Current through all regulations passed and filed through September 16, 2024
(A) For purposes of
this rule:
(1) "Allowed physical condition" -
Means a physical condition diagnosed by an approved physician that arises from
an injury inflicted by a ward. It is also a physical condition resulting from
substantial aggravation of a pre-existing condition, if such aggravation arises
from an injury inflicted by a ward.
(2) "Approved physician" - Means a
psychologist, psychiatrist, or physician from the approved physician list. In
the event an injury requires emergency room treatment, the emergency room
physician will be considered an approved physician for purposes of the initial
diagnosis and evaluation of the allowed physical or psychological
condition.
(3) "Allowed
psychological condition" - Means a psychological condition, diagnosed by an
approved psychiatrist or psychologist from the approved physician list that
develops after, and is related to, the allowed physical condition.
(4) "Date of injury" - Means the date the
event triggering the claim occurred.
(5) "Disabled" - Means the employee is unable
to perform the essential functions of their job due to an injury while
on-duty.
(6) "Inflicted by a ward"
- Means injured by a ward of the state in one or more of the following ways:
(a) an attempt to subdue, control or restrain
a ward's inappropriate behavior;
(b) as the result of being physically harmed
in the course of the employee's duty, as long as the injury was not accidental
in nature or caused by the employee's own misconduct or negligence; or
(c) during the pursuit of a ward in
such circumstances where a ward attempts to flee following in appropriate
behavior listed in this paragraph.
(7) "Ward" - Means an inmate, patient,
resident, client, youth or student.
(B) Eligibility.
(1) Occupational injury leave benefits (OIL).
Each permanent employee employed by an agency listed in section
124.381 of the Revised Code who
sustains an allowed physical condition or an allowed psychological condition
filed on or after February 1, 2010 shall, pursuant to this rule and with the
approval of the director of the department of administrative services (DAS),
receive OIL. Any subsequent injury that is determined to be an aggravation of a
previous injury for which OIL was approved shall not be considered
an
independent injury. It is the employee's responsibility to prove that the
allowed physical condition or an allowed psychological condition was inflicted
by a ward.
(2) Salary continuation
benefits. All permanent employees, including employees not eligible for OIL as
described in paragraph (B)(1) of this rule, who sustain physical injuries or
other disabilities in the performance of and arising out of state employment on
or after February 1, 2010 may apply for salary continuation benefits for each
independent injury sustained.
(3)
If the employee's OIL claim is denied and the workers' compensation claim is
still pending, the employee may apply for salary continuation
benefits.
(C)
Application. In order to receive OIL or salary continuation benefits, the
injured employee shall, within twenty days from the date of the injury,
complete and submit the employee's portion of the claim application to the
employee's appointing authority. If the employee is physically unable to
complete the application, someone acting on the employee's behalf may complete
and submit the application.
(D)
Amount and length of benefit.
(1) OIL
benefits. In no case shall the payment of OIL exceed nine hundred sixty hours
per independent injury. A part-time employee's OIL benefits shall be based on
the average number of hours worked during the six weeks immediately preceding
the related injury, up to forty hours per week.
(2) Salary continuation benefits. In no case
shall the payment of salary continuation benefits exceed four hundred eighty
hours per independent injury. Any leave provisionally granted under OIL shall
count towards the four hundred eighty hour maximum for salary continuation
benefits.
(3) Payment. Payment of
OIL or salary continuation benefits will begin immediately upon the employee's
filing of an application, retroactive to the date the employee became disabled,
and will be paid at the employee's total rate of pay.
(E) Other benefits. OIL and salary
continuation benefits are in lieu of any other employer-paid leave or workers'
compensation benefits. Employees receiving OIL or salary continuation benefits
are in active pay status and shall continue to accrue sick leave and personal
leave. During the time an employee is receiving OIL or salary continuation
benefits under this rule, the employee shall be exempt from receiving vacation
leave. OIL and salary continuation benefits shall not be charged against the
employee's accumulated sick leave balance.
(F) Employee's responsibilities. In order to
receive OIL or salary continuation benefits, the injured employee must also:
(1) Follow the agency's accident or injury
reporting guidelines;
(2) Be
evaluated by an approved physician to determine if the injury will keep the
employee from performing the essential functions of the employee's position. If
the employee is unable to schedule an appointment with an approved physician
within forty-eight hours of the date of the injury, the employee must contact
the agency's workers' compensation coordinator. The employee must continue to
seek treatment from an approved physician for the duration of the
benefit;
(3) Ensure that an
approved physician completes and returns the DAS designated medical
form;
(4) Demonstrate that any
transitional work program offered by the agency is not appropriate based upon
an approved physician's restrictions;
(5) Apply for workers' compensation benefits
at the time that OIL or salary continuation is being requested; and.
(6) Receive approval from the bureau of
workers' compensation for an additional injury allowance, in the case where,
after an initial diagnosis, the injury is determined to more extensive and the
employee requests an extension of benefits.
(G) Failure to be evaluated. If the employee
refuses to be evaluated by an approved physician, the application for OIL or
salary continuation benefits will be denied and will be reviewed by the bureau
of workers' compensation as a normal request for workers' compensation
benefits. If the employee has been paid any OIL or salary continuation
benefits, the employee shall substitute sick leave, vacation leave, personal
leave, compensatory time, or reimburse the employer for any benefits
received.
(H) Appointing
authority's responsibilities. The employee's appointing authority or designee
must promptly review the employee's claim and forward the employee's paperwork
to the director or authorized designee within five days of receiving the
employee's application. In the case of OIL, the appointing authority or
designee should also forward any documentation certifying or disputing that the
injury was sustained in the line of duty and was inflicted by a ward. In the
case of salary continuation benefits, the appointing authority should also
forward any documentation certifying or disputing that the injury was sustained
in the line of duty, as well as any witness statements.
(I) Medical treatment and return to work.
It shall be
the responsibility of the employee to receive necessary medical treatment and
to return to active work status at the earliest time permitted by the approved
physician.
(J) Termination of
benefits. OIL and salary continuation benefits shall terminate when:
(1) The employee engages in any activity that
adversely affects the employee's recovery;
(2) The employee engages in any outside
activity for wage or profit if the outside activity is inconsistent with the
employee's medical or psychological restrictions;
(3) The employee knowingly makes a false or
misleading statement, or alters, falsifies, destroys or conceals any document
in order to receive the benefit;
(4) The approved physician releases the
employee back to work;
(5) The
employee is incarcerated and the incarceration prevents the employee from
coming to work;
(6) The employee's
workers' compensation claim is denied by the bureau of workers'
compensation;
(7) The industrial
commission determines the employee has reached maximum medical
improvement;
(8) The employee is
disqualified from receiving workers' compensation benefits or if the employee
accepts workers' compensation temporary total disability benefits; or
(9) The employee is no longer employed by the
state.
(K) Denied claims.
(1) If an agency denies an employee's
application for OIL on the basis that the injury was not inflicted by a ward,
OIL shall cease. The employee may appeal the decision to DAS within twenty days
of the postmark on the letter of denial and the decision of DAS shall be
binding. If the employee's claim is approved by DAS, the agency shall render
OIL benefits to the employee back to the time of the initial agency denial. If
the employee's OIL claim is denied by DAS, the employee may be eligible for
salary continuation benefits.
(2)
If the bureau of workers' compensation denies the claim on the basis that the
injury was not an allowed physical or psychological condition, OIL or salary
continuation benefits shall cease. The employee may appeal the decision to the
industrial commission. If the employee's claim is approved by the industrial
commission, the agency shall render OIL or salary continuation benefits on the
employee back to the time of the initial denial by the bureau of workers'
compensation. If the employee's claim is denied by the industrial commission,
the employee shall substitute sick leave, vacation leave, personal leave,
compensatory time, or reimburse the employer for any benefits
received.
(L) Insurance.
An employee who receives OIL or salary continuation benefits is responsible for
the employee's share of health insurance premiums.
(M) Transitional work program. An employee
receiving OIL or salary continuation benefits may participate in a transitional
work program pursuant to rule
123:1-33-07 of the
Administrative Code. If a permanent employee is given a transitional work
assignment with less than the employee's regularly scheduled hours, the
employee may use OIL or salary continuation hours to supplement up to the
amount of the employee's regularly scheduled hours. If an employee does not
successfully complete a transitional work program, the employee may resume OIL
or salary continuation benefits up to the number of hours that remain for the
injury.
