Ohio Administrative Code Search

...applying for payment from the state insurance fund due to an injury, occupational disease, or death may be completed by the employee, employer, medical provider, or other interested party. If someone other than the employee submits a FROI-1 or equivalent, the bureau may contact the employee to attempt to verify that the employee wishes to pursue the application. To accept or deny the validity of ...

...applying for payment from the state insurance fund due to an injury, occupational disease, or death may be completed by the employee, employer, medical provider, or other interested party. If someone other than the employee submits a FROI or equivalent, the bureau may contact the employee to attempt to verify that the employee wishes to pursue the application. To accept or deny the validity of the...

...represent the interest of the state insurance fund and/or the surplus fund. (4) The bureau shall make payment on orders of the commission, and district or staff hearing officers in accordance with law and rules of the bureau and the industrial commission. (5) If the administrator or his or her designee is of the opinion that an emergency exists which requires an immediate hearing of a claim, he ...

...represent the interest of the state insurance fund and/or the surplus fund. (4) The bureau will make payment on orders of the commission, and district or staff hearing officers in accordance with law and rules of the bureau and the industrial commission. (5) If the administrator or their designee is of the opinion that an emergency exists which requires an immediate hearing of a claim, they may ...

...entative appeals on behalf of the state insurance fund and/or the surplus fund. (2) The named eligible appellants may appeal decisions of the district hearing officers, or staff hearing officers. (3) Decisions of district hearing officers are appealable to the staff hearing officers. Decisions of the staff hearing officers are appealable to the industrial commission. (4) Appeals shall be ...

...entative appeals on behalf of the state insurance fund and/or the surplus fund. (2) The named eligible appellants may appeal decisions of the district hearing officers, or staff hearing officers. (3) Decisions of district hearing officers are appealable to the staff hearing officers. Decisions of the staff hearing officers are appealable to the industrial commission. (4) Appeals shall be filed in accordance with ...

...entative appeals on behalf of the state insurance fund or the surplus fund. (2) The named eligible appellants may appeal decisions of district hearing officers or staff hearing officers, in accordance with rule 4121-3-18 of the Administrative Code. (3) Decisions of district hearing officers are appealable to staff hearing officers. Decisions of the staff hearing officers are appealable to th...

...be appropriate, consistent with general insurance principles, to evaluate a claim for settlement. When a settlement agreement has been approved by the administrator, a notice of approval shall be sent to the claimant, the employer, and their representatives, informing them of their rights to withdraw consent to the settlement agreement within thirty days. If written notice of the withdrawal of con...

...be appropriate, consistent with general insurance principles, to evaluate a claim for settlement. When a settlement agreement has been approved by the administrator, a notice of approval shall be sent to the claimant, the employer, and their representatives, informing them of their rights to withdraw consent to the settlement agreement within thirty days. . An employer shall not deny or withdraw consent to a settleme...

... appropriate, consistent with general insurance principles, to evaluate the claim for a lump sum advancement. (3) For a lump sum advancement from an award of compensation made pursuant to section 4123.58 of the Revised Code or from an award of death benefits pursuant to section 4123.59 of the Revised Code, if the bureau determines that the lump sum advancement is advisable, the bureau shall ca...

... appropriate, consistent with general insurance principles, to evaluate the claim for a lump sum advancement. (3) For a lump sum advancement from an award of compensation made pursuant to section 4123.58 of the Revised Code or from an award of death benefits pursuant to section 4123.59 of the Revised Code, if the bureau determines the lump sum advancement is advisable, the bureau will calculat...

...rs that pay premiums into the state insurance fund. (a) The employer must have had active workers' compensation coverage on the date of injury of the claim. (b) The employer must be current with respect to all payments due the bureau, as defined in paragraph (A)(1)(b) of rule 4123-17-14 of the Administrative Code. (c) The employer must be current on the payment schedule of any part-pay agreemen...

...rs that pay premiums into the state insurance fund. (a) The employer must have had active workers' compensation coverage on the date of injury of the claim. (b) The employer must be current with respect to all payments due the bureau, as defined in paragraph (A)(1)(b) of rule 4123-17-14 of the Administrative Code. (c) The employer must be current on the payment schedule of any part-pay agreemen...

... in maintaining the solvency of the insurance fund, establishing policies and procedures for fiscal management, receiving and disbursing funds from the state insurance fund, and preparing the bureau's budget. (B) A division responsible for the medical services function to assist the administrator in establishing and maintaining a quality pool of medical and vocational service providers, devel...

...fessional malpractice and liability insurance, and provide proof of such coverage to BWC upon request. (7) Provide documentation of the provider's malpractice history for the previous five years. (8) Not have any outstanding provider overpayment or other indebtedness to the bureau which has been certified to the attorney general for collection. (9) Provide proof of and maintain workers' co...

...fessional malpractice and liability insurance, and provide proof of such coverage to BWC upon request. (6) Provide documentation of the provider's malpractice history for the previous five years. (7) Not have any outstanding provider overpayment or other indebtedness to the bureau which has been certified to the attorney general for collection. (8) Maintain workers' compensation coverage t...

...tation of intent to obtain and maintain insurance coverage as required by the MCO contract, with proof of such coverage to be submitted to the bureau prior to execution of the contract, and current workers' compensation coverage. (18) Attestation of intent to obtain and maintain professional accreditations as required by the MCO contract, with proof of such accreditations to be submitted to the bureau prior to execu...

...on of intent to obtain and maintain insurance coverage as required by the MCO contract, with proof of such coverage to be submitted to the bureau prior to execution of the contract, and current workers' compensation coverage. (18) Attestation of intent to obtain and maintain professional accreditations as required by the MCO contract, with proof of such accreditations to be submitted to the b...

...rule, "agent" of the MCO means: (a) An insurance agent or broker contracted by the MCO and licensed by the Ohio department of insurance pursuant to Title XXXIX of the Revised Code; (b) A corporation or entity contracted by the MCO to conduct non-telephonic marketing that has not had and does not contemplate having activities of any nature with the Ohio workers' compensation system so as to crea...

...rule, "agent" of the MCO means: (a) An insurance agent or broker contracted by the MCO and licensed by the Ohio department of insurance pursuant to Title XXXIX of the Revised Code; (b) A corporation or entity contracted by the MCO to conduct non-telephonic marketing that has not had and does not contemplate having activities of any nature with the Ohio workers' compensation system so as to crea...

...count and not charged through the state insurance fund to the employer against whom the claim was filed.

... programs and the children's health insurance program; hospital inpatient prospective payment systems for acute care hospitals and the long-term care hospital prospective payment system and policy changes and fiscal year 2025 rates; quality programs requirements; and other policy changes final rule," 89 Fed. Reg. 68986 - 70046 (2024). (c) The department of health and human services, centers for ...

...onnection with claims against the state insurance fund, public work relief employees' compensation fund, coal workers pneumoconiosis fund, or marine industry fund in accordance with section 126.30 of the Revised Code. For the purpose of this rule, the required payment date is the date on which payment is due under the terms of a written agreement between the bureau, or its agent, and the provider. Payment will be ma...

... make payments of premiums to the state insurance fund, as required by Chapter 4123. of the Revised Code and the rules of the industrial commission and the bureau of workers' compensation, or fails to comply with the requirements for self-insurance under section 4123.35 of the Revised Code and the rules of the industrial commission or bureau of workers' compensation, shall be regarded as a non-complying employer. (B...

...e payments of premiums to the state insurance fund, as set forth by Chapter 4123. of the Revised Code and the rules of the industrial commission and the bureau of workers' compensation, or fails to comply with the requirements for self-insurance under section 4123.35 of the Revised Code and the rules of the industrial commission or bureau of workers' compensation, is a non-complying employer. ...