As Passed by the House 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-CALLENDER-HARTNETT-METZGER-AMSTUTZ-VESPER- 9
WILLAMOWSKI-BUCHY-JONES-SYKES-BARRETT-REDFERN-TERWILLEGER-HOOPS- 10
AUSTRIA-PATTON 11
_________________________________________________________________ 12
A B I L L
To amend sections 4121.31, 4123.511, 4123.52, and 14
4123.84 of the Revised Code to require the 15
Administrator of Workers' Compensation and the 16
Industrial Commission jointly to adopt rules
governing the submission and sending of documents 17
via electronic transmission, to modify the 18
processing requirements for claim applications
that are not written, and to declare an 19
emergency.
BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF OHIO: 21
Section 1. That sections 4121.31, 4123.511, 4123.52, and 23
4123.84 of the Revised Code be amended to read as follows: 24
Sec. 4121.31. (A) The administrator of workers' 33
compensation and the industrial commission jointly shall adopt 34
rules covering the following general topics with respect to this 35
chapter and Chapter 4123. of the Revised Code: 36
(A)(1) Rules that set forth any general policy and the 38
principal operating procedures of the bureau of workers' 39
compensation or commission, including but not limited to: 40
(1)(a) Assignment to various operational units of any 42
duties placed upon the administrator or the commission by 43
statute;
(2)(b) Procedures for decision-making; 45
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(3)(c) Procedures governing the appearances of a claimant, 47
employer, or their representatives before the agency in a 48
hearing; 49
(4)(d) Procedures that inform claimants, on request, of 51
the status of a claim and any actions necessary to maintain the 52
claim; 53
(5)(e) Time goals for activities of the bureau or 55
commission;
(6)(f) Designation of the person or persons authorized to 57
issue directives with directives numbered and distributed from a 58
central distribution point to persons on a list maintained for 59
that purpose. 60
(B)(2) A rule barring any employee of the bureau or 62
commission from having a workers' compensation claims file in the 63
employee's possession unless the file is necessary to the 64
performance of the employee's duties. 65
(C)(3) All claims, whether of a state fund or 67
self-insuring employer, be processed in an orderly, uniform, and 68
timely fashion. 69
(4) RULES GOVERNING THE SUBMISSION AND SENDING OF 71
APPLICATIONS, NOTICES, EVIDENCE, AND OTHER DOCUMENTS BY 72
ELECTRONIC MEANS. THE RULES SHALL PROVIDE THAT WHERE THIS 73
CHAPTER OR CHAPTER 4123., 4127., OR 4131. OF THE REVISED CODE 75
REQUIRES THAT A DOCUMENT BE IN WRITING OR REQUIRES A SIGNATURE,
THE ADMINISTRATOR AND THE COMMISSION, TO THE EXTENT OF THEIR 77
RESPECTIVE JURISDICTIONS, MAY APPROVE OF AND PROVIDE FOR THE 78
ELECTRONIC SUBMISSION AND SENDING OF THOSE DOCUMENTS, AND THE USE 79
OF AN ELECTRONIC SIGNATURE ON THOSE DOCUMENTS. 80
(B) AS USED IN THIS SECTION: 82
(1) "ELECTRONIC" INCLUDES ELECTRICAL, DIGITAL, MAGNETIC, 84
OPTICAL, ELECTROMAGNETIC, OR ANY OTHER FORM OF TECHNOLOGY THAT 85
ENTAILS CAPABILITIES SIMILAR TO THESE TECHNOLOGIES. 86
(2) "ELECTRONIC RECORD" MEANS A RECORD GENERATED, 88
COMMUNICATED, RECEIVED, OR STORED BY ELECTRONIC MEANS FOR USE IN 89
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AN INFORMATION SYSTEM OR FOR TRANSMISSION FROM ONE INFORMATION 90
SYSTEM TO ANOTHER.
(3) "ELECTRONIC SIGNATURE" MEANS A SIGNATURE IN ELECTRONIC 92
FORM ATTACHED TO OR LOGICALLY ASSOCIATED WITH AN ELECTRONIC 93
RECORD.
Sec. 4123.511. (A) Within seven days after receipt of any 103
claim under this chapter, the bureau of workers' compensation
shall notify the claimant and the employer of the claimant of the 104
receipt of the claim and of the facts alleged therein. If the 105
bureau receives from a person other than the claimant written or 106
telecommunicated information OR INFORMATION COMMUNICATED VERBALLY 107
OVER THE TELEPHONE indicating that an injury or occupational 108
disease has occurred or been contracted with WHICH may be 109
compensable under this chapter, the bureau shall notify the 111
employee and the employer of the information. If the information 112
is provided by any method of telecommunication VERBALLY OVER THE 113
TELEPHONE, the person providing the information shall provide 115
written verification of the information to the bureau according 116
to division (E) of section 4123.84 of the Revised Code. The 117
receipt of the information in writing, or if INITIALLY by a 118
method of telecommunications TELEPHONE, the SUBSEQUENT written 120
verification, and the notice by the bureau shall be considered an 121
application for compensation under section 4123.84 or 4123.85 of 122
the Revised Code, provided that the conditions of division (E) of 123
section 4123.84 of the Revised Code apply to information provided 124
by a method of telecommunication VERBALLY OVER THE TELEPHONE. 125
Upon receipt of a claim, the bureau shall advise the claimant of 126
the claim number assigned and the claimant's right to
representation in the processing of a claim or to elect no 128
representation. If the bureau determines that a claim is 129
determined to be a compensable lost-time claim, the bureau shall 130
notify the claimant and the employer of the availability of 131
rehabilitation services. No bureau or industrial commission 132
employee shall directly or indirectly convey any information in 133
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derogation of this right. This section shall in no way abrogate 134
the bureau's responsibility to aid and assist a claimant in the 135
filing of a claim and to advise the claimant of the claimant's 136
rights under the law.
The administrator of workers' compensation shall assign all 138
claims and investigations to the bureau service office from which 139
investigation and determination may be made most expeditiously. 140
The bureau shall investigate the facts concerning an injury 142
or occupational disease and ascertain such facts in whatever 143
manner is most appropriate and may obtain statements of the 144
employee, employer, attending physician, and witnesses in 145
whatever manner is most appropriate. 146
(B)(1) Except as provided in division (B)(2) of this 148
section, in claims other than those in which the employer is a 149
self-insuring employer, if the administrator determines under 150
division (A) of this section that a claimant is or is not 151
entitled to an award of compensation or benefits, the 152
administrator shall issue an order no later than twenty-eight 154
days after the sending of the notice under division (A) of this 155
section, granting or denying the payment of the compensation or 156
benefits, or both as is appropriate to the claimant. 157
Notwithstanding the time limitation specified in this division
for the issuance of an order, if a medical examination of the 158
claimant is required by statute, the administrator promptly shall 159
schedule the claimant for that examination and shall issue an 160
order no later than twenty-eight days after receipt of the report 161
of the examination. The administrator shall notify the claimant 162
and the employer of the claimant and their respective 163
representatives in writing of the nature of the order and the 164
amounts of compensation and benefit payments involved. The 165
employer or claimant may appeal the order pursuant to division 166
(C) of this section within fourteen days after the date of the 167
receipt of the order. The employer and claimant may waive, in 168
writing, their rights to an appeal under this division. 169
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(2) Notwithstanding the time limitation specified in 171
division (B)(1) of this section for the issuance of an order, if 172
the employer certifies a claim for payment of compensation or 173
benefits, or both, to a claimant, and the administrator has 174
completed the investigation of the claim, the payment of benefits 176
or compensation, or both, as is appropriate, shall commence upon 177
the later of the date of the certification or completion of the 178
investigation and issuance of the order by the administrator, 179
provided that the administrator shall issue the order no later 180
than the time limitation specified in division (B)(1) of this 181
section. 182
(3) If an appeal is made under division (B)(1) or (2) of 184
this section, the administrator shall forward the claim file to 185
the appropriate district hearing officer within seven days of the 186
appeal. In contested claims other than state fund claims, the 187
administrator shall forward the claim within seven days of the 188
administrator's receipt of the claim to the commission, which 190
shall refer the claim to an appropriate district hearing officer 191
for a hearing in accordance with division (C) of this section. 192
(C) If an employer or claimant timely appeals the order of 194
the administrator issued under division (B) of this section or in 195
the case of other contested claims other than state fund claims, 196
the commission shall refer the claim to an appropriate district 197
hearing officer according to rules the commission adopts under 198
section 4121.36 of the Revised Code. The district hearing 199
officer shall notify the parties and their respective 200
representatives of the time and place of the hearing. 201
The district hearing officer shall hold a hearing on a 203
disputed issue or claim within forty-five days after the filing 205
of the appeal under this division and issue a decision within 206
seven days after holding the hearing. The district hearing 207
officer shall notify the parties and their respective
representatives in writing of the order. Any party may appeal an 209
order issued under this division pursuant to division (D) of this 210
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section within fourteen days after receipt of the order under 211
this division. 212
(D) Upon the timely filing of an appeal of the order of 214
the district hearing officer issued under division (C) of this 215
section, the commission shall refer the claim file to an 216
appropriate staff hearing officer according to its rules adopted 217
under section 4121.36 of the Revised Code. The staff hearing 218
officer shall hold a hearing within forty-five days after the 219
filing of an appeal under this division and issue a decision 220
within seven days after holding the hearing under this division. 223
The staff hearing officer shall notify the parties and their 224
respective representatives in writing of the staff hearing
officer's order. Any party may appeal an order issued under this 226
division pursuant to division (E) of this section within fourteen 227
days after receipt of the order under this division. 228
(E) Upon the filing of a timely appeal of the order of the 230
staff hearing officer issued under division (D) of this section, 231
the commission or a designated staff hearing officer, on behalf 232
of the commission, shall determine whether the commission will 234
hear the appeal. If the commission or the designated staff
hearing officer decides to hear the appeal, the commission or the 236
designated staff hearing officer shall notify the parties and 237
their respective representatives in writing of the time and place 238
of the hearing. The commission shall hold the hearing within 239
forty-five days after the filing of the notice of appeal and, 240
within seven days after the conclusion of the hearing, the 241
commission shall issue its order affirming, modifying, or 242
reversing the order issued under division (D) of this section. 243
The commission shall notify the parties and their respective 244
representatives in writing of the order. If the commission or 245
the designated staff hearing officer determines not to hear the 246
appeal, within fourteen days after the filing of the notice of 247
appeal, the commission or the designated staff hearing officer 248
shall issue an order to that effect and notify the parties and
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their respective representatives in writing of that order. 249
Except as otherwise provided in this chapter and Chapters 251
4121., 4127., and 4131. of the Revised Code, any party may appeal 252
an order issued under this division to the court pursuant to 253
section 4123.512 of the Revised Code within sixty days after 254
receipt of the order, subject to the limitations contained in 255
that section. 256
(F) Every notice of an appeal from an order issued under 258
divisions (B), (C), (D), and (E) of this section shall state the 259
names of the claimant and employer, the number of the claim, the 260
date of the decision appealed from, and the fact that the 261
appellant appeals therefrom. 262
(G) All of the following apply to the proceedings under 264
divisions (C), (D), and (E) of this section: 265
(1) The parties shall proceed promptly and without 267
continuances except for good cause; 268
(2) The parties, in good faith, shall engage in the free 270
exchange of information relevant to the claim prior to the 271
conduct of a hearing according to the rules the commission adopts 272
under section 4121.36 of the Revised Code; 273
(3) The administrator is a party and may appear and 275
participate at all administrative proceedings on behalf of the 276
state insurance fund. However, in cases in which the employer is 277
represented, the administrator shall neither present arguments 278
nor introduce testimony that is cumulative to that presented or 279
introduced by the employer or the employer's representative. The 280
administrator may file an appeal under this section on behalf of
the state insurance fund; however, except in cases arising under 281
section 4123.343 of the Revised Code, the administrator only may 282
appeal questions of law or issues of fraud when the employer 283
appears in person or by representative.
(H) Except as provided in section 4121.63 of the Revised 285
Code and division (J) of this section, payments of compensation 286
to a claimant or on behalf of a claimant as a result of any order 287
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issued under this chapter shall commence upon the earlier of the 288
following:
(1) Fourteen days after the date the administrator issues 290
an order under division (B) of this section, unless that order is 291
appealed; 292
(2) The date when the employer has waived the right to 295
appeal a decision issued under division (B) of this section; 296
(3) If no appeal of an order has been filed under this 298
section or to a court under section 4123.512 of the Revised Code, 299
the expiration of the time limitations for the filing of an 300
appeal of an order; 301
(4) The date of receipt by the employer of an order of a 303
district hearing officer, a staff hearing officer, or the 305
industrial commission issued under division (C), (D), or (E) of 306
this section.
(I) No medical benefits payable under this chapter or 308
Chapter 4121., 4127., or 4131. of the Revised Code are payable 309
until the earlier of the following: 310
(1) The date of the issuance of the staff hearing 312
officer's order under division (D) of this section; 313
(2) The date of the final administrative or judicial 315
determination. 316
(J) Upon the final administrative or judicial 318
determination under this section or section 4123.512 of the 319
Revised Code of an appeal of an order to pay compensation, if a 320
claimant is found to have received compensation pursuant to a 321
prior order which is reversed upon subsequent appeal, the 322
claimant's employer, if a self-insuring employer, or the bureau, 324
shall withhold from any amount to which the claimant becomes 325
entitled pursuant to any claim, past, present, or future, under 326
Chapter 4121., 4123., 4127., or 4131. of the Revised Code, the 327
amount of previously paid compensation to the claimant which, due 328
to reversal upon appeal, the claimant is not entitled, pursuant 329
to the following criteria: 330
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(1) No withholding for the first twelve weeks of temporary 332
total disability compensation pursuant to section 4123.56 of the 333
Revised Code shall be made; 334
(2) Forty per cent of all awards of compensation paid 336
pursuant to sections 4123.56 and 4123.57 of the Revised Code, 337
until the amount overpaid is refunded; 338
(3) Twenty-five per cent of any compensation paid pursuant 340
to section 4123.58 of the Revised Code until the amount overpaid 341
is refunded; 342
(4) If, pursuant to an appeal under section 4123.512 of 344
the Revised Code, the court of appeals or the supreme court 345
reverses the allowance of the claim, then no amount of any 346
compensation will be withheld. 347
The administrator and self-insuring employers, as 349
appropriate, are subject to the repayment schedule of this 350
division only with respect to an order to pay compensation that 351
was properly paid under a previous order, but which is
subsequently reversed upon an administrative or judicial appeal. 352
The administrator and self-insuring employers are not subject to, 353
but may utilize, the repayment schedule of this division, or any 354
other lawful means, to collect payment of compensation made to a 355
person who was not entitled to the compensation due to fraud as 356
determined by the administrator or the industrial commission. 357
(K) If a staff hearing officer or the commission fails to 359
issue a decision or the commission fails to refuse to hear an 360
appeal within the time periods required by this section, payments 361
to a claimant shall cease until the staff hearing officer or 362
commission issues a decision or hears the appeal, unless the 363
failure was due to the fault or neglect of the employer or the 364
employer agrees that the payments should continue for a longer 365
period of time. 366
(L) Except as otherwise provided in this section or 368
section 4123.522 of the Revised Code, no appeal is timely filed 369
under this section unless the appeal is filed with the time 370
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limits set forth in this section.
(M) No person who is not an employee of the bureau or 372
commission or who is not by law given access to the contents of a 373
claims file shall have a file in the person's possession. 374
(N) Upon application of a party who resides in an area in 377
which an emergency or disaster is declared, the industrial 378
commission and hearing officers of the commission may waive the 379
time frame within which claims and appeals of claims set forth in 380
this section must be filed upon a finding that the applicant was 381
unable to comply with a filing deadline due to an emergency or a 382
disaster.
As used in this division: 384
(1) "Emergency" means any occasion or instance for which 386
the governor of Ohio or the president of the United States 388
publicly declares an emergency and orders state or federal 389
assistance to save lives and protect property, the public health 390
and safety, or to lessen or avert the threat of a catastrophe. 391
(2) "Disaster" means any natural catastrophe or fire, 393
flood, or explosion, regardless of the cause, that causes damage 394
of sufficient magnitude that the governor of Ohio or the 395
President PRESIDENT of the United States, through a public 396
declaration, orders state or federal assistance to alleviate 398
damage, loss, hardship, or suffering that results from the 399
occurrence.
Sec. 4123.52. The jurisdiction of the industrial 408
commission and the authority of the administrator of workers' 409
compensation over each case is continuing, and the commission may 410
make such modification or change with respect to former findings 411
or orders with respect thereto, as, in its opinion is justified. 412
No modification or change nor any finding or award in respect of 413
any claim shall be made with respect to disability, compensation, 414
dependency, or benefits, after six years from the date of injury 416
in the absence of the payment of medical benefits under this
chapter, in which event the modification, change, finding, or 417
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award shall be made within six years after the payment of medical 419
benefits, or in the absence of payment of compensation under
section 4123.57, 4123.58, or division (A) or (B) of section 421
4123.56 of the Revised Code or wages in lieu of compensation in a 422
manner so as to satisfy the requirements of section 4123.84 of
the Revised Code, in which event the modification, change, 423
finding, or award shall be made within ten years from the date of 424
the last payment of compensation or from the date of death, nor 425
unless written notice of claim for the specific part or parts of 426
the body injured or disabled has been given as provided in 427
section 4123.84 or 4123.85 of the Revised Code, and the 428
commission shall not make any modification, change, finding, or 429
award which shall award compensation for a back period in excess 430
of two years prior to the date of filing application therefor. 431
This section does not affect the right of a claimant to 432
compensation accruing subsequent to the filing of any such 433
application, provided the application is filed within the time 434
limit provided in this section.
This section does not deprive the commission of its 436
continuing jurisdiction to determine the questions raised by any 437
application for modification of award which has been filed with 438
the commission after June 1, 1932, and prior to the expiration of 439
the applicable period but in respect to which no award has been 440
granted or denied during the applicable period. 441
The commission may, by general rules, provide for the 443
destruction of files of cases in which no further action may be 444
taken. 445
The commission and administrator of workers' compensation 447
each may, by general rules, provide for the retention and 448
destruction of all other records in their possession or under 449
their control pursuant to section 121.211 and sections 149.34 to 450
149.36 of the Revised Code. The bureau of workers' compensation 451
may purchase or rent required equipment for the document 452
retention media, as determined necessary to preserve the records. 453
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Photographs, microphotographs, microfilm, films, or other direct 454
document retention media, when properly identified, have the same 455
effect as the original record and may be offered in like manner 456
and may be received as evidence in PROCEEDINGS BEFORE THE 457
INDUSTRIAL COMMISSION, STAFF HEARING OFFICERS, AND DISTRICT 458
HEARING OFFICERS, AND IN any court where the original record 460
could have been introduced.
Sec. 4123.84. (A) In all cases of injury or death, claims 469
for compensation or benefits for the specific part or parts of 470
the body injured shall be forever barred unless, within two years 471
after the injury or death: 472
(1) Written notice of the specific part or parts of the 474
body claimed to have been injured has been made to the industrial 475
commission or the bureau of workers' compensation; 476
(2) The employer, with knowledge of a claimed compensable 478
injury or occupational disease, has paid wages in lieu of 479
compensation for total disability; 480
(3) In the event the employer is a self-insuring employer, 482
one of the following has occurred: 483
(a) Written notice of the specific part or parts of the 485
body claimed to have been injured has been given to the 486
commission or bureau or the employer has furnished treatment by a 487
licensed physician in the employ of an employer, provided, 488
however, that the furnishing of such treatment shall not 489
constitute a recognition of a claim as compensable, but shall do 490
no more than satisfy the requirements of this section; 491
(b) Compensation or benefits have been paid or furnished 493
equal to or greater than is provided for in sections 4123.52, 494
4123.55 to 4123.62, and 4123.64 to 4123.67 of the Revised Code. 495
(4) Written notice of death has been given to the 497
commission or bureau.
(B) The bureau shall provide printed notices quoting in 499
full division (A) of this section, and every self-insuring 500
employer shall post and maintain at all times one or more of the 501
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notices in conspicuous places in the workshop or places of 502
employment. 503
(C) The commission has continuing jurisdiction as set 505
forth in section 4123.52 of the Revised Code over a claim which 506
meets the requirement of this section, including jurisdiction to 507
award compensation or benefits for loss or impairment of bodily 508
functions developing in a part or parts of the body not specified 509
pursuant to division (A)(1) of this section, if the commission 510
finds that the loss or impairment of bodily functions was due to 511
and a result of or a residual of the injury to one of the parts 512
of the body set forth in the written notice filed pursuant to 513
division (A)(1) of this section. 514
(D) Any claim pending before the administrator, the 516
commission, or a court on December 11, 1967, in which the remedy 517
is affected by this section is governed by this section. 518
(E) Notwithstanding the requirement that the notice 520
required to be given to the bureau, commission, or employer under 521
this section is to be in writing, the bureau may accept, assign a 522
claim number, and process a CLAIM WHEN notice IS provided by any 524
method of telecommunication VERBALLY OVER THE TELEPHONE. 525
Immediately upon receipt of the telecommunicated notice PROVIDED 527
VERBALLY OVER THE TELEPHONE, the bureau shall send a written 528
notice to the employer of the bureau's receipt of the 529
telecommunicated VERBAL notice. Within fifteen days after 530
receipt of the BUREAU'S WRITTEN notice, the employer may in 532
writing either verify or not verify the telecommunicated VERBAL 533
notice. If the bureau does not receive the written notification 535
from the employer or receives a written notification verifying 536
the telecommunicated VERBAL notice within such time period, the 538
claim is validly filed and such telecommunicated VERBAL notice 539
tolls the statute of limitations in regard to the claim filed and 540
is considered to meet the requirements of written notice required 541
by this section.
(F) As used in division (A)(3)(b) of this section, 543
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"benefits" means payments by a self-insuring employer to, or on 544
behalf of, an employee for a hospital bill, a medical bill to a 545
licensed physician or hospital, or an orthopedic or prosthetic 546
device. 547
Section 2. That existing sections 4121.31, 4123.511, 549
4123.52, and 4123.84 of the Revised Code are hereby repealed. 550
Section 3. This act is hereby declared to be an emergency 552
measure necessary for the immediate preservation of the public 553
peace, health, and safety. The reason for such necessity is to 554
enable the Bureau of Workers' Compensation to continue processing 555
claims and the Industrial Commission to continue adjudicating 556
claims in a timely and efficient manner and to ensure that 557
unnecessary lapses and avoidable delays do not interfere with the 558
continuing care and treatment of claimants throughout the state. 559
Therefore, this act shall go into immediate effect. 560