Ohio Administrative Code
Title 4123 - Bureau of Workers' Compensation
Chapter 4123-3 - Claims Procedure
Section 4123-3-15.1 - Dismissal of an application for the determination of percentage of permanent partial disability
Universal Citation: OH Admin Code 4123-3-15.1
Current through all regulations passed and filed through September 16, 2024
(A) This paragraph of this rule applies to any employee's application for a determination of the percentage of permanent partial disability or for an increase of permanent partial disability filed on or after September 29, 2017.
(1)
If an employee
who files an application for a determination of percentage of permanent partial
disability or for an increase of permanent partial disability fails to respond
to the bureau's attempt to schedule a medical examination, or fails to attend a
medical examination scheduled under section
4123.57 of the Revised Code
without notice or explanation, the bureau shall dismiss the application without
prejudice. The employee, the employer, or their representative may object to
the bureau's tentative order dismissing the application within twenty days
after receipt of the notice as provided in section
4123.57 of the Revised Code, and
if the employee, the employer, or their representative timely notify the bureau
of an objection, the bureau shall refer the matter to a district hearing
officer for a hearing.
(a)
The bureau shall contact the employee to schedule the
employee for an examination on an application for a determination of percentage
of permanent partial disability or for an increase of permanent partial
disability. The bureau may use a variety of communication methods to contact
the employee, such as by telephone, mail, or other methods, but the bureau
shall not limit the contact to one method or one attempt if the bureau is not
able to contact the employee on the first attempt. If the bureau is unable to
contact the employee and the employee is represented, the bureau shall contact
the employee's representative for assistance in scheduling the examination. The
bureau shall document its contacts in the claim file. If the bureau attempts to
contact the employee by mail and the mail is returned undeliverable, the bureau
shall attempt to find a correct address for the employee and shall document the
attempt in the claim file. If the employee fails to respond to the bureau's
attempts to contact the employee to schedule the examination, the bureau shall
dismiss the application.
(b)
If the bureau schedules the employee for an examination
on the employee's application for a determination of the percentage of
permanent partial disability or for an increase of permanent partial disability
and the employee fails to attend the examination, the bureau shall contact the
employee for an explanation why the employee did not attend the examination. If
the employee is represented, the bureau shall contact the employee's
representative. If the employee provides an explanation for missing the
examination, the bureau shall reschedule the employee for an examination. If
the employee fails to respond or fails to provide an explanation, the bureau
shall dismiss the application.
(2)
If the bureau
dismisses an employee's application for a determination of percentage of
permanent partial disability or for an increase of permanent partial disability
under this rule, the employee may refile an application as provided in
paragraph (B) of rule
4123-3-15 of the Administrative
Code. The employee shall file the application subject to the continuing
jurisdiction limitations of section
4123.52 of the Revised Code. A
dismissed application does not toll the continuing jurisdiction of the bureau
or the industrial commission under section
4123.52 of the Revised
Code.
(B) This paragraph of this rule applies to an employee's application for a determination of the percentage of the employee's permanent partial disability or for an increase of permanent partial disability filed under section 4123.57 of the Revised Code that has been suspended pursuant to division (C) of section 4123.53 of the Revised Code as of September 29, 2017.
(1)
For an employee's application for a determination of
the percentage of the employee's permanent partial disability or for an
increase of permanent partial disability filed under section
4123.57 of the Revised Code that
has been suspended pursuant to division (C) of section
4123.53 of the Revised Code as
of September 29, 2017, the bureau shall send a notice to the employee's last
known address informing the employee that the bureau may dismiss the
application unless the employee schedules a medical examination with the bureau
within thirty days after receiving the notice.
(a)
If the employee
does not schedule a medical examination with the bureau within thirty days
after receiving the notice provided in paragraph (B) (1) of this rule, the
bureau may dismiss the application. The employee, the employer, or their
representative may object to the bureau's tentative order dismissing the
application within twenty days after receipt of the notice as provided in
section 4123.57 of the Revised Code, and
if the employee, the employer, or their representative timely notify the bureau
of an objection, the bureau shall refer the matter to a district hearing
officer for a hearing.
(b)
For an employee whose application has been suspended
who schedules an examination but fails to appear for the examination, the
bureau shall follow the same procedure as provided in paragraph (A)(1)(b) of
this rule.
(2)
If the bureau dismisses an employee's application for a
determination of percentage of permanent partial disability or for an increase
of permanent partial disability under this rule, the employee may refile the
application as provided in paragraph (B) of rule
4123-3-15 of the Administrative
Code. The employee shall file the application subject to the continuing
jurisdiction limitations of section
4123.52 of the Revised Code. A
dismissed application does not toll the continuing jurisdiction of the bureau
or the industrial commission under section
4123.52 of the Revised
Code.
Effective: 6/18/2018
Five Year
Review (FYR) Dates: 01/01/2019
Promulgated Under: 119.03
Statutory Authority: 4121.12,
4121.121, 4121.30, 4121.31, 4123.05
Rule Amplifies: 4121.121,
4123.57, 4123.65
Disclaimer: These regulations may not be the most recent version. Ohio may have more current or accurate information. We make no warranties or guarantees about the accuracy, completeness, or adequacy of the information contained on this site or the information linked to on the state site. Please check official sources.
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