As Reported by House Commerce and Labor Committee 1
123rd General Assembly 4
Regular Session H. B. No. 611 5
1999-2000 6
REPRESENTATIVES CATES-CORBIN-WILLIAMS-BUEHRER-TRAKAS-HARRIS- 8
ROBINSON-YOUNG-HOOD 9
_________________________________________________________________ 10
A B I L L
To amend sections 4121.31, 4123.511, 4123.52, and 12
4123.84 of the Revised Code to require the 13
Administrator of Workers' Compensation and the 14
Industrial Commission jointly to adopt rules
governing the submission and sending of documents 15
via electronic transmission, to modify the 16
processing requirements for claim applications
that are not written, and to declare an 17
emergency.
BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF OHIO: 19
Section 1. That sections 4121.31, 4123.511, 4123.52, and 21
4123.84 of the Revised Code be amended to read as follows: 22
Sec. 4121.31. (A) The administrator of workers' 31
compensation and the industrial commission jointly shall adopt 32
rules covering the following general topics with respect to this 33
chapter and Chapter 4123. of the Revised Code: 34
(A)(1) Rules that set forth any general policy and the 36
principal operating procedures of the bureau of workers' 37
compensation or commission, including but not limited to: 38
(1)(a) Assignment to various operational units of any 40
duties placed upon the administrator or the commission by 41
statute;
(2)(b) Procedures for decision-making; 43
(3)(c) Procedures governing the appearances of a claimant, 45
employer, or their representatives before the agency in a 46
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hearing; 47
(4)(d) Procedures that inform claimants, on request, of 49
the status of a claim and any actions necessary to maintain the 50
claim; 51
(5)(e) Time goals for activities of the bureau or 53
commission;
(6)(f) Designation of the person or persons authorized to 55
issue directives with directives numbered and distributed from a 56
central distribution point to persons on a list maintained for 57
that purpose. 58
(B)(2) A rule barring any employee of the bureau or 60
commission from having a workers' compensation claims file in the 61
employee's possession unless the file is necessary to the 62
performance of the employee's duties. 63
(C)(3) All claims, whether of a state fund or 65
self-insuring employer, be processed in an orderly, uniform, and 66
timely fashion. 67
(4) RULES GOVERNING THE SUBMISSION AND SENDING OF 69
APPLICATIONS, NOTICES, EVIDENCE, AND OTHER DOCUMENTS BY 70
ELECTRONIC MEANS. THE RULES SHALL PROVIDE THAT WHERE THIS 71
CHAPTER OR CHAPTER 4123., 4127., OR 4131. OF THE REVISED CODE 73
REQUIRES THAT A DOCUMENT BE IN WRITING OR REQUIRES A SIGNATURE,
THE ADMINISTRATOR AND THE COMMISSION, TO THE EXTENT OF THEIR 75
RESPECTIVE JURISDICTIONS, MAY APPROVE OF AND PROVIDE FOR THE 76
ELECTRONIC SUBMISSION AND SENDING OF THOSE DOCUMENTS, AND THE USE 77
OF AN ELECTRONIC SIGNATURE ON THOSE DOCUMENTS. 78
(B) AS USED IN THIS SECTION: 80
(1) "ELECTRONIC" INCLUDES ELECTRICAL, DIGITAL, MAGNETIC, 82
OPTICAL, ELECTROMAGNETIC, OR ANY OTHER FORM OF TECHNOLOGY THAT 83
ENTAILS CAPABILITIES SIMILAR TO THESE TECHNOLOGIES. 84
(2) "ELECTRONIC RECORD" MEANS A RECORD GENERATED, 86
COMMUNICATED, RECEIVED, OR STORED BY ELECTRONIC MEANS FOR USE IN 87
AN INFORMATION SYSTEM OR FOR TRANSMISSION FROM ONE INFORMATION 88
SYSTEM TO ANOTHER.
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(3) "ELECTRONIC SIGNATURE" MEANS A SIGNATURE IN ELECTRONIC 90
FORM ATTACHED TO OR LOGICALLY ASSOCIATED WITH AN ELECTRONIC 91
RECORD.
Sec. 4123.511. (A) Within seven days after receipt of any 101
claim under this chapter, the bureau of workers' compensation
shall notify the claimant and the employer of the claimant of the 102
receipt of the claim and of the facts alleged therein. If the 103
bureau receives from a person other than the claimant written or 104
telecommunicated information OR INFORMATION COMMUNICATED VERBALLY 105
OVER THE TELEPHONE indicating that an injury or occupational 106
disease has occurred or been contracted with WHICH may be 107
compensable under this chapter, the bureau shall notify the 109
employee and the employer of the information. If the information 110
is provided by any method of telecommunication VERBALLY OVER THE 111
TELEPHONE, the person providing the information shall provide 113
written verification of the information to the bureau according 114
to division (E) of section 4123.84 of the Revised Code. The 115
receipt of the information in writing, or if INITIALLY by a 116
method of telecommunications TELEPHONE, the SUBSEQUENT written 118
verification, and the notice by the bureau shall be considered an 119
application for compensation under section 4123.84 or 4123.85 of 120
the Revised Code, provided that the conditions of division (E) of 121
section 4123.84 of the Revised Code apply to information provided 122
by a method of telecommunication VERBALLY OVER THE TELEPHONE. 123
Upon receipt of a claim, the bureau shall advise the claimant of 124
the claim number assigned and the claimant's right to
representation in the processing of a claim or to elect no 126
representation. If the bureau determines that a claim is 127
determined to be a compensable lost-time claim, the bureau shall 128
notify the claimant and the employer of the availability of 129
rehabilitation services. No bureau or industrial commission 130
employee shall directly or indirectly convey any information in 131
derogation of this right. This section shall in no way abrogate 132
the bureau's responsibility to aid and assist a claimant in the 133
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filing of a claim and to advise the claimant of the claimant's 134
rights under the law.
The administrator of workers' compensation shall assign all 136
claims and investigations to the bureau service office from which 137
investigation and determination may be made most expeditiously. 138
The bureau shall investigate the facts concerning an injury 140
or occupational disease and ascertain such facts in whatever 141
manner is most appropriate and may obtain statements of the 142
employee, employer, attending physician, and witnesses in 143
whatever manner is most appropriate. 144
(B)(1) Except as provided in division (B)(2) of this 146
section, in claims other than those in which the employer is a 147
self-insuring employer, if the administrator determines under 148
division (A) of this section that a claimant is or is not 149
entitled to an award of compensation or benefits, the 150
administrator shall issue an order no later than twenty-eight 152
days after the sending of the notice under division (A) of this 153
section, granting or denying the payment of the compensation or 154
benefits, or both as is appropriate to the claimant. 155
Notwithstanding the time limitation specified in this division
for the issuance of an order, if a medical examination of the 156
claimant is required by statute, the administrator promptly shall 157
schedule the claimant for that examination and shall issue an 158
order no later than twenty-eight days after receipt of the report 159
of the examination. The administrator shall notify the claimant 160
and the employer of the claimant and their respective 161
representatives in writing of the nature of the order and the 162
amounts of compensation and benefit payments involved. The 163
employer or claimant may appeal the order pursuant to division 164
(C) of this section within fourteen days after the date of the 165
receipt of the order. The employer and claimant may waive, in 166
writing, their rights to an appeal under this division. 167
(2) Notwithstanding the time limitation specified in 169
division (B)(1) of this section for the issuance of an order, if 170
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the employer certifies a claim for payment of compensation or 171
benefits, or both, to a claimant, and the administrator has 172
completed the investigation of the claim, the payment of benefits 174
or compensation, or both, as is appropriate, shall commence upon 175
the later of the date of the certification or completion of the 176
investigation and issuance of the order by the administrator, 177
provided that the administrator shall issue the order no later 178
than the time limitation specified in division (B)(1) of this 179
section. 180
(3) If an appeal is made under division (B)(1) or (2) of 182
this section, the administrator shall forward the claim file to 183
the appropriate district hearing officer within seven days of the 184
appeal. In contested claims other than state fund claims, the 185
administrator shall forward the claim within seven days of the 186
administrator's receipt of the claim to the commission, which 188
shall refer the claim to an appropriate district hearing officer 189
for a hearing in accordance with division (C) of this section. 190
(C) If an employer or claimant timely appeals the order of 192
the administrator issued under division (B) of this section or in 193
the case of other contested claims other than state fund claims, 194
the commission shall refer the claim to an appropriate district 195
hearing officer according to rules the commission adopts under 196
section 4121.36 of the Revised Code. The district hearing 197
officer shall notify the parties and their respective 198
representatives of the time and place of the hearing. 199
The district hearing officer shall hold a hearing on a 201
disputed issue or claim within forty-five days after the filing 203
of the appeal under this division and issue a decision within 204
seven days after holding the hearing. The district hearing 205
officer shall notify the parties and their respective
representatives in writing of the order. Any party may appeal an 207
order issued under this division pursuant to division (D) of this 208
section within fourteen days after receipt of the order under 209
this division. 210
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(D) Upon the timely filing of an appeal of the order of 212
the district hearing officer issued under division (C) of this 213
section, the commission shall refer the claim file to an 214
appropriate staff hearing officer according to its rules adopted 215
under section 4121.36 of the Revised Code. The staff hearing 216
officer shall hold a hearing within forty-five days after the 217
filing of an appeal under this division and issue a decision 218
within seven days after holding the hearing under this division. 221
The staff hearing officer shall notify the parties and their 222
respective representatives in writing of the staff hearing
officer's order. Any party may appeal an order issued under this 224
division pursuant to division (E) of this section within fourteen 225
days after receipt of the order under this division. 226
(E) Upon the filing of a timely appeal of the order of the 228
staff hearing officer issued under division (D) of this section, 229
the commission or a designated staff hearing officer, on behalf 230
of the commission, shall determine whether the commission will 232
hear the appeal. If the commission or the designated staff
hearing officer decides to hear the appeal, the commission or the 234
designated staff hearing officer shall notify the parties and 235
their respective representatives in writing of the time and place 236
of the hearing. The commission shall hold the hearing within 237
forty-five days after the filing of the notice of appeal and, 238
within seven days after the conclusion of the hearing, the 239
commission shall issue its order affirming, modifying, or 240
reversing the order issued under division (D) of this section. 241
The commission shall notify the parties and their respective 242
representatives in writing of the order. If the commission or 243
the designated staff hearing officer determines not to hear the 244
appeal, within fourteen days after the filing of the notice of 245
appeal, the commission or the designated staff hearing officer 246
shall issue an order to that effect and notify the parties and
their respective representatives in writing of that order. 247
Except as otherwise provided in this chapter and Chapters 249
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4121., 4127., and 4131. of the Revised Code, any party may appeal 250
an order issued under this division to the court pursuant to 251
section 4123.512 of the Revised Code within sixty days after 252
receipt of the order, subject to the limitations contained in 253
that section. 254
(F) Every notice of an appeal from an order issued under 256
divisions (B), (C), (D), and (E) of this section shall state the 257
names of the claimant and employer, the number of the claim, the 258
date of the decision appealed from, and the fact that the 259
appellant appeals therefrom. 260
(G) All of the following apply to the proceedings under 262
divisions (C), (D), and (E) of this section: 263
(1) The parties shall proceed promptly and without 265
continuances except for good cause; 266
(2) The parties, in good faith, shall engage in the free 268
exchange of information relevant to the claim prior to the 269
conduct of a hearing according to the rules the commission adopts 270
under section 4121.36 of the Revised Code; 271
(3) The administrator is a party and may appear and 273
participate at all administrative proceedings on behalf of the 274
state insurance fund. However, in cases in which the employer is 275
represented, the administrator shall neither present arguments 276
nor introduce testimony that is cumulative to that presented or 277
introduced by the employer or the employer's representative. The 278
administrator may file an appeal under this section on behalf of
the state insurance fund; however, except in cases arising under 279
section 4123.343 of the Revised Code, the administrator only may 280
appeal questions of law or issues of fraud when the employer 281
appears in person or by representative.
(H) Except as provided in section 4121.63 of the Revised 283
Code and division (J) of this section, payments of compensation 284
to a claimant or on behalf of a claimant as a result of any order 285
issued under this chapter shall commence upon the earlier of the 286
following:
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(1) Fourteen days after the date the administrator issues 288
an order under division (B) of this section, unless that order is 289
appealed; 290
(2) The date when the employer has waived the right to 293
appeal a decision issued under division (B) of this section; 294
(3) If no appeal of an order has been filed under this 296
section or to a court under section 4123.512 of the Revised Code, 297
the expiration of the time limitations for the filing of an 298
appeal of an order; 299
(4) The date of receipt by the employer of an order of a 301
district hearing officer, a staff hearing officer, or the 303
industrial commission issued under division (C), (D), or (E) of 304
this section.
(I) No medical benefits payable under this chapter or 306
Chapter 4121., 4127., or 4131. of the Revised Code are payable 307
until the earlier of the following: 308
(1) The date of the issuance of the staff hearing 310
officer's order under division (D) of this section; 311
(2) The date of the final administrative or judicial 313
determination. 314
(J) Upon the final administrative or judicial 316
determination under this section or section 4123.512 of the 317
Revised Code of an appeal of an order to pay compensation, if a 318
claimant is found to have received compensation pursuant to a 319
prior order which is reversed upon subsequent appeal, the 320
claimant's employer, if a self-insuring employer, or the bureau, 322
shall withhold from any amount to which the claimant becomes 323
entitled pursuant to any claim, past, present, or future, under 324
Chapter 4121., 4123., 4127., or 4131. of the Revised Code, the 325
amount of previously paid compensation to the claimant which, due 326
to reversal upon appeal, the claimant is not entitled, pursuant 327
to the following criteria: 328
(1) No withholding for the first twelve weeks of temporary 330
total disability compensation pursuant to section 4123.56 of the 331
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Revised Code shall be made; 332
(2) Forty per cent of all awards of compensation paid 334
pursuant to sections 4123.56 and 4123.57 of the Revised Code, 335
until the amount overpaid is refunded; 336
(3) Twenty-five per cent of any compensation paid pursuant 338
to section 4123.58 of the Revised Code until the amount overpaid 339
is refunded; 340
(4) If, pursuant to an appeal under section 4123.512 of 342
the Revised Code, the court of appeals or the supreme court 343
reverses the allowance of the claim, then no amount of any 344
compensation will be withheld. 345
The administrator and self-insuring employers, as 347
appropriate, are subject to the repayment schedule of this 348
division only with respect to an order to pay compensation that 349
was properly paid under a previous order, but which is
subsequently reversed upon an administrative or judicial appeal. 350
The administrator and self-insuring employers are not subject to, 351
but may utilize, the repayment schedule of this division, or any 352
other lawful means, to collect payment of compensation made to a 353
person who was not entitled to the compensation due to fraud as 354
determined by the administrator or the industrial commission. 355
(K) If a staff hearing officer or the commission fails to 357
issue a decision or the commission fails to refuse to hear an 358
appeal within the time periods required by this section, payments 359
to a claimant shall cease until the staff hearing officer or 360
commission issues a decision or hears the appeal, unless the 361
failure was due to the fault or neglect of the employer or the 362
employer agrees that the payments should continue for a longer 363
period of time. 364
(L) Except as otherwise provided in this section or 366
section 4123.522 of the Revised Code, no appeal is timely filed 367
under this section unless the appeal is filed with the time 368
limits set forth in this section.
(M) No person who is not an employee of the bureau or 370
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commission or who is not by law given access to the contents of a 371
claims file shall have a file in the person's possession. 372
(N) Upon application of a party who resides in an area in 375
which an emergency or disaster is declared, the industrial 376
commission and hearing officers of the commission may waive the 377
time frame within which claims and appeals of claims set forth in 378
this section must be filed upon a finding that the applicant was 379
unable to comply with a filing deadline due to an emergency or a 380
disaster.
As used in this division: 382
(1) "Emergency" means any occasion or instance for which 384
the governor of Ohio or the president of the United States 386
publicly declares an emergency and orders state or federal 387
assistance to save lives and protect property, the public health 388
and safety, or to lessen or avert the threat of a catastrophe. 389
(2) "Disaster" means any natural catastrophe or fire, 391
flood, or explosion, regardless of the cause, that causes damage 392
of sufficient magnitude that the governor of Ohio or the 393
President PRESIDENT of the United States, through a public 394
declaration, orders state or federal assistance to alleviate 396
damage, loss, hardship, or suffering that results from the 397
occurrence.
Sec. 4123.52. The jurisdiction of the industrial 406
commission and the authority of the administrator of workers' 407
compensation over each case is continuing, and the commission may 408
make such modification or change with respect to former findings 409
or orders with respect thereto, as, in its opinion is justified. 410
No modification or change nor any finding or award in respect of 411
any claim shall be made with respect to disability, compensation, 412
dependency, or benefits, after six years from the date of injury 414
in the absence of the payment of medical benefits under this
chapter, in which event the modification, change, finding, or 415
award shall be made within six years after the payment of medical 417
benefits, or in the absence of payment of compensation under
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section 4123.57, 4123.58, or division (A) or (B) of section 419
4123.56 of the Revised Code or wages in lieu of compensation in a 420
manner so as to satisfy the requirements of section 4123.84 of
the Revised Code, in which event the modification, change, 421
finding, or award shall be made within ten years from the date of 422
the last payment of compensation or from the date of death, nor 423
unless written notice of claim for the specific part or parts of 424
the body injured or disabled has been given as provided in 425
section 4123.84 or 4123.85 of the Revised Code, and the 426
commission shall not make any modification, change, finding, or 427
award which shall award compensation for a back period in excess 428
of two years prior to the date of filing application therefor. 429
This section does not affect the right of a claimant to 430
compensation accruing subsequent to the filing of any such 431
application, provided the application is filed within the time 432
limit provided in this section.
This section does not deprive the commission of its 434
continuing jurisdiction to determine the questions raised by any 435
application for modification of award which has been filed with 436
the commission after June 1, 1932, and prior to the expiration of 437
the applicable period but in respect to which no award has been 438
granted or denied during the applicable period. 439
The commission may, by general rules, provide for the 441
destruction of files of cases in which no further action may be 442
taken. 443
The commission and administrator of workers' compensation 445
each may, by general rules, provide for the retention and 446
destruction of all other records in their possession or under 447
their control pursuant to section 121.211 and sections 149.34 to 448
149.36 of the Revised Code. The bureau of workers' compensation 449
may purchase or rent required equipment for the document 450
retention media, as determined necessary to preserve the records. 451
Photographs, microphotographs, microfilm, films, or other direct 452
document retention media, when properly identified, have the same 453
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effect as the original record and may be offered in like manner 454
and may be received as evidence in PROCEEDINGS BEFORE THE 455
INDUSTRIAL COMMISSION, STAFF HEARING OFFICERS, AND DISTRICT 456
HEARING OFFICERS, AND IN any court where the original record 458
could have been introduced.
Sec. 4123.84. (A) In all cases of injury or death, claims 467
for compensation or benefits for the specific part or parts of 468
the body injured shall be forever barred unless, within two years 469
after the injury or death: 470
(1) Written notice of the specific part or parts of the 472
body claimed to have been injured has been made to the industrial 473
commission or the bureau of workers' compensation; 474
(2) The employer, with knowledge of a claimed compensable 476
injury or occupational disease, has paid wages in lieu of 477
compensation for total disability; 478
(3) In the event the employer is a self-insuring employer, 480
one of the following has occurred: 481
(a) Written notice of the specific part or parts of the 483
body claimed to have been injured has been given to the 484
commission or bureau or the employer has furnished treatment by a 485
licensed physician in the employ of an employer, provided, 486
however, that the furnishing of such treatment shall not 487
constitute a recognition of a claim as compensable, but shall do 488
no more than satisfy the requirements of this section; 489
(b) Compensation or benefits have been paid or furnished 491
equal to or greater than is provided for in sections 4123.52, 492
4123.55 to 4123.62, and 4123.64 to 4123.67 of the Revised Code. 493
(4) Written notice of death has been given to the 495
commission or bureau.
(B) The bureau shall provide printed notices quoting in 497
full division (A) of this section, and every self-insuring 498
employer shall post and maintain at all times one or more of the 499
notices in conspicuous places in the workshop or places of 500
employment. 501
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(C) The commission has continuing jurisdiction as set 503
forth in section 4123.52 of the Revised Code over a claim which 504
meets the requirement of this section, including jurisdiction to 505
award compensation or benefits for loss or impairment of bodily 506
functions developing in a part or parts of the body not specified 507
pursuant to division (A)(1) of this section, if the commission 508
finds that the loss or impairment of bodily functions was due to 509
and a result of or a residual of the injury to one of the parts 510
of the body set forth in the written notice filed pursuant to 511
division (A)(1) of this section. 512
(D) Any claim pending before the administrator, the 514
commission, or a court on December 11, 1967, in which the remedy 515
is affected by this section is governed by this section. 516
(E) Notwithstanding the requirement that the notice 518
required to be given to the bureau, commission, or employer under 519
this section is to be in writing, the bureau may accept, assign a 520
claim number, and process a CLAIM WHEN notice IS provided by any 522
method of telecommunication VERBALLY OVER THE TELEPHONE. 523
Immediately upon receipt of the telecommunicated notice PROVIDED 525
VERBALLY OVER THE TELEPHONE, the bureau shall send a written 526
notice to the employer of the bureau's receipt of the 527
telecommunicated VERBAL notice. Within fifteen days after 528
receipt of the BUREAU'S WRITTEN notice, the employer may in 530
writing either verify or not verify the telecommunicated VERBAL 531
notice. If the bureau does not receive the written notification 533
from the employer or receives a written notification verifying 534
the telecommunicated VERBAL notice within such time period, the 536
claim is validly filed and such telecommunicated VERBAL notice 537
tolls the statute of limitations in regard to the claim filed and 538
is considered to meet the requirements of written notice required 539
by this section.
(F) As used in division (A)(3)(b) of this section, 541
"benefits" means payments by a self-insuring employer to, or on 542
behalf of, an employee for a hospital bill, a medical bill to a 543
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licensed physician or hospital, or an orthopedic or prosthetic 544
device. 545
Section 2. That existing sections 4121.31, 4123.511, 547
4123.52, and 4123.84 of the Revised Code are hereby repealed. 548
Section 3. This act is hereby declared to be an emergency 550
measure necessary for the immediate preservation of the public 551
peace, health, and safety. The reason for such necessity is to 552
enable the Bureau of Workers' Compensation to continue processing 553
claims and the Industrial Commission to continue adjudicating 554
claims in a timely and efficient manner and to ensure that 555
unnecessary lapses and avoidable delays do not interfere with the 556
continuing care and treatment of claimants throughout the state. 557
Therefore, this act shall go into immediate effect. 558