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To amend sections 2305.24, 2305.25, 4121.04, and | 1 |
4123.511 of the Revised Code to make changes to | 2 |
the Industrial Commission Law, to make | 3 |
appropriations for the Industrial Commission for | 4 |
the biennium beginning July 1, 2009, and ending | 5 |
June 30, 2011, and to provide authorization and | 6 |
conditions for the operation of Commission | 7 |
programs. | 8 |
Section 101. That sections 2305.24, 2305.25, 4121.04, and | 9 |
4123.511 of the Revised Code be amended to read as follows: | 10 |
Sec. 2305.24. Any information, data, reports, or records | 11 |
made available to a quality assurance committee or utilization | 12 |
committee of a hospital or long-term care facility or of any | 13 |
not-for-profit health care corporation that is a member of the | 14 |
hospital or long-term care facility or of which the hospital or | 15 |
long-term care facility is a member are confidential and shall be | 16 |
used by the committee and the committee members only in the | 17 |
exercise of the proper functions of the committee. Any | 18 |
information, data, reports, or records made available to a | 19 |
utilization committee of a state or local medical society composed | 20 |
of doctors of medicine or doctors of osteopathic medicine are | 21 |
confidential and shall be used by the committee and the committee | 22 |
members only in the exercise of the proper functions of the | 23 |
committee. A right of action similar to that a patient may have | 24 |
against an attending physician for misuse of information, data, | 25 |
reports, or records arising out of the physician-patient | 26 |
relationship shall accrue against a member of a quality assurance | 27 |
committee or utilization committee for misuse of any information, | 28 |
data, reports, or records furnished to the committee by an | 29 |
attending physician. No physician, institution, hospital, or | 30 |
long-term care facility furnishing information, data, reports, or | 31 |
records to a committee with respect to any patient examined or | 32 |
treated by the physician or confined in the institution, hospital, | 33 |
or long-term care facility shall, by reason of the furnishing, be | 34 |
deemed liable in damages to any person, or be held to answer for | 35 |
betrayal of a professional confidence within the meaning and | 36 |
intent of section 4731.22 of the Revised Code. Information, data, | 37 |
or reports furnished to a utilization committee of a state or | 38 |
local medical society shall contain no name of any person involved | 39 |
therein. | 40 |
Any information, data, reports, or records made available to | 41 |
a quality assurance committee of the bureau of workers' | 42 |
compensation or the industrial commission that is responsible for | 43 |
reviewing the professional qualifications and the performance of | 44 |
providers conducting medical examinations or file reviews for the | 45 |
bureau or the commission are confidential and shall be used by the | 46 |
committee and the committee members only in the exercise of the | 47 |
proper functions of the committee. | 48 |
As used in this section, "utilization committee" is the | 49 |
committee established to administer a utilization review plan of a | 50 |
hospital, of a not-for-profit health care corporation which is a | 51 |
member of the hospital or of which the hospital is a member, or of | 52 |
a skilled nursing facility as provided in the "Health Insurance | 53 |
for the Aged Act," 79 Stat. 313 (1965), 42 U.S.C. 1395x(k). | 54 |
Sec. 2305.25. As used in this section and sections 2305.251 | 55 |
to 2305.253 of the Revised Code: | 56 |
(A)(1) "Health care entity" means an entity, whether acting | 57 |
on its own behalf or on behalf of or in affiliation with other | 58 |
health care entities, that conducts as part of its regular | 59 |
business activities professional credentialing or quality review | 60 |
activities involving the competence of, professional conduct of, | 61 |
or quality of care provided by health care providers, including | 62 |
both individuals who provide health care and entities that provide | 63 |
health care. | 64 |
(2) "Health care entity" includes any entity described in | 65 |
division (A)(1) of this section, regardless of whether it is a | 66 |
government entity; for-profit or nonprofit corporation; limited | 67 |
liability company; partnership; professional corporation; state or | 68 |
local society composed of physicians, dentists, optometrists, | 69 |
psychologists, or pharmacists; or other health care organization. | 70 |
(B) "Health insuring corporation" means an entity that holds | 71 |
a certificate of authority under Chapter 1751. of the Revised | 72 |
Code. "Health insuring corporation" includes wholly owned | 73 |
subsidiaries of a health insuring corporation. | 74 |
(C) "Hospital" means either of the following: | 75 |
(1) An institution that has been registered or licensed by | 76 |
the department of health as a hospital; | 77 |
(2) An entity, other than an insurance company authorized to | 78 |
do business in this state, that owns, controls, or is affiliated | 79 |
with an institution that has been registered or licensed by the | 80 |
department of health as a hospital. | 81 |
(D) "Incident report or risk management report" means a | 82 |
report of an incident involving injury or potential injury to a | 83 |
patient as a result of patient care provided by health care | 84 |
providers, including both individuals who provide health care and | 85 |
entities that provide health care, that is prepared by or for the | 86 |
use of a peer review committee of a health care entity and is | 87 |
within the scope of the functions of that committee. | 88 |
(E)(1) "Peer review committee" means a utilization review | 89 |
committee, quality assessment committee, performance improvement | 90 |
committee, tissue committee, credentialing committee, or other | 91 |
committee that does either of the following: | 92 |
(a) Conducts professional credentialing or quality review | 93 |
activities involving the competence of, professional conduct of, | 94 |
or quality of care provided by health care providers, including | 95 |
both individuals who provide health care and entities that provide | 96 |
health care; | 97 |
(b) Conducts any other attendant hearing process initiated as | 98 |
a result of a peer review committee's recommendations or actions. | 99 |
(2) "Peer review committee" includes all of the following: | 100 |
(a) A peer review committee of a hospital or long-term care | 101 |
facility or a peer review committee of a nonprofit health care | 102 |
corporation that is a member of the hospital or long-term care | 103 |
facility or of which the hospital or facility is a member; | 104 |
(b) A peer review committee of a community mental health | 105 |
center; | 106 |
(c) A board or committee of a hospital, a long-term care | 107 |
facility, or other health care entity when reviewing professional | 108 |
qualifications or activities of health care providers, including | 109 |
both individuals who provide health care and entities that provide | 110 |
health care; | 111 |
(d) A peer review committee, professional standards review | 112 |
committee, or arbitration committee of a state or local society | 113 |
composed of members who are in active practice as physicians, | 114 |
dentists, optometrists, psychologists, or pharmacists; | 115 |
(e) A peer review committee of a health insuring corporation | 116 |
that has at least a two-thirds majority of member physicians in | 117 |
active practice and that conducts professional credentialing and | 118 |
quality review activities involving the competence or professional | 119 |
conduct of health care providers that adversely affects or could | 120 |
adversely affect the health or welfare of any patient; | 121 |
(f) A peer review committee of a health insuring corporation | 122 |
that has at least a two-thirds majority of member physicians in | 123 |
active practice and that conducts professional credentialing and | 124 |
quality review activities involving the competence or professional | 125 |
conduct of a health care facility that has contracted with the | 126 |
health insuring corporation to provide health care services to | 127 |
enrollees, which conduct adversely affects, or could adversely | 128 |
affect, the health or welfare of any patient; | 129 |
(g) A peer review committee of a sickness and accident | 130 |
insurer that has at least a two-thirds majority of physicians in | 131 |
active practice and that conducts professional credentialing and | 132 |
quality review activities involving the competence or professional | 133 |
conduct of health care providers that adversely affects or could | 134 |
adversely affect the health or welfare of any patient; | 135 |
(h) A peer review committee of a sickness and accident | 136 |
insurer that has at least a two-thirds majority of physicians in | 137 |
active practice and that conducts professional credentialing and | 138 |
quality review activities involving the competence or professional | 139 |
conduct of a health care facility that has contracted with the | 140 |
insurer to provide health care services to insureds, which conduct | 141 |
adversely affects, or could adversely affect, the health or | 142 |
welfare of any patient; | 143 |
(i) A peer review committee of any insurer authorized under | 144 |
Title XXXIX of the Revised Code to do the business of medical | 145 |
professional liability insurance in this state that conducts | 146 |
professional quality review activities involving the competence or | 147 |
professional conduct of health care providers that adversely | 148 |
affects or could affect the health or welfare of any patient; | 149 |
(j) A peer review committee of the bureau of workers' | 150 |
compensation or the industrial commission that is responsible for | 151 |
reviewing the professional qualifications and the performance of | 152 |
providers conducting medical examinations or file reviews for the | 153 |
bureau or the commission; | 154 |
(k) Any other peer review committee of a health care entity. | 155 |
(F) "Physician" means an individual authorized to practice | 156 |
medicine and surgery, osteopathic medicine and surgery, or | 157 |
podiatric medicine and surgery. | 158 |
(G) "Sickness and accident insurer" means an entity | 159 |
authorized under Title XXXIX of the Revised Code to do the | 160 |
business of sickness and accident insurance in this state. | 161 |
(H) "Tort action" means a civil action for damages for | 162 |
injury, death, or loss to a patient of a health care entity. "Tort | 163 |
action" includes a product liability claim, as defined in section | 164 |
2307.71 of the Revised Code, and an asbestos claim, as defined in | 165 |
section 2307.91 of the Revised Code, but does not include a civil | 166 |
action for a breach of contract or another agreement between | 167 |
persons. | 168 |
Sec. 4121.04. (A) There is hereby created the industrial | 169 |
commission nominating council consisting of | 170 |
representatives | 171 |
representative from the Ohio association for justice, and two | 172 |
members of the public, each of a different political party, who | 173 |
are appointed by the governor. The nominating council shall make | 174 |
recommendations to the governor for the appointment of members | 175 |
to the industrial commission as provided in section 4121.02 of | 176 |
the Revised Code. | 177 |
(B) | 178 |
179 | |
180 | |
181 | |
182 | |
select the members representing employees from a list of eight | 183 |
names submitted by the Ohio federation of labor, the member | 184 |
representing the Ohio association for justice from a list of two | 185 |
names submitted by the Ohio association of justice, and the | 186 |
members
representing employers from a
list of | 187 |
submitted
jointly by the | 188 |
organizations
| 189 |
190 | |
191 | |
192 | |
193 | |
appoint at least one member from each of the Ohio industry | 194 |
organizations | 195 |
196 | |
list submitted by the Ohio industry organizations
| 197 |
198 | |
organizations | 199 |
200 | |
included in the list. | 201 |
202 | |
203 | |
204 | |
205 | |
206 | |
207 | |
208 | |
Terms of office of employer and employee representatives are for | 209 |
four years, each term ending on the same day as the date of their | 210 |
original appointment. The Ohio federation of labor for a vacancy | 211 |
of an employee representative on the council, and the Ohio | 212 |
industry organizations, for a vacancy of an employer | 213 |
representative on the council, shall submit to the governor a list | 214 |
containing two names for appointment and the governor shall | 215 |
appoint an individual from the list to fill the vacancy provided | 216 |
that the list submitted to fill an industry representative vacancy | 217 |
shall contain the names of individuals who represent the | 218 |
organizations for which a vacancy has occurred. One public member | 219 |
shall represent the interests of small business | 220 |
221 | |
222 | |
223 | |
two years, each term ending on the same day as the date of their | 224 |
original appointment. The governor shall fill a vacancy occurring | 225 |
on the nominating council for a public member in the same manner | 226 |
as for the original appointment but only for the unexpired part of | 227 |
the term. As used in this division, "small business" means any | 228 |
manufacturing establishment employing five hundred or fewer | 229 |
employees or any retail, or other service establishment employing | 230 |
one hundred or fewer employees. The representative from the Ohio | 231 |
association for justice shall serve for a term of four years, each | 232 |
term ending on the twentieth day of October of the appropriate | 233 |
year. The governor shall fill a vacancy occurring on the | 234 |
nominating council for the representative from the Ohio | 235 |
association for justice in the same manner as the original | 236 |
appointment. In the event that an appointment to the council | 237 |
does not conform to this division, such organizations may | 238 |
challenge the appointment pursuant to division (E) of this | 239 |
section, provided that the industry organizations only may | 240 |
challenge the appointment of an industry representative, and | 241 |
further provided that the labor organization only may challenge | 242 |
the appointment of a labor representative. | 243 |
(C) | 244 |
245 | |
246 | |
247 | |
248 | |
249 | |
250 | |
nominating council annually shall meet and elect such officers as | 251 |
it determines appropriate and shall meet at such other times as | 252 |
it determines appropriate in order to make recommendations to the | 253 |
governor for the appointment of industrial commission members | 254 |
pursuant to section 4121.02 of the Revised Code. | 255 |
(D) Members of the nominating council shall be paid fifty | 256 |
dollars per day and their actual and necessary expenses while | 257 |
engaged in the performance of their duties as members of the | 258 |
nominating council, which the industrial commission shall pay from | 259 |
funds which the industrial commission uses to pay its operating | 260 |
expenses. | 261 |
(E) An association generally recognized as representing the | 262 |
interests of labor or industry may file, within fifteen days after | 263 |
the governor's appointment of a member, a challenge in the common | 264 |
pleas court of Franklin county asserting that a representative | 265 |
named to represent its interests is not representative of the | 266 |
interests the appointee has been appointed to represent. An | 267 |
appointee whose appointment has been challenged shall not receive | 268 |
any pay nor serve on the nominating council until the court, | 269 |
acting without a jury and following the expedited timetable | 270 |
provided for hearing on restraining orders in Civil Rule 65, makes | 271 |
a determination that the appointee is a true and qualified | 272 |
representative of the group for which the appointee is selected | 273 |
and possesses all of the qualifications. | 274 |
A challenged appointee may request the attorney general to | 275 |
represent the appointee in an action brought under this division | 276 |
and the attorney general shall provide the appointee with | 277 |
competent representation without charge. | 278 |
(F) As used in this section, "Ohio industry organizations" | 279 |
means all of the following organizations: | 280 |
(1) The Ohio self-insurers' association; | 281 |
(2) The Ohio manufacturers' association; | 282 |
(3) The Ohio council of retail merchants; | 283 |
(4) The Ohio chamber of commerce; | 284 |
(5) The national federation of independent business. | 285 |
Sec. 4123.511. (A) Within seven days after receipt of any | 286 |
claim under this chapter, the bureau of workers' compensation | 287 |
shall notify the claimant and the employer of the claimant of the | 288 |
receipt of the claim and of the facts alleged therein. If the | 289 |
bureau receives from a person other than the claimant written or | 290 |
facsimile information or information communicated verbally over | 291 |
the telephone indicating that an injury or occupational disease | 292 |
has occurred or been contracted which may be compensable under | 293 |
this chapter, the bureau shall notify the employee and the | 294 |
employer of the information. If the information is provided | 295 |
verbally over the telephone, the person providing the information | 296 |
shall provide written verification of the information to the | 297 |
bureau according to division (E) of section 4123.84 of the Revised | 298 |
Code. The receipt of the information in writing or facsimile, or | 299 |
if initially by telephone, the subsequent written verification, | 300 |
and the notice by the bureau shall be considered an application | 301 |
for compensation under section 4123.84 or 4123.85 of the Revised | 302 |
Code, provided that the conditions of division (E) of section | 303 |
4123.84 of the Revised Code apply to information provided verbally | 304 |
over the telephone. Upon receipt of a claim, the bureau shall | 305 |
advise the claimant of the claim number assigned and the | 306 |
claimant's right to representation in the processing of a claim or | 307 |
to elect no representation. If the bureau determines that a claim | 308 |
is determined to be a compensable lost-time claim, the bureau | 309 |
shall notify the claimant and the employer of the availability of | 310 |
rehabilitation services. No bureau or industrial commission | 311 |
employee shall directly or indirectly convey any information in | 312 |
derogation of this right. This section shall in no way abrogate | 313 |
the bureau's responsibility to aid and assist a claimant in the | 314 |
filing of a claim and to advise the claimant of the claimant's | 315 |
rights under the law. | 316 |
The administrator of workers' compensation shall assign all | 317 |
claims and investigations to the bureau service office from which | 318 |
investigation and determination may be made most expeditiously. | 319 |
The bureau shall investigate the facts concerning an injury | 320 |
or occupational disease and ascertain such facts in whatever | 321 |
manner is most appropriate and may obtain statements of the | 322 |
employee, employer, attending physician, and witnesses in whatever | 323 |
manner is most appropriate. | 324 |
The administrator, with the advice and consent of the bureau | 325 |
of workers' compensation board of directors, may adopt rules that | 326 |
identify specified medical conditions that have a historical | 327 |
record of being allowed whenever included in a claim. The | 328 |
administrator may grant immediate allowance of any medical | 329 |
condition identified in those rules upon the filing of a claim | 330 |
involving that medical condition and may make immediate payment of | 331 |
medical bills for any medical condition identified in those rules | 332 |
that is included in a claim. If an employer contests the allowance | 333 |
of a claim involving any medical condition identified in those | 334 |
rules, and the claim is disallowed, payment for the medical | 335 |
condition included in that claim shall be charged to and paid from | 336 |
the surplus fund created under section 4123.34 of the Revised | 337 |
Code. | 338 |
(B)(1) Except as provided in division (B)(2) of this section, | 339 |
in claims other than those in which the employer is a | 340 |
self-insuring employer, if the administrator determines under | 341 |
division (A) of this section that a claimant is or is not entitled | 342 |
to an award of compensation or benefits, the administrator shall | 343 |
issue an order no later than twenty-eight days after the sending | 344 |
of the notice under division (A) of this section, granting or | 345 |
denying the payment of the compensation or benefits, or both as is | 346 |
appropriate to the claimant. Notwithstanding the time limitation | 347 |
specified in this division for the issuance of an order, if a | 348 |
medical examination of the claimant is required by statute, the | 349 |
administrator promptly shall schedule the claimant for that | 350 |
examination and shall issue an order no later than twenty-eight | 351 |
days after receipt of the report of the examination. The | 352 |
administrator shall notify the claimant and the employer of the | 353 |
claimant and their respective representatives in writing of the | 354 |
nature of the order and the amounts of compensation and benefit | 355 |
payments involved. The employer or claimant may appeal the order | 356 |
pursuant to division (C) of this section within fourteen days | 357 |
after the date of the receipt of the order. The employer and | 358 |
claimant may waive, in writing, their rights to an appeal under | 359 |
this division. | 360 |
(2) Notwithstanding the time limitation specified in division | 361 |
(B)(1) of this section for the issuance of an order, if the | 362 |
employer certifies a claim for payment of compensation or | 363 |
benefits, or both, to a claimant, and the administrator has | 364 |
completed the investigation of the claim, the payment of benefits | 365 |
or compensation, or both, as is appropriate, shall commence upon | 366 |
the later of the date of the certification or completion of the | 367 |
investigation and issuance of the order by the administrator, | 368 |
provided that the administrator shall issue the order no later | 369 |
than the time limitation specified in division (B)(1) of this | 370 |
section. | 371 |
(3) If an appeal is made under division (B)(1) or (2) of this | 372 |
section, the administrator shall forward the claim file to the | 373 |
appropriate district hearing officer within seven days of the | 374 |
appeal. In contested claims other than state fund claims, the | 375 |
administrator shall forward the claim within seven days of the | 376 |
administrator's receipt of the claim to the industrial commission, | 377 |
which shall refer the claim to an appropriate district hearing | 378 |
officer for a hearing in accordance with division (C) of this | 379 |
section. | 380 |
(C) If an employer or claimant timely appeals the order of | 381 |
the administrator issued under division (B) of this section or in | 382 |
the case of other contested claims other than state fund claims, | 383 |
the commission shall refer the claim to an appropriate district | 384 |
hearing officer according to rules the commission adopts under | 385 |
section 4121.36 of the Revised Code. The district hearing officer | 386 |
shall notify the parties and their respective representatives of | 387 |
the time and place of the hearing. | 388 |
The district hearing officer shall hold a hearing on a | 389 |
disputed issue or claim within forty-five days after the filing of | 390 |
the appeal under this division and issue a decision within seven | 391 |
days after holding the hearing. The district hearing officer shall | 392 |
notify the parties and their respective representatives in writing | 393 |
of the order. Any party may appeal an order issued under this | 394 |
division pursuant to division (D) of this section within fourteen | 395 |
days after receipt of the order under this division. | 396 |
(D) Upon the timely filing of an appeal of the order of the | 397 |
district hearing officer issued under division (C) of this | 398 |
section, the commission shall refer the claim file to an | 399 |
appropriate staff hearing officer according to its rules adopted | 400 |
under section 4121.36 of the Revised Code. The staff hearing | 401 |
officer shall hold a hearing within forty-five days after the | 402 |
filing of an appeal under this division and issue a decision | 403 |
within seven days after holding the hearing under this division. | 404 |
The staff hearing officer shall notify the parties and their | 405 |
respective representatives in writing of the staff hearing | 406 |
officer's order. Any party may appeal an order issued under this | 407 |
division pursuant to division (E) of this section within fourteen | 408 |
days after receipt of the order under this division. | 409 |
(E) Upon the filing of a timely appeal of the order of the | 410 |
staff hearing officer issued under division (D) of this section, | 411 |
the commission or a designated staff hearing officer, on behalf of | 412 |
the commission, shall determine whether the commission will hear | 413 |
the appeal. If the commission or the designated staff hearing | 414 |
officer decides to hear the appeal, the commission or the | 415 |
designated staff hearing officer shall notify the parties and | 416 |
their respective representatives in writing of the time and place | 417 |
of the hearing. The commission shall hold the hearing within | 418 |
forty-five days after the filing of the notice of appeal and, | 419 |
within seven days after the conclusion of the hearing, the | 420 |
commission shall issue its order affirming, modifying, or | 421 |
reversing the order issued under division (D) of this section. The | 422 |
commission shall notify the parties and their respective | 423 |
representatives in writing of the order. If the commission or the | 424 |
designated staff hearing officer determines not to hear the | 425 |
appeal, within fourteen days after the | 426 |
427 | |
the staff hearing officer may be filed as provided in division (D) | 428 |
of this section, the commission or the designated staff hearing | 429 |
officer shall issue an order to that effect and notify the | 430 |
parties and their respective representatives in writing of that | 431 |
order. | 432 |
Except as otherwise provided in this chapter and Chapters | 433 |
4121., 4127., and 4131. of the Revised Code, any party may appeal | 434 |
an order issued under this division to the court pursuant to | 435 |
section 4123.512 of the Revised Code within sixty days after | 436 |
receipt of the order, subject to the limitations contained in that | 437 |
section. | 438 |
(F) Every notice of an appeal from an order issued under | 439 |
divisions (B), (C), (D), and (E) of this section shall state the | 440 |
names of the claimant and employer, the number of the claim, the | 441 |
date of the decision appealed from, and the fact that the | 442 |
appellant appeals therefrom. | 443 |
(G) All of the following apply to the proceedings under | 444 |
divisions (C), (D), and (E) of this section: | 445 |
(1) The parties shall proceed promptly and without | 446 |
continuances except for good cause; | 447 |
(2) The parties, in good faith, shall engage in the free | 448 |
exchange of information relevant to the claim prior to the conduct | 449 |
of a hearing according to the rules the commission adopts under | 450 |
section 4121.36 of the Revised Code; | 451 |
(3) The administrator is a party and may appear and | 452 |
participate at all administrative proceedings on behalf of the | 453 |
state insurance fund. However, in cases in which the employer is | 454 |
represented, the administrator shall neither present arguments nor | 455 |
introduce testimony that is cumulative to that presented or | 456 |
introduced by the employer or the employer's representative. The | 457 |
administrator may file an appeal under this section on behalf of | 458 |
the state insurance fund; however, except in cases arising under | 459 |
section 4123.343 of the Revised Code, the administrator only may | 460 |
appeal questions of law or issues of fraud when the employer | 461 |
appears in person or by representative. | 462 |
(H) Except as provided in section 4121.63 of the Revised Code | 463 |
and division (K) of this section, payments of compensation to a | 464 |
claimant or on behalf of a claimant as a result of any order | 465 |
issued under this chapter shall commence upon the earlier of the | 466 |
following: | 467 |
(1) Fourteen days after the date the administrator issues an | 468 |
order under division (B) of this section, unless that order is | 469 |
appealed; | 470 |
(2) The date when the employer has waived the right to appeal | 471 |
a decision issued under division (B) of this section; | 472 |
(3) If no appeal of an order has been filed under this | 473 |
section or to a court under section 4123.512 of the Revised Code, | 474 |
the expiration of the time limitations for the filing of an appeal | 475 |
of an order; | 476 |
(4) The date of receipt by the employer of an order of a | 477 |
district hearing officer, a staff hearing officer, or the | 478 |
industrial commission issued under division (C), (D), or (E) of | 479 |
this section. | 480 |
(I) Payments of medical benefits payable under this chapter | 481 |
or Chapter 4121., 4127., or 4131. of the Revised Code shall | 482 |
commence upon the earlier of the following: | 483 |
(1) The date of the issuance of the staff hearing officer's | 484 |
order under division (D) of this section; | 485 |
(2) The date of the final administrative or judicial | 486 |
determination. | 487 |
(J) The administrator shall charge the compensation payments | 488 |
made in accordance with division (H) of this section or medical | 489 |
benefits payments made in accordance with division (I) of this | 490 |
section to an employer's experience immediately after the employer | 491 |
has exhausted the employer's administrative appeals as provided in | 492 |
this section or has waived the employer's right to an | 493 |
administrative appeal under division (B) of this section, subject | 494 |
to the adjustment specified in division (H) of section 4123.512 of | 495 |
the Revised Code. | 496 |
(K) Upon the final administrative or judicial determination | 497 |
under this section or section 4123.512 of the Revised Code of an | 498 |
appeal of an order to pay compensation, if a claimant is found to | 499 |
have received compensation pursuant to a prior order which is | 500 |
reversed upon subsequent appeal, the claimant's employer, if a | 501 |
self-insuring employer, or the bureau, shall withhold from any | 502 |
amount to which the claimant becomes entitled pursuant to any | 503 |
claim, past, present, or future, under Chapter 4121., 4123., | 504 |
4127., or 4131. of the Revised Code, the amount of previously paid | 505 |
compensation to the claimant which, due to reversal upon appeal, | 506 |
the claimant is not entitled, pursuant to the following criteria: | 507 |
(1) No withholding for the first twelve weeks of temporary | 508 |
total disability compensation pursuant to section 4123.56 of the | 509 |
Revised Code shall be made; | 510 |
(2) Forty per cent of all awards of compensation paid | 511 |
pursuant to sections 4123.56 and 4123.57 of the Revised Code, | 512 |
until the amount overpaid is refunded; | 513 |
(3) Twenty-five per cent of any compensation paid pursuant to | 514 |
section 4123.58 of the Revised Code until the amount overpaid is | 515 |
refunded; | 516 |
(4) If, pursuant to an appeal under section 4123.512 of the | 517 |
Revised Code, the court of appeals or the supreme court reverses | 518 |
the allowance of the claim, then no amount of any compensation | 519 |
will be withheld. | 520 |
The administrator and self-insuring employers, as | 521 |
appropriate, are subject to the repayment schedule of this | 522 |
division only with respect to an order to pay compensation that | 523 |
was properly paid under a previous order, but which is | 524 |
subsequently reversed upon an administrative or judicial appeal. | 525 |
The administrator and self-insuring employers are not subject to, | 526 |
but may utilize, the repayment schedule of this division, or any | 527 |
other lawful means, to collect payment of compensation made to a | 528 |
person who was not entitled to the compensation due to fraud as | 529 |
determined by the administrator or the industrial commission. | 530 |
(L) If a staff hearing officer or the commission fails to | 531 |
issue a decision or the commission fails to refuse to hear an | 532 |
appeal within the time periods required by this section, payments | 533 |
to a claimant shall cease until the staff hearing officer or | 534 |
commission issues a decision or hears the appeal, unless the | 535 |
failure was due to the fault or neglect of the employer or the | 536 |
employer agrees that the payments should continue for a longer | 537 |
period of time. | 538 |
(M) Except as otherwise provided in this section or section | 539 |
4123.522 of the Revised Code, no appeal is timely filed under this | 540 |
section unless the appeal is filed with the time limits set forth | 541 |
in this section. | 542 |
(N) No person who is not an employee of the bureau or | 543 |
commission or who is not by law given access to the contents of a | 544 |
claims file shall have a file in the person's possession. | 545 |
(O) Upon application of a party who resides in an area in | 546 |
which an emergency or disaster is declared, the industrial | 547 |
commission and hearing officers of the commission may waive the | 548 |
time frame within which claims and appeals of claims set forth in | 549 |
this section must be filed upon a finding that the applicant was | 550 |
unable to comply with a filing deadline due to an emergency or a | 551 |
disaster. | 552 |
As used in this division: | 553 |
(1) "Emergency" means any occasion or instance for which the | 554 |
governor of Ohio or the president of the United States publicly | 555 |
declares an emergency and orders state or federal assistance to | 556 |
save lives and protect property, the public health and safety, or | 557 |
to lessen or avert the threat of a catastrophe. | 558 |
(2) "Disaster" means any natural catastrophe or fire, flood, | 559 |
or explosion, regardless of the cause, that causes damage of | 560 |
sufficient magnitude that the governor of Ohio or the president of | 561 |
the United States, through a public declaration, orders state or | 562 |
federal assistance to alleviate damage, loss, hardship, or | 563 |
suffering that results from the occurrence. | 564 |
Section 102. That existing sections 2305.24, 2305.25, | 565 |
4121.04, and 4123.511 of the Revised Code are hereby repealed. | 566 |
Section 201. All items in this section are hereby | 567 |
appropriated out of any moneys in the state treasury to the | 568 |
credit of the designated fund. For all appropriations made in this | 569 |
section, those in the first column are for fiscal year 2010, and | 570 |
those in the second column are for fiscal year 2011. | 571 |
Appropriations | 572 |
FND | AI | AI TITLE | FY 2010 | FY 2011 | 573 |
574 | |
Workers' Compensation Fund Group | 575 |
5W30 | 845321 | Operating Expenses | $ | 50,838,924 | $ | 52,838,924 | 576 | ||||
5W30 | 845402 | Rent - William Green Building | $ | 6,149,960 | $ | 6,011,960 | 577 | ||||
5W30 | 845410 | Attorney General Payments | $ | 3,793,650 | $ | 3,793,650 | 578 | ||||
TOTAL WCF Workers' Compensation | 579 | ||||||||||
Fund Group | $ | 60,782,534 | $ | 62,644,534 | 580 | ||||||
TOTAL ALL BUDGET FUND GROUPS | $ | 60,782,534 | $ | 62,644,534 | 581 |
RENT - WILLIAM GREEN BUILDING | 582 |
The foregoing appropriation item 845402, Rent - William Green | 583 |
Building, shall be used for rent and operating expenses for the | 584 |
space occupied by the Industrial Commission in the William Green | 585 |
Building. | 586 |
Section 210. Nothing in this act shall affect the term of | 587 |
any member of the Industrial Commission Nominating Council | 588 |
serving on the effective date of this section. | 589 |
The Governor shall appoint to the Industrial Commission | 590 |
Nominating Council a person to serve as a member who represents | 591 |
employers and a person to serve as a representative from the Ohio | 592 |
Association for Justice not later than fourteen days after the | 593 |
effective date of this section, and those members shall take | 594 |
office not later than ninety days after the effective date of | 595 |
this section. The Governor shall choose the employer | 596 |
representative from a list of two names selected by the National | 597 |
Federation of Independent Business and shall appoint that | 598 |
employer representative to a term ending October 20, 2013. The | 599 |
Governor shall appoint the representative from the Ohio | 600 |
Association for Justice to a term ending October 20, 2010. | 601 |
Except as otherwise provided in this section, the | 602 |
appointments made by the Governor pursuant to this section shall | 603 |
comply with section 4121.04 of the Revised Code, as amended by | 604 |
this act. | 605 |
Section 230. Law contained in the main operating | 606 |
appropriations act of the 128th General Assembly that applies | 607 |
generally to the appropriations made in that act also applies | 608 |
generally to the appropriations made in this act. | 609 |
Section 301. The provisions of law contained in this act, and | 610 |
their applications, are severable. If any provision of law | 611 |
contained in this act, or if any application of any provision of | 612 |
law contained in this act, is held invalid, the invalidity does | 613 |
not affect other provisions of law contained in this act and their | 614 |
applications that can be given effect without the invalid | 615 |
provision or application. | 616 |
Section 401. An item that composes the whole or part of an | 617 |
uncodified section of law contained in this act has no effect | 618 |
after June 30, 2011, unless the context clearly indicates | 619 |
otherwise. | 620 |
Section 501. Except as otherwise provided in this act, the | 621 |
amendment or enactment by this act of a section of law is exempt | 622 |
from the referendum because it is or relates to an appropriation | 623 |
for current expenses within the meaning of Ohio Constitution, | 624 |
Article II, Section 1d and section 1.471 of the Revised Code and | 625 |
therefore takes effect immediately when this act becomes law. | 626 |
Section 503. The amendment of sections 2305.24, 2305.25, and | 627 |
4123.511 of the Revised Code by this act are subject to the | 628 |
referendum under Ohio Constitution, Article II, Section 1c and | 629 |
therefore take effect on the ninety-first day after this act is | 630 |
filed with the Secretary of State. | 631 |