Ohio Revised Code Search

... 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 the state ins...

...te action concerning any allegations of misconduct, abuse of authority, or fraud committed in his service office; (4) Ensure that all current bureau rules and operating procedures are carried out by all employees under his direction; (5) Assist claimants and employers who contact the service office for information or assistance with respect to claims processing and coverage. (B) The administrator shall assign to ...

...(A) The administrator of workers' compensation shall operate a program designed to inform employees and employers of 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 process...

...ers' compensation and the industrial commission shall cooperatively implement with adequate staff a comprehensive in-service training program for their respective personnel that provides training with respect to the workers' compensation system in at least all of the following areas: (1) General policies; (2) Organization; (3) Regulations; (4) Management training, including supervision, system design, and budget ...

...The administrator of workers' compensation shall: (A) Adopt rules to ensure that all compensation payments 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 ...

...(A) The administrator of workers' compensation shall oversee the implementation of the Ohio workers' compensation qualified health plan system as established under section 4121.442 of the Revised Code. (B) The administrator shall direct the implementation of the health partnership program administered by the bureau as set forth in section 4121.441 of the Revised Code. To implement the health partnership program and ...

...rovisions for provider referrals, pre-admission and post-admission approvals, second surgical opinions, and other cost management techniques; (j) Antifraud mechanisms; (k) Standards and criteria for the bureau to utilize in certifying or recertifying a health care provider or a managed care organization for participation in the health partnership program; (l) Standards for the bureau to utilize in penalizing ...

...(A) The administrator of workers' compensation shall develop standards for qualification of health care plans of the Ohio workers' compensation qualified health plan system to provide medical, surgical, nursing, drug, hospital, 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. In a...

...icted of or pleaded guilty to any other criminal offense related to the delivery of or billing for health care services. (3) The bureau determines, by clear and convincing evidence, that the continued participation by the provider in the health partnership program presents a danger of immediate and serious harm to claimants. (B) The bureau shall serve a written order of summary suspension in accordance with sec...

...he attorney general may settle or compromise any action brought under this section with the approval of the administrator. Notwithstanding any other law providing a shorter period of limitations, the attorney general or a self-insuring employer may bring an action to enforce this section at any time within six years after the conduct in violation of this section terminates. (E) The availability of remedies under th...

...fice, 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...

...ers' compensation and the industrial commission. The industrial commission nominating council shall appoint a chief ombudsperson. The chief ombudsperson, with the advice and consent of the nominating council, may appoint such assistant ombudspersons as the nominating council deems necessary. The position of chief ombudsperson is for a term of six years. A person appointed to the position of chief ombudsperson shall s...

...f hearing officer's decision, if the commission refuses to hear the appeal under division (E) of section 4123.511 of the Revised Code, or a decision of the commission, if the commission hears the appeal under that division, to a court of common pleas pursuant to the Rules of Civil Procedure. An appeal operates to stay the payment of the fine pending the appeal. (D) The administrator shall deposit all penalties colle...

...A claim for an additional award under Section 35 of Article II, Ohio Constitution, alleging that an injury, occupational disease, 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 t...

...e 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.

...(A) As used in sections 4121.61 to 4121.69 of the Revised Code, "self-insuring employer" has the same meaning as in section 4123.01 of the Revised Code. (B) The administrator of workers' compensation, with the advice and consent of the bureau of workers' compensation board of directors, shall adopt rules, take measures, and make expenditures as it deems necessary to aid claimants who have sustained compensable inju...

...(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...

...Claimants who the administrator of workers' compensation determines 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 ...

...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.

...(A) Except as provided in division (D) of this section, the administrator of workers' compensation shall pay the expense of providing rehabilitation services, counseling, training, and living maintenance payments from the surplus fund established by section 4123.34 of the Revised Code. (B) Living maintenance payments are not subject to garnishment, levy, or attachment. (C) Sections 4123.343, 4123.63, and 4123.64 of...

...(A) The administrator of workers' compensation, with the advice and consent of the bureau of workers' compensation board of directors, shall adopt rules: (1) For the encouragement of reemployment of claimants who have successfully completed prescribed rehabilitation programs by payment from the surplus fund established by section 4123.34 of the Revised Code to employers who employ or re-employ the claimants. The per...

...In the event a claimant sustains an injury or occupational disease or dies as a result of any injury or disease received in the course of and arising out of the claimant's participation in a rehabilitation program, the claimant or, in the case of death, a dependent of the claimant, may file a claim for compensation and benefits. All compensation and benefit awards made as a result of the injury, disease, or death sha...

...(A) The administrator of workers' compensation may establish compensation plans, including schedules of hourly rates, for the compensation of professional, administrative, and managerial employees who are employed to fulfill the duties placed upon the bureau of workers' compensation pursuant to sections 4121.61 to 4121.69 of the Revised Code. The administrator may establish rules or policies for the administrat...