| Section 1. That sections 2913.48, 3121.034, 3121.037, | 10 |
| 4111.02, 4121.10, 4121.12, 4121.44, 4121.441, 4123.01, 4123.29, | 11 |
| 4123.32, 4123.35, 4123.512, 4123.52, 4123.54, 4123.56, 4123.57, | 12 |
| 4123.58, 4123.61, 4123.65, 4123.88, 5703.21, and 5747.18 be | 13 |
| amended and sections 3121.0311, 4121.131, 4121.444, 4123.271, and | 14 |
| 4123.311 of the Revised Code be enacted to read as follows: | 15 |
| (3) Alter, falsify, destroy, conceal, or remove any record
or | 26 |
| document that is necessary to fully establish the validity of
any | 27 |
| claim filed with, or necessary to establish the nature and | 28 |
|
validity of all goods and services for which reimbursement or | 29 |
|
payment was received or is requested from, the bureau of workers' | 30 |
|
compensation, or a self-insuring employer under Chapter 4121., | 31 |
|
4123., 4127., or 4131. of the Revised Code; | 32 |
| (B) Whoever violates this section is guilty of workers' | 49 |
|
compensation fraud. Except as
otherwise provided in this division, | 50 |
| a
violation of this section is a misdemeanor of the
first degree. | 51 |
If the value of thepremiums and assessments unpaid
pursuant to | 52 |
| actions described in division (A)(5), (6), or (7) of this
section, | 53 |
| or of
goods, services, property, or
money stolen is five hundred | 54 |
| dollars or more and is less than
five thousand dollars, a | 55 |
| violation of
this section is a felony of the fifth degree. If
the | 56 |
value of thepremiums and assessments unpaid
pursuant to actions | 57 |
| described in division (A)(5), (6), or (7) of this
section, or of | 58 |
|
goods, services, property, or money stolen is five thousand | 59 |
|
dollars or more and is less than one hundred thousand dollars, a | 60 |
| violation of
this section is a felony of the fourth degree. If
the | 61 |
value of thepremiums and assessments unpaid
pursuant to actions | 62 |
| described in division (A)(5), (6), or (7) of this
section, or of | 63 |
|
goods, services, property, or money stolen is one hundred
thousand | 64 |
| dollars or more, a violation of this section is a felony of the | 65 |
| third
degree. | 66 |
| (8) "Statement" includes, but is not limited to, any oral, | 101 |
|
written, electronic, electronic impulse, or magnetic
communication | 102 |
| notice, letter, memorandum, receipt for payment,
invoice, account, | 103 |
| financial statement, or bill for services;
a diagnosis, prognosis, | 104 |
| prescription, hospital, medical, or dental
chart or other record; | 105 |
| and a computer generated document. | 106 |
| (B) When two or more withholding notices
are received by a | 122 |
| payor, the payor shall comply with all
of the
requirements | 123 |
| contained in the notices to the extent that the
total amount | 124 |
| withheld from the obligor's
income does not exceed the maximum | 125 |
| amount
permitted under section 303(b) of the "Consumer
Credit | 126 |
| Protection
Act," 15 U.S.C. 1673(b), withhold amounts in
accordance | 127 |
|
with the allocation set forth in divisions (B)(1)
and (2) of
this | 128 |
| section, notify each court or child support enforcement
agency | 129 |
| that issued one of the notices of the allocation, and give | 130 |
|
priority to amounts designated in each notice as current support | 131 |
|
in the following manner: | 132 |
| (2) If the total of the amounts designated in the notices
as | 142 |
| current support does not exceed the amount available for | 143 |
|
withholding under section 303(b) of the "Consumer
Credit | 144 |
|
Protection Act," 15 U.S.C. 1673(b), the payor
shall pay all of the | 145 |
|
amounts designated as current support in the notices and shall | 146 |
|
allocate to each notice an amount for past-due support equal to | 147 |
|
the amount designated in that notice as past-due support | 148 |
|
multiplied by a fraction in which the numerator is the amount of | 149 |
|
income remaining available
for withholding after the payment of | 150 |
| current support and the
denominator is the total amount designated | 151 |
| in all of the notices
as past-due support. | 152 |
| (a) Promptly notify the
child support enforcement agency | 189 |
|
administering the support order, in writing,
within ten business | 190 |
|
days after the date of any situation that occurs
in which the | 191 |
|
payor ceases to pay
income to the obligor in an amount sufficient | 192 |
|
to comply with the order,
including termination of employment, | 193 |
|
layoff of the obligor from employment,
any leave of absence of the | 194 |
|
obligor from employment without pay, termination
of workers' | 195 |
|
compensation benefits, or termination of any pension, annuity, | 196 |
|
allowance, or retirement benefit; | 197 |
| (a) Identify in the
notice given under division
(A)(8) of | 205 |
|
this section
any types of benefits other than personal earnings | 206 |
|
the
obligor is receiving or is eligible to receive as a benefit of | 207 |
|
employment or as a result of the obligor's termination of | 208 |
|
employment, including, but not limited to, unemployment | 209 |
|
compensation, workers' compensation benefits, severance pay, sick | 210 |
|
leave, lump sum payments of retirement benefits or contributions, | 211 |
|
and bonuses or profit-sharing payments or distributions, and the | 212 |
|
amount of the benefits; | 213 |
(10) ASubject to section 3121.0311 of the Revised Code, a | 218 |
| requirement that, no later than the earlier of
forty-five days | 219 |
| before a lump sum payment is to be made or, if
the
obligor's right | 220 |
| to the lump sum payment is determined less
than
forty-five days | 221 |
| before it is to be made, the date on which
that
determination is | 222 |
| made, the payor notify the child
support
enforcement agency | 223 |
| administering the support order of any lump sum
payment of
any | 224 |
| kind of
one hundred fifty dollars or more that is
to be paid to | 225 |
| the
obligor, hold
each lump sum payment of one
hundred fifty | 226 |
| dollars
or more for thirty
days after the date on
which it
would | 227 |
| otherwise be paid to the obligor and, on
order of
the court or | 228 |
| agency that issued the support order, pay all or a
specified | 229 |
|
amount of the lump sum
payment to the office of child
support; | 230 |
| (6) A requirement that the financial institution promptly | 256 |
|
notify the child support enforcement agency administering the | 257 |
|
support order,
in writing, within
ten days after the date of any | 258 |
|
termination of the account from
which the deduction is being made | 259 |
|
and notify the agency, in
writing, of the opening of a new account | 260 |
|
at that financial
institution, the account number of the new | 261 |
|
account, the name of
any other known financial institutions in | 262 |
|
which the obligor has
any accounts, and the numbers of those | 263 |
|
accounts; | 264 |
| Sec. 3121.0311. (A) If a lump sum payment referred to in | 272 |
| division (A)(10) of section 3121.037 of the Revised Code consists | 273 |
| of workers' compensation benefits and the obligor is represented | 274 |
| by an attorney with respect to the obligor's workers' compensation | 275 |
| claim, prior to issuing the notice to the child support | 276 |
| enforcement agency required by that division, the administrator of | 277 |
| workers' compensation, for claims involving state fund employers, | 278 |
| or a self-insuring employer, for that employer's claims, shall | 279 |
| notify the obligor and the obligor's attorney in writing that the | 280 |
| obligor is subject to a support order and that the administrator | 281 |
| or self-insuring employer, as appropriate, shall hold the lump sum | 282 |
| payment for a period of thirty days after the administrator or | 283 |
| self-insuring employer sends this written notice, pending receipt | 284 |
| of the information referred to in division (B) of this section. | 285 |
| (B) The administrator or self-insuring employer, as | 286 |
| appropriate, shall instruct the obligor's attorney in writing to | 287 |
| file a copy of the fee agreement signed by the obligor, along with | 288 |
| an affidavit signed by the attorney setting forth the amount of | 289 |
| the attorney's fee with respect to the lump sum payment award to | 290 |
| the obligor and the amount of all necessary expenses, along with | 291 |
| documentation of those expenses, incurred by the attorney with | 292 |
| respect to obtaining the lump sum award. The obligor's attorney | 293 |
| shall file the fee agreement and attorney affidavit with the | 294 |
| administrator or self-insuring employer, as appropriate, within | 295 |
| thirty days after the date the administrator or self-insuring | 296 |
| employer sends the notice required by division (A) of this | 297 |
| section. | 298 |
| Sec. 4111.02. (A) Every employer and employers with less | 311 |
| than one hundred fifty thousand dollars gross annual sales shall | 312 |
pay each of histhe
employer's employees at a wage rate of not | 313 |
less than three dollars and
eighty cents per hourthe wage rate | 314 |
| specified in the "Fair Labor Standards Act," 29 U.S.C. 206, as now | 315 |
or hereafter amended, beginning on September 25, 1990, and not | 316 |
less than four
dollars and twenty-five cents an hour after March | 317 |
31, 1991the effective date of this amendment, except as
otherwise | 318 |
| provided in this section. | 319 |
(C) Every employer shall pay each employee in agriculture
at | 326 |
a wage rate not less than three dollars and eighty cents per
hour | 327 |
beginning on September 25, 1990, and four dollars and twenty-five | 328 |
cents
per hour after
March 31, 1991the wage rate described in | 329 |
| division (A) of this section. This provision does not apply to any | 330 |
| employee
employed in agriculture if the employee: (1)(a) is | 331 |
| employed as a
hand harvest laborer and is paid on a piece rate | 332 |
| basis in an
operation which has been, and is customarily and | 333 |
| generally
recognized as having been, paid on a piece rate basis in | 334 |
the
region of employment, (b) commutes daily from histhe | 335 |
employee's
permanent residence to the farm on which hethe | 336 |
| employee is so
employed, and (c) has
been employed in agriculture | 337 |
| less than thirteen weeks during the
preceding calendar year, or | 338 |
| (2)(a) is sixteen years of age or
under, is employed as a hand | 339 |
| harvest laborer, and is paid on a
piece rate basis in an operation | 340 |
| which has been, and is
customarily and generally recognized as | 341 |
| having been paid on a
piece rate basis in the region of | 342 |
employment, (b) is employed on
the same farm as histhe employee's | 343 |
parent or person standing in
the place of histhe employee's | 344 |
| parent, and (c) is paid at the
same piece rate as employees over | 345 |
| age sixteen are paid on the same farm. Such
employees shall be | 346 |
paid no less than the amount specified in division (E) of
this | 347 |
sectiontwo dollars and eighty cents per hour. | 348 |
(D)(C) For any employee engaged in an occupation in which he | 349 |
the
employee customarily and regularly receives more than thirty | 350 |
dollars per
month in tips from patrons or others, the employer may | 351 |
shall pay as a
minimum fifty-five per cent of the wage prescribed | 352 |
in division
(A) of this section beginning on September 25, 1990, | 353 |
and fifty per cent of
such wage after March 31, 1991, if all the | 354 |
following occur: (1) the tips or
gratuities are proven gratuities | 355 |
as indicated by the employee's
declaration for federal insurance | 356 |
contribution act purposes, (2)
the employer can establish by his | 357 |
records that
for each week where credit is taken, when adding tips | 358 |
received to wages paid,
not less than the minimum rate prescribed | 359 |
in division (A) of this
section was received by the employee, and | 360 |
(3) the employee was
informed by the employer of the provisions of | 361 |
this division. No
employer shall use all or part of any tips or | 362 |
gratuities received
by employees toward the payment of the | 363 |
statutory minimum hourly
wage as required by this division. | 364 |
Nothing prevents employees
from entering into an agreement to | 365 |
divide tips or gratuities
among themselvesrate specified for | 366 |
| tipped employees in the "Fair Labor Standards Act," 29 U.S.C. 203, | 367 |
| as now or hereafter amended. | 368 |
(E) Notwithstanding the definition of "employer" in
division | 369 |
(C) of section 4111.01 of the Revised Code that exempts
certain | 370 |
employers from the operation of this chapter, every
employer with | 371 |
less than one hundred fifty thousand dollars gross
annual sales | 372 |
shall pay at least two dollars and fifty cents per
hour in wages | 373 |
beginning on September 25, 1990, and two dollars and eighty
cents | 374 |
per hour in wages after March 31, 1991, to all employees except | 375 |
for
those employees who meet the requirements of division (D) of | 376 |
this
section, in which event, the employer may pay the wage as | 377 |
specified in division(G) of this section for tipped employees. | 378 |
(F)Any employer defined as an enterprise under division
(s) | 379 |
of section 3 of the federal "Fair Labor Standards Act of
1938," 52 | 380 |
Stat. 1060, 29 U.S.C.A. 203(s), that on March 31, 1990,
was | 381 |
subject to division (a)(1) of section 6 of such act, 52 Stat. | 382 |
1062, 29 U.S.C.A. 206 (a)(1), and that because
of the amendment | 383 |
made by subsection (a) of section 3 of the
federal "Fair Labor | 384 |
Standards Act Amendments of 1989," P.L.
101-157, is not subject to | 385 |
division (a)(1) of section (6)(a)(1),
shall pay its employees: | 386 |
(1) Not less than two dollars and eighty-two cents an hour | 387 |
beginning on September 25, 1990, except for those employees who | 388 |
meet the
requirements of
division (D) of this section, in which | 389 |
event the employer shall
pay not less than one dollar and | 390 |
fifty-eight cents an hour and,
after March 31, 1991, not less than | 391 |
the minimum wage in effect
under section 3 of the federal "Fair | 392 |
Labor Standards Act of
1938," 52 Stat. 1060, 29 U.S.C.A. 203 as | 393 |
that section existed on
March 31, 1990; and | 394 |
| Sec. 4121.10. The industrial commission shall be in | 410 |
| continuous session and
open for the transaction of business during | 411 |
| all business hours of every day
excepting Sundays and legal | 412 |
| holidays. The sessions of the commission shall be
open to the | 413 |
| public and shall stand and be adjourned without further notice | 414 |
|
thereof on its record. All of the proceedings of the commission | 415 |
| shall be
shown on its record, which shall be a public record | 416 |
| except as provided in section 4123.88 of the Revised Code, and all | 417 |
| voting shall be
had by calling the name of each member of the | 418 |
| industrial commission by the
executive director, and each member's | 419 |
| vote shall be
recorded on the record of
proceedings as cast. The | 420 |
| commission shall keep a separate record of its
proceedings | 421 |
| relative to claims coming before it for compensation for injured | 422 |
|
and the dependents of killed employees, which record shall contain | 423 |
| its
findings and the award in each such claim for compensation | 424 |
| considered by it,
and in all such claims the reasons for the | 425 |
| allowance or rejection thereof
shall be stated in said record. | 426 |
| Sec. 4121.12. (A) There is hereby created the workers' | 427 |
|
compensation oversight commission consisting of eleven members, of | 428 |
|
which members the governor shall appoint five with the advice and | 429 |
| consent of
the senate. Of the five members the governor appoints, | 430 |
| two shall be
individuals who, on
account of their previous | 431 |
| vocation, employment, or affiliations,
can be classed as | 432 |
| representative of employees, at least one of whom is | 433 |
|
representative of employees who are members of an employee | 434 |
| organization; two
shall be individuals who, on account of their | 435 |
| previous vocation, employment,
or affiliations, can be classed as | 436 |
| representative of employers, one of whom
represents self-insuring | 437 |
| employers and one of whom has experience as an
employer in | 438 |
| compliance with section 4123.35 of the Revised Code
other than a | 439 |
| self-insuring employer, and one of those two representatives also | 440 |
|
shall represent employers whose employees are not members of an | 441 |
| employee
organization; and one shall represent the public and also | 442 |
| be an individual
who, on account of the individual's previous | 443 |
| vocation, employment, or
affiliations, cannot be classed as either | 444 |
| predominantly representative of
employees or of employers. The | 445 |
|
governor shall select the chairperson of the
commission who shall | 446 |
| serve as chairperson at the pleasure of the
governor. No more than | 447 |
| three members
appointed by the governor shall belong to or be | 448 |
| affiliated with the same
political party. | 449 |
| Each of these five members shall have at least three years' | 450 |
|
experience in the field of insurance, finance, workers' | 451 |
|
compensation, law, accounting, actuarial, personnel, investments, | 452 |
|
or data processing, or in the management of an organization whose | 453 |
|
size is commensurate with that of the bureau of workers' | 454 |
|
compensation. At least one of these five members shall be an | 455 |
|
attorney licensed under Chapter 4705. of the Revised Code to | 456 |
| practice
law in this state. | 457 |
| (B) Of the initial appointments made to the
commission, the | 458 |
| governor shall appoint one member who represents
employees to a | 459 |
| term ending one year after September 1,
1995, one member who | 460 |
|
represents employers to a term ending two
years after September 1, | 461 |
| 1995, the member who
represents the public to a term
ending three | 462 |
| years after September 1, 1995, one member who represents
employees | 463 |
| to a term ending four years after September 1,
1995, and one | 464 |
| member who represents employers to a term
ending five years after | 465 |
| September 1, 1995. Thereafter, terms of office shall
be for three | 466 |
| years, with each term ending on the same day of the same
month as | 467 |
| did the term that it succeeds. Each member shall hold office from | 468 |
|
the date of the member's appointment until the end of the term for | 469 |
|
which the
member was appointed. | 470 |
| The governor shall not appoint any person to more than two | 471 |
|
full terms of office on the commission. This restriction does
not | 472 |
| prevent the governor from appointing a person to fill a
vacancy | 473 |
| caused by the death, resignation, or removal of a
commission | 474 |
| member and also appointing that person twice to full
terms on the | 475 |
| commission, or from appointing a person previously
appointed to | 476 |
| fill less than a full term twice to full terms on
the commission. | 477 |
| Any member appointed to fill a vacancy occurring
prior to the | 478 |
| expiration date of the term for which the
member's predecessor was | 479 |
| appointed shall hold office as a member for the
remainder of that | 480 |
| term. A member shall continue in office subsequent to the | 481 |
|
expiration date of the member's term until a successor takes | 482 |
|
office or until a period of sixty days has elapsed, whichever | 483 |
|
occurs first. | 484 |
| (C) In making appointments to the commission, the governor | 485 |
| shall
select the members from the list of names
submitted by the | 486 |
| workers' compensation oversight commission
nominating committee | 487 |
| pursuant to this division. Within fourteen
days after the governor | 488 |
| calls the initial meeting of the nominating committee
pursuant to | 489 |
| division (C) of section 4121.123 of the Revised Code, the | 490 |
|
nominating committee shall submit to the governor, for the initial | 491 |
|
appointments, a list containing four separate names for each of | 492 |
| the members on
the commission. Within
fourteen days after the | 493 |
| submission of the list, the governor
shall appoint individuals | 494 |
| from the list. | 495 |
| Thereafter, within sixty days after a vacancy
occurring as a | 502 |
| result of the expiration of a term and within
thirty days after | 503 |
| other vacancies occurring on the commission, the nominating | 504 |
|
committee shall submit a list containing four names for each | 505 |
| vacancy. Within
fourteen days after the submission of the list, | 506 |
| the governor shall appoint
individuals from the list. With respect | 507 |
| to the filling of
vacancies, the nominating committee shall | 508 |
| provide the governor with a list of
four individuals who are, in | 509 |
| the judgment of the nominating committee, the
most fully qualified | 510 |
| to accede to membership on the
commission. The nominating | 511 |
| committee shall not include the name of
an individual upon the | 512 |
| list for the filling of vacancies if the appointment of
that | 513 |
| individual by the governor would result in more than three members | 514 |
| of the
commission belonging to or being affiliated with the same | 515 |
| political party.
The committee shall include on the list for the | 516 |
| filling of vacancies only the
names of attorneys admitted to | 517 |
| practice law in this state if, to fulfill the
requirement of | 518 |
| division (A) of section 4121.12 of the Revised Code, the
vacancy | 519 |
| must be filled by an attorney. | 520 |
| Terms of office of the investment expert members shall be for | 540 |
| three years, with each term ending on the same day of the same | 541 |
| month as did the term that it succeeds. Each member shall hold | 542 |
| office for the date of the member's appointment until the end of | 543 |
| the term for which the member was appointed. The president, | 544 |
| speaker, and treasurer shall not appoint any person to more than | 545 |
| two full terms of office on the commission. This restriction does | 546 |
| not prevent the president, speaker, and treasurer from appointing | 547 |
| a person to fill a vacancy caused by the death, resignation, or | 548 |
| removal of a commission member and also appointing that person | 549 |
| twice to full terms on the commission, or from appointing a person | 550 |
| previously appointed to fill less than a full term twice to full | 551 |
| terms on the commission. Any investment expert member appointed to | 552 |
| fill a vacancy occurring prior to the expiration of the term for | 553 |
| which the member's predecessor was appointed shall hold office | 554 |
| until the end of that term. The member shall continue in office | 555 |
| subsequent to the expiration date of the member's term until the | 556 |
| member's successor takes office or until a period of sixty days | 557 |
| has elapsed, whichever occurs first. | 558 |
| (E) The remaining four members of the commission
shall be the | 561 |
| chairperson and ranking minority member of
the standing committees | 562 |
| of the house of representatives and of the senate to
which | 563 |
| legislation concerning this chapter and Chapters 4123., 4127., and | 564 |
| 4131.
of the Revised Code normally are
referred, or a designee of | 565 |
| the chairperson or ranking
minority member, provided
that the | 566 |
| designee is a member of the standing committee. Legislative | 567 |
| members
shall serve during the session of the general
assembly to | 568 |
| which they are elected and for as long as they are members of the | 569 |
|
general assembly. Legislative members shall serve in an advisory | 570 |
| capacity to
the commission and shall have no voting rights on | 571 |
| matters coming before the
commission. Membership on the commission | 572 |
| by legislative members shall not be
deemed as holding a public | 573 |
| office. | 574 |
| The chairperson of the commission shall set the meeting dates | 590 |
| of the
commission as necessary to perform the duties of the | 591 |
| commission under this
chapter and Chapters 4123., 4127., and 4131. | 592 |
| of the Revised
Code. The commission shall meet at least nine times | 593 |
| during the
period commencing
on the first day of September and | 594 |
| ending on the thirty-first day of
August of the following year. | 595 |
| The administrator of
workers' compensation shall
provide | 596 |
| professional and
clerical assistance to the commission, as the | 597 |
| commission considers
appropriate. | 598 |
| (6) Establish objectives, policies, and
criteria for the | 614 |
|
administration of the investment program that include
asset | 615 |
| allocation targets and ranges, risk factors, asset class | 616 |
|
benchmarks, time horizons, total return objectives, and | 617 |
|
performance evaluation guidelines, and
monitor the administrator's | 618 |
| progress in implementing the
objectives, policies, and criteria on | 619 |
| a quarterly basis. The commission shall not specify in the | 620 |
| objectives, policies, and criteria that the administrator or | 621 |
| employees of the bureau are prohibited from conducting business | 622 |
| with an investment management firm, any investment management | 623 |
| professional associated with that firm, any third party solicitor | 624 |
| associated with that firm, or any political action committee | 625 |
| controlled by that firm or controlled by an investment management | 626 |
| professional of that firm based on criteria that are more | 627 |
| restrictive than the restrictions described in divisions (Y) and | 628 |
| (Z) of section 3517.13 of the Revised Code. The commission
shall | 629 |
| review and
publish the objectives, policies, and criteria no less | 630 |
| than
annually and shall make copies available to interested | 631 |
| parties. The
commission shall prohibit, on a prospective basis, | 632 |
| any
specific investment it finds to be contrary to its investment | 633 |
|
objectives, policies, and criteria. | 634 |
| (7) Specify in the objectives, policies, and criteria for the | 651 |
| investment program that the administrator is permitted to invest | 652 |
| in an investment class only if the commission, by a majority vote, | 653 |
| opens that class. After the commission opens a class but prior to | 654 |
| the administrator investing in that class, the commission shall | 655 |
adopt rules establishing due diligence standards for employees' of | 656 |
| the bureau to follow when investing in that class and shall | 657 |
| establish policies and procedures to review and monitor the | 658 |
| performance and value of each investment class. The commission | 659 |
| shall submit a report annually on the performance and value of | 660 |
| each investment class to the governor, the president and minority | 661 |
| leader of the senate, and the speaker and minority leader of the | 662 |
| house of representatives. The commission may vote to close any | 663 |
| investment class. | 664 |
| (H) The office of a member of the commission who is convicted | 688 |
| of or pleads guilty to a felony, a theft offense as defined in | 689 |
| section 2913.01 of the Revised Code, or a violation of section | 690 |
| 102.02, 102.03, 102.04, 2921.02, 2921.11, 2921.13, 2921.31, | 691 |
| 2921.41, 2921.42, 2921.43, or 2921.44 of the Revised Code shall be | 692 |
| deemed vacant. The vacancy shall be filled in the same manner as | 693 |
| the original appointment. A person who has pleaded guilty to or | 694 |
| been convicted of an offense of that nature is ineligible to be a | 695 |
| member of the commission. A member who receives a bill of | 696 |
| indictment for any of the offenses specified in this section shall | 697 |
| be automatically suspended from the commission pending resolution | 698 |
| of the criminal matter. | 699 |
| (D)(1) Information contained in a
vendor's application for | 771 |
|
certification in the health partnership program, and
other | 772 |
|
information
furnished to the bureau by a vendor for purposes of | 773 |
|
obtaining certification or
to comply with performance and | 774 |
|
financial auditing requirements established by
the
administrator, | 775 |
|
is for the exclusive use and information
of the bureau in the | 776 |
|
discharge of its official duties, and shall not be open to the | 777 |
|
public or be used in any court in any proceeding pending therein, | 778 |
|
unless the bureau is a party to the action or proceeding, but the | 779 |
|
information may be tabulated and published by the bureau in | 780 |
|
statistical form for the use and information of other state | 781 |
|
departments and the public. No employee of the bureau, except as | 782 |
|
otherwise authorized by the administrator, shall divulge any | 783 |
|
information secured by the employee while in the employ of the | 784 |
|
bureau in respect to a vendor's application for certification or | 785 |
|
in respect to the business or other trade processes of any vendor | 786 |
|
to any person other than the administrator or to the employee's | 787 |
|
superior. | 788 |
| (2) Notwithstanding the restrictions imposed by division | 789 |
|
(D)(1)
of this section, the governor, members of select or | 790 |
|
standing committees of the
senate or house of representatives, the | 791 |
|
auditor
of state, the attorney general, or their designees, | 792 |
|
pursuant to the
authority granted in this chapter and Chapter | 793 |
|
4123. of the
Revised Code, may examine any vendor application
or | 794 |
|
other information furnished to the bureau by the vendor. None
of | 795 |
|
those individuals shall divulge any information secured in the | 796 |
|
exercise of that authority in respect to a vendor's application | 797 |
|
for certification or in respect to the business or other trade | 798 |
|
processes of any vendor to any person. | 799 |
| (G) The administrator, six
months prior to the expiration of | 811 |
|
the bureau's
certification or recertification of the vendor or | 812 |
|
vendors as set forth
in division (B)(1) or (2) of this
section, | 813 |
|
may certify and provide evidence to the governor, the
speaker of | 814 |
|
the house of representatives, and the president of the
senate that | 815 |
|
the existing bureau staff is able to match or exceed
the | 816 |
|
performance and outcomes of the external vendor or vendors
and | 817 |
|
that the bureau should be permitted to internally administer
the | 818 |
|
health partnership program upon the expiration of
the | 819 |
|
certification or recertification as set forth in
division (B)(1) | 820 |
|
or (2) of this section. | 821 |
| (J) In areas outside the state or within the state where
no | 846 |
|
qualified health plan or an inadequate number of providers
within | 847 |
|
the health partnership program exist, the administrator
shall | 848 |
|
permit employees to use a nonplan or nonprogram health care | 849 |
|
provider and shall pay the provider for the services or supplies | 850 |
|
provided to or on behalf of an employee for an injury or | 851 |
|
occupational disease that is compensable under this chapter or | 852 |
|
Chapter 4123., 4127., or 4131. of the Revised Code on a fee | 853 |
|
schedule the administrator adopts. | 854 |
| (L) The administrator shall permit any employer or group
of | 861 |
|
employers who agree to abide by the rules adopted under this | 862 |
|
section and sections 4121.441 and 4121.442 of the Revised Code to | 863 |
|
provide services or supplies to or on behalf of an employee for
an | 864 |
|
injury or occupational disease that is compensable under this | 865 |
|
chapter or Chapter 4123., 4127., or 4131. of the Revised Code | 866 |
|
through qualified health plans of the Ohio workers' compensation | 867 |
|
qualified health plan system pursuant to section 4121.442 of the | 868 |
|
Revised Code or through the health partnership program pursuant
to | 869 |
|
section 4121.441 of the Revised Code. No amount paid under
the | 870 |
|
qualified health plan system pursuant to section 4121.442 of
the | 871 |
|
Revised Code by an employer who is a state fund employer
shall be | 872 |
|
charged to the employer's experience or otherwise be
used in | 873 |
|
merit-rating or determining the risk of that employer for
the | 874 |
|
purpose of the payment of premiums under this chapter, and if
the | 875 |
|
employer is a self-insuring employer, the employer shall not | 876 |
|
include that amount in the paid compensation the employer
reports | 877 |
|
under section 4123.35 of the Revised Code. | 878 |
| Sec. 4121.441. (A) The administrator of workers' | 879 |
| compensation, with the
advice and consent of the workers' | 880 |
| compensation oversight commission, shall
adopt rules under Chapter | 881 |
| 119. of the Revised Code for the health care
partnership program | 882 |
| administered by the bureau of workers' compensation to
provide | 883 |
| medical, surgical, nursing, drug, hospital, and rehabilitation | 884 |
|
services and supplies to an employee for an injury or occupational | 885 |
| disease
that is compensable under this chapter or Chapter 4123., | 886 |
| 4127., or 4131. of
the Revised Code. | 887 |
| (1) Procedures for the resolution of medical disputes
between | 890 |
| an employer and an employee, an employee and a provider,
or an | 891 |
| employer and a provider, prior to an appeal under section
4123.511 | 892 |
of the Revised Code;. Rules the administrator adopts pursuant to | 893 |
| division (A)(1) of this section may specify that the resolution | 894 |
| procedures shall not be used to resolve disputes concerning | 895 |
| medical services rendered that have been approved through standard | 896 |
| treatment guidelines, pathways, or presumptive authorization | 897 |
| guidelines. | 898 |
| Sec. 4121.444. (A) No person, health care provider, managed | 937 |
| care
organization, or owner of a health care provider or managed | 938 |
| care organization
shall obtain or attempt to obtain payments by | 939 |
| deception under
Chapter 4121., 4123., 4127., or 4131. of the | 940 |
| Revised Code to which the person, health care
provider, managed | 941 |
| care organization, or owner is not
entitled under rules of the | 942 |
| bureau of workers' compensation adopted pursuant
to sections | 943 |
| 4121.441 and 4121.442 of the Revised
Code. | 944 |
| (a) The person, health care provider, managed care | 975 |
|
organization, or its owner, or an officer, authorized agent, | 976 |
| associate,
manager, or employee of a person, provider, or | 977 |
| organization is convicted of or
pleads
guilty to a violation of | 978 |
| sections 2913.48 or 2923.31 to 2923.36 of the Revised Code or any | 979 |
| other criminal offense related to the delivery of or billing for | 980 |
| health care benefits. | 981 |
| (b) There exists an entry of judgment against the person, | 982 |
|
health care provider, managed care organization, or its owner, or | 983 |
| an officer,
authorized agent, associate, manager, or employee of a | 984 |
| person, provider, or
organization and proof of the specific intent | 985 |
| of
the person, health care provider, managed care organization, or | 986 |
| owner to defraud, in a
civil action brought pursuant to this | 987 |
| section. | 988 |
| (2) No person, health care provider, or managed care | 994 |
| organization that has had its
agreement with and reimbursement | 995 |
| from the bureau terminated by the
administrator pursuant to | 996 |
| division (C)(1) of this section, or an
owner,
officer, authorized | 997 |
| agent, associate, manager, or employee of that person, health care | 998 |
|
provider, or managed care organization shall do either of the | 999 |
| following: | 1000 |
| (3) The administrator shall not terminate the agreement or | 1008 |
| reimbursement
if the person, health care provider, managed care | 1009 |
| organization, or owner
demonstrates that the person, provider, | 1010 |
| organization, or owner did not directly or
indirectly sanction the | 1011 |
| action of the authorized agent, associate, manager, or
employee | 1012 |
| that resulted
in the conviction, plea of guilty, or entry of | 1013 |
| judgment as described in
division (C)(1) of this section. | 1014 |
| (4) Nothing in division (C) of this
section prohibits an | 1015 |
| owner, officer, authorized agent, associate, manager, or
employee | 1016 |
| of a person, health care provider, or managed care organization | 1017 |
| from entering
into an agreement with the bureau if the provider, | 1018 |
| organization, owner,
officer, authorized agent, associate, | 1019 |
| manager, or employee demonstrates
absence
of knowledge of the | 1020 |
| action of the person, health care provider, or managed care | 1021 |
|
organization with which that individual or organization was | 1022 |
| formerly
associated that resulted in
a conviction, plea of guilty, | 1023 |
| or entry of judgment as described in division
(C)(1) of this | 1024 |
| section. | 1025 |
| (a) Every person in the service of the state, or of any | 1058 |
|
county, municipal corporation, township, or school district | 1059 |
|
therein, including regular members of lawfully constituted police | 1060 |
|
and fire departments of municipal corporations and townships, | 1061 |
|
whether paid or volunteer, and wherever serving within the state | 1062 |
|
or on temporary assignment outside thereof, and executive officers | 1063 |
|
of boards of education, under any appointment or contract of hire, | 1064 |
|
express or implied, oral or written, including any elected | 1065 |
|
official of the state, or of any county, municipal corporation, or | 1066 |
|
township, or members of boards of education. | 1067 |
| (b) Every person in the service of any person, firm, or | 1088 |
|
private corporation, including any public service corporation, | 1089 |
|
that (i) employs one or more persons regularly in the same | 1090 |
|
business or in or about the same establishment under any contract | 1091 |
|
of hire, express or implied, oral or written, including aliens and | 1092 |
|
minors, household workers who earn one hundred sixty dollars or | 1093 |
|
more in cash in any calendar quarter from a single household and | 1094 |
|
casual workers who earn one hundred sixty dollars or more in cash | 1095 |
|
in any calendar quarter from a single employer, or (ii) is bound | 1096 |
|
by any such contract of hire or by any other written contract, to | 1097 |
|
pay into the state insurance fund the premiums provided by this | 1098 |
|
chapter. | 1099 |
| Every person in the service of any independent contractor or | 1146 |
|
subcontractor who has failed to pay into the state insurance fund | 1147 |
|
the amount of premium determined and fixed by the administrator of | 1148 |
|
workers' compensation for the person's employment or occupation or | 1149 |
|
if a self-insuring employer has failed to pay compensation and | 1150 |
|
benefits directly to the employer's injured and to the dependents | 1151 |
|
of the employer's killed employees as required by section 4123.35 | 1152 |
|
of the Revised Code, shall be considered as the employee of the | 1153 |
|
person who has entered into a contract, whether written or verbal, | 1154 |
|
with such independent contractor unless such employees or their | 1155 |
|
legal representatives or beneficiaries elect, after injury or | 1156 |
|
death, to regard such independent contractor as the employer. | 1157 |
| Any employer may elect to include as an "employee" within | 1169 |
|
this chapter, any person excluded from the definition of | 1170 |
|
"employee" pursuant to division (A)(2) of this section. If an | 1171 |
|
employer is a partnership, sole proprietorship, individual | 1172 |
| incorporated as a corporation, or family farm
corporation, such | 1173 |
| employer may elect to include as an "employee"
within this | 1174 |
| chapter, any member of such partnership, the owner of
the sole | 1175 |
| proprietorship, the individual incorporated as a corporation, or | 1176 |
| the officers of the family farm
corporation. In the event of an | 1177 |
| election, the employer shall
serve upon the bureau of workers' | 1178 |
| compensation written notice
naming the persons to be covered, | 1179 |
| include such employee's
remuneration for premium purposes in all | 1180 |
| future payroll reports,
and no person excluded from the definition | 1181 |
| of "employee" pursuant
to division (A)(2) of this section, | 1182 |
| proprietor, individual incorporated as a corporation, or partner | 1183 |
| shall
be deemed an employee within this division until the | 1184 |
| employer has
served such notice. | 1185 |
| For informational purposes only, the bureau shall prescribe | 1186 |
|
such language as it considers appropriate, on such of its forms as | 1187 |
|
it considers appropriate, to advise employers of their right to | 1188 |
|
elect to include as an "employee" within this chapter a sole | 1189 |
|
proprietor, any member of a partnership, an individual | 1190 |
| incorporated as a corporation, the officers of a family
farm | 1191 |
| corporation, or a person excluded from the definition of | 1192 |
|
"employee" under division (A)(2) of this section, that they
should | 1193 |
| check any health and disability insurance policy, or other
form of | 1194 |
| health and disability plan or contract, presently covering
them, | 1195 |
| or the purchase of which they may be considering, to
determine | 1196 |
| whether such policy, plan, or contract excludes benefits
for | 1197 |
| illness or injury that they might have elected to have covered
by | 1198 |
| workers' compensation. | 1199 |
| (2) Every person, firm, professional employer organization as | 1205 |
| defined in section 4125.01 of the Revised Code, and private | 1206 |
| corporation, including
any public service corporation, that (a) | 1207 |
| has in service one or
more employees or shared employees regularly | 1208 |
| in the same business or in or about the
same establishment under | 1209 |
| any contract of hire, express or implied,
oral or written, or (b) | 1210 |
| is bound by any such contract of hire or
by any other written | 1211 |
| contract, to pay into the insurance fund the
premiums provided by | 1212 |
| this chapter. | 1213 |
| All such employers are subject to this chapter. Any member
of | 1214 |
| a firm or association, who regularly performs manual labor in
or | 1215 |
| about a mine, factory, or other establishment, including a | 1216 |
|
household establishment, shall be considered an employee in | 1217 |
|
determining whether such person, firm, or private corporation, or | 1218 |
|
public service corporation, has in its service, one or more | 1219 |
|
employees and the employer shall report the income derived from | 1220 |
|
such labor to the bureau as part of the payroll of such employer, | 1221 |
|
and such member shall thereupon be entitled to all the benefits of | 1222 |
|
an employee. | 1223 |
| (4) A condition that pre-existed an injury unless that | 1241 |
| pre-existing condition is substantially aggravated by the injury. | 1242 |
| Such a substantial aggravation must be documented by objective | 1243 |
| diagnostic findings, objective clinical findings, or objective | 1244 |
| test results. Subjective complaints may be evidence of such a | 1245 |
| substantial aggravation. However, subjective complaints without | 1246 |
| objective diagnostic findings, objective clinical findings, or | 1247 |
| objective test results are insufficient to substantiate a | 1248 |
| substantial aggravation. | 1249 |
| (E) "Family farm corporation" means a corporation founded
for | 1252 |
| the purpose of farming agricultural land in which the majority
of | 1253 |
| the voting stock is held by and the majority of the
stockholders | 1254 |
| are persons or the spouse of persons related to each
other within | 1255 |
| the fourth degree of kinship, according to the rules
of the civil | 1256 |
| law, and at least one of the related persons is
residing on or | 1257 |
| actively operating the farm, and none of whose
stockholders are a | 1258 |
| corporation. A family farm corporation does
not cease to qualify | 1259 |
| under this division where, by reason of any
devise, bequest, or | 1260 |
| the operation of the laws of descent or
distribution, the | 1261 |
| ownership of shares of voting stock is
transferred to another | 1262 |
| person, as long as that person is within
the degree of kinship | 1263 |
| stipulated in this division. | 1264 |
| (I) "Sexual conduct" means vaginal intercourse between a male | 1282 |
| and female; anal intercourse, fellatio, and cunnilingus between | 1283 |
| persons regardless of gender; and, without privilege to do so, the | 1284 |
| insertion, however slight, of any part of the body or any | 1285 |
| instrument, apparatus, or other object into the vaginal or anal | 1286 |
| cavity of another. Penetration, however slight, is sufficient to | 1287 |
| complete vaginal or anal intercourse. | 1288 |
| Sec. 4123.271. The administrator of workers' compensation may | 1289 |
| furnish to the tax commissioner, on a quarterly basis, a list in a | 1290 |
| format approved by the tax commissioner containing the name and | 1291 |
| social security number or employer identification number of any | 1292 |
| employer, and may request that the tax commissioner, on a | 1293 |
| quarterly basis, report the total amount of compensation paid that | 1294 |
| the employer reported for the period for which the annual return | 1295 |
| is made pursuant to division (F)(3) of section 5747.07 of the | 1296 |
| Revised Code, for each employer contained on the administrator's | 1297 |
| list. | 1298 |
| Upon receipt of this list and request, the tax commissioner | 1299 |
| shall provide to the administrator, in a format designed by the | 1300 |
| tax commissioner, information identifying any employer listed by | 1301 |
| the administrator who reported compensation paid to employees on | 1302 |
| the most recent return filed by the person pursuant to section | 1303 |
| 5747.07 of the Revised Code and the total amount of compensation | 1304 |
| paid that the employer reported for the period for which the | 1305 |
| annual return is made pursuant to division (F)(3) of section | 1306 |
| 5747.07 of the Revised Code. | 1307 |
| (2) Fix the rates of premium of the risks of the classes | 1316 |
|
based upon the total payroll in each of the classes of occupation | 1317 |
|
or industry sufficiently large to provide a fund for the | 1318 |
|
compensation provided for in this chapter and to maintain a state | 1319 |
|
insurance fund from year to year. The administrator shall set
the | 1320 |
| rates at a level that assures the solvency of the fund.
Where the | 1321 |
| payroll cannot be obtained or, in the opinion of the | 1322 |
|
administrator, is not an adequate measure for determining the | 1323 |
|
premium to be paid for the degree of hazard, the administrator
may | 1324 |
| determine the rates of premium upon such other basis,
consistent | 1325 |
| with insurance principles, as is equitable in view of
the degree | 1326 |
| of hazard, and whenever in this chapter reference is
made to | 1327 |
| payroll or expenditure of wages with reference to fixing
premiums, | 1328 |
| the reference shall be construed to have been made also
to such | 1329 |
| other basis for fixing the rates of premium as the
administrator | 1330 |
| may determine under this section. | 1331 |
| In providing employer group plans under division (A)(4) of | 1371 |
| this section, the administrator shall establish a program designed | 1372 |
| to mitigate the impact of a significant claim that would come into | 1373 |
| the experience of a private, state fund group-rated employer for | 1374 |
| the first time and be a contributing factor in that employer being | 1375 |
| excluded from a group-rated plan. The administrator shall | 1376 |
| establish eligibility criteria and requirements that such | 1377 |
| employers must satisfy in order to participate in this program. | 1378 |
| For purposes of this program, the administrator shall establish a | 1379 |
| discount on premium rates applicable to employers who qualify for | 1380 |
| the program. | 1381 |
| (6) Make available to every employer who is paying
premiums | 1396 |
to the state insurance fund a program whereby the
employer or his | 1397 |
| the employer's agent pays to the claimant or on
behalf of the | 1398 |
claimant the first onefive thousand dollars of a compensable | 1399 |
| workers'
compensation medical-only claim filed by that claimant | 1400 |
| that is
related to the same injury or occupational disease. If an | 1401 |
|
employer elects to enter the program, the administrator shall not | 1402 |
|
reimburse the employer for such amounts paid and shall not charge | 1403 |
the first onefive thousand dollars of any medical-only claim paid | 1404 |
| by
an employer to the employer's experience or otherwise use it in | 1405 |
|
merit rating or determining the risks of any employer for the | 1406 |
|
purpose of payment of premiums under this chapter. If an employer | 1407 |
| elects to enter the program and the employer fails to pay a bill | 1408 |
| for a medical-only claim included in the program, the employer | 1409 |
| shall be liable for that bill and the employee for whom the | 1410 |
| employer failed to pay the bill shall not be liable for that bill. | 1411 |
| The
administrator shall adopt rules to implement and administer | 1412 |
|
division (A)(6) of this section. | 1413 |
| (B) A rule providing that the premium security deposit | 1474 |
|
collected from
any employer entitles the employer to the benefits | 1475 |
|
of
this chapter for the remainder of
the six months and also for | 1476 |
|
an additional adjustment period of two months,
and,
thereafter, if | 1477 |
|
the employer pays the premium due at the close of any six-month | 1478 |
|
period, coverage shall be extended for an additional eight-month | 1479 |
|
period
beginning from the end of the six-month period for which | 1480 |
|
the employer pays the
premium due; | 1481 |
| (D) Such special rules as the administrator considers | 1490 |
|
necessary to safeguard the fund and that are just in the | 1491 |
|
circumstances, covering the rates to be applied where one
employer | 1492 |
|
takes over the occupation or industry of another or
where an | 1493 |
|
employer first makes application for state insurance,
and the | 1494 |
|
administrator may require that if any employer transfers
a | 1495 |
|
business in whole or in part or otherwise reorganizes the | 1496 |
|
business, the successor in interest shall assume, in proportion
to | 1497 |
|
the extent of the transfer, as determined by the
administrator, | 1498 |
|
the employer's account and shall continue the
payment of all | 1499 |
|
contributions due under this chapter; | 1500 |
| (2) The premium determined by the administrator to be due | 1509 |
|
from an employer
shall be payable on or before the end of the | 1510 |
|
coverage period established by
the premium security deposit, or | 1511 |
|
within the time specified by the
administrator if
the period for | 1512 |
|
which the advance premium has been paid is less than eight
months. | 1513 |
If an employer fails to pay the premium when due, an amount equal | 1514 |
to
three per cent of the premium shall be added to the premium.
If | 1515 |
the failure
to pay continues for more than one month, the
premium | 1516 |
shall be increased
further
in an amount equal to two per
cent of | 1517 |
the premium for each additional month or
part of a month,
but the | 1518 |
total of all additional amounts shall not exceed
twelve
per cent | 1519 |
of the premium. Ifthe administrator may add a late fee penalty of | 1520 |
| not more than thirty dollars to the premium plus an additional | 1521 |
| penalty amount as follows: | 1522 |
| (F) A rule providing that each employer, on the occasion
of | 1574 |
|
instituting coverage under this chapter, shall submit a
premium | 1575 |
|
security deposit. The deposit shall be calculated
equivalent to | 1576 |
|
thirty per cent of the semiannual premium
obligation of the | 1577 |
|
employer based upon the employer's estimated
expenditure for wages | 1578 |
|
for the ensuing six-month period plus
thirty per cent of an | 1579 |
|
additional adjustment period of two months
but only up to a | 1580 |
|
maximum of one thousand dollars and not less
than ten dollars.
The | 1581 |
|
administrator shall review the security
deposit of every
employer | 1582 |
|
who has submitted a deposit which is
less than the | 1583 |
|
one-thousand-dollar maximum. The administrator may
require any | 1584 |
|
such employer to submit additional money up to the
maximum of one | 1585 |
|
thousand dollars that, in the administrator's
opinion, reflects | 1586 |
|
the employer's current payroll expenditure for
an eight-month | 1587 |
|
period. | 1588 |
| Sec. 4123.35. (A) Except as provided in this section,
every | 1589 |
| employer mentioned in division (B)(2) of section 4123.01 of
the | 1590 |
| Revised Code, and every publicly owned utility shall pay | 1591 |
|
semiannually in the months of January and July into the state | 1592 |
|
insurance fund the amount of annual premium the administrator of | 1593 |
|
workers' compensation fixes for the employment or occupation of | 1594 |
|
the employer, the amount of which premium to be paid by each | 1595 |
|
employer to be determined by the classifications, rules, and rates | 1596 |
|
made and published by the administrator. The employer shall pay | 1597 |
|
semiannually a further sum of money into the state insurance fund | 1598 |
|
as may be ascertained to be due from the employer by applying the | 1599 |
|
rules of the administrator, and a receipt or certificate | 1600 |
|
certifying that payment has been made, along with a written notice | 1601 |
| as is required in section 4123.54 of the Revised Code, shall be | 1602 |
| mailed immediately
to the employer by the bureau of workers' | 1603 |
| compensation. The
receipt or certificate is prima-facie evidence | 1604 |
| of the payment of
the premium, and the proper posting of the | 1605 |
| notice constitutes the employer's compliance with the notice | 1606 |
| requirement mandated in section 4123.54 of the Revised Code. | 1607 |
| The administrator shall adopt rules to permit employers to | 1626 |
|
make periodic payments of the semiannual premium due under this | 1627 |
|
division. The rules shall include provisions for the assessment
of | 1628 |
| interest charges, where appropriate, and for the assessment of | 1629 |
|
penalties when an employer fails to make timely premium payments. | 1630 |
|
An employer who timely pays the amounts due under this division is | 1631 |
|
entitled to all of the benefits and protections of this chapter. | 1632 |
|
Upon receipt of payment, the bureau immediately shall mail a | 1633 |
|
receipt or certificate to the employer certifying that payment has | 1634 |
|
been made, which receipt is prima-facie evidence of payment. | 1635 |
|
Workers' compensation coverage under this chapter continues | 1636 |
|
uninterrupted upon timely receipt of payment under this division. | 1637 |
| (B) Employers who will abide by the rules of the | 1642 |
|
administrator and who may be of sufficient financial ability to | 1643 |
|
render certain the payment of compensation to injured employees or | 1644 |
|
the dependents of killed employees, and the furnishing of medical, | 1645 |
|
surgical, nursing, and hospital attention and services and | 1646 |
|
medicines, and funeral expenses, equal to or greater than is | 1647 |
|
provided for in sections 4123.52, 4123.55 to 4123.62, and 4123.64 | 1648 |
|
to 4123.67 of the Revised Code, and who do not desire to insure | 1649 |
|
the payment thereof or indemnify themselves against loss sustained | 1650 |
|
by the direct payment thereof, upon a finding of such facts by the | 1651 |
|
administrator, may be granted the privilege to pay individually | 1652 |
|
compensation, and furnish medical, surgical, nursing, and hospital | 1653 |
|
services and attention and funeral expenses directly to injured | 1654 |
|
employees or the dependents of killed employees, thereby being | 1655 |
|
granted status as a self-insuring employer. The administrator may | 1656 |
|
charge employers who apply for the status as a self-insuring | 1657 |
|
employer a reasonable application fee to cover the bureau's costs | 1658 |
|
in connection with processing and making a determination with | 1659 |
|
respect to an application. | 1660 |
| The administrator may waive the requirements of divisions | 1701 |
|
(B)(1)(a) and (b) of this section and the requirement of division | 1702 |
|
(B)(1)(e) of this section that the financial records, documents, | 1703 |
|
and data be certified by a certified public accountant. The | 1704 |
|
administrator shall adopt rules establishing the criteria that an | 1705 |
|
employer shall meet in order for the administrator to waive the | 1706 |
|
requirement of division (B)(1)(e) of this section. Such rules may | 1707 |
|
require additional security of that employer pursuant to division | 1708 |
|
(E) of section 4123.351 of the Revised Code. | 1709 |
| (C) A board of county commissioners described in division
(G) | 1776 |
| of section 4123.01 of the Revised Code, as an employer, that
will | 1777 |
| abide by the rules of the administrator and that may be of | 1778 |
|
sufficient financial ability to render certain the payment of | 1779 |
|
compensation to injured employees or the dependents of killed | 1780 |
|
employees, and the furnishing of medical, surgical, nursing, and | 1781 |
|
hospital attention and services and medicines, and funeral | 1782 |
|
expenses, equal to or greater than is provided for in sections | 1783 |
|
4123.52, 4123.55 to 4123.62, and 4123.64 to 4123.67 of the Revised | 1784 |
|
Code, and that does not desire to insure the payment thereof or | 1785 |
|
indemnify itself against loss sustained by the direct payment | 1786 |
|
thereof, upon a finding of such facts by the administrator, may be | 1787 |
|
granted the privilege to pay individually compensation, and | 1788 |
|
furnish medical, surgical, nursing, and hospital services and | 1789 |
|
attention and funeral expenses directly to injured employees or | 1790 |
|
the dependents of killed employees, thereby being granted status | 1791 |
|
as a self-insuring employer. The administrator may charge a board | 1792 |
|
of county commissioners described in division (G) of section | 1793 |
|
4123.01 of the Revised Code that applies for the status as a | 1794 |
|
self-insuring employer a reasonable application fee to cover the | 1795 |
|
bureau's costs in connection with processing and making a | 1796 |
|
determination with respect to an application. All employers | 1797 |
|
granted such status shall demonstrate sufficient financial and | 1798 |
|
administrative ability to assure that all obligations under this | 1799 |
|
section are promptly met. The administrator shall deny the | 1800 |
|
privilege where the employer is unable to demonstrate the | 1801 |
|
employer's ability to promptly meet all the obligations imposed on | 1802 |
|
the employer by this section. The administrator shall consider, | 1803 |
|
but is not limited to, the following factors, where applicable, in | 1804 |
|
determining the employer's ability to meet all of the obligations | 1805 |
|
imposed on the board as an employer by this section: | 1806 |
| (D) The administrator shall require a surety bond from all | 1837 |
|
self-insuring employers, issued pursuant to section 4123.351 of | 1838 |
|
the Revised Code, that is sufficient to compel, or secure to | 1839 |
|
injured employees, or to the dependents of employees killed, the | 1840 |
|
payment of compensation and expenses, which shall in no event be | 1841 |
|
less than that paid or furnished out of the state insurance fund | 1842 |
|
in similar cases to injured employees or to dependents of killed | 1843 |
|
employees whose employers contribute to the fund, except when an | 1844 |
|
employee of the employer, who has suffered the loss of a hand, | 1845 |
|
arm, foot, leg, or eye prior to the injury for which compensation | 1846 |
|
is to be paid, and thereafter suffers the loss of any other of the | 1847 |
|
members as the result of any injury sustained in the course of and | 1848 |
|
arising out of the employee's employment, the compensation to be | 1849 |
|
paid by the self-insuring employer is limited to the disability | 1850 |
| suffered in the subsequent injury, additional compensation, if | 1851 |
|
any, to be paid by the bureau out of the surplus created by | 1852 |
|
section 4123.34 of the Revised Code. | 1853 |
| (E) In addition to the requirements of this section, the | 1854 |
|
administrator shall make and publish rules governing the manner of | 1855 |
|
making application and the nature and extent of the proof required | 1856 |
|
to justify a finding of fact by the administrator as to granting | 1857 |
|
the status of a self-insuring employer, which rules shall be | 1858 |
|
general in their application, one of which rules shall provide | 1859 |
|
that all self-insuring employers shall pay into the state | 1860 |
|
insurance fund such amounts as are required to be credited to the | 1861 |
|
surplus fund in division (B) of section 4123.34 of the Revised | 1862 |
|
Code. The administrator may adopt rules establishing requirements | 1863 |
|
in addition to the requirements described in division (B)(2) of | 1864 |
|
this section that a public employer shall meet in order to qualify | 1865 |
|
for self-insuring status. | 1866 |
| Employers shall secure directly from the bureau central | 1867 |
|
offices application forms upon which the bureau shall stamp a | 1868 |
|
designating number. Prior to submission of an application, an | 1869 |
|
employer shall make available to the bureau, and the bureau shall | 1870 |
|
review, the information described in division (B)(1) of this | 1871 |
|
section, and public employers shall make available, and the bureau | 1872 |
|
shall review, the information necessary to verify whether the | 1873 |
|
public employer meets the requirements listed in division (B)(2) | 1874 |
|
of this section. An employer shall file the completed application | 1875 |
|
forms with an application fee, which shall cover the costs of | 1876 |
|
processing the application, as established by the administrator, | 1877 |
|
by rule, with the bureau at least ninety days prior to the | 1878 |
|
effective date of the employer's new status as a self-insuring | 1879 |
|
employer. The application form is not deemed complete until all | 1880 |
|
the required information is attached thereto. The bureau shall | 1881 |
|
only accept applications that contain the required information. | 1882 |
| (F) The bureau shall review completed applications within a | 1883 |
|
reasonable time. If the bureau determines to grant an employer
the | 1884 |
| status as a self-insuring employer, the bureau shall issue a | 1885 |
|
statement, containing its findings of fact, that is prepared by | 1886 |
|
the bureau and signed by the administrator. If the bureau | 1887 |
|
determines not to grant the status as a self-insuring employer, | 1888 |
|
the bureau shall notify the employer of the determination and | 1889 |
|
require the employer to continue to pay its full premium into the | 1890 |
|
state insurance fund. The administrator also shall adopt rules | 1891 |
|
establishing a minimum level of performance as a criterion for | 1892 |
|
granting and maintaining the status as a self-insuring employer | 1893 |
|
and fixing time limits beyond which failure of the self-insuring | 1894 |
|
employer to provide for the necessary medical examinations and | 1895 |
|
evaluations may not delay a decision on a claim. | 1896 |
| (J) On the first day of July of each year, the administrator | 1936 |
|
shall calculate separately each self-insuring employer's | 1937 |
|
assessments for the safety and hygiene fund, administrative costs | 1938 |
|
pursuant to section 4123.342 of the Revised Code, and for the | 1939 |
|
portion of the surplus fund under division (B) of section 4123.34 | 1940 |
|
of the Revised Code that is not used for handicapped | 1941 |
|
reimbursement, on the basis of the paid compensation attributable | 1942 |
|
to the individual self-insuring employer according to the | 1943 |
|
following calculation: | 1944 |
| (2) Multiply the quotient in division (J)(1) of this section | 1951 |
|
by the total amount of paid compensation for the previous calendar | 1952 |
|
year that is attributable to the individual self-insuring employer | 1953 |
|
for whom the assessment is being determined. Each self-insuring | 1954 |
|
employer shall pay the assessment that results from this | 1955 |
|
calculation, unless the assessment resulting from this calculation | 1956 |
|
falls below a minimum assessment, which minimum assessment the | 1957 |
|
administrator shall determine on the first day of July of each | 1958 |
|
year with the advice and consent of the workers' compensation | 1959 |
|
oversight commission, in which event, the self-insuring employer | 1960 |
|
shall pay the minimum assessment. | 1961 |
| The administrator shall calculate the assessment for the | 1968 |
|
portion of the surplus fund under division (B) of section 4123.34 | 1969 |
|
of the Revised Code that is used for handicapped reimbursement in | 1970 |
|
the same manner as set forth in divisions (J)(1) and (2) of this | 1971 |
|
section except that the administrator shall calculate the total | 1972 |
|
assessment for this portion of the surplus fund only on the basis | 1973 |
|
of those self-insuring employers that retain participation in the | 1974 |
|
handicapped reimbursement program and the individual self-insuring | 1975 |
|
employer's proportion of paid compensation shall be calculated | 1976 |
|
only for those self-insuring employers who retain participation in | 1977 |
|
the handicapped reimbursement program. The administrator, as the | 1978 |
|
administrator determines appropriate, may determine the total | 1979 |
|
assessment for the handicapped portion of the surplus fund in | 1980 |
|
accordance with sound actuarial principles. | 1981 |
| The administrator shall calculate the assessment for the | 1982 |
|
portion of the surplus fund under division (B) of section 4123.34 | 1983 |
|
of the Revised Code that under division (D) of section 4121.66 of | 1984 |
|
the Revised Code is used for rehabilitation costs in the same | 1985 |
|
manner as set forth in divisions (J)(1) and (2) of this section, | 1986 |
|
except that the administrator shall calculate the total assessment | 1987 |
|
for this portion of the surplus fund only on the basis of those | 1988 |
|
self-insuring employers who have not made the election to make | 1989 |
|
payments directly under division (D) of section 4121.66 of the | 1990 |
|
Revised Code and an individual self-insuring employer's proportion | 1991 |
|
of paid compensation only for those self-insuring employers who | 1992 |
|
have not made that election. | 1993 |
| The administrator shall calculate the assessment for the | 1994 |
| portion of the surplus fund under division (B) of section 4123.34 | 1995 |
| of the Revised Code that is used for reimbursement to a | 1996 |
| self-insuring employer under division (H) of section 4123.512 of | 1997 |
| the Revised Code in the same manner as set forth in divisions | 1998 |
| (J)(1) and (2) of this section except that the administrator shall | 1999 |
| calculate the total assessment for this portion of the surplus | 2000 |
| fund only on the basis of those self-insuring employers that | 2001 |
| retain participation in reimbursement to the self-insuring | 2002 |
| employer under division (H) of section 4123.512 of the Revised | 2003 |
| Code and the individual self-insuring employer's proportion of | 2004 |
| paid compensation shall be calculated only for those self-insuring | 2005 |
| employers who retain participation in reimbursement to the | 2006 |
| self-insuring employer under division (H) of section 4123.512 of | 2007 |
| the Revised Code. | 2008 |
| (L) Every self-insuring employer shall certify, in affidavit | 2022 |
|
form subject to the penalty for perjury, to the bureau the amount | 2023 |
|
of the self-insuring employer's paid compensation for the previous | 2024 |
|
calendar year. In reporting paid compensation paid for the | 2025 |
|
previous year, a self-insuring employer shall exclude from the | 2026 |
|
total amount of paid compensation any reimbursement the | 2027 |
|
self-insuring employer receives in the previous calendar year from | 2028 |
|
the surplus fund pursuant to section 4123.512 of the Revised Code | 2029 |
|
for any paid compensation. The self-insuring employer also shall | 2030 |
|
exclude from the paid compensation reported any amount recovered | 2031 |
|
under section 4123.931 of the Revised Code and any amount that is | 2032 |
|
determined not to have been payable to or on behalf of a claimant | 2033 |
|
in any final administrative or judicial proceeding. The | 2034 |
|
self-insuring employer shall exclude such amounts from the paid | 2035 |
|
compensation reported in the reporting period subsequent to the | 2036 |
|
date the determination is made. The administrator shall adopt | 2037 |
|
rules, in accordance with Chapter 119. of the Revised Code, | 2038 |
establishingthat provide for all of the following: | 2039 |
| (M) As used in this section, "paid compensation" means all | 2078 |
|
amounts paid by a self-insuring employer for living maintenance | 2079 |
|
benefits, all amounts for compensation paid pursuant to sections | 2080 |
|
4121.63, 4121.67, 4123.56, 4123.57, 4123.58, 4123.59, 4123.60, and | 2081 |
|
4123.64 of the Revised Code, all amounts paid as wages in lieu of | 2082 |
|
such compensation, all amounts paid in lieu of such compensation | 2083 |
|
under a nonoccupational accident and sickness program fully funded | 2084 |
|
by the self-insuring employer, and all amounts paid by a | 2085 |
|
self-insuring employer for a violation of a specific safety | 2086 |
|
standard pursuant to Section 35 of Article II, Ohio Constitution | 2087 |
|
and section 4121.47 of the Revised Code. | 2088 |
| (O) The administrator may grant a self-insuring employer the | 2096 |
|
privilege to self-insure a construction project entered into by | 2097 |
|
the self-insuring employer that is scheduled for completion within | 2098 |
|
six years after the date the project begins, and the total cost of | 2099 |
|
which is estimated to exceed one hundred million dollars
or, for | 2100 |
|
employers described in division (R) of this section, if the | 2101 |
|
construction project is estimated to exceed twenty-five million | 2102 |
|
dollars. The
administrator may waive such cost and time criteria | 2103 |
|
and grant a
self-insuring employer the privilege to self-insure a | 2104 |
|
construction
project regardless of the time needed to complete the | 2105 |
|
construction
project and provided that the cost of the | 2106 |
|
construction project is
estimated to exceed fifty million dollars. | 2107 |
|
A self-insuring
employer who desires to self-insure a construction | 2108 |
|
project shall
submit to the administrator an application listing | 2109 |
|
the dates the
construction project is scheduled to begin and end, | 2110 |
|
the estimated
cost of the construction project, the contractors | 2111 |
|
and
subcontractors whose employees are to be self-insured by the | 2112 |
|
self-insuring employer, the provisions of a safety program that is | 2113 |
|
specifically designed for the construction project, and a | 2114 |
|
statement as to whether a collective bargaining agreement | 2115 |
|
governing the rights, duties, and obligations of each of the | 2116 |
|
parties to the agreement with respect to the construction project | 2117 |
|
exists between the self-insuring employer and a labor | 2118 |
|
organization. | 2119 |
| Upon approval of the application, the administrator shall | 2127 |
|
mail a certificate granting the privilege to self-insure the | 2128 |
|
construction project to the self-insuring employer. The | 2129 |
|
certificate shall contain the name of the self-insuring employer | 2130 |
|
and the name, address, and telephone number of the self-insuring | 2131 |
|
employer's representatives who are responsible for administering | 2132 |
|
workers' compensation claims for the construction project. The | 2133 |
|
self-insuring employer shall post the certificate in a conspicuous | 2134 |
|
place at the site of the construction project. | 2135 |
| Upon approval of the application, the self-insuring employer | 2142 |
|
is responsible for the administration and payment of all claims | 2143 |
|
under this chapter and Chapter 4121. of the Revised Code for the | 2144 |
|
employees of the contractor and subcontractors covered under the | 2145 |
|
certificate who receive injuries or are killed in the course of | 2146 |
|
and arising out of employment on the construction project, or who | 2147 |
|
contract an occupational disease in the course of employment on | 2148 |
|
the construction project. For purposes of this chapter and
Chapter | 2149 |
| 4121. of the Revised Code, a claim that is administered
and paid | 2150 |
| in accordance with this division is considered a claim
against the | 2151 |
| self-insuring employer listed in the certificate. A
contractor or | 2152 |
| subcontractor included under the certificate shall
report to the | 2153 |
| self-insuring employer listed in the certificate,
all claims that | 2154 |
| arise under this chapter and Chapter 4121. of the
Revised Code in | 2155 |
| connection with the construction project for which
the certificate | 2156 |
| is issued. | 2157 |
| A self-insuring employer who complies with this division is | 2158 |
|
entitled to the protections provided under this chapter and | 2159 |
|
Chapter 4121. of the Revised Code with respect to the employees of | 2160 |
|
the contractors and subcontractors covered under a certificate | 2161 |
|
issued under this division for death or injuries that arise out | 2162 |
|
of, or death, injuries, or occupational diseases that arise in the | 2163 |
|
course of, those employees' employment on that construction | 2164 |
|
project, as if the employees were employees of the self-insuring | 2165 |
|
employer, provided that the self-insuring employer also complies | 2166 |
|
with this section. No employee of the contractors and | 2167 |
|
subcontractors covered under a certificate issued under this | 2168 |
|
division shall be considered the employee of the self-insuring | 2169 |
|
employer listed in that certificate for any purposes other than | 2170 |
|
this chapter and Chapter 4121. of the Revised Code. Nothing in | 2171 |
|
this division gives a self-insuring employer authority to control | 2172 |
|
the means, manner, or method of employment of the employees of the | 2173 |
|
contractors and subcontractors covered under a certificate issued | 2174 |
|
under this division. | 2175 |
| The contractors and subcontractors included under a | 2176 |
|
certificate issued under this division are entitled to the | 2177 |
|
protections provided under this chapter and Chapter 4121. of the | 2178 |
|
Revised Code with respect to the contractor's or subcontractor's | 2179 |
|
employees who are employed on the construction project which is | 2180 |
|
the subject of the certificate, for death or injuries that arise | 2181 |
|
out of, or death, injuries, or occupational diseases that arise in | 2182 |
|
the course of, those employees' employment on that construction | 2183 |
|
project. | 2184 |
| The contractors and subcontractors included under a | 2185 |
|
certificate issued under this division shall identify in their | 2186 |
|
payroll records the employees who are considered the employees of | 2187 |
|
the self-insuring employer listed in that certificate for purposes | 2188 |
|
of this chapter and Chapter 4121. of the Revised Code, and the | 2189 |
|
amount that those employees earned for employment on the | 2190 |
|
construction project that is the subject of that certificate. | 2191 |
|
Notwithstanding any provision to the contrary under this chapter | 2192 |
|
and Chapter 4121. of the Revised Code, the administrator shall | 2193 |
|
exclude the payroll that is reported for employees who are | 2194 |
|
considered the employees of the self-insuring employer listed in | 2195 |
|
that certificate, and that the employees earned for employment on | 2196 |
|
the construction project that is the subject of that certificate, | 2197 |
|
when determining those contractors' or subcontractors' premiums or | 2198 |
|
assessments required under this chapter and Chapter 4121. of the | 2199 |
|
Revised Code. A self-insuring employer issued a certificate under | 2200 |
|
this division shall include in the amount of paid compensation it | 2201 |
|
reports pursuant to division (L) of this section, the amount of | 2202 |
|
paid compensation the self-insuring employer paid pursuant to this | 2203 |
|
division for the previous calendar year. | 2204 |
| (2) Whether the safety program that is specifically designed | 2250 |
|
for the construction project provides for the safety of employees | 2251 |
|
employed on the construction project, is applicable to all | 2252 |
|
contractors and subcontractors who perform labor or work or | 2253 |
|
provide materials for the construction project, and has
as a | 2254 |
|
component, a safety training program that complies with standards | 2255 |
|
adopted pursuant to the "Occupational Safety and Health Act of | 2256 |
|
1970," 84 Stat. 1590, 29 U.S.C.A. 651, and provides for continuing | 2257 |
|
management and employee involvement; | 2258 |
| Sec. 4123.512. (A) The claimant or the employer may
appeal | 2289 |
| an order of the industrial commission made under division
(E) of | 2290 |
| section 4123.511 of the Revised Code in any injury or
occupational | 2291 |
| disease case, other than a decision as to the extent
of disability | 2292 |
| to the court of common pleas of the county in
which the injury was | 2293 |
| inflicted or in which the contract of
employment was made if the | 2294 |
| injury occurred outside the state, or
in which the contract of | 2295 |
| employment was made if the exposure
occurred outside the state. If | 2296 |
| no common pleas court has
jurisdiction for the purposes of an | 2297 |
| appeal by the use of the
jurisdictional requirements described in | 2298 |
| this division, the
appellant may use the venue provisions in the | 2299 |
| Rules of Civil
Procedure to vest jurisdiction in a court. If the | 2300 |
| claim is for
an occupational disease, the appeal shall be to the | 2301 |
| court of
common pleas of the county in which the exposure which | 2302 |
| caused the
disease occurred. Like appeal may be taken from an | 2303 |
| order of a
staff hearing officer made under division (D) of | 2304 |
| section 4123.511
of the Revised Code from which the commission has | 2305 |
| refused to hear
an appeal. The appellant shall file the notice of | 2306 |
| appeal with a
court of common pleas within sixty days after the | 2307 |
| date of the
receipt of the order appealed from or the date of | 2308 |
| receipt of the
order of the commission refusing to hear an appeal | 2309 |
| of a staff
hearing officer's decision under division (D) of | 2310 |
| section 4123.511
of the Revised Code. The filing of the notice of | 2311 |
| the appeal with
the court is the only act required to perfect the | 2312 |
| appeal. | 2313 |
| Notwithstanding anything to the contrary in this section,
if | 2318 |
| the commission determines under section 4123.522 of the
Revised | 2319 |
| Code that an employee, employer, or their respective | 2320 |
|
representatives have not received written notice of an order or | 2321 |
|
decision which is appealable to a court under this section and | 2322 |
|
which grants relief pursuant to section 4123.522 of the Revised | 2323 |
|
Code, the party granted the relief has sixty days from receipt of | 2324 |
|
the order under section 4123.522 of the Revised Code to file a | 2325 |
|
notice of appeal under this section. | 2326 |
| The administrator of workers' compensation, the claimant, and | 2331 |
| the employer shall be
parties to the appeal and the court, upon | 2332 |
| the application of the
commission, shall make the commission a | 2333 |
| party. The party filing the appeal
shall serve a copy of the | 2334 |
notice of appeal on the admnistrator
of workers' compensation | 2335 |
| administrator at the central office of the
bureau of workers' | 2336 |
| compensation in Columbus. The administrator
shall notify the | 2337 |
| employer that if the employer fails to
become an active
party to | 2338 |
| the appeal, then the administrator may act on behalf of
the | 2339 |
| employer and the results of the appeal could have an adverse | 2340 |
|
effect upon the employer's premium rates. | 2341 |
| (C) The attorney general or one or more of the attorney | 2342 |
|
general's assistants
or special counsel designated by the attorney | 2343 |
| general shall
represent the administrator and the commission. In | 2344 |
| the event the attorney
general or the attorney general's | 2345 |
| designated assistants or
special counsel are
absent, the | 2346 |
| administrator or the commission shall select one or
more of the | 2347 |
| attorneys in the employ of the administrator or the
commission as | 2348 |
| the administrator's attorney or
the commission's attorney in the | 2349 |
| appeal. Any attorney so
employed shall continue the representation | 2350 |
| during the entire
period of the appeal and in all hearings thereof | 2351 |
| except where the
continued representation becomes impractical. | 2352 |
| The claimant shall, within thirty days after the filing of | 2356 |
|
the notice of appeal, file a petition containing a statement of | 2357 |
|
facts in ordinary and concise language showing a cause of action | 2358 |
|
to participate or to continue to participate in the fund and | 2359 |
|
setting forth the basis for the jurisdiction of the court over
the | 2360 |
| action. Further pleadings shall be had in accordance with
the | 2361 |
| Rules of Civil Procedure, provided that service of summons on
such | 2362 |
| petition shall not be required and provided that the claimant may | 2363 |
| not dismiss the complaint without the employer's consent if the | 2364 |
| employer is the party that filed the notice of appeal to court | 2365 |
| pursuant to this section. The clerk of the court shall,
upon | 2366 |
| receipt thereof, transmit by certified mail a copy
thereof to each | 2367 |
| party named in the notice of appeal other than
the claimant. Any | 2368 |
| party may file with the clerk prior to the
trial of the action a | 2369 |
| deposition of any physician taken in
accordance with the | 2370 |
| provisions of the Revised Code, which
deposition may be read in | 2371 |
| the trial of the action even though the
physician is a resident of | 2372 |
| or subject to service in the county in
which the trial is had. The | 2373 |
| bureau of workers' compensation
shall pay the cost of the | 2374 |
| stenographic deposition filed in court and of
copies
of the | 2375 |
| stenographic deposition for each party from the surplus fund and | 2376 |
|
charge
the costs thereof against the unsuccessful party if the | 2377 |
|
claimant's right to participate or continue to participate is | 2378 |
|
finally sustained or established in the appeal. In the event the | 2379 |
|
deposition is taken and filed, the physician whose deposition is | 2380 |
|
taken is not required to respond to any subpoena issued in the | 2381 |
|
trial of the action. The court, or the jury under the
instructions | 2382 |
| of the court, if a jury is demanded, shall determine
the right of | 2383 |
| the claimant to participate or to continue to
participate in the | 2384 |
| fund upon the evidence adduced at the hearing
of the action. | 2385 |
| (F) The cost of any legal proceedings authorized by this | 2390 |
|
section, including an attorney's fee to the claimant's attorney
to | 2391 |
| be fixed by the trial judge, based upon the effort expended,
in | 2392 |
| the event the claimant's right to participate or to continue
to | 2393 |
| participate in the fund is established upon the final | 2394 |
|
determination of an appeal, shall be taxed against the employer
or | 2395 |
| the commission if the commission or the administrator rather
than | 2396 |
| the employer contested the right of the claimant to
participate in | 2397 |
the fund. The attorney's fee shall not exceed
twenty-five | 2398 |
| forty-two hundred dollars. | 2399 |
| (H) An appeal from an order issued under division (E) of | 2406 |
|
section 4123.511 of the Revised Code or any action filed in court | 2407 |
|
in a case in which an award of compensation has been made shall | 2408 |
|
not stay the payment of compensation under the award or payment
of | 2409 |
| compensation for subsequent periods of total disability during
the | 2410 |
| pendency of the appeal. If, in a final administrative or
judicial | 2411 |
| action, it is determined that payments of compensation
or | 2412 |
| benefits, or both, made to or on behalf of a claimant should
not | 2413 |
| have been made, the amount thereof shall be charged to the
surplus | 2414 |
| fund under division (B) of section 4123.34 of the Revised
Code. In | 2415 |
| the event the employer is a state risk, the amount
shall not be | 2416 |
| charged to the employer's experience. In the event
the employer is | 2417 |
| a self-insuring employer, the self-insuring
employer shall deduct | 2418 |
| the amount from the paid compensation the
self-insuring employer | 2419 |
|
reports to the administrator under division (L) of section
4123.35 | 2420 |
of the Revised Code. All | 2421 |
| A self-insuring employer may elect to pay compensation and | 2422 |
| benefits under this section directly to an employee or an | 2423 |
| employee's dependents by filing an application with the bureau of | 2424 |
| workers' compensation not more than one hundred eighty days and | 2425 |
| not less than ninety days before the first day of the employer's | 2426 |
| next six-month coverage period. If the self-insuring employer | 2427 |
| timely files the application, the application is effective on the | 2428 |
| first day of the employer's next six-month coverage period, | 2429 |
| provided that the administrator shall compute the employer's | 2430 |
| assessment for the surplus fund due with respect to the period | 2431 |
| during which that application was filed without regard to the | 2432 |
| filing of the application. On and after the effective date of the | 2433 |
| employer's election, the self-insuring employer shall pay directly | 2434 |
| to an employee or to an employee's dependents compensation and | 2435 |
| benefits under this section regardless of the date of the injury | 2436 |
| or occupational disease, and the employer shall receive no money | 2437 |
| or credits from the surplus fund on account of those payments and | 2438 |
| shall not be required to pay any amounts into the surplus fund on | 2439 |
| account of this section. The election made under this division is | 2440 |
| irrevocable. | 2441 |
| Sec. 4123.52. The jurisdiction of the industrial
commission | 2454 |
| and the authority of the administrator of workers'
compensation | 2455 |
| over each case is continuing, and the commission may
make such | 2456 |
| modification or change with respect to former findings
or orders | 2457 |
| with respect thereto, as, in its opinion is justified. No | 2458 |
| modification or change nor any finding or award in respect of
any | 2459 |
| claim shall be made with respect to disability, compensation, | 2460 |
dependency, or benefits, after sixfive years from the date of | 2461 |
|
injury in the absence of the payment of medical benefits under | 2462 |
this
chapter, in which event the modification, change, finding, or | 2463 |
award shall be made within six years after the payment of
medical | 2464 |
benefits, or in the absence of payment of compensation under | 2465 |
|
section 4123.57, 4123.58, or division (A) or
(B) of section | 2466 |
| 4123.56 of the Revised Code or wages in lieu of compensation in
a | 2467 |
| manner so as to satisfy the requirements of section 4123.84 of
the | 2468 |
| Revised Code, in which event the modification, change,
finding, or | 2469 |
award shall be made within tenfive years from the date of
the | 2470 |
| last payment of compensation or from the date of death, nor
unless | 2471 |
| written notice of claim for the specific part or parts of
the body | 2472 |
| injured or disabled has been given as provided in
section 4123.84 | 2473 |
or 4123.85 of the Revised Code, and the. The
commission shall not | 2474 |
| make any modification, change, finding, or
award which shall award | 2475 |
| compensation for a back period in excess
of two years prior to the | 2476 |
| date of filing application therefor. This section
does not affect | 2477 |
| the right of a claimant to compensation accruing subsequent to
the | 2478 |
| filing of any such application, provided the application is filed | 2479 |
| within
the time limit provided in this section. | 2480 |
| The commission and administrator of workers' compensation | 2490 |
|
each may, by general rules, provide for the retention and | 2491 |
|
destruction of all other records in their possession or under | 2492 |
|
their control pursuant to section 121.211 and sections 149.34 to | 2493 |
|
149.36 of the Revised Code. The bureau of workers' compensation | 2494 |
|
may purchase or rent required equipment for the document
retention | 2495 |
| media, as determined necessary to preserve the records. | 2496 |
|
Photographs, microphotographs, microfilm, films, or other direct | 2497 |
|
document retention media, when properly identified, have the same | 2498 |
|
effect as the original record and may be offered in like manner | 2499 |
|
and may be received as evidence in proceedings before the | 2500 |
| industrial
commission, staff hearing officers, and district | 2501 |
| hearing officers, and in
any court where the original
record could | 2502 |
| have been introduced. | 2503 |
| (2) Caused by the employee being intoxicated or under the | 2511 |
|
influence of a controlled substance not prescribed by a physician | 2512 |
|
where the intoxication or being under the influence of the | 2513 |
|
controlled substance not prescribed by a physician was the | 2514 |
|
proximate cause of the injury, is entitled to receive, either | 2515 |
|
directly from the employee's self-insuring employer as
provided in | 2516 |
|
section
4123.35 of the Revised Code, or from the state insurance | 2517 |
|
fund,
the compensation for loss sustained on account of the | 2518 |
|
injury,
occupational disease, or death, and the medical, nurse, | 2519 |
|
and
hospital services and medicines, and the amount of funeral | 2520 |
|
expenses in case of death, as are provided by this chapter. | 2521 |
| (B) For the purpose of this section, provided that an
| 2522 |
| employer has posted written notice to employees that the results | 2523 |
| of, or
the employee's refusal
to submit to, any chemical test | 2524 |
| described
under this division may affect the
employee's | 2525 |
| eligibility for
compensation and benefits pursuant to this chapter | 2526 |
|
and Chapter
4121. of the Revised Code,
there is a rebuttable | 2527 |
| presumption that
an employee is intoxicated
or under the influence | 2528 |
| of a controlled
substance not prescribed by the employee's | 2529 |
|
physician and that being intoxicated
or under the influence of a | 2530 |
|
controlled substance not prescribed by
the employee's physician is | 2531 |
| the
proximate cause of an injury under either of the following | 2532 |
| conditions: | 2533 |
| (a) Observable phenomena, such as direct observation of use, | 2607 |
| possession, or distribution of alcohol or a controlled substance, | 2608 |
| or of the physical symptoms of being under the influence of | 2609 |
| alcohol or a controlled substance, such as but not limited to | 2610 |
| slurred speech, dilated pupils, odor of alcohol or a controlled | 2611 |
| substance, changes in affect, or dynamic mood swings; | 2612 |
| (H) Whenever, with respect to an employee of an employer who | 2651 |
| is
subject to and has complied with this chapter, there is | 2652 |
|
possibility of conflict with respect to the application of | 2653 |
|
workers' compensation laws because the contract of employment is | 2654 |
|
entered into and all or some portion of the work is or is to be | 2655 |
|
performed in a state or states other than Ohio, the employer and | 2656 |
|
the employee may agree to be bound by the laws of this state or
by | 2657 |
|
the laws of some other state in which all or some portion of
the | 2658 |
|
work of the employee is to be performed. The agreement shall
be
in | 2659 |
| writing and shall be filed with the bureau of workers' | 2660 |
|
compensation within ten days after it is executed and shall
remain | 2661 |
|
in force until terminated or modified by agreement of the
parties | 2662 |
|
similarly filed. If the agreement is to be bound by the
laws of | 2663 |
|
this state and the employer has complied with this
chapter, then | 2664 |
|
the employee is entitled to compensation and
benefits regardless | 2665 |
|
of where the injury occurs or the disease is
contracted and the | 2666 |
|
rights of the employee and the employee's
dependents
under the | 2667 |
|
laws of this state are the exclusive remedy against the
employer | 2668 |
|
on account of injury, disease, or death in the course of
and | 2669 |
|
arising out of the employee's employment. If the
agreement is to | 2670 |
|
be
bound by the laws of another state and the employer has | 2671 |
|
complied
with the laws of that state, the rights of the employee | 2672 |
|
and the
employee's
dependents under the laws of that state are the | 2673 |
|
exclusive remedy
against the employer on account of injury, | 2674 |
|
disease, or death in
the course of and arising out of the | 2675 |
|
employee's employment
without regard
to
the place where the injury | 2676 |
|
was sustained or the disease
contracted. | 2677 |
| If an employee is a resident of a state other than this
state | 2685 |
|
and is insured under the workers' compensation law or
similar laws | 2686 |
|
of a state other than this state, the employee and the employee's | 2687 |
|
dependents are not entitled to receive
compensation or
benefits | 2688 |
|
under this chapter, on account of injury, disease, or
death | 2689 |
|
arising out of or in the course of employment while
temporarily | 2690 |
|
within this state, and the rights of the employee and the | 2691 |
|
employee's dependents under the laws of the other state
are the | 2692 |
|
exclusive remedy against the employer on account of the injury, | 2693 |
|
disease, or death. | 2694 |
| Sec. 4123.56. (A) Except as provided in division (D) of
this | 2701 |
| section, in the case of temporary disability, an employee
shall | 2702 |
| receive sixty-six and two-thirds per cent of the
employee's | 2703 |
|
average
weekly wage so long as such disability is total, not to | 2704 |
|
exceed a
maximum amount of weekly compensation which is equal to | 2705 |
|
the
statewide average weekly wage as defined in division (C) of | 2706 |
|
section 4123.62 of the Revised Code, and not less than a minimum | 2707 |
|
amount of compensation which is equal to thirty-three and | 2708 |
|
one-third per cent of the statewide average weekly wage as
defined | 2709 |
|
in division (C) of section 4123.62 of the Revised Code
unless the | 2710 |
|
employee's wage is less than thirty-three and
one-third per cent | 2711 |
|
of the minimum statewide average weekly wage,
in which event the | 2712 |
|
employee shall receive compensation equal
to the employee's full | 2713 |
|
wages; provided that for the first twelve weeks of total | 2714 |
|
disability the employee shall receive seventy-two per cent of
the | 2715 |
|
employee's full weekly wage, but not to exceed a maximum amount of | 2716 |
|
weekly compensation which is equal to the lesser of the statewide | 2717 |
|
average weekly wage as defined in division (C) of section 4123.62 | 2718 |
|
of the Revised Code or one hundred per cent of the employee's net | 2719 |
|
take-home weekly wage. In the case of a self-insuring employer, | 2720 |
|
payments
shall be for a duration based upon the medical reports
of | 2721 |
|
the attending physician. If the employer disputes the
attending | 2722 |
|
physician's report, payments may be terminated only
upon | 2723 |
|
application and hearing by a district hearing officer
pursuant to | 2724 |
|
division (C) of section 4123.511 of the Revised Code.
Payments | 2725 |
|
shall continue pending the determination of the matter,
however | 2726 |
|
payment shall not be made for the period when any
employee has | 2727 |
|
returned to work, when an employee's treating
physician has made a | 2728 |
|
written statement that the employee is
capable of returning to the | 2729 |
|
employee's former position of
employment, when work within the | 2730 |
|
physical capabilities of the employee is made
available by the | 2731 |
|
employer or another employer, or when the
employee has reached the | 2732 |
|
maximum medical improvement. Where the
employee is capable of
work | 2733 |
| activity, but the employee's
employer is unable
to offer the | 2734 |
|
employee any employment, the employee shall
register with the | 2735 |
|
director of job
and family services,
who shall assist
the
employee | 2736 |
|
in finding suitable employment. The termination of temporary
total | 2737 |
|
disability, whether by order or otherwise, does not preclude
the | 2738 |
|
commencement of temporary total disability at another point in | 2739 |
|
time if the employee again becomes temporarily totally disabled. | 2740 |
| If any compensation under this section has been paid for
the | 2757 |
|
same period or periods for which temporary nonoccupational | 2758 |
|
accident and sickness insurance is or has been paid pursuant to
an | 2759 |
|
insurance policy or program to which the employer has made the | 2760 |
|
entire contribution or payment for providing insurance or under a | 2761 |
|
nonoccupational accident and sickness program fully funded by the | 2762 |
|
employer, compensation paid under this section for the period or | 2763 |
|
periods shall be paid only to the extent by which the payment or | 2764 |
|
payments exceeds the amount of the nonoccupational insurance or | 2765 |
|
program paid or payable. Offset of the compensation shall be
made | 2766 |
|
only upon the prior order of the bureau or industrial commission | 2767 |
|
or
agreement of the
claimant. | 2768 |
| As used in this division,
"net take-home weekly wage" means | 2769 |
|
the amount obtained by dividing an employee's total remuneration, | 2770 |
|
as defined in section 4141.01 of the Revised Code, paid to or | 2771 |
|
earned by the employee during the first four of the last five | 2772 |
|
completed calendar quarters which immediately precede the first | 2773 |
|
day of the employee's entitlement to benefits under this
division, | 2774 |
|
by the number of weeks during which the employee was
paid or | 2775 |
|
earned remuneration during those four quarters, less the
amount of | 2776 |
|
local, state, and federal income taxes deducted for
each such | 2777 |
|
week. | 2778 |
(B) Where(1) If an employee in a claim allowed under this | 2779 |
|
chapter
suffers a wage loss as a result of returning to
employment | 2780 |
other
than the employee's former position of
employment or as a | 2781 |
result
of being unable to find employment consistent with the | 2782 |
claimant's
physical capabilities due to an injury or occupational | 2783 |
| disease, the employee shall
receive compensation at
sixty-six and | 2784 |
| two-thirds per cent of the difference between the
employee's | 2785 |
average weekly wage
lossand the employee's present earnings not | 2786 |
to exceed the statewide average weekly
wage for a period
not to | 2787 |
exceed two hundred weeks.
The payments may continue for up to a | 2788 |
|
maximum of two hundred weeks, but the payments shall be reduced by | 2789 |
| the
corresponding number of weeks in which the employee receives | 2790 |
| payments pursuant
to division (B) of section 4121.67 Of the | 2791 |
| Revised Code. | 2792 |
| (2) If an employee in a claim allowed under this
chapter | 2793 |
| suffers a wage loss as a result of being unable
to find employment | 2794 |
| consistent with the employee's disability resulting from the | 2795 |
| employee's injury or occupational disease, the
employee shall | 2796 |
| receive
compensation at
sixty-six and two-thirds per cent of the | 2797 |
| difference between the
employee's average weekly wage
and
the | 2798 |
|
employee's present earnings, not to exceed the statewide average | 2799 |
|
weekly wage. The payments may continue for up to a maximum of | 2800 |
|
fifty-two weeks. The first twenty-six weeks of payments under | 2801 |
| division (B)(2) of this section shall be in addition to the | 2802 |
| maximum of two hundred weeks of payments allowed under division | 2803 |
| (B)(1) of this section. If an employee in a claim allowed under | 2804 |
| this chapter receives compensation under division (B)(2) of this | 2805 |
| section in excess of twenty-six weeks, the number of weeks of | 2806 |
| compensation allowable under division (B)(1) of this section shall | 2807 |
| be reduced by the corresponding number of weeks in excess of | 2808 |
| twenty-six, and up to fifty-two, that is allowable under division | 2809 |
| (B)(1) of this section. | 2810 |
| (C) In the event an employee of a professional sports | 2814 |
|
franchise domiciled in this state is disabled as the result
of an | 2815 |
|
injury or occupational disease, the total amount of payments made | 2816 |
|
under a contract of hire or collective bargaining agreement to
the | 2817 |
|
employee during a period of disability is deemed an advanced | 2818 |
|
payment of compensation payable under sections 4123.56 to 4123.58 | 2819 |
|
of the Revised Code. The employer shall be reimbursed the total | 2820 |
|
amount of the advanced payments out of any award of compensation | 2821 |
|
made pursuant to sections 4123.56 to 4123.58 of the Revised Code. | 2822 |
Except as provided in this section, not earlier than forty | 2832 |
| twenty-six
weeks after the date of termination of the latest | 2833 |
| period of
payments under section 4123.56 of the Revised Code, or | 2834 |
not
earlier than fortytwenty-six weeks after the date of the | 2835 |
| injury or
contraction of an occupational disease in the absence of | 2836 |
| payments
under section 4123.56 of the Revised Code, the employee | 2837 |
| may
file an application with the bureau of workers' compensation | 2838 |
| for
the determination of the percentage of the employee's | 2839 |
|
permanent partial disability resulting from an injury or | 2840 |
| occupational disease. | 2841 |
| Whenever the application is filed, the bureau shall send a | 2842 |
|
copy of the application to the employee's employer or the | 2843 |
|
employer's representative and shall schedule the employee for a | 2844 |
|
medical examination by the bureau medical section. The bureau | 2845 |
|
shall send a copy of the report of the medical examination to the | 2846 |
|
employee, the employer, and their representatives. Thereafter, the | 2847 |
|
administrator of
workers' compensation shall review the employee's | 2848 |
| claim file and make a
tentative order as the evidence before the | 2849 |
| administrator at
the time of the making of the order warrants. If | 2850 |
| the administrator determines
that there is a conflict of evidence, | 2851 |
| the administrator shall
send the application, along with the | 2852 |
| claimant's file, to the district hearing
officer who shall set the | 2853 |
| application for a hearing. | 2854 |
| The administrator shall notify the employee, the employer, | 2855 |
|
and their representatives, in writing, of the tentative order and | 2856 |
|
of the parties' right to request a hearing. Unless the employee, | 2857 |
|
the employer, or their representative notifies the administrator, | 2858 |
|
in writing, of an objection to the tentative order within twenty | 2859 |
|
days after receipt of the notice thereof, the tentative order | 2860 |
|
shall go into effect and the employee shall receive the | 2861 |
|
compensation provided in the order. In no event shall there be a | 2862 |
|
reconsideration of a tentative order issued under this division. | 2863 |
| (A) The district hearing officer, upon the
application, shall | 2871 |
| determine the percentage of the employee's permanent
disability, | 2872 |
| except as is subject to division (B) of this section,
based upon | 2873 |
| that condition of the employee resulting from the
injury or | 2874 |
| occupational disease and causing permanent impairment
evidenced by | 2875 |
| medical or clinical findings reasonably
demonstrable. The employee | 2876 |
| shall receive sixty-six and
two-thirds per cent of the employee's | 2877 |
| average weekly wage,
but not more than a maximum of thirty-three | 2878 |
| and one-third per cent of the
statewide average weekly wage as | 2879 |
| defined in division (C) of section 4123.62
of the Revised Code, | 2880 |
| per week regardless of the average weekly
wage, for the number of | 2881 |
| weeks which equals the percentage of two
hundred weeks. Except on | 2882 |
| application for reconsideration,
review, or modification, which is | 2883 |
| filed within ten days after the
date of receipt of the decision of | 2884 |
| the district hearing officer,
in no instance shall the former | 2885 |
| award be modified unless it is
found from medical or clinical | 2886 |
| findings that the condition of the
claimant resulting from the | 2887 |
| injury has so progressed as to have
increased the percentage of | 2888 |
| permanent partial disability. A
staff hearing officer shall hear | 2889 |
| an application for reconsideration filed and
the staff hearing | 2890 |
| officer's decision is final. An employee
may file an application | 2891 |
| for a subsequent determination of the
percentage of the employee's | 2892 |
| permanent
disability. If such an application is filed, the bureau | 2893 |
| shall
send a copy of the application to the
employer or the | 2894 |
| employer's representative. No sooner than sixty
days from the date | 2895 |
| of the mailing of the application to the
employer or the | 2896 |
| employer's representative, the administrator
shall review the | 2897 |
| application. The administrator may require a
medical examination | 2898 |
| or medical review of the employee. The
administrator shall issue a | 2899 |
| tentative order based upon the
evidence before the administrator, | 2900 |
| provided that if
the administrator requires a medical examination | 2901 |
| or medical
review, the administrator shall not issue the tentative | 2902 |
| order until the
completion of the examination or review. | 2903 |
| The employer may obtain a medical examination of the
employee | 2904 |
| and may submit medical evidence at any stage of the
process up to | 2905 |
| a hearing before the district hearing officer,
pursuant to rules | 2906 |
| of the commission. The administrator shall
notify the employee, | 2907 |
| the employer, and their representatives, in
writing, of the nature | 2908 |
| and amount of any tentative order issued
on an application | 2909 |
| requesting a subsequent determination of the
percentage of an | 2910 |
| employee's permanent disability. An employee,
employer, or their | 2911 |
| representatives may object to the tentative
order within twenty | 2912 |
| days after the receipt of the notice thereof.
If no timely | 2913 |
| objection is made, the tentative order shall go into
effect. In no | 2914 |
| event shall there be a reconsideration of a
tentative order issued | 2915 |
| under this division. If an objection is
timely made, the | 2916 |
| application for a subsequent determination shall
be referred to a | 2917 |
| district hearing officer who shall set the
application for a | 2918 |
| hearing with written notice to all interested
persons. No | 2919 |
| application for subsequent percentage determinations
on the same | 2920 |
| claim for injury or occupational disease shall be
accepted for | 2921 |
| review by the district hearing officer unless
supported by | 2922 |
| substantial evidence of new and changed
circumstances developing | 2923 |
| since the time of the hearing on the
original or last | 2924 |
| determination. | 2925 |
| If the claimant has suffered the loss of two or more
fingers | 2975 |
| by amputation or ankylosis and the nature of the
claimant's | 2976 |
| employment in the course of which the claimant was working at
the | 2977 |
| time of the injury or occupational disease is such that the | 2978 |
|
handicap or disability resulting from the loss of
fingers, or loss | 2979 |
| of use of fingers, exceeds the normal handicap or disability | 2980 |
|
resulting from the loss of fingers, or loss of use of fingers,
the | 2981 |
| administrator may take that fact into consideration and
increase | 2982 |
| the award of compensation accordingly, but the award
made shall | 2983 |
| not exceed the amount of compensation for loss of a
hand. | 2984 |
| For the permanent partial loss of sight of an eye, the | 3002 |
|
portion of one hundred twenty-five weeks as the administrator in | 3003 |
|
each case determines, based upon the percentage of vision
actually | 3004 |
| lost as a result of the injury or occupational disease,
but, in no | 3005 |
| case shall an award of compensation be made for less
than | 3006 |
| twenty-five per cent loss of uncorrected vision. "Loss of | 3007 |
|
uncorrected vision" means the percentage of vision actually lost | 3008 |
|
as the result of the injury or occupational disease. | 3009 |
| In case an injury or occupational disease results in
serious | 3018 |
| facial or head disfigurement which either impairs or may
in the | 3019 |
| future impair the opportunities to secure or retain
employment, | 3020 |
| the administrator shall make an award of compensation
as it deems | 3021 |
| proper and equitable, in view of the nature of the
disfigurement, | 3022 |
and not to exceed the sum of fiveten thousand
dollars. For the | 3023 |
| purpose of making the award, it is not material
whether the | 3024 |
| employee is gainfully employed in any occupation or
trade at the | 3025 |
| time of the administrator's determination. | 3026 |
| In all cases arising under division (B) of this section, if | 3045 |
|
it is determined by any one of the following: (1) the amputee | 3046 |
|
clinic at University hospital, Ohio state university; (2) the | 3047 |
|
rehabilitation services commission; (3) an amputee clinic or | 3048 |
|
prescribing physician approved by the administrator or the | 3049 |
|
administrator's designee, that an injured or disabled employee is | 3050 |
| in need
of an artificial appliance, or in need of a repair | 3051 |
| thereof, regardless
of whether the appliance or its repair will be | 3052 |
| serviceable in the
vocational rehabilitation of the injured | 3053 |
| employee, and regardless
of whether the employee has returned to | 3054 |
| or can ever again return
to any gainful employment, the bureau | 3055 |
| shall pay the cost of the
artificial appliance or its repair out | 3056 |
| of the surplus created by
division (B) of section 4123.34 of the | 3057 |
| Revised Code. | 3058 |
| (D) If an employee of a state fund employer makes
application | 3066 |
| for a finding and the administrator finds that the
employee has | 3067 |
| contracted silicosis as defined in division (X), or coal
miners' | 3068 |
| pneumoconiosis as defined in division (Y), or asbestosis as | 3069 |
|
defined in division (AA) of section 4123.68 of the Revised Code, | 3070 |
|
and that a change of such employee's occupation is medically | 3071 |
|
advisable in order to decrease substantially further exposure to | 3072 |
|
silica dust, asbestos, or coal dust and if the employee, after
the | 3073 |
| finding, has changed or shall change the employee's
occupation to | 3074 |
| an occupation in which the exposure to silica dust, asbestos, or | 3075 |
|
coal dust is substantially decreased, the administrator shall | 3076 |
| allow to the
employee an amount equal to fifty per cent of the | 3077 |
|
statewide average weekly wage per week for a period of thirty | 3078 |
|
weeks, commencing as of the date of the discontinuance or change, | 3079 |
|
and for a period of one hundred weeks immediately following the | 3080 |
|
expiration of the period of thirty weeks, the employee shall | 3081 |
|
receive sixty-six and two-thirds per cent of the loss
of wages | 3082 |
| resulting directly and solely from the change of
occupation but | 3083 |
| not to exceed a maximum of an amount equal to
fifty per cent of | 3084 |
| the statewide average weekly wage per week. No
such employee is | 3085 |
| entitled to receive more than one allowance on
account of | 3086 |
| discontinuance of employment or change of occupation
and benefits | 3087 |
| shall cease for any period during which the employee
is employed | 3088 |
| in an occupation in which the exposure to silica
dust, asbestos, | 3089 |
| or coal dust is not substantially less than the
exposure in the | 3090 |
| occupation in which the employee was formerly
employed or for any | 3091 |
| period during which the employee may be entitled to
receive | 3092 |
| compensation or benefits under section 4123.68 of the
Revised Code | 3093 |
| on account of disability from silicosis, asbestosis,
or coal | 3094 |
| miners' pneumoconiosis. An award for change of
occupation for a | 3095 |
| coal miner who has contracted coal miners'
pneumoconiosis may be | 3096 |
| granted under this division even though the
coal miner continues | 3097 |
| employment with the same employer, so long
as the coal miner's | 3098 |
| employment subsequent to the change is
such that the coal miner's | 3099 |
| exposure to
coal dust is substantially decreased and a change of | 3100 |
| occupation
is certified by the claimant as permanent. The | 3101 |
| administrator may accord to
the employee medical and other | 3102 |
| benefits in accordance with section 4123.66 of
the Revised Code. | 3103 |
| (E) If a firefighter or police officer makes
application for | 3104 |
| a finding and the administrator finds that the
firefighter or | 3105 |
| police officer has contracted
a cardiovascular and pulmonary | 3106 |
| disease as defined in division (W)
of section 4123.68 of the | 3107 |
| Revised Code, and that a change of the
firefighter's or police | 3108 |
| officer's occupation is
medically advisable in order to decrease | 3109 |
| substantially further exposure to
smoke, toxic gases, chemical | 3110 |
| fumes, and other toxic vapors, and
if the firefighter, or police | 3111 |
| officer, after the
finding, has changed or changes occupation to | 3112 |
| an occupation in
which the
exposure to smoke, toxic gases, | 3113 |
| chemical fumes, and other toxic
vapors is substantially decreased, | 3114 |
| the administrator shall allow
to the firefighter or police officer | 3115 |
| an amount
equal to fifty per cent of the statewide average weekly | 3116 |
| wage per week for a
period of thirty weeks, commencing as of the | 3117 |
| date of the
discontinuance or change, and for a period of | 3118 |
| seventy-five weeks
immediately following the expiration of the | 3119 |
| period of thirty
weeks the administrator shall allow the | 3120 |
| firefighter
or police officer sixty-six and two-thirds per cent of | 3121 |
| the loss of wages
resulting directly and solely from the change of | 3122 |
| occupation but
not to exceed a maximum of an amount equal to fifty | 3123 |
| per cent of
the statewide average weekly wage per week. No such | 3124 |
|
firefighter or police officer is entitled to
receive more than one | 3125 |
| allowance
on account of discontinuance of employment or change of | 3126 |
|
occupation and benefits shall cease for any period during which | 3127 |
|
the firefighter or police officer is employed in an
occupation in | 3128 |
| which the exposure to smoke, toxic gases, chemical fumes, and | 3129 |
|
other toxic vapors is not substantially less than the exposure in | 3130 |
|
the occupation in which the firefighter or police officer
was | 3131 |
| formerly employed or for any period during which the
firefighter | 3132 |
| or police officer may be entitled to receive compensation
or | 3133 |
| benefits under section
4123.68 of the Revised Code on account of | 3134 |
| disability from a
cardiovascular and pulmonary disease. The | 3135 |
| administrator may
accord to the firefighter or police officer | 3136 |
| medical
and other benefits in accordance with section 4123.66 of | 3137 |
| the Revised Code. | 3138 |
| Sec. 4123.58. (A) In cases of permanent total disability, | 3142 |
the employee shall
receive an award to continue until histhe | 3143 |
| employee's death
in the amount of sixty-six and two-thirds per | 3144 |
cent of histhe
employee's average
weekly wage, but, except as | 3145 |
| otherwise provided in division (B) of
this section, not more than | 3146 |
| a maximum amount of weekly
compensation which is equal to | 3147 |
| sixty-six and two-thirds per cent
of the statewide average weekly | 3148 |
| wage as defined in division (C)
of section 4123.62 of the Revised | 3149 |
| Code in effect on the date of injury or on the date the disability | 3150 |
| due to the occupational disease begins, nor not less than a | 3151 |
|
minimum amount of weekly compensation which is equal to fifty per | 3152 |
|
cent of the statewide average weekly wage as defined in division | 3153 |
|
(C) of section 4123.62 of the Revised Code in effect on the date | 3154 |
| of injury or on the date the disability due to the occupational | 3155 |
| disease begins, unless the employee's
average weekly wage is less | 3156 |
| than fifty per cent of the statewide
average weekly wage at the | 3157 |
time of the injury, in which event hethe
employee shall receive | 3158 |
compensation in an amount equal to histhe employee's average | 3159 |
| weekly wage. | 3160 |
| (B) In the event the weekly workers' compensation amount
when | 3161 |
| combined with disability benefits received pursuant to the
Social | 3162 |
| Security Act is less than the statewide average weekly
wage as | 3163 |
| defined in division (C) of section 4123.62 of the Revised
Code, | 3164 |
| then the maximum amount of weekly compensation shall be the | 3165 |
|
statewide average weekly wage as defined in division (C) of | 3166 |
|
section 4123.62 of the Revised Code. At any time that social | 3167 |
|
security disability benefits terminate or are reduced, the | 3168 |
|
workers' compensation award shall be recomputed to pay the
maximum | 3169 |
| amount permitted under this division. | 3170 |
| (F) If an employee is awarded compensation for permanent | 3200 |
| total disability under this section because the employee sustained | 3201 |
| a traumatic brain injury, the employee is entitled to that | 3202 |
| compensation regardless of the employee's employment in a | 3203 |
| sheltered workshop subsequent to the award, on the condition that | 3204 |
| the employee does not receive income, compensation, or | 3205 |
| remuneration from that employment in excess of two thousand | 3206 |
| dollars in any calendar quarter. As used in this division, | 3207 |
| "sheltered workshop" means a state agency or nonprofit | 3208 |
| organization established to carry out a program of rehabilitation | 3209 |
| for handicapped individuals or to provide these individuals with | 3210 |
| remunerative employment or other occupational rehabilitating | 3211 |
| activity. | 3212 |
| In cases of temporary total disability the compensation for | 3217 |
|
the first twelve weeks for which compensation is payable shall be | 3218 |
|
based on the full weekly wage of the claimant at the time of the | 3219 |
|
injury or at the time of the disability due to occupational | 3220 |
|
disease begins; when a factory, mine, or other place of employment | 3221 |
| is
working short time in order to divide work among the employees, | 3222 |
|
the bureau of workers' compensation shall take that fact into | 3223 |
|
consideration when determining the wage for the first twelve
weeks | 3224 |
| of temporary total disability. | 3225 |
| In death, permanent total disability claims,
permanent | 3228 |
| partial disability claims, and impairment of earnings claims, the | 3229 |
|
claimant's or the decedent's average weekly wage for the year | 3230 |
|
preceding the injury or the date the disability due to the | 3231 |
|
occupational disease begins is the weekly wage upon which | 3232 |
|
compensation shall be based. In ascertaining the average weekly | 3233 |
|
wage for the year previous to the injury, or the date the | 3234 |
|
disability due to the occupational disease begins any period of | 3235 |
|
unemployment due to sickness, industrial depression, strike, | 3236 |
|
lockout, or other cause beyond the employee's control shall be | 3237 |
|
eliminated. | 3238 |
| In cases where there are special circumstances under which | 3239 |
|
the average weekly wage cannot justly be determined by applying | 3240 |
|
this section, the administrator of workers' compensation, in | 3241 |
|
determining the average weekly wage in such cases, shall use such | 3242 |
method as will enable himthe administrator to do substantial | 3243 |
|
justice to the claimants, provided that the administrator shall | 3244 |
| not recalculate the claimant's average weekly wage for awards for | 3245 |
| permanent total disability solely for the reason that the claimant | 3246 |
| continued working and the claimant's wages increased following the | 3247 |
| injury. | 3248 |
| Sec. 4123.65. (A) A state fund employer or the employee
of | 3249 |
| such an employer may file an application with the
administrator of | 3250 |
| workers' compensation for approval of a final
settlement of a | 3251 |
| claim under this chapter. The application shall
include the | 3252 |
| settlement agreement, and except as otherwise specified in this | 3253 |
|
division, be signed by the claimant and
employer, and clearly set | 3254 |
| forth the circumstances by reason of
which the proposed settlement | 3255 |
| is deemed desirable and that the
parties agree to the terms of the | 3256 |
settlement agreement provided
that the agreement need not be | 3257 |
signed by the
employer if the. A claimant may file an application | 3258 |
| without an employer's signature in the following situations: | 3259 |
| If a state fund
employer or an employee of such an employer | 3274 |
| has not filed an
application for a final settlement under this | 3275 |
| division, the
administrator may file an application on behalf of | 3276 |
| the employer
or the employee, provided that the administrator | 3277 |
| gives notice of
the filing to the employer and the employee and to | 3278 |
| the
representative of record of the employer and of the employee | 3279 |
|
immediately upon the filing. An application filed by the | 3280 |
|
administrator shall contain all of the information and signatures | 3281 |
|
required of an employer or an employee who files an application | 3282 |
|
under this division. Every self-insuring employer that enters
into | 3283 |
| a final settlement agreement with an employee shall mail,
within | 3284 |
| seven days of executing the agreement, a copy of the
agreement to | 3285 |
| the administrator and the employee's representative.
The | 3286 |
| administrator shall place the agreement into the claimant's
file. | 3287 |
| (C) No settlement agreed to under division (A) of this | 3292 |
|
section or agreed to by a self-insuring employer and the | 3293 |
|
self-insuring employer's employee shall take effect until thirty | 3294 |
| days
after the administrator approves the settlement for state | 3295 |
| fund employees and
employers, or after the self-insuring employer | 3296 |
| and employee sign the final
settlement agreement. During the | 3297 |
| thirty-day period, the
employer, employee, or administrator, for | 3298 |
| state fund settlements,
and the employer or employee, for | 3299 |
| self-insuring settlements, may
withdraw consent to the settlement | 3300 |
| by an employer
providing
written notice to the employer's employee | 3301 |
| and the
administrator or by an
employee providing written notice | 3302 |
| to the employee's employer
and the administrator, or by the | 3303 |
| administrator providing written notice to the
state fund employer | 3304 |
| and employee. If an employee dies during the thirty-day waiting | 3305 |
| period following the approval of a settlement, the settlement can | 3306 |
| be voided by any party for good cause shown. | 3307 |
| (D) At the time of agreement to any final settlement | 3308 |
|
agreement under division (A) of this section or agreement between | 3309 |
|
a self-insuring employer and the self-insuring employer's | 3310 |
|
employee, the administrator, for state fund settlements, and
the | 3311 |
| self-insuring
employer, for self-insuring settlements, immediately | 3312 |
| shall send a copy of the
agreement to the industrial commission | 3313 |
| who shall assign the
matter to a staff hearing officer. The staff | 3314 |
| hearing officer
shall determine, within the time limitations | 3315 |
| specified in
division (C) of this section, whether the settlement | 3316 |
| agreement is
or is not a gross miscarriage of justice. If the | 3317 |
|
staff hearing
officer determines within that time period that the | 3318 |
| settlement
agreement is clearly unfair, the staff hearing officer | 3319 |
| shall issue an order
disapproving the settlement agreement. If
the | 3320 |
| staff hearing officer determines that the settlement agreement is | 3321 |
| not
clearly unfair or fails to act within those time limits, the | 3322 |
| settlement
agreement is approved. | 3323 |
| (E) A settlement entered into under this section may
pertain | 3324 |
| to one or more claims of a claimant, or one or more parts
of a | 3325 |
| claim, or the compensation or benefits pertaining to either,
or | 3326 |
| any combination thereof, provided that nothing in this section | 3327 |
|
shall be interpreted to require a claimant to enter into a | 3328 |
|
settlement agreement for every claim that has been filed with the | 3329 |
|
bureau of workers' compensation by that claimant under Chapter | 3330 |
|
4121., 4123., 4127., or 4131. of the Revised Code. | 3331 |
| Sec. 4123.88. (A) No person shall orally or in writing, | 3334 |
|
directly or indirectly, or through any agent or other person | 3335 |
fraudulently hold himselfthe person's self out or represent | 3336 |
himselfthe person's
self or hisany of the person's partners or | 3337 |
| associates as authorized by a
claimant or employer to
take charge | 3338 |
| of, or represent the claimant or employer in respect
of, any claim | 3339 |
| or matter in connection therewith before the bureau
of workers' | 3340 |
| compensation or the industrial commission or its
district or staff | 3341 |
| hearing officers. No person shall directly or indirectly
solicit | 3342 |
|
authority, or pay or give anything of value to another person to | 3343 |
|
solicit authority, or accept or receive pay or anything of value | 3344 |
|
from another person for soliciting authority, from a claimant or | 3345 |
|
employer to take charge of, or represent the claimant or employer | 3346 |
|
in respect of, any claim or appeal which is or may be filed with | 3347 |
|
the bureau or commission. No person shall, without prior
authority | 3348 |
| from the bureau, a member of the commission, the
claimant, or the | 3349 |
| employer, examine or directly or indirectly
cause or employ | 3350 |
| another person to examine any claim file or any
other file | 3351 |
| pertaining thereto. No person shall forge an
authorization for the | 3352 |
| purpose of examining or cause another
person to examine any such | 3353 |
| file. No district or staff hearing
officer or other employee of | 3354 |
| the bureau or commission,
notwithstanding the provisions of | 3355 |
| section 4123.27 of the Revised
Code, shall divulge any information | 3356 |
| in respect of any claim or
appeal which is or may be filed with a | 3357 |
| district or staff hearing
officer, the bureau, or commission to | 3358 |
| any person other than
members of the commission or to the superior | 3359 |
| of the employee
except upon authorization of the administrator of | 3360 |
| workers'
compensation or a member of the commission or upon | 3361 |
authorization
of the claimant or employer. No | 3362 |
| (C) Except as otherwise specified in division (D) of this | 3371 |
| section, information kept by the commission or the bureau pursuant | 3372 |
| to this section is for the exclusive use and information of the | 3373 |
| commission and the bureau in the discharge of their official | 3374 |
| duties, and shall not be open to the public nor be used in any | 3375 |
| court in any action or proceeding pending therein, unless the | 3376 |
| commission or the bureau is a party to the action or proceeding. | 3377 |
| The information, however, may be tabulated and published by the | 3378 |
| commission or the bureau in statistical form for the use and | 3379 |
| information of other state agencies and the public. | 3380 |
| Sec. 5703.21. (A) Except as provided in divisions (B) and | 3402 |
|
(C) of this section, no agent
of the department of taxation, | 3403 |
|
except in the agent's report to the department or when called on | 3404 |
|
to
testify in any court or proceeding, shall divulge any | 3405 |
|
information
acquired by the agent as to the transactions, | 3406 |
|
property, or business
of any person while acting or claiming to | 3407 |
|
act under orders of the
department. Whoever violates this | 3408 |
|
provision shall thereafter be
disqualified from acting as an | 3409 |
|
officer or employee or in any
other capacity under appointment or | 3410 |
|
employment of the department. | 3411 |
| (B)(1) For purposes of an audit pursuant to section 117.15
of | 3412 |
| the Revised Code, or an audit of the department pursuant to | 3413 |
|
Chapter 117. of the Revised Code, or an audit, pursuant to that | 3414 |
|
chapter, the objective of which is to express an opinion on a | 3415 |
|
financial report or statement prepared or issued pursuant to | 3416 |
|
division (A)(7) or (9) of section
126.21 of
the Revised Code, the | 3417 |
|
officers and employees of the auditor of state charged with | 3418 |
|
conducting the audit shall have access to and the right to
examine | 3419 |
|
any state tax returns and state tax return information in
the | 3420 |
|
possession of the department to the extent that the
access
and | 3421 |
|
examination are necessary for purposes of the audit. Any | 3422 |
|
information acquired as the result of that access and
examination | 3423 |
|
shall not be divulged for any purpose other than as required for | 3424 |
|
the audit or unless the officers and employees are required
to | 3425 |
|
testify in a court or proceeding under compulsion of legal | 3426 |
|
process. Whoever violates this provision shall thereafter be | 3427 |
|
disqualified from acting as an officer or employee or in any
other | 3428 |
|
capacity under appointment or employment of the auditor of
state. | 3429 |
| (7) Providing information regarding the name, account
number, | 3460 |
| or business
address of a holder of a vendor's
license
issued | 3461 |
| pursuant to section 5739.17 of the Revised Code, a holder
of a | 3462 |
|
direct payment permit issued pursuant to section 5739.031 of
the | 3463 |
|
Revised Code, or a seller having a use tax account maintained | 3464 |
|
pursuant to
section 5741.17 of the Revised Code, or information | 3465 |
|
regarding the active or inactive status of a vendor's license, | 3466 |
|
direct payment permit, or seller's use tax account; | 3467 |
| Any information gained as the result of returns, | 3485 |
|
investigations, hearings, or verifications required or authorized | 3486 |
|
by this chapter is confidential, and no person shall disclose
such | 3487 |
| information, except for official purposes, or as provided by | 3488 |
|
section 3125.43, 4123.271, 4123.591, 4507.023, or 5101.182, | 3489 |
| division (B) of
section 5703.21 of the Revised Code, or in | 3490 |
| accordance with a
proper judicial order. The tax commissioner may | 3491 |
| furnish the
internal revenue service with copies of returns or | 3492 |
| reports filed and
may furnish the officer of a municipal | 3493 |
| corporation charged with the
duty of enforcing a tax subject to | 3494 |
| Chapter 718. of the Revised
Code with the names, addresses, and | 3495 |
| identification numbers of
taxpayers who may be subject to such | 3496 |
| tax. A municipal
corporation shall use this information for tax | 3497 |
| collection
purposes only. This section does not prohibit the | 3498 |
| publication of
statistics in a form which does not disclose | 3499 |
| information with
respect to individual taxpayers. | 3500 |
| Section 2. That existing sections 2913.48, 3121.034, | 3501 |
| 3121.037, 4111.02, 4121.10, 4121.12, 4121.44, 4121.441, 4123.01, | 3502 |
| 4123.29, 4123.32, 4123.35, 4123.512, 4123.52, 4123.54, 4123.56, | 3503 |
| 4123.57, 4123.58, 4123.61, 4123.65, 4123.88, 5703.21, and 5747.18 | 3504 |
| of the Revised Code are hereby repealed. | 3505 |