist reports; 261
(8) Determining the percentage of permanent partial 263
disability, temporary IMPAIRMENT IN ACCORDANCE WITH THE MOST 264
RECENT EDITION OF THE AMERICAN MEDICAL ASSOCIATION'S GUIDES TO 265
THE EVALUATION OF PERMANENT IMPAIRMENT; 266
(9) DETERMINING THE PERCENTAGE OF TEMPORARY partial 268
disability, temporary total disability, violations of specific 271
safety requirements, an award under division (B) of section 272
4123.57 of the Revised Code, and permanent total disability 273
IMPAIRMENT.
(D) The bureau shall establish, adopt, and implement 275
policy guidelines and bases for decisions involving reimbursement 276
issues including, but not limited to, the adjustment of invoices, 277
the reduction of payments for future services when an internal 278
audit concludes that a health care provider was overpaid or
improperly paid for past services, reimbursement fees, or other 279
adjustments to payments. These policy guidelines and bases for 280
decisions, and any changes to the guidelines and bases, shall be 281
set forth in a reimbursement manual and provider bulletins. 282
Neither the policy guidelines nor the bases set forth in 284
the reimbursement manual or provider bulletins referred to in 285
this division is a rule as defined in section 119.01 of the 286
Revised Code.
(E) With respect to any determination of disability OR 288
IMPAIRMENT under Chapter 4123. of the Revised Code, when the 290
physician makes a determination based upon statements or 291
information furnished by the claimant or upon subjective 292
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evidence, he THE PHYSICIAN shall clearly indicate this fact in 294
his THE PHYSICIAN'S report.
(F) The administrator shall publish the manuals and make 296
copies of all manuals available to interested parties at cost. 297
Sec. 4121.34. (A) The industrial commission shall appoint 306
a sufficient number of district hearing officers for the purpose 307
of hearing the matters listed in division (B) of this section. 308
District hearing officers are in the classified civil service of 309
the state, are full-time employees of the commission, and shall 310
be persons admitted to the practice of law in this state. 312
District hearing officers shall not engage in any other activity
that interferes with their full-time employment by the commission 313
during normal working hours. 314
(B) District hearing officers shall have original 316
jurisdiction on all of the following matters: 317
(1) Determinations under section 4123.57 of the Revised 319
Code; 320
(2) All appeals from a decision of the administrator of 322
workers' compensation under division (B) of section 4123.511 of 323
the Revised Code; 324
(3) All other contested claims matters under this chapter 326
and Chapters 4123., 4127., and 4131. of the Revised Code, except 327
those matters over which staff hearing officers have original 328
jurisdiction. 329
(C) The administrator of workers' compensation shall make 331
available to each district hearing officer the facilities and 332
assistance of bureau employees and furnish all information 333
necessary to the performance of the district hearing officer's 334
duties. 335
(D) A DISTRICT HEARING OFFICER SHALL REPORT TO THE 337
INSPECTION DIVISION OF THE BUREAU OF WORKERS' COMPENSATION 338
SUSPECTED FRAUDULENT ACTIVITY PERTAINING TO THE OPERATION OF THE 339
WORKERS' COMPENSATION SYSTEM AND ITS SEVERAL INSURANCE FUNDS AS 340
EVIDENCED DURING ANY HEARING IN WHICH THE HEARING OFFICER IS 341
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PRESENT OR AS EVIDENCED BY ANY MATERIAL SUBMITTED FOR USE IN A
HEARING. A DISTRICT HEARING OFFICER SHALL BE HELD HARMLESS FOR 342
SUBMITTING A REPORT UNDER THIS DIVISION. THE INSPECTION DIVISION 343
SHALL MAINTAIN IN CONFIDENCE THE IDENTITY OF ANY HEARING OFFICER 344
WHO SUBMITS A REPORT UNDER THIS DIVISION. 345
Sec. 4121.35. (A) The industrial commission shall appoint 354
staff hearing officers to consider and decide all matters 355
specified in division (B) of this section. All staff hearing 356
officers are full-time employees of the commission and shall be 357
admitted to the practice of law in this state. Staff hearing 358
officers shall not engage in any other activity that interferes 360
with their full-time employment by the commission during normal 361
working hours.
(B) Except as provided in division (D) of this section, 363
staff hearing officers have original jurisdiction to hear and 364
decide the following matters: 365
(1) Applications for permanent, total disability 367
IMPAIRMENT awards pursuant to section 4123.58 of the Revised 369
Code;
(2) Appeals from an order of a district hearing officer 371
issued under division (C) of section 4123.511 of the Revised 372
Code; 373
(3) Applications for additional awards for violation of a 375
specific safety rule of the administrator of workers' 376
compensation pursuant to Section 35 of Article II of the Ohio 377
Constitution; 378
(4) Applications for reconsideration pursuant to division 380
(A) of section 4123.57 of the Revised Code. Decisions of the 381
staff hearing officers on reconsideration pursuant to division 382
(A) of section 4123.57 of the Revised Code are final. 383
(5) Reviews of settlement agreements pursuant to section 385
4123.65 of the Revised Code. Decisions of the staff hearing 386
officer under that section are final and not appealable to the 387
commission or to court under section 4123.511 or 4123.512 of the 388
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Revised Code. 389
(C) The decision of a staff hearing officer under division 391
(D) of section 4123.511 of the Revised Code is the decision of 392
the commission for the purposes of section 4123.512 of the 393
Revised Code unless the commission hears an appeal under division 394
(E) of section 4123.511 of the Revised Code. 395
(D) Staff hearing officers shall hold hearings on all 397
matters referred to them for hearing. Hearing procedures shall 398
conform to the rules the commission adopts pursuant to section 399
4121.36 of the Revised Code. 400
(E) A STAFF HEARING OFFICER SHALL REPORT TO THE INSPECTION 403
DIVISION OF THE BUREAU OF WORKERS' COMPENSATION SUSPECTED 404
FRAUDULENT ACTIVITY PERTAINING TO THE OPERATION OF THE WORKERS'
COMPENSATION SYSTEM AND ITS SEVERAL INSURANCE FUNDS AS EVIDENCED 405
DURING ANY HEARING IN WHICH THE HEARING OFFICER IS PRESENT OR AS 406
EVIDENCED BY ANY MATERIAL SUBMITTED FOR USE IN A HEARING. A 407
STAFF HEARING OFFICER SHALL BE HELD HARMLESS FOR SUBMITTING A 408
REPORT UNDER THIS DIVISION. THE INSPECTION DIVISION SHALL 409
MAINTAIN IN CONFIDENCE THE IDENTITY OF ANY HEARING OFFICER WHO
SUBMITS A REPORT UNDER THIS DIVISION. 410
Sec. 4121.36. (A) The industrial commission shall adopt 419
rules as to the conduct of all hearings before the commission and 420
its staff and district hearing officers and the rendering of a 421
decision and shall focus such rules on managing, directing, and 422
otherwise ensuring a fair, equitable, and uniform hearing 423
process. These rules shall provide for at least the following 424
steps and procedures: 425
(1) Adequate notice to all parties and their 427
representatives to ensure that no hearing is conducted unless all 428
parties have the opportunity to be present and to present 429
evidence and arguments in support of their positions or in 430
rebuttal to the evidence or arguments of other parties; 431
(2) A public hearing; 433
(3) Written decisions; 435
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(4) Impartial assignment of staff and district hearing 437
officers and assignment of appeals from a decision of the 438
administrator of workers' compensation to a district hearing 439
officer located at the commission service office that is the 440
closest in geographic proximity to the claimant's residence; 442
(5) Publication of a docket; 444
(6) The securing of the attendance or testimony of 446
witnesses; 447
(7) Prehearing rules, including rules relative to 449
discovery, the taking of depositions, and exchange of information 450
relevant to a claim prior to the conduct of a hearing; 451
(8) The issuance of orders by the district or staff 453
hearing officer who renders the decision. 454
(B) Every decision by a staff or district hearing officer 456
or the commission shall be in writing and contain all of the 457
following elements: 458
(1) A concise statement of the order or award; 460
(2) A notation as to notice provided and as to appearance 462
of parties; 463
(3) Signatures of each commissioner or appropriate hearing 465
officer on the original copy of the decision only, verifying the 467
commissioner's or hearing officer's vote; 468
(4) Description of the part of the body and nature of the 470
disability recognized in the claim. 471
(C) The commission shall adopt rules that require the 473
regular rotation of district hearing officers with respect to the 474
types of matters under consideration and that ensure that no 475
district or staff hearing officer or the commission hears a claim 476
unless all interested and affected parties have the opportunity 477
to be present and to present evidence and arguments in support of 478
their positions or in rebuttal to the evidence or arguments of 479
other parties. 480
(D) All matters which, at the request of one of the 482
parties or on the initiative of the administrator and any 483
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commissioner, are to be expedited, shall require at least 484
forty-eight hours' notice, a public hearing, and a statement in 485
any order of the circumstances that justified such expeditious 486
hearings. 487
(E) All meetings of the commission and district and staff 489
hearing officers shall be public with adequate notice, including 490
if necessary, to the claimant, the employer, their 491
representatives, and the administrator. Confidentiality of 492
medical evidence presented at a hearing does not constitute a 493
sufficient ground to relieve the requirement of a public hearing, 494
but the presentation of privileged or confidential evidence shall 495
not create any greater right of public inspection of evidence 496
than presently exists. 497
(F) The commission shall compile all of its original 499
memorandums, orders, and decisions in a journal and make the 500
journal available to the public with sufficient indexing to allow 501
orderly review of documents. The journal shall indicate the vote 502
of each commissioner. 503
(G)(1) All original orders, rules, and memoranda, and 505
decisions of the commission shall contain the signatures of two 507
of the three commissioners and state whether adopted at a meeting 508
of the commission or by circulation to individual commissioners. 509
Any facsimile or secretarial signature, initials of 510
commissioners, and delegated employees, and any printed record of 511
the "yes" and "no" vote of a commission member or of a hearing 512
officer on such original is invalid. 514
(2) Written copies of final decisions of district or staff 516
hearing officers or the commission that are mailed to the 517
administrator, employee, employer, and their respective 518
representatives need not contain the signatures of the hearing 519
officer or commission members if the hearing officer or 520
commission members have complied with divisions (B)(3) and (G)(1) 521
of this section.
(H) The commission shall do both of the following: 523
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(1) Appoint an individual as a hearing officer trainer who 525
is in the unclassified civil service of the state and who serves 526
at the pleasure of the commission. The trainer shall be an 527
attorney registered to practice law in this state and have 528
experience in training or education, and the ability to furnish 529
the necessary training for district and staff hearing officers. 530
The hearing officer trainer shall develop and periodically 532
update a training manual and such other training materials and 533
courses as will adequately prepare district and staff hearing 534
officers for their duties under this chapter and Chapter 4123. of 535
the Revised Code. All district and staff hearing officers shall 536
undergo the training courses developed by the hearing officer 537
trainer, the cost of which the commission shall pay. The 538
commission shall make the hearing officer manual and all 539
revisions thereto available to the public at cost. 540
The commission shall have the final right of approval over 542
all training manuals, courses, and other materials the hearing 543
officer trainer develops and updates. 544
(2) Appoint a hearing administrator, who shall be in the 546
classified civil service of the state, for each bureau service 547
office, and sufficient support personnel for each hearing 548
administrator, which support personnel shall be under the direct 549
supervision of the hearing administrator. The hearing 550
administrator shall do all of the following: 551
(a) Assist the commission in ensuring that district 553
hearing officers comply with the time limitations for the holding 554
of hearings and issuance of orders under section 4123.511 of the 555
Revised Code. For that purpose, each hearing administrator shall 556
prepare a monthly report identifying the status of all claims in 557
its office and identifying specifically the claims which have not 558
been decided within the time limits set forth in section 4123.511 559
of the Revised Code. The commission shall submit an annual 560
report of all such reports to the standing committees of the 561
house of representatives and of the state to which matters 562
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concerning workers' compensation are normally referred. 563
(b) Provide information to requesting parties or their 565
representatives on the status of their claim; 566
(c) Issue compliance letters, upon a finding of good cause 568
and without a formal hearing in all of the following areas: 569
(i) Divisions (B) and (C) of section 4123.651 of the 571
Revised Code; 572
(ii) Requests for the taking of depositions of bureau and 574
commission physicians; 575
(iii) The issuance of subpoenas; 577
(iv) The granting or denying of requests for continuances; 579
(v) Matters involving section 4123.522 of the Revised 581
Code; 582
(vi) Requests for conducting telephone pre-hearing 584
conferences; 585
(vii) Any other matter that will cause a free exchange of 587
information prior to the formal hearing. 588
(d) Ensure that claim files are reviewed by the district 590
hearing officer prior to the hearing to ensure that there is 591
sufficient information to proceed to a hearing; 592
(e) Ensure that for occupational disease claims under 594
section 4123.68 of the Revised Code that require a medical 595
examination the medical examination is conducted prior to the 596
hearing; 597
(f) Take the necessary steps to prepare a claim to proceed 599
to a hearing where the parties agree and advise the hearing 600
administrator that the claim is not ready for a hearing. 602
(I) The commission shall permit any person direct access 604
to information contained in electronic data processing equipment 605
regarding the status of a claim in the hearing process. The 606
information shall indicate the number of days that the claim has 607
been in process, the number of days the claim has been in its 608
current location, and the number of days in the current point of 609
the process within that location. 610
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(J)(1) The industrial commission may establish an 612
alternative dispute resolution process for workers' compensation 613
claims that are within the commission's jurisdiction under 615
Chapters 4121., 4123., 4127., and 4131. of the Revised Code when 617
the commission determines that such a process is necessary. 618
Notwithstanding sections 4121.34 and 4121.35 of the Revised Code, 619
the commission may enter into personal service contracts with 620
individuals who are qualified because of their education and 621
experience to act as facilitators in the commission's alternative 622
dispute resolution process.
(2) The parties' use of the alternative dispute resolution 624
process is voluntary, and requires the agreement of all necessary 625
parties. The use of the alternative dispute resolution process 627
does not alter the rights or obligations of the parties, nor does 629
it delay the timelines set forth in section 4123.511 of the 630
Revised Code. 631
(3) The commission shall prepare monthly reports and 633
submit those reports to the governor, the president of the 634
senate, and the speaker of the house of representatives 635
describing all of the following:
(a) The names of each facilitator employed under a 637
personal service contract; 638
(b) The hourly amount of money and the total amount of 641
money paid to each facilitator;
(c) The number of disputed issues resolved during that 644
month by each facilitator;
(d) The number of decisions of each facilitator that were 647
appealed by a party;
(e) A certification by the commission that the alternative 650
dispute resolution process did not delay any hearing timelines as
set forth in section 4123.511 of the Revised Code for any 652
disputed issue.
(4) The commission may adopt rules in accordance with 654
chapter 119. of the Revised Code for the administration of any 657
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alternative dispute resolution process that the commission 658
establishes.
Sec. 4121.361. THE INDUSTRIAL COMMISSION MAY, BY RULE, 660
AUTHORIZE PERSONS OTHER THAN PERSONS WHO ARE ADMITTED TO THE 661
PRACTICE OF LAW ALSO TO APPEAR BEFORE THE COMMISSION OR A 662
DISTRICT OR STAFF HEARING OFFICER IN ANY KIND OF PROCEEDING AS 664
REPRESENTATIVES OF EMPLOYERS OR EMPLOYEES. THE COMMISSION MAY 665
PRESCRIBE IN A RULE ADOPTED PURSUANT TO THIS SECTION, THE MINIMUM 666
QUALIFICATIONS FOR SUCH PERSONS AND MINIMUM STANDARDS OF PRACTICE 667
AS THE COMMISSION DETERMINES TO BE APPROPRIATE. 668
NOTWITHSTANDING SECTION 119.13 OF THE REVISED CODE, THE 672
REPRESENTATION OF PARTIES BEFORE THE COMMISSION OR DISTRICT OR
STAFF HEARING OFFICERS BY A PERSON NOT ADMITTED TO THE PRACTICE 673
OF LAW DOES NOT IMPAIR OR INVALIDATE A PROCEEDING FOR THE PURPOSE 675
OF A SUBSEQUENT APPEAL TO A COURT OR FOR ANY OTHER PURPOSE WHERE 676
A PARTY KNOWINGLY SELECTS REPRESENTATION BY A PERSON NOT ADMITTED 677
TO THE PRACTICE OF LAW.
AN EMPLOYEE CLAIMING BENEFITS UNDER THIS CHAPTER OR 680
CHAPTERS 4123., 4127., OR 4131. OF THE REVISED CODE, OR AN 682
EMPLOYER MAY REPRESENT SELF PERSONALLY OR BE REPRESENTED BY A
PERSON ADMITTED TO THE PRACTICE OF LAW, OR BY A PERSON NOT 683
ADMITTED TO THE PRACTICE OF LAW, IN ANY PROCEEDING BEFORE THE 685
INDUSTRIAL COMMISSION OR A DISTRICT OR STAFF HEARING OFFICER. 686
Sec. 4121.38. (A) The industrial commission shall DO ALL 695
OF THE FOLLOWING: 696
(1) Implement a program of impairment evaluation training 698
for its staff physicians; 699
(2) Issue a manual of commission policy as to impairment 701
evaluation so as to increase consistency of medical reports, 702
INCLUDING, BUT NOT LIMITED TO, A POLICY REQUIRING THE USE OF THE 703
MOST RECENT EDITION OF THE AMERICAN MEDICAL ASSOCIATION'S GUIDES 704
TO THE EVALUATION OF PERMANENT IMPAIRMENT FOR THE EVALUATION OF 705
PERMANENT PARTIAL IMPAIRMENT CLAIMS. This manual shall be 707
available to the public at cost but shall be provided free to all 708
17
physicians who treat claimants or to whom claimants are referred 709
for evaluation. The commission shall take steps to ensure that 710
the manual receives the widest possible distribution to 711
physicians.
(3) Develop a method of peer review of medical reports 713
prepared by the commission referral doctors; 714
(4) Issue a policy manual as to the basis upon which 716
referrals to other than commission specialists will be made; 717
(5) Designate two hearing examiners and two medical staff 719
members who shall be specially trained in medical-legal analysis. 720
The specialists shall write evaluations of medical-legal problems 721
upon assignment by other hearing examiners or the commission. The 723
director of administrative services upon commission advice shall 724
assign such employees to a salary schedule commensurate with 725
expertise required of them.
(6) Require that prior to any examination, a physician to 727
whom a claimant is referred for examination receives all 728
necessary medical information in the claim file about the 729
claimant and a complete statement as to the purpose of the 730
examination. 731
(B) The commission may establish a medical section within 733
the commission to perform the duties assigned to the commission 734
under this section. 735
Sec. 4121.444. (A) NO HEALTH CARE PROVIDER, MANAGED CARE 737
ORGANIZATION, OR OWNER OF A HEALTH CARE PROVIDER OR MANAGED CARE 738
ORGANIZATION SHALL OBTAIN OR ATTEMPT TO OBTAIN PAYMENTS BY 739
DECEPTION UNDER CHAPTER 4121., 4123., 4127., OR 4131. OF THE 740
REVISED CODE TO WHICH THE HEALTH CARE PROVIDER, MANAGED CARE 741
ORGANIZATION, OR OWNER IS NOT ENTITLED UNDER RULES OF THE BUREAU 742
OF WORKERS' COMPENSATION ADOPTED PURSUANT TO SECTIONS 4121.441 743
AND 4121.442 OF THE REVISED CODE. 744
(B) ANY HEALTH CARE PROVIDER, MANAGED CARE ORGANIZATION, 746
OR OWNER THAT VIOLATES DIVISION (A) OF THIS SECTION IS LIABLE, IN 748
ADDITION TO ANY OTHER PENALTIES PROVIDED BY LAW, FOR ALL OF THE
18
FOLLOWING PENALTIES: 749
(1) PAYMENT OF INTEREST ON THE AMOUNT OF THE EXCESS 751
PAYMENTS AT THE MAXIMUM INTEREST RATE ALLOWABLE FOR REAL ESTATE 752
MORTGAGES UNDER SECTION 1343.01 OF THE REVISED CODE. THE 753
INTEREST SHALL BE CALCULATED FROM THE DATE THE PAYMENT WAS MADE 754
TO THE OWNER, HEALTH CARE PROVIDER, OR MANAGED CARE ORGANIZATION 756
THROUGH THE DATE UPON WHICH REPAYMENT IS MADE TO THE BUREAU OR
THE SELF-INSURING EMPLOYER. 758
(2) PAYMENT OF AN AMOUNT EQUAL TO THREE TIMES THE AMOUNT 760
OF ANY EXCESS PAYMENTS; 761
(3) UPON PROOF OF A SPECIFIC INTENT OF THE HEALTH CARE 764
PROVIDER, MANAGED CARE ORGANIZATION, OR OWNER TO DEFRAUD, PAYMENT 766
OF A SUM OF NOT LESS THAN FIVE THOUSAND DOLLARS AND NOT MORE THAN 768
TEN THOUSAND DOLLARS FOR EACH ACT OF DECEPTION;
(4) ALL REASONABLE AND NECESSARY EXPENSES THAT THE COURT 770
DETERMINES HAVE BEEN INCURRED BY THE BUREAU OR THE SELF-INSURING 771
EMPLOYER IN THE ENFORCEMENT OF THIS SECTION. 773
ALL MONEYS COLLECTED BY THE BUREAU PURSUANT TO THIS SECTION 775
SHALL BE DEPOSITED INTO THE STATE INSURANCE FUND CREATED IN 776
SECTION 4123.30 OF THE REVISED CODE. ALL MONEYS COLLECTED BY A 778
SELF-INSURING EMPLOYER PURSUANT TO THIS SECTION SHALL BE AWARDED 779
TO THE SELF-INSURING EMPLOYER. 780
(C)(1) IN ADDITION TO THE MONETARY PENALTIES PROVIDED IN 783
DIVISION (B) OF THIS SECTION AND EXCEPT AS PROVIDED IN DIVISION 784
(C)(3) OF THIS SECTION, THE ADMINISTRATOR MAY TERMINATE, FOR A 785
PERIOD NOT TO EXCEED FIVE YEARS FROM THE DATE OF CONVICTION, PLEA 786
OF GUILTY, OR JUDGMENT ENTRY, ANY AGREEMENT BETWEEN THE BUREAU 787
AND A HEALTH CARE PROVIDER OR MANAGED CARE ORGANIZATION OR ITS 788
OWNER AND CEASE REIMBURSEMENT TO THAT PROVIDER, ORGANIZATION, OR 789
OWNER FOR SERVICES RENDERED IF ANY OF THE FOLLOWING APPLY: 790
(a) THE HEALTH CARE PROVIDER, MANAGED CARE ORGANIZATION, 793
OR ITS OWNER, OR AN OFFICER, AUTHORIZED AGENT, ASSOCIATE,
MANAGER, OR EMPLOYEE OF A PROVIDER OR ORGANIZATION IS CONVICTED 794
OF OR PLEADS GUILTY TO A VIOLATION OF SECTIONS 2913.48 OR 2923.31 796
19
TO 2923.36 OF THE REVISED CODE.
(b) THERE EXISTS AN ENTRY OF JUDGMENT AGAINST THE HEALTH 799
CARE PROVIDER, MANAGED CARE ORGANIZATION, OR ITS OWNER, OR AN
OFFICER, AUTHORIZED AGENT, ASSOCIATE, MANAGER, OR EMPLOYEE OF A 800
PROVIDER OR ORGANIZATION AND PROOF OF THE SPECIFIC INTENT OF THE 802
HEALTH CARE PROVIDER, MANAGED CARE ORGANIZATION, OR OWNER TO
DEFRAUD, IN A CIVIL ACTION BROUGHT PURSUANT TO THIS SECTION. 803
(c) THERE EXISTS AN ENTRY OF JUDGMENT AGAINST THE HEALTH 805
CARE PROVIDER, MANAGED CARE ORGANIZATION, OR ITS OWNER, OR AN 806
OFFICER, AUTHORIZED AGENT, ASSOCIATE, MANAGER, OR EMPLOYEE OF A 807
PROVIDER OR ORGANIZATION IN A CIVIL ACTION BROUGHT PURSUANT TO 809
SECTIONS 2923.31 TO 2923.36 OF THE REVISED CODE. 810
(2) NO HEALTH CARE PROVIDER OR MANAGED CARE ORGANIZATION 812
THAT HAS HAD ITS AGREEMENT WITH AND REIMBURSEMENT FROM THE BUREAU 813
TERMINATED BY THE ADMINISTRATOR PURSUANT TO DIVISION (C)(1) OF 814
THIS SECTION, OR AN OWNER, OFFICER, AUTHORIZED AGENT, ASSOCIATE, 816
MANAGER, OR EMPLOYEE OF THAT HEALTH CARE PROVIDER OR MANAGED CARE 817
ORGANIZATION SHALL DO ANY OF THE FOLLOWING:
(a) DIRECTLY PROVIDE SERVICES TO ANY OTHER BUREAU PROVIDER 820
OR HAVE AN OWNERSHIP INTEREST IN A PROVIDER OF SERVICES THAT
FURNISHES SERVICES TO ANY OTHER BUREAU PROVIDER; 822
(b) ARRANGE FOR, RENDER, OR ORDER SERVICES FOR CLAIMANTS 825
DURING THE PERIOD THAT THE AGREEMENT OF THE HEALTH CARE PROVIDER,
MANAGED CARE ORGANIZATION, OR ITS OWNER IS TERMINATED AS 826
DESCRIBED IN DIVISION (C)(1) OF THIS SECTION; 827
(c) RECEIVE REIMBURSEMENT IN THE FORM OF DIRECT PAYMENTS 830
FROM THE BUREAU OR INDIRECT PAYMENTS OF BUREAU FUNDS IN THE FORM
OF SALARIES, SHARED FEES, CONTRACTS, KICKBACKS, OR REBATES FROM 831
OR THROUGH ANY PARTICIPATING PROVIDER. 832
(3) THE ADMINISTRATOR SHALL NOT TERMINATE THE AGREEMENT OR 834
REIMBURSEMENT IF THE HEALTH CARE PROVIDER, MANAGED CARE 835
ORGANIZATION, OR OWNER DEMONSTRATES THAT THE PROVIDER, 836
ORGANIZATION, OR OWNER DID NOT DIRECTLY OR INDIRECTLY SANCTION 837
THE ACTION OF THE AUTHORIZED AGENT, ASSOCIATE, MANAGER, OR
20
EMPLOYEE THAT RESULTED IN THE CONVICTION, PLEA OF GUILTY, OR 839
ENTRY OF JUDGMENT AS DESCRIBED IN DIVISION (C)(1) OF THIS 840
SECTION.
(4) NOTHING IN DIVISION (C) OF THIS SECTION PROHIBITS AN 843
OWNER, OFFICER, AUTHORIZED AGENT, ASSOCIATE, MANAGER, OR EMPLOYEE 844
OF A HEALTH CARE PROVIDER OR MANAGED CARE ORGANIZATION FROM
ENTERING INTO AN AGREEMENT WITH THE BUREAU IF THE PROVIDER, 845
ORGANIZATION, OWNER, OFFICER, AUTHORIZED AGENT, ASSOCIATE, 846
MANAGER, OR EMPLOYEE DEMONSTRATES ABSENCE OF KNOWLEDGE OF THE 848
ACTION OF THE HEALTH CARE PROVIDER OR MANAGED CARE ORGANIZATION 849
WITH WHICH THAT INDIVIDUAL OR ORGANIZATION WAS FORMERLY
ASSOCIATED THAT RESULTED IN A CONVICTION, PLEA OF GUILTY, OR 851
ENTRY OF JUDGMENT AS DESCRIBED IN DIVISION (C)(1) OF THIS 852
SECTION.
(D) THE ATTORNEY GENERAL MAY BRING AN ACTION ON BEHALF OF 855
THE STATE AND A SELF-INSURING EMPLOYER MAY BRING AN ACTION ON ITS 856
OWN BEHALF TO ENFORCE THIS SECTION IN ANY COURT OF COMPETENT
JURISDICTION. THE ATTORNEY GENERAL MAY SETTLE OR COMPROMISE ANY 857
ACTION BROUGHT UNDER THIS SECTION WITH THE APPROVAL OF THE 859
ADMINISTRATOR.
NOTWITHSTANDING ANY OTHER LAW PROVIDING A SHORTER PERIOD OF 861
LIMITATIONS, THE ATTORNEY GENERAL OR A SELF-INSURING EMPLOYER MAY 862
BRING AN ACTION TO ENFORCE THIS SECTION AT ANY TIME WITHIN SIX 863
YEARS AFTER THE CONDUCT IN VIOLATION OF THIS SECTION TERMINATES. 864
(E) THE AVAILABILITY OF REMEDIES UNDER THIS SECTION AND 867
SECTIONS 2913.48 AND 2923.31 TO 2923.36 OF THE REVISED CODE FOR 868
RECOVERING BENEFITS PAID ON BEHALF OF CLAIMANTS FOR MEDICAL
ASSISTANCE DOES NOT LIMIT THE AUTHORITY OF THE BUREAU OR A 869
SELF-INSURING EMPLOYER TO RECOVER EXCESS PAYMENTS MADE TO AN 870
OWNER, HEALTH CARE PROVIDER, OR MANAGED CARE ORGANIZATION UNDER 872
STATE AND FEDERAL LAW.
(F) AS USED IN THIS SECTION: 874
(1) "DECEPTION" MEANS ACTING WITH ACTUAL KNOWLEDGE OF, IN 876
DELIBERATE IGNORANCE OF, OR RECKLESS DISREGARD OF THE TRUTH OR 877
21
FALSITY OF, ANY REPRESENTATION OR INFORMATION IN ORDER TO DECEIVE 878
ANOTHER OR CAUSE ANOTHER TO BE DECEIVED BY MEANS OF ANY OF THE 879
FOLLOWING:
(a) A FALSE OR MISLEADING REPRESENTATION; 881
(b) THE WITHHOLDING OF INFORMATION; 883
(c) THE PREVENTING OF ANOTHER FROM ACQUIRING INFORMATION; 886
(d) ANY OTHER CONDUCT, ACT, OR OMISSION THAT CREATES, 889
CONFIRMS, OR PERPETUATES A FALSE IMPRESSION AS TO A FACT, THE
LAW, THE VALUE OF SOMETHING, OR A PERSON'S STATE OF MIND. 891
EXCEPT AS PROVIDED IN DIVISION (B)(3) OF THIS SECTION, FOR 895
PURPOSES OF THIS SECTION PROOF OF SPECIFIC INTENT TO DEFRAUD IS 896
NOT REQUIRED IN ORDER TO SHOW THAT AN OWNER, HEALTH CARE 897
PROVIDER, OR MANAGED CARE ORGANIZATION IS ENGAGING IN OR HAS 898
ENGAGED IN DECEPTION.
(2) "OWNER" MEANS ANY PERSON HAVING AT LEAST A FIVE PER 900
CENT OWNERSHIP INTEREST IN A HEALTH CARE PROVIDER OR MANAGED CARE 901
ORGANIZATION.
Sec. 4121.47. (A) No employer shall violate a specific 910
safety rule adopted by the administrator of workers' compensation 911
pursuant to section 4121.13 of the Revised Code or an act of the 913
general assembly to protect the lives, health, and safety of 914
employees pursuant to Section 35 of Article II, Ohio 915
Constitution. Chapter 4167. of the Revised Code and rules and 916
standards adopted thereunder UNDER THAT CHAPTER are not the rules 917
or enactment referred to in this division and shall not be 918
considered as such for purposes of this section. FOR PURPOSES OF 919
THIS SECTION, A SPECIFIC SAFETY RULE OF THE ADMINISTRATOR THAT 921
REFERS TO OR IS INTERPRETED AS APPLYING TO WORKSHOPS AND
FACTORIES SHALL NOT APPLY TO BUILDINGS OR STRUCTURES USED FOR 922
AGRICULTURAL PRODUCTION, OR TO ANY OF THE FIXTURES, MACHINERY, 923
EQUIPMENT, TOOLS, OR DEVICES UTILIZED IN THOSE BUILDINGS OR 924
STRUCTURES.
"AGRICULTURAL PRODUCTION" MEANS OPERATIONS UPON FARM 926
PREMISES, INCLUDING THE PLANTING, CULTIVATING, PRODUCING, 927
22
GROWING, HARVESTING, DRYING, AND STORING OF AGRICULTURAL OR 928
HORTICULTURAL COMMODITIES AND PREPARATION FOR MARKET OF THOSE 929
COMMODITIES ON FARM PREMISES, THE RAISING OF LIVESTOCK, FOR FOOD
PRODUCTS, OR RACING PURPOSES, AND POULTRY ON FARM PREMISES, AND 930
ANY WORK PERFORMED INCIDENT TO OR IN CONNECTION WITH THOSE FARM 931
OPERATIONS. "AGRICULTURAL PRODUCTION" DOES NOT INCLUDE THE 932
COMMERCIAL PROCESSING, PACKING, DRYING, STORING, OR CANNING OF 933
THOSE COMMODITIES FOR MARKET, OR COMMERCIAL TIMBER HARVESTING BY 934
AN INDEPENDENT CONTRACTOR.
(B) If a staff hearing officer, in the course of his THE 936
HEARING OFFICER'S determination of a claim for an additional 937
award under Section 35 of Article II, Ohio Constitution, finds 938
the employer guilty of violating division (A) of this section, he 939
shall THE HEARING OFFICER, in addition to any award paid to the 940
claimant, SHALL issue an order to the employer to correct the 942
violation within the period of time he fixes FIXED BY THE HEARING 943
OFFICER. For any violation occurring within twenty-four months 944
of the last violation, the staff hearing officer shall assess 945
against the employer a civil penalty in an amount he THE HEARING 946
OFFICER determines up to a maximum of fifty thousand dollars for 948
each violation. In fixing the exact penalty, the staff hearing 949
officer shall base his THE decision upon the size of the employer 951
as measured by the number of employees, assets, and earnings of 952
the employer.
(C) An employer dissatisfied with the imposition of a 954
civil penalty pursuant to division (B) of this section may appeal 955
the staff hearing officer's decision, if the commission refuses 956
to hear the appeal under division (E) of section 4123.511 of the 957
Revised Code, or a decision of the commission, if the commission 958
hears the appeal under that division, to a court of common pleas 959
pursuant to the Rules of Civil Procedure. An appeal operates to 960
stay the payment of the fine pending the appeal. 961
(D) The administrator shall deposit all penalties 963
collected pursuant to this section in the occupational safety 964
23
loan program fund established pursuant to section 4121.48 of the 965
Revised Code. 966
Sec. 4121.61. (A) The administrator of workers' 975
compensation, with the advice and consent of the workers' 977
compensation oversight commission, shall adopt rules, INCLUDING 978
RULES DESCRIBED IN DIVISION (B) OF THIS SECTION, take measures, 979
and make expenditures as it THE ADMINISTRATOR deems necessary to 980
aid claimants who have sustained compensable injuries or incurred 981
compensable occupational diseases pursuant to Chapter 4123., 982
4127., or 4131. of the Revised Code to return to work or to 983
assist in lessening or removing any resulting handicap.
(B) THE ADMINISTRATOR SHALL ADOPT RULES UNDER THIS SECTION 985
ESTABLISHING CRITERIA GOVERNING DETERMINATIONS FOR THE PROVISION 986
OF REHABILITATION SERVICES, COUNSELING, OR TRAINING BY 987
SELF-INSURING EMPLOYERS WHO PAY DIRECTLY TO A CLAIMANT OR TO THE 988
PROVIDER OF REHABILITATION SERVICES, COUNSELING, OR TRAINING. 989
THE INDUSTRIAL COMMISSION SHALL ESTABLISH RULES REGARDING A 990
HEARING PROCEDURE TO GOVERN DISPUTES BETWEEN A CLAIMANT AND A 991
SELF-INSURING EMPLOYER REGARDING THE PROVISION OF REHABILITATION 992
SERVICES, COUNSELING, OR TRAINING.
Sec. 4121.67. The administrator of workers' compensation, 1,000
with the advice and consent of the workers' compensation 1,002
oversight commission, shall adopt rules: 1,003
(A) For the encouragement of reemployment of claimants who 1,005
have successfully completed prescribed rehabilitation programs by 1,006
payment from the surplus fund established by section 4123.34 of 1,007
the Revised Code to employers who employ or reemploy the 1,008
claimants. The period or periods of payments shall not exceed 1,009
six months in the aggregate, unless the administrator or his THE 1,010
ADMINISTRATOR'S designee determines that the claimant will be 1,011
benefited by an extension of payments. 1,012
(B) Requiring payment, in the same manner as living 1,014
maintenance payments are made pursuant to section 4121.63 of the 1,015
Revised Code, to the claimant who completes a rehabilitation 1,016
24
training program and returns to employment, but who suffers a 1,017
wage loss compared to the wage the claimant was receiving at the 1,018
time of injury. Payments per week shall be sixty-six and 1,019
two-thirds per cent of the difference, if any, between the 1,020
claimant's weekly wage at the time of injury and the weekly wage 1,021
received while employed, up to a maximum payment per week equal 1,022
to the statewide average weekly wage. The payments may continue 1,023
for up to a maximum of two hundred weeks but shall be reduced by 1,024
the corresponding number of weeks in which the claimant receives 1,025
payments pursuant to division (B)(C) of section 4123.56 of the 1,026
Revised Code. 1,027
Sec. 4123.01. As used in this chapter: 1,036
(A)(1) "Employee" means: 1,038
(a) Every person in the service of the state, or of any 1,040
county, municipal corporation, township, or school district 1,041
therein, including regular members of lawfully constituted police 1,042
and fire departments of municipal corporations and townships, 1,043
whether paid or volunteer, and wherever serving within the state 1,044
or on temporary assignment outside thereof, and executive 1,045
officers of boards of education, under any appointment or 1,046
contract of hire, express or implied, oral or written, including 1,047
any elected official of the state, or of any county, municipal 1,048
corporation, or township, or members of boards of education; 1,049
(b) Every person in the service of any person, firm, or 1,051
private corporation, including any public service corporation, 1,052
that (i) employs one or more persons regularly in the same 1,053
business or in or about the same establishment under any contract 1,054
of hire, express or implied, oral or written, including aliens 1,055
and minors, household workers who earn one hundred sixty dollars 1,056
or more in cash in any calendar quarter from a single household 1,057
and casual workers who earn one hundred sixty dollars or more in 1,058
cash in any calendar quarter from a single employer, or (ii) is 1,059
bound by any such contract of hire or by any other written 1,060
contract, to pay into the state insurance fund the premiums 1,061
25
provided by this chapter. 1,062
(c) Every person who performs labor or provides services 1,065
pursuant to a construction contract, as defined in section 1,066
4123.79 of the Revised Code, if at least ten of the following
criteria apply:
(i) The person is required to comply with instructions 1,069
from the other contracting party regarding the manner or method 1,070
of performing services;
(ii) The person is required by the other contracting party 1,073
to have particular training;
(iii) The person's services are integrated into the 1,076
regular functioning of the other contracting party; 1,077
(iv) The person is required to perform the work 1,079
personally;
(v) The person is hired, supervised, or paid by the other 1,081
contracting party;
(vi) A continuing relationship exists between the person 1,084
and the other contracting party that contemplates continuing or 1,085
recurring work even if the work is not full time; 1,086
(vii) The person's hours of work are established by the 1,089
other contracting party;
(viii) The person is required to devote full time to the 1,092
business of the other contracting party;
(ix) The person is required to perform the work on the 1,095
premises of the other contracting party;
(x) The person is required to follow the order of work set 1,098
by the other contracting party;
(xi) The person is required to make oral or written 1,101
reports of progress to the other contracting party; 1,102
(xii) The person is paid for services on a regular basis 1,105
such as hourly, weekly, or monthly;
(xiii) The person's expenses are paid for by the other 1,107
contracting party;
(xiv) The person's tools and materials are furnished by 1,110
26
the other contracting party;
(xv) The person is provided with the facilities used to 1,112
perform services;
(xvi) The person does not realize a profit or suffer a 1,115
loss as a result of the services provided;
(xvii) The person is not performing services for a number 1,118
of employers at the same time;
(xviii) The person does not make the same services 1,120
available to the general public; 1,121
(xix) The other contracting party has a right to discharge 1,124
the person;
(xx) The person has the right to end the relationship with 1,127
the other contracting party without incurring liability pursuant 1,128
to an employment contract or agreement. 1,129
Every person in the service of any independent contractor 1,131
or subcontractor who has failed to pay into the state insurance 1,132
fund the amount of premium determined and fixed by the 1,133
administrator of workers' compensation for the person's 1,134
employment or occupation or if a self-insuring employer has 1,135
failed to pay compensation and benefits directly to the 1,136
employer's injured and to the dependents of the employer's killed 1,137
employees as required by section 4123.35 of the Revised Code, 1,139
shall be considered as the employee of the person who has entered 1,140
into a contract, whether written or verbal, with such independent 1,141
contractor unless such employees or their legal representatives 1,142
or beneficiaries elect, after injury or death, to regard such 1,143
independent contractor as the employer.
(2) "Employee" does not mean: 1,145
(a) A duly ordained, commissioned, or licensed minister or 1,147
assistant or associate minister of a church in the exercise of 1,148
ministry; or 1,149
(b) Any officer of a family farm corporation; 1,151
(c) AN INDIVIDUAL WHO SIGNS THE WAIVER AND AFFIDAVIT 1,153
PROVIDED FOR IN SECTION 4123.15 OF THE REVISED CODE, PROVIDED 1,154
27
THAT THE ADMINISTRATOR HAS GRANTED A WAIVER AND EXCEPTION TO THE 1,155
INDIVIDUAL'S EMPLOYER UNDER THAT SECTION.
Any employer may elect to include as an "employee" within 1,157
this chapter, any person excluded from the definition of 1,158
"employee" pursuant to division (A)(2) of this section. If an 1,159
employer is a partnership, sole proprietorship, or family farm 1,160
corporation, such employer may elect to include as an "employee" 1,161
within this chapter, any member of such partnership, the owner of 1,162
the sole proprietorship, or the officers of the family farm 1,163
corporation. In the event of an election, the employer shall 1,164
serve upon the bureau of workers' compensation written notice 1,165
naming the persons to be covered, include such employee's 1,166
remuneration for premium purposes in all future payroll reports, 1,167
and no person excluded from the definition of "employee" pursuant 1,168
to division (A)(2) of this section, proprietor, or partner shall 1,169
be deemed an employee within this division until the employer has 1,170
served such notice. 1,171
For informational purposes only, the bureau shall prescribe 1,173
such language as it considers appropriate, on such of its forms 1,174
as it considers appropriate, to advise employers of their right 1,175
to elect to include as an "employee" within this chapter a sole 1,176
proprietor, any member of a partnership, the officers of a family 1,177
farm corporation, or a person excluded from the definition of 1,178
"employee" under division (A)(2)(a) of this section, that they 1,179
should check any health and disability insurance policy, or other 1,180
form of health and disability plan or contract, presently 1,181
covering them, or the purchase of which they may be considering, 1,182
to determine whether such policy, plan, or contract excludes 1,183
benefits for illness or injury that they might have elected to 1,184
have covered by workers' compensation. 1,185
(B) "Employer" means: 1,187
(1) The state, including state hospitals, each county, 1,189
municipal corporation, township, school district, and hospital 1,190
owned by a political subdivision or subdivisions other than the 1,191
28
state; 1,192
(2) Every person, firm, and private corporation, including 1,194
any public service corporation, that (a) has in service one or 1,195
more employees regularly in the same business or in or about the 1,196
same establishment under any contract of hire, express or 1,197
implied, oral or written, or (b) is bound by any such contract of 1,198
hire or by any other written contract, to pay into the insurance 1,199
fund the premiums provided by this chapter. 1,200
All such employers are subject to this chapter. Any member 1,202
of a firm or association, who regularly performs manual labor in 1,203
or about a mine, factory, or other establishment, including a 1,204
household establishment, shall be considered an employee in 1,205
determining whether such person, firm, or private corporation, or 1,206
public service corporation, has in its service, one or more 1,207
employees and the employer shall report the income derived from 1,208
such labor to the bureau as part of the payroll of such employer, 1,209
and such member shall thereupon be entitled to all the benefits 1,210
of an employee. 1,211
(C) "Injury" includes any injury, whether caused by 1,213
external accidental means or accidental in character and result, 1,214
received in the course of, and arising out of, the injured 1,215
employee's employment. "Injury" does not include: 1,216
(1) Psychiatric conditions except where the conditions 1,218
have arisen from an injury or occupational disease; 1,219
(2) Injury, IMPAIRMENT, or disability caused primarily by 1,222
the natural deterioration of tissue, an organ, or part of the 1,223
body;
(3) Injury, IMPAIRMENT, or disability incurred in 1,225
voluntary participation in an employer-sponsored recreation or 1,227
fitness activity if the employee signs a waiver of the employee's 1,228
right to compensation or benefits under this chapter prior to 1,229
engaging in the recreation or fitness activity; 1,230
(4) A CONDITION, IMPAIRMENT, OR DISEASE PROCESS THAT 1,234
PREEXISTED AN INJURY UNLESS THAT PREEXISTING CONDITION OR
29
IMPAIRMENT IS SUBSTANTIALLY WORSENED OR THAT DISEASE PROCESS IS 1,235
SUBSTANTIALLY ACCELERATED BY AN INJURY AS DOCUMENTED BY OBJECTIVE 1,236
CLINICAL FINDINGS AND TEST RESULTS, AND SUBJECTIVE COMPLAINTS 1,237
WITHOUT THESE FINDINGS AND RESULTS ARE INSUFFICIENT TO ESTABLISH 1,238
A COMPENSABLE INJURY AS DESCRIBED IN DIVISION (C)(4) OF THIS 1,240
SECTION;
(5) INJURY, IMPAIRMENT, OR DISABILITY RESULTING FROM 1,242
CUMULATIVE OR REPETITIVE TRAUMA. 1,243
(D) "Child" includes a posthumous child and a child 1,245
legally adopted prior to the injury. 1,246
(E) "Family farm corporation" means a corporation founded 1,248
for the purpose of farming agricultural land in which the 1,249
majority of the voting stock is held by and the majority of the 1,250
stockholders are persons or the spouse of persons related to each 1,251
other within the fourth degree of kinship, according to the rules 1,252
of the civil law, and at least one of the related persons is 1,253
residing on or actively operating the farm, and none of whose 1,254
stockholders are a corporation. A family farm corporation does 1,255
not cease to qualify under this division where, by reason of any 1,256
devise, bequest, or the operation of the laws of descent or 1,257
distribution, the ownership of shares of voting stock is 1,258
transferred to another person, as long as that person is within 1,259
the degree of kinship stipulated in this division. 1,260
(F) "Occupational disease" means a disease contracted in 1,262
the course of employment, which by its causes and the 1,263
characteristics of its manifestation or the condition of the 1,264
employment results in a hazard which distinguishes the employment 1,265
in character from employment generally, and the employment 1,266
creates a risk of contracting the disease in greater degree and 1,267
in a different manner from the public in general, INCLUDING A 1,268
DISEASE OR CONDITION THAT RESULTS FROM A CUMULATIVE OR REPETITIVE 1,270
TRAUMA, THAT IS CONTRACTED IN THE COURSE OF EMPLOYMENT, THAT 1,272
RESULTS IN DAMAGE OR HARM TO THE PHYSICAL STRUCTURE OF THE BODY, 1,273
AND THAT IS DUE TO CAUSES AND CONDITIONS THAT ARE CHARACTERISTIC 1,274
30
OF OR PECULIAR TO A PARTICULAR INDUSTRIAL PROCESS, TRADE, OR 1,275
OCCUPATION. "OCCUPATIONAL DISEASE" DOES NOT INCLUDE ANY OF THE 1,276
FOLLOWING:
(1) A DISEASE OR CONDITION TO WHICH THE GENERAL PUBLIC IS 1,278
EXPOSED OUTSIDE OF EMPLOYMENT ABSENT A SHOWING, BY A 1,279
PREPONDERANCE OF THE EVIDENCE, THAT THE DISEASE OR CONDITION IS 1,281
CHARACTERISTIC OF OR PECULIAR TO A PARTICULAR INDUSTRIAL PROCESS, 1,283
TRADE, OR OCCUPATION;
(2) A DISEASE OR CONDITION THAT WOULD HAVE ARISEN WITHOUT 1,285
THE OCCUPATIONAL EXPOSURE; 1,286
(3) A DISEASE OR CONDITION THAT RESULTS FROM AGGRAVATION 1,288
OF A PREEXISTING DISEASE, CONDITION, OR DISEASE PROCESS; 1,289
(4) A DISEASE OR CONDITION CAUSED PRIMARILY BY THE NATURAL 1,291
DETERIORATION OF THE TISSUE, ORGANS, OR OTHER PARTS OF THE BODY; 1,292
(5) PSYCHIATRIC CONDITIONS, EXCEPT WHERE THE CONDITIONS 1,294
HAVE ARISEN FROM AN OCCUPATIONAL DISEASE. 1,296
(G) "Self-insuring employer" means any of the following 1,298
categories of employers if granted the privilege of paying 1,299
compensation and benefits directly under section 4123.35 of the 1,300
Revised Code: 1,301
(1) Any employer mentioned in division (B)(2) of this 1,303
section; 1,304
(2) A board of county hospital trustees; 1,306
(3) A publicly owned utility. 1,308
Sec. 4123.032. Every emergency management worker shall, 1,317
with respect to the performance of his THE WORKER'S duties as 1,319
such AN emergency management worker, SHALL be in the employment 1,322
of the state or political subdivision for purposes of sections
4123.01 to 4123.94 of the Revised Code, and every emergency 1,323
management worker or, in case of death, his THE EMERGENCY 1,324
MANAGEMENT WORKERS' dependents shall be entitled to the benefits 1,325
payable on account of total disability OR IMPAIRMENT, loss of 1,326
member, or death as accorded by such sections to employees 1,328
covered by its THEIR provisions. No payment for such disability 1,330
31
OR IMPAIRMENT, loss of member, or death shall be made unless a 1,331
claim is filed within one year of the date of the accidental 1,332
injury causing the total disability OR IMPAIRMENT, loss of 1,333
member, or death. If an injury claim is filed within the said 1,335
THAT one-year period and the claimant subsequently dies, his THE 1,337
EMERGENCY MANAGEMENT WORKERS' dependents shall file any death 1,339
claim based on such injury within six months after the death or
be forever barred. 1,340
Sec. 4123.033. Any emergency management worker who suffers 1,349
an accidental injury while performing emergency management 1,350
duties, as defined herein, shall be compensated for any total 1,352
disability, IMPAIRMENT, or loss of member and his THE WORKERS' 1,353
dependents shall be compensated for any death resulting from such 1,354
an injury on the same basis as provided for workers, employees, 1,355
and their dependents under sections 4123.01 to 4123.94 of the 1,356
Revised Code. 1,357
This section shall not apply in the case of any person who 1,359
is otherwise entitled, under sections 4123.01 to 4123.94 of the 1,360
Revised Code, to receive workers' compensation benefits for such 1,361
accidental injury or death. 1,362
Sec. 4123.061. ANY RECORDS, FILES, PLEADINGS, OR DOCUMENTS 1,365
GENERATED BY A CLAIMANT'S ATTORNEY WITH RESPECT TO A CLIENT IN A 1,366
WORKERS' COMPENSATION CLAIM ARE THE PROPERTY OF THAT CLIENT. 1,367
UPON THE CLIENT'S REQUEST, THE ATTORNEY SHALL CONVEY TO THE 1,368
CLIENT COPIES OF ALL RECORDS, FILES, PLEADINGS, AND DOCUMENTS 1,369
RELATING TO THE CLIENT'S WORKERS' COMPENSATION CLAIM NO LATER 1,370
THAN FIFTEEN DAYS AFTER THE CLIENT'S REQUEST.
Sec. 4123.07. The administrator of the bureau of workers' 1,379
compensation shall prepare and furnish blank forms of application 1,380
for benefits or compensation from the state insurance fund, 1,381
reports of injury, disability, IMPAIRMENT, or occupational 1,383
disease, notices to employers and employees, proofs of injury, 1,384
disease, disability, IMPAIRMENT, or death, proofs of medical 1,386
attendance and hospital and nursing care, and proofs of 1,387
32
employment and wage earnings, and other necessary blanks, and 1,388
shall provide in his THE ADMINISTRATOR'S rules for their 1,389
preparation and distribution so that they may be readily
available and so prepared that the furnishing of information 1,390
required of any person with respect to any aspect of a claim 1,391
shall not be delayed by a requirement that information with 1,392
respect to another aspect of such claim shall be furnished on the 1,393
form by the same or another person. Insured employers shall keep 1,394
on hand a sufficient supply of such blanks. 1,395
Sec. 4123.15. (A) AN EMPLOYER WHO IS A MEMBER OF A 1,397
RECOGNIZED RELIGIOUS SECT OR DIVISION OF A RECOGNIZED RELIGIOUS 1,398
SECT AND WHO IS AN ADHERENT OF ESTABLISHED TENETS OR TEACHINGS OF 1,400
THAT SECT OR DIVISION BY REASON OF WHICH THE EMPLOYER IS
CONSCIENTIOUSLY OPPOSED TO ACCEPTANCE OF THE BENEFITS OF ANY 1,401
PUBLIC OR PRIVATE INSURANCE THAT MAKES PAYMENTS IN THE EVENT OF 1,402
DEATH, DISABILITY, IMPAIRMENT, OLD AGE, OR RETIREMENT OR MAKES 1,404
PAYMENTS TOWARD THE COST OF, OR PROVIDES SERVICES FOR, MEDICAL 1,405
BILLS, INCLUDING THE BENEFITS OF ANY INSURANCE SYSTEM ESTABLISHED
BY THE FEDERAL "SOCIAL SECURITY ACT," 42 U.S.C.A. 301, ET SEQ., 1,407
MAY APPLY TO THE ADMINISTRATOR OF WORKERS' COMPENSATION TO BE 1,408
EXCEPTED FROM PAYMENT OF PREMIUMS AND OTHER CHARGES ASSESSED 1,409
UNDER THIS CHAPTER AND CHAPTER 4121. OF THE REVISED CODE WITH 1,411
RESPECT TO, OR IF THE EMPLOYER IS A SELF-INSURING EMPLOYER, FROM 1,412
PAYMENT OF DIRECT COMPENSATION AND BENEFITS TO AND ASSESSMENTS 1,413
REQUIRED BY THIS CHAPTER AND CHAPTER 4121. OF THE REVISED CODE ON 1,414
ACCOUNT OF, AN INDIVIDUAL WHO MEETS THE REQUIREMENTS OF THIS 1,415
SECTION. THE APPLICATION SHALL BE ON FORMS PROVIDED BY THE 1,416
BUREAU OF WORKERS' COMPENSATION, WHICH FORMS MAY BE THOSE USED BY 1,417
OR SIMILAR TO THOSE USED BY THE INTERNAL REVENUE SERVICE FOR THE 1,418
PURPOSE OF GRANTING AN EXEMPTION FROM THE PAYMENT OF SOCIAL 1,419
SECURITY TAXES UNDER 26 U.S.C.A. 1402(g) OF THE INTERNAL REVENUE 1,421
CODE, AND SHALL INCLUDE A WRITTEN WAIVER, SIGNED BY THE 1,422
INDIVIDUAL TO BE EXCEPTED, OF ALL THE BENEFITS AND COMPENSATION 1,423
PROVIDED FOR IN THIS CHAPTER AND CHAPTER 4121. OF THE REVISED 1,425
33
CODE.
THE APPLICATION ALSO SHALL INCLUDE AFFIDAVITS SIGNED BY THE 1,428
EMPLOYER AND THAT INDIVIDUAL THAT THE EMPLOYER AND THE INDIVIDUAL 1,429
ARE MEMBERS OF A RECOGNIZED RELIGIOUS SECT OR DIVISION OF A 1,430
RECOGNIZED RELIGIOUS SECT AND ARE ADHERENTS OF ESTABLISHED TENETS 1,432
OR TEACHINGS OF THAT SECT OR DIVISION BY REASON OF WHICH THE 1,433
EMPLOYER AND THE INDIVIDUAL ARE CONSCIENTIOUSLY OPPOSED TO
ACCEPTANCE OF THE BENEFITS OF ANY PUBLIC OR PRIVATE INSURANCE 1,435
THAT MAKES PAYMENTS IN THE EVENT OF DEATH, DISABILITY, 1,436
IMPAIRMENT, OLD AGE, OR RETIREMENT OR MAKES PAYMENTS TOWARD THE 1,437
COST OF, OR PROVIDES SERVICES FOR, MEDICAL BILLS, INCLUDING THE 1,438
BENEFITS OF ANY INSURANCE SYSTEM ESTABLISHED BY THE FEDERAL 1,439
"SOCIAL SECURITY ACT," 42 U.S.C.A. 301, ET SEQ. IF THE 1,441
INDIVIDUAL IS A MINOR, THE GUARDIAN OF THE MINOR SHALL COMPLETE 1,442
THE WAIVER AND AFFIDAVIT REQUIRED BY THIS DIVISION. 1,443
(B) THE ADMINISTRATOR SHALL GRANT THE WAIVER AND EXCEPTION 1,446
TO THE EMPLOYER FOR A PARTICULAR INDIVIDUAL IF THE ADMINISTRATOR
FINDS THAT THE EMPLOYER AND THE INDIVIDUAL ARE MEMBERS OF A SECT 1,447
OR DIVISION HAVING THE ESTABLISHED TENETS OR TEACHINGS DESCRIBED 1,448
IN DIVISION (A) OF THIS SECTION, THAT IT IS THE PRACTICE, AND HAS 1,449
BEEN FOR A SUBSTANTIAL NUMBER OF YEARS, FOR MEMBERS OF THAT SECT 1,450
OR DIVISION OF THAT SECT TO MAKE PROVISION FOR THEIR DEPENDENT 1,451
MEMBERS WHICH IN THE ADMINISTRATOR'S JUDGMENT IS REASONABLE IN 1,452
VIEW OF THEIR GENERAL LEVEL OF HIRING, AND THAT THAT SECT OR 1,453
DIVISION OF THAT SECT HAS BEEN IN EXISTENCE AT ALL TIMES SINCE 1,454
DECEMBER 31, 1950. 1,455
(C) A WAIVER AND EXCEPTION UNDER DIVISION (B) OF THIS 1,458
SECTION IS EFFECTIVE ON THE DATE THE ADMINISTRATOR GRANTS THE 1,459
WAIVER AND EXCEPTION. AN EMPLOYER WHO COMPLIES WITH THIS CHAPTER 1,460
AND THE EMPLOYER'S EMPLOYEES, WITH RESPECT TO AN INDIVIDUAL FOR 1,461
WHOM THE ADMINISTRATOR GRANTS THE WAIVER AND EXCEPTION, ARE 1,462
ENTITLED, AS TO THAT INDIVIDUAL AND AS TO ALL INJURIES AND 1,463
OCCUPATIONAL DISEASES OF THAT INDIVIDUAL THAT OCCURRED PRIOR TO 1,464
THE EFFECTIVE DATE OF THE WAIVER AND EXCEPTION, TO THE 1,465
34
PROTECTIONS OF SECTIONS 4123.74 AND 4123.741 OF THE REVISED CODE. 1,466
ON AND AFTER THE EFFECTIVE DATE OF THE WAIVER AND EXCEPTION, THE 1,467
EMPLOYER IS NOT LIABLE FOR THE PAYMENT OF ANY PREMIUMS OR OTHER 1,468
CHARGES ASSESSED UNDER THIS CHAPTER OR CHAPTER 4121. OF THE 1,469
REVISED CODE, OR IF THE INDIVIDUAL IS A SELF-INSURING EMPLOYER, 1,470
THE EMPLOYER IS NOT LIABLE FOR THE PAYMENT OF ANY COMPENSATION OR 1,471
BENEFITS DIRECTLY OR OTHER CHARGES ASSESSED UNDER THIS CHAPTER OR 1,472
CHAPTER 4121. OF THE REVISED CODE, IN REGARD TO THAT INDIVIDUAL, 1,474
IS CONSIDERED A COMPLYING EMPLOYER UNDER THOSE CHAPTERS, AND THE 1,475
EMPLOYER AND THE EMPLOYER'S EMPLOYEES ARE ENTITLED TO THE 1,476
PROTECTIONS OF SECTIONS 4123.74 AND 4123.741 OF THE REVISED CODE, 1,477
AS TO THAT INDIVIDUAL, AND AS TO INJURIES AND OCCUPATIONAL 1,478
DISEASES OF THAT INDIVIDUAL THAT OCCUR ON AND AFTER THE EFFECTIVE 1,479
DATE OF THE WAIVER AND EXCEPTION. 1,480
(D) A WAIVER AND EXCEPTION GRANTED IN REGARD TO A SPECIFIC 1,483
INDIVIDUAL IS VALID FOR ALL FUTURE YEARS UNLESS THE ADMINISTRATOR 1,484
DETERMINES THAT THE EMPLOYER, INDIVIDUAL, OR SECT OR DIVISION
CEASES TO MEET THE REQUIREMENTS OF THIS SECTION. IF THE 1,485
ADMINISTRATOR MAKES THIS DETERMINATION, THE EMPLOYER IS LIABLE 1,486
FOR THE PAYMENT OF PREMIUMS AND OTHER CHARGES ASSESSED UNDER THIS 1,487
CHAPTER AND CHAPTER 4121. OF THE REVISED CODE, OR IF THE 1,489
INDIVIDUAL IS A SELF-INSURING EMPLOYER, THE EMPLOYER IS LIABLE 1,490
FOR THE PAYMENT OF COMPENSATION AND BENEFITS DIRECTLY AND OTHER 1,491
CHARGES ASSESSED UNDER THOSE CHAPTERS, IN REGARD TO THAT 1,492
INDIVIDUAL FOR ALL INJURIES AND OCCUPATIONAL DISEASES OF THAT 1,493
INDIVIDUAL THAT OCCUR ON AND AFTER THE DATE OF THE 1,494
ADMINISTRATOR'S DETERMINATION AND THE INDIVIDUAL IS ENTITLED TO 1,495
ALL OF THE BENEFITS AND COMPENSATION PROVIDED IN THOSE CHAPTERS 1,496
FOR AN INJURY OR OCCUPATIONAL DISEASE THAT OCCURS ON OR AFTER THE 1,497
DATE OF THE ADMINISTRATOR'S DETERMINATION.
Sec. 4123.25. (A) No employer shall KNOWINGLY 1,506
misrepresent to the bureau of workers' compensation the amount OR 1,507
CLASSIFICATION of payroll upon which the premium under this 1,509
chapter is based. Whoever violates this division shall be liable 1,510
35
to the state in FOR UP TO ten times the amount of the difference 1,512
in BETWEEN THE premium paid and the amount the employer should 1,513
have paid. THE ADMINISTRATOR OF WORKERS' COMPENSATION, WITH THE 1,514
ADVICE AND CONSENT OF THE WORKERS' COMPENSATION OVERSIGHT 1,515
COMMISSION, SHALL ADOPT RULES IN ACCORDANCE WITH CHAPTER 119. OF 1,516
THE REVISED CODE FOR THE ASSESSMENT OF A FINE OR PENALTY AGAINST 1,517
AN EMPLOYER FOR A VIOLATION OF THIS DIVISION. The liability to 1,518
the state under this division shall MAY be enforced in a civil 1,519
action in the name of the state, and all sums collected under 1,520
this division shall be paid into the state insurance fund. 1,521
(B) No self-insuring employer shall misrepresent the 1,523
amount of paid compensation paid by such employer for purposes of 1,524
the assessments provided under this chapter and Chapter 4121. of 1,525
the Revised Code as required by section 4123.35 of the Revised 1,526
Code. Whoever violates this division is liable to the state in 1,527
an amount assessed by the self-insuring employers evaluation 1,528
board ADMINISTRATOR pursuant to division (C)(B) of section 1,530
4123.352 of the Revised Code or UP TO ten times the amount of the 1,531
difference between the assessment paid and the amount of the 1,532
assessment that should have been paid along with any other 1,533
penalty as determined by the board. The liability to the state 1,534
under this division may be enforced in a civil action in the name 1,535
of the state and all sums collected under this division shall be 1,536
paid into the self-insurance assessment fund created pursuant to 1,537
division (J) of section 4123.35 of the Revised Code. 1,538
Sec. 4123.27. Information contained in the annual 1,546
statement provided for in section 4123.26 of the Revised Code, 1,547
and such other information as may be furnished to the bureau of 1,548
workers' compensation by employers in pursuance of that section, 1,549
is OR AS THE BUREAU DEVELOPS OR CREATES, AND RECORDS KEPT BY THE 1,551
DIVISION OF SAFETY AND HYGIENE PERTAINING TO WORKPLACE INJURIES 1,552
AND ILLNESSES OR OCCUPATIONAL SAFETY AND HEALTH CONDITIONS IN 1,553
SPECIFIC WORKPLACES, INCLUDING, BUT NOT LIMITED TO, INDUSTRIAL 1,554
HYGIENE REPORTS, ERGONOMIC SURVEY REPORTS, TEAM APPROACH REPORTS, 1,555
36
SAFETY CONSULTANT REPORTS, ACCIDENT INVESTIGATION REPORTS, LOSS 1,556
CONTROL ANALYSIS REPORTS, AND ILLNESS AND INJURY DATA PERTAINING 1,557
TO SPECIFIC WORKPLACES, ARE for the exclusive use and information 1,558
of the bureau in the discharge of its official duties, and shall 1,559
not be open to the public nor be used in any court in any action 1,560
or proceeding pending therein unless the bureau is a party to the 1,561
action or proceeding; but the information contained in the 1,562
statement may be tabulated and published by the bureau in 1,563
statistical form for the use and information of other state 1,564
departments and the public. No person in the employ of the 1,565
bureau, except those who are authorized by the administrator of 1,566
workers' compensation, shall divulge any information secured by 1,567
him THE PERSON while in the employ of the bureau in respect to 1,568
the transactions, property, claim files, records, or papers of 1,571
the bureau or in respect to the business or mechanical, chemical, 1,573
or other industrial process of any company, firm, corporation, 1,574
person, association, partnership, or public utility to any person 1,575
other than the administrator or to the superior of such employee
of the bureau. 1,576
Notwithstanding the restrictions imposed by this section, 1,578
the governor, select or standing committees of the general 1,579
assembly, the auditor of state, the attorney general, or their 1,580
designees, pursuant to the authority granted in this chapter and 1,581
Chapter 4121. of the Revised Code, may examine any records, claim 1,582
files, or papers in possession of the industrial commission or 1,583
the bureau. They also are bound by the privilege that attaches 1,584
to these papers. 1,585
The administrator shall report to the director of human 1,587
services or to the county director of human services the name, 1,588
address, and social security number or other identification 1,589
number of any person receiving workers' compensation whose name 1,590
or social security number or other identification number is the 1,591
same as that of a person required by a court or child support 1,592
enforcement agency to provide support payments to a recipient of 1,593
37
public assistance, and whose name is submitted to the 1,594
administrator by the director under section 5101.36 of the 1,595
Revised Code. The administrator also shall inform the director 1,596
of the amount of workers' compensation paid to the person during 1,597
such period as the director specifies. 1,598
Within fourteen days after receiving from the director of 1,600
human services a list of the names and social security numbers of 1,601
recipients of public assistance pursuant to section 5101.181 of 1,602
the Revised Code, the administrator shall inform the auditor of 1,603
state of the name, current or most recent address, and social 1,604
security number of each person receiving workers' compensation 1,605
pursuant to this chapter whose name and social security number 1,606
are the same as that of a person whose name or social security 1,607
number was submitted by the director. The administrator also 1,609
shall inform the auditor of state of the amount of workers'
compensation paid to the person during such period as the 1,610
director specifies. 1,611
The bureau and its employees, except for purposes of 1,613
furnishing the auditor of state with information required by this 1,614
section, shall preserve the confidentiality of recipients of 1,615
public assistance in compliance with division (A) of section 1,616
5101.181 of the Revised Code. 1,617
For the purposes of this section, "public assistance" means 1,619
medical assistance provided through the medical assistance 1,620
program established under section 5111.01 of the Revised Code, 1,621
aid to dependent children provided under Chapter 5107. of the 1,622
Revised Code, or disability assistance provided under Chapter 1,623
5115. of the Revised Code. 1,624
Sec. 4123.28. Every employer in this state shall keep a 1,633
record of all injuries and occupational diseases, fatal or 1,634
otherwise, received or contracted by his THE EMPLOYER'S employees 1,636
in the course of their employment and resulting in seven days or 1,637
more of total disability OR IMPAIRMENT. Within a week after 1,638
acquiring knowledge of an injury or death therefrom, and in the 1,640
38
event of occupational disease or death therefrom, within one week 1,641
after acquiring knowledge of or diagnosis of or death from an 1,642
occupational disease or of a report to the employer of the 1,643
occupational disease or death, a report thereof shall be made in 1,644
writing to the bureau of workers' compensation upon blanks to be 1,645
procured from the bureau for that purpose. The report shall 1,646
state the name and nature of the business of the employer, the 1,647
location of his THE EMPLOYER'S establishment or place of work, 1,649
the name, address, nature and duration of occupation of the 1,650
injured, disabled, IMPAIRED, or deceased employee and the time, 1,652
the nature, and the cause of injury, occupational disease, or 1,653
death, and such other information as is required by the bureau. 1,654
The employer shall give a copy of each report to the 1,656
employee it concerns or his THE EMPLOYEE'S surviving dependents. 1,658
No employer shall refuse or neglect to make any report 1,660
required by this section. 1,661
Each day that an employer fails to file a report required 1,663
by this section constitutes an additional day within the time 1,664
period given to a claimant by the applicable statute of 1,665
limitations for the filing of a claim based on the injury or 1,666
occupational disease, provided that a failure to file a report 1,667
shall not extend the applicable statute of limitations for more 1,668
than two additional years. 1,669
Sec. 4123.343. This section shall be construed liberally 1,678
to the end that employers shall be encouraged to employ and 1,679
retain in their employment handicapped employees as defined in 1,680
this section. 1,681
(A) As used in this section, "handicapped employee" means 1,683
an employee who is afflicted with or subject to any physical or 1,684
mental impairment, or both, whether congenital or due to an 1,685
injury or disease of such character that the impairment 1,686
constitutes a handicap in obtaining employment or would 1,687
constitute a handicap in obtaining reemployment if the employee 1,688
should become unemployed and whose handicap is due to any of the 1,689
39
following diseases or conditions: 1,690
(1) Epilepsy; 1,692
(2) Diabetes; 1,694
(3) Cardiac disease; 1,696
(4) Arthritis; 1,698
(5) Amputated foot, leg, arm, or hand; 1,700
(6) Loss of sight of one or both eyes or a partial loss of 1,702
uncorrected vision of more than seventy-five per cent 1,703
bilaterally; 1,704
(7) Residual disability OR IMPAIRMENT from poliomyelitis; 1,706
(8) Cerebral palsy; 1,708
(9) Multiple sclerosis; 1,710
(10) Parkinson's disease; 1,712
(11) Cerebral vascular accident; 1,714
(12) Tuberculosis; 1,716
(13) Silicosis; 1,718
(14) Psycho-neurotic disability OR IMPAIRMENT following 1,720
treatment in a recognized medical or mental institution; 1,721
(15) Hemophilia; 1,723
(16) Chronic osteomyelitis; 1,725
(17) Ankylosis of joints; 1,727
(18) Hyper insulinism; 1,729
(19) Muscular dystrophies; 1,731
(20) Arterio-sclerosis; 1,733
(21) Thrombo-phlebitis; 1,735
(22) Varicose veins; 1,737
(23) Cardiovascular, pulmonary, or respiratory diseases of 1,739
a fire fighter or police officer employed by a municipal 1,740
corporation or township as a regular member of a lawfully 1,741
constituted police department or fire department; 1,742
(24) Coal miners' pneumoconiosis, commonly referred to as 1,744
"black lung disease"; 1,745
(25) Disability OR IMPAIRMENT with respect to which an 1,747
individual has completed a rehabilitation program conducted 1,748
40
pursuant to sections 4121.61 to 4121.69 of the Revised Code. 1,749
(B) Under the circumstances set forth in this section all 1,751
or such portion as the administrator determines of the 1,752
compensation and benefits paid in any claim arising hereafter 1,753
shall be charged to and paid from the statutory surplus fund 1,754
created under section 4123.34 of the Revised Code and only the 1,755
portion remaining shall be merit-rated or otherwise treated as 1,756
part of the accident or occupational disease experience of the 1,757
employer. If the employer is a self-insuring employer, the 1,758
proportion of such costs whether charged to the statutory surplus 1,759
fund in whole or in part shall be by way of direct payment to 1,760
such employee or his THE EMPLOYEE'S dependents or by way of 1,761
reimbursement to the self-insuring employer as the circumstances 1,763
indicate. The provisions of this section apply only in cases of 1,764
death, TEMPORARY total disability, whether temporary or permanent 1,766
TOTAL IMPAIRMENT, and all disabilities IMPAIRMENTS compensated 1,768
under division (B) of section 4123.57 of the Revised Code. The 1,769
administrator shall adopt rules specifying the grounds upon which 1,770
charges to the statutory surplus fund are to be made. The rules 1,771
shall prohibit as a grounds any agreement between employer and 1,772
claimant as to the merits of a claim and the amount of the 1,773
charge.
(C) Any employer who advises the bureau of workers' 1,775
compensation prior to the occurrence of an injury or occupational 1,776
disease that it has in its employ a handicapped employee is 1,777
entitled, in the event the person is injured, to a determination 1,778
under this section. Any employer who fails to notify the bureau 1,779
but applies for a determination under this section is entitled to 1,780
a determination if the bureau finds that there was good cause for 1,781
the failure to give notice of the employment of the handicapped 1,782
employee. The bureau annually shall require employers to file an 1,783
inventory of current handicapped employees. 1,784
An employer shall file an application for a determination 1,786
with the bureau or commission in the same manner as other claims. 1,787
41
An application only may be made in cases where IN WHICH a 1,788
handicapped employee or his THE HANDICAPPED EMPLOYEE'S dependents 1,790
claim or is ARE receiving an award of compensation as a result of 1,791
an injury OCCURRING or AN occupational disease occurring or 1,793
contracted FIRST DIAGNOSED BY A LICENSED PHYSICIAN on or after 1,794
the date on which division (A) of this section first included the 1,796
handicap of such employee.
(D) The circumstances under and the manner in which an 1,798
apportionment under this section shall be made are AS FOLLOWS: 1,799
(1) Whenever a handicapped employee is injured, IMPAIRED, 1,802
or disabled or dies as the result of an injury or occupational 1,803
disease sustained in the course of and arising out of his THE 1,804
EMPLOYEE'S employment in this state and the administrator awards 1,806
compensation therefor and when it appears to the satisfaction of 1,807
the administrator that the injury or occupational disease or the 1,808
death resulting therefrom would not have occurred but for the 1,809
pre-existing physical or mental impairment of the handicapped 1,810
employee, all compensation and benefits payable on account of the 1,811
disability, IMPAIRMENT, or death shall be paid from the surplus 1,813
fund.
(2) Whenever a handicapped employee is injured, IMPAIRED, 1,816
or disabled or dies as a result of an injury or occupational 1,817
disease and the administrator finds that the injury or 1,818
occupational disease would have been sustained or suffered 1,819
without regard to the employee's pre-existing impairment but that 1,820
the resulting IMPAIRMENT, disability, or death was caused at 1,822
least in part through aggravation of the employee's pre-existing 1,823
disability IMPAIRMENT, the administrator shall determine in a 1,825
manner that is equitable and, reasonable, and based upon medical 1,827
evidence the amount of disability, IMPAIRMENT, or proportion of 1,828
the cost of the death award that is attributable to the 1,829
employee's pre-existing disability IMPAIRMENT and the amount 1,830
found shall be charged to the statutory surplus fund. 1,832
(E) The benefits and provisions of this section apply only 1,834
42
to employers who have complied with this chapter either through 1,835
insurance with the state fund or as a self-insuring employer. 1,836
(F) No employer shall in any year SHALL receive credit 1,838
under this section in an amount greater than the premium he THE 1,839
EMPLOYER paid if a state fund employer or greater than his THE 1,841
EMPLOYER'S assessments if a self-insuring employer. 1,843
(G) Self-insuring employers may, for all claims made after 1,845
January 1, 1987, for compensation and benefits under this 1,846
section, MAY pay the compensation and benefits directly to the 1,847
employee or the employee's dependents. If such an employer 1,848
chooses to pay compensation and benefits directly, he THE 1,849
EMPLOYER shall receive no money or credit from the surplus fund 1,851
for the payment under this section, nor shall he THE EMPLOYER be 1,852
required to pay any amounts into the surplus fund that otherwise 1,854
would be assessed for handicapped reimbursements for claims made 1,855
after January 1, 1987. Where IF a self-insuring employer elects 1,856
to pay for compensation and benefits pursuant to this section, he 1,858
THE EMPLOYER shall assume responsibility for compensation and 1,860
benefits arising out of claims made prior to January 1, 1987, and 1,861
shall not be required to pay any amounts into the surplus fund 1,862
and may not receive any money or credit from that fund on account 1,863
of this section. The election made under this division is 1,864
irrevocable.
(H) An order issued by the administrator pursuant to this 1,866
section is appealable under section 4123.511 of the Revised Code 1,867
but is not appealable to court under section 4123.512 of the 1,868
Revised Code. 1,869
Sec. 4123.35. (A) Except as provided in this section, 1,878
every employer mentioned in division (B)(2) of section 4123.01 of 1,879
the Revised Code, and every publicly owned utility shall pay 1,880
semiannually in the months of January and July into the state 1,882
insurance fund the amount of annual premium the administrator of 1,883
workers' compensation fixes for the employment or occupation of 1,884
the employer, the amount of which premium to be paid by each 1,885
43
employer to be determined by the classifications, rules, and 1,886
rates made and published by the administrator. The employer
shall pay semiannually a further sum of money into the state 1,887
insurance fund as may be ascertained to be due from the employer 1,890
by applying the rules of the administrator, and a receipt or 1,891
certificate certifying that payment has been made shall be mailed 1,893
immediately to the employer by the bureau of workers'
compensation. The receipt or certificate is prima facie evidence 1,894
of the payment of the premium. 1,895
The bureau of workers' compensation shall verify with the 1,897
secretary of state the existence of all corporations and 1,898
organizations making application for workers' compensation 1,899
coverage and shall require every such application to include the 1,900
employer's federal identification number. 1,901
An employer as defined in division (B)(2) of section 1,903
4123.01 of the Revised Code who has contracted with a 1,904
subcontractor is liable for the unpaid premium due from any 1,905
subcontractor with respect to that part of the payroll of the 1,906
subcontractor that is for work performed pursuant to the contract 1,908
with the employer.
Division (A) of section 4123.35 of the Revised Code 1,910
providing for the payment of premiums semiannually does not apply 1,911
to any employer who was a subscriber to the state insurance fund 1,912
prior to January 1, 1914, or who may first become a subscriber to 1,913
the fund in any month other than January or July. Instead, the 1,914
semiannual premiums shall be paid by those employers from time to 1,915
time upon the expiration of the respective periods for which 1,916
payments into the fund have been made by them.
The administrator shall adopt rules to permit employers to 1,918
make periodic payments of the semiannual premium due under this 1,919
division. The rules shall include provisions for the assessment 1,920
of interest charges, where appropriate, and for the assessment of 1,921
penalties when an employer fails to make timely premium payments. 1,923
An employer who timely pays the amounts due under this division 1,924
44
is entitled to all of the benefits and protections of this 1,925
chapter. Upon receipt of payment, the bureau immediately shall 1,926
mail a receipt or certificate to the employer certifying that
payment has been made, which receipt is prima-facie evidence of 1,928
payment. Workers' compensation coverage under this chapter 1,929
continues uninterrupted upon timely receipt of payment under this 1,930
division.
Every employer mentioned in division (B)(1) of section 1,932
4123.01 of the Revised Code, except boards of county hospital 1,933
trustees that are self-insuring employers under this section, 1,934
shall comply with sections 4123.38 to 4123.41, and 4123.48 of the 1,936
Revised Code in regard to the contribution of moneys to the 1,937
public insurance fund. 1,938
(B) Provided, that employers mentioned in division (B)(2) 1,940
of section 4123.01 of the Revised Code, boards of county hospital 1,941
trustees, and publicly owned utilities who will abide by the 1,942
rules of the administrator and who may be of sufficient financial 1,943
ability to render certain the payment of compensation to injured 1,944
employees or the dependents of killed employees, and the 1,945
furnishing of medical, surgical, nursing, and hospital attention 1,946
and services and medicines, and funeral expenses, equal to or 1,947
greater than is provided for in sections 4123.52, 4123.55 to 1,948
4123.62, and 4123.64 to 4123.67 of the Revised Code, and who do 1,949
not desire to insure the payment thereof or indemnify themselves 1,950
against loss sustained by the direct payment thereof, upon a 1,951
finding of such facts by the administrator, may be granted the 1,952
privilege to pay individually compensation, and furnish medical, 1,954
surgical, nursing, and hospital services and attention and 1,955
funeral expenses directly to injured employees or the dependents 1,956
of killed employees, thereby being granted status as a 1,958
self-insuring employer. The administrator may charge employers, 1,959
boards of county hospital trustees, or publicly owned utilities 1,960
who apply for the status as a self-insuring employer a reasonable 1,961
application fee to cover the bureau's costs in connection with 1,962
45
processing and making a determination with respect to an 1,963
application. All employers granted such status shall demonstrate 1,964
sufficient financial and administrative ability to assure that 1,965
all obligations under this section are promptly met. The 1,966
administrator shall deny the privilege where the employer is 1,967
unable to demonstrate the employer's ability to promptly meet all 1,968
the obligations imposed on the employer by this section. The 1,969
administrator shall consider, but is not limited to, the 1,971
following factors, where applicable, in determining the
employer's ability to meet all of the obligations imposed on the 1,972
employer by this section: 1,973
(1) The employer employs a minimum of five hundred 1,975
employees in this state; 1,976
(2) The employer has operated in this state for a minimum 1,978
of two years, provided that an employer who has purchased, 1,979
acquired, or otherwise succeeded to the operation of a business, 1,980
or any part thereof, situated in this state that has operated for 1,981
at least two years in this state, also shall qualify; 1,982
(3) Where the employer previously contributed to the state 1,984
insurance fund or is a successor employer as defined by bureau 1,985
rules, the amount of the buy-out, as defined by bureau rules; 1,986
(4) The sufficiency of the employer's assets located in 1,988
this state to insure the employer's solvency in paying 1,989
compensation directly; 1,990
(5) The financial records, documents, and data, certified 1,992
by a certified public accountant, necessary to provide the 1,993
employer's full financial disclosure. The records, documents, 1,994
and data include, but are not limited to, balance sheets and 1,995
profit and loss history for the current year and previous four 1,996
years. 1,997
(6) The employer's organizational plan for the 1,999
administration of the workers' compensation law; 2,000
(7) The employer's proposed plan to inform employees of 2,002
the change from a state fund insurer to a self-insuring employer, 2,003
46
the procedures the employer will follow as a self-insuring 2,004
employer, and the employees' rights to compensation and benefits; 2,005
and 2,006
(8) The employer has either an account in a financial 2,008
institution in this state, or if the employer maintains an 2,009
account with a financial institution outside this state, ensures 2,010
that workers' compensation checks are drawn from the same account 2,011
as payroll checks or the employer clearly indicates that payment 2,012
will be honored by a financial institution in this state. 2,013
The administrator may waive the requirements of divisions 2,015
(B)(1) and (2) of this section and the requirement of division 2,016
(B)(5) of this section that the financial records, documents, and 2,017
data be certified by a certified public accountant. The 2,018
administrator shall adopt rules establishing the criteria that an 2,019
employer shall meet in order for the administrator to waive the 2,020
requirement of division (B)(5) of this section. Such rules may 2,021
require additional security of that employer pursuant to division 2,022
(E) of section 4123.351 of the Revised Code. The administrator 2,023
shall not grant the status of self-insuring employer to any 2,024
public employer, other than publicly owned utilities and boards 2,025
of county hospital trustees. 2,026
(C) The administrator shall require a surety bond from all 2,028
self-insuring employers, issued pursuant to section 4123.351 of 2,029
the Revised Code, that is sufficient to compel, or secure to 2,030
injured employees, or to the dependents of employees killed, the 2,031
payment of compensation and expenses, which shall in no event be 2,032
less than that paid or furnished out of the state insurance fund 2,033
in similar cases to injured employees or to dependents of killed 2,034
employees whose employers contribute to the fund, except when an 2,035
employee of the employer, who has suffered the loss of a hand, 2,036
arm, foot, leg, or eye prior to the injury for which compensation 2,037
is to be paid, and thereafter suffers the loss of any other of 2,038
the members as the result of any injury sustained in the course 2,039
of and arising out of the employee's employment, the compensation 2,041
47
to be paid by the self-insuring employer is limited to the
disability OR IMPAIRMENT suffered in the subsequent injury, 2,042
additional compensation, if any, to be paid by the bureau out of 2,044
the surplus created by section 4123.34 of the Revised Code. 2,045
(D) In addition to the requirements of this section, the 2,047
administrator shall make and publish rules governing the manner 2,048
of making application and the nature and extent of the proof 2,049
required to justify a finding of fact by the administrator as to 2,050
granting the status of a self-insuring employer, which rules 2,051
shall be general in their application, one of which rules shall 2,052
provide that all self-insuring employers shall pay into the state 2,053
insurance fund such amounts as are required to be credited to the 2,054
surplus fund in division (B) of section 4123.34 of the Revised 2,055
Code. 2,056
Employers shall secure directly from the bureau central 2,058
offices application forms upon which the bureau shall stamp a 2,059
designating number. Prior to submission of an application, an 2,060
employer shall make available to the bureau, and the bureau shall 2,061
review, the information described in divisions (B)(1) to (8) of 2,062
this section. An employer shall file the completed application 2,063
forms with an application fee, which shall cover the costs of 2,064
processing the application, as established by the administrator, 2,065
by rule, with the bureau at least ninety days prior to the 2,066
effective date of the employer's new status as a self-insuring 2,067
employer. The application form is not deemed complete until all 2,068
the required information is attached thereto. The bureau shall 2,069
only accept applications that contain the required information. 2,070
(E) The bureau shall review completed applications within 2,072
a reasonable time. If the bureau determines to grant an employer 2,073
the status as a self-insuring employer, the bureau shall issue a 2,074
statement, containing its findings of fact, that is prepared by 2,075
the bureau and signed by the administrator. If the bureau 2,076
determines not to grant the status as a self-insuring employer, 2,077
the bureau shall notify the employer of the determination and 2,078
48
require the employer to continue to pay its full premium into the 2,079
state insurance fund. The administrator also shall adopt rules 2,080
establishing a minimum level of performance as a criterion for 2,081
granting and maintaining the status as a self-insuring employer 2,082
and fixing time limits beyond which failure of the self-insuring 2,083
employer to provide for the necessary medical examinations and 2,084
evaluations may not delay a decision on a claim. 2,085
(F) The administrator shall adopt rules setting forth 2,087
procedures for auditing the program of self-insuring employers. 2,088
The bureau shall conduct the audit upon a random basis or 2,089
whenever the bureau has grounds for believing that an employer is 2,090
not in full compliance with bureau rules or this chapter. 2,091
The administrator shall monitor the programs conducted by 2,093
self-insuring employers, to ensure compliance with bureau 2,094
requirements and for that purpose, shall develop and issue to 2,095
self-insuring employers standardized forms for use by the 2,096
employer in all aspects of the employers' direct compensation 2,097
program and for reporting of information to the bureau. 2,098
The bureau shall receive and transmit to the employer all 2,100
complaints concerning any self-insuring employer. In the case of 2,101
a complaint against a self-insuring employer, the administrator 2,102
shall handle the complaint through the self-insurance division of 2,103
the bureau. The bureau shall maintain a file by employer of all 2,104
complaints received that relate to the employer. The bureau 2,105
shall evaluate each complaint and take appropriate action. 2,106
The administrator shall adopt as a rule a prohibition 2,108
against any self-insuring employer from harassing, dismissing, or 2,109
otherwise disciplining any employee making a complaint, which 2,110
rule shall provide for a financial penalty to be levied by the 2,111
administrator payable by the offending employer. 2,112
(G) For the purpose of making determinations as to whether 2,114
to grant status as a self-insuring employer, the administrator 2,115
may subscribe to and pay for a credit reporting service that 2,116
offers financial and other business information about individual 2,117
49
employers. The costs in connection with the bureau's 2,118
subscription or individual reports from the service about an 2,119
applicant may be included in the application fee charged 2,120
employers under this section. 2,121
(H) The administrator, notwithstanding other provisions of 2,124
this chapter, may permit a self-insuring employer to resume 2,125
payment of premiums to the state insurance fund with appropriate 2,126
credit modifications to the employer's basic premium rate as such 2,127
rate is determined pursuant to section 4123.29 of the Revised 2,128
Code.
(I) On the first day of July of each year, the 2,130
administrator shall calculate separately each self-insuring 2,131
employer's assessments for the safety and hygiene fund, 2,132
administrative costs pursuant to section 4123.342 of the Revised 2,133
Code, and for the portion of the surplus fund under division (B) 2,134
of section 4123.34 of the Revised Code that is not used for 2,135
handicapped reimbursement, on the basis of the paid compensation 2,136
attributable to the individual self-insuring employer according 2,137
to the following calculation: 2,138
(1) The total assessment against all self-insuring 2,140
employers as a class for each fund and for the administrative 2,141
costs for the year that the assessment is being made, as 2,142
determined by the administrator, divided by the total amount of 2,143
paid compensation for the previous calendar year attributable to 2,144
all amenable self-insuring employers; 2,145
(2) Multiply the quotient in division (I)(1) of this 2,147
section by the total amount of paid compensation for the previous 2,148
calendar year that is attributable to the individual 2,149
self-insuring employer for whom the assessment is being 2,150
determined. Each self-insuring employer shall pay the assessment 2,151
that results from this calculation, unless the assessment 2,152
resulting from this calculation falls below a minimum assessment, 2,153
which minimum assessment the administrator shall determine on the 2,154
first day of July of each year with the advice and consent of the 2,155
50
workers' compensation oversight commission, in which event, the 2,156
self-insuring employer shall pay the minimum assessment. 2,157
In determining the total amount due for the total 2,159
assessment against all self-insuring employers as a class for 2,160
each fund and the administrative assessment, the administrator 2,161
shall reduce proportionately the total for each fund and 2,163
assessment by the amount of money in the self-insurance 2,164
assessment fund as of the date of the computation of the 2,165
assessment. 2,166
The administrator shall calculate the assessment for the 2,168
portion of the surplus fund under division (B) of section 4123.34 2,169
of the Revised Code that is used for handicapped reimbursement in 2,170
the same manner as set forth in divisions (I)(1) and (2) of this 2,171
section except that the administrator shall calculate the total 2,172
assessment for this portion of the surplus fund only on the basis 2,173
of those self-insuring employers that retain participation in the 2,174
handicapped reimbursement program and the individual 2,175
self-insuring employer's proportion of paid compensation shall be 2,176
calculated only for those self-insuring employers who retain 2,177
participation in the handicapped reimbursement program. The 2,178
administrator, as the administrator determines appropriate, may 2,180
determine the total assessment for the handicapped portion of the 2,181
surplus fund in accordance with sound actuarial principles. 2,182
The administrator shall calculate the assessment for the 2,184
portion of the surplus fund under division (B) of section 4123.34 2,185
of the Revised Code that under division (D) of section 4121.66 of 2,186
the Revised Code is used for rehabilitation costs in the same 2,187
manner as set forth in divisions (I)(1) and (2) of this section, 2,188
except that the administrator shall calculate the total 2,189
assessment for this portion of the surplus fund only on the basis 2,190
of those self-insuring employers who have not made the election 2,191
to make payments directly under division (D) of section 4121.66 2,192
of the Revised Code and an individual self-insuring employer's 2,193
proportion of paid compensation only for those self-insuring 2,194
51
employers who have not made that election. 2,195
An employer who no longer is a self-insuring employer in 2,197
this state or who no longer is operating in this state, shall 2,198
continue to pay assessments for administrative costs and for the 2,199
portion of the surplus fund under division (B) of section 4123.34 2,200
of the Revised Code that is not used for handicapped 2,201
reimbursement, based upon paid compensation attributable to 2,202
claims that occurred while the employer was a self-insuring 2,203
employer within this state. 2,204
(J) There is hereby created in the state treasury the 2,206
self-insurance assessment fund. All investment earnings of the 2,207
fund shall be deposited in the fund. The administrator shall use 2,208
the money in the self-insurance assessment fund only for 2,209
administrative costs as specified in section 4123.341 of the 2,210
Revised Code. 2,211
(K) Every self-insuring employer shall certify, in 2,213
affidavit form subject to the penalty for perjury, to the bureau 2,214
the amount of the self-insuring employer's paid compensation for 2,215
the previous calendar year. In reporting paid compensation paid 2,216
for the previous year, a self-insuring employer shall exclude 2,217
from the total amount of paid compensation any reimbursement the 2,218
employer receives in the previous calendar year from the surplus 2,219
fund pursuant to section 4123.512 of the Revised Code for any 2,220
paid compensation. The self-insuring employer also shall exclude 2,221
from the paid compensation reported any amount recovered under 2,222
section 4123.93 of the Revised Code and any amount that is 2,223
determined not to have been payable to or on behalf of a claimant 2,224
in any final administrative or judicial proceeding. The 2,225
self-insuring employer shall exclude such amounts from the paid 2,226
compensation reported in the reporting period subsequent to the 2,227
date the determination is made. The administrator shall adopt 2,228
rules, in accordance with Chapter 119. of the Revised Code, 2,229
establishing the date by which self-insuring employers must 2,230
submit such information and the amount of the assessments 2,231
52
provided for in division (I) of this section for employers who 2,232
have been granted self-insuring status within the last calendar 2,233
year. 2,234
The administrator shall include any assessment that remains 2,236
unpaid for previous assessment periods in the calculation and 2,237
collection of any assessments due under this division or division 2,238
(I) of this section. 2,239
(L) As used in this section, "paid compensation" means all 2,241
amounts paid by a self-insuring employer for living maintenance 2,242
benefits, all amounts for compensation paid pursuant to sections 2,243
4121.63, 4121.67, 4123.56, 4123.57, 4123.58, 4123.59, 4123.60, 2,244
and 4123.64 of the Revised Code, all amounts paid as wages in 2,245
lieu of such compensation, all amounts paid in lieu of such 2,246
compensation under a nonoccupational accident and sickness 2,247
program fully funded by the self-insuring employer, and all 2,248
amounts paid by a self-insuring employer for a violation of a 2,249
specific safety standard pursuant to Section 35 of Article II, 2,250
Ohio Constitution and section 4121.47 of the Revised Code. 2,251
(M) Should any section of this chapter or Chapter 4121. of 2,253
the Revised Code providing for self-insuring employers' 2,254
assessments based upon compensation paid be declared 2,255
unconstitutional by a final decision of any court, then that 2,256
section of the Revised Code declared unconstitutional shall 2,257
revert back to the section in existence prior to November 3, 2,258
1989, providing for assessments based upon payroll. 2,259
(N) The administrator may grant a self-insuring employer 2,261
the privilege to self-insure a construction project entered into 2,262
by the self-insuring employer that is scheduled for completion 2,263
within six years after the date the project begins, and the total 2,264
cost of which is estimated to exceed one hundred million dollars. 2,266
The administrator may waive such cost and time criteria and grant 2,267
a self-insuring employer the privilege to self-insure a
construction project regardless of the time needed to complete 2,268
the construction project and provided that the cost of the 2,269
53
construction project is estimated to exceed fifty million 2,270
dollars. A self-insuring employer who desires to self-insure a 2,272
construction project shall submit to the administrator an
application listing the dates the construction project is 2,273
scheduled to begin and end, the estimated cost of the 2,275
construction project, the contractors and subcontractors whose
employees are to be self-insured by the self-insuring employer, 2,276
the provisions of a safety program that is specifically designed 2,277
for the construction project, and a statement as to whether a 2,278
collective bargaining agreement governing the rights, duties, and 2,279
obligations of each of the parties to the agreement with respect 2,280
to the construction project exists between the self-insuring 2,281
employer and a labor organization. 2,282
A self-insuring employer may apply to self-insure the 2,284
employees of either of the following: 2,285
(1) All contractors and subcontractors who perform labor 2,287
or work or provide materials for the construction project; 2,288
(2) All contractors and, at the administrator's 2,290
discretion, a substantial number of all the subcontractors who 2,291
perform labor or work or provide materials for the construction 2,292
project.
Upon approval of the application, the administrator shall 2,294
mail a certificate granting the privilege to self-insure the 2,295
construction project to the self-insuring employer. The 2,296
certificate shall contain the name of the self-insuring employer 2,297
and the name, address, and telephone number of the self-insuring 2,298
employer's representatives who are responsible for administering
workers' compensation claims for the construction project. The 2,299
self-insuring employer shall post the certificate in a 2,300
conspicuous place at the site of the construction project. 2,301
The administrator shall maintain a record of the 2,303
contractors and subcontractors whose employees are covered under 2,304
the certificate issued to the self-insured employer. A 2,305
self-insuring employer immediately shall notify the administrator 2,306
54
when any contractor or subcontractor is added or eliminated from 2,307
inclusion under the certificate.
Upon approval of the application, the self-insuring 2,309
employer is responsible for the administration and payment of all 2,310
claims under this chapter and Chapter 4121. of the Revised Code 2,311
for the employees of the contractor and subcontractors covered 2,312
under the certificate who receive injuries or are killed in the 2,313
course of and arising out of employment on the construction 2,315
project, or who contract an occupational disease in the course of 2,316
employment on the construction project. For purposes of this
chapter and Chapter 4121. of the Revised Code, a claim that is 2,318
administered and paid in accordance with this division is
considered a claim against the self-insuring employer listed in 2,319
the certificate. A contractor or subcontractor included under 2,320
the certificate shall report to the self-insuring employer listed 2,321
in the certificate, all claims that arise under this chapter and 2,322
Chapter 4121. of the Revised Code in connection with the 2,324
construction project for which the certificate is issued. 2,325
A self-insuring employer who complies with this division is 2,327
entitled to the protections provided under this chapter and 2,328
Chapter 4121. of the Revised Code with respect to the employees 2,330
of the contractors and subcontractors covered under a certificate 2,331
issued under this division for death or injuries that arise out 2,332
of, or death, injuries, or occupational diseases that arise in
the course of, those employees' employment on that construction 2,334
project, as if the employees were employees of the self-insuring 2,335
employer, provided that the self-insuring employer also complies 2,336
with this section. No employee of the contractors and
subcontractors covered under a certificate issued under this 2,337
division shall be considered the employee of the self-insuring 2,338
employer listed in that certificate for any purposes other than 2,339
this chapter and Chapter 4121. of the Revised Code. Nothing in 2,340
this division gives a self-insuring employer authority to control 2,341
the means, manner, or method of employment of the employees of 2,342
55
the contractors and subcontractors covered under a certificate 2,343
issued under this division. 2,344
The contractors and subcontractors included under a 2,346
certificate issued under this division are entitled to the 2,347
protections provided under this chapter and Chapter 4121. of the 2,348
Revised Code with respect to the contractor's or subcontractor's 2,349
employees who are employed on the construction project which is 2,350
the subject of the certificate, for death or injuries that arise 2,351
out of, or death, injuries, or occupational diseases that arise 2,352
in the course of, those employees' employment on that 2,353
construction project.
The contractors and subcontractors included under a 2,355
certificate issued under this division shall identify in their 2,356
payroll records the employees who are considered the employees of 2,357
the self-insuring employer listed in that certificate for 2,358
purposes of this chapter and Chapter 4121. of the Revised Code, 2,360
and the amount that those employees earned for employment on the 2,361
construction project that is the subject of that certificate. 2,362
Notwithstanding any provision to the contrary under this chapter
and Chapter 4121. of the Revised Code, the administrator shall 2,365
exclude the payroll that is reported for employees who are 2,366
considered the employees of the self-insuring employer listed in
that certificate, and that the employees earned for employment on 2,367
the construction project that is the subject of that certificate, 2,368
when determining those contractors' or subcontractors' premiums 2,369
or assessments required under this chapter and Chapter 4121. of 2,370
the Revised Code. A self-insuring employer issued a certificate 2,371
under this division shall include in the amount of paid 2,372
compensation it reports pursuant to division (K) of this section, 2,373
the amount of paid compensation the self-insuring employer paid 2,374
pursuant to this division for the previous calendar year. 2,375
Nothing in this division shall be construed as altering the 2,377
rights of employees under this chapter and Chapter 4121. of the 2,378
Revised Code as those rights existed prior to the effective date 2,380
56
of this amendment SEPTEMBER 17, 1996. Nothing in this division 2,381
shall be construed as altering the rights devolved under sections 2,382
2305.31 and 4123.82 of the Revised Code as those rights existed 2,384
prior to the effective date of this amendment SEPTEMBER 17, 1996. 2,385
As used in this division, "privilege to self-insure a 2,387
construction project" means privilege to pay individually 2,388
compensation, and to furnish medical, surgical, nursing, and 2,389
hospital services and attention and funeral expenses directly to 2,390
injured employees or the dependents of killed employees. 2,391
(O) A self-insuring employer whose application is granted 2,393
under division (N) of this section shall designate a safety 2,394
professional to be responsible for the administration and 2,395
enforcement of the safety program that is specifically designed 2,396
for the construction project that is the subject of the 2,397
application.
A self-insuring employer whose application is granted under 2,399
division (N) of this section shall employ an ombudsperson for the 2,400
construction project that is the subject of the application. The 2,401
ombudsperson shall have experience in workers' compensation or 2,402
the construction industry, or both. The ombudsperson shall 2,403
perform all of the following duties:
(1) Communicate with and provide information to employees 2,405
who are injured in the course of, or whose injury arises out of 2,406
employment on the construction project, or who contract an 2,407
occupational disease in the course of employment on the 2,408
construction project;
(2) Investigate the status of a claim upon the request of 2,410
an employee to do so; 2,411
(3) Provide information to claimants, third party 2,413
administrators, employers, and other persons to assist those 2,414
persons in protecting their rights under this chapter and Chapter 2,415
4121. of the Revised Code. 2,416
A self-insuring employer whose application is granted under 2,418
division (N) of this section shall post the name of the safety 2,420
57
professional and the ombudsperson and instructions for contacting
the safety professional and the ombudsperson in a conspicuous 2,421
place at the site of the construction project. 2,422
(P) The administrator may consider all of the following 2,425
when deciding whether to grant a self-insuring employer the 2,426
privilege to self-insure a construction project as provided under 2,427
division (N) of this section: 2,428
(1) Whether the self-insuring employer has an 2,430
organizational plan for the administration of the workers' 2,431
compensation law; 2,432
(2) Whether the safety program that is specifically 2,434
designed for the construction project provides for the safety of 2,435
employees employed on the construction project, is applicable to 2,437
all contractors and subcontractors who perform labor or work or 2,438
provide materials for the construction project, and has a
component, a safety training program that complies with standards 2,439
adopted pursuant to the "Occupational Safety and Health Act of 2,440
1970," 84 Stat. 1590, 29 U.S.C.A. 651, and provides for 2,441
continuing management and employee involvement; 2,442
(3) Whether granting the privilege to self-insure the 2,444
construction project will reduce the costs of the construction 2,445
project; 2,446
(4) Whether the self-insuring employer has employed an 2,448
ombudsperson as required under division (O) of this section; 2,450
(5) Whether the self-insuring employer has sufficient 2,452
surety to secure the payment of claims for which the 2,453
self-insuring employer would be responsible pursuant to the 2,454
granting of the privilege to self-insure a construction project 2,455
under division (N) of this section. 2,457
Sec. 4123.352. (A) There is hereby created the 2,466
self-insuring employers evaluation board consisting of three 2,467
members. The member of the industrial commission representing 2,468
the public shall be a member of the self-insuring employers 2,469
evaluation board and shall serve, ex officio, as chairman 2,470
58
CHAIRPERSON. The governor shall appoint the remaining two 2,471
members with the advice and consent of the senate. One member 2,472
shall be a member of the Ohio self-insurance association and one 2,473
member shall be a representative of labor. Not more than two of 2,474
the three members of the board may be of the same political 2,475
party.
Of the two members originally appointed by the governor 2,477
pursuant to this section, one shall serve an initial term of two 2,478
years and one an initial term of four years. Thereafter, terms 2,479
of office of the two members are for four years, each term ending 2,480
on the same date as the original date of appointment. Any member 2,481
appointed to fill a vacancy occurring prior to the expiration of 2,482
the term for which his THE MEMBER'S predecessor was appointed 2,483
shall hold office for the remainder of such term. Any member 2,484
shall continue in office subsequent to the expiration date of his 2,485
THE MEMBER'S term until his A successor takes office, or until a 2,486
period of sixty days has elapsed, whichever occurs first. A 2,488
vacancy in an unexpired term shall be filled in the same manner 2,489
as the original appointment. The governor may remove any member 2,490
pursuant to section 3.05 of the Revised Code. 2,491
The board member who also is a member of the commission 2,493
shall receive no additional compensation but shall be reimbursed 2,494
for actual and necessary expenses in the performance of his THE 2,495
MEMBER'S duties AS A MEMBER OF THE BOARD. The two remaining 2,496
members of the board shall receive per diem compensation fixed 2,497
pursuant to division (J) of section 124.15 of the Revised Code 2,498
and actual and necessary expenses incurred in the performance of 2,499
their duties.
For administrative purposes, the board is a part of the 2,501
bureau of workers' compensation, and the bureau shall furnish the 2,502
board with necessary office space, staff, and supplies. The 2,503
board shall meet as required by the administrator of workers' 2,504
compensation. 2,505
(B) In addition to the grounds listed in section 4123.35 2,507
59
of the Revised Code pertaining to criteria for being granted the 2,508
status as a self-insuring employer, the grounds upon which the 2,509
administrator may ASSESS A FINE OR PENALTY AGAINST, OR revoke or 2,510
refuse to renew the SELF-INSURING status includes OF A 2,511
SELF-INSURING EMPLOYER INCLUDE failure to comply with any rules 2,512
or orders of the administrator or to pay contributions to the 2,514
self-insuring employers' guaranty fund established by section 2,515
4123.351 of the Revised Code, continued failure to file medical 2,516
reports bearing upon the injury of the claimant, and failure to 2,517
pay compensation or benefits in accordance with law in a timely 2,518
manner. A deficiency in any of the grounds listed in this 2,519
division is sufficient to justify the administrator's ASSESSMENT 2,520
OF A FINE OR PENALTY AGAINST A SELF-INSURING EMPLOYER, OR THE 2,521
revocation or refusal to renew the employer's status as a 2,522
self-insuring employer. THE ADMINISTRATOR, OR THE
ADMINISTRATOR'S DESIGNEE, SHALL HOLD A HEARING, AFTER NOTICE TO 2,523
THE SELF-INSURING EMPLOYER OF THE HEARING, BEFORE ASSESSING A 2,524
FINE OR PENALTY AGAINST A SELF-INSURING EMPLOYER OR REVOKING OR 2,525
REFUSING TO RENEW AN EMPLOYER'S STATUS AS A SELF-INSURING 2,526
EMPLOYER. The administrator need not ASSESS A FINE OR PENALTY 2,528
AGAINST A SELF-INSURING EMPLOYER, OR revoke or refuse to renew an 2,529
employer's status as a self-insuring employer if adequate 2,530
corrective action is taken by the employer pursuant to division 2,531
(C) of this section. THE ADMINISTRATOR, WITH THE ADVICE AND 2,532
CONSENT OF THE WORKERS' COMPENSATION OVERSIGHT COMMISSION, SHALL 2,533
ADOPT RULES IN ACCORDANCE WITH CHAPTER 119. OF THE REVISED CODE 2,536
FOR THE ASSESSMENT OF A FINE OR PENALTY UNDER THIS SECTION 2,537
AGAINST A SELF-INSURING EMPLOYER. ALL SUMS COLLECTED UNDER THIS 2,538
DIVISION SHALL BE PAID INTO THE SELF-INSURANCE ASSESSMENT FUND 2,539
CREATED PURSUANT TO DIVISION (J) OF SECTION 4123.35 OF THE 2,541
REVISED CODE. 2,542
(C) The administrator shall refer to the board all 2,544
complaints or allegations of misconduct against a self-insuring 2,545
employer or questions as to whether a self-insuring employer 2,546
60
continues to meet minimum standards. The board shall investigate 2,547
and may order the employer to take corrective action in 2,548
accordance with the schedule the board fixes. The board's 2,549
determination in this regard need not be made by formal hearing 2,550
but shall be issued in written form and contain the signature of 2,551
at least two board members. If the board determines, after A 2,553
SELF-INSURING EMPLOYER MAY APPEAL THE ADMINISTRATOR'S ASSESSMENT 2,554
OF A FINE OR PENALTY AGAINST A SELF-INSURING EMPLOYER, OR THE 2,555
REVOCATION OF OR REFUSAL TO RENEW THE SELF-INSURING STATUS OF A 2,556
SELF-INSURING EMPLOYER UNDER THIS SECTION, WITHIN THIRTY DAYS 2,557
AFTER RECEIPT OF NOTICE OF THE FINE, PENALTY, REVOCATION, OR 2,558
RENEWAL REFUSAL, TO THE SELF-INSURING EMPLOYERS EVALUATION BOARD. 2,559
THE FILING OF AN APPEAL SHALL STAY THE ADMINISTRATOR'S ORDER. 2,560
AFTER a hearing conducted pursuant to Chapter 119. of the Revised 2,561
Code and the rules of the bureau, that the employer has failed to 2,562
correct the deficiencies within the time fixed by the board or is 2,563
otherwise in violation of this chapter, the board shall recommend 2,565
to the administrator revocation of an employer's status as a
self-insuring employer or such other penalty which may include, 2,566
but is not limited to, probation, or a civil penalty not to 2,567
exceed ten thousand dollars for each failure. A board 2,568
recommendation to revoke an employer's status as a self-insuring 2,569
employer shall be by unanimous vote. A recommendation for any 2,570
other penalty shall be by majority vote. Where the board makes 2,571
recommendations to the administrator for disciplining a 2,572
self-insuring employer, the administrator promptly and fully 2,573
shall implement the recommendations AFFIRM OR VACATE THE 2,575
ASSESSMENT OF A FINE OR PENALTY AGAINST A SELF-INSURING EMPLOYER 2,576
BY MAJORITY VOTE OF THE BOARD. IF THE ADMINISTRATOR DECIDES TO 2,577
REVOKE OR REFUSE TO RENEW THE EMPLOYER'S STATUS AS A 2,578
SELF-INSURING EMPLOYER, THE BOARD'S DECISION TO AFFIRM THE 2,579
ADMINISTRATOR'S DECISION SHALL BE BY UNANIMOUS VOTE. 2,580
Sec. 4123.411. (A) For the purpose of carrying out 2,589
sections 4123.412 to 4123.418 of the Revised Code, the 2,590
61
administrator of workers' compensation, with the advice and 2,592
consent of the workers' compensation oversight commission, shall 2,593
levy an assessment against all employers at a rate, of at least 2,595
five but not to exceed ten cents per one hundred dollars of 2,596
payroll, such rate to be determined annually for each employer 2,597
group listed in divisions (A)(1) to (3) of this section, which 2,598
will produce an amount no greater than the amount the 2,599
administrator estimates to be necessary to carry out such 2,600
sections for the period for which the assessment is levied. In 2,601
the event the amount produced by the assessment is not sufficient 2,602
to carry out such sections the additional amount necessary shall 2,603
be provided from the income produced as a result of investments 2,604
made pursuant to section 4123.44 of the Revised Code. 2,605
Assessments shall be levied according to the following 2,607
schedule: 2,608
(1) Private fund employers, except self-insuring 2,610
employers--in January and July of each year upon gross payrolls 2,611
of the preceding six months; 2,612
(2) Counties and taxing district employers therein, except 2,614
county hospitals that are self-insuring employers--in January of 2,615
each year upon gross payrolls of the preceding twelve months; 2,616
(3) The state as an employer--in January, April, July, and 2,618
October of each year upon gross payrolls of the preceding three 2,619
months. 2,620
Amounts assessed in accordance with this section shall be 2,622
collected from each employer as prescribed in rules the 2,623
administrator adopts. 2,624
The moneys derived from the assessment provided for in this 2,626
section shall be credited to the disabled workers' relief fund 2,627
created by section 4123.412 of the Revised Code. The 2,628
administrator shall establish by rule classifications of 2,629
employers within divisions (A)(1) to (3) of this section and 2,630
shall determine rates for each class so as to fairly apportion 2,631
the costs of carrying out sections 4123.412 to 4123.418 of the 2,632
62
Revised Code. 2,633
(B) For all injuries and disabilities occurring on or 2,636
after January 1, 1987, AND FOR ALL INJURIES, IMPAIRMENTS, AND 2,637
DISABILITIES ARISING ON OR AFTER THE EFFECTIVE DATE OF THIS 2,638
AMENDMENT, the administrator, for the purposes of carrying out 2,640
sections 4123.412 to 4123.418 of the Revised Code, shall levy an 2,641
assessment against all employers at a rate per one hundred 2,642
dollars of payroll, such rate to be determined annually for each 2,643
classification of employer in each employer group listed in 2,644
divisions (A)(1) to (3) of this section, which will produce an
amount no greater than the amount the administrator estimates to 2,645
be necessary to carry out such sections for the period for which 2,646
the assessment is levied. 2,647
Amounts assessed in accordance with this division shall be 2,649
billed at the same time premiums are billed and credited to the 2,650
disabled workers' relief fund created by section 4123.412 of the 2,651
Revised Code. The administrator shall determine the rates for 2,652
each class in the same manner as he THE ADMINISTRATOR fixes the 2,653
rates for premiums pursuant to section 4123.29 of the Revised 2,655
Code.
(C) For a self-insuring employer, the bureau of workers' 2,657
compensation shall pay to employees who are participants 2,658
regardless of the date of injury, any amounts due to the 2,659
participants under section 4123.414 of the Revised Code and shall 2,660
bill the self-insuring employer, semiannually, for all amounts 2,661
paid to a participant. 2,662
Sec. 4123.412. For the relief of persons who are 2,671
permanently and totally disabled IMPAIRED as the result of injury 2,673
or disease sustained in the course of their employment and who 2,674
are receiving workers' compensation which is payable to them by 2,675
virtue of and under the laws of this state in amounts, the total 2,676
of which, when combined with disability benefits received 2,677
pursuant to the Social Security Act is less than three hundred 2,678
forty-two dollars per month adjusted annually as provided in 2,679
63
division (B) of section 4123.62 of the Revised Code, there is 2,680
hereby created a separate fund to be known as the disabled 2,681
workers' relief fund, which fund shall consist of the sums that 2,682
are from time to time appropriated by the general assembly and 2,683
made available to the order of the bureau of workers' 2,684
compensation to carry out the objects and purposes of sections 2,685
4123.412 to 4123.418 of the Revised Code. The fund shall be in 2,686
the custody of the treasurer of the state. Disbursements from 2,687
the fund shall be made by the bureau to those persons entitled to 2,688
participate therein and in amounts to each participant as is 2,689
provided in section 4123.414 of the Revised Code. All investment 2,690
earnings of the fund shall be credited to the fund. 2,691
Sec. 4123.413. To be eligible to participate in said THE 2,700
DISABLED WORKERS' RELIEF fund, a participant must be permanently 2,702
and totally disabled IMPAIRED and be receiving workers' 2,703
compensation payments, the total of which, when combined with 2,704
disability benefits received pursuant to The THE Social Security 2,705
Act is less than three hundred forty-two dollars per month 2,707
adjusted annually as provided in division (B) of section 4123.62 2,708
of the Revised Code.
Sec. 4123.414. Each person determined eligible, pursuant 2,717
to section 4123.413 of the Revised Code, to participate in the 2,718
disabled workers' relief fund is entitled to receive payments, 2,719
without application, from the fund of a monthly amount equal to 2,720
the lesser of the difference between three hundred forty-two 2,721
dollars, adjusted annually pursuant to division (B) of section 2,722
4123.62 of the Revised Code, and: 2,723
(1)(A) The amount he THE PERSON is receiving per month as 2,726
the disability monthly benefits award pursuant to The Social 2,728
Security Act; or
(2)(B) The amount he THE PERSON is receiving monthly under 2,731
the workers' compensation laws for permanent and total disability 2,733
IMPAIRMENT. In determining such difference, a participant shall 2,735
be considered as receiving the amount of such participant's 2,736
64
compensation which shall have been commuted under the provisions 2,737
of section 4123.64 of the Revised Code. Such payments shall be 2,738
made monthly during the period in which such participant is 2,739
permanently and totally disabled IMPAIRED. 2,740
Sec. 4123.416. The administrator of workers' compensation 2,749
shall promptly require of each employer who has elected to pay 2,750
compensation direct under the provisions of section 4123.35 of 2,751
the Revised Code SELF-INSURING EMPLOYER a verified list of the 2,752
names and addresses of all persons to whom the employer is paying 2,754
workers' compensation on account of permanent and total 2,755
disability IMPAIRMENT and the evidence respecting such persons as 2,757
the administrator reasonably deems necessary to determine the 2,758
eligibility of any such person to participate in the disabled 2,759
workers' relief fund. The superintendent of insurance shall 2,760
promptly require of each insurance company which is organized or 2,761
licensed to do business in this state and which has at any time 2,762
written workers' compensation insurance in this state a like 2,763
verified list and like evidence respecting persons to whom the 2,764
insurance companies are paying workers' compensation under the 2,765
Ohio workers' compensation laws and contracts of insurance in 2,766
respect thereof; and the superintendent of insurance shall 2,767
promptly transmit all such lists and evidence to the bureau of 2,768
workers' compensation. Any person claiming the right to 2,769
participate in the fund may file his AN application therefor with 2,770
the bureau and shall be accorded a hearing thereon. 2,771
Sec. 4123.419. The assessment rate established pursuant to 2,780
section 4123.411 of the Revised Code, subject to the limits set 2,781
forth in that section, shall be adequate to provide the amounts 2,782
estimated as necessary by the administrator of workers' 2,783
compensation to carry out the provisions of sections 4123.412 to 2,784
4123.418 of the Revised Code, and in addition to provide moneys 2,785
to reimburse the general revenue fund for moneys appropriated by 2,786
Section 2 of H.B. No. 1131 of the 103rd general assembly or by 2,787
the 104th and succeeding general assemblies for disabled OR 2,788
65
IMPAIRED workers' relief. When the additional moneys are 2,790
available in whole or part for the purpose of making the 2,791
reimbursement, the director of budget and management shall 2,792
certify the amount to the bureau of workers' compensation which 2,793
shall thereupon cause the moneys to be paid to the general 2,794
revenue fund from the disabled workers' relief fund except that 2,795
any amounts due because of the state's obligation as an employer 2,796
pursuant to section 4123.411 of the Revised Code and not paid to 2,797
the disabled workers' relief fund shall be deducted from any such 2,798
reimbursement.
Sec. 4123.511. (A) Within seven days after receipt of any 2,808
claim under this chapter, the bureau of workers' compensation
shall notify the claimant and the employer of the claimant of the 2,809
receipt of the claim and of the facts alleged therein. If the 2,810
bureau receives from a person other than the claimant written or 2,811
telecommunicated information indicating that an injury HAS 2,812
OCCURRED or AN occupational disease has occurred or been 2,813
contracted which THAT may be compensable under this chapter HAS 2,815
BEEN DIAGNOSED BY A LICENSED PHYSICIAN, the bureau shall notify 2,816
the employee and the employer of the information. If the 2,817
information is provided by any method of telecommunication, the 2,818
person providing the information shall provide written 2,819
verification of the information to the bureau according to 2,820
division (E) of section 4123.84 of the Revised Code. The receipt 2,821
of the information in writing, or if by a method of 2,822
telecommunications, the written verification, and the notice by 2,823
the bureau shall be considered an application for compensation 2,824
under section 4123.84 or 4123.85 of the Revised Code provided 2,825
that the conditions of division (E) of section 4123.84 of the 2,826
Revised Code apply to information provided by a method of 2,827
telecommunication. Upon receipt of a claim, the bureau shall 2,828
advise the claimant of the claim number assigned and the 2,829
claimant's right to representation in the processing of a claim 2,830
or to elect no representation. If the bureau determines that a 2,831
66
claim is determined to be a compensable lost time claim, the 2,832
bureau shall notify the claimant and the employer of the 2,833
availability of rehabilitation services. No bureau or industrial 2,834
commission employee shall directly or indirectly convey any 2,835
information in derogation of this right. This section shall in no 2,836
way abrogate the bureau's responsibility to aid and assist a 2,837
claimant in the filing of a claim and to advise the claimant of 2,838
the claimant's rights under the law.
The administrator of workers' compensation shall assign all 2,840
claims and investigations to the bureau service office from which 2,841
investigation and determination may be made most expeditiously. 2,842
The bureau shall investigate the facts concerning an injury 2,844
or occupational disease and ascertain such facts in whatever 2,845
manner is most appropriate and may obtain statements of the 2,846
employee, employer, attending physician, and witnesses in 2,847
whatever manner is most appropriate. 2,848
(B)(1) Except as provided in division (B)(2) of this 2,850
section, in claims other than those in which the employer is a 2,851
self-insuring employer, if the administrator determines under 2,852
division (A) of this section that a claimant is or is not 2,853
entitled to an award of compensation or benefits, the 2,854
administrator shall issue an order, no sooner than twenty-one 2,855
days but no later than twenty-eight days after the sending of the 2,857
notice under division (A) of this section, granting or denying 2,858
the payment of the compensation or benefits, or both as is 2,859
appropriate to the claimant. Notwithstanding the time limitation 2,860
specified in this division for the issuance of an order, if a 2,861
medical examination of the claimant is required by statute, the 2,862
administrator promptly shall schedule the claimant for that
examination and shall issue an order no later than twenty-eight 2,863
days after receipt of the report of the examination. The 2,864
administrator shall notify the claimant and the employer of the 2,866
claimant and their respective representatives in writing of the 2,867
nature of the order and the amounts of compensation and benefit 2,868
67
payments involved. The employer or claimant may appeal the order 2,869
pursuant to division (C) of this section within fourteen days 2,870
after the date of the receipt of the order. The employer and 2,871
claimant may waive, in writing, their rights to an appeal under 2,872
this division.
(2) Notwithstanding the time limitation specified in 2,874
division (B)(1) of this section for the issuance of an order, if 2,875
the employer certifies a claim for payment of compensation or 2,876
benefits, or both, to a claimant, and the administrator has 2,877
completed the investigation of the claim, the payment of benefits 2,879
or compensation, or both, as is appropriate, shall commence upon 2,880
the later of the date of the certification or completion of the 2,881
investigation and issuance of the order by the administrator, 2,882
provided that the administrator shall issue the order no later 2,883
than the time limitation specified in division (B)(1) of this 2,884
section. 2,885
(3) If an appeal is made under division (B)(1) or (2) of 2,887
this section, the administrator shall forward the claim file to 2,888
the appropriate district hearing officer within seven days of the 2,889
appeal. In contested claims other than state fund claims, the 2,890
administrator shall forward the claim within seven days of the 2,891
administrator's receipt of the claim to the commission, which 2,893
shall refer the claim to an appropriate district hearing officer 2,894
for a hearing in accordance with division (C) of this section. 2,895
(C) If an employer or claimant timely appeals the order of 2,897
the administrator issued under division (B) of this section or in 2,898
the case of other contested claims other than state fund claims, 2,899
the commission shall refer the claim to an appropriate district 2,900
hearing officer according to rules the commission adopts under 2,901
section 4121.36 of the Revised Code. The district hearing 2,902
officer shall notify the parties and their respective 2,903
representatives of the time and place of the hearing. 2,904
The district hearing officer shall hold a hearing on a 2,906
disputed issue or claim within forty-five days after the filing 2,908
68
of the appeal under this division and issue a decision within 2,909
seven days after holding the hearing. The district hearing 2,910
officer shall notify the parties and their respective
representatives in writing of the order. Any party may appeal an 2,912
order issued under this division pursuant to division (D) of this 2,913
section within fourteen days after receipt of the order under 2,914
this division. 2,915
(D) Upon the timely filing of an appeal of the order of 2,917
the district hearing officer issued under division (C) of this 2,918
section, the commission shall refer the claim file to an 2,919
appropriate staff hearing officer according to its rules adopted 2,920
under section 4121.36 of the Revised Code. The staff hearing 2,921
officer shall hold a hearing within forty-five days after the 2,922
filing of an appeal under this division and issue a decision 2,923
within seven days after holding the hearing under this division. 2,926
The staff hearing officer shall notify the parties and their 2,927
respective representatives in writing of his THE STAFF HEARING
OFFICER'S order. Any party may appeal an order issued under this 2,929
division pursuant to division (E) of this section within fourteen 2,930
days after receipt of the order under this division. 2,931
(E) Upon the filing of a timely appeal of the order of the 2,933
staff hearing officer issued under division (D) of this section, 2,934
the commission or a designated staff hearing officer, on behalf 2,935
of the commission, shall determine whether the commission will 2,937
hear the appeal. If the commission or the designated staff
hearing officer decides to hear the appeal, the commission or the 2,939
designated staff hearing officer shall notify the parties and 2,940
their respective representatives in writing of the time and place 2,941
of the hearing. The commission shall hold the hearing within 2,942
forty-five days after the filing of the notice of appeal and, 2,943
within seven days after the conclusion of the hearing, the 2,944
commission shall issue its order affirming, modifying, or 2,945
reversing the order issued under division (D) of this section. 2,946
The commission shall notify the parties and their respective 2,947
69
representatives in writing of the order. If the commission or 2,948
the designated staff hearing officer determines not to hear the 2,949
appeal, within fourteen days after the filing of the notice of 2,950
appeal, the commission or the designated staff hearing officer 2,951
shall issue an order to that effect and notify the parties and
their respective representatives in writing of that order. 2,952
Except as otherwise provided in this chapter and Chapters 2,954
4121., 4127., and 4131. of the Revised Code, any party may appeal 2,955
an order issued under this division to the court pursuant to 2,956
section 4123.512 of the Revised Code within sixty days after 2,957
receipt of the order, subject to the limitations contained in 2,958
that section. 2,959
(F) Every notice of an appeal from an order issued under 2,961
divisions (B), (C), (D), and (E) of this section shall state the 2,962
names of the claimant and employer, the number of the claim, the 2,963
date of the decision appealed from, and the fact that the 2,964
appellant appeals therefrom. 2,965
(G) All of the following apply to the proceedings under 2,967
divisions (C), (D), and (E) of this section: 2,968
(1) The parties shall proceed promptly and without 2,970
continuances except for good cause; 2,971
(2) The parties, in good faith, shall engage in the free 2,973
exchange of information relevant to the claim prior to the 2,974
conduct of a hearing according to the rules the commission adopts 2,975
under section 4121.36 of the Revised Code; 2,976
(3) The administrator is a party and may appear and 2,978
participate at all administrative proceedings on behalf of the 2,979
state insurance fund. However, in cases in which the employer is 2,980
represented, the administrator shall neither present arguments 2,981
nor introduce testimony that is cumulative to that presented or 2,982
introduced by the employer or the employer's representative. The 2,983
administrator may file an appeal under this section on behalf of
the state insurance fund; however, except in cases arising under 2,984
section 4123.343 of the Revised Code, the administrator only may 2,985
70
appeal questions of law or issues of fraud when the employer 2,986
appears in person or by representative.
(H) Except as provided in division (J) of this section, 2,988
payments of compensation to a claimant or on behalf of a claimant 2,989
as a result of any order issued under this chapter shall commence 2,990
upon the earlier of the following: 2,991
(1) Fourteen days after the date the administrator issues 2,993
an order under division (B) of this section, unless that order is 2,994
appealed; 2,995
(2) The date when the employer has waived the right to 2,997
appeal a decision issued under division (B) of this section; 2,998
(3) If no appeal of an order has been filed under this 3,000
section or to a court under section 4123.512 of the Revised Code, 3,001
the expiration of the time limitations for the filing of an 3,002
appeal of an order; 3,003
(4) The TWENTY-ONE DAYS AFTER THE date of receipt by the 3,005
employer of an order of a district hearing officer, a staff 3,006
hearing officer, or the industrial commission issued under 3,008
division (C), (D), or (E) of this section. 3,009
(I) No medical benefits payable under this chapter or 3,011
Chapter 4121., 4127., or 4131. of the Revised Code are payable 3,012
until the earlier of the following: 3,013
(1) The date of the issuance of the staff hearing 3,015
officer's order under division (D) of this section; 3,016
(2) The date of the final administrative or judicial 3,018
determination. 3,019
(J) Upon the final administrative or judicial 3,021
determination, if a claimant is found to have received 3,022
compensation to which the claimant was not entitled, the 3,024
claimant's employer, if a self-insuring employer, or the bureau, 3,025
shall withhold from any amount to which the claimant becomes 3,026
entitled pursuant to any claim, past, present, or future, under 3,027
Chapter 4121., 4123., 4127., or 4131. of the Revised Code, the 3,028
amount to which the claimant was not entitled pursuant to the 3,029
71
following criteria:
(1) No withholding for the first twelve weeks of temporary 3,031
total disability compensation pursuant to section 4123.56 of the 3,032
Revised Code shall be made; 3,033
(2) Forty per cent of all awards of compensation paid 3,035
pursuant to sections 4123.56 and 4123.57 of the Revised Code, 3,036
until the amount overpaid is refunded; 3,037
(3) Twenty-five per cent of any compensation paid pursuant 3,039
to section 4123.58 of the Revised Code until the amount overpaid 3,040
is refunded; 3,041
(4) If, pursuant to an appeal under section 4123.512 of 3,043
the Revised Code, the court of appeals or the supreme court 3,044
reverses the allowance of the claim, then no amount of any 3,045
compensation will be withheld. 3,046
(K) If a staff hearing officer or the commission fails to 3,048
issue a decision or the commission fails to refuse to hear an 3,049
appeal within the time periods required by this section, payments 3,050
to a claimant shall cease until the staff hearing officer or 3,051
commission issues a decision or hears the appeal, unless the 3,052
failure was due to the fault or neglect of the employer or the 3,053
employer agrees that the payments should continue for a longer 3,054
period of time. 3,055
(L) Except as provided in section 4123.522 of the Revised 3,057
Code, no appeal is timely filed under this section unless the 3,058
appeal is filed with the time limits set forth in this section. 3,059
(M) No person who is not an employee of the bureau or 3,061
commission or who is not by law given access to the contents of a 3,062
claims file shall have a file in the person's possession. 3,063
Sec. 4123.512. (A) The claimant or the employer may 3,073
appeal an order of the industrial commission made under division 3,074
(E) of section 4123.511 of the Revised Code in any injury or 3,075
occupational disease case, other than a decision as to the extent 3,076
of disability OR IMPAIRMENT, to the court of common pleas of the 3,077
county in which the injury was inflicted or in which the contract 3,079
72
of employment was made if the injury occurred outside the state, 3,080
or in which the contract of employment was made if the exposure 3,081
occurred outside the state. If no common pleas court has 3,082
jurisdiction for the purposes of an appeal by the use of the 3,083
jurisdictional requirements described in this division, the 3,084
appellant may use the venue provisions in the Rules of Civil 3,085
Procedure to vest jurisdiction in a court. If the claim is for 3,086
an occupational disease the appeal shall be to the court of 3,087
common pleas of the county in which the exposure which caused the 3,088
disease occurred. Like appeal may be taken from an order of a 3,089
staff hearing officer made under division (D) of section 4123.511 3,090
of the Revised Code from which the commission has refused to hear 3,091
an appeal. The appellant shall file the notice of appeal with a 3,092
court of common pleas within sixty days after the date of the 3,093
receipt of the order appealed from or the date of receipt of the 3,094
order of the commission refusing to hear an appeal of a staff 3,095
hearing officer's decision under division (D) of section 4123.511 3,096
of the Revised Code. The filing of the notice of the appeal with 3,097
the court is the only act required to perfect the appeal. 3,098
If an action has been commenced in a court of a county 3,100
other than a court of a county having jurisdiction over the 3,101
action, the court, upon notice by any party or upon its own 3,102
motion, shall transfer the action to a court of a county having 3,103
jurisdiction. 3,104
Notwithstanding anything to the contrary in this section, 3,106
if the commission determines under section 4123.522 of the 3,107
Revised Code that an employee, employer, or their respective 3,108
representatives have not received written notice of an order or 3,109
decision which is appealable to a court under this section and 3,110
which grants relief pursuant to section 4123.522 of the Revised 3,111
Code, the party granted the relief has sixty days from receipt of 3,112
the order under section 4123.522 of the Revised Code to file a 3,113
notice of appeal under this section. 3,114
(B) The notice of appeal shall state the names of the 3,116
73
claimant and the employer, the number of the claim, the date of 3,117
the order appealed from, and the fact that the appellant appeals 3,118
therefrom. 3,119
The administrator, the claimant, and the employer shall be 3,121
parties to the appeal and the court, upon the application of the 3,122
commission, shall make the commission a party. The administrator 3,123
shall notify the employer that, if he THE EMPLOYER fails to 3,125
become an active party to the appeal, then the administrator may 3,127
act on behalf of the employer and the results of the appeal could 3,128
have an adverse effect upon the employer's premium rates. 3,129
(C) The attorney general or one or more of his THE 3,131
ATTORNEY GENERAL'S assistants or special counsel designated by 3,133
him THE ATTORNEY GENERAL shall represent the administrator and 3,135
the commission. In the event IF the attorney general or his THE 3,136
ATTORNEY GENERAL'S designated assistants or special counsel are 3,137
absent, the administrator or the commission shall select one or 3,138
more of the attorneys in the employ of the administrator or the 3,139
commission as his THE ADMINISTRATOR'S ATTORNEY or its THE 3,141
COMMISSION'S attorney in the appeal. Any attorney so employed 3,143
shall continue his THE representation during the entire period of 3,144
the appeal and in all hearings thereof except where the continued 3,145
representation becomes impractical.
(D) Upon receipt of notice of appeal the clerk of courts 3,147
shall provide notice to all parties who are appellees and to the 3,148
commission. 3,149
The claimant shall, within thirty days after the filing of 3,151
the notice of appeal, SHALL file a petition containing a 3,152
statement of facts in ordinary and concise language showing a 3,153
cause of action to participate or to continue to participate in 3,154
the fund and setting forth the basis for the jurisdiction of the 3,155
court over the action. Further pleadings shall be had in 3,156
accordance with the Rules of Civil Procedure, provided that 3,157
service of summons on such petition shall not be required. The 3,158
clerk of the court shall, upon receipt thereof, SHALL transmit by 3,159
74
certified mail a copy thereof to each party named in the notice 3,161
of appeal other than the claimant. Any party may file with the 3,162
clerk prior to the trial of the action a deposition of any 3,163
physician taken in accordance with the provisions of the Revised 3,164
Code, which deposition may be read in the trial of the action 3,165
even though the physician is a resident of or subject to service 3,166
in the county in which the trial is had. The bureau of workers' 3,167
compensation shall pay the cost of the deposition filed in court 3,168
and of copies of the deposition for each party from the surplus 3,169
fund and charge the costs thereof against the unsuccessful party 3,170
if the claimant's right to participate or continue to participate 3,171
is finally sustained or established in the appeal. In the event 3,172
the deposition is taken and filed, the physician whose deposition 3,173
is taken is not required to respond to any subpoena issued in the 3,174
trial of the action. The court, or the jury under the 3,175
instructions of the court, if a jury is demanded, shall determine 3,176
the right of the claimant to participate or to continue to 3,177
participate in the fund upon the evidence adduced at the hearing 3,178
of the action. 3,179
(E) The court shall certify its decision to the commission 3,181
and the certificate shall be entered in the records of the court. 3,182
Appeals from the judgment are governed by the law applicable to 3,183
the appeal of civil actions. 3,184
(F) The cost of any legal proceedings authorized by this 3,186
section, including an attorney's fee to the claimant's attorney 3,187
to be fixed by the trial judge, based upon the effort expended, 3,188
in the event the claimant's right to participate or to continue 3,189
to participate in the fund is established upon the final 3,190
determination of an appeal, shall be taxed against the employer 3,191
or the commission if the commission or the administrator rather 3,192
than the employer contested the right of the claimant to 3,193
participate in the fund. The attorney's fee shall not exceed 3,194
twenty-five hundred dollars. 3,195
(G) If the finding of the court or the verdict of the jury 3,197
75
is in favor of the claimant's right to participate in the fund, 3,198
the commission and the administrator shall thereafter proceed in 3,199
the matter of the claim as if the judgment were the decision of 3,200
the commission, subject to the power of modification provided by 3,201
section 4123.52 of the Revised Code. 3,202
(H) An appeal from an order issued under division (E) of 3,204
section 4123.511 of the Revised Code or any action filed in court 3,205
in a case in which an award of compensation has been made shall 3,206
not stay the payment of compensation under the award or payment 3,207
of compensation for subsequent periods of total disability OR 3,208
IMPAIRMENT during the pendency of the appeal. If, in a final 3,210
administrative or judicial action, it is determined that payments 3,211
of compensation or benefits, or both, made to or on behalf of a 3,212
claimant should not have been made, the amount thereof shall be 3,213
charged to the surplus fund under division (B) of section 4123.34 3,214
of the Revised Code. In the event the employer is a state risk, 3,215
the amount shall not be charged to the employer's experience. In 3,216
the event the employer is a self-insuring employer, the 3,217
self-insuring employer shall deduct the amount from the paid 3,218
compensation he reports to the administrator under division (K) 3,219
of section 4123.35 of the Revised Code. All actions and 3,220
proceedings under this section which are the subject of an appeal 3,221
to the court of common pleas or the court of appeals shall be 3,222
preferred over all other civil actions except election causes, 3,223
irrespective of position on the calendar. 3,224
This section applies to all decisions of the commission or 3,226
the administrator on November 2, 1959, and all claims filed 3,227
thereafter are governed by sections 4123.511 and 4123.512 of the 3,228
Revised Code. 3,229
Any action pending in common pleas court or any other court 3,231
on January 1, 1986, under this section is governed by former 3,232
sections 4123.514, 4123.515, 4123.516, and 4123.519 and section 3,233
4123.522 of the Revised Code. 3,234
Sec. 4123.52. The (A)(1) EXCEPT AS OTHERWISE PROVIDED IN 3,243
76
DIVISION (B) OF THIS SECTION, THE jurisdiction of the industrial 3,244
commission and the authority of the administrator of workers' 3,245
compensation over each case is continuing, and the commission may 3,246
make such modification or change with respect to former findings 3,247
or orders with respect thereto, as, in its opinion is justified. 3,248
No EXCEPT AS PROVIDED IN DIVISIONS (A)(1), (B), AND (C) OF THIS 3,250
SECTION, THE COMMISSION SHALL MAKE NO modification or, change nor 3,253
any, finding, or award in ANY CLAIM WITH respect of any claim 3,255
shall be made with respect to disability, compensation,
dependency, or MEDICAL benefits, after six FIVE years from the 3,257
date of injury in the absence of the payment of medical benefits 3,258
under this chapter, in which event the modification, change, 3,259
finding, or award shall be made within six years after the 3,260
payment of medical benefits, or in the absence of payment of 3,262
compensation under section 4123.57, 4123.58, or division (A) or 3,263
(B) of section 4123.56 of the Revised Code or wages in lieu of 3,264
compensation in a manner so as to satisfy the requirements of 3,266
section 4123.84 of the Revised Code, in which event the 3,267
modification, change, finding, or award shall be made within ten 3,268
years from the date of the last payment of compensation or from 3,270
the date of death, nor unless written notice of claim for the 3,271
specific part or parts of the body injured or disabled has been 3,272
given as provided in section 4123.84 or 4123.85 of the Revised 3,274
Code, and the commission shall not make any modification, change, 3,275
finding, or award which shall award compensation for a back 3,276
period in excess of two years prior to the date of filing 3,277
application therefor OR THE DATE OF FIRST DIAGNOSIS OF AN 3,278
OCCUPATIONAL DISEASE, UNLESS COMPENSATION UNDER SECTION 4123.56 3,279
OF THE REVISED CODE, WAGES IN LIEU OF THAT COMPENSATION IN A 3,280
MANNER THAT SATISFIES THE REQUIREMENTS OF SECTION 4123.84 OF THE 3,281
REVISED CODE, COMPENSATION UNDER DIVISION (B) OF SECTION 4123.57 3,284
OR SECTION 4123.58 OR 4123.59 OF THE REVISED CODE, OR MEDICAL 3,285
BENEFITS HAVE BEEN PAID, IN WHICH EVENT, IN CASES IN WHICH 3,286
COMPENSATION OR WAGES IN LIEU OF THAT COMPENSATION HAS BEEN PAID 3,288
77
UNDER SECTION 4123.56 OF THE REVISED CODE, OR IN CASES IN WHICH
COMPENSATION HAS BEEN PAID UNDER DIVISION (B) OF SECTION 4123.57 3,289
OR SECTION 4123.58 OR 4123.59 OF THE REVISED CODE, THE COMMISSION 3,291
MAY ONLY MAKE A MODIFICATION, CHANGE, FINDING, OR AWARD IN A
CLAIM WITH RESPECT TO COMPENSATION, DEPENDENCY, OR MEDICAL 3,292
BENEFITS WITHIN FIVE YEARS AFTER THE DATE OF THE LAST PAYMENT OF 3,293
COMPENSATION UNDER SECTION 4123.56, WAGES IN LIEU OF THAT 3,294
COMPENSATION, OR COMPENSATION UNDER DIVISION (B) OF SECTION 3,295
4123.57 OR SECTION 4123.58 OR 4123.59 OF THE REVISED CODE. 3,297
(2) THE COMMISSION MAY MAKE A MODIFICATION, CHANGE, 3,300
FINDING, OR AWARD IN ANY CLAIM WITH RESPECT TO MEDICAL BENEFITS 3,301
WITHIN FIVE YEARS AFTER THE DATE OF THE LAST TREATMENT FOR WHICH 3,302
MEDICAL BENEFITS HAVE BEEN PAID OR ORDERED TO BE PAID.
(B) IN ALL CASES FOR A CLAIM INVOLVING AN OCCUPATIONAL 3,304
DISEASE DESCRIBED IN DIVISIONS (A) THROUGH (AA) OF SECTION 3,306
4123.68 OF THE REVISED CODE OR OTHER OCCUPATIONAL DISEASE THAT 3,307
RESULTS FROM EXPOSURE TO FIBROSIS-PRODUCING OR TOXIC DUSTS, 3,308
FUMES, MISTS, VAPORS, GASES, OR LIQUIDS, OR OTHER TOXIC
MATERIALS, OR A COMBINATION OF THOSE, THE JURISDICTION OF THE 3,309
COMMISSION AND THE AUTHORITY OF THE ADMINISTRATOR OVER EACH CASE 3,310
IS CONTINUING PURSUANT TO DIVISION (A) OF THIS SECTION, EXCEPT 3,311
THAT THE JURISDICTION TO MAKE A MODIFICATION, CHANGE, FINDING, OR 3,312
AWARD IN THE CLAIM WITH RESPECT TO COMPENSATION, DEPENDENCY, OR 3,313
MEDICAL BENEFITS MAY EXTEND BEYOND THE TIME LIMITATIONS CONTAINED 3,314
IN THAT DIVISION, UP TO A MAXIMUM OF SIX MONTHS AFTER THE DATE AN 3,315
EMPLOYEE FIRST BECOMES TOTALLY DISABLED AS A RESULT OF THE
OCCUPATIONAL DISEASE THAT IS THE SUBJECT OF THE EMPLOYEE'S CLAIM, 3,316
AND THEREAFTER, THE TIME LIMITATIONS CONTAINED IN DIVISION (A) OF 3,317
THIS SECTION APPLY TO THAT CASE. 3,318
(C)(1) IN ALL CASES FOR A CLAIM DESCRIBED IN DIVISION 3,321
(C)(2) OF THIS SECTION, THE JURISDICTION OF THE COMMISSION AND
THE AUTHORITY OF THE ADMINISTRATOR OVER EACH CASE IS CONTINUING, 3,322
EXCEPT THAT THE COMMISSION MAY ONLY MAKE A MODIFICATION, CHANGE, 3,323
FINDING, OR AWARD IN THAT CLAIM WITH RESPECT TO MEDICAL BENEFITS 3,324
78
AND COMPENSATION UNDER SECTION 4123.56 OF THE REVISED CODE OR 3,325
WAGES IN LIEU OF THAT COMPENSATION, SUBJECT TO THE LIMITATION 3,326
DESCRIBED IN DIVISION (C)(3) OF THIS SECTION. 3,327
(2) THIS DIVISION APPLIES ONLY TO A CLAIM INVOLVING AN 3,329
EMPLOYEE TO WHOM EITHER OF THE FOLLOWING APPLIES: 3,330
(a) THE EMPLOYEE HAS AN INTERNAL OR EXTERNAL PROSTHETIC 3,332
DEVICE THAT WAS PROVIDED UNDER AN ALLOWED CLAIM UNDER THIS 3,333
CHAPTER OR CHAPTERS 4121., 4127., OR 4131. OF THE REVISED CODE; 3,334
(b) A DETERMINATION IS MADE THAT THE EMPLOYEE REQUIRES AN 3,336
INTERNAL OR EXTERNAL PROSTHETIC DEVICE AS A DIRECT RESULT OF AN 3,337
ALLOWED CONDITION IN A CLAIM UNDER THIS CHAPTER OR CHAPTERS 3,338
4121., 4127., OR 4131. OF THE REVISED CODE, REGARDLESS OF WHEN 3,339
THAT CLAIM WAS ALLOWED.
(3) COMPENSATION UNDER SECTION 4123.56 OF THE REVISED CODE 3,341
OR WAGES IN LIEU OF THAT COMPENSATION ALLOWED UNDER THIS DIVISION 3,342
SHALL BE FOR A PERIOD NOT TO EXCEED NINE MONTHS AFTER THE DATE OF 3,343
THE MODIFICATION, CHANGE, FINDING, OR AWARD.
(D) UNLESS WRITTEN NOTICE HAS BEEN GIVEN AS PROVIDED IN 3,346
SECTION 4123.84 OR 4123.85 OF THE REVISED CODE, THE COMMISSION 3,348
SHALL MAKE NO MODIFICATION, CHANGE, FINDING, OR AWARD THAT AWARDS 3,349
COMPENSATION FOR A BACK PERIOD IN EXCESS OF TWO YEARS PRIOR TO
THE DATE OF FILING AN APPLICATION FOR THAT COMPENSATION. This 3,350
section does not affect the right of a claimant to compensation 3,352
accruing subsequent to the filing of any such application, 3,353
provided IF the application is filed within the time limit 3,354
provided in this section.
(E) This section does not deprive the commission of its 3,356
continuing jurisdiction to determine the questions raised by any 3,357
application for modification of award which has been filed with 3,358
the commission after June 1, 1932, and prior to the expiration of 3,359
the applicable period but in respect to which no award has been 3,360
granted or denied during the applicable period. 3,361
(F) The commission may, by general rules, MAY provide for 3,364
the destruction of files of cases in which no further action may 3,365
79
be taken. 3,366
The commission and administrator of workers' compensation 3,368
each may, by general rules, MAY provide for the retention and 3,369
destruction of all other records in their possession or under 3,370
their control pursuant to section 121.211 and sections 149.34 to 3,371
149.36 of the Revised Code. The bureau of workers' compensation 3,372
may purchase or rent required equipment for the document 3,373
retention media, as determined necessary to preserve the records. 3,374
Photographs, microphotographs, microfilm, films, or other direct 3,375
document retention media, when properly identified, have the same 3,376
effect as the original record and may be offered in like manner 3,377
and may be received as evidence in any court where the original 3,378
record could have been introduced. 3,379
(G) AS USED IN DIVISION (A) OF THIS SECTION, "MEDICAL 3,381
BENEFITS" MEANS PAYMENTS TO, OR ON BEHALF OF, AN EMPLOYEE FOR A 3,382
HOSPITAL BILL, MEDICAL BILL FOR A LICENSED PHYSICIAN OR HOSPITAL, 3,383
AN ORTHOPEDIC OR PROSTHETIC DEVICE, OR A PRESCRIPTION MEDICATION. 3,384
Sec. 4123.531. THE ADMINISTRATOR OF WORKERS' COMPENSATION 3,386
OR THE INDUSTRIAL COMMISSION MAY REQUIRE ANY EMPLOYEE CLAIMING 3,387
THE RIGHT TO RECEIVE COMPENSATION TO SUBMIT TO A VOCATIONAL 3,388
REHABILITATION EVALUATION. IF THE PERSON WHO CONDUCTS THE 3,389
EVALUATION RECOMMENDS A VOCATIONAL REHABILITATION PLAN FOR THE 3,390
EMPLOYEE, THE EMPLOYEE SHALL COMPLY WITH THE REHABILITATION PLAN. 3,392
IF AN EMPLOYEE REFUSES TO SUBMIT TO ANY VOCATIONAL 3,394
REHABILITATION EVALUATION SCHEDULED PURSUANT TO THIS SECTION OR 3,395
OBSTRUCTS THE EVALUATION, THE EMPLOYEE'S RIGHT TO HAVE THE 3,396
EMPLOYEE'S CLAIM FOR COMPENSATION CONSIDERED, IF THE CLAIM IS 3,397
PENDING BEFORE THE BUREAU OR COMMISSION, OR TO RECEIVE ANY 3,398
PAYMENT FOR COMPENSATION THAT HAS BEEN GRANTED, IS SUSPENDED 3,399
DURING THE PERIOD OF THE REFUSAL OR OBSTRUCTION. 3,400
Sec. 4123.54. Every employee, who is injured or who 3,409
contracts an occupational disease, and the dependents of each 3,410
employee who is killed, or dies as the result of an occupational 3,411
disease contracted in the course of employment, wherever such 3,412
80
injury has occurred or occupational disease has been contracted, 3,413
provided the same were not: 3,414
(A) Purposely self-inflicted; or 3,416
(B) Caused by the employee being intoxicated or under the 3,418
influence of a controlled substance not prescribed by a physician 3,419
where the intoxication or being under the influence of the 3,420
controlled substance not prescribed by a physician was the 3,421
proximate cause of the injury, is entitled to receive, either 3,422
directly from his THE EMPLOYEE'S self-insuring employer as 3,423
provided in section 4123.35 of the Revised Code, or from the 3,425
state insurance fund, the compensation for loss sustained on 3,426
account of the injury, occupational disease, or death, and the 3,427
medical, nurse, and hospital services and medicines, and the 3,428
amount of funeral expenses in case of death, as are provided by 3,429
this chapter.
FOR THE PURPOSE OF THIS DIVISION, IF THE EMPLOYEE, THROUGH 3,431
A CHEMICAL TEST OR A TEST OF THE EMPLOYEE'S BLOOD, BREATH, OR 3,433
URINE ADMINISTERED WITHIN A REASONABLE TIME AFTER THE OCCURRENCE 3,434
OF THE EMPLOYEE'S INJURY, IS DETERMINED TO HAVE AN ALCOHOL 3,436
CONTENT EQUAL TO OR IN EXCESS OF THAT SPECIFIED IN SECTION
4511.19 OF THE REVISED CODE OR HAVE A CONTROLLED SUBSTANCE NOT 3,437
PRESCRIBED BY THE EMPLOYEE'S PHYSICIAN FOR THE EMPLOYEE'S USE IN 3,438
THE EMPLOYEE'S SYSTEM, IT IS A REBUTTABLE PRESUMPTION THAT THE 3,439
EMPLOYEE WAS INTOXICATED OR UNDER THE INFLUENCE OF THE CONTROLLED 3,440
SUBSTANCE AND THAT THAT INTOXICATION OR BEING UNDER THE INFLUENCE
IS THE PROXIMATE CAUSE OF THE INJURY. AN EMPLOYEE'S REFUSAL TO 3,442
SUBMIT TO A CHEMICAL TEST OR A TEST OF THE EMPLOYEE'S BLOOD, 3,443
BREATH, OR URINE IS ADMISSIBLE AS EVIDENCE OF THE EMPLOYEE'S 3,444
INTOXICATION OR BEING UNDER THE INFLUENCE OF A CONTROLLED
SUBSTANCE NOT PRESCRIBED BY A PHYSICIAN AT ANY HEARING PURSUANT 3,445
TO SECTION 4123.511 OF THE REVISED CODE TO DETERMINE THE 3,446
ALLOWANCE OF THE EMPLOYEE'S CLAIM AND ON ANY APPEAL TO COURT 3,447
PURSUANT TO SECTION 4123.512 OF THE REVISED CODE.
IF AN INJURY DESCRIBED IN DIVISION (C)(4) OF SECTION 3,450
81
4123.01 OF THE REVISED CODE OCCURS, COMPENSATION AND MEDICAL 3,451
BENEFITS ARE PAYABLE ONLY FOR THE IMPAIRMENT OR DISABILITY THAT 3,452
RESULTS FROM THE SUBSTANTIAL WORSENING OF THE PREEXISTING 3,453
CONDITION OR IMPAIRMENT OR THE SUBSTANTIAL ACCELERATION OF THE 3,454
DISEASE PROCESS. NO COMPENSATION OR BENEFITS ARE PAYABLE BECAUSE 3,455
OF THE PREEXISTING CONDITION, IMPAIRMENT, OR DISEASE PROCESS ONCE 3,456
THAT CONDITION, IMPAIRMENT, OR DISEASE PROCESS HAS RETURNED TO A 3,457
LEVEL THAT WOULD HAVE EXISTED WITHOUT THE INJURY. 3,458
Whenever, with respect to an employee of an employer who is 3,460
subject to and has complied with this chapter, there is 3,461
possibility of conflict with respect to the application of 3,462
workers' compensation laws because the contract of employment is 3,463
entered into and all or some portion of the work is or is to be 3,464
performed in a state or states other than Ohio, the employer and 3,465
the employee may agree to be bound by the laws of this state or 3,466
by the laws of some other state in which all or some portion of 3,467
the work of the employee is to be performed. The agreement shall 3,468
be in writing and shall be filed with the bureau of workers' 3,469
compensation within ten days after it is executed and shall 3,470
remain in force until terminated or modified by agreement of the 3,471
parties similarly filed. If the agreement is to be bound by the 3,472
laws of this state and the employer has complied with this 3,473
chapter, then the employee is entitled to compensation and 3,474
benefits regardless of where the injury occurs or the disease is 3,475
contracted and the rights of the employee and his THE EMPLOYEE'S 3,476
dependents under the laws of this state are the exclusive remedy 3,478
against the employer on account of injury, disease, or death in 3,479
the course of and arising out of his THE EMPLOYEE'S employment. 3,480
If the agreement is to be bound by the laws of another state and 3,482
the employer has complied with the laws of that state, the rights 3,483
of the employee and his THE EMPLOYEE'S dependents under the laws 3,485
of that state are the exclusive remedy against the employer on 3,486
account of injury, disease, or death in the course of and arising 3,487
out of his THE EMPLOYEE'S employment without regard to the place 3,489
82
where the injury was sustained or the disease contracted. 3,490
If any employee or his THE EMPLOYEE'S dependents are 3,492
awarded workers' compensation benefits or recover damages from 3,494
the employer under the laws of another state, the amount awarded 3,495
or recovered, whether paid or to be paid in future installments, 3,496
shall be credited on the amount of any award of compensation or 3,497
benefits made to the employee or his THE EMPLOYEE'S dependents by 3,498
the bureau. 3,499
If an employee is a resident of a state other than this 3,501
state and is insured under the workers' compensation law or 3,502
similar laws of a state other than this state, the employee and 3,503
his THE EMPLOYEE'S dependents are not entitled to receive 3,504
compensation or benefits under this chapter, on account of 3,506
injury, disease, or death arising out of or in the course of 3,507
employment while temporarily within this state and the rights of 3,508
the employee and his THE EMPLOYEE'S dependents under the laws of 3,509
the other state are the exclusive remedy against the employer on 3,511
account of the injury, disease, or death. 3,512
Compensation or benefits are not payable to a claimant 3,514
during the period of confinement of the claimant in any state or 3,515
federal correctional institution whether in this or any other 3,516
state for conviction of violation of any state or federal 3,517
criminal law.
Sec. 4123.541. In the event that IF any person who is 3,526
entitled to receive benefits for TEMPORARY total disability OR 3,528
PERMANENT TOTAL IMPAIRMENT, loss of member, or death through the 3,530
application of section 4123.033 of the Revised Code, receives, in 3,531
connection with the injury giving rise to such entitlement, 3,532
benefits under an act of congress or federal program providing 3,533
benefits for civil defense workers and their survivors, the 3,534
benefits payable hereunder, shall be reduced in proportion to the 3,535
benefits received under such other act or program.
Sec. 4123.55. No compensation shall be allowed for the 3,544
first week after an injury is received or occupational disease 3,545
83
contracted IS FIRST DIAGNOSED and no compensation shall be 3,548
allowed for the first week of total disability OR IMPAIRMENT,
whenever it may occur, unless and until the employee is totally 3,550
disable DISABLED OR IMPAIRED for a continuous period of two weeks 3,552
or more, in which event compensation for the first week of total 3,553
disability OR IMPAIRMENT, whenever it has occurred, shall be
paid, in addition to any other weekly benefits which are due, 3,555
immediately following the second week of total disability OR 3,556
IMPAIRMENT. There shall be no waiting period in connection with 3,557
the disbursements provided by section 4123.66 of the Revised 3,558
Code.
Sec. 4123.56. (A) Except as provided in division (D)(E) 3,567
of this section, in the case of temporary disability, an employee 3,568
shall receive sixty-six and two-thirds per cent of his THE 3,569
EMPLOYEE'S average weekly wage so long as such disability is 3,571
total, not to exceed a maximum amount of weekly compensation 3,572
which is equal to the statewide average weekly wage as defined in 3,573
division (C) of section 4123.62 of the Revised Code, and not less 3,574
than a minimum amount of compensation which is equal to 3,575
thirty-three and one-third per cent of the statewide average 3,576
weekly wage as defined in division (C) of section 4123.62 of the 3,577
Revised Code unless the employee's wage is less than thirty-three 3,578
and one-third per cent of the minimum statewide average weekly 3,579
wage, in which event he THE EMPLOYEE shall receive compensation 3,580
equal to his THE EMPLOYEE'S full wages; provided that for the 3,582
first twelve weeks of total disability the employee shall receive 3,583
seventy-two per cent of his THE EMPLOYEE'S full weekly wage, but 3,585
not to exceed a maximum amount of weekly compensation which is 3,586
equal to the lesser of the statewide average weekly wage as 3,587
defined in division (C) of section 4123.62 of the Revised Code or 3,588
one hundred per cent of the employee's net take home weekly wage. 3,589
In the case of a self-insuring employer, payments 3,590
AS USED IN THIS DIVISION, "NET TAKE HOME WEEKLY WAGE" MEANS 3,593
THE AMOUNT OBTAINED BY DIVIDING AN EMPLOYEE'S TOTAL REMUNERATION, 3,594
84
AS DEFINED IN SECTION 4141.01 OF THE REVISED CODE, PAID TO OR 3,596
EARNED BY THE EMPLOYEE DURING THE FIRST FOUR OF THE LAST FIVE 3,597
COMPLETED CALENDAR QUARTERS WHICH IMMEDIATELY PRECEDE THE FIRST 3,598
DAY OF THE EMPLOYEE'S ENTITLEMENT TO BENEFITS UNDER THIS 3,599
DIVISION, BY THE NUMBER OF WEEKS DURING WHICH THE EMPLOYEE WAS 3,600
PAID OR EARNED REMUNERATION DURING THOSE FOUR QUARTERS, LESS THE 3,601
AMOUNT OF LOCAL, STATE, AND FEDERAL INCOME TAXES DEDUCTED FOR 3,602
EACH SUCH WEEK. 3,603
(B)(1) IF THE PAYMENT OF COMPENSATION FOR TEMPORARY 3,606
DISABILITY IS COMMENCED VOLUNTARILY BY A SELF-INSURING EMPLOYER, 3,607
PAYMENTS OF COMPENSATION SHALL BE CONTINUED AT THE DISCRETION OF 3,609
THE SELF-INSURING EMPLOYER. WHEN A SELF-INSURING EMPLOYER MAKES 3,611
ITS FIRST PAYMENT OF COMPENSATION TO AN EMPLOYEE UNDER THIS 3,612
DIVISION, THE SELF-INSURING EMPLOYER SHALL NOTIFY THE EMPLOYEE, 3,613
IN WRITING, OF ALL OF THE FOLLOWING: 3,614
(a) THAT THE SELF-INSURING EMPLOYER VOLUNTARILY HAS 3,616
COMMENCED THE PAYMENTS; 3,617
(b) THAT THE SELF-INSURING EMPLOYER MAY TERMINATE THE 3,619
PAYMENTS AT ANY TIME; 3,620
(c) THAT THE EMPLOYEE HAS A RIGHT TO A HEARING ON THE 3,622
EMPLOYEE'S CLAIM; 3,623
(d) IF THE EMPLOYEE'S CLAIM THAT IS THE SUBJECT OF THE 3,625
PAYMENTS COMMENCED UNDER THIS DIVISION IS DETERMINED TO BE VALID, 3,627
THAT ANY COMPENSATION TO WHICH THE EMPLOYEE IS OR BECOMES
ENTITLED UNDER THIS SECTION FOR THAT CLAIM SHALL BE OFFSET BY THE 3,628
PAYMENTS THE EMPLOYEE RECEIVES FROM THE SELF-INSURING EMPLOYER 3,629
UNDER THIS DIVISION. 3,630
A SELF-INSURING EMPLOYER EITHER SHALL CERTIFY OR CONTEST 3,632
THE CLAIM FOR WHICH IT VOLUNTARILY IS MAKING PAYMENTS UNDER THIS 3,633
DIVISION WITHIN SEVENTY-FIVE DAYS AFTER THE SELF-INSURING 3,635
EMPLOYER MAKES THE FIRST PAYMENT OF COMPENSATION TO AN EMPLOYEE 3,636
UNDER THIS DIVISION. A CLAIM IS DEEMED CONTESTED IF THE 3,637
SELF-INSURING EMPLOYER FAILS EITHER TO CERTIFY OR CONTEST THE 3,638
CLAIM WITHIN SEVENTY-FIVE DAYS AFTER MAKING THE FIRST PAYMENT OF 3,639
85
COMPENSATION UNDER THIS DIVISION TO AN EMPLOYEE.
(2) PAYMENT OF COMPENSATION FOR ALL CLAIMS FOR TEMPORARY 3,641
DISABILITY OTHER THAN THOSE DESCRIBED IN DIVISION (B)(1) OF THIS 3,643
SECTION, shall be for a duration based upon the medical reports 3,644
of the attending physician. If the employer disputes the 3,645
attending physician's report, payments may be terminated only 3,646
upon application and hearing by a district hearing officer 3,647
pursuant to division (C) of section 4123.511 of the Revised Code. 3,648
Payments shall continue pending the determination of the matter, 3,649
however, payment shall not be made for the period when any 3,650
employee has returned to work, when an employee's treating 3,651
physician has made a written statement that the employee is 3,652
capable of returning to his THE EMPLOYEE'S former position of 3,653
employment, when work within the physical capabilities of the 3,655
employee is made available by the employer or another employer, 3,656
or when the employee has reached the maximum medical improvement. 3,657
Where IF the employee is capable of work activity, but his THE 3,659
EMPLOYEE'S employer is unable to offer him THE EMPLOYEE any 3,662
employment, the employee shall register with the bureau of 3,664
employment services, which shall assist the employee in finding 3,665
suitable employment. The
(3) THE termination of temporary total disability, whether 3,668
by order or otherwise, does not preclude the commencement of 3,669
temporary total disability at another point in time if the 3,670
employee again becomes temporarily totally disabled.
(4) IF A DISTRICT HEARING OFFICER, STAFF HEARING OFFICER, 3,672
OR THE INDUSTRIAL COMMISSION DETERMINES, BASED UPON THE EVIDENCE, 3,674
THAT AN EMPLOYEE WAS NOT ENTITLED PURSUANT TO THIS CHAPTER OR 3,675
CHAPTER 4121., 4127., OR 4131. OF THE REVISED CODE TO RECEIVE 3,676
TEMPORARY TOTAL DISABILITY COMPENSATION PRIOR TO THE DATE OF THE 3,677
HEARING IN WHICH THAT DETERMINATION IS MADE, THE HEARING OFFICER
OR THE COMMISSION SHALL DECLARE AN OVERPAYMENT EFFECTIVE FROM THE 3,679
DATE THE EMPLOYEE WAS NOT ENTITLED TO RECEIVE THAT COMPENSATION. 3,680
IF THE EMPLOYER PAYS PREMIUMS TO THE STATE INSURANCE FUND, THE 3,681
86
AMOUNT OF THE OVERPAYMENT SHALL NOT BE CHARGED TO THE EMPLOYER'S 3,682
EXPERIENCE. IF THE EMPLOYER IS A SELF-INSURING EMPLOYER, THE 3,683
SELF-INSURING EMPLOYER SHALL DEDUCT THE AMOUNT OF THE OVERPAYMENT 3,684
FROM THE PAID COMPENSATION IT REPORTS TO THE ADMINISTRATOR UNDER 3,685
DIVISION (K) OF SECTION 4123.35 OF THE REVISED CODE. THE 3,686
SELF-INSURING EMPLOYER OR THE BUREAU, AS APPROPRIATE, SHALL 3,687
WITHHOLD THE AMOUNT OF THE OVERPAYMENT FROM ANY AMOUNT TO WHICH 3,688
THE EMPLOYEE BECOMES ENTITLED UNDER ANY CLAIM PAST, PRESENT, OR 3,689
FUTURE UNDER CHAPTER 4121., 4123., 4127., OR 4131. OF THE REVISED 3,690
CODE PURSUANT TO DIVISION (J) OF SECTION 4123.511 OF THE REVISED 3,691
CODE.
(5) After two hundred weeks of temporary total disability 3,693
benefits, the bureau medical section shall schedule the claimant 3,694
EMPLOYEE for an examination for an evaluation to determine 3,695
whether or not the temporary disability has become permanent. A 3,697
self-insuring employer shall notify the bureau of workers' 3,698
compensation immediately after payment of two hundred weeks of 3,699
temporary total disability and request that the bureau of 3,700
workers' compensation schedule the claimant EMPLOYEE for such an 3,701
examination.
(6) When the employee is awarded compensation for 3,703
temporary total disability for a period for which he THE EMPLOYEE 3,704
has received benefits under Chapter 4141. of the Revised Code, 3,706
the bureau of workers' compensation shall pay an amount equal to 3,707
the amount received from the award to the bureau of employment 3,708
services and the administrator OF THE BUREAU of employment 3,709
services shall credit the amount to the accounts of the employers 3,711
to whose accounts the payment of benefits was charged or is 3,712
chargeable to the extent it was charged or is chargeable. 3,713
(7) If any compensation under this section has been paid 3,715
for the same period or periods for which temporary 3,716
nonoccupational accident and sickness insurance is or has been 3,717
paid pursuant to an insurance policy or program to which the 3,718
employer has made the entire contribution or payment for 3,719
87
providing insurance or under a nonoccupational accident and 3,720
sickness program fully funded by the employer, compensation paid 3,721
under this section for the period or periods shall be paid only 3,722
to the extent by which the payment or payments exceeds the amount 3,723
of the nonoccupational insurance or program paid or payable. 3,724
Offset of the compensation shall be made only upon the prior 3,725
order of the bureau of workers' compensation or industrial 3,726
commission or agreement of the claimant. 3,727
As used in this division, "net take home weekly wage" means 3,729
the amount obtained by dividing an employee's total remuneration, 3,730
as defined in section 4141.01 of the Revised Code, paid to or 3,731
earned by the employee during the first four of the last five 3,732
completed calendar quarters which immediately precede the first 3,733
day of the employee's entitlement to benefits under this 3,734
division, by the number of weeks during which the employee was 3,735
paid or earned remuneration during those four quarters, less the 3,736
amount of local, state, and federal income taxes deducted for 3,737
each such week. 3,738
(B) Where (C)(1) IF an employee in a claim allowed under 3,741
this chapter suffers a wage loss as a DIRECT result of returning 3,742
to employment other than his THE EMPLOYEE'S former position of 3,743
employment or as a result of being unable to find employment 3,745
consistent with DUE TO A LIMITATION IN the claimant's physical 3,747
capabilities CAUSED SOLELY BY THE ALLOWED CONDITION OR CONDITIONS 3,748
IN THE EMPLOYEE'S CLAIM, he THE EMPLOYEE shall receive 3,749
compensation at sixty-six and two-thirds per cent of his THE 3,750
DIFFERENCE BETWEEN THE EMPLOYEE'S AVERAGE weekly wage loss AT THE 3,751
TIME OF THE INJURY OR DATE OF DISEASE AND THE EMPLOYEE'S PRESENT 3,752
EARNINGS not to exceed the statewide average weekly wage for a 3,753
period not to exceed two hundred weeks. THE PAYMENTS MAY 3,754
CONTINUE FOR UP TO A MAXIMUM OF TWO HUNDRED WEEKS, BUT THE 3,755
PAYMENTS SHALL BE REDUCED BY THE CORRESPONDING NUMBER OF WEEKS IN 3,756
WHICH THE EMPLOYEE RECEIVES PAYMENTS PURSUANT TO DIVISION (B) OF 3,757
SECTION 4121.67 OF THE REVISED CODE.
88
(2) IF AN EMPLOYEE IN A CLAIM ALLOWED UNDER THIS CHAPTER 3,760
SUFFERS A WAGE LOSS AS A DIRECT RESULT OF BEING UNABLE TO FIND 3,761
EMPLOYMENT CONSISTENT WITH THE EMPLOYEE'S PHYSICAL CAPABILITIES 3,762
RESULTING FROM THE EMPLOYEE'S INJURY OR OCCUPATIONAL DISEASE, THE
EMPLOYEE SHALL RECEIVE COMPENSATION AT SIXTY-SIX AND TWO-THIRDS 3,765
PER CENT OF THE DIFFERENCE BETWEEN THE EMPLOYEE'S AVERAGE WEEKLY 3,766
WAGE AT THE TIME OF THE INJURY OR DATE OF DISEASE AND THE 3,768
EMPLOYEE'S PRESENT EARNINGS, NOT TO EXCEED THE STATEWIDE AVERAGE 3,769
WEEKLY WAGE. THE PAYMENTS MAY CONTINUE FOR UP TO A MAXIMUM OF 3,770
TWENTY-SIX WEEKS; HOWEVER, AN EMPLOYEE IN A CLAIM ALLOWED UNDER 3,771
THIS CHAPTER MAY RECEIVE COMPENSATION UNDER DIVISION (C)(2) OF 3,773
THIS SECTION FOR UP TO A MAXIMUM OF FIFTY-TWO WEEKS IF, AT ANY 3,774
TIME DURING THE PERIOD IN WHICH THE EMPLOYEE IS RECEIVING 3,775
COMPENSATION UNDER DIVISION (C)(2) OF THIS SECTION, THE BENEFIT 3,776
PERIOD FOR UNEMPLOYMENT IS IN EXTENSION PURSUANT TO SECTION 3,777
4141.301 OF THE REVISED CODE. NEITHER THE FILING OF A REQUEST 3,778
FOR NOR THE RECEIPT OF COMPENSATION PURSUANT TO DIVISION (C)(2) 3,780
OF THIS SECTION SHALL AFFECT AN INJURED EMPLOYEE'S APPLICATION 3,781
FOR COMPENSATION PROVIDED UNDER SECTION 4123.58 OF THE REVISED 3,783
CODE.
(3) THE NUMBER OF WEEKS OF WAGE LOSS PAYABLE TO AN 3,785
EMPLOYEE UNDER DIVISIONS (C)(1) AND (2) OF THIS SECTION SHALL NOT 3,786
EXCEED TWO HUNDRED WEEKS IN THE AGGREGATE. 3,787
(4) AS USED IN THIS DIVISION, "DATE OF DISEASE" MEANS THE 3,789
DATE AN OCCUPATIONAL DISEASE IS FIRST DIAGNOSED BY A LICENSED 3,790
PHYSICIAN, OR FOR AN OCCUPATIONAL DISEASE DESCRIBED IN DIVISIONS 3,791
(A) THROUGH (AA) OF SECTION 4123.68 OF THE REVISED CODE, OR OTHER 3,795
OCCUPATIONAL DISEASE THAT RESULTS FROM EXPOSURE TO
FIBROSIS-PRODUCING OR TOXIC DUSTS, FUMES, MISTS, VAPORS, GASES, 3,796
OR LIQUIDS, OR OTHER TOXIC MATERIALS, OR A COMBINATION OF THOSE, 3,797
THE DATE THAT THE EMPLOYEE FIRST MISSES WORK AS A RESULT OF THE 3,798
OCCUPATIONAL DISEASE.
(C)(D) In the event an employee of a professional sports 3,800
franchise domiciled in this state is disabled OR IMPAIRED as the 3,801
89
result of an injury or occupational disease, the total amount of 3,803
payments made under a contract of hire or collective bargaining 3,804
agreement to the employee during a period of disability OR 3,805
IMPAIRMENT is deemed an advanced payment of compensation payable 3,807
under sections 4123.56 to 4123.58 of the Revised Code. The 3,808
employer shall be reimbursed the total amount of the advanced 3,809
payments out of any award of compensation made pursuant to 3,810
sections 4123.56 to 4123.58 of the Revised Code.
(D)(E) If an employee receives temporary total disability 3,812
benefits pursuant to division (A) of this section and social 3,813
security retirement benefits pursuant to the "Social Security 3,814
Act," the weekly benefit amount under division (A) of this 3,815
section shall not exceed sixty-six and two-thirds per cent of the 3,816
statewide average weekly wage as defined in division (C) of 3,817
section 4123.62 of the Revised Code. 3,818
(F) THE COMMENCEMENT OF THE PAYMENT OF COMPENSATION UNDER 3,821
DIVISION (B) OF THIS SECTION SHALL NOT CONSTITUTE A RECOGNITION 3,823
BY A SELF-INSURING EMPLOYER OF A CLAIM OR OF A CONDITION IN THE 3,824
CLAIM AS COMPENSABLE, BUT SHALL DO NO MORE THAN SATISFY THE 3,825
REQUIREMENTS OF SECTION 4123.84 OF THE REVISED CODE. 3,827
Sec. 4123.57. Partial disability compensation shall be 3,837
paid as follows.
(A)(1) Except as provided in DIVISION (A)(2) OF this 3,839
section, not earlier than forty weeks after the date of 3,841
termination of the latest period of payments under section 3,842
4123.56 of the Revised Code, or not earlier than forty weeks 3,843
after the date of the injury or contraction THE DATE OF FIRST 3,844
DIAGNOSIS of an occupational disease BY A LICENSED PHYSICIAN in 3,845
the absence of payments under section 4123.56 of the Revised 3,846
Code, the AN employee may file an application with the bureau of 3,847
workers' compensation for the determination of the percentage of 3,849
his THE EMPLOYEE'S permanent partial disability IMPAIRMENT 3,851
resulting from the AN injury or occupational disease. 3,852
(2) AN EMPLOYEE MAY FILE THE APPLICATION SPECIFIED IN 3,855
90
DIVISION (A)(1) OF THIS SECTION WITHOUT WAITING FORTY WEEKS WHEN 3,857
EITHER OF THE FOLLOWING OCCURS:
(a) THE RECEIPT OF PAYMENTS UNDER DIVISION (A) OF SECTION 3,860
4123.56 OF THE REVISED CODE IS TERMINATED BY A HEARING OFFICER 3,862
BECAUSE THE EMPLOYEE HAS REACHED MAXIMUM MEDICAL IMPROVEMENT. 3,864
(b) THE RECEIPT OF BENEFITS UNDER DIVISION (A) OF SECTION 3,867
4123.56 OF THE REVISED CODE IS TERMINATED BECAUSE THE EMPLOYEE'S 3,868
ATTENDING PHYSICIAN CERTIFIES THAT THE EMPLOYEE HAS REACHED 3,869
MAXIMUM MEDICAL IMPROVEMENT.
(3) Whenever the AN application is filed UNDER DIVISION 3,872
(A)(1) OR (2) OF THIS SECTION, the bureau shall send a copy of 3,873
the application to the employee's employer or the employer's 3,874
representative and shall schedule the employee for a medical 3,875
examination by the bureau medical section. The bureau shall send 3,876
a copy of the report of the medical examination to the employee, 3,877
the employer, and their representatives. Thereafter, the 3,878
administrator of workers' compensation shall review the
employee's claim file and make a tentative order as the evidence 3,879
before him at the time of the making of the order warrants. If 3,880
the administrator determines that there is a conflict of 3,881
evidence, he shall send the application, along with the 3,882
claimant's file, to the district hearing officer who shall set 3,883
the application for a hearing THE REPORT OF THE MEDICAL 3,884
EXAMINATION SHALL CONTAIN A STATEMENT OF THE EXAMINER'S FINDING 3,886
ON THE EMPLOYEE'S PERCENTAGE OF PERMANENT PARTIAL IMPAIRMENT 3,887
RESULTING FROM ALLOWED CONDITIONS IN THE CLAIM UNDER THE MOST 3,888
RECENT EDITION OF THE AMERICAN MEDICAL ASSOCIATION'S GUIDES TO 3,890
THE EVALUATION OF PERMANENT IMPAIRMENT. AFTER RECEIVING THE 3,891
REPORT OF THE MEDICAL EXAMINATION, THE ADMINISTRATOR OF WORKERS' 3,892
COMPENSATION SHALL MAKE A TENTATIVE ORDER FINDING THAT THE 3,893
EMPLOYEE'S PERCENTAGE OF PERMANENT PARTIAL IMPAIRMENT IS THE SAME 3,894
PERCENTAGE SHOWN BY THE REPORT OF THE MEDICAL EXAMINATION, UNLESS 3,895
THE ADMINISTRATOR DETERMINES THAT THE REPORT CLEARLY IS 3,896
ERRONEOUS. IF THE ADMINISTRATOR DETERMINES THAT THE REPORT 3,897
91
CLEARLY IS ERRONEOUS, THE ADMINISTRATOR SHALL DISREGARD THE 3,898
REPORT, SCHEDULE THE EMPLOYEE FOR ANOTHER EXAMINATION BY THE 3,899
BUREAU MEDICAL SECTION, AND ISSUE A TENTATIVE ORDER THAT FINDS 3,900
THAT THE EMPLOYEE'S PERCENTAGE OF PERMANENT PARTIAL IMPAIRMENT IS 3,901
THE SAME PERCENTAGE SHOWN BY THE SECOND MEDICAL EXAMINATION 3,902
REPORT. 3,903
(4) The administrator shall notify the employee, the 3,905
employer, and their representatives, in writing, of the tentative 3,906
order and of the parties' right to request a hearing. Unless the 3,907
employee, the employer, or their representative notifies the 3,908
administrator, in writing, of an objection to the tentative order 3,909
within twenty days after receipt of the notice thereof, the 3,910
tentative order shall go into effect and the employee shall 3,911
receive the compensation provided in the order. In no event 3,912
shall there be a reconsideration of a tentative order issued 3,913
under this division WITHIN FOURTEEN DAYS AFTER RECEIPT OF THE 3,914
TENTATIVE ORDER, THE EMPLOYEE, THE EMPLOYER, OR THEIR 3,915
REPRESENTATIVES, MAY FILE WITH THE BUREAU AN OBJECTION TO THE 3,917
TENTATIVE ORDER. THE OPPOSING PARTY MUST BE SERVED BY THE FILING 3,919
PARTY WITH A COPY OF THE OBJECTION TO THE TENTATIVE ORDER NOT
LATER THAN THE DAY OF FILING. PROPER MAILING OF THE OBJECTION TO 3,921
THE TENTATIVE ORDER TO THE OPPOSING PARTY CONSTITUTES SERVICE. 3,922
IF AN OBJECTION TO THE TENTATIVE ORDER IS NOT FILED BY A PARTY BY 3,923
THE DEADLINE ESTABLISHED BY DIVISION (A)(4) OF THIS SECTION, THE 3,924
ORDER BECOMES FINAL. 3,925
(5) If the employee, the employer, or their 3,927
representatives timely notify the administrator of an objection 3,928
to the tentative order, EITHER PARTY, WITHIN FOURTEEN DAYS AFTER 3,931
THE DATE OF FILING OR OF RECEIPT OF AN OBJECTION, WHICHEVER IS
LATER, MAY REQUEST ANOTHER EXAMINATION BY THE BUREAU MEDICAL 3,933
SECTION. THE PARTY REQUESTING THAT EXAMINATION SHALL PAY THE 3,934
COST OF THAT EXAMINATION. UPON THAT REQUEST, THE BUREAU SHALL 3,935
SCHEDULE THE EMPLOYEE FOR ANOTHER MEDICAL EXAMINATION BY THE 3,937
BUREAU MEDICAL SECTION. ALL PROVISIONS OF DIVISION (A)(3) OF 3,938
92
THIS SECTION APPLICABLE TO THE FIRST MEDICAL EXAMINATION APPLY TO 3,939
A SUBSEQUENT MEDICAL EXAMINATION REQUESTED PURSUANT TO DIVISION 3,940
(A)(5) OF THIS SECTION. THE BUREAU SHALL SEND A COPY OF THE 3,941
REPORT OF THE MEDICAL EXAMINATION TO THE EMPLOYEE, THE EMPLOYER, 3,942
AND THEIR REPRESENTATIVES.
UPON THE FILING OF AN OBJECTION TO THE TENTATIVE ORDER OR 3,944
UPON THE COMPLETION OF THE MEDICAL EXAMINATION REQUESTED PURSUANT 3,945
TO DIVISION (A)(5) OF THIS SECTION, WHICHEVER IS LATER, the 3,948
matter shall be referred to a district hearing officer who shall 3,949
set the application for hearing with written notices to all 3,950
interested persons. Upon referral to a district hearing officer, 3,951
the employer may obtain a medical examination of the employee, 3,952
pursuant to rules of the industrial commission AT THE HEARING, 3,953
THE DISTRICT HEARING OFFICER FIRST SHALL MAKE A FINDING AS TO
WHETHER ANY OF THE FOLLOWING HAS OCCURRED: 3,955
(a) THE BUREAU MEDICAL SECTION BASED ITS REPORT, AT LEAST 3,958
IN PART, ON CONDITIONS NOT ALLOWED IN THE CLAIM;
(b) THE BUREAU MEDICAL SECTION FAILED TO CONSIDER ALL OF 3,961
THE ALLOWED CONDITIONS IN THE CLAIM;
(c) THE BUREAU MEDICAL SECTION'S EXAMINER WAS PREJUDICED 3,964
AGAINST THE EMPLOYER OR THE EMPLOYEE;
(d) THE TENTATIVE ORDER PROVIDES FOR THE PAYMENT OF 3,966
COMPENSATION UNDER A CIRCUMSTANCE IN WHICH THAT COMPENSATION IS 3,967
BARRED BY THIS SECTION OR ANY OTHER PROVISION OF LAW. 3,968
(A) The district hearing officer, upon the application, 3,971
shall determine the percentage of the employee's permanent
disability, except as is subject to division (B) of this section, 3,972
based upon that condition of the employee resulting from the 3,973
injury or occupational disease and causing permanent impairment 3,974
evidenced by medical or clinical findings reasonably 3,975
demonstrable. The employee shall receive sixty-six and 3,976
two-thirds per cent of his average weekly wage, but not more than 3,977
a maximum of thirty-three and one-third per cent of the statewide 3,978
average weekly wage as defined in division (C) of section 4123.62 3,979
93
of the Revised Code, per week regardless of the average weekly 3,980
wage, for the number of weeks which equals the percentage of two 3,981
hundred weeks. Except on application for reconsideration, 3,982
review, or modification, which is filed within ten days after the 3,983
date of receipt of the decision of the district hearing officer, 3,984
in no instance shall the former award be modified unless it is 3,985
found from medical or clinical findings that the condition of the 3,986
claimant resulting from the injury has so progressed as to have 3,987
increased the percentage of permanent partial disability. A 3,988
staff hearing officer shall hear an application for 3,989
reconsideration filed and his decision is final. An IF THE 3,990
DISTRICT HEARING OFFICER FINDS ONE OF THE SITUATIONS DESCRIBED IN 3,992
DIVISION (A)(5)(a), (b), OR (c) OF THIS SECTION, THE DISTRICT 3,993
HEARING OFFICER SHALL ISSUE AN ORDER REJECTING THE REPORT OF THE 3,994
MEDICAL EXAMINATION AND REQUIRING THE BUREAU MEDICAL SECTION TO 3,995
PERFORM A NEW MEDICAL EXAMINATION. ALL PROVISIONS OF THIS 3,996
DIVISION APPLICABLE TO THE FIRST MEDICAL EXAMINATION AND THE 3,998
DETERMINATION OF THE PERCENTAGE OF PERMANENT PARTIAL IMPAIRMENT
APPLY TO ANY SUBSEQUENT MEDICAL EXAMINATION THAT IS ORDERED UNDER 3,999
THIS DIVISION. IF THE DISTRICT HEARING OFFICER FINDS THE 4,001
SITUATION DESCRIBED IN DIVISION (A)(5)(d) OF THIS SECTION, THE 4,003
DISTRICT HEARING OFFICER SHALL ISSUE AN ORDER DENYING THE 4,004
APPLICATION. IF THE DISTRICT HEARING OFFICER FINDS NONE OF THE 4,005
SITUATIONS DESCRIBED IN DIVISION (A)(5)(A), (B), (C), OR (D) OF 4,008
THIS SECTION, THE DISTRICT HEARING OFFICER SHALL ISSUE AN ORDER 4,009
FINDING THAT THE EMPLOYEE'S PERCENTAGE OF PERMANENT PARTIAL 4,010
IMPAIRMENT IS THE SAME PERCENTAGE SHOWN BY EITHER THE FIRST OR 4,011
ANY SUBSEQUENT BUREAU MEDICAL EXAMINATION REPORT. 4,012
(6) AN employee may file an application for a subsequent 4,015
determination of the percentage of his THE EMPLOYEE'S permanent 4,016
disability IMPAIRMENT. NO APPLICATION FOR SUBSEQUENT PERCENTAGE 4,018
DETERMINATIONS ON THE SAME CLAIM FOR INJURY OR OCCUPATIONAL
DISEASE SHALL BE ACCEPTED UNLESS SUPPORTED BY SUBSTANTIAL 4,019
EVIDENCE OF NEW AND CHANGED CIRCUMSTANCES DEVELOPING SINCE THE 4,020
94
TIME OF THE LAST DETERMINATION. If such an application is filed 4,022
UNDER DIVISION (A)(6) OF THIS SECTION, the bureau shall send a 4,023
copy of the application to the employer or the employer's 4,024
representative. No sooner than sixty days from the date of the 4,025
mailing of the application to the employer or the employer's 4,026
representative, the administrator shall review the application. 4,027
The administrator may require a medical examination or medical 4,028
review of the employee. The administrator shall issue a 4,029
tentative order based upon the evidence before him, provided that 4,030
if he requires a medical examination or medical review, the 4,031
administrator shall not issue the tentative order until the 4,032
completion of the examination or review. 4,033
The employer may obtain a medical examination of the 4,035
employee and may submit medical evidence at any stage of the 4,036
process up to a hearing before the district hearing officer, 4,037
pursuant to rules of the commission. The administrator shall 4,038
notify the employee, the employer, and their representatives, in 4,039
writing, of the nature and amount of any tentative order issued 4,040
on an application requesting a subsequent determination of the 4,041
percentage of an employee's permanent disability. An employee, 4,042
employer, or their representatives may object to the tentative 4,043
order within twenty days after the receipt of the notice thereof. 4,044
If no timely objection is made, the tentative order shall go into 4,045
effect. In no event shall there be a reconsideration of a 4,046
tentative order issued under this division. If an objection is 4,047
timely made, the application for a subsequent determination shall 4,048
be referred to a district hearing officer who shall set the 4,049
application for a hearing with written notice to all interested 4,050
persons. No application for subsequent percentage determinations 4,051
on the same claim for injury or occupational disease shall be 4,052
accepted for review by the district hearing officer unless 4,053
supported by substantial evidence of new and changed 4,054
circumstances developing since the time of the hearing on the 4,055
original or last determination. 4,056
95
No award shall be made under this division based upon a 4,059
percentage of disability which, when taken with all other 4,061
percentages of permanent disability, exceeds one hundred per 4,063
cent. If the percentage of the permanent disability of the 4,064
employee equals or exceeds ninety per cent, compensation for
permanent partial disability shall be paid for two hundred weeks. 4,067
TREAT THE APPLICATION AS THOUGH IT WAS AN ORIGINAL APPLICATION 4,068
FOR THE DETERMINATION OF THE PERCENTAGE OF PERMANENT PARTIAL 4,069
IMPAIRMENT. IN NO INSTANCE SHALL THE FORMER AWARD BE MODIFIED 4,070
UNLESS IT IS FOUND FROM MEDICAL OR CLINICAL FINDINGS THAT THE
CONDITION OF THE EMPLOYEE RESULTING FROM THE INJURY OR 4,071
OCCUPATIONAL DISEASE HAS SO PROGRESSED AS TO HAVE INCREASED THE 4,073
PERCENTAGE OF PERMANENT PARTIAL IMPAIRMENT. ALL PROVISIONS OF 4,074
THIS DIVISION APPLICABLE TO AN ORIGINAL APPLICATION APPLY TO AN 4,075
APPLICATION FOR SUBSEQUENT DETERMINATION. THE DECISION OF A 4,077
DISTRICT HEARING OFFICER ON AN EMPLOYEE'S APPLICATION FILED UNDER
DIVISION (A)(1), (2), AND (6) OF THIS SECTION IS FINAL. 4,080
(7) Compensation payable under this division (A) OF THIS 4,083
SECTION accrues and is payable to the employee from the date of 4,085
last payment of compensation, or, in cases where no previous 4,086
compensation has been paid, from the date of the injury or the 4,087
date of the FIRST diagnosis of the occupational disease BY A 4,088
LICENSED PHYSICIAN. THE EMPLOYEE SHALL RECEIVE SIXTY-SIX AND 4,089
TWO-THIRDS PER CENT OF THE EMPLOYEE'S AVERAGE WEEKLY WAGE, BUT 4,090
NOT MORE THAN A MAXIMUM OF THIRTY-THREE AND ONE-THIRD PER CENT OF 4,091
THE STATEWIDE AVERAGE WEEKLY WAGE AS DEFINED IN DIVISION (C) OF 4,093
SECTION 4123.62 OF THE REVISED CODE, PER WEEK REGARDLESS OF THE 4,094
AVERAGE WEEKLY WAGE FOR THE NUMBER OF WEEKS THAT EQUALS THE 4,095
PERCENTAGE OF TWO HUNDRED WEEKS. IF THE PERCENTAGE OF THE 4,097
PERMANENT IMPAIRMENT OF THE EMPLOYEE EQUALS OR EXCEEDS NINETY PER 4,098
CENT, COMPENSATION FOR PERMANENT PARTIAL IMPAIRMENT SHALL BE PAID 4,099
FOR TWO HUNDRED WEEKS. NO AWARD SHALL BE MADE UNDER DIVISION (A) 4,100
OF THIS SECTION BASED UPON A PERCENTAGE OF IMPAIRMENT THAT, WHEN 4,101
TAKEN WITH ALL OTHER PERCENTAGES OF PERMANENT IMPAIRMENT, EXCEEDS 4,102
96
ONE HUNDRED PER CENT. NOTWITHSTANDING DIVISION (H) OF SECTION 4,103
4123.511 OF THE REVISED CODE, THE BUREAU OR A SELF-INSURING 4,105
EMPLOYER SHALL PAY A PERMANENT PARTIAL IMPAIRMENT AWARD WITHIN 4,106
TWENTY-ONE DAYS AFTER THE DATE ON WHICH AN ORDER FIXING THE 4,108
EMPLOYEE'S PERCENTAGE OF PERMANENT PARTIAL IMPAIRMENT BECOMES 4,109
FINAL.
(8) When an award under this division (A) OF THIS SECTION 4,112
has been made prior to the death of an employee, all unpaid 4,114
installments accrued or to accrue under the provisions of the 4,115
award are payable to the surviving spouse, or if there is no 4,116
surviving spouse, to the dependent children of the employee, and 4,117
if there are no children surviving, then to other dependents as 4,118
the administrator determines. 4,119
(B) In cases included in the following schedule the 4,121
compensation payable per week to the employee is the statewide 4,122
average weekly wage as defined in division (C) of section 4123.62 4,123
of the Revised Code per week and shall continue during the 4,124
periods provided in the following schedule: 4,125
For the loss of a thumb, sixty weeks. 4,127
For the loss of a first finger, commonly called index 4,129
finger, thirty-five weeks. 4,130
For the loss of a second finger, thirty weeks. 4,132
For the loss of a third finger, twenty weeks. 4,134
For the loss of a fourth finger, commonly known as the 4,136
little finger, fifteen weeks. 4,137
The loss of a second, or distal, phalange of the thumb is 4,139
considered equal to the loss of one half of such thumb; the loss 4,140
of more than one half of such thumb is considered equal to the 4,141
loss of the whole thumb. 4,142
The loss of the third, or distal, phalange of any finger is 4,144
considered equal to the loss of one-third of the finger. 4,145
The loss of the middle, or second, phalange of any finger 4,147
is considered equal to the loss of two-thirds of the finger. 4,148
The loss of more than the middle and distal phalanges of 4,150
97
any finger is considered equal to the loss of the whole finger. 4,151
In no case shall the amount received for more than one finger 4,152
exceed the amount provided in this schedule for the loss of a 4,153
hand. 4,154
For the loss of the metacarpal bone (bones of the palm) for 4,156
the corresponding thumb, or fingers, add ten weeks to the number 4,157
of weeks under this division. 4,158
For ankylosis (total stiffness of) or contractures (due to 4,160
scars or injuries) which makes any of the fingers, thumbs, or 4,161
parts of either useless, the same number of weeks apply to the 4,162
members or parts thereof as given for the loss thereof. 4,163
If the claimant has suffered the loss of two or more 4,165
fingers by amputation or ankylosis and the nature of his THE 4,166
CLAIMANT'S employment in the course of which the claimant was 4,168
working at the time of the injury or occupational disease is such 4,169
that the handicap or disability IMPAIRMENT resulting from the 4,170
loss of fingers, or loss of use of fingers, exceeds the normal 4,172
handicap or disability IMPAIRMENT resulting from the loss of 4,174
fingers, or loss of use of fingers, the administrator may take 4,175
that fact into consideration and increase the award of 4,176
compensation accordingly, but the award made shall not exceed the 4,177
amount of compensation for loss of a hand. 4,178
For the loss of a hand, one hundred seventy-five weeks. 4,180
For the loss of an arm, two hundred twenty-five weeks. 4,182
For the loss of a great toe, thirty weeks. 4,184
For the loss of one of the toes other than the great toe, 4,186
ten weeks. 4,187
The loss of more than two-thirds of any toe is considered 4,189
equal to the loss of the whole toe. 4,190
The loss of less than two-thirds of any toe is considered 4,192
no loss, except as to the great toe; the loss of the great toe up 4,193
to the interphalangeal joint is co-equal to the loss of one-half 4,194
of the great toe; the loss of the great toe beyond the 4,195
interphalangeal joint is considered equal to the loss of the 4,196
98
whole great toe. 4,197
For the loss of a foot, one hundred fifty weeks. 4,199
For the loss of a leg, two hundred weeks. 4,201
For the loss of the sight of an eye, one hundred 4,203
twenty-five weeks. 4,204
For the permanent partial loss of sight of an eye, the 4,206
portion of one hundred twenty-five weeks as the administrator in 4,207
each case determines, based upon the percentage of vision 4,208
actually lost as a result of the injury or occupational disease, 4,209
but, in no case shall an award of compensation be made for less 4,210
than twenty-five per cent loss of uncorrected vision. "Loss of 4,211
uncorrected vision" means the percentage of vision actually lost 4,212
as the result of the injury or occupational disease. 4,213
For the permanent and total loss of hearing of one ear, 4,215
twenty-five weeks; but in no case shall an award of compensation 4,216
be made for less than permanent and total loss of hearing of one 4,217
ear. 4,218
For the permanent and total loss of hearing, one hundred 4,220
twenty-five weeks; but, except pursuant to the next preceding 4,221
paragraph, in no case shall an award of compensation be made for 4,222
less than permanent and total loss of hearing. 4,223
In case an injury or occupational disease results in 4,225
serious facial or head disfigurement which either impairs or may 4,226
in the future impair the opportunities to secure or retain 4,227
employment, the administrator shall make an award of compensation 4,228
as it THE ADMINISTRATOR deems proper and equitable, in view of 4,229
the nature of the disfigurement, and not to exceed the sum of 4,231
five thousand dollars. For the purpose of making the award, it 4,232
is not material whether the employee is gainfully employed in any 4,233
occupation or trade at the time of the administrator's 4,234
determination.
When an award under this division has been made prior to 4,236
the death of an employee all unpaid installments accrued or to 4,237
accrue under the provisions of the award shall be payable to the 4,238
99
surviving spouse, or if there is no surviving spouse, to the 4,239
dependent children of the employee and if there are no such 4,240
children, then to such dependents as the administrator 4,241
determines. 4,242
When an employee has sustained the loss of a member by 4,244
severance, but no award has been made on account thereof prior to 4,245
his THE EMPLOYEE'S death, the administrator shall make an award 4,246
in accordance with this division for the loss which shall be 4,248
payable to the surviving spouse, or if there is no surviving 4,249
spouse, to the dependent children of the employee and if there 4,250
are no such children, then to such dependents as the 4,251
administrator determines. 4,252
(C) Compensation for partial disability IMPAIRMENT under 4,254
divisions (A) and (B) of this section is in addition to the 4,256
compensation paid the employee pursuant to section 4123.56 of the 4,257
Revised Code. A claimant may receive compensation under 4,258
divisions (A) and (B) of this section. NO EMPLOYEE MAY RECEIVE 4,259
COMPENSATION UNDER DIVISION (A) OF THIS SECTION OR RECEIVE A 4,261
MEDICAL EXAMINATION PROVIDED FOR BY THIS SECTION DURING THE TIME 4,262
IN WHICH THAT EMPLOYEE IS RECEIVING COMPENSATION UNDER SECTION
4123.58 OF THE REVISED CODE IN ANY CLAIM OR IS RECEIVING 4,265
COMPENSATION UNDER SECTION 4123.56 OF THE REVISED CODE ON THE 4,267
SAME CLAIM IN WHICH THE EMPLOYEE IS SEEKING COMPENSATION UNDER 4,268
THIS SECTION. THE EMPLOYEE SHALL LIST ON THE APPLICATION 4,269
SPECIFIED IN DIVISIONS (A)(1) AND (2) OF THIS SECTION THE CLAIM 4,270
NUMBERS OF ALL OTHER CLAIMS FOR WHICH THE EMPLOYEE IS A CLAIMANT. 4,271
In all cases arising under division (B) of this section, if 4,273
it is determined by any one of the following: (1) the amputee 4,274
clinic at University hospital, Ohio state university; (2) the 4,275
rehabilitation services commission; (3) an amputee clinic or 4,276
prescribing physician approved by the administrator or his THE 4,277
ADMINISTRATOR'S designee, that an injured or disabled IMPAIRED 4,279
employee is in need of an artificial appliance, or in need of a 4,281
repair thereof, regardless of whether the appliance or its repair 4,282
100
will be serviceable in the vocational rehabilitation of the 4,283
injured employee, and regardless of whether the employee has 4,284
returned to or can ever again return to any gainful employment, 4,285
the bureau shall pay the cost of the artificial appliance or its 4,286
repair out of the surplus created by division (B) of section 4,287
4123.34 of the Revised Code.
In those cases where a rehabilitation services commission 4,289
recommendation that an injured or disabled IMPAIRED employee is 4,290
in need of an artificial appliance would conflict with their 4,292
state plan, adopted pursuant to the "Rehabilitation Act of 1973," 4,293
87 Stat. 355, 29 U.S.C.A. 701, the administrator or his THE 4,294
ADMINISTRATOR'S designee or the bureau may obtain a 4,296
recommendation from an amputee clinic or prescribing physician 4,297
that they determine appropriate.
(D) If an employee of a state fund employer makes 4,299
application for a finding and the administrator finds that he has 4,301
IS FOUND TO HAVE contracted silicosis as defined in division (X), 4,302
or coal miners' pneumoconiosis as defined in division (Y), or 4,303
asbestosis as defined in division (AA) of section 4123.68 of the 4,304
Revised Code, and IT IS FOUND that a change of such employee's 4,305
occupation is medically advisable in order to decrease 4,307
substantially further exposure to silica dust, asbestos, or coal 4,308
dust and if the employee, after the finding, has changed or shall 4,309
change his THE EMPLOYEE'S occupation to an occupation in which 4,311
the exposure to silica dust, asbestos, or coal dust is 4,312
substantially decreased, the administrator shall allow to the 4,313
employee SHALL RECEIVE an amount equal to fifty per cent of the 4,314
statewide average weekly wage per week for a period of thirty 4,315
weeks, commencing as of the date of the discontinuance or change, 4,316
and for a period of one hundred weeks immediately following the 4,317
expiration of the period of thirty weeks the administrator shall 4,318
allow, the employee SHALL RECEIVE sixty-six and two-thirds per 4,320
cent of the loss of wages resulting directly and solely from the 4,321
change of occupation but not to exceed a maximum of an amount 4,322
101
equal to fifty per cent of the statewide average weekly wage per 4,323
week. No such employee is entitled to receive more than one 4,324
allowance on account of discontinuance of employment or change of 4,325
occupation and benefits shall cease for any period during which 4,326
the employee is employed in an occupation in which the exposure 4,327
to silica dust, asbestos, or coal dust is not substantially less 4,328
than the exposure in the occupation in which he THE EMPLOYEE was 4,329
formerly employed or for any period during which the employee may 4,331
be entitled to receive compensation or benefits under section 4,332
4123.68 of the Revised Code on account of disability from 4,333
silicosis, asbestosis, or coal miners' pneumoconiosis. An award 4,334
for change of occupation for a coal miner who has contracted coal 4,335
miners' pneumoconiosis may be granted under this division even 4,336
though he THE COAL MINER continues his employment with the same 4,338
employer, so long as his THE COAL MINER'S employment subsequent 4,340
to the change is such that his THE COAL MINER'S exposure to coal 4,342
dust is substantially decreased and a change of occupation is 4,343
certified by the claimant as permanent. The administrator may
accord to the employee medical MEDICAL and other benefits SHALL 4,344
BE PAID TO THE EMPLOYEE in accordance with section 4123.66 of the 4,346
Revised Code.
(E) If a fire fighter FIREFIGHTER or police officer makes 4,348
application for a finding and the administrator finds that he THE 4,350
FIREFIGHTER OR POLICE OFFICER has contracted a cardiovascular and 4,352
pulmonary disease as defined in division (W) of section 4123.68 4,353
of the Revised Code, and that a change of the fire fighter's 4,354
FIREFIGHTER'S or police officer's occupation is medically 4,355
advisable in order to decrease substantially further exposure to 4,356
smoke, toxic gases, chemical fumes, and other toxic vapors, and 4,357
if the fire fighter FIREFIGHTER, or police officer, after the 4,358
finding, has changed or changes his occupation to an occupation 4,360
in which the exposure to smoke, toxic gases, chemical fumes, and 4,361
other toxic vapors is substantially decreased, the administrator 4,362
shall allow to the fire fighter FIREFIGHTER or police officer an 4,363
102
amount equal to fifty per cent of the statewide average weekly 4,365
wage per week for a period of thirty weeks, commencing as of the 4,366
date of the discontinuance or change, and for a period of 4,367
seventy-five weeks immediately following the expiration of the 4,368
period of thirty weeks the administrator shall allow the fire 4,369
fighter FIREFIGHTER or police officer sixty-six and two-thirds 4,371
per cent of the loss of wages resulting directly and solely from 4,372
the change of occupation but not to exceed a maximum of an amount 4,373
equal to fifty per cent of the statewide average weekly wage per 4,374
week. No such fire fighter FIREFIGHTER or police officer is 4,376
entitled to receive more than one allowance on account of 4,377
discontinuance of employment or change of occupation and benefits 4,378
shall cease for any period during which the fire fighter 4,379
FIREFIGHTER or police officer is employed in an occupation in 4,381
which the exposure to smoke, toxic gases, chemical fumes, and
other toxic vapors is not substantially less than the exposure in 4,382
the occupation in which he THE FIREFIGHTER OR POLICE OFFICER was 4,383
formerly employed or for any period during which the fire fighter 4,385
FIREFIGHTER or police officer may be entitled to receive 4,387
compensation or benefits under section 4123.68 of the Revised 4,388
Code on account of disability from a cardiovascular and pulmonary 4,389
disease. The administrator may accord to the fire fighter 4,390
FIREFIGHTER or police officer medical and other benefits in 4,392
accordance with section 4123.66 of the Revised Code.
(F) An order issued under DIVISION (B), (D), OR (E) OF 4,395
this section is appealable pursuant to section 4123.511 of the 4,396
Revised Code but is not appealable to court under section 4,397
4123.512 of the Revised Code.
Sec. 4123.58. (A) In cases of permanent total disability 4,406
IMPAIRMENT, the employee shall receive an award to continue until 4,408
his death in the amount of sixty-six and two-thirds per cent of 4,409
his THE EMPLOYEE'S average weekly wage, but, except as otherwise 4,411
provided in division (B) of this section, not more than a maximum 4,412
amount of weekly compensation which is equal to sixty-six and 4,413
103
two-thirds per cent of the statewide average weekly wage as 4,414
defined in division (C) of section 4123.62 of the Revised Code, 4,415
nor not less than a minimum amount of weekly compensation which 4,416
is equal to fifty per cent of the statewide average weekly wage 4,417
as defined in division (C) of section 4123.62 of the Revised 4,418
Code, unless the employee's average weekly wage is less than 4,419
fifty per cent of the statewide average weekly wage at the time 4,420
of the injury, in which event he THE EMPLOYEE shall receive 4,421
compensation in an amount equal to his THE EMPLOYEE'S average 4,422
weekly wage. PERMANENT TOTAL IMPAIRMENT MEANS THAT THE PHYSICAL 4,423
OR MENTAL LIMITATIONS THAT DIRECTLY RESULT FROM THE ALLOWED 4,424
CONDITIONS IN THE EMPLOYEE'S CLAIM OR CLAIMS PREVENT THE EMPLOYEE 4,425
FROM ENGAGING IN SUSTAINED REMUNERATIVE EMPLOYMENT. A STAFF 4,426
HEARING OFFICER MAY CONSIDER AN EMPLOYEE'S AGE IN DETERMINING 4,428
WHETHER THE EMPLOYEE IS PREVENTED FROM ENGAGING IN SUSTAINED 4,429
REMUNERATIVE EMPLOYMENT OR FROM ACQUIRING THE CAPACITY TO ENGAGE 4,430
IN SUSTAINED REMUNERATIVE EMPLOYMENT THROUGH TRAINING,
REHABILITATION, EDUCATION, OR OTHER SIMILAR EFFORTS, SUBJECT TO 4,431
BOTH OF THE FOLLOWING: 4,432
(1) AN EMPLOYEE IS NOT ENTITLED TO COMPENSATION FOR 4,434
PERMANENT TOTAL IMPAIRMENT WHEN THE EMPLOYEE'S AGE IS THE PRIMARY 4,436
REASON THAT THE EMPLOYEE IS PREVENTED FROM ENGAGING IN OR FROM 4,437
ACQUIRING THE CAPACITY TO ENGAGE IN SUSTAINED REMUNERATIVE 4,438
EMPLOYMENT;
(2) A STAFF HEARING OFFICER MAY DETERMINE WHETHER AN 4,440
EMPLOYEE IS ENTITLED TO COMPENSATION FOR PERMANENT TOTAL 4,441
IMPAIRMENT WHEN THE EMPLOYEE'S AGE IS A REASON, BUT NOT THE 4,443
PRIMARY REASON, THAT THE EMPLOYEE IS PREVENTED FROM ENGAGING IN 4,444
OR FROM ACQUIRING THE CAPACITY TO ENGAGE IN SUSTAINED
REMUNERATIVE EMPLOYMENT. 4,445
(B) In the event the weekly workers' compensation amount 4,447
when combined with disability benefits received pursuant to the 4,448
Social Security Act is less than the statewide average weekly 4,449
wage as defined in division (C) of section 4123.62 of the Revised 4,450
104
Code, then the maximum amount of weekly compensation shall be the 4,451
statewide average weekly wage as defined in division (C) of 4,452
section 4123.62 of the Revised Code. At any time that social 4,453
security disability benefits terminate or are reduced, the 4,454
workers' compensation award shall be recomputed to pay the 4,455
maximum amount permitted under this division. 4,456
(C) The loss or loss of use of both hands or both arms, or 4,458
both feet or both legs, or both eyes, or of any two thereof, 4,459
constitutes total and permanent disability IMPAIRMENT, to be 4,460
compensated according to this section. Compensation payable 4,462
under this section for permanent total disability IMPAIRMENT is 4,463
in addition to benefits payable under division (B) of section 4,465
4123.57 of the Revised Code. 4,466
Sec. 4123.59. In case an injury to or an occupational 4,475
disease contracted by an employee causes his THE EMPLOYEE'S 4,476
death, benefits shall be in the amount and to the persons 4,478
following:
(A) If there are no dependents, the disbursements from the 4,480
state insurance fund is limited to the expenses provided for in 4,481
section 4123.66 of the Revised Code. 4,482
(B) If there are wholly dependent persons at the time of 4,484
the death, the weekly payment is sixty-six and two-thirds per 4,485
cent of the average weekly wage, but not to exceed a maximum 4,486
aggregate amount of weekly compensation which is equal to 4,487
sixty-six and two-thirds per cent of the statewide average weekly 4,488
wage as defined in division (C) of section 4123.62 of the Revised 4,489
Code, and not in any event less than a minimum amount of weekly 4,490
compensation which is equal to fifty per cent of the statewide 4,491
average weekly wage as defined in division (C) of section 4123.62 4,492
of the Revised Code, regardless of the average weekly wage; 4,493
provided however, that if the death is due to injury received or 4,494
occupational disease first diagnosed after January 1, 1976, the 4,495
weekly payment is sixty-six and two-thirds per cent of the 4,496
average weekly wage but not to exceed a maximum aggregate amount 4,497
105
of weekly compensation which is equal to the statewide average 4,498
weekly wage as defined in division (C) of section 4123.62 of the 4,499
Revised Code; provided that when any claimant is receiving total 4,500
disability OR IMPAIRMENT compensation at the time of death the 4,501
wholly dependent person is eligible for the maximum compensation 4,503
provided for in this section. Where there is more than one person 4,504
who is wholly dependent at the time of the death of the employee, 4,505
the administrator of workers' compensation shall promptly 4,506
apportion the weekly amount of compensation payable under this 4,507
section among the dependent persons as provided in division (D) 4,508
of this section. 4,509
(1) The payment as provided in this section shall continue 4,511
from the date of death of an injured, IMPAIRED, or disabled 4,513
employee until the death or remarriage of such dependent spouse. 4,515
If the dependent spouse remarries, an amount equal to two years 4,516
of compensation benefits at the weekly amount determined to be 4,517
applicable to and being paid to the dependent spouse shall be 4,518
paid in a lump sum to such spouse and no further compensation 4,519
shall be paid to such spouse. 4,520
(2) That portion of the payment provided in division (B) 4,522
of this section applicable to wholly dependent persons other than 4,523
a spouse shall continue from the date of death of an injured, 4,524
IMPAIRED, or disabled employee to a dependent as of the date of 4,526
death, other than a spouse, at the weekly amount determined to be 4,527
applicable and being paid to such dependent other than a spouse, 4,528
until he THE DEPENDENT: 4,529
(a) Reaches eighteen years of age; 4,531
(b) If pursuing a full time educational program while 4,533
enrolled in an accredited educational institution and program, 4,534
reaches twenty-five years of age; 4,535
(c) If mentally or physically incapacitated from having 4,537
any earnings, is no longer so incapacitated. 4,538
(C) If there are partly dependent persons at the time of 4,540
the death the weekly payment is sixty-six and two-thirds per cent 4,541
106
of the employee's average weekly wage, not to exceed sixty-six 4,542
and two-thirds per cent of the statewide average weekly wage as 4,543
defined in division (C) of section 4123.62 of the Revised Code, 4,544
and shall continue for such time as the administrator in each 4,545
case determines. 4,546
(D) The following persons are presumed to be wholly 4,548
dependent for their support upon a deceased employee: 4,549
(1) A surviving spouse who was living with the employee at 4,551
the time of death or a surviving spouse who was separated from 4,552
the employee at the time of death because of the aggression of 4,553
the employee; 4,554
(2) A child under the age of eighteen years, or 4,556
twenty-five years if pursuing a full-time educational program 4,557
while enrolled in an accredited educational institution and 4,558
program, or over said THAT age if physically or mentally 4,559
incapacitated from earning, upon only the one parent who is 4,561
contributing more than one-half of the support for such child and 4,562
with whom he THAT CHILD is living at the time of the death of 4,564
such parent, or for whose maintenance such parent was legally 4,565
liable at the time of his THE PARENT'S death. 4,567
It is presumed that there is sufficient dependency to 4,569
entitle a surviving natural parent or surviving natural parents, 4,570
share and share alike, with whom the decedent was living at the 4,571
time of his death, to a total minimum award of three thousand 4,572
dollars. 4,573
The administrator may take into consideration any 4,575
circumstances which, at the time of the death of the decedent, 4,576
clearly indicate prospective dependency on the part of the 4,577
claimant and potential support on the part of the decedent. No 4,578
person shall be considered a prospective dependent unless such 4,579
person is a member of the family of the deceased employee and 4,580
bears to him THE DECEDENT the relation of surviving spouse, 4,581
lineal descendant, ancestor, or brother, or sister. The total 4,583
award for any or all prospective dependency to all such 4,584
107
claimants, except to a natural parent or natural parents of the 4,585
deceased, shall not exceed three thousand dollars to be 4,586
apportioned among them as the administrator orders. 4,587
In all other cases, the question of dependency, in whole or 4,589
in part, shall be determined in accordance with the facts in each 4,590
particular case existing at the time of the injury resulting in 4,591
the death of such employee, but no person shall be considered as 4,592
dependent unless such person is a member of the family of the 4,593
deceased employee, or bears to him THE DECEDENT the relation of 4,594
surviving spouse, lineal descendant, ancestor, or brother, or 4,596
sister.
(E) An order issued by the administrator under this 4,598
section is appealable pursuant to sections 4123.511 to 4123.512 4,599
of the Revised Code. 4,600
Sec. 4123.60. (A) Benefits in case of death shall be paid 4,609
to such one or more of the dependents of the decedent, for the 4,610
benefit of all the dependents as the administrator of workers' 4,611
compensation determines. The administrator may apportion the 4,612
benefits among the dependents in such manner as he THE 4,613
ADMINISTRATOR deems just and equitable. Payment to a dependent 4,615
subsequent in right may be made, if the administrator deems it 4,616
proper, and operates to discharge all other claims therefor. The 4,617
dependents or person to whom benefits are paid shall apply the 4,618
same to the use of the several beneficiaries thereof according to 4,619
their respective claims upon the decedent for support, in 4,620
compliance with the finding and direction of the administrator. 4,621
In all cases of death where the dependents are a surviving 4,623
spouse and one or more children, it is sufficient for the 4,624
surviving spouse to apply to the administrator on behalf of the 4,625
spouse and minor children. In cases where all the dependents are 4,626
minors, a guardian or next friend of such minor dependents shall 4,627
apply. 4,628
In all cases where an award had been made on account of 4,630
temporary DISABILITY, or permanent partial IMPAIRMENT, or total 4,632
108
disability OR IMPAIRMENT, in which there remains an unpaid 4,634
balance, representing payments accrued and due to the decedent at 4,635
the time of his death, the administrator may, after satisfactory 4,636
proof has been made warranting such action, MAY award or pay any 4,637
unpaid balance of such award to such of the dependents of the 4,638
decedent, or for services rendered on account of the last illness 4,639
or death of such THAT decedent, as the administrator determines 4,640
in accordance with the circumstances in each such case. If the 4,641
decedent would have been lawfully entitled to have applied for an 4,642
award at the time of his death, the administrator may, after 4,643
satisfactory proof to warrant an award and payment, MAY award and 4,645
pay an amount, not exceeding the compensation which the decedent 4,646
might have received, but for his THE DECEDENT'S death, for the 4,648
period prior to the date of his death, to such of the dependents 4,649
of the decedent, or for services rendered on account of the last 4,650
illness or death of such decedent, as the administrator 4,651
determines in accordance with the circumstances in each such 4,652
case, but such payments may be made only in cases in which 4,653
application for compensation was made in the manner required by 4,654
this chapter, during the lifetime of such injured, IMPAIRED, or 4,655
disabled person, or within one year after the death of such THAT 4,656
injured, IMPAIRED, or disabled person. 4,657
An order issued by the administrator under this section 4,659
DIVISION is appealable pursuant to section 4123.511 of the 4,661
Revised Code but is not appealable to court under section 4,662
4123.512 of the Revised Code. 4,663
(B) THE DEATH OF A CLAIMANT WHO IS ENTITLED TO PAYMENT 4,665
UNDER A SETTLEMENT AGREED TO AND EFFECTIVE IN ACCORDANCE WITH 4,666
SECTION 4123.65 OF THE REVISED CODE DOES NOT ABATE THAT 4,667
SETTLEMENT. PAYMENT OF THAT SETTLEMENT SHALL BE MADE TO THE 4,668
CLAIMANT'S ESTATE.
Sec. 4123.61. The average weekly wage of an injured 4,677
employee at the time of the injury or at the time disability due 4,679
to the occupational disease begins is the basis upon which to
109
compute benefits. FOR OCCUPATIONAL DISEASE CLAIMS, THE AVERAGE 4,680
WEEKLY WAGE AT THE DATE OF DISEASE IS THE BASIS UPON WHICH TO 4,682
COMPUTE BENEFITS.
In cases of temporary total disability the compensation for 4,684
the first twelve weeks for which compensation is payable shall be 4,685
based on the full weekly wage of the claimant at the time of the 4,686
injury or at the time disability due to occupational DATE OF 4,687
disease begins; when a factory, mine, or other place of 4,689
employment is working short time in order to divide work among 4,690
the employees, the bureau of workers' compensation shall take 4,691
that fact into consideration when determining the wage for the 4,692
first twelve weeks of temporary total disability. 4,693
Compensation for all further temporary total disability 4,695
shall be based as provided for permanent disability IMPAIRMENT 4,696
claims. 4,697
In death, permanent total disability IMPAIRMENT CLAIMS, 4,699
permanent partial disability IMPAIRMENT claims, and impairment of 4,702
earnings claims, the claimant's or the decedent's average weekly 4,704
wage for the year preceding the injury or AT the date the 4,705
disability due to the occupational OF disease begins is the 4,706
weekly wage upon which compensation shall be based. In 4,708
ascertaining the average weekly wage for the year previous to the 4,709
injury, or the date the disability due to the occupational OF 4,710
disease begins, any period of unemployment due to sickness, 4,712
industrial depression, strike, lockout, or other cause beyond the 4,713
employee's control shall be eliminated. 4,714
In cases where there are special circumstances under which 4,716
the average weekly wage cannot justly be determined by applying 4,717
this section, the administrator of workers' compensation, in 4,718
determining the average weekly wage in such cases, shall use such 4,719
method as will enable him THE ADMINISTRATOR to do substantial 4,720
justice to the claimants. FOR PURPOSES OF THIS SECTION, "SPECIAL 4,723
CIRCUMSTANCES" DOES NOT INCLUDE AND THE ADMINISTRATOR SHALL NOT 4,724
ADJUST THE AVERAGE WEEKLY WAGE FOR A CLAIMANT FOR ANY PERIOD OF 4,725
110
TIME IN WHICH THE CLAIMANT IS ENROLLED AS A FULL- OR PART-TIME 4,726
STUDENT IN A PUBLIC OR PRIVATE COLLEGE OR UNIVERSITY, INCLUDING A 4,727
TECHNICAL COLLEGE CREATED PURSUANT TO CHAPTER 3357. OF THE 4,728
REVISED CODE OR A COMMUNITY COLLEGE AS DEFINED IN SECTION 3354.01 4,729
OF THE REVISED CODE. 4,731
A DETERMINATION MADE BY THE ADMINISTRATOR UNDER THIS 4,733
SECTION IS APPEALABLE PURSUANT TO SECTION 4123.511 OF THE REVISED 4,734
CODE, BUT IT IS NOT APPEALABLE TO COURT UNDER SECTION 4123.512 OF 4,735
THE REVISED CODE.
AS USED IN THIS SECTION, "DATE OF DISEASE" MEANS THE DATE 4,737
AN OCCUPATIONAL DISEASE IS FIRST DIAGNOSED BY A LICENSED 4,738
PHYSICIAN, OR FOR AN OCCUPATIONAL DISEASE DESCRIBED IN DIVISIONS 4,739
(A) THROUGH (AA) OF SECTION 4123.68 OF THE REVISED CODE OR OTHER 4,743
OCCUPATIONAL DISEASE THAT RESULTS FROM EXPOSURE TO
FIBROSIS-PRODUCING OR TOXIC DUSTS, FUMES, MISTS, VAPORS, GASES, 4,744
OR LIQUIDS, OR OTHER TOXIC MATERIALS, OR A COMBINATION OF THOSE, 4,745
THE DATE THAT THE EMPLOYEE FIRST MISSES WORK AS A RESULT OF THE 4,746
OCCUPATIONAL DISEASE.
Sec. 4123.62. (A) If it is established that an injured, 4,755
IMPAIRED, or disabled employee was of such age and experience 4,757
when injured, IMPAIRED, or disabled as that under natural 4,759
conditions his THE EMPLOYEE'S wages would be expected to 4,761
increase, the administrator of workers' compensation may consider 4,762
that fact in arriving at his THE EMPLOYEE'S average weekly wage, 4,763
EXCEPT THAT THE ADMINISTRATOR SHALL NOT CONSIDER AND SHALL NOT 4,765
ADJUST THE AVERAGE WEEKLY WAGE FOR AN EMPLOYEE FOR ANY PERIOD OF 4,766
TIME IN WHICH THE EMPLOYEE IS ENROLLED AS A FULL- OR PART-TIME 4,767
STUDENT IN A PUBLIC OR PRIVATE COLLEGE OR UNIVERSITY, INCLUDING A 4,768
TECHNICAL COLLEGE CREATED PURSUANT TO CHAPTER 3357. OF THE
REVISED CODE OR A COMMUNITY COLLEGE AS DEFINED IN SECTION 3354.01 4,769
OF THE REVISED CODE. 4,771
(B) On each first day of January, the current maximum 4,773
monthly benefit amounts provided in sections 4123.412, 4123.413, 4,774
and 4123.414 of the Revised Code in injury cases shall be 4,775
111
adjusted based on the United States department of labor's 4,776
national consumer price index. The percentage increase in the 4,777
cost of living using the index figure for the first day of 4,778
September of the preceding year and the first day of September of 4,779
the year preceding that year shall be applied to the maximums in 4,780
effect on the preceding thirty-first day of December to obtain 4,781
the increase in the cost of living during that year. 4,782
In determining the increase in the maximum benefits for any 4,784
year after 1972, the base shall be the national consumer price 4,785
index on the first day of September of the preceding year. The 4,786
increase in the index for the applicable twelve-month period 4,787
shall be determined and shall be divided by the base used. The 4,788
resulting percentage shall be applied to the existing maximums to 4,789
arrive at the new maximums. 4,790
(C) Effective January 1, 1974, and each first day of 4,792
January thereafter, the current maximum weekly benefit amounts 4,793
provided in sections 4123.56, 4123.58, and 4123.59, and division 4,794
(B) of section 4123.57 of the Revised Code shall be adjusted 4,795
based on the increase or decrease in the statewide average weekly 4,796
wage. 4,797
"Statewide average weekly wage" means the average weekly 4,799
earnings of all workers in Ohio employment subject to Chapter 4,800
4141. of the Revised Code as determined as of the first day of 4,801
September for the four full calendar quarters preceding the first 4,802
day of July of each year, by the administrator of the bureau of 4,803
employment services. 4,804
The statewide average weekly wage to be used for the 4,806
determination of compensation for any employee who sustains an 4,807
injury, or death WHO DIES, or who contracts an occupational 4,809
disease WITH A DATE OF DISEASE THAT ARISES during the subsequent 4,810
calendar year beginning with the first day of January, shall be 4,811
the statewide average weekly wage so determined as of the prior 4,812
first day of September adjusted to the next higher even multiple 4,813
of one dollar.
112
Any change in benefit amounts is effective with respect to 4,815
injuries sustained, occupational diseases contracted, and deaths 4,817
occurring during the calendar year for which adjustment is made. 4,818
In determining the change in the maximum benefits for any 4,820
year after 1978, the base shall be the statewide average weekly 4,821
wage on the first day of September of the preceding year. 4,822
AS USED IN THIS DIVISION, "DATE OF DISEASE" MEANS THE DATE 4,824
AN OCCUPATIONAL DISEASE IS FIRST DIAGNOSED BY A LICENSED 4,825
PHYSICIAN, OR FOR AN OCCUPATIONAL DISEASE DESCRIBED IN DIVISIONS 4,826
(A) THROUGH (AA) OF SECTION 4123.68 OF THE REVISED CODE, OR OTHER 4,830
OCCUPATIONAL DISEASE THAT RESULTS FROM EXPOSURE TO
FIBROSIS-PRODUCING OR TOXIC DUSTS, FUMES, MISTS, VAPORS, GASES, 4,831
OR LIQUIDS, OR OTHER TOXIC MATERIALS, OR A COMBINATION OF THOSE, 4,832
THE DATE THAT THE EMPLOYEE FIRST MISSES WORK AS A RESULT OF THE 4,833
OCCUPATIONAL DISEASE.
Sec. 4123.64. (A) The administrator of workers' 4,842
compensation, under special circumstances, and when the same is 4,843
deemed advisable for the purpose of rendering the injured, 4,844
IMPAIRED, or disabled employee financial relief or for the 4,846
purpose of furthering his THE EMPLOYEE'S rehabilitation, may 4,847
commute payments of compensation or benefits to one or more 4,849
lump-sum payments.
(B) The administrator shall adopt rules which set forth 4,851
the policy for awarding lump sum payments. The rules shall: 4,852
(1) Enumerate the allowable purposes for payments and the 4,854
conditions for making such awards; 4,855
(2) Enumerate the maximum reduction in compensation 4,857
allowable; 4,858
(3) Enumerate the documentation necessary to award a 4,860
lump-sum payment; 4,861
(4) Require that all checks include the claimant as a 4,863
payee, except where the check is for the payment of attorney's 4,864
fees in accordance with section 4123.06 of the Revised Code, in 4,865
which case the attorney shall be named as the only payee on the 4,866
113
check; 4,867
(5) Require a fully completed and current application 4,869
including notary and seal; and 4,870
(6) Specify procedures to make a claimant aware of the 4,872
reduction in amount of compensation which will occur. 4,873
(C) An order of the administrator issued under this 4,875
section is appealable pursuant to section 4123.551 of the Revised 4,876
Code but is not appealable to court under section 4123.512 of the 4,877
Revised Code. 4,878
Sec. 4123.65. (A) A state fund employer or the employee 4,887
of such an employer may file an application with the 4,888
administrator of workers' compensation for approval of a final 4,889
settlement of a claim under this chapter. The application shall 4,890
include the settlement agreement, AND EXCEPT AS OTHERWISE 4,891
PROVIDED IN THIS DIVISION, be signed by the claimant and 4,892
employer, and clearly set forth the circumstances by reason of 4,893
which the proposed settlement is deemed desirable and that the 4,894
parties agree to the terms of the settlement agreement provided 4,895
that the. A CLAIMANT MAY FILE AN APPLICATION FOR AN AGREEMENT 4,897
WITHOUT AN EMPLOYER'S SIGNATURE. IF A CLAIMANT FILES AN 4,898
AGREEMENT WITHOUT AN EMPLOYER'S SIGNATURE, AND THE EMPLOYER STILL 4,899
IS DOING BUSINESS IN THIS STATE, THE ADMINISTRATOR SHALL SEND 4,900
WRITTEN NOTICE OF THE APPLICATION TO THE EMPLOYER IMMEDIATELY 4,901
UPON RECEIPT OF THE APPLICATION, AND A SECOND WRITTEN NOTICE
WITHIN FORTY-FIVE DAYS AFTER THE FIRST NOTICE IS SENT, IF THE 4,902
EMPLOYER DOES NOT RESPOND TO THE FIRST NOTICE. IF THE EMPLOYER 4,903
FAILS TO RESPOND TO THE NOTICE WITHIN SIXTY DAYS AFTER RECEIPT OF 4,905
THE NOTICE, OR IF THE CLAIM THAT IS THE SUBJECT OF THE AGREEMENT
NO LONGER REMAINS IN THE ACCIDENT OR OCCUPATIONAL DISEASE 4,906
EXPERIENCE OF THE EMPLOYER, THE AGREEMENT NEED NOT CONTAIN THE 4,907
EMPLOYER'S SIGNATURE. AN agreement need not be signed by the AN 4,908
employer if the employer WHO is no longer doing business in Ohio 4,910
THIS STATE. If a state fund employer or an employee of such an 4,912
employer has not filed an application for a final settlement 4,913
114
under this division, the administrator may file an application on 4,914
behalf of the employer or the employee, provided that the 4,915
administrator gives notice of the filing to the employer and the 4,916
employee and to the representative of record of the employer and 4,917
of the employee immediately upon the filing. An application 4,918
filed by the administrator shall contain all of the information 4,919
and signatures required of an employer or an employee who files 4,920
an application under this division. Every self-insuring employer 4,921
that enters into a final settlement agreement with an employee 4,922
shall mail, within seven days of executing the agreement, a copy 4,923
of the agreement to the administrator and the employee's 4,924
representative. The administrator shall place the agreement into 4,925
the claimant's file. 4,926
(B) Except as provided in divisions (C) and (D) of this 4,928
section, a settlement agreed to under this section is binding 4,929
upon all parties thereto and as to items, injuries, and 4,930
occupational diseases to which the settlement applies. 4,931
(C) No settlement agreed to under division (A) of this 4,933
section or agreed to by a self-insuring employer and the 4,934
self-insuring employer's employee shall take effect until thirty 4,935
days after the administrator approves the settlement for state 4,936
fund employees and employers, or after the self-insuring employer 4,937
and employee sign the final settlement agreement. During the 4,938
thirty-day period, the employer, employee, or administrator, for 4,939
state fund settlements, and the employer or employee, for 4,940
self-insuring settlements, may withdraw consent to OR MAY OBJECT 4,941
TO the settlement by an employer providing written notice to the 4,943
employer's employee and the administrator or by an employee 4,945
providing written notice to the employee's employer and the 4,946
administrator, or by the administrator providing written notice
to the state fund employer and employee. 4,947
(D) At the time of agreement to any final settlement 4,949
agreement under division (A) of this section or agreement between 4,950
a self-insuring employer and the self-insuring employer's 4,951
115
employee, IN CASES IN WHICH ONE OR MORE PARTIES TO THE AGREEMENT 4,952
ARE UNREPRESENTED, the administrator, for state fund settlements, 4,953
and the self-insuring employer, for self-insuring settlements, 4,955
immediately shall send a copy of the agreement to the industrial 4,956
commission who shall assign the matter to a staff hearing 4,957
officer. The staff hearing officer shall determine, within the 4,958
time limitations specified in division (C) of this section, 4,959
whether the settlement agreement is or is not a gross miscarriage 4,960
of justice CLEARLY UNFAIR. If the staff hearing officer 4,962
determines within that time period that the settlement agreement 4,963
is clearly unfair, the staff hearing officer shall issue an order
disapproving the settlement agreement. If the staff hearing 4,965
officer determines that the settlement agreement is not clearly 4,966
unfair or fails to act within those time limits, the settlement
agreement is approved. 4,967
(E) A settlement entered into under this section may 4,969
pertain to one or more claims of a claimant, or one or more parts 4,970
of a claim, or the compensation or benefits pertaining to either, 4,971
or any combination thereof, provided that nothing in this section 4,972
shall be interpreted to require a claimant to enter into a 4,973
settlement agreement for every claim that has been filed with the 4,974
bureau of workers' compensation by that claimant under Chapter 4,975
4121., 4123., 4127., or 4131. of the Revised Code. 4,976
(F) A settlement entered into under this section is not 4,978
appealable under section 4123.511 or 4123.512 of the Revised 4,979
Code. 4,980
(G) FOR PURPOSES OF DETERMINING WHETHER A PARTY IS 4,982
UNREPRESENTED AS SPECIFIED IN DIVISION (D) OF THIS SECTION, A 4,984
PARTY IS CONSIDERED REPRESENTED ONLY IF THE PARTY HAS THE 4,985
SERVICES OF ONE OF THE FOLLOWING PERSONS: 4,986
(1) AN ATTORNEY ADMITTED TO THE PRACTICE OF LAW IN THIS 4,988
STATE;
(2) A DULY AUTHORIZED REPRESENTATIVE OF AN EMPLOYEE 4,990
ORGANIZATION RECOGNIZED BY THE EMPLOYER FOR COLLECTIVE BARGAINING 4,992
116
PURPOSES;
(3) A PERSON REGULARLY ENGAGED IN THE BUSINESS OF 4,994
PROVIDING WORKERS' COMPENSATION-RELATED SERVICES TO EMPLOYERS; 4,995
(4) AN EMPLOYEE OF THE SELF-INSURING EMPLOYER WHOSE JOB 4,997
DUTIES OR RESPONSIBILITIES INCLUDE PARTICIPATION IN THE 4,998
ADMINISTRATION OF THE SELF-INSURING EMPLOYER'S WORKERS' 4,999
COMPENSATION PROGRAM.
Sec. 4123.651. (A) The employer of a claimant who is 5,008
injured, IMPAIRED, or disabled in the course of his THE 5,010
CLAIMANT'S employment may require, without the approval of the 5,011
administrator or the industrial commission, that the claimant be 5,012
examined by a physician of the employer's choice one time upon 5,013
any issue asserted by the employee or a physician of the 5,014
employee's choice or which is to be considered by the commission. 5,015
Any further requests for medical examinations shall be made to 5,016
the commission which shall consider and rule on the request. The 5,017
employer shall pay the cost of any examinations initiated by the 5,018
employer.
(B) The bureau of workers' compensation shall prepare a 5,020
form for the release of medical information, records, and reports 5,021
relative to the issues necessary for the administration of a 5,022
claim under this chapter. The claimant promptly shall provide a 5,023
current signed release of the information, records, and reports 5,024
when requested by the employer. The employer promptly shall 5,025
provide copies of all medical information, records, and reports 5,026
to the bureau and to the claimant or his THE CLAIMANT'S 5,027
representative upon request. 5,029
(C) If, without good cause, an employee refuses to submit 5,031
to any examination scheduled under this section or refuses to 5,032
release or execute a release for any medical information, record, 5,033
or report that is required to be released under this section and 5,034
involves an issue pertinent to the condition alleged in the 5,035
claim, his THE EMPLOYEE'S right to have his THE claim for 5,037
compensation or benefits considered, if his THE claim is pending 5,038
117
before the administrator, THE commission, or a district or staff 5,040
hearing officer, or to receive any payment for compensation or 5,041
benefits previously granted, is suspended during the period of 5,042
refusal.
(D) No bureau or commission employee shall alter any 5,044
medical report obtained from a health care provider the bureau or 5,045
commission has selected or cause or request the health care 5,046
provider to alter or change a report. The bureau and commission 5,047
shall make any request for clarification of a health care 5,048
provider's report in writing and shall provide a copy of the 5,049
request to the affected parties and their representatives at the 5,050
time of making the request. 5,051
Sec. 4123.66. (A) In addition to the compensation 5,059
provided for in this chapter, the administrator of workers' 5,060
compensation shall disburse and pay from the state insurance fund 5,061
the amounts for medical, nurse, and hospital services and 5,062
medicine as he THE ADMINISTRATOR deems proper, and, in case death 5,064
ensues from the injury or occupational disease, he THE 5,066
ADMINISTRATOR shall disburse and pay from the fund reasonable 5,068
funeral expenses in an amount not to exceed thirty-two hundred 5,069
dollars. The bureau of workers' compensation shall reimburse 5,070
anyone, whether dependent, volunteer, or otherwise, who pays the 5,071
funeral expenses of any employee whose death ensues from any 5,072
injury or occupational disease as provided in this section. The 5,073
administrator may adopt rules, with the advice and consent of the 5,074
workers' compensation oversight commission, with respect to 5,075
furnishing medical, nurse, and hospital service and medicine to 5,076
injured, IMPAIRED, or disabled employees entitled thereto, and 5,078
for the payment therefor. In case an injury or industrial 5,079
accident that injures an employee also causes damage to the 5,081
employee's eyeglasses, artificial teeth or other denture, or 5,082
hearing aid, or in the event an injury or occupational disease 5,083
makes it necessary or advisable to replace, repair, or adjust the 5,084
same, the bureau shall disburse and pay a reasonable amount to 5,085
118
repair or replace the same. IF AN EMPLOYEE'S ATTENDING PHYSICIAN 5,086
DETERMINES THAT IT IS IN THE EMPLOYEE'S BEST INTEREST TO RECEIVE 5,088
HEALTH CARE IN THE EMPLOYEE'S HOME, THE ADMINISTRATOR SHALL 5,089
DISBURSE AND PAY FROM THE STATE INSURANCE FUND, AND A
SELF-INSURING EMPLOYER SHALL PAY THE AMOUNTS NECESSARY FOR 5,090
IN-HOME HEALTH CARE, INCLUDING THE COST OF SERVICES NECESSARY ON 5,092
A CONTINUOUS BASIS, UP TO AND INCLUDING TWENTY-FOUR HOURS A DAY, 5,093
PROVIDED THAT THE ESTIMATED COST OF THAT IN-HOME HEALTH CARE DOES 5,094
NOT EXCEED THE ESTIMATED COST OF RECEIVING THE NECESSARY HEALTH 5,095
CARE OUTSIDE OF THE EMPLOYEE'S HOME.
(B)(1) If an employer or a welfare plan has provided to or 5,097
on behalf of an employee any benefits or compensation for an 5,098
injury or occupational disease and that injury or occupational 5,099
disease is determined compensable under this chapter, the 5,100
employer or a welfare plan may request that the administrator 5,101
reimburse the employer or welfare plan for the amount the 5,102
employer or welfare plan paid to or on behalf of the employee in 5,103
compensation or benefits. The administrator shall reimburse the 5,104
employer or welfare plan for the compensation and benefits paid 5,105
if, at the time the employer or welfare plan provides the 5,106
benefits or compensation to or on behalf of employee, the injury 5,107
or occupational disease had not been determined to be compensable 5,108
under this chapter and if the employee was not receiving 5,109
compensation or benefits under this chapter for that injury or 5,110
occupational disease. The administrator shall reimburse the 5,111
employer or welfare plan in the amount that the administrator 5,112
would have paid to or on behalf of the employee under this 5,113
chapter if the injury or occupational disease originally would 5,114
have been determined compensable under this chapter. If the 5,115
employer is a merit-rated employer, the administrator shall 5,116
adjust the amount of premium next due from the employer according 5,117
to the amount the administrator pays the employer. The 5,118
administrator shall adopt rules, in accordance with Chapter 119. 5,119
of the Revised Code, to implement this division. 5,120
119
(2) As used in this division, "welfare plan" has the same 5,122
meaning as in division (1) of 29 U.S.C.A. 1002. 5,123
Sec. 4123.68. Every employee who is disabled OR IMPAIRED 5,132
because of the contraction of an occupational disease or the 5,133
dependent of an employee whose death is caused by an occupational 5,134
disease, is entitled to the compensation provided by sections 5,135
4123.55 to 4123.59 and 4123.66 of the Revised Code subject to the 5,136
modifications relating to occupational diseases contained in this 5,137
chapter. An order of the administrator issued under this section 5,138
is appealable pursuant to sections 4123.511 and 4123.512 of the 5,139
Revised Code. 5,140
The following diseases are occupational diseases and 5,142
compensable as such when contracted by an employee in the course 5,143
of the employment in which such employee was engaged and due to 5,144
the nature of any process described in this section. A disease 5,145
which meets the definition of an occupational disease is 5,146
compensable pursuant to this chapter EVEN though it is not 5,147
specifically listed in this section. 5,148
SCHEDULE 5,150
Description of disease or injury and description of 5,152
process: 5,153
(A) Anthrax: Handling of wool, hair, bristles, hides, and 5,155
skins. 5,156
(B) Glanders: Care of any equine animal suffering from 5,158
glanders; handling carcass of such animal. 5,159
(C) Lead poisoning: Any industrial process involving the 5,161
use of lead or its preparations or compounds. 5,162
(D) Mercury poisoning: Any industrial process involving 5,164
the use of mercury or its preparations or compounds. 5,165
(E) Phosphorous poisoning: Any industrial process 5,167
involving the use of phosphorous or its preparations or 5,168
compounds. 5,169
(F) Arsenic poisoning: Any industrial process involving 5,171
the use of arsenic or its preparations or compounds. 5,172
120
(G) Poisoning by benzol or by nitro-derivatives and 5,174
amido-derivatives of benzol (dinitro-benzol, anilin, and others): 5,175
Any industrial process involving the use of benzol or 5,176
nitro-derivatives or amido-derivatives of benzol or its 5,177
preparations or compounds. 5,178
(H) Poisoning by gasoline, benzine, naphtha, or other 5,180
volatile petroleum products: Any industrial process involving 5,181
the use of gasoline, benzine, naphtha, or other volatile 5,182
petroleum products. 5,183
(I) Poisoning by carbon bisulphide: Any industrial 5,185
process involving the use of carbon bisulphide or its 5,186
preparations or compounds. 5,187
(J) Poisoning by wood alcohol: Any industrial process 5,189
involving the use of wood alcohol or its preparations. 5,190
(K) Infection or inflammation of the skin on contact 5,192
surfaces due to oils, cutting compounds or lubricants, dust, 5,193
liquids, fumes, gases, or vapors: Any industrial process 5,194
involving the handling or use of oils, cutting compounds or 5,195
lubricants, or involving contact with dust, liquids, fumes, 5,196
gases, or vapors. 5,197
(L) Epithelion cancer or ulceration of the skin or of the 5,199
corneal surface of the eye due to carbon, pitch, tar, or tarry 5,200
compounds: Handling or industrial use of carbon, pitch, or tarry 5,201
compounds. 5,202
(M) Compressed air illness: Any industrial process 5,204
carried on in compressed air. 5,205
(N) Carbon dioxide poisoning: Any process involving the 5,207
evolution or resulting in the escape of carbon dioxide. 5,208
(O) Brass or zinc poisoning: Any process involving the 5,210
manufacture, founding, or refining of brass or the melting or 5,211
smelting of zinc. 5,212
(P) Manganese dioxide poisoning: Any process involving 5,214
the grinding or milling of manganese dioxide or the escape of 5,215
manganese dioxide dust. 5,216
121
(Q) Radium poisoning: Any industrial process involving 5,218
the use of radium and other radioactive substances in luminous 5,219
paint. 5,220
(R) Tenosynovitis and prepatellar bursitis: Primary 5,222
tenosynovitis characterized by a passive effusion or crepitus 5,223
into the tendon sheath of the flexor or extensor muscles of the 5,224
hand, due to frequently repetitive motions or vibrations, or 5,225
prepatellar bursitis due to continued pressure. 5,226
(S) Chrome ulceration of the skin or nasal passages: Any 5,228
industrial process involving the use of or direct contact with 5,229
chromic acid or bichromates of ammonium, potassium, or sodium or 5,230
their preparations. 5,231
(T) Potassium cyanide poisoning: Any industrial process 5,233
involving the use of or direct contact with potassium cyanide. 5,234
(U) Sulphur dioxide poisoning: Any industrial process in 5,236
which sulphur dioxide gas is evolved by the expansion of liquid 5,237
sulphur dioxide. 5,238
(V) Berylliosis: Berylliosis means a disease of the lungs 5,240
caused by breathing beryllium in the form of dust or fumes, 5,241
producing characteristic changes in the lungs and demonstrated by 5,242
x-ray examination, by biopsy or by autopsy. 5,243
This chapter does not entitle an employee or his THE 5,245
EMPLOYEE'S dependents to compensation, medical treatment, or 5,247
payment of funeral expenses for disability, IMPAIRMENT, or death 5,248
from berylliosis unless the employee has been subjected to 5,250
injurious exposure to beryllium dust or fumes in his THE 5,251
EMPLOYEE'S employment in this state preceding his THE EMPLOYEE'S 5,252
disablement OR IMPAIRMENT and only in the event of such 5,253
disability, IMPAIRMENT, or death resulting within eight years 5,256
after the last injurious exposure; provided that such eight-year 5,257
limitation does not apply to disability, IMPAIRMENT, or death 5,258
from exposure occurring after January 1, 1976. In the event of 5,260
death following continuous total disability OR IMPAIRMENT 5,261
commencing within eight years after the last injurious exposure, 5,263
122
the requirement of death within eight years after the last 5,264
injurious exposure does not apply.
Before awarding compensation for partial or total 5,266
disability OR IMPAIRMENT or death due to berylliosis, the 5,267
administrator of workers' compensation shall refer the claim to a 5,269
qualified MEDICAL SPECIALIST FOR EXAMINATION AND RECOMMENDATION 5,270
WITH REGARD to the diagnosis, the extent of the disability OR 5,271
IMPAIRMENT, the nature of the disability OR IMPAIRMENT, whether 5,272
permanent or temporary, the cause of death, and other medical 5,274
questions connected with the claim. An employee shall submit to 5,275
such examinations, including clinical and x-ray examinations, as 5,276
the administrator requires. In the event that an employee 5,277
refuses to submit to examinations, including clinical and x-ray 5,278
examinations, after notice from the administrator, or in the 5,279
event that a claimant for compensation for death due to 5,280
berylliosis fails to produce necessary consents and permits, 5,281
after notice from the administrator, so that such autopsy 5,282
examination and tests may be performed, then all rights for 5,283
compensation are forfeited. The reasonable compensation of such 5,284
specialist and the expenses of examinations and tests shall be 5,285
paid, if the claim is allowed, as part of the expenses of the
claim, otherwise they shall be paid from the surplus fund. 5,286
(W) Cardiovascular, pulmonary, or respiratory diseases 5,288
incurred by fire fighters FIREFIGHTERS or police officers 5,289
following exposure to heat, smoke, toxic gases, chemical fumes 5,291
and other toxic substances: Any cardiovascular, pulmonary, or 5,292
respiratory disease of a fire fighter FIREFIGHTERS or police 5,293
officer OFFICERS caused or induced by the cumulative effect of 5,295
exposure to heat, the inhalation of smoke, toxic gases, chemical 5,296
fumes and other toxic substances in the performance of his THEIR 5,297
duty constitutes a presumption, which may be refuted by 5,299
affirmative evidence, that such occurred in the course of and 5,300
arising out of his THEIR employment. For the purpose of this 5,302
section, "fire fighter FIREFIGHTER" means any regular member of a 5,303
123
lawfully constituted fire department of a municipal corporation 5,304
or township, whether paid or volunteer, and "police officer" 5,305
means any regular member of a lawfully constituted police 5,306
department of a municipal corporation, township or county, 5,307
whether paid or volunteer. 5,308
This chapter does not entitle a fire fighter FIREFIGHTER, 5,310
or police officer, or his THE FIREFIGHTER'S OR POLICE OFFICER'S 5,312
dependents to compensation, medical treatment, or payment of 5,314
funeral expenses for disability, IMPAIRMENT, or death from a 5,315
cardiovascular, pulmonary, or respiratory disease, unless the 5,316
fire fighter FIREFIGHTER or police officer has been subject to 5,317
injurious exposure to heat, smoke, toxic gases, chemical fumes, 5,319
and other toxic substances in his THE FIREFIGHTER'S OR POLICE 5,320
OFFICER'S employment in this state preceding his THE disablement 5,322
OR IMPAIRMENT, some portion of which has been after January 1, 5,323
1967, except as provided in division (E) of section 4123.57 of 5,324
the Revised Code. 5,325
Compensation on account of cardiovascular, pulmonary, or 5,327
respiratory diseases of fire fighters FIREFIGHTERS and police 5,328
officers is payable only in the event of temporary total 5,330
disability, permanent total disability IMPAIRMENT, or death, in 5,331
accordance with section 4123.56, 4123.58, or 4123.59 of the 5,333
Revised Code. Medical, hospital, and nursing expenses are 5,334
payable in accordance with this chapter. Compensation, medical, 5,335
hospital, and nursing expenses are payable only in the event of 5,336
such disability, IMPAIRMENT, or death resulting within eight 5,338
years after the last injurious exposure; provided that such 5,339
eight-year limitation does not apply to disability, IMPAIRMENT, 5,340
or death from exposure occurring after January 1, 1976. In the 5,342
event of death following continuous total disability OR 5,343
IMPAIRMENT commencing within eight years after the last injurious 5,344
exposure, the requirement of death within eight years after the 5,345
last injurious exposure does not apply. 5,346
This chapter does not entitle a fire fighter FIREFIGHTER or 5,348
124
police officer, or his THE dependents OF A FIREFIGHTER OR POLICE 5,350
OFFICER, to compensation, medical, hospital, and nursing 5,353
expenses, or payment of funeral expenses for disability, 5,354
IMPAIRMENT, or death due to a cardiovascular, pulmonary, or 5,355
respiratory disease in the event of failure or omission on the 5,356
part of the fire fighter FIREFIGHTER or police officer truthfully 5,358
to state, when seeking employment, the place, duration, and 5,359
nature of previous employment in answer to an inquiry made by the 5,360
employer.
Before awarding compensation for disability, IMPAIRMENT, or 5,363
death under this division, the administrator shall refer the 5,364
claim to a qualified medical specialist for examination and 5,365
recommendation with regard to the diagnosis, the extent of 5,366
disability OR IMPAIRMENT, the cause of death, and other medical 5,368
questions connected with the claim. A fire fighter FIREFIGHTER or 5,369
police officer shall submit to such examinations, including 5,371
clinical and x-ray examinations, as the administrator requires. 5,372
In the event that a fire fighter FIREFIGHTER or police officer 5,374
refuses to submit to examinations, including clinical and x-ray 5,375
examinations, after notice from the administrator, or in the 5,376
event that a claimant for compensation for death under this 5,377
division fails to produce necessary consents and permits, after 5,378
notice from the administrator, so that such autopsy examination 5,379
and tests may be performed, then all rights for compensation are 5,380
forfeited. The reasonable compensation of such specialists and 5,381
the expenses of examination and tests shall be paid, if the claim 5,382
is allowed, as part of the expenses of the claim, otherwise they 5,383
shall be paid from the surplus fund.
(X) Silicosis: Silicosis means a disease of the lungs 5,385
caused by breathing silica dust (silicon dioxide) producing 5,386
fibrous nodules distributed through the lungs and demonstrated by 5,387
x-ray examination, by biopsy or by autopsy. 5,388
(Y) Coal miners' pneumoconiosis: Coal miners' 5,390
pneumoconiosis, commonly referred to as "black lung disease," 5,391
125
resulting from working in the coal mine industry and due to 5,392
exposure to the breathing of coal dust, and demonstrated by x-ray 5,393
examination, biopsy, autopsy or other medical or clinical tests. 5,394
This chapter does not entitle an employee or his THE 5,396
EMPLOYEE'S dependents to compensation, medical treatment, or 5,398
payment of funeral expenses for disability, IMPAIRMENT, or death 5,399
from silicosis, asbestosis, or coal miners' pneumoconiosis unless 5,401
the employee has been subject to injurious exposure to silica 5,402
dust (silicon dioxide), asbestos, or coal dust in his THE 5,403
EMPLOYEE'S employment in this state preceding his THE disablement 5,405
OR IMPAIRMENT, some portion of which has been after October 12, 5,406
1945, except as provided in division (E) of section 4123.57 of 5,407
the Revised Code. 5,408
Compensation on account of silicosis, asbestosis, or coal 5,410
miners' pneumoconiosis are payable only in the event of temporary 5,411
total disability, permanent total disability IMPAIRMENT, or 5,412
death, in accordance with sections 4123.56, 4123.58, and 4123.59 5,414
of the Revised Code. Medical, hospital, and nursing expenses are 5,415
payable in accordance with this chapter. Compensation, medical, 5,416
hospital, and nursing expenses are payable only in the event of 5,417
such disability, IMPAIRMENT, or death resulting within eight 5,419
years after the last injurious exposure; provided that such 5,420
eight-year limitation does not apply to disability, IMPAIRMENT, 5,421
or death occurring after January 1, 1976, and further provided 5,423
that such eight-year limitation does not apply to any asbestosis 5,424
cases. In the event of death following continuous total 5,425
disability OR IMPAIRMENT commencing within eight years after the 5,427
last injurious exposure, the requirement of death within eight 5,428
years after the last injurious exposure does not apply. 5,429
This chapter does not entitle an employee or his THE 5,431
EMPLOYEE'S dependents to compensation, medical, hospital, and 5,433
nursing expenses, or payment of funeral expenses for disability, 5,434
IMPAIRMENT, or death due to silicosis, asbestosis, or coal 5,436
miners' pneumoconiosis in the event of the failure or omission on 5,437
126
the part of the employee truthfully to state, when seeking 5,438
employment, the place, duration, and nature of previous 5,439
employment in answer to an inquiry made by the employer. 5,440
Before awarding WHEN compensation IS REQUESTED for 5,442
disability, IMPAIRMENT, or death due to silicosis, asbestosis, or 5,445
coal miners' pneumoconiosis, the administrator shall refer MAY 5,446
DETERMINE WHETHER THERE IS SUFFICIENT LIKELIHOOD THAT ANY OF 5,447
THOSE DISEASES EXISTS, CAUSES DISABILITY OR IMPAIRMENT, OR CAUSED 5,449
DEATH TO WARRANT REFERRING the claim to a qualified medical
specialist for examination and recommendation with regard to the 5,450
diagnosis, the extent of disability OR IMPAIRMENT, the cause of 5,451
death, and other medical questions connected with the claim. IN 5,453
NO EVENT SHALL COMPENSATION FOR DISABILITY, IMPAIRMENT, OR DEATH 5,454
DUE TO SILICOSIS, ASBESTOSIS, OR COAL MINERS' PNEUMOCONIOSIS BE 5,455
AWARDED WITHOUT THE CLAIM BEING REFERRED TO A QUALIFIED MEDICAL 5,456
SPECIALIST FOR THAT EXAMINATION AND RECOMMENDATION. An employee 5,457
shall submit to such examinations, including clinical and x-ray 5,458
examinations, as the administrator requires. In the event that 5,459
an employee refuses to submit to examinations, including clinical 5,460
and x-ray examinations, after notice from the administrator, or 5,461
in the event that a claimant for compensation for death due to 5,462
silicosis, asbestosis, or coal miners' pneumoconiosis fails to 5,463
produce necessary consents and permits, after notice from the 5,464
commission, so that such autopsy examination and tests may be 5,465
performed, then all rights for compensation are forfeited. The 5,466
reasonable compensation of such specialist and the expenses of 5,467
examinations and tests shall be paid, if the claim is allowed, as 5,468
a part of the expenses of the claim, otherwise they shall be paid 5,469
from the surplus fund. 5,470
(Z) Radiation illness: Any industrial process involving 5,472
the use of radioactive materials. 5,473
Claims for compensation and benefits due to radiation 5,475
illness are payable only in the event death, IMPAIRMENT, or 5,477
disability occurred within eight years after the last injurious 5,478
127
exposure provided that such eight-year limitation does not apply 5,479
to disability, IMPAIRMENT, or death from exposure occurring after 5,481
January 1, 1976. In the event of death following continuous 5,482
disability OR IMPAIRMENT which commenced within eight years of 5,484
the last injurious exposure, the requirement of death within 5,485
eight years after the last injurious exposure does not apply. 5,486
(AA) Asbestosis: Asbestosis means a disease caused by 5,488
inhalation or ingestion of asbestos, demonstrated by x-ray 5,489
examination, biopsy, autopsy, or other objective medical or 5,490
clinical tests. 5,491
All conditions, restrictions, limitations, and other 5,493
provisions of this section, with reference to the payment of 5,494
compensation or benefits on account of silicosis or coal miners' 5,495
pneumoconiosis apply to the payment of compensation or benefits 5,496
on account of any other occupational disease of the respiratory 5,497
tract resulting from injurious exposures to dust. 5,498
The refusal to produce the necessary consents and permits 5,500
for autopsy examination and testing shall not result in 5,501
forfeiture of compensation provided the administrator finds that 5,502
such refusal was the result of bona fide religious convictions or 5,503
teachings to which the claimant for compensation adhered prior to 5,504
the death of the decedent. 5,505
Sec. 4123.70. No compensation shall be awarded on account 5,514
of disability, IMPAIRMENT, or death from disease suffered by an 5,516
employee who, at the time of entering into the employment from 5,517
which the disease is claimed to have resulted, willfully and 5,518
falsely represented himself THE EMPLOYEE as not having previously 5,519
suffered from such disease. Compensation shall not be awarded on 5,521
account of both injury and disease, except when the disability OR 5,522
IMPAIRMENT is caused by a disease and an injury, in which event 5,523
the administrator of workers' compensation may apportion the 5,524
payment of compensation provided for in sections 4123.56 to 5,525
4123.59 of the Revised Code between the funds as in his THE 5,526
ADMINISTRATOR'S judgment seems just and proper. 5,527
128
If an employee is suffering from both occupational disease 5,529
and an injury, and the administrator can determine which is 5,530
causing his THE EMPLOYEE'S disability OR IMPAIRMENT, the 5,531
administrator shall pay compensation therefor from the proper 5,533
fund.
Compensation for loss sustained on account of occupational 5,535
disease by an employee mentioned in division (A)(1) of section 5,536
4123.01 of the Revised Code, or the dependents of such employee, 5,537
shall be paid from the fund provided for in sections 4123.38 to 5,538
4123.41 and 4123.48 of the Revised Code. 5,539
Compensation for loss sustained on account of a disease by 5,541
an employee mentioned in division (A)(2) of section 4123.01 of 5,542
the Revised Code, or the dependents of the employee, shall be 5,543
paid from the occupational disease fund or by the employer of the 5,544
employee, if the employer is a self-insuring employer. 5,545
Sec. 4123.80. No agreement by an employee to waive his THE 5,553
EMPLOYEE'S rights to compensation under this chapter is valid, 5,555
except that:
(A) An employee who is blind may waive the compensation 5,557
that may become due him TO THE EMPLOYEE for injury, IMPAIRMENT, 5,559
or disability in cases where the injury, IMPAIRMENT, or 5,560
disability may be directly caused by or due to his THAT 5,562
blindness. The administrator of workers' compensation, with the 5,564
advice and consent of the workers' compensation oversight 5,566
commission, may adopt and enforce rules governing the employment 5,568
of such persons and the inspection of their places of employment. 5,569
(B) An employee may waive his THE EMPLOYEE'S rights to 5,571
compensation or benefits as authorized pursuant to division 5,572
(C)(3) of section 4123.01 OR SECTION 4123.15 of the Revised Code. 5,574
No agreement by an employee to pay any portion of the 5,576
premium paid by his THE EMPLOYEE'S employer into the state 5,578
insurance fund is valid.
Sec. 4123.82. (A) All contracts and agreements are void 5,587
which undertake to indemnify or insure an employer against loss 5,588
129
or liability for the payment of compensation to workers or their 5,589
dependents for death, injury, or occupational disease occasioned 5,590
in the course of the workers' employment, or which provide that 5,591
the insurer shall pay the compensation, or which indemnify the 5,592
employer against damages when the injury, disease, or death 5,593
arises from the failure to comply with any lawful requirement for 5,594
the protection of the lives, health, and safety of employees, or 5,595
when the same is occasioned by the willful act of the employer or 5,596
any of his THE EMPLOYER'S officers or agents, or by which it is 5,597
agreed that the insurer shall pay any such damages. No license 5,599
or authority to enter into any such agreements or issue any such 5,600
policies of insurance shall be granted or issued by any public 5,601
authority in this state. Any corporation organized or admitted 5,602
under the laws of this state to transact liability insurance as 5,603
defined in section 3929.01 of the Revised Code may by amendment 5,604
of its articles of incorporation or by original articles of 5,605
incorporation, provide therein for the authority and purpose to 5,606
make insurance in states, territories, districts, and counties, 5,607
other than the state of Ohio, and in the state of Ohio in respect 5,608
of contracts permitted by division (B) of this section, 5,609
indemnifying employers against loss or liability for payment of 5,610
compensation to workers and employees and their dependents for 5,611
death, injury, or occupational disease occasioned in the course 5,612
of the employment and to insure and indemnify employers against 5,613
loss, expense, and liability by risk of bodily injury or death by 5,614
accident, disability, IMPAIRMENT, sickness, or disease suffered 5,615
by workers and employees for which the employer may be liable or 5,617
has assumed liability. 5,618
(B) Notwithstanding division (A) of this section: 5,620
(1) No contract because of that division is void which 5,622
undertakes to indemnify a self-insuring employer against all or 5,623
part of such employer's loss in excess of at least fifty thousand 5,624
dollars from any one disaster or event arising out of the 5,625
employer's liability under this chapter, but no insurance 5,626
130
corporation shall, directly or indirectly, SHALL represent an 5,627
employer in the settlement, adjudication, determination, 5,628
allowance, or payment of claims. The superintendent of insurance 5,629
shall enforce this prohibition by such disciplinary orders 5,630
directed against the offending insurance corporation as the 5,631
superintendent of insurance deems appropriate in the 5,632
circumstances and the administrator of workers' compensation 5,633
shall enforce this prohibition by such disciplinary orders 5,634
directed against the offending employer as the administrator 5,635
deems appropriate in the circumstances, which orders may include 5,636
revocation of the insurance corporation's right to enter into 5,637
indemnity contracts and revocation of the employer's status as a 5,638
self-insuring employer. 5,639
(2) The administrator may enter into a contract of 5,641
indemnity with any such employer upon such terms, payment of such 5,642
premium, and for such amount and form of indemnity as the 5,643
administrator determines and the administrator may procure 5,644
reinsurance of the liability of the public and private funds 5,645
under this chapter, or any part of the liability in respect of 5,646
either or both of the funds, upon such terms and premiums or 5,647
other payments from the fund or funds as the administrator deems 5,648
prudent in the maintenance of a solvent fund or funds from year 5,649
to year. When making the finding of fact which the administrator 5,650
is required by section 4123.35 of the Revised Code to make with 5,651
respect to the financial ability of an employer, no contract of 5,652
indemnity, or the ability of the employer to procure such a 5,653
contract, shall be considered as increasing the financial ability 5,654
of the employer. 5,655
Sec. 4123.84. (A) In all cases of injury or death, claims 5,664
for compensation or benefits for the specific part or parts of 5,665
the body injured shall be forever barred unless, within two years 5,666
after the injury or death: 5,667
(1) Written notice of the specific part or parts of the 5,669
body claimed to have been injured has been made to the industrial 5,670
131
commission or the bureau of workers' compensation; 5,671
(2) The employer, with knowledge of a claimed compensable 5,673
injury or occupational disease, has paid wages in lieu of 5,674
compensation for total disability OR IMPAIRMENT; 5,675
(3) In the event the employer is a self-insuring employer, 5,677
one of the following has occurred: 5,678
(a) Written notice of the specific part or parts of the 5,680
body claimed to have been injured has been given to the 5,681
commission or bureau or the employer has furnished treatment by a 5,682
licensed physician in the employ of an employer, provided, 5,683
however, that the furnishing of such treatment shall not 5,684
constitute a recognition of a claim as compensable, but shall do 5,685
no more than satisfy the requirements of this section; 5,686
(b) Compensation or benefits have been paid or furnished 5,688
equal to or greater than is provided for in sections 4123.52, 5,689
4123.55 to 4123.62, and 4123.64 to 4123.67 of the Revised Code, 5,690
PROVIDED THAT THE PAYMENT OR FURNISHING OF THE COMPENSATION OR 5,691
BENEFITS SHALL NOT CONSTITUTE A RECOGNITION OF A CLAIM OR ANY 5,692
CONDITION IN A CLAIM AS COMPENSABLE. THAT PAYMENT, THAT 5,693
COMPENSATION, OR THOSE BENEFITS SHALL DO NO MORE THAN SATISFY THE 5,695
REQUIREMENTS OF THIS SECTION.
(4) Written notice of death has been given to the 5,697
commission or bureau.
(B) The bureau shall provide printed notices quoting in 5,699
full division (A) of this section, and every self-insuring 5,700
employer shall post and maintain at all times one or more of the 5,701
notices in conspicuous places in the workshop or places of 5,702
employment. 5,703
(C) The commission has continuing jurisdiction as set 5,705
forth in section 4123.52 of the Revised Code over a claim which 5,706
meets the requirement of this section, including jurisdiction to 5,707
award compensation or benefits for loss or impairment of bodily 5,708
functions developing in a part or parts of the body not specified 5,709
pursuant to division (A)(1) of this section, if the commission 5,710
132
finds that the loss or impairment of bodily functions was due to 5,711
and a result of or a residual of the injury to one of the parts 5,712
of the body set forth in the written notice filed pursuant to 5,713
division (A)(1) of this section. 5,714
(D) Any claim pending before the administrator, the 5,716
commission, or a court on December 11, 1967, in which the remedy 5,717
is affected by this section is governed by this section. 5,718
(E) Notwithstanding the requirement that the notice 5,720
required to be given to the bureau, commission, or employer under 5,721
this section is to be in writing, the bureau may accept, assign a 5,722
claim number, and process a notice provided by any method of 5,723
telecommunication. Immediately upon receipt of the 5,724
telecommunicated notice, the bureau shall send a written notice 5,725
to the employer of the bureau's receipt of the telecommunicated 5,726
notice. Within fifteen days after receipt of the notice, the 5,727
employer may in writing either MAY verify or not verify the 5,728
telecommunicated notice. If the bureau does not receive the 5,729
written notification from the employer or receives a written 5,730
notification verifying the telecommunicated notice within such 5,731
time period, the claim is validly filed and such telecommunicated 5,732
notice tolls the statute of limitations in regard to the claim 5,733
filed and is considered to meet the requirements of written 5,734
notice required by this section. 5,735
(F) As used in division (A)(3)(b) of this section, 5,737
"benefits" means payments by a self-insuring employer to, or on 5,738
behalf of, an employee for a hospital bill, a medical bill to a 5,739
licensed physician or hospital, or an orthopedic or prosthetic 5,740
device. 5,741
Sec. 4123.85. In all cases of occupational disease, or 5,750
death resulting from occupational disease, claims for 5,751
compensation or benefits are forever barred unless, within two 5,752
years after the disability due to the disease began, or within 5,754
such longer period as does not exceed six months after FIRST
diagnosis of the occupational disease by a licensed physician or 5,755
133
within two years after death occurs, application is made to the 5,756
industrial commission or the bureau of workers' compensation or 5,757
to the employer if he THE EMPLOYER is a self-insuring employer. 5,759
Sec. 4123.90. (A) The bureau ADMINISTRATOR of workers' 5,768
compensation, industrial commission WORKERS' COMPENSATION HEARING 5,769
OFFICERS, or any other PERSON OR body constituted by the statutes 5,771
of this state, or any court of this state, in awarding
compensation to the dependents of employees, or others killed in 5,772
Ohio THIS STATE, shall not make any discrimination against the 5,773
widows SURVIVING SPOUSES, children, or other dependents who 5,775
reside in a foreign country. The bureau ADMINISTRATOR, commission 5,776
HEARING OFFICER, or any other board, PERSON, or court, in 5,778
determining the amount of compensation to be paid to the 5,779
dependents of killed employees, shall pay to the alien dependents 5,780
residing in foreign countries the same benefits as to those 5,781
dependents residing in this state. 5,782
(B) No employer shall discharge, demote, reassign, or take 5,784
any punitive action against any employee because the employee 5,785
filed a claim or instituted, pursued, or testified in any 5,786
proceedings under the workers' compensation act THIS CHAPTER OR 5,787
CHAPTER 4126., 4127., OR 4131. OF THE REVISED CODE for an injury 5,788
or occupational disease which occurred in the course of and 5,789
arising out of his employment with that employer. Any such 5,790
AN employee AFFECTED BY A VIOLATION OF THIS DIVISION may 5,792
file an action in the COURT OF common pleas court of the county 5,793
of such employment in which the relief which may be granted shall 5,795
be limited to reinstatement with back pay, if the action is based 5,796
upon discharge, or an award for wages lost if based upon 5,797
demotion, reassignment, or punitive action taken, offset by 5,798
earnings subsequent to discharge, demotion, reassignment, or 5,799
punitive action taken, and payments received pursuant to section 5,800
4123.56 and Chapter 4141. of the Revised Code plus reasonable 5,801
attorney fees. The action shall be IS forever barred unless 5,802
filed within one hundred eighty days immediately following the 5,803
134
discharge, demotion, reassignment, or punitive action taken, and 5,804
no action may be instituted or maintained unless the employer has 5,805
received written notice of a claimed violation of this paragraph 5,806
within the ninety days immediately following the discharge, 5,807
demotion, reassignment, or punitive action taken. 5,808
Sec. 4127.03. Every work-relief employee who sustains an 5,817
injury and the dependents of such as are killed, in the course of 5,818
and arising out of employment, wheresoever such WHEREVER THAT 5,819
injury or death occurs, except when such injury or death is 5,821
caused by willful misconduct or intent to bring about such injury 5,822
or death, or when the use of intoxicating liquors or drugs is the 5,823
proximate cause of such injury or death, is entitled to receive 5,824
out of the public work-relief employees' compensation fund, 5,825
compensation, death benefits, medical, nurse, and hospital 5,826
services, medicine, and funeral expenses, for loss sustained on 5,827
account of such injury or death, as is provided for by Chapter 5,828
4123. of the Revised Code.
Except as provided in section 4127.06 of the Revised Code, 5,830
no compensation shall be paid from the work-relief employees' 5,831
compensation fund for or on account of any temporary disability 5,832
or partial disability IMPAIRMENT; except that in the cases 5,833
included in the schedule of loss of specific members or sight, 5,835
set forth in section 4123.57 of the Revised Code, the disability 5,836
OR IMPAIRMENT is deemed to continue for the periods mentioned for 5,838
each of such cases in that section. In cases where the injury 5,839
results in the total or partial loss of use of any such member, 5,840
the disability OR IMPAIRMENT is deemed to continue for such 5,842
proportion of the period fixed for the total loss of a member as 5,843
the administrator of workers' compensation finds that the actual 5,844
physical disability OR IMPAIRMENT bears to the total loss of such 5,846
members.
All compensation payable under this chapter shall be paid 5,848
on the basis of computation provided for in this chapter. 5,849
Sec. 4127.06. During periods of temporary disability and 5,858
135
partial disability IMPAIRMENT other than that resulting from loss 5,860
of a member or sight or total or partial loss of use of a member, 5,861
an injured work-relief employee shall be paid directly out of the 5,862
fund from which the employee was receiving relief, the amounts 5,863
required to meet the budgetary needs of the employee and his THE 5,864
EMPLOYEE'S dependents, and in the manner determined by the person 5,865
or agency having control over or supervision of the fund. 5,866
When all of the funds for relief purposes which are 5,868
available to any employer are exhausted, or when, disability OR 5,869
IMPAIRMENT as a result of the injury is continuous beyond a 5,872
period of six months, the injured work-relief employee shall be
compensated for temporary DISABILITY and partial disability 5,873
IMPAIRMENT out of the public work-relief employees' compensation 5,875
fund by the bureau of workers' compensation in the same manner 5,876
and amount as is provided in sections 4127.01 to 4127.14 of the
Revised Code for other disabilities AND IMPAIRMENTS. 5,877
Sec. 4141.31. (A) Benefits otherwise payable for any week 5,886
shall be reduced by the amount of remuneration a claimant 5,887
receives with respect to such week as follows: 5,888
(1) Remuneration in lieu of notice; 5,890
(2) Compensation for wage loss under division (B)(C) of 5,892
section 4123.56 of the Revised Code or temporary partial 5,893
disability under the workers' compensation law of any state or 5,894
under a similar law of the United States; 5,895
(3) Except as provided in section 4141.312 of the Revised 5,897
Code, payments in the form of retirement, or pension allowances 5,898
under a plan wholly financed by an employer which payments are 5,899
paid either directly by the employer, or indirectly through a 5,900
trust, annuity, insurance fund, or under an insurance contract 5,901
whether payable upon retirement, termination, or separation from 5,902
employment, provided that if the claimant has twenty-six weeks or 5,903
more of employment with a subsequent employer or employers who 5,904
are not paying him a pension or retirement allowance, then such 5,905
pension or retirement payments shall not reduce the benefits 5,906
136
payable for the week, and provided further that no benefits shall 5,907
thereafter be charged to the account of the employer who is 5,908
paying the pension, but instead such benefits shall be charged to 5,909
the mutualized account except as provided in division (B)(1)(b) 5,910
of section 4141.241 of the Revised Code if the claimant's 5,911
separation from the employer was disqualifying under division 5,912
(D)(2)(a) of section 4141.29 of the Revised Code. 5,913
(4) Remuneration in the form of separation or termination 5,915
pay paid to an employee at the time of his THE EMPLOYEE'S 5,916
separation from employment; 5,918
(5) Vacation pay or allowance payable under the terms of a 5,920
labor-management contract or agreement, or other contract of 5,921
hire, which payments are allocated to designated weeks. 5,922
If payments under this division are paid with respect to a 5,924
month then the amount of remuneration deemed to be received with 5,925
respect to any week during such month shall be computed by 5,926
multiplying such monthly amount by twelve and dividing the 5,927
product by fifty-two. If there is no designation of the period 5,928
with respect to which payments to an individual are made under 5,929
this section then an amount equal to such individual's normal 5,930
weekly wage shall be attributed to and deemed paid with respect 5,931
to the first and each succeeding week following his THE 5,932
EMPLOYEE'S separation or termination from the employment of the 5,934
employer making the payment until such amount so paid is 5,935
exhausted.
If benefits for any week, when reduced as provided in this 5,937
division, result in an amount not a multiple of one dollar, such 5,938
benefits shall be rounded to the next lower multiple of one 5,939
dollar. 5,940
Any payment allocated by the employer or the administrator 5,942
of the bureau of employment services to weeks under division 5,943
(A)(1), (4), or (5) of this section shall be deemed to be 5,944
remuneration for the purposes of establishing a qualifying week 5,945
and a benefit year under divisions (O)(1) and (R) of section 5,946
137
4141.01 of the Revised Code. 5,947
(B) Benefits payable for any week shall not be reduced by 5,949
the amount of remuneration a claimant receives with respect to 5,950
such week in the form of drill or reserve pay received by a 5,951
member of the Ohio national guard or the armed forces reserve for 5,952
attendance at a regularly scheduled drill or meeting. 5,953
(C) No benefits shall be paid for any week with respect to 5,955
which or a part of which an individual has received or is seeking 5,956
unemployment benefits under an unemployment compensation law of 5,957
any other state or of the United States, provided the 5,958
disqualifications shall not apply if the appropriate agency of 5,959
such other state or of the United States finally determines that 5,960
he is not entitled to such unemployment benefits. A law of the 5,961
United States providing any payment of any type and in any 5,962
amounts for periods of unemployment due to lack of work shall be 5,963
considered an unemployment compensation law of the United States. 5,964
(D) Notwithstanding any other provision in this chapter, 5,966
benefits otherwise payable shall not be reduced by payments that 5,967
were made to an individual on or after August 1, 1991, pursuant 5,968
to "The National Defense Authorization Act for Fiscal Years 1992 5,969
and 1993," Public Law 102-190, 105 Stat. 1394, 1396, 10 U.S.C.A. 5,970
1174a, 1175, in the form of voluntary separation incentive 5,971
payments and special separation pay. 5,972
Section 2. That existing sections 2913.48, 4121.32, 5,974
4121.34, 4121.35, 4121.36, 4121.38, 4121.47, 4121.61, 4121.67, 5,975
4123.01, 4123.032, 4123.033, 4123.07, 4123.25, 4123.27, 4123.28, 5,976
4123.343, 4123.35, 4123.352, 4123.411, 4123.412, 4123.413, 5,977
4123.414, 4123.416, 4123.419, 4123.511, 4123.512, 4123.52, 5,978
4123.54, 4123.541, 4123.55, 4123.56, 4123.57, 4123.58, 4123.59, 5,979
4123.60, 4123.61, 4123.62, 4123.64, 4123.65, 4123.651, 4123.66, 5,980
4123.68, 4123.70. 4123.80, 4123.82, 4123.84, 4123.85, 4123.90, 5,981
4127.03, 4127.06, and 4141.31 of the Revised Code are hereby 5,982
repealed. 5,983
Section 3. The provisions of this act apply to all claims 5,985
138
arising on and after the effective date of this act. 5,986
Section 4. The penalties provided for in divisions (B) and 5,988
(C) of section 4121.444 of the Revised Code apply to any 5,989
overpayment, billing, or falsification occurring on or after the 5,990
effective date of this act.
Section 5. The amendments to the definition of 5,992
"occupational disease" made by this act contained in division (F) 5,993
of section 4123.01 of the Revised Code are not intended and shall 5,994
not be construed as altering a firefighter's or police officer's 5,995
rights to compensation pursuant to division (W) of section
4123.68 of the Revised Code as those rights existed on the 5,997
effective date of this act by virtue of statute, administrative 5,998
rule, or judicial decision or a combination of statutes, rules, 5,999
or decisions.