Section 1. That sections 2913.48, 3121.034, 3121.037, | 9 |
4121.10, 4121.44, 4121.441, 4123.01, 4123.32, 4123.35, 4123.512, | 10 |
4123.52, 4123.54, 4123.56, 4123.57, 4123.58, 4123.61, 4123.65, | 11 |
4123.88, 5703.21, and 5747.18 be amended and sections 3121.0311, | 12 |
4121.131, 4121.444, 4123.271, and 4123.311 of the Revised Code be | 13 |
enacted to read as follows: | 14 |
(3) Alter, falsify, destroy, conceal, or remove any record
or | 25 |
document that is necessary to fully establish the validity of
any | 26 |
claim filed with, or necessary to establish the nature and | 27 |
validity of all goods and services for which reimbursement or | 28 |
payment was received or is requested from, the bureau of workers' | 29 |
compensation, or a self-insuring employer under Chapter 4121., | 30 |
4123., 4127., or 4131. of the Revised Code; | 31 |
(B) Whoever violates this section is guilty of workers' | 48 |
compensation fraud. Except as
otherwise provided in this division, | 49 |
a
violation of this section is a misdemeanor of the
first degree. | 50 |
If the value of thepremiums and assessments unpaid
pursuant to | 51 |
actions described in division (A)(5), (6), or (7) of this
section, | 52 |
or of
goods, services, property, or
money stolen is five hundred | 53 |
dollars or more and is less than
five thousand dollars, a | 54 |
violation of
this section is a felony of the fifth degree. If
the | 55 |
value of thepremiums and assessments unpaid
pursuant to actions | 56 |
described in division (A)(5), (6), or (7) of this
section, or of | 57 |
goods, services, property, or money stolen is five thousand | 58 |
dollars or more and is less than one hundred thousand dollars, a | 59 |
violation of
this section is a felony of the fourth degree. If
the | 60 |
value of thepremiums and assessments unpaid
pursuant to actions | 61 |
described in division (A)(5), (6), or (7) of this
section, or of | 62 |
goods, services, property, or money stolen is one hundred
thousand | 63 |
dollars or more, a violation of this section is a felony of the | 64 |
third
degree. | 65 |
(8) "Statement" includes, but is not limited to, any oral, | 100 |
written, electronic, electronic impulse, or magnetic
communication | 101 |
notice, letter, memorandum, receipt for payment,
invoice, account, | 102 |
financial statement, or bill for services;
a diagnosis, prognosis, | 103 |
prescription, hospital, medical, or dental
chart or other record; | 104 |
and a computer generated document. | 105 |
(B) When two or more withholding notices
are received by a | 121 |
payor, the payor shall comply with all
of the
requirements | 122 |
contained in the notices to the extent that the
total amount | 123 |
withheld from the obligor's
income does not exceed the maximum | 124 |
amount
permitted under section 303(b) of the "Consumer
Credit | 125 |
Protection
Act," 15 U.S.C. 1673(b), withhold amounts in
accordance | 126 |
with the allocation set forth in divisions (B)(1)
and (2) of
this | 127 |
section, notify each court or child support enforcement
agency | 128 |
that issued one of the notices of the allocation, and give | 129 |
priority to amounts designated in each notice as current support | 130 |
in the following manner: | 131 |
(2) If the total of the amounts designated in the notices
as | 141 |
current support does not exceed the amount available for | 142 |
withholding under section 303(b) of the "Consumer
Credit | 143 |
Protection Act," 15 U.S.C. 1673(b), the payor
shall pay all of the | 144 |
amounts designated as current support in the notices and shall | 145 |
allocate to each notice an amount for past-due support equal to | 146 |
the amount designated in that notice as past-due support | 147 |
multiplied by a fraction in which the numerator is the amount of | 148 |
income remaining available
for withholding after the payment of | 149 |
current support and the
denominator is the total amount designated | 150 |
in all of the notices
as past-due support. | 151 |
(a) Promptly notify the
child support enforcement agency | 188 |
administering the support order, in writing,
within ten business | 189 |
days after the date of any situation that occurs
in which the | 190 |
payor ceases to pay
income to the obligor in an amount sufficient | 191 |
to comply with the order,
including termination of employment, | 192 |
layoff of the obligor from employment,
any leave of absence of the | 193 |
obligor from employment without pay, termination
of workers' | 194 |
compensation benefits, or termination of any pension, annuity, | 195 |
allowance, or retirement benefit; | 196 |
(a) Identify in the
notice given under division
(A)(8) of | 204 |
this section
any types of benefits other than personal earnings | 205 |
the
obligor is receiving or is eligible to receive as a benefit of | 206 |
employment or as a result of the obligor's termination of | 207 |
employment, including, but not limited to, unemployment | 208 |
compensation, workers' compensation benefits, severance pay, sick | 209 |
leave, lump sum payments of retirement benefits or contributions, | 210 |
and bonuses or profit-sharing payments or distributions, and the | 211 |
amount of the benefits; | 212 |
(10) ASubject to section 3121.0311 of the Revised Code, a | 217 |
requirement that, no later than the earlier of
forty-five days | 218 |
before a lump sum payment is to be made or, if
the
obligor's right | 219 |
to the lump sum payment is determined less
than
forty-five days | 220 |
before it is to be made, the date on which
that
determination is | 221 |
made, the payor notify the child
support
enforcement agency | 222 |
administering the support order of any lump sum
payment of
any | 223 |
kind of
one hundred fifty dollars or more that is
to be paid to | 224 |
the
obligor, hold
each lump sum payment of one
hundred fifty | 225 |
dollars
or more for thirty
days after the date on
which it
would | 226 |
otherwise be paid to the obligor and, on
order of
the court or | 227 |
agency that issued the support order, pay all or a
specified | 228 |
amount of the lump sum
payment to the office of child
support; | 229 |
(6) A requirement that the financial institution promptly | 255 |
notify the child support enforcement agency administering the | 256 |
support order,
in writing, within
ten days after the date of any | 257 |
termination of the account from
which the deduction is being made | 258 |
and notify the agency, in
writing, of the opening of a new account | 259 |
at that financial
institution, the account number of the new | 260 |
account, the name of
any other known financial institutions in | 261 |
which the obligor has
any accounts, and the numbers of those | 262 |
accounts; | 263 |
Sec. 3121.0311. (A) If a lump sum payment referred to in | 271 |
division (A)(10) of section 3121.037 of the Revised Code consists | 272 |
of workers' compensation benefits and the obligor is represented | 273 |
by an attorney with respect to the obligor's workers' compensation | 274 |
claim, prior to issuing the notice to the child support | 275 |
enforcement agency required by that division, the administrator of | 276 |
workers' compensation, for claims involving state fund employers, | 277 |
or a self-insuring employer, for that employer's claims, shall | 278 |
notify the obligor and the obligor's attorney in writing that the | 279 |
obligor is subject to a support order and that the administrator | 280 |
or self-insuring employer, as appropriate, shall hold the lump sum | 281 |
payment for a period of thirty days after the administrator or | 282 |
self-insuring employer sends this written notice, pending receipt | 283 |
of the information referred to in division (B) of this section. | 284 |
(B) The administrator or self-insuring employer, as | 285 |
appropriate, shall instruct the obligor's attorney in writing to | 286 |
file a copy of the fee agreement signed by the obligor, along with | 287 |
an affidavit signed by the attorney setting forth the amount of | 288 |
the attorney's fee with respect to the lump sum payment award to | 289 |
the obligor and the amount of all necessary expenses, along with | 290 |
documentation of those expenses, incurred by the attorney with | 291 |
respect to obtaining the lump sum award. The obligor's attorney | 292 |
shall file the fee agreement and attorney affidavit with the | 293 |
administrator or self-insuring employer, as appropriate, within | 294 |
thirty days after the date the administrator or self-insuring | 295 |
employer sends the notice required by division (A) of this | 296 |
section. | 297 |
Sec. 4121.10. The industrial commission shall be in | 310 |
continuous session and
open for the transaction of business during | 311 |
all business hours of every day
excepting Sundays and legal | 312 |
holidays. The sessions of the commission shall be
open to the | 313 |
public and shall stand and be adjourned without further notice | 314 |
thereof on its record. All of the proceedings of the commission | 315 |
shall be
shown on its record, which shall be a public record | 316 |
except as provided in section 4123.88 of the Revised Code, and all | 317 |
voting shall be
had by calling the name of each member of the | 318 |
industrial commission by the
executive director, and each member's | 319 |
vote shall be
recorded on the record of
proceedings as cast. The | 320 |
commission shall keep a separate record of its
proceedings | 321 |
relative to claims coming before it for compensation for injured | 322 |
and the dependents of killed employees, which record shall contain | 323 |
its
findings and the award in each such claim for compensation | 324 |
considered by it,
and in all such claims the reasons for the | 325 |
allowance or rejection thereof
shall be stated in said record. | 326 |
(D)(1) Information contained in a
vendor's application for | 393 |
certification in the health partnership program, and
other | 394 |
information
furnished to the bureau by a vendor for purposes of | 395 |
obtaining certification or
to comply with performance and | 396 |
financial auditing requirements established by
the
administrator, | 397 |
is for the exclusive use and information
of the bureau in the | 398 |
discharge of its official duties, and shall not be open to the | 399 |
public or be used in any court in any proceeding pending therein, | 400 |
unless the bureau is a party to the action or proceeding, but the | 401 |
information may be tabulated and published by the bureau in | 402 |
statistical form for the use and information of other state | 403 |
departments and the public. No employee of the bureau, except as | 404 |
otherwise authorized by the administrator, shall divulge any | 405 |
information secured by the employee while in the employ of the | 406 |
bureau in respect to a vendor's application for certification or | 407 |
in respect to the business or other trade processes of any vendor | 408 |
to any person other than the administrator or to the employee's | 409 |
superior. | 410 |
(2) Notwithstanding the restrictions imposed by division | 411 |
(D)(1)
of this section, the governor, members of select or | 412 |
standing committees of the
senate or house of representatives, the | 413 |
auditor
of state, the attorney general, or their designees, | 414 |
pursuant to the
authority granted in this chapter and Chapter | 415 |
4123. of the
Revised Code, may examine any vendor application
or | 416 |
other information furnished to the bureau by the vendor. None
of | 417 |
those individuals shall divulge any information secured in the | 418 |
exercise of that authority in respect to a vendor's application | 419 |
for certification or in respect to the business or other trade | 420 |
processes of any vendor to any person. | 421 |
(G) The administrator, six
months prior to the expiration of | 433 |
the bureau's
certification or recertification of the vendor or | 434 |
vendors as set forth
in division (B)(1) or (2) of this
section, | 435 |
may certify and provide evidence to the governor, the
speaker of | 436 |
the house of representatives, and the president of the
senate that | 437 |
the existing bureau staff is able to match or exceed
the | 438 |
performance and outcomes of the external vendor or vendors
and | 439 |
that the bureau should be permitted to internally administer
the | 440 |
health partnership program upon the expiration of
the | 441 |
certification or recertification as set forth in
division (B)(1) | 442 |
or (2) of this section. | 443 |
(J) In areas outside the state or within the state where
no | 468 |
qualified health plan or an inadequate number of providers
within | 469 |
the health partnership program exist, the administrator
shall | 470 |
permit employees to use a nonplan or nonprogram health care | 471 |
provider and shall pay the provider for the services or supplies | 472 |
provided to or on behalf of an employee for an injury or | 473 |
occupational disease that is compensable under this chapter or | 474 |
Chapter 4123., 4127., or 4131. of the Revised Code on a fee | 475 |
schedule the administrator adopts. | 476 |
(L) The administrator shall permit any employer or group
of | 483 |
employers who agree to abide by the rules adopted under this | 484 |
section and sections 4121.441 and 4121.442 of the Revised Code to | 485 |
provide services or supplies to or on behalf of an employee for
an | 486 |
injury or occupational disease that is compensable under this | 487 |
chapter or Chapter 4123., 4127., or 4131. of the Revised Code | 488 |
through qualified health plans of the Ohio workers' compensation | 489 |
qualified health plan system pursuant to section 4121.442 of the | 490 |
Revised Code or through the health partnership program pursuant
to | 491 |
section 4121.441 of the Revised Code. No amount paid under
the | 492 |
qualified health plan system pursuant to section 4121.442 of
the | 493 |
Revised Code by an employer who is a state fund employer
shall be | 494 |
charged to the employer's experience or otherwise be
used in | 495 |
merit-rating or determining the risk of that employer for
the | 496 |
purpose of the payment of premiums under this chapter, and if
the | 497 |
employer is a self-insuring employer, the employer shall not | 498 |
include that amount in the paid compensation the employer
reports | 499 |
under section 4123.35 of the Revised Code. | 500 |
Sec. 4121.441. (A) The administrator of workers' | 501 |
compensation, with the
advice and consent of the workers' | 502 |
compensation oversight commission, shall
adopt rules under Chapter | 503 |
119. of the Revised Code for the health care
partnership program | 504 |
administered by the bureau of workers' compensation to
provide | 505 |
medical, surgical, nursing, drug, hospital, and rehabilitation | 506 |
services and supplies to an employee for an injury or occupational | 507 |
disease
that is compensable under this chapter or Chapter 4123., | 508 |
4127., or 4131. of
the Revised Code. | 509 |
(1) Procedures for the resolution of medical disputes
between | 512 |
an employer and an employee, an employee and a provider,
or an | 513 |
employer and a provider, prior to an appeal under section
4123.511 | 514 |
of the Revised Code;. Rules the administrator adopts pursuant to | 515 |
division (A)(1) of this section may specify that the resolution | 516 |
procedures shall not be used to resolve disputes concerning | 517 |
medical services rendered that have been approved through standard | 518 |
treatment guidelines, pathways, or presumptive authorization | 519 |
guidelines. | 520 |
Sec. 4121.444. (A) No person, health care provider, managed | 559 |
care
organization, or owner of a health care provider or managed | 560 |
care organization
shall obtain or attempt to obtain payments by | 561 |
deception under
Chapter 4121., 4123., 4127., or 4131. of the | 562 |
Revised Code to which the person, health care
provider, managed | 563 |
care organization, or owner is not
entitled under rules of the | 564 |
bureau of workers' compensation adopted pursuant
to sections | 565 |
4121.441 and 4121.442 of the Revised
Code. | 566 |
(a) The person, health care provider, managed care | 597 |
organization, or its owner, or an officer, authorized agent, | 598 |
associate,
manager, or employee of a person, provider, or | 599 |
organization is convicted of or
pleads
guilty to a violation of | 600 |
sections 2913.48 or 2923.31 to 2923.36 of the Revised Code or any | 601 |
other criminal offense related to the delivery of or billing for | 602 |
health care benefits. | 603 |
(b) There exists an entry of judgment against the person, | 604 |
health care provider, managed care organization, or its owner, or | 605 |
an officer,
authorized agent, associate, manager, or employee of a | 606 |
person, provider, or
organization and proof of the specific intent | 607 |
of
the person, health care provider, managed care organization, or | 608 |
owner to defraud, in a
civil action brought pursuant to this | 609 |
section. | 610 |
(2) No person, health care provider, or managed care | 616 |
organization that has had its
agreement with and reimbursement | 617 |
from the bureau terminated by the
administrator pursuant to | 618 |
division (C)(1) of this section, or an
owner,
officer, authorized | 619 |
agent, associate, manager, or employee of that person, health care | 620 |
provider, or managed care organization shall do either of the | 621 |
following: | 622 |
(3) The administrator shall not terminate the agreement or | 630 |
reimbursement
if the person, health care provider, managed care | 631 |
organization, or owner
demonstrates that the person, provider, | 632 |
organization, or owner did not directly or
indirectly sanction the | 633 |
action of the authorized agent, associate, manager, or
employee | 634 |
that resulted
in the conviction, plea of guilty, or entry of | 635 |
judgment as described in
division (C)(1) of this section. | 636 |
(4) Nothing in division (C) of this
section prohibits an | 637 |
owner, officer, authorized agent, associate, manager, or
employee | 638 |
of a person, health care provider, or managed care organization | 639 |
from entering
into an agreement with the bureau if the provider, | 640 |
organization, owner,
officer, authorized agent, associate, | 641 |
manager, or employee demonstrates
absence
of knowledge of the | 642 |
action of the person, health care provider, or managed care | 643 |
organization with which that individual or organization was | 644 |
formerly
associated that resulted in
a conviction, plea of guilty, | 645 |
or entry of judgment as described in division
(C)(1) of this | 646 |
section. | 647 |
(a) Every person in the service of the state, or of any | 680 |
county, municipal corporation, township, or school district | 681 |
therein, including regular members of lawfully constituted police | 682 |
and fire departments of municipal corporations and townships, | 683 |
whether paid or volunteer, and wherever serving within the state | 684 |
or on temporary assignment outside thereof, and executive officers | 685 |
of boards of education, under any appointment or contract of hire, | 686 |
express or implied, oral or written, including any elected | 687 |
official of the state, or of any county, municipal corporation, or | 688 |
township, or members of boards of education. | 689 |
(b) Every person in the service of any person, firm, or | 710 |
private corporation, including any public service corporation, | 711 |
that (i) employs one or more persons regularly in the same | 712 |
business or in or about the same establishment under any contract | 713 |
of hire, express or implied, oral or written, including aliens and | 714 |
minors, household workers who earn one hundred sixty dollars or | 715 |
more in cash in any calendar quarter from a single household and | 716 |
casual workers who earn one hundred sixty dollars or more in cash | 717 |
in any calendar quarter from a single employer, or (ii) is bound | 718 |
by any such contract of hire or by any other written contract, to | 719 |
pay into the state insurance fund the premiums provided by this | 720 |
chapter. | 721 |
Every person in the service of any independent contractor or | 768 |
subcontractor who has failed to pay into the state insurance fund | 769 |
the amount of premium determined and fixed by the administrator of | 770 |
workers' compensation for the person's employment or occupation or | 771 |
if a self-insuring employer has failed to pay compensation and | 772 |
benefits directly to the employer's injured and to the dependents | 773 |
of the employer's killed employees as required by section 4123.35 | 774 |
of the Revised Code, shall be considered as the employee of the | 775 |
person who has entered into a contract, whether written or verbal, | 776 |
with such independent contractor unless such employees or their | 777 |
legal representatives or beneficiaries elect, after injury or | 778 |
death, to regard such independent contractor as the employer. | 779 |
Any employer may elect to include as an "employee" within | 791 |
this chapter, any person excluded from the definition of | 792 |
"employee" pursuant to division (A)(2) of this section. If an | 793 |
employer is a partnership, sole proprietorship, individual | 794 |
incorporated as a corporation, or family farm
corporation, such | 795 |
employer may elect to include as an "employee"
within this | 796 |
chapter, any member of such partnership, the owner of
the sole | 797 |
proprietorship, the individual incorporated as a corporation, or | 798 |
the officers of the family farm
corporation. In the event of an | 799 |
election, the employer shall
serve upon the bureau of workers' | 800 |
compensation written notice
naming the persons to be covered, | 801 |
include such employee's
remuneration for premium purposes in all | 802 |
future payroll reports,
and no person excluded from the definition | 803 |
of "employee" pursuant
to division (A)(2) of this section, | 804 |
proprietor, individual incorporated as a corporation, or partner | 805 |
shall
be deemed an employee within this division until the | 806 |
employer has
served such notice. | 807 |
For informational purposes only, the bureau shall prescribe | 808 |
such language as it considers appropriate, on such of its forms as | 809 |
it considers appropriate, to advise employers of their right to | 810 |
elect to include as an "employee" within this chapter a sole | 811 |
proprietor, any member of a partnership, an individual | 812 |
incorporated as a corporation, the officers of a family
farm | 813 |
corporation, or a person excluded from the definition of | 814 |
"employee" under division (A)(2) of this section, that they
should | 815 |
check any health and disability insurance policy, or other
form of | 816 |
health and disability plan or contract, presently covering
them, | 817 |
or the purchase of which they may be considering, to
determine | 818 |
whether such policy, plan, or contract excludes benefits
for | 819 |
illness or injury that they might have elected to have covered
by | 820 |
workers' compensation. | 821 |
(2) Every person, firm, professional employer organization as | 827 |
defined in section 4125.01 of the Revised Code, and private | 828 |
corporation, including
any public service corporation, that (a) | 829 |
has in service one or
more employees or shared employees regularly | 830 |
in the same business or in or about the
same establishment under | 831 |
any contract of hire, express or implied,
oral or written, or (b) | 832 |
is bound by any such contract of hire or
by any other written | 833 |
contract, to pay into the insurance fund the
premiums provided by | 834 |
this chapter. | 835 |
All such employers are subject to this chapter. Any member
of | 836 |
a firm or association, who regularly performs manual labor in
or | 837 |
about a mine, factory, or other establishment, including a | 838 |
household establishment, shall be considered an employee in | 839 |
determining whether such person, firm, or private corporation, or | 840 |
public service corporation, has in its service, one or more | 841 |
employees and the employer shall report the income derived from | 842 |
such labor to the bureau as part of the payroll of such employer, | 843 |
and such member shall thereupon be entitled to all the benefits of | 844 |
an employee. | 845 |
(4) A condition that pre-existed an injury unless that | 863 |
pre-existing condition is substantially aggravated by the injury. | 864 |
Such a substantial aggravation must be documented by objective | 865 |
diagnostic findings, objective clinical findings, or objective | 866 |
test results. Subjective complaints may be evidence of such a | 867 |
substantial aggravation. However, subjective complaints without | 868 |
objective diagnostic findings, objective clinical findings, or | 869 |
objective test results are insufficient to substantiate a | 870 |
substantial aggravation. | 871 |
(E) "Family farm corporation" means a corporation founded
for | 874 |
the purpose of farming agricultural land in which the majority
of | 875 |
the voting stock is held by and the majority of the
stockholders | 876 |
are persons or the spouse of persons related to each
other within | 877 |
the fourth degree of kinship, according to the rules
of the civil | 878 |
law, and at least one of the related persons is
residing on or | 879 |
actively operating the farm, and none of whose
stockholders are a | 880 |
corporation. A family farm corporation does
not cease to qualify | 881 |
under this division where, by reason of any
devise, bequest, or | 882 |
the operation of the laws of descent or
distribution, the | 883 |
ownership of shares of voting stock is
transferred to another | 884 |
person, as long as that person is within
the degree of kinship | 885 |
stipulated in this division. | 886 |
(I) "Sexual conduct" means vaginal intercourse between a male | 904 |
and female; anal intercourse, fellatio, and cunnilingus between | 905 |
persons regardless of gender; and, without privilege to do so, the | 906 |
insertion, however slight, of any part of the body or any | 907 |
instrument, apparatus, or other object into the vaginal or anal | 908 |
cavity of another. Penetration, however slight, is sufficient to | 909 |
complete vaginal or anal intercourse. | 910 |
Sec. 4123.271. The administrator of workers' compensation may | 911 |
furnish to the tax commissioner, on a quarterly basis, a list in a | 912 |
format approved by the tax commissioner containing the name and | 913 |
social security number or employer identification number of any | 914 |
employer, and may request that the tax commissioner, on a | 915 |
quarterly basis, report the total amount of compensation paid that | 916 |
the employer reported for the period for which the annual return | 917 |
is made pursuant to division (F)(3) of section 5747.07 of the | 918 |
Revised Code, for each employer contained on the administrator's | 919 |
list. | 920 |
Upon receipt of this list and request, the tax commissioner | 921 |
shall provide to the administrator, in a format designed by the | 922 |
tax commissioner, information identifying any employer listed by | 923 |
the administrator who reported compensation paid to employees on | 924 |
the most recent return filed by the person pursuant to section | 925 |
5747.07 of the Revised Code and the total amount of compensation | 926 |
paid that the employer reported for the period for which the | 927 |
annual return is made pursuant to division (F)(3) of section | 928 |
5747.07 of the Revised Code. | 929 |
(B) A rule providing that the premium security deposit | 980 |
collected from
any employer entitles the employer to the benefits | 981 |
of
this chapter for the remainder of
the six months and also for | 982 |
an additional adjustment period of two months,
and,
thereafter, if | 983 |
the employer pays the premium due at the close of any six-month | 984 |
period, coverage shall be extended for an additional eight-month | 985 |
period
beginning from the end of the six-month period for which | 986 |
the employer pays the
premium due; | 987 |
(D) Such special rules as the administrator considers | 996 |
necessary to safeguard the fund and that are just in the | 997 |
circumstances, covering the rates to be applied where one
employer | 998 |
takes over the occupation or industry of another or
where an | 999 |
employer first makes application for state insurance,
and the | 1000 |
administrator may require that if any employer transfers
a | 1001 |
business in whole or in part or otherwise reorganizes the | 1002 |
business, the successor in interest shall assume, in proportion
to | 1003 |
the extent of the transfer, as determined by the
administrator, | 1004 |
the employer's account and shall continue the
payment of all | 1005 |
contributions due under this chapter; | 1006 |
(2) The premium determined by the administrator to be due | 1015 |
from an employer
shall be payable on or before the end of the | 1016 |
coverage period established by
the premium security deposit, or | 1017 |
within the time specified by the
administrator if
the period for | 1018 |
which the advance premium has been paid is less than eight
months. | 1019 |
If an employer fails to pay the premium when due, an amount equal | 1020 |
to
three per cent of the premium shall be added to the premium.
If | 1021 |
the failure
to pay continues for more than one month, the
premium | 1022 |
shall be increased
further
in an amount equal to two per
cent of | 1023 |
the premium for each additional month or
part of a month,
but the | 1024 |
total of all additional amounts shall not exceed
twelve
per cent | 1025 |
of the premium. Ifthe administrator may add a thirty dollar late | 1026 |
fee penalty to the premium plus an additional penalty amount as | 1027 |
follows: | 1028 |
(F) A rule providing that each employer, on the occasion
of | 1081 |
instituting coverage under this chapter, shall submit a
premium | 1082 |
security deposit. The deposit shall be calculated
equivalent to | 1083 |
thirty per cent of the semiannual premium
obligation of the | 1084 |
employer based upon the employer's estimated
expenditure for wages | 1085 |
for the ensuing six-month period plus
thirty per cent of an | 1086 |
additional adjustment period of two months
but only up to a | 1087 |
maximum of one thousand dollars and not less
than ten dollars.
The | 1088 |
administrator shall review the security
deposit of every
employer | 1089 |
who has submitted a deposit which is
less than the | 1090 |
one-thousand-dollar maximum. The administrator may
require any | 1091 |
such employer to submit additional money up to the
maximum of one | 1092 |
thousand dollars that, in the administrator's
opinion, reflects | 1093 |
the employer's current payroll expenditure for
an eight-month | 1094 |
period. | 1095 |
Sec. 4123.35. (A) Except as provided in this section,
every | 1096 |
employer mentioned in division (B)(2) of section 4123.01 of
the | 1097 |
Revised Code, and every publicly owned utility shall pay | 1098 |
semiannually in the months of January and July into the state | 1099 |
insurance fund the amount of annual premium the administrator of | 1100 |
workers' compensation fixes for the employment or occupation of | 1101 |
the employer, the amount of which premium to be paid by each | 1102 |
employer to be determined by the classifications, rules, and rates | 1103 |
made and published by the administrator. The employer shall pay | 1104 |
semiannually a further sum of money into the state insurance fund | 1105 |
as may be ascertained to be due from the employer by applying the | 1106 |
rules of the administrator, and a receipt or certificate | 1107 |
certifying that payment has been made, along with a written notice | 1108 |
as is required in section 4123.54 of the Revised Code, shall be | 1109 |
mailed immediately
to the employer by the bureau of workers' | 1110 |
compensation. The
receipt or certificate is prima-facie evidence | 1111 |
of the payment of
the premium, and the proper posting of the | 1112 |
notice constitutes the employer's compliance with the notice | 1113 |
requirement mandated in section 4123.54 of the Revised Code. | 1114 |
The administrator shall adopt rules to permit employers to | 1133 |
make periodic payments of the semiannual premium due under this | 1134 |
division. The rules shall include provisions for the assessment
of | 1135 |
interest charges, where appropriate, and for the assessment of | 1136 |
penalties when an employer fails to make timely premium payments. | 1137 |
An employer who timely pays the amounts due under this division is | 1138 |
entitled to all of the benefits and protections of this chapter. | 1139 |
Upon receipt of payment, the bureau immediately shall mail a | 1140 |
receipt or certificate to the employer certifying that payment has | 1141 |
been made, which receipt is prima-facie evidence of payment. | 1142 |
Workers' compensation coverage under this chapter continues | 1143 |
uninterrupted upon timely receipt of payment under this division. | 1144 |
(B) Employers who will abide by the rules of the | 1149 |
administrator and who may be of sufficient financial ability to | 1150 |
render certain the payment of compensation to injured employees or | 1151 |
the dependents of killed employees, and the furnishing of medical, | 1152 |
surgical, nursing, and hospital attention and services and | 1153 |
medicines, and funeral expenses, equal to or greater than is | 1154 |
provided for in sections 4123.52, 4123.55 to 4123.62, and 4123.64 | 1155 |
to 4123.67 of the Revised Code, and who do not desire to insure | 1156 |
the payment thereof or indemnify themselves against loss sustained | 1157 |
by the direct payment thereof, upon a finding of such facts by the | 1158 |
administrator, may be granted the privilege to pay individually | 1159 |
compensation, and furnish medical, surgical, nursing, and hospital | 1160 |
services and attention and funeral expenses directly to injured | 1161 |
employees or the dependents of killed employees, thereby being | 1162 |
granted status as a self-insuring employer. The administrator may | 1163 |
charge employers who apply for the status as a self-insuring | 1164 |
employer a reasonable application fee to cover the bureau's costs | 1165 |
in connection with processing and making a determination with | 1166 |
respect to an application. | 1167 |
The administrator may waive the requirements of divisions | 1208 |
(B)(1)(a) and (b) of this section and the requirement of division | 1209 |
(B)(1)(e) of this section that the financial records, documents, | 1210 |
and data be certified by a certified public accountant. The | 1211 |
administrator shall adopt rules establishing the criteria that an | 1212 |
employer shall meet in order for the administrator to waive the | 1213 |
requirement of division (B)(1)(e) of this section. Such rules may | 1214 |
require additional security of that employer pursuant to division | 1215 |
(E) of section 4123.351 of the Revised Code. | 1216 |
(C) A board of county commissioners described in division
(G) | 1283 |
of section 4123.01 of the Revised Code, as an employer, that
will | 1284 |
abide by the rules of the administrator and that may be of | 1285 |
sufficient financial ability to render certain the payment of | 1286 |
compensation to injured employees or the dependents of killed | 1287 |
employees, and the furnishing of medical, surgical, nursing, and | 1288 |
hospital attention and services and medicines, and funeral | 1289 |
expenses, equal to or greater than is provided for in sections | 1290 |
4123.52, 4123.55 to 4123.62, and 4123.64 to 4123.67 of the Revised | 1291 |
Code, and that does not desire to insure the payment thereof or | 1292 |
indemnify itself against loss sustained by the direct payment | 1293 |
thereof, upon a finding of such facts by the administrator, may be | 1294 |
granted the privilege to pay individually compensation, and | 1295 |
furnish medical, surgical, nursing, and hospital services and | 1296 |
attention and funeral expenses directly to injured employees or | 1297 |
the dependents of killed employees, thereby being granted status | 1298 |
as a self-insuring employer. The administrator may charge a board | 1299 |
of county commissioners described in division (G) of section | 1300 |
4123.01 of the Revised Code that applies for the status as a | 1301 |
self-insuring employer a reasonable application fee to cover the | 1302 |
bureau's costs in connection with processing and making a | 1303 |
determination with respect to an application. All employers | 1304 |
granted such status shall demonstrate sufficient financial and | 1305 |
administrative ability to assure that all obligations under this | 1306 |
section are promptly met. The administrator shall deny the | 1307 |
privilege where the employer is unable to demonstrate the | 1308 |
employer's ability to promptly meet all the obligations imposed on | 1309 |
the employer by this section. The administrator shall consider, | 1310 |
but is not limited to, the following factors, where applicable, in | 1311 |
determining the employer's ability to meet all of the obligations | 1312 |
imposed on the board as an employer by this section: | 1313 |
(D) The administrator shall require a surety bond from all | 1344 |
self-insuring employers, issued pursuant to section 4123.351 of | 1345 |
the Revised Code, that is sufficient to compel, or secure to | 1346 |
injured employees, or to the dependents of employees killed, the | 1347 |
payment of compensation and expenses, which shall in no event be | 1348 |
less than that paid or furnished out of the state insurance fund | 1349 |
in similar cases to injured employees or to dependents of killed | 1350 |
employees whose employers contribute to the fund, except when an | 1351 |
employee of the employer, who has suffered the loss of a hand, | 1352 |
arm, foot, leg, or eye prior to the injury for which compensation | 1353 |
is to be paid, and thereafter suffers the loss of any other of the | 1354 |
members as the result of any injury sustained in the course of and | 1355 |
arising out of the employee's employment, the compensation to be | 1356 |
paid by the self-insuring employer is limited to the disability | 1357 |
suffered in the subsequent injury, additional compensation, if | 1358 |
any, to be paid by the bureau out of the surplus created by | 1359 |
section 4123.34 of the Revised Code. | 1360 |
(E) In addition to the requirements of this section, the | 1361 |
administrator shall make and publish rules governing the manner of | 1362 |
making application and the nature and extent of the proof required | 1363 |
to justify a finding of fact by the administrator as to granting | 1364 |
the status of a self-insuring employer, which rules shall be | 1365 |
general in their application, one of which rules shall provide | 1366 |
that all self-insuring employers shall pay into the state | 1367 |
insurance fund such amounts as are required to be credited to the | 1368 |
surplus fund in division (B) of section 4123.34 of the Revised | 1369 |
Code. The administrator may adopt rules establishing requirements | 1370 |
in addition to the requirements described in division (B)(2) of | 1371 |
this section that a public employer shall meet in order to qualify | 1372 |
for self-insuring status. | 1373 |
Employers shall secure directly from the bureau central | 1374 |
offices application forms upon which the bureau shall stamp a | 1375 |
designating number. Prior to submission of an application, an | 1376 |
employer shall make available to the bureau, and the bureau shall | 1377 |
review, the information described in division (B)(1) of this | 1378 |
section, and public employers shall make available, and the bureau | 1379 |
shall review, the information necessary to verify whether the | 1380 |
public employer meets the requirements listed in division (B)(2) | 1381 |
of this section. An employer shall file the completed application | 1382 |
forms with an application fee, which shall cover the costs of | 1383 |
processing the application, as established by the administrator, | 1384 |
by rule, with the bureau at least ninety days prior to the | 1385 |
effective date of the employer's new status as a self-insuring | 1386 |
employer. The application form is not deemed complete until all | 1387 |
the required information is attached thereto. The bureau shall | 1388 |
only accept applications that contain the required information. | 1389 |
(F) The bureau shall review completed applications within a | 1390 |
reasonable time. If the bureau determines to grant an employer
the | 1391 |
status as a self-insuring employer, the bureau shall issue a | 1392 |
statement, containing its findings of fact, that is prepared by | 1393 |
the bureau and signed by the administrator. If the bureau | 1394 |
determines not to grant the status as a self-insuring employer, | 1395 |
the bureau shall notify the employer of the determination and | 1396 |
require the employer to continue to pay its full premium into the | 1397 |
state insurance fund. The administrator also shall adopt rules | 1398 |
establishing a minimum level of performance as a criterion for | 1399 |
granting and maintaining the status as a self-insuring employer | 1400 |
and fixing time limits beyond which failure of the self-insuring | 1401 |
employer to provide for the necessary medical examinations and | 1402 |
evaluations may not delay a decision on a claim. | 1403 |
(J) On the first day of July of each year, the administrator | 1443 |
shall calculate separately each self-insuring employer's | 1444 |
assessments for the safety and hygiene fund, administrative costs | 1445 |
pursuant to section 4123.342 of the Revised Code, and for the | 1446 |
portion of the surplus fund under division (B) of section 4123.34 | 1447 |
of the Revised Code that is not used for handicapped | 1448 |
reimbursement, on the basis of the paid compensation attributable | 1449 |
to the individual self-insuring employer according to the | 1450 |
following calculation: | 1451 |
(2) Multiply the quotient in division (J)(1) of this section | 1458 |
by the total amount of paid compensation for the previous calendar | 1459 |
year that is attributable to the individual self-insuring employer | 1460 |
for whom the assessment is being determined. Each self-insuring | 1461 |
employer shall pay the assessment that results from this | 1462 |
calculation, unless the assessment resulting from this calculation | 1463 |
falls below a minimum assessment, which minimum assessment the | 1464 |
administrator shall determine on the first day of July of each | 1465 |
year with the advice and consent of the workers' compensation | 1466 |
oversight commission, in which event, the self-insuring employer | 1467 |
shall pay the minimum assessment. | 1468 |
The administrator shall calculate the assessment for the | 1475 |
portion of the surplus fund under division (B) of section 4123.34 | 1476 |
of the Revised Code that is used for handicapped reimbursement in | 1477 |
the same manner as set forth in divisions (J)(1) and (2) of this | 1478 |
section except that the administrator shall calculate the total | 1479 |
assessment for this portion of the surplus fund only on the basis | 1480 |
of those self-insuring employers that retain participation in the | 1481 |
handicapped reimbursement program and the individual self-insuring | 1482 |
employer's proportion of paid compensation shall be calculated | 1483 |
only for those self-insuring employers who retain participation in | 1484 |
the handicapped reimbursement program. The administrator, as the | 1485 |
administrator determines appropriate, may determine the total | 1486 |
assessment for the handicapped portion of the surplus fund in | 1487 |
accordance with sound actuarial principles. | 1488 |
The administrator shall calculate the assessment for the | 1489 |
portion of the surplus fund under division (B) of section 4123.34 | 1490 |
of the Revised Code that under division (D) of section 4121.66 of | 1491 |
the Revised Code is used for rehabilitation costs in the same | 1492 |
manner as set forth in divisions (J)(1) and (2) of this section, | 1493 |
except that the administrator shall calculate the total assessment | 1494 |
for this portion of the surplus fund only on the basis of those | 1495 |
self-insuring employers who have not made the election to make | 1496 |
payments directly under division (D) of section 4121.66 of the | 1497 |
Revised Code and an individual self-insuring employer's proportion | 1498 |
of paid compensation only for those self-insuring employers who | 1499 |
have not made that election. | 1500 |
The administrator shall calculate the assessment for the | 1501 |
portion of the surplus fund under division (B) of section 4123.34 | 1502 |
of the Revised Code that is used for reimbursement to a | 1503 |
self-insuring employer under division (H) of section 4123.512 of | 1504 |
the Revised Code in the same manner as set forth in divisions | 1505 |
(J)(1) and (2) of this section except that the administrator shall | 1506 |
calculate the total assessment for this portion of the surplus | 1507 |
fund only on the basis of those self-insuring employers that | 1508 |
retain participation in reimbursement to the self-insuring | 1509 |
employer under division (H) of section 4123.512 of the Revised | 1510 |
Code and the individual self-insuring employer's proportion of | 1511 |
paid compensation shall be calculated only for those self-insuring | 1512 |
employers who retain participation in reimbursement to the | 1513 |
self-insuring employer under division (H) of section 4123.512 of | 1514 |
the Revised Code. | 1515 |
(L) Every self-insuring employer shall certify, in affidavit | 1529 |
form subject to the penalty for perjury, to the bureau the amount | 1530 |
of the self-insuring employer's paid compensation for the previous | 1531 |
calendar year. In reporting paid compensation paid for the | 1532 |
previous year, a self-insuring employer shall exclude from the | 1533 |
total amount of paid compensation any reimbursement the | 1534 |
self-insuring employer receives in the previous calendar year from | 1535 |
the surplus fund pursuant to section 4123.512 of the Revised Code | 1536 |
for any paid compensation. The self-insuring employer also shall | 1537 |
exclude from the paid compensation reported any amount recovered | 1538 |
under section 4123.931 of the Revised Code and any amount that is | 1539 |
determined not to have been payable to or on behalf of a claimant | 1540 |
in any final administrative or judicial proceeding. The | 1541 |
self-insuring employer shall exclude such amounts from the paid | 1542 |
compensation reported in the reporting period subsequent to the | 1543 |
date the determination is made. The administrator shall adopt | 1544 |
rules, in accordance with Chapter 119. of the Revised Code, | 1545 |
establishingthat provide for all of the following: | 1546 |
(M) As used in this section, "paid compensation" means all | 1585 |
amounts paid by a self-insuring employer for living maintenance | 1586 |
benefits, all amounts for compensation paid pursuant to sections | 1587 |
4121.63, 4121.67, 4123.56, 4123.57, 4123.58, 4123.59, 4123.60, and | 1588 |
4123.64 of the Revised Code, all amounts paid as wages in lieu of | 1589 |
such compensation, all amounts paid in lieu of such compensation | 1590 |
under a nonoccupational accident and sickness program fully funded | 1591 |
by the self-insuring employer, and all amounts paid by a | 1592 |
self-insuring employer for a violation of a specific safety | 1593 |
standard pursuant to Section 35 of Article II, Ohio Constitution | 1594 |
and section 4121.47 of the Revised Code. | 1595 |
(O) The administrator may grant a self-insuring employer the | 1603 |
privilege to self-insure a construction project entered into by | 1604 |
the self-insuring employer that is scheduled for completion within | 1605 |
six years after the date the project begins, and the total cost of | 1606 |
which is estimated to exceed one hundred million dollars
or, for | 1607 |
employers described in division (R) of this section, if the | 1608 |
construction project is estimated to exceed twenty-five million | 1609 |
dollars. The
administrator may waive such cost and time criteria | 1610 |
and grant a
self-insuring employer the privilege to self-insure a | 1611 |
construction
project regardless of the time needed to complete the | 1612 |
construction
project and provided that the cost of the | 1613 |
construction project is
estimated to exceed fifty million dollars. | 1614 |
A self-insuring
employer who desires to self-insure a construction | 1615 |
project shall
submit to the administrator an application listing | 1616 |
the dates the
construction project is scheduled to begin and end, | 1617 |
the estimated
cost of the construction project, the contractors | 1618 |
and
subcontractors whose employees are to be self-insured by the | 1619 |
self-insuring employer, the provisions of a safety program that is | 1620 |
specifically designed for the construction project, and a | 1621 |
statement as to whether a collective bargaining agreement | 1622 |
governing the rights, duties, and obligations of each of the | 1623 |
parties to the agreement with respect to the construction project | 1624 |
exists between the self-insuring employer and a labor | 1625 |
organization. | 1626 |
Upon approval of the application, the administrator shall | 1634 |
mail a certificate granting the privilege to self-insure the | 1635 |
construction project to the self-insuring employer. The | 1636 |
certificate shall contain the name of the self-insuring employer | 1637 |
and the name, address, and telephone number of the self-insuring | 1638 |
employer's representatives who are responsible for administering | 1639 |
workers' compensation claims for the construction project. The | 1640 |
self-insuring employer shall post the certificate in a conspicuous | 1641 |
place at the site of the construction project. | 1642 |
Upon approval of the application, the self-insuring employer | 1649 |
is responsible for the administration and payment of all claims | 1650 |
under this chapter and Chapter 4121. of the Revised Code for the | 1651 |
employees of the contractor and subcontractors covered under the | 1652 |
certificate who receive injuries or are killed in the course of | 1653 |
and arising out of employment on the construction project, or who | 1654 |
contract an occupational disease in the course of employment on | 1655 |
the construction project. For purposes of this chapter and
Chapter | 1656 |
4121. of the Revised Code, a claim that is administered
and paid | 1657 |
in accordance with this division is considered a claim
against the | 1658 |
self-insuring employer listed in the certificate. A
contractor or | 1659 |
subcontractor included under the certificate shall
report to the | 1660 |
self-insuring employer listed in the certificate,
all claims that | 1661 |
arise under this chapter and Chapter 4121. of the
Revised Code in | 1662 |
connection with the construction project for which
the certificate | 1663 |
is issued. | 1664 |
A self-insuring employer who complies with this division is | 1665 |
entitled to the protections provided under this chapter and | 1666 |
Chapter 4121. of the Revised Code with respect to the employees of | 1667 |
the contractors and subcontractors covered under a certificate | 1668 |
issued under this division for death or injuries that arise out | 1669 |
of, or death, injuries, or occupational diseases that arise in the | 1670 |
course of, those employees' employment on that construction | 1671 |
project, as if the employees were employees of the self-insuring | 1672 |
employer, provided that the self-insuring employer also complies | 1673 |
with this section. No employee of the contractors and | 1674 |
subcontractors covered under a certificate issued under this | 1675 |
division shall be considered the employee of the self-insuring | 1676 |
employer listed in that certificate for any purposes other than | 1677 |
this chapter and Chapter 4121. of the Revised Code. Nothing in | 1678 |
this division gives a self-insuring employer authority to control | 1679 |
the means, manner, or method of employment of the employees of the | 1680 |
contractors and subcontractors covered under a certificate issued | 1681 |
under this division. | 1682 |
The contractors and subcontractors included under a | 1683 |
certificate issued under this division are entitled to the | 1684 |
protections provided under this chapter and Chapter 4121. of the | 1685 |
Revised Code with respect to the contractor's or subcontractor's | 1686 |
employees who are employed on the construction project which is | 1687 |
the subject of the certificate, for death or injuries that arise | 1688 |
out of, or death, injuries, or occupational diseases that arise in | 1689 |
the course of, those employees' employment on that construction | 1690 |
project. | 1691 |
The contractors and subcontractors included under a | 1692 |
certificate issued under this division shall identify in their | 1693 |
payroll records the employees who are considered the employees of | 1694 |
the self-insuring employer listed in that certificate for purposes | 1695 |
of this chapter and Chapter 4121. of the Revised Code, and the | 1696 |
amount that those employees earned for employment on the | 1697 |
construction project that is the subject of that certificate. | 1698 |
Notwithstanding any provision to the contrary under this chapter | 1699 |
and Chapter 4121. of the Revised Code, the administrator shall | 1700 |
exclude the payroll that is reported for employees who are | 1701 |
considered the employees of the self-insuring employer listed in | 1702 |
that certificate, and that the employees earned for employment on | 1703 |
the construction project that is the subject of that certificate, | 1704 |
when determining those contractors' or subcontractors' premiums or | 1705 |
assessments required under this chapter and Chapter 4121. of the | 1706 |
Revised Code. A self-insuring employer issued a certificate under | 1707 |
this division shall include in the amount of paid compensation it | 1708 |
reports pursuant to division (L) of this section, the amount of | 1709 |
paid compensation the self-insuring employer paid pursuant to this | 1710 |
division for the previous calendar year. | 1711 |
(2) Whether the safety program that is specifically designed | 1757 |
for the construction project provides for the safety of employees | 1758 |
employed on the construction project, is applicable to all | 1759 |
contractors and subcontractors who perform labor or work or | 1760 |
provide materials for the construction project, and has
as a | 1761 |
component, a safety training program that complies with standards | 1762 |
adopted pursuant to the "Occupational Safety and Health Act of | 1763 |
1970," 84 Stat. 1590, 29 U.S.C.A. 651, and provides for continuing | 1764 |
management and employee involvement; | 1765 |
Sec. 4123.512. (A) The claimant or the employer may
appeal | 1796 |
an order of the industrial commission made under division
(E) of | 1797 |
section 4123.511 of the Revised Code in any injury or
occupational | 1798 |
disease case, other than a decision as to the extent
of disability | 1799 |
to the court of common pleas of the county in
which the injury was | 1800 |
inflicted or in which the contract of
employment was made if the | 1801 |
injury occurred outside the state, or
in which the contract of | 1802 |
employment was made if the exposure
occurred outside the state. If | 1803 |
no common pleas court has
jurisdiction for the purposes of an | 1804 |
appeal by the use of the
jurisdictional requirements described in | 1805 |
this division, the
appellant may use the venue provisions in the | 1806 |
Rules of Civil
Procedure to vest jurisdiction in a court. If the | 1807 |
claim is for
an occupational disease, the appeal shall be to the | 1808 |
court of
common pleas of the county in which the exposure which | 1809 |
caused the
disease occurred. Like appeal may be taken from an | 1810 |
order of a
staff hearing officer made under division (D) of | 1811 |
section 4123.511
of the Revised Code from which the commission has | 1812 |
refused to hear
an appeal. The appellant shall file the notice of | 1813 |
appeal with a
court of common pleas within sixty days after the | 1814 |
date of the
receipt of the order appealed from or the date of | 1815 |
receipt of the
order of the commission refusing to hear an appeal | 1816 |
of a staff
hearing officer's decision under division (D) of | 1817 |
section 4123.511
of the Revised Code. The filing of the notice of | 1818 |
the appeal with
the court is the only act required to perfect the | 1819 |
appeal. | 1820 |
Notwithstanding anything to the contrary in this section,
if | 1825 |
the commission determines under section 4123.522 of the
Revised | 1826 |
Code that an employee, employer, or their respective | 1827 |
representatives have not received written notice of an order or | 1828 |
decision which is appealable to a court under this section and | 1829 |
which grants relief pursuant to section 4123.522 of the Revised | 1830 |
Code, the party granted the relief has sixty days from receipt of | 1831 |
the order under section 4123.522 of the Revised Code to file a | 1832 |
notice of appeal under this section. | 1833 |
The administrator of workers' compensation, the claimant, and | 1838 |
the employer shall be
parties to the appeal and the court, upon | 1839 |
the application of the
commission, shall make the commission a | 1840 |
party. The party filing the appeal
shall serve a copy of the | 1841 |
notice of appeal on the admnistrator
of workers' compensation | 1842 |
administrator at the central office of the
bureau of workers' | 1843 |
compensation in Columbus. The administrator
shall notify the | 1844 |
employer that if the employer fails to
become an active
party to | 1845 |
the appeal, then the administrator may act on behalf of
the | 1846 |
employer and the results of the appeal could have an adverse | 1847 |
effect upon the employer's premium rates. | 1848 |
(C) The attorney general or one or more of the attorney | 1849 |
general's assistants
or special counsel designated by the attorney | 1850 |
general shall
represent the administrator and the commission. In | 1851 |
the event the attorney
general or the attorney general's | 1852 |
designated assistants or
special counsel are
absent, the | 1853 |
administrator or the commission shall select one or
more of the | 1854 |
attorneys in the employ of the administrator or the
commission as | 1855 |
the administrator's attorney or
the commission's attorney in the | 1856 |
appeal. Any attorney so
employed shall continue the representation | 1857 |
during the entire
period of the appeal and in all hearings thereof | 1858 |
except where the
continued representation becomes impractical. | 1859 |
The claimant shall, within thirty days after the filing of | 1863 |
the notice of appeal, file a petition containing a statement of | 1864 |
facts in ordinary and concise language showing a cause of action | 1865 |
to participate or to continue to participate in the fund and | 1866 |
setting forth the basis for the jurisdiction of the court over
the | 1867 |
action. Further pleadings shall be had in accordance with
the | 1868 |
Rules of Civil Procedure, provided that service of summons on
such | 1869 |
petition shall not be required and provided that the claimant may | 1870 |
not dismiss the complaint without the employer's consent if the | 1871 |
employer is the party that filed the notice of appeal to court | 1872 |
pursuant to this section. The clerk of the court shall,
upon | 1873 |
receipt thereof, transmit by certified mail a copy
thereof to each | 1874 |
party named in the notice of appeal other than
the claimant. Any | 1875 |
party may file with the clerk prior to the
trial of the action a | 1876 |
deposition of any physician taken in
accordance with the | 1877 |
provisions of the Revised Code, which
deposition may be read in | 1878 |
the trial of the action even though the
physician is a resident of | 1879 |
or subject to service in the county in
which the trial is had. The | 1880 |
bureau of workers' compensation
shall pay the cost of the | 1881 |
stenographic deposition filed in court and of
copies
of the | 1882 |
stenographic deposition for each party from the surplus fund and | 1883 |
charge
the costs thereof against the unsuccessful party if the | 1884 |
claimant's right to participate or continue to participate is | 1885 |
finally sustained or established in the appeal. In the event the | 1886 |
deposition is taken and filed, the physician whose deposition is | 1887 |
taken is not required to respond to any subpoena issued in the | 1888 |
trial of the action. The court, or the jury under the
instructions | 1889 |
of the court, if a jury is demanded, shall determine
the right of | 1890 |
the claimant to participate or to continue to
participate in the | 1891 |
fund upon the evidence adduced at the hearing
of the action. | 1892 |
(F) The cost of any legal proceedings authorized by this | 1897 |
section, including an attorney's fee to the claimant's attorney
to | 1898 |
be fixed by the trial judge, based upon the effort expended,
in | 1899 |
the event the claimant's right to participate or to continue
to | 1900 |
participate in the fund is established upon the final | 1901 |
determination of an appeal, shall be taxed against the employer
or | 1902 |
the commission if the commission or the administrator rather
than | 1903 |
the employer contested the right of the claimant to
participate in | 1904 |
the fund. The attorney's fee shall not exceed
twenty-five | 1905 |
forty-two hundred dollars. | 1906 |
(H) An appeal from an order issued under division (E) of | 1913 |
section 4123.511 of the Revised Code or any action filed in court | 1914 |
in a case in which an award of compensation has been made shall | 1915 |
not stay the payment of compensation under the award or payment
of | 1916 |
compensation for subsequent periods of total disability during
the | 1917 |
pendency of the appeal. If, in a final administrative or
judicial | 1918 |
action, it is determined that payments of compensation
or | 1919 |
benefits, or both, made to or on behalf of a claimant should
not | 1920 |
have been made, the amount thereof shall be charged to the
surplus | 1921 |
fund under division (B) of section 4123.34 of the Revised
Code. In | 1922 |
the event the employer is a state risk, the amount
shall not be | 1923 |
charged to the employer's experience. In the event
the employer is | 1924 |
a self-insuring employer, the self-insuring
employer shall deduct | 1925 |
the amount from the paid compensation the
self-insuring employer | 1926 |
reports to the administrator under division (L) of section
4123.35 | 1927 |
of the Revised Code. All | 1928 |
A self-insuring employer may elect to pay compensation and | 1929 |
benefits under this section directly to an employee or an | 1930 |
employee's dependents by filing an application with the bureau of | 1931 |
workers' compensation not more than one hundred eighty days and | 1932 |
not less than ninety days before the first day of the employer's | 1933 |
next six-month coverage period. If the self-insuring employer | 1934 |
timely files the application, the application is effective on the | 1935 |
first day of the employer's next six-month coverage period, | 1936 |
provided that the administrator shall compute the employer's | 1937 |
assessment for the surplus fund due with respect to the period | 1938 |
during which that application was filed without regard to the | 1939 |
filing of the application. On and after the effective date of the | 1940 |
employer's election, the self-insuring employer shall pay directly | 1941 |
to an employee or to an employee's dependents compensation and | 1942 |
benefits under this section regardless of the date of the injury | 1943 |
or occupational disease, and the employer shall receive no money | 1944 |
or credits from the surplus fund on account of those payments and | 1945 |
shall not be required to pay any amounts into the surplus fund on | 1946 |
account of this section. The election made under this division is | 1947 |
irrevocable. | 1948 |
Sec. 4123.52. The jurisdiction of the industrial
commission | 1961 |
and the authority of the administrator of workers'
compensation | 1962 |
over each case is continuing, and the commission may
make such | 1963 |
modification or change with respect to former findings
or orders | 1964 |
with respect thereto, as, in its opinion is justified. No | 1965 |
modification or change nor any finding or award in respect of
any | 1966 |
claim shall be made with respect to disability, compensation, | 1967 |
dependency, or benefits, after sixfive years from the date of | 1968 |
injury in the absence of the payment of medical benefits under | 1969 |
this
chapter, in which event the modification, change, finding, or | 1970 |
award shall be made within six years after the payment of
medical | 1971 |
benefits, or in the absence of payment of compensation under | 1972 |
section 4123.57, 4123.58, or division (A) or
(B) of section | 1973 |
4123.56 of the Revised Code or wages in lieu of compensation in
a | 1974 |
manner so as to satisfy the requirements of section 4123.84 of
the | 1975 |
Revised Code, in which event the modification, change,
finding, or | 1976 |
award shall be made within tenfive years from the date of
the | 1977 |
last payment of compensation or from the date of death, nor
unless | 1978 |
written notice of claim for the specific part or parts of
the body | 1979 |
injured or disabled has been given as provided in
section 4123.84 | 1980 |
or 4123.85 of the Revised Code, and the. The
commission shall not | 1981 |
make any modification, change, finding, or
award which shall award | 1982 |
compensation for a back period in excess
of two years prior to the | 1983 |
date of filing application therefor. This section
does not affect | 1984 |
the right of a claimant to compensation accruing subsequent to
the | 1985 |
filing of any such application, provided the application is filed | 1986 |
within
the time limit provided in this section. | 1987 |
The commission and administrator of workers' compensation | 1997 |
each may, by general rules, provide for the retention and | 1998 |
destruction of all other records in their possession or under | 1999 |
their control pursuant to section 121.211 and sections 149.34 to | 2000 |
149.36 of the Revised Code. The bureau of workers' compensation | 2001 |
may purchase or rent required equipment for the document
retention | 2002 |
media, as determined necessary to preserve the records. | 2003 |
Photographs, microphotographs, microfilm, films, or other direct | 2004 |
document retention media, when properly identified, have the same | 2005 |
effect as the original record and may be offered in like manner | 2006 |
and may be received as evidence in proceedings before the | 2007 |
industrial
commission, staff hearing officers, and district | 2008 |
hearing officers, and in
any court where the original
record could | 2009 |
have been introduced. | 2010 |
(2) Caused by the employee being intoxicated or under the | 2018 |
influence of a controlled substance not prescribed by a physician | 2019 |
where the intoxication or being under the influence of the | 2020 |
controlled substance not prescribed by a physician was the | 2021 |
proximate cause of the injury, is entitled to receive, either | 2022 |
directly from the employee's self-insuring employer as
provided in | 2023 |
section
4123.35 of the Revised Code, or from the state insurance | 2024 |
fund,
the compensation for loss sustained on account of the | 2025 |
injury,
occupational disease, or death, and the medical, nurse, | 2026 |
and
hospital services and medicines, and the amount of funeral | 2027 |
expenses in case of death, as are provided by this chapter. | 2028 |
(B) For the purpose of this section, provided that an
| 2029 |
employer has posted written notice to employees that the results | 2030 |
of, or
the employee's refusal
to submit to, any chemical test | 2031 |
described
under this division may affect the
employee's | 2032 |
eligibility for
compensation and benefits pursuant to this chapter | 2033 |
and Chapter
4121. of the Revised Code,
there is a rebuttable | 2034 |
presumption that
an employee is intoxicated
or under the influence | 2035 |
of a controlled
substance not prescribed by the employee's | 2036 |
physician and that being intoxicated
or under the influence of a | 2037 |
controlled substance not prescribed by
the employee's physician is | 2038 |
the
proximate cause of an injury under either of the following | 2039 |
conditions: | 2040 |
(a) Observable phenomena, such as direct observation of use, | 2114 |
possession, or distribution of alcohol or a controlled substance, | 2115 |
or of the physical symptoms of being under the influence of | 2116 |
alcohol or a controlled substance, such as but not limited to | 2117 |
slurred speech, dilated pupils, odor of alcohol or a controlled | 2118 |
substance, changes in affect, or dynamic mood swings; | 2119 |
(H) Whenever, with respect to an employee of an employer who | 2158 |
is
subject to and has complied with this chapter, there is | 2159 |
possibility of conflict with respect to the application of | 2160 |
workers' compensation laws because the contract of employment is | 2161 |
entered into and all or some portion of the work is or is to be | 2162 |
performed in a state or states other than Ohio, the employer and | 2163 |
the employee may agree to be bound by the laws of this state or
by | 2164 |
the laws of some other state in which all or some portion of
the | 2165 |
work of the employee is to be performed. The agreement shall
be
in | 2166 |
writing and shall be filed with the bureau of workers' | 2167 |
compensation within ten days after it is executed and shall
remain | 2168 |
in force until terminated or modified by agreement of the
parties | 2169 |
similarly filed. If the agreement is to be bound by the
laws of | 2170 |
this state and the employer has complied with this
chapter, then | 2171 |
the employee is entitled to compensation and
benefits regardless | 2172 |
of where the injury occurs or the disease is
contracted and the | 2173 |
rights of the employee and the employee's
dependents
under the | 2174 |
laws of this state are the exclusive remedy against the
employer | 2175 |
on account of injury, disease, or death in the course of
and | 2176 |
arising out of the employee's employment. If the
agreement is to | 2177 |
be
bound by the laws of another state and the employer has | 2178 |
complied
with the laws of that state, the rights of the employee | 2179 |
and the
employee's
dependents under the laws of that state are the | 2180 |
exclusive remedy
against the employer on account of injury, | 2181 |
disease, or death in
the course of and arising out of the | 2182 |
employee's employment
without regard
to
the place where the injury | 2183 |
was sustained or the disease
contracted. | 2184 |
If an employee is a resident of a state other than this
state | 2192 |
and is insured under the workers' compensation law or
similar laws | 2193 |
of a state other than this state, the employee and the employee's | 2194 |
dependents are not entitled to receive
compensation or
benefits | 2195 |
under this chapter, on account of injury, disease, or
death | 2196 |
arising out of or in the course of employment while
temporarily | 2197 |
within this state, and the rights of the employee and the | 2198 |
employee's dependents under the laws of the other state
are the | 2199 |
exclusive remedy against the employer on account of the injury, | 2200 |
disease, or death. | 2201 |
Sec. 4123.56. (A) Except as provided in division (D) of
this | 2208 |
section, in the case of temporary disability, an employee
shall | 2209 |
receive sixty-six and two-thirds per cent of the
employee's | 2210 |
average
weekly wage so long as such disability is total, not to | 2211 |
exceed a
maximum amount of weekly compensation which is equal to | 2212 |
the
statewide average weekly wage as defined in division (C) of | 2213 |
section 4123.62 of the Revised Code, and not less than a minimum | 2214 |
amount of compensation which is equal to thirty-three and | 2215 |
one-third per cent of the statewide average weekly wage as
defined | 2216 |
in division (C) of section 4123.62 of the Revised Code
unless the | 2217 |
employee's wage is less than thirty-three and
one-third per cent | 2218 |
of the minimum statewide average weekly wage,
in which event the | 2219 |
employee shall receive compensation equal
to the employee's full | 2220 |
wages; provided that for the first twelve weeks of total | 2221 |
disability the employee shall receive seventy-two per cent of
the | 2222 |
employee's full weekly wage, but not to exceed a maximum amount of | 2223 |
weekly compensation which is equal to the lesser of the statewide | 2224 |
average weekly wage as defined in division (C) of section 4123.62 | 2225 |
of the Revised Code or one hundred per cent of the employee's net | 2226 |
take-home weekly wage. In the case of a self-insuring employer, | 2227 |
payments
shall be for a duration based upon the medical reports
of | 2228 |
the attending physician. If the employer disputes the
attending | 2229 |
physician's report, payments may be terminated only
upon | 2230 |
application and hearing by a district hearing officer
pursuant to | 2231 |
division (C) of section 4123.511 of the Revised Code.
Payments | 2232 |
shall continue pending the determination of the matter,
however | 2233 |
payment shall not be made for the period when any
employee has | 2234 |
returned to work, when an employee's treating
physician has made a | 2235 |
written statement that the employee is
capable of returning to the | 2236 |
employee's former position of
employment, when work within the | 2237 |
physical capabilities of the employee is made
available by the | 2238 |
employer or another employer, or when the
employee has reached the | 2239 |
maximum medical improvement. Where the
employee is capable of
work | 2240 |
activity, but the employee's
employer is unable
to offer the | 2241 |
employee any employment, the employee shall
register with the | 2242 |
director of job
and family services,
who shall assist
the
employee | 2243 |
in finding suitable employment. The termination of temporary
total | 2244 |
disability, whether by order or otherwise, does not preclude
the | 2245 |
commencement of temporary total disability at another point in | 2246 |
time if the employee again becomes temporarily totally disabled. | 2247 |
If any compensation under this section has been paid for
the | 2264 |
same period or periods for which temporary nonoccupational | 2265 |
accident and sickness insurance is or has been paid pursuant to
an | 2266 |
insurance policy or program to which the employer has made the | 2267 |
entire contribution or payment for providing insurance or under a | 2268 |
nonoccupational accident and sickness program fully funded by the | 2269 |
employer, compensation paid under this section for the period or | 2270 |
periods shall be paid only to the extent by which the payment or | 2271 |
payments exceeds the amount of the nonoccupational insurance or | 2272 |
program paid or payable. Offset of the compensation shall be
made | 2273 |
only upon the prior order of the bureau or industrial commission | 2274 |
or
agreement of the
claimant. | 2275 |
As used in this division,
"net take-home weekly wage" means | 2276 |
the amount obtained by dividing an employee's total remuneration, | 2277 |
as defined in section 4141.01 of the Revised Code, paid to or | 2278 |
earned by the employee during the first four of the last five | 2279 |
completed calendar quarters which immediately precede the first | 2280 |
day of the employee's entitlement to benefits under this
division, | 2281 |
by the number of weeks during which the employee was
paid or | 2282 |
earned remuneration during those four quarters, less the
amount of | 2283 |
local, state, and federal income taxes deducted for
each such | 2284 |
week. | 2285 |
(B) Where(1) If an employee in a claim allowed under this | 2286 |
chapter
suffers a wage loss as a result of returning to
employment | 2287 |
other
than the employee's former position of
employment or as a | 2288 |
result
of being unable to find employment consistent with the | 2289 |
claimant's
physical capabilities due to an injury or occupational | 2290 |
disease, the employee shall
receive compensation at
sixty-six and | 2291 |
two-thirds per cent of the difference between the
employee's | 2292 |
average weekly wage
lossand the employee's present earnings not | 2293 |
to exceed the statewide average weekly
wage for a period
not to | 2294 |
exceed two hundred weeks.
The payments may continue for up to a | 2295 |
maximum of two hundred weeks, but the payments shall be reduced by | 2296 |
the
corresponding number of weeks in which the employee receives | 2297 |
payments pursuant
to division (B) of section 4121.67 Of the | 2298 |
Revised Code. | 2299 |
(2) If an employee in a claim allowed under this
chapter | 2300 |
suffers a wage loss as a result of being unable
to find employment | 2301 |
consistent with the employee's disability resulting from the | 2302 |
employee's injury or occupational disease, the
employee shall | 2303 |
receive
compensation at
sixty-six and two-thirds per cent of the | 2304 |
difference between the
employee's average weekly wage
and
the | 2305 |
employee's present earnings, not to exceed the statewide average | 2306 |
weekly wage. The payments may continue for up to a maximum of | 2307 |
fifty-two weeks. The first twenty-six weeks of payments under | 2308 |
division (B)(2) of this section shall be in addition to the | 2309 |
maximum of two hundred weeks of payments allowed under division | 2310 |
(B)(1) of this section. If an employee in a claim allowed under | 2311 |
this chapter receives compensation under division (B)(2) of this | 2312 |
section in excess of twenty-six weeks, the number of weeks of | 2313 |
compensation allowable under division (B)(1) of this section shall | 2314 |
be reduced by the corresponding number of weeks in excess of | 2315 |
twenty-six, and up to fifty-two, that is allowable under division | 2316 |
(B)(1) of this section. | 2317 |
(C) In the event an employee of a professional sports | 2321 |
franchise domiciled in this state is disabled as the result
of an | 2322 |
injury or occupational disease, the total amount of payments made | 2323 |
under a contract of hire or collective bargaining agreement to
the | 2324 |
employee during a period of disability is deemed an advanced | 2325 |
payment of compensation payable under sections 4123.56 to 4123.58 | 2326 |
of the Revised Code. The employer shall be reimbursed the total | 2327 |
amount of the advanced payments out of any award of compensation | 2328 |
made pursuant to sections 4123.56 to 4123.58 of the Revised Code. | 2329 |
Except as provided in this section, not earlier than forty | 2339 |
twenty-six
weeks after the date of termination of the latest | 2340 |
period of
payments under section 4123.56 of the Revised Code, or | 2341 |
not
earlier than fortytwenty-six weeks after the date of the | 2342 |
injury or
contraction of an occupational disease in the absence of | 2343 |
payments
under section 4123.56 of the Revised Code, the employee | 2344 |
may
file an application with the bureau of workers' compensation | 2345 |
for
the determination of the percentage of the employee's | 2346 |
permanent partial disability resulting from an injury or | 2347 |
occupational disease. | 2348 |
Whenever the application is filed, the bureau shall send a | 2349 |
copy of the application to the employee's employer or the | 2350 |
employer's representative and shall schedule the employee for a | 2351 |
medical examination by the bureau medical section. The bureau | 2352 |
shall send a copy of the report of the medical examination to the | 2353 |
employee, the employer, and their representatives. Thereafter, the | 2354 |
administrator of
workers' compensation shall review the employee's | 2355 |
claim file and make a
tentative order as the evidence before the | 2356 |
administrator at
the time of the making of the order warrants. If | 2357 |
the administrator determines
that there is a conflict of evidence, | 2358 |
the administrator shall
send the application, along with the | 2359 |
claimant's file, to the district hearing
officer who shall set the | 2360 |
application for a hearing. | 2361 |
The administrator shall notify the employee, the employer, | 2362 |
and their representatives, in writing, of the tentative order and | 2363 |
of the parties' right to request a hearing. Unless the employee, | 2364 |
the employer, or their representative notifies the administrator, | 2365 |
in writing, of an objection to the tentative order within twenty | 2366 |
days after receipt of the notice thereof, the tentative order | 2367 |
shall go into effect and the employee shall receive the | 2368 |
compensation provided in the order. In no event shall there be a | 2369 |
reconsideration of a tentative order issued under this division. | 2370 |
(A) The district hearing officer, upon the
application, shall | 2378 |
determine the percentage of the employee's permanent
disability, | 2379 |
except as is subject to division (B) of this section,
based upon | 2380 |
that condition of the employee resulting from the
injury or | 2381 |
occupational disease and causing permanent impairment
evidenced by | 2382 |
medical or clinical findings reasonably
demonstrable. The employee | 2383 |
shall receive sixty-six and
two-thirds per cent of the employee's | 2384 |
average weekly wage,
but not more than a maximum of thirty-three | 2385 |
and one-third per cent of the
statewide average weekly wage as | 2386 |
defined in division (C) of section 4123.62
of the Revised Code, | 2387 |
per week regardless of the average weekly
wage, for the number of | 2388 |
weeks which equals the percentage of two
hundred weeks. Except on | 2389 |
application for reconsideration,
review, or modification, which is | 2390 |
filed within ten days after the
date of receipt of the decision of | 2391 |
the district hearing officer,
in no instance shall the former | 2392 |
award be modified unless it is
found from medical or clinical | 2393 |
findings that the condition of the
claimant resulting from the | 2394 |
injury has so progressed as to have
increased the percentage of | 2395 |
permanent partial disability. A
staff hearing officer shall hear | 2396 |
an application for reconsideration filed and
the staff hearing | 2397 |
officer's decision is final. An employee
may file an application | 2398 |
for a subsequent determination of the
percentage of the employee's | 2399 |
permanent
disability. If such an application is filed, the bureau | 2400 |
shall
send a copy of the application to the
employer or the | 2401 |
employer's representative. No sooner than sixty
days from the date | 2402 |
of the mailing of the application to the
employer or the | 2403 |
employer's representative, the administrator
shall review the | 2404 |
application. The administrator may require a
medical examination | 2405 |
or medical review of the employee. The
administrator shall issue a | 2406 |
tentative order based upon the
evidence before the administrator, | 2407 |
provided that if
the administrator requires a medical examination | 2408 |
or medical
review, the administrator shall not issue the tentative | 2409 |
order until the
completion of the examination or review. | 2410 |
The employer may obtain a medical examination of the
employee | 2411 |
and may submit medical evidence at any stage of the
process up to | 2412 |
a hearing before the district hearing officer,
pursuant to rules | 2413 |
of the commission. The administrator shall
notify the employee, | 2414 |
the employer, and their representatives, in
writing, of the nature | 2415 |
and amount of any tentative order issued
on an application | 2416 |
requesting a subsequent determination of the
percentage of an | 2417 |
employee's permanent disability. An employee,
employer, or their | 2418 |
representatives may object to the tentative
order within twenty | 2419 |
days after the receipt of the notice thereof.
If no timely | 2420 |
objection is made, the tentative order shall go into
effect. In no | 2421 |
event shall there be a reconsideration of a
tentative order issued | 2422 |
under this division. If an objection is
timely made, the | 2423 |
application for a subsequent determination shall
be referred to a | 2424 |
district hearing officer who shall set the
application for a | 2425 |
hearing with written notice to all interested
persons. No | 2426 |
application for subsequent percentage determinations
on the same | 2427 |
claim for injury or occupational disease shall be
accepted for | 2428 |
review by the district hearing officer unless
supported by | 2429 |
substantial evidence of new and changed
circumstances developing | 2430 |
since the time of the hearing on the
original or last | 2431 |
determination. | 2432 |
If the claimant has suffered the loss of two or more
fingers | 2482 |
by amputation or ankylosis and the nature of the
claimant's | 2483 |
employment in the course of which the claimant was working at
the | 2484 |
time of the injury or occupational disease is such that the | 2485 |
handicap or disability resulting from the loss of
fingers, or loss | 2486 |
of use of fingers, exceeds the normal handicap or disability | 2487 |
resulting from the loss of fingers, or loss of use of fingers,
the | 2488 |
administrator may take that fact into consideration and
increase | 2489 |
the award of compensation accordingly, but the award
made shall | 2490 |
not exceed the amount of compensation for loss of a
hand. | 2491 |
For the permanent partial loss of sight of an eye, the | 2509 |
portion of one hundred twenty-five weeks as the administrator in | 2510 |
each case determines, based upon the percentage of vision
actually | 2511 |
lost as a result of the injury or occupational disease,
but, in no | 2512 |
case shall an award of compensation be made for less
than | 2513 |
twenty-five per cent loss of uncorrected vision. "Loss of | 2514 |
uncorrected vision" means the percentage of vision actually lost | 2515 |
as the result of the injury or occupational disease. | 2516 |
In case an injury or occupational disease results in
serious | 2525 |
facial or head disfigurement which either impairs or may
in the | 2526 |
future impair the opportunities to secure or retain
employment, | 2527 |
the administrator shall make an award of compensation
as it deems | 2528 |
proper and equitable, in view of the nature of the
disfigurement, | 2529 |
and not to exceed the sum of fiveten thousand
dollars. For the | 2530 |
purpose of making the award, it is not material
whether the | 2531 |
employee is gainfully employed in any occupation or
trade at the | 2532 |
time of the administrator's determination. | 2533 |
In all cases arising under division (B) of this section, if | 2552 |
it is determined by any one of the following: (1) the amputee | 2553 |
clinic at University hospital, Ohio state university; (2) the | 2554 |
rehabilitation services commission; (3) an amputee clinic or | 2555 |
prescribing physician approved by the administrator or the | 2556 |
administrator's designee, that an injured or disabled employee is | 2557 |
in need
of an artificial appliance, or in need of a repair | 2558 |
thereof, regardless
of whether the appliance or its repair will be | 2559 |
serviceable in the
vocational rehabilitation of the injured | 2560 |
employee, and regardless
of whether the employee has returned to | 2561 |
or can ever again return
to any gainful employment, the bureau | 2562 |
shall pay the cost of the
artificial appliance or its repair out | 2563 |
of the surplus created by
division (B) of section 4123.34 of the | 2564 |
Revised Code. | 2565 |
(D) If an employee of a state fund employer makes
application | 2573 |
for a finding and the administrator finds that the
employee has | 2574 |
contracted silicosis as defined in division (X), or coal
miners' | 2575 |
pneumoconiosis as defined in division (Y), or asbestosis as | 2576 |
defined in division (AA) of section 4123.68 of the Revised Code, | 2577 |
and that a change of such employee's occupation is medically | 2578 |
advisable in order to decrease substantially further exposure to | 2579 |
silica dust, asbestos, or coal dust and if the employee, after
the | 2580 |
finding, has changed or shall change the employee's
occupation to | 2581 |
an occupation in which the exposure to silica dust, asbestos, or | 2582 |
coal dust is substantially decreased, the administrator shall | 2583 |
allow to the
employee an amount equal to fifty per cent of the | 2584 |
statewide average weekly wage per week for a period of thirty | 2585 |
weeks, commencing as of the date of the discontinuance or change, | 2586 |
and for a period of one hundred weeks immediately following the | 2587 |
expiration of the period of thirty weeks, the employee shall | 2588 |
receive sixty-six and two-thirds per cent of the loss
of wages | 2589 |
resulting directly and solely from the change of
occupation but | 2590 |
not to exceed a maximum of an amount equal to
fifty per cent of | 2591 |
the statewide average weekly wage per week. No
such employee is | 2592 |
entitled to receive more than one allowance on
account of | 2593 |
discontinuance of employment or change of occupation
and benefits | 2594 |
shall cease for any period during which the employee
is employed | 2595 |
in an occupation in which the exposure to silica
dust, asbestos, | 2596 |
or coal dust is not substantially less than the
exposure in the | 2597 |
occupation in which the employee was formerly
employed or for any | 2598 |
period during which the employee may be entitled to
receive | 2599 |
compensation or benefits under section 4123.68 of the
Revised Code | 2600 |
on account of disability from silicosis, asbestosis,
or coal | 2601 |
miners' pneumoconiosis. An award for change of
occupation for a | 2602 |
coal miner who has contracted coal miners'
pneumoconiosis may be | 2603 |
granted under this division even though the
coal miner continues | 2604 |
employment with the same employer, so long
as the coal miner's | 2605 |
employment subsequent to the change is
such that the coal miner's | 2606 |
exposure to
coal dust is substantially decreased and a change of | 2607 |
occupation
is certified by the claimant as permanent. The | 2608 |
administrator may accord to
the employee medical and other | 2609 |
benefits in accordance with section 4123.66 of
the Revised Code. | 2610 |
(E) If a firefighter or police officer makes
application for | 2611 |
a finding and the administrator finds that the
firefighter or | 2612 |
police officer has contracted
a cardiovascular and pulmonary | 2613 |
disease as defined in division (W)
of section 4123.68 of the | 2614 |
Revised Code, and that a change of the
firefighter's or police | 2615 |
officer's occupation is
medically advisable in order to decrease | 2616 |
substantially further exposure to
smoke, toxic gases, chemical | 2617 |
fumes, and other toxic vapors, and
if the firefighter, or police | 2618 |
officer, after the
finding, has changed or changes occupation to | 2619 |
an occupation in
which the
exposure to smoke, toxic gases, | 2620 |
chemical fumes, and other toxic
vapors is substantially decreased, | 2621 |
the administrator shall allow
to the firefighter or police officer | 2622 |
an amount
equal to fifty per cent of the statewide average weekly | 2623 |
wage per week for a
period of thirty weeks, commencing as of the | 2624 |
date of the
discontinuance or change, and for a period of | 2625 |
seventy-five weeks
immediately following the expiration of the | 2626 |
period of thirty
weeks the administrator shall allow the | 2627 |
firefighter
or police officer sixty-six and two-thirds per cent of | 2628 |
the loss of wages
resulting directly and solely from the change of | 2629 |
occupation but
not to exceed a maximum of an amount equal to fifty | 2630 |
per cent of
the statewide average weekly wage per week. No such | 2631 |
firefighter or police officer is entitled to
receive more than one | 2632 |
allowance
on account of discontinuance of employment or change of | 2633 |
occupation and benefits shall cease for any period during which | 2634 |
the firefighter or police officer is employed in an
occupation in | 2635 |
which the exposure to smoke, toxic gases, chemical fumes, and | 2636 |
other toxic vapors is not substantially less than the exposure in | 2637 |
the occupation in which the firefighter or police officer
was | 2638 |
formerly employed or for any period during which the
firefighter | 2639 |
or police officer may be entitled to receive compensation
or | 2640 |
benefits under section
4123.68 of the Revised Code on account of | 2641 |
disability from a
cardiovascular and pulmonary disease. The | 2642 |
administrator may
accord to the firefighter or police officer | 2643 |
medical
and other benefits in accordance with section 4123.66 of | 2644 |
the Revised Code. | 2645 |
Sec. 4123.58. (A) In cases of permanent total disability, | 2649 |
the employee shall
receive an award to continue until histhe | 2650 |
employee's death
in the amount of sixty-six and two-thirds per | 2651 |
cent of histhe
employee's average
weekly wage, but, except as | 2652 |
otherwise provided in division (B) of
this section, not more than | 2653 |
a maximum amount of weekly
compensation which is equal to | 2654 |
sixty-six and two-thirds per cent
of the statewide average weekly | 2655 |
wage as defined in division (C)
of section 4123.62 of the Revised | 2656 |
Code in effect on the date of injury or on the date the disability | 2657 |
due to the occupational disease begins, nor not less than a | 2658 |
minimum amount of weekly compensation which is equal to fifty per | 2659 |
cent of the statewide average weekly wage as defined in division | 2660 |
(C) of section 4123.62 of the Revised Code in effect on the date | 2661 |
of injury or on the date the disability due to the occupational | 2662 |
disease begins, unless the employee's
average weekly wage is less | 2663 |
than fifty per cent of the statewide
average weekly wage at the | 2664 |
time of the injury, in which event hethe
employee shall receive | 2665 |
compensation in an amount equal to histhe employee's average | 2666 |
weekly wage. | 2667 |
(B) In the event the weekly workers' compensation amount
when | 2668 |
combined with disability benefits received pursuant to the
Social | 2669 |
Security Act is less than the statewide average weekly
wage as | 2670 |
defined in division (C) of section 4123.62 of the Revised
Code, | 2671 |
then the maximum amount of weekly compensation shall be the | 2672 |
statewide average weekly wage as defined in division (C) of | 2673 |
section 4123.62 of the Revised Code. At any time that social | 2674 |
security disability benefits terminate or are reduced, the | 2675 |
workers' compensation award shall be recomputed to pay the
maximum | 2676 |
amount permitted under this division. | 2677 |
(F) If an employee is awarded compensation for permanent | 2707 |
total disability under this section because the employee sustained | 2708 |
a traumatic brain injury, the employee is entitled to that | 2709 |
compensation regardless of the employee's employment in a | 2710 |
sheltered workshop subsequent to the award, on the condition that | 2711 |
the employee does not receive income, compensation, or | 2712 |
remuneration from that employment in excess of two thousand | 2713 |
dollars in any calendar quarter. As used in this division, | 2714 |
"sheltered workshop" means a state agency or nonprofit | 2715 |
organization established to carry out a program of rehabilitation | 2716 |
for handicapped individuals or to provide these individuals with | 2717 |
remunerative employment or other occupational rehabilitating | 2718 |
activity. | 2719 |
In cases of temporary total disability the compensation for | 2724 |
the first twelve weeks for which compensation is payable shall be | 2725 |
based on the full weekly wage of the claimant at the time of the | 2726 |
injury or at the time of the disability due to occupational | 2727 |
disease begins; when a factory, mine, or other place of employment | 2728 |
is
working short time in order to divide work among the employees, | 2729 |
the bureau of workers' compensation shall take that fact into | 2730 |
consideration when determining the wage for the first twelve
weeks | 2731 |
of temporary total disability. | 2732 |
In death, permanent total disability claims,
permanent | 2735 |
partial disability claims, and impairment of earnings claims, the | 2736 |
claimant's or the decedent's average weekly wage for the year | 2737 |
preceding the injury or the date the disability due to the | 2738 |
occupational disease begins is the weekly wage upon which | 2739 |
compensation shall be based. In ascertaining the average weekly | 2740 |
wage for the year previous to the injury, or the date the | 2741 |
disability due to the occupational disease begins any period of | 2742 |
unemployment due to sickness, industrial depression, strike, | 2743 |
lockout, or other cause beyond the employee's control shall be | 2744 |
eliminated. | 2745 |
In cases where there are special circumstances under which | 2746 |
the average weekly wage cannot justly be determined by applying | 2747 |
this section, the administrator of workers' compensation, in | 2748 |
determining the average weekly wage in such cases, shall use such | 2749 |
method as will enable himthe administrator to do substantial | 2750 |
justice to the claimants, provided that the administrator shall | 2751 |
not recalculate the claimant's average weekly wage for awards for | 2752 |
permanent total disability solely for the reason that the claimant | 2753 |
continued working and the claimant's wages increased following the | 2754 |
injury. | 2755 |
Sec. 4123.65. (A) A state fund employer or the employee
of | 2756 |
such an employer may file an application with the
administrator of | 2757 |
workers' compensation for approval of a final
settlement of a | 2758 |
claim under this chapter. The application shall
include the | 2759 |
settlement agreement, and except as otherwise specified in this | 2760 |
division, be signed by the claimant and
employer, and clearly set | 2761 |
forth the circumstances by reason of
which the proposed settlement | 2762 |
is deemed desirable and that the
parties agree to the terms of the | 2763 |
settlement agreement provided
that the agreement need not be | 2764 |
signed by the
employer if the. A claimant may file an application | 2765 |
without an employer's signature in the following situations: | 2766 |
If a state fund
employer or an employee of such an employer | 2781 |
has not filed an
application for a final settlement under this | 2782 |
division, the
administrator may file an application on behalf of | 2783 |
the employer
or the employee, provided that the administrator | 2784 |
gives notice of
the filing to the employer and the employee and to | 2785 |
the
representative of record of the employer and of the employee | 2786 |
immediately upon the filing. An application filed by the | 2787 |
administrator shall contain all of the information and signatures | 2788 |
required of an employer or an employee who files an application | 2789 |
under this division. Every self-insuring employer that enters
into | 2790 |
a final settlement agreement with an employee shall mail,
within | 2791 |
seven days of executing the agreement, a copy of the
agreement to | 2792 |
the administrator and the employee's representative.
The | 2793 |
administrator shall place the agreement into the claimant's
file. | 2794 |
(C) No settlement agreed to under division (A) of this | 2799 |
section or agreed to by a self-insuring employer and the | 2800 |
self-insuring employer's employee shall take effect until thirty | 2801 |
days
after the administrator approves the settlement for state | 2802 |
fund employees and
employers, or after the self-insuring employer | 2803 |
and employee sign the final
settlement agreement. During the | 2804 |
thirty-day period, the
employer, employee, or administrator, for | 2805 |
state fund settlements,
and the employer or employee, for | 2806 |
self-insuring settlements, may
withdraw consent to the settlement | 2807 |
by an employer
providing
written notice to the employer's employee | 2808 |
and the
administrator or by an
employee providing written notice | 2809 |
to the employee's employer
and the administrator, or by the | 2810 |
administrator providing written notice to the
state fund employer | 2811 |
and employee. If an employee dies during the thirty-day waiting | 2812 |
period following the approval of a settlement, the settlement can | 2813 |
be voided by any party for good cause shown. | 2814 |
(D) At the time of agreement to any final settlement | 2815 |
agreement under division (A) of this section or agreement between | 2816 |
a self-insuring employer and the self-insuring employer's | 2817 |
employee, the administrator, for state fund settlements, and
the | 2818 |
self-insuring
employer, for self-insuring settlements, immediately | 2819 |
shall send a copy of the
agreement to the industrial commission | 2820 |
who shall assign the
matter to a staff hearing officer. The staff | 2821 |
hearing officer
shall determine, within the time limitations | 2822 |
specified in
division (C) of this section, whether the settlement | 2823 |
agreement is
or is not a gross miscarriage of justice. If the | 2824 |
staff hearing
officer determines within that time period that the | 2825 |
settlement
agreement is clearly unfair, the staff hearing officer | 2826 |
shall issue an order
disapproving the settlement agreement. If
the | 2827 |
staff hearing officer determines that the settlement agreement is | 2828 |
not
clearly unfair or fails to act within those time limits, the | 2829 |
settlement
agreement is approved. | 2830 |
(E) A settlement entered into under this section may
pertain | 2831 |
to one or more claims of a claimant, or one or more parts
of a | 2832 |
claim, or the compensation or benefits pertaining to either,
or | 2833 |
any combination thereof, provided that nothing in this section | 2834 |
shall be interpreted to require a claimant to enter into a | 2835 |
settlement agreement for every claim that has been filed with the | 2836 |
bureau of workers' compensation by that claimant under Chapter | 2837 |
4121., 4123., 4127., or 4131. of the Revised Code. | 2838 |
Sec. 4123.88. (A) No person shall orally or in writing, | 2841 |
directly or indirectly, or through any agent or other person | 2842 |
fraudulently hold himselfthe person's self out or represent | 2843 |
himselfthe person's
self or hisany of the person's partners or | 2844 |
associates as authorized by a
claimant or employer to
take charge | 2845 |
of, or represent the claimant or employer in respect
of, any claim | 2846 |
or matter in connection therewith before the bureau
of workers' | 2847 |
compensation or the industrial commission or its
district or staff | 2848 |
hearing officers. No person shall directly or indirectly
solicit | 2849 |
authority, or pay or give anything of value to another person to | 2850 |
solicit authority, or accept or receive pay or anything of value | 2851 |
from another person for soliciting authority, from a claimant or | 2852 |
employer to take charge of, or represent the claimant or employer | 2853 |
in respect of, any claim or appeal which is or may be filed with | 2854 |
the bureau or commission. No person shall, without prior
authority | 2855 |
from the bureau, a member of the commission, the
claimant, or the | 2856 |
employer, examine or directly or indirectly
cause or employ | 2857 |
another person to examine any claim file or any
other file | 2858 |
pertaining thereto. No person shall forge an
authorization for the | 2859 |
purpose of examining or cause another
person to examine any such | 2860 |
file. No district or staff hearing
officer or other employee of | 2861 |
the bureau or commission,
notwithstanding the provisions of | 2862 |
section 4123.27 of the Revised
Code, shall divulge any information | 2863 |
in respect of any claim or
appeal which is or may be filed with a | 2864 |
district or staff hearing
officer, the bureau, or commission to | 2865 |
any person other than
members of the commission or to the superior | 2866 |
of the employee
except upon authorization of the administrator of | 2867 |
workers'
compensation or a member of the commission or upon | 2868 |
authorization
of the claimant or employer. No | 2869 |
(C) Except as otherwise specified in division (D) of this | 2878 |
section, information kept by the commission or the bureau pursuant | 2879 |
to this section is for the exclusive use and information of the | 2880 |
commission and the bureau in the discharge of their official | 2881 |
duties, and shall not be open to the public nor be used in any | 2882 |
court in any action or proceeding pending therein, unless the | 2883 |
commission or the bureau is a party to the action or proceeding. | 2884 |
The information, however, may be tabulated and published by the | 2885 |
commission or the bureau in statistical form for the use and | 2886 |
information of other state agencies and the public. | 2887 |
Sec. 5703.21. (A) Except as provided in divisions (B) and | 2909 |
(C) of this section, no agent
of the department of taxation, | 2910 |
except in the agent's report to the department or when called on | 2911 |
to
testify in any court or proceeding, shall divulge any | 2912 |
information
acquired by the agent as to the transactions, | 2913 |
property, or business
of any person while acting or claiming to | 2914 |
act under orders of the
department. Whoever violates this | 2915 |
provision shall thereafter be
disqualified from acting as an | 2916 |
officer or employee or in any
other capacity under appointment or | 2917 |
employment of the department. | 2918 |
(B)(1) For purposes of an audit pursuant to section 117.15
of | 2919 |
the Revised Code, or an audit of the department pursuant to | 2920 |
Chapter 117. of the Revised Code, or an audit, pursuant to that | 2921 |
chapter, the objective of which is to express an opinion on a | 2922 |
financial report or statement prepared or issued pursuant to | 2923 |
division (A)(7) or (9) of section
126.21 of
the Revised Code, the | 2924 |
officers and employees of the auditor of state charged with | 2925 |
conducting the audit shall have access to and the right to
examine | 2926 |
any state tax returns and state tax return information in
the | 2927 |
possession of the department to the extent that the
access
and | 2928 |
examination are necessary for purposes of the audit. Any | 2929 |
information acquired as the result of that access and
examination | 2930 |
shall not be divulged for any purpose other than as required for | 2931 |
the audit or unless the officers and employees are required
to | 2932 |
testify in a court or proceeding under compulsion of legal | 2933 |
process. Whoever violates this provision shall thereafter be | 2934 |
disqualified from acting as an officer or employee or in any
other | 2935 |
capacity under appointment or employment of the auditor of
state. | 2936 |
(7) Providing information regarding the name, account
number, | 2967 |
or business
address of a holder of a vendor's
license
issued | 2968 |
pursuant to section 5739.17 of the Revised Code, a holder
of a | 2969 |
direct payment permit issued pursuant to section 5739.031 of
the | 2970 |
Revised Code, or a seller having a use tax account maintained | 2971 |
pursuant to
section 5741.17 of the Revised Code, or information | 2972 |
regarding the active or inactive status of a vendor's license, | 2973 |
direct payment permit, or seller's use tax account; | 2974 |
Any information gained as the result of returns, | 2992 |
investigations, hearings, or verifications required or authorized | 2993 |
by this chapter is confidential, and no person shall disclose
such | 2994 |
information, except for official purposes, or as provided by | 2995 |
section 3125.43, 4123.271, 4123.591, 4507.023, or 5101.182, | 2996 |
division (B) of
section 5703.21 of the Revised Code, or in | 2997 |
accordance with a
proper judicial order. The tax commissioner may | 2998 |
furnish the
internal revenue service with copies of returns or | 2999 |
reports filed and
may furnish the officer of a municipal | 3000 |
corporation charged with the
duty of enforcing a tax subject to | 3001 |
Chapter 718. of the Revised
Code with the names, addresses, and | 3002 |
identification numbers of
taxpayers who may be subject to such | 3003 |
tax. A municipal
corporation shall use this information for tax | 3004 |
collection
purposes only. This section does not prohibit the | 3005 |
publication of
statistics in a form which does not disclose | 3006 |
information with
respect to individual taxpayers. | 3007 |
Section 2. That existing sections 2913.48, 3121.034, | 3008 |
3121.037, 4121.10, 4121.44, 4121.441, 4123.01, 4123.32, 4123.35, | 3009 |
4123.512, 4123.52, 4123.54, 4123.56, 4123.57, 4123.58, 4123.61, | 3010 |
4123.65, 4123.88, 5703.21, and 5747.18 of the Revised Code are | 3011 |
hereby repealed. | 3012 |