As Introduced 1
123rd General Assembly 4
Regular Session H. B. No. 611 5
1999-2000 6
REPRESENTATIVE CATES 8
_________________________________________________________________ 9
A B I L L
To amend sections 4121.31, 4123.511, 4123.52, and 11
4123.84 of the Revised Code to require the 12
Administrator of Workers' Compensation and the 13
Industrial Commission jointly to adopt rules
governing the submission and sending of documents 14
via electronic transmission, to modify the 15
processing requirements for claim applications
that are not written, and to declare an 16
emergency.
BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF OHIO: 18
Section 1. That sections 4121.31, 4123.511, 4123.52, and 20
4123.84 of the Revised Code be amended to read as follows: 21
Sec. 4121.31. (A) The administrator of workers' 30
compensation and the industrial commission jointly shall adopt 31
rules covering the following general topics with respect to this 32
chapter and Chapter 4123. of the Revised Code: 33
(A)(1) Rules that set forth any general policy and the 35
principal operating procedures of the bureau of workers' 36
compensation or commission, including but not limited to: 37
(1)(a) Assignment to various operational units of any 39
duties placed upon the administrator or the commission by 40
statute;
(2)(b) Procedures for decision-making; 42
(3)(c) Procedures governing the appearances of a claimant, 44
employer, or their representatives before the agency in a 45
hearing; 46
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(4)(d) Procedures that inform claimants, on request, of 48
the status of a claim and any actions necessary to maintain the 49
claim; 50
(5)(e) Time goals for activities of the bureau or 52
commission;
(6)(f) Designation of the person or persons authorized to 54
issue directives with directives numbered and distributed from a 55
central distribution point to persons on a list maintained for 56
that purpose. 57
(B)(2) A rule barring any employee of the bureau or 59
commission from having a workers' compensation claims file in the 60
employee's possession unless the file is necessary to the 61
performance of the employee's duties. 62
(C)(3) All claims, whether of a state fund or 64
self-insuring employer, be processed in an orderly, uniform, and 65
timely fashion. 66
(4) RULES GOVERNING THE SUBMISSION AND SENDING OF 68
APPLICATIONS, NOTICES, EVIDENCE, AND OTHER DOCUMENTS BY 69
ELECTRONIC MEANS. THE RULES SHALL PROVIDE THAT WHERE THIS 70
CHAPTER OR CHAPTER 4123., 4127., OR 4131. OF THE REVISED CODE 72
REQUIRES THAT A DOCUMENT BE IN WRITING OR REQUIRES A SIGNATURE,
THE ADMINISTRATOR AND THE COMMISSION, TO THE EXTENT OF THEIR 74
RESPECTIVE JURISDICTIONS, MAY APPROVE OF AND PROVIDE FOR THE 75
ELECTRONIC SUBMISSION AND SENDING OF THOSE DOCUMENTS, AND THE USE 76
OF AN ELECTRONIC SIGNATURE ON THOSE DOCUMENTS. 77
(B) AS USED IN THIS SECTION: 79
(1) "ELECTRONIC" INCLUDES ELECTRICAL, DIGITAL, MAGNETIC, 81
OPTICAL, ELECTROMAGNETIC, OR ANY OTHER FORM OF TECHNOLOGY THAT 82
ENTAILS CAPABILITIES SIMILAR TO THESE TECHNOLOGIES. 83
(2) "ELECTRONIC RECORD" MEANS A RECORD GENERATED, 85
COMMUNICATED, RECEIVED, OR STORED BY ELECTRONIC MEANS FOR USE IN 86
AN INFORMATION SYSTEM OR FOR TRANSMISSION FROM ONE INFORMATION 87
SYSTEM TO ANOTHER.
(3) "ELECTRONIC SIGNATURE" MEANS A SIGNATURE IN ELECTRONIC 89
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FORM ATTACHED TO OR LOGICALLY ASSOCIATED WITH AN ELECTRONIC 90
RECORD.
Sec. 4123.511. (A) Within seven days after receipt of any 100
claim under this chapter, the bureau of workers' compensation
shall notify the claimant and the employer of the claimant of the 101
receipt of the claim and of the facts alleged therein. If the 102
bureau receives from a person other than the claimant written or 103
telecommunicated information OR INFORMATION COMMUNICATED VERBALLY 104
OVER THE TELEPHONE indicating that an injury or occupational 105
disease has occurred or been contracted with WHICH may be 106
compensable under this chapter, the bureau shall notify the 108
employee and the employer of the information. If the information 109
is provided by any method of telecommunication VERBALLY OVER THE 110
TELEPHONE, the person providing the information shall provide 112
written verification of the information to the bureau according 113
to division (E) of section 4123.84 of the Revised Code. The 114
receipt of the information in writing, or if INITIALLY by a 115
method of telecommunications TELEPHONE, the SUBSEQUENT written 117
verification, and the notice by the bureau shall be considered an 118
application for compensation under section 4123.84 or 4123.85 of 119
the Revised Code, provided that the conditions of division (E) of 120
section 4123.84 of the Revised Code apply to information provided 121
by a method of telecommunication VERBALLY OVER THE TELEPHONE. 122
Upon receipt of a claim, the bureau shall advise the claimant of 123
the claim number assigned and the claimant's right to
representation in the processing of a claim or to elect no 125
representation. If the bureau determines that a claim is 126
determined to be a compensable lost-time claim, the bureau shall 127
notify the claimant and the employer of the availability of 128
rehabilitation services. No bureau or industrial commission 129
employee shall directly or indirectly convey any information in 130
derogation of this right. This section shall in no way abrogate 131
the bureau's responsibility to aid and assist a claimant in the 132
filing of a claim and to advise the claimant of the claimant's 133
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rights under the law.
The administrator of workers' compensation shall assign all 135
claims and investigations to the bureau service office from which 136
investigation and determination may be made most expeditiously. 137
The bureau shall investigate the facts concerning an injury 139
or occupational disease and ascertain such facts in whatever 140
manner is most appropriate and may obtain statements of the 141
employee, employer, attending physician, and witnesses in 142
whatever manner is most appropriate. 143
(B)(1) Except as provided in division (B)(2) of this 145
section, in claims other than those in which the employer is a 146
self-insuring employer, if the administrator determines under 147
division (A) of this section that a claimant is or is not 148
entitled to an award of compensation or benefits, the 149
administrator shall issue an order no later than twenty-eight 151
days after the sending of the notice under division (A) of this 152
section, granting or denying the payment of the compensation or 153
benefits, or both as is appropriate to the claimant. 154
Notwithstanding the time limitation specified in this division
for the issuance of an order, if a medical examination of the 155
claimant is required by statute, the administrator promptly shall 156
schedule the claimant for that examination and shall issue an 157
order no later than twenty-eight days after receipt of the report 158
of the examination. The administrator shall notify the claimant 159
and the employer of the claimant and their respective 160
representatives in writing of the nature of the order and the 161
amounts of compensation and benefit payments involved. The 162
employer or claimant may appeal the order pursuant to division 163
(C) of this section within fourteen days after the date of the 164
receipt of the order. The employer and claimant may waive, in 165
writing, their rights to an appeal under this division. 166
(2) Notwithstanding the time limitation specified in 168
division (B)(1) of this section for the issuance of an order, if 169
the employer certifies a claim for payment of compensation or 170
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benefits, or both, to a claimant, and the administrator has 171
completed the investigation of the claim, the payment of benefits 173
or compensation, or both, as is appropriate, shall commence upon 174
the later of the date of the certification or completion of the 175
investigation and issuance of the order by the administrator, 176
provided that the administrator shall issue the order no later 177
than the time limitation specified in division (B)(1) of this 178
section. 179
(3) If an appeal is made under division (B)(1) or (2) of 181
this section, the administrator shall forward the claim file to 182
the appropriate district hearing officer within seven days of the 183
appeal. In contested claims other than state fund claims, the 184
administrator shall forward the claim within seven days of the 185
administrator's receipt of the claim to the commission, which 187
shall refer the claim to an appropriate district hearing officer 188
for a hearing in accordance with division (C) of this section. 189
(C) If an employer or claimant timely appeals the order of 191
the administrator issued under division (B) of this section or in 192
the case of other contested claims other than state fund claims, 193
the commission shall refer the claim to an appropriate district 194
hearing officer according to rules the commission adopts under 195
section 4121.36 of the Revised Code. The district hearing 196
officer shall notify the parties and their respective 197
representatives of the time and place of the hearing. 198
The district hearing officer shall hold a hearing on a 200
disputed issue or claim within forty-five days after the filing 202
of the appeal under this division and issue a decision within 203
seven days after holding the hearing. The district hearing 204
officer shall notify the parties and their respective
representatives in writing of the order. Any party may appeal an 206
order issued under this division pursuant to division (D) of this 207
section within fourteen days after receipt of the order under 208
this division. 209
(D) Upon the timely filing of an appeal of the order of 211
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the district hearing officer issued under division (C) of this 212
section, the commission shall refer the claim file to an 213
appropriate staff hearing officer according to its rules adopted 214
under section 4121.36 of the Revised Code. The staff hearing 215
officer shall hold a hearing within forty-five days after the 216
filing of an appeal under this division and issue a decision 217
within seven days after holding the hearing under this division. 220
The staff hearing officer shall notify the parties and their 221
respective representatives in writing of the staff hearing
officer's order. Any party may appeal an order issued under this 223
division pursuant to division (E) of this section within fourteen 224
days after receipt of the order under this division. 225
(E) Upon the filing of a timely appeal of the order of the 227
staff hearing officer issued under division (D) of this section, 228
the commission or a designated staff hearing officer, on behalf 229
of the commission, shall determine whether the commission will 231
hear the appeal. If the commission or the designated staff
hearing officer decides to hear the appeal, the commission or the 233
designated staff hearing officer shall notify the parties and 234
their respective representatives in writing of the time and place 235
of the hearing. The commission shall hold the hearing within 236
forty-five days after the filing of the notice of appeal and, 237
within seven days after the conclusion of the hearing, the 238
commission shall issue its order affirming, modifying, or 239
reversing the order issued under division (D) of this section. 240
The commission shall notify the parties and their respective 241
representatives in writing of the order. If the commission or 242
the designated staff hearing officer determines not to hear the 243
appeal, within fourteen days after the filing of the notice of 244
appeal, the commission or the designated staff hearing officer 245
shall issue an order to that effect and notify the parties and
their respective representatives in writing of that order. 246
Except as otherwise provided in this chapter and Chapters 248
4121., 4127., and 4131. of the Revised Code, any party may appeal 249
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an order issued under this division to the court pursuant to 250
section 4123.512 of the Revised Code within sixty days after 251
receipt of the order, subject to the limitations contained in 252
that section. 253
(F) Every notice of an appeal from an order issued under 255
divisions (B), (C), (D), and (E) of this section shall state the 256
names of the claimant and employer, the number of the claim, the 257
date of the decision appealed from, and the fact that the 258
appellant appeals therefrom. 259
(G) All of the following apply to the proceedings under 261
divisions (C), (D), and (E) of this section: 262
(1) The parties shall proceed promptly and without 264
continuances except for good cause; 265
(2) The parties, in good faith, shall engage in the free 267
exchange of information relevant to the claim prior to the 268
conduct of a hearing according to the rules the commission adopts 269
under section 4121.36 of the Revised Code; 270
(3) The administrator is a party and may appear and 272
participate at all administrative proceedings on behalf of the 273
state insurance fund. However, in cases in which the employer is 274
represented, the administrator shall neither present arguments 275
nor introduce testimony that is cumulative to that presented or 276
introduced by the employer or the employer's representative. The 277
administrator may file an appeal under this section on behalf of
the state insurance fund; however, except in cases arising under 278
section 4123.343 of the Revised Code, the administrator only may 279
appeal questions of law or issues of fraud when the employer 280
appears in person or by representative.
(H) Except as provided in section 4121.63 of the Revised 282
Code and division (J) of this section, payments of compensation 283
to a claimant or on behalf of a claimant as a result of any order 284
issued under this chapter shall commence upon the earlier of the 285
following:
(1) Fourteen days after the date the administrator issues 287
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an order under division (B) of this section, unless that order is 288
appealed; 289
(2) The date when the employer has waived the right to 292
appeal a decision issued under division (B) of this section; 293
(3) If no appeal of an order has been filed under this 295
section or to a court under section 4123.512 of the Revised Code, 296
the expiration of the time limitations for the filing of an 297
appeal of an order; 298
(4) The date of receipt by the employer of an order of a 300
district hearing officer, a staff hearing officer, or the 302
industrial commission issued under division (C), (D), or (E) of 303
this section.
(I) No medical benefits payable under this chapter or 305
Chapter 4121., 4127., or 4131. of the Revised Code are payable 306
until the earlier of the following: 307
(1) The date of the issuance of the staff hearing 309
officer's order under division (D) of this section; 310
(2) The date of the final administrative or judicial 312
determination. 313
(J) Upon the final administrative or judicial 315
determination under this section or section 4123.512 of the 316
Revised Code of an appeal of an order to pay compensation, if a 317
claimant is found to have received compensation pursuant to a 318
prior order which is reversed upon subsequent appeal, the 319
claimant's employer, if a self-insuring employer, or the bureau, 321
shall withhold from any amount to which the claimant becomes 322
entitled pursuant to any claim, past, present, or future, under 323
Chapter 4121., 4123., 4127., or 4131. of the Revised Code, the 324
amount of previously paid compensation to the claimant which, due 325
to reversal upon appeal, the claimant is not entitled, pursuant 326
to the following criteria: 327
(1) No withholding for the first twelve weeks of temporary 329
total disability compensation pursuant to section 4123.56 of the 330
Revised Code shall be made; 331
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(2) Forty per cent of all awards of compensation paid 333
pursuant to sections 4123.56 and 4123.57 of the Revised Code, 334
until the amount overpaid is refunded; 335
(3) Twenty-five per cent of any compensation paid pursuant 337
to section 4123.58 of the Revised Code until the amount overpaid 338
is refunded; 339
(4) If, pursuant to an appeal under section 4123.512 of 341
the Revised Code, the court of appeals or the supreme court 342
reverses the allowance of the claim, then no amount of any 343
compensation will be withheld. 344
The administrator and self-insuring employers, as 346
appropriate, are subject to the repayment schedule of this 347
division only with respect to an order to pay compensation that 348
was properly paid under a previous order, but which is
subsequently reversed upon an administrative or judicial appeal. 349
The administrator and self-insuring employers are not subject to, 350
but may utilize, the repayment schedule of this division, or any 351
other lawful means, to collect payment of compensation made to a 352
person who was not entitled to the compensation due to fraud as 353
determined by the administrator or the industrial commission. 354
(K) If a staff hearing officer or the commission fails to 356
issue a decision or the commission fails to refuse to hear an 357
appeal within the time periods required by this section, payments 358
to a claimant shall cease until the staff hearing officer or 359
commission issues a decision or hears the appeal, unless the 360
failure was due to the fault or neglect of the employer or the 361
employer agrees that the payments should continue for a longer 362
period of time. 363
(L) Except as otherwise provided in this section or 365
section 4123.522 of the Revised Code, no appeal is timely filed 366
under this section unless the appeal is filed with the time 367
limits set forth in this section.
(M) No person who is not an employee of the bureau or 369
commission or who is not by law given access to the contents of a 370
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claims file shall have a file in the person's possession. 371
(N) Upon application of a party who resides in an area in 374
which an emergency or disaster is declared, the industrial 375
commission and hearing officers of the commission may waive the 376
time frame within which claims and appeals of claims set forth in 377
this section must be filed upon a finding that the applicant was 378
unable to comply with a filing deadline due to an emergency or a 379
disaster.
As used in this division: 381
(1) "Emergency" means any occasion or instance for which 383
the governor of Ohio or the president of the United States 385
publicly declares an emergency and orders state or federal 386
assistance to save lives and protect property, the public health 387
and safety, or to lessen or avert the threat of a catastrophe. 388
(2) "Disaster" means any natural catastrophe or fire, 390
flood, or explosion, regardless of the cause, that causes damage 391
of sufficient magnitude that the governor of Ohio or the 392
President PRESIDENT of the United States, through a public 393
declaration, orders state or federal assistance to alleviate 395
damage, loss, hardship, or suffering that results from the 396
occurrence.
Sec. 4123.52. The jurisdiction of the industrial 405
commission and the authority of the administrator of workers' 406
compensation over each case is continuing, and the commission may 407
make such modification or change with respect to former findings 408
or orders with respect thereto, as, in its opinion is justified. 409
No modification or change nor any finding or award in respect of 410
any claim shall be made with respect to disability, compensation, 411
dependency, or benefits, after six years from the date of injury 413
in the absence of the payment of medical benefits under this
chapter, in which event the modification, change, finding, or 414
award shall be made within six years after the payment of medical 416
benefits, or in the absence of payment of compensation under
section 4123.57, 4123.58, or division (A) or (B) of section 418
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4123.56 of the Revised Code or wages in lieu of compensation in a 419
manner so as to satisfy the requirements of section 4123.84 of
the Revised Code, in which event the modification, change, 420
finding, or award shall be made within ten years from the date of 421
the last payment of compensation or from the date of death, nor 422
unless written notice of claim for the specific part or parts of 423
the body injured or disabled has been given as provided in 424
section 4123.84 or 4123.85 of the Revised Code, and the 425
commission shall not make any modification, change, finding, or 426
award which shall award compensation for a back period in excess 427
of two years prior to the date of filing application therefor. 428
This section does not affect the right of a claimant to 429
compensation accruing subsequent to the filing of any such 430
application, provided the application is filed within the time 431
limit provided in this section.
This section does not deprive the commission of its 433
continuing jurisdiction to determine the questions raised by any 434
application for modification of award which has been filed with 435
the commission after June 1, 1932, and prior to the expiration of 436
the applicable period but in respect to which no award has been 437
granted or denied during the applicable period. 438
The commission may, by general rules, provide for the 440
destruction of files of cases in which no further action may be 441
taken. 442
The commission and administrator of workers' compensation 444
each may, by general rules, provide for the retention and 445
destruction of all other records in their possession or under 446
their control pursuant to section 121.211 and sections 149.34 to 447
149.36 of the Revised Code. The bureau of workers' compensation 448
may purchase or rent required equipment for the document 449
retention media, as determined necessary to preserve the records. 450
Photographs, microphotographs, microfilm, films, or other direct 451
document retention media, when properly identified, have the same 452
effect as the original record and may be offered in like manner 453
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and may be received as evidence in PROCEEDINGS BEFORE THE 454
INDUSTRIAL COMMISSION, STAFF HEARING OFFICERS, AND DISTRICT 455
HEARING OFFICERS, AND IN any court where the original record 457
could have been introduced.
Sec. 4123.84. (A) In all cases of injury or death, claims 466
for compensation or benefits for the specific part or parts of 467
the body injured shall be forever barred unless, within two years 468
after the injury or death: 469
(1) Written notice of the specific part or parts of the 471
body claimed to have been injured has been made to the industrial 472
commission or the bureau of workers' compensation; 473
(2) The employer, with knowledge of a claimed compensable 475
injury or occupational disease, has paid wages in lieu of 476
compensation for total disability; 477
(3) In the event the employer is a self-insuring employer, 479
one of the following has occurred: 480
(a) Written notice of the specific part or parts of the 482
body claimed to have been injured has been given to the 483
commission or bureau or the employer has furnished treatment by a 484
licensed physician in the employ of an employer, provided, 485
however, that the furnishing of such treatment shall not 486
constitute a recognition of a claim as compensable, but shall do 487
no more than satisfy the requirements of this section; 488
(b) Compensation or benefits have been paid or furnished 490
equal to or greater than is provided for in sections 4123.52, 491
4123.55 to 4123.62, and 4123.64 to 4123.67 of the Revised Code. 492
(4) Written notice of death has been given to the 494
commission or bureau.
(B) The bureau shall provide printed notices quoting in 496
full division (A) of this section, and every self-insuring 497
employer shall post and maintain at all times one or more of the 498
notices in conspicuous places in the workshop or places of 499
employment. 500
(C) The commission has continuing jurisdiction as set 502
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forth in section 4123.52 of the Revised Code over a claim which 503
meets the requirement of this section, including jurisdiction to 504
award compensation or benefits for loss or impairment of bodily 505
functions developing in a part or parts of the body not specified 506
pursuant to division (A)(1) of this section, if the commission 507
finds that the loss or impairment of bodily functions was due to 508
and a result of or a residual of the injury to one of the parts 509
of the body set forth in the written notice filed pursuant to 510
division (A)(1) of this section. 511
(D) Any claim pending before the administrator, the 513
commission, or a court on December 11, 1967, in which the remedy 514
is affected by this section is governed by this section. 515
(E) Notwithstanding the requirement that the notice 517
required to be given to the bureau, commission, or employer under 518
this section is to be in writing, the bureau may accept, assign a 519
claim number, and process a CLAIM WHEN notice IS provided by any 521
method of telecommunication VERBALLY OVER THE TELEPHONE. 522
Immediately upon receipt of the telecommunicated notice PROVIDED 524
VERBALLY OVER THE TELEPHONE, the bureau shall send a written 525
notice to the employer of the bureau's receipt of the 526
telecommunicated VERBAL notice. Within fifteen days after 527
receipt of the BUREAU'S WRITTEN notice, the employer may in 529
writing either verify or not verify the telecommunicated VERBAL 530
notice. If the bureau does not receive the written notification 532
from the employer or receives a written notification verifying 533
the telecommunicated VERBAL notice within such time period, the 535
claim is validly filed and such telecommunicated VERBAL notice 536
tolls the statute of limitations in regard to the claim filed and 537
is considered to meet the requirements of written notice required 538
by this section.
(F) As used in division (A)(3)(b) of this section, 540
"benefits" means payments by a self-insuring employer to, or on 541
behalf of, an employee for a hospital bill, a medical bill to a 542
licensed physician or hospital, or an orthopedic or prosthetic 543
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device. 544
Section 2. That existing sections 4121.31, 4123.511, 546
4123.52, and 4123.84 of the Revised Code are hereby repealed. 547
Section 3. This act is hereby declared to be an emergency 549
measure necessary for the immediate preservation of the public 550
peace, health, and safety. The reason for such necessity is to 551
enable the Bureau of Workers' Compensation to continue processing 552
claims and the Industrial Commission to continue adjudicating 553
claims in a timely and efficient manner and to ensure that 554
unnecessary lapses and avoidable delays do not interfere with the 555
continuing care and treatment of claimants throughout the state. 556
Therefore, this act shall go into immediate effect. 557