Ohio Revised Code Search

...ficers are full-time employees of the industrial commission and shall be admitted to the practice of law in this state. Staff hearing officers shall not engage in any other activity that interferes with their full-time employment by the commission during normal working hours. (B) Except as provided in division (D) of this section, staff hearing officers have original jurisdiction to hear and decide the follow...

...nd to present evidence and arguments in support of their positions or in rebuttal to the evidence or arguments of other parties; (2) A public hearing; (3) Written decisions; (4) Impartial assignment of staff and district hearing officers and assignment of appeals from a decision of the administrator of workers' compensation to a district hearing officer located at the commission service office that is the close...

...the bureau of workers' compensation, which is hereby created. The administrator, with the advice and consent of the board, shall pay into the safety and hygiene fund, which is hereby created in the state treasury, the portion of the contributions paid by employers, calculated as though all employers paid premiums based upon payroll, not to exceed one per cent thereof in any year, as is necessary for the payment of t...

...a policy manual as to the basis upon which referrals to other than commission specialists will be made; (5) Designate two hearing examiners and two medical staff members who shall be specially trained in medical-legal analysis. The specialists shall write evaluations of medical-legal problems upon assignment by other hearing examiners or the commission. The director of administrative services upon commission advice...

...s; (C) Make payment on orders of the industrial commission and district and staff hearing officers as provided in section 4123.511 of the Revised Code; (D) Serve as representative of the state insurance fund; (E) Establish a legal section within the bureau to provide legal advice and assistance to the administrator and the administrator's staff as to claims procedure and policy; appeals to be lodged on behalf of t...

... shall appoint a service director for each service office who shall have all of the following duties: (1) Provide each claimant and employer fair, impartial, and equal treatment; (2) Recommend any needed improvements for changes in staff size and accessibility to service offices; (3) Recommend to the administrator appropriate action concerning any allegations of misconduct, abuse of authority, or fraud committed i...

...their rights and responsibilities under Chapter 4123. of the Revised Code and as part of that program prepare and distribute pamphlets, which clearly and simply explain at least all of the following: (1) The rights and responsibilities of claimants and employers; (2) The procedures for processing claims; (3) The procedure for fulfilling employer responsibility; (4) All applicable statutes of limitation; (5)...

... bureau designates. (C) Personnel of each administrative section of the bureau and the commission shall receive training programs adequate to ensure all of the following: (1) Familiarity with section duties and policy; (2) Familiarity with duties and policy of sections which directly relate to their section; (3) Continuous updating of policy and techniques for accomplishing section duties.

...ments are accompanied by information which clearly indicates the source of payment, type of payment, method of computation, inclusive days of payment, reason for changes in payment, and telephone number or address for inquiries; (B) Adopt rules to govern the method of issuing and delivering checks, including time limits for issuance of checks; (C) Set standards and inform claimant of procedure for attorney or oth...

...ave the attendant computer system which supports such activity and measures the outcomes and the savings. (10) Management experience and flexibility to be able to react quickly to the needs of the bureau in the case of required change in federal or state requirements. (G)(1) The administrator may decertify a managed care organization if the managed care organization does any of the following: (a) Fails to maintain...

...pital, and rehabilitation services and supplies to an employee for an injury or occupational disease that is compensable under this chapter or Chapter 4123., 4127., or 4131. of the Revised Code, and to regulate contracts with managed care organizations pursuant to this chapter. (1) The rules shall include, but are not limited to, the following: (a) Procedures for the resolution of medical disputes between a...

... disease that is compensable under this chapter or Chapter 4123., 4127., or 4131. of the Revised Code. In adopting the standards, the administrator shall use nationally recognized accreditation standards. The standards the administrator adopts must provide that a qualified plan provides for all of the following: (1) Criteria for selective contracting of health care providers; (2) Adequate plan structure and financi...

...days after completion of its hearing. A failure to issue the order within the seventy-five-day time period shall result in dissolution of the summary suspension order but shall not invalidate any subsequent, final adjudication order. (G) As used in this section, "provider" does not include a hospital.

... the Revised Code or any other criminal offense related to the delivery of or billing for health care benefits. (b) There exists an entry of judgment against the person, health care provider, managed care organization, or its owner, or an officer, authorized agent, associate, manager, or employee of a person, provider, or organization and proof of the specific intent of the person, health care provider, managed care...

...r more managed care organizations for each state office, agency, institution, board, or commission, except for a public college or university, unless otherwise agreed to between the department and a state office, agency, institution, board, or commission.

...Each contract the administrator of workers' compensation enters into with a managed care organization under division (B)(4) of section 4121.44 of the Revised Code shall require the managed care organization to enter into a data security agreement with the state board of pharmacy governing the managed care organization's use of the board's drug database established and maintained under section 4729.75 of the Rev...

...ief ombudsperson with the office space, supplies, and clerical assistance that will enable the chief ombudsperson and the ombudsperson system staff to perform their duties effectively. The ombudsperson program shall be funded out of the budget of the bureau and the chief ombudsperson and the ombudsperson system staff shall be carried on the bureau payroll. The chief ombudsperson and the ombudsperson system shall be u...

...n 35 of Article II, Ohio Constitution. Chapter 4167. of the Revised Code and rules and standards adopted thereunder are not the rules or enactment referred to in this division and shall not be considered as such for purposes of this section. (B) If a staff hearing officer, in the course of the staff hearing officer's determination of a claim for an additional award under Section 35 of Article II, Ohio Constitution...

...e, or death resulted from an employer's failure to comply with a specific safety rule for the protection of the lives, health, and safety of employees shall be forever barred unless it is filed within one year after the date of the injury or death or within one year after the disability due to the occupational disease began.

... order of the administrator or of the industrial commission or by a self-insuring employer but were obtained at a frequency or in an amount that is not medically necessary. The program shall be implemented in a manner that is substantially similar to the coordinated services programs established for the medicaid program under sections 5164.758 and 5167.13 of the Revised Code.

...sable occupational diseases pursuant to Chapter 4123., 4127., or 4131. of the Revised Code to return to work or to assist in lessening or removing any resulting impairment.

...(A) The authority granted to the administrator of workers' compensation pursuant to sections 4121.61 to 4121.69 of the Revised Code includes the authority to do all of the following: (1) Contract with any public or private person for the rendition of rehabilitation services; (2) Take actions and utilize money in the state insurance fund as necessary to obtain federal funds and assistance in the max...

...nes could probably be rehabilitated to achieve the goals established by section 4121.61 of the Revised Code and who agree to undergo rehabilitation shall be paid living maintenance payments for a period or periods which do not exceed six months in the aggregate, unless review by the administrator or the administrator's designee reveals that the claimant will be benefited by an extension of such payments. Living main...

...Notwithstanding section 4123.512 of the Revised Code, no person may appeal to court any action or decision issued under sections 4121.61 to 4121.69 of the Revised Code. A person may, however, appeal the decision pursuant to section 4123.511 of the Revised Code.

...Self-insuring employers may furnish rehabilitation services as long as the quality and content of the services are equal to or greater than that provided by the bureau of workers' compensation.