Workers’ Compensation Benefits Reduction Bill Passed

Workers’ Compensation Benefits Reduction Bill Passed

On March 8, 2006, the legislature passed Amended Substitute Senate Bill 7 which reduces workers’ compensation benefits paid to injured workers.

Note: A referendum challenge to Amended Substitute Senate Bill 7 was filed, but failed to receive enough signatures.

Note on Effective Date: The effective date of Am. Sub S.B. 7 depends on the provision. Provisions which the referendum did not challenge became effective June 30, 2006; the provisions challenged by the referendum petition became effective August 25, 2006. See which effective date applies to the various provisions of Am. Sub. S.B. 7.

Changes Affecting Injured Workers

Injury:

• R.C. 4123.01(C)(1) is amended to require that a psychological injury is only compensable if there is a physical injury to the person suffering the psychological harm. This requirement overrides the Supreme Court’s decision in Bailey v. Republic Engineered Steels, Inc. (2001), 91 Ohio St.3d 38, 2001-Ohio-236.
• R.C. 4123.01(C)(4) adds a requirement that there must be “substantial aggravation” in order for aggravation of an injury to be compensable. This requirement overrides the Supreme Court’s decision in Schell v. Globe Trucking, Inc. (1990), 48 Ohio St.3d 1.
• R.C. 4123.54(G) provides that if a condition is “substantially aggravated”, no compensation is payable once the condition returns to the state it was in before the injury.

Method of Payment:

• R.C. 4123.311 permits the BWC to require use of debit cards and/or direct deposit for payments.

Appeals to Court:

• R.C. 4123.512(D) provides that a claimant cannot dismiss a case in the Common Pleas court without the employer’s consent if the employer filed the appeal. This overrides the Supreme Court’s decision in Kaiser v. Ameritemps, Inc. (1999), 84 Ohio St.3d 411, 1999-Ohio-360.
• R.C. 4123.512(G) raises the attorney fee paid in cases where an injured worker establishes the right to participate in an appeal to court from $2,500 to $4,200.

Continuing Jurisdiction:

• R.C. 4123.52 reduces continuing jurisdiction in medical only claims from 6 years to 5 years, and reduces continuing jurisdiction in lost time claims from 10 years to 5 years.

Wage Loss:

• R.C. 4123.56(B)(1) reduces the total amount of weeks of wage loss compensation by counting R.C. 4123.67 (rehabilitation) wage loss compensation as part of the overall 200 week limit for payment of working wage loss.
• R.C. 4123.56(B)(2) reduces non-working wage loss from 200 to 52 weeks but, together with R.C. 4123.56(B)(3) raises the total possible weeks of wage loss compensation to 226 by providing that 26 weeks of non-working wage compensation do not count against the 200 week limit for wage loss compensation.

Permanent Partial

• R.C. 4123.57 reduces the 40 week waiting period to 26 weeks.
• R.C. 4123.57(B) raises the maximum facial disfigurement award from $5,000 to $10,000.

Permanent Total

• R.C. 4123.58(A) reduces that amount of permanent total paid in some situations by providing that the permanent total amount is based on the average weekly wage at the time of the injury or occupational disease. This overrides the Supreme Court’s decision in State, ex rel. Lemke v. Brush Wellman, Inc. (1998), 84 Ohio St.3d 161.
• R.C. 4123.61 also limits recalculation of the average weekly wage for permanent total awards.
• R.C. 4123.58(C)(1) provides that the loss of one limb does not equal the loss of two body parts, overriding the Supreme Court’s decision in State, ex rel. Thomas v. Indus. Comm. (2002), 97 Ohio St.3d 37, 2002-Ohio-5306.

Settlement

• R.C. 4123.65(A) permits filing settlement applications without the employer’s signature in certain situations (employer no longer in state, claim not in employer’s experience, employer did not comply with 4123.35) and indicates that if a settlement application is filed without the employer’s signature and the employer doesn’t respond to a notice within 30 days, the employer’s signature is not required.
• R.C. 4123.65(C) provides that a settlement can be voided if the employee dies within the 30 day waiting period after the settlement is signed.

Changes Affecting the BWC

Fraud

• R.C. 2913.48 creates categories of fraud applicable to employers.

Child Support

• R.C. 3121.0311 provides that if a claim is subject to withholding for child support, the BWC (or self-insurer) shall hold lump sum payments for 30 days to permit payment of the attorney’s fee, if the attorney files the appropriate paperwork.

Oversight Commission

• R.C. 4121.12 provides that the Oversight Commission cannot create limits on conducting business with investment managers that are more restrictive than those contained in R.C. 3517.13.

Investigations

• R.C. 4121.131 establishes the BWC’s special investigations department as a criminal justice agency authorized to access criminal databases.

Medical

• R.C. 4121.441 permits the BWC to exempt medical services which were approved by presumptive authorization or standard guidelines from the dispute resolution process.
• R.C. 4121.444 establishes health care fraud penalties.

Premiums/payments

• R.C. 4123.29 requires the administrator to create a program to mitigate significant first time claims from excluding employers from group-rated plans.
• R.C. 4123.311 permits the BWC to use direct deposit for payments and also permits BWC to contract with an agent to provide debit cards for claimants to use to access workers’ compensation payments.
• R.C. 4123.32 provides penalties for late payment of premiums by employers.
• R.C. 4123.35 provides for assessments for the surplus fund, and provides penalties for late payments.

Public Records

• R.C. 4123.88 indicates what matters are excluded from public records laws and what information shall be given to journalists.