Ohio Administrative Code › Title 4123 - Bureau of Workers' Compensation › Chapter 4123-3 - Claims Procedure › Section 4123-3-32 - Temporary total examinations

Current through all regulations passed and filed through July 1, 2024
(A) Pursuant to the provisions of section
			 4123.53 of the Revised Code, the
			 bureau of workers' compensation shall schedule an examination to determine the
			 employee's continued entitlement to temporary total disability compensation,
			 the employee's rehabilitation potential, and the appropriateness of the
			 employee's medical treatment. The bureau shall schedule the examination for a
			 date not later than thirty days following the end of the initial ninety-day
			 period of temporary total disability compensation. The bureau shall mail a copy
			 of the bureau's determination to schedule the examination to the employee,
			 employer, and their authorized representatives, except where the bureau has
			 determined the employer is out of business.
(B) If the result of the medical examination
			 is that the employee continues to receive temporary total disability
			 compensation, the bureau shall determine a date for the employee to be
			 scheduled to be reexamined. The bureau shall determine a date for the
			 subsequent examination based upon the recommendation of the medical examiner or
			 other available evidence. If at the date the bureau has determined to schedule
			 the employee to be reexamined the employee is receiving temporary total
			 disability compensation, the bureau shall schedule the employee for the
			 examination. The bureau shall continue to determine dates to schedule the
			 employee for subsequent examinations as long as the employee continues to
			 receive temporary total disability compensation.
(C) The bureau, for good cause, may waive the
			 scheduling of the employee's medical examination under section
			 4123.53 of the Revised Code.
			 "Good cause" shall be determined at the discretion of the bureau, but generally
			 shall be for a reason that the medical examination is not feasible, such as the
			 employee's medical instability. The bureau shall contact the employer or the
			 employer's representative if the bureau determines that a waiver of the
			 examination is advisable. If the employer objects to the bureau's waiver of the
			 medical examination, the bureau shall schedule the medical examination. If the
			 employer does not object to the bureau's waiver of the examination, the bureau
			 shall notify the employee, employer, and their authorized representatives of
			 the waiver of the examination, except where the bureau has determined the
			 employer is out of business. If the bureau has waived an examination, the
			 bureau shall determine a date for the employee to be scheduled to be reexamined
			 pursuant to paragraph (B) of this rule.
(D) An employer of an employee scheduled for
			 an examination by the bureau under section
			 4123.53 of the Revised Code may
			 waive the bureau's scheduling of any such examination. The employer shall
			 notify the bureau of its intent to waive the examination. The employer shall
			 indicate whether the waiver is temporary or permanent, the reason for the
			 waiver, and, if applicable, a recommended subsequent date upon which the
			 employee should be reevaluated for scheduling the examination if the employee
			 is receiving temporary total disability compensation. The waiver shall indicate
			 the name and title of the person waiving the examination for the employer. The
			 bureau may schedule the examination even if the employer waives the examination
			 where the bureau determines that an examination is necessary. The bureau shall
			 cancel the examination if the bureau had scheduled the examination and agrees
			 with the employer's waiver of the examination.
(E) The bureau shall conduct ninety day
			 examinations for employees of self-insuring employers upon the request of the
			 self-insuring employer. A self-insuring employer may determine that a ninety
			 day examination is not necessary, and in that instance may decide not to
			 request such examination be conducted by the bureau. At the appropriate time
			 thereafter, the self-insuring employer may request that the ninety day
			 examination be conducted. The self-insuring employer shall pay for the ninety
			 day examination, as well as all reasonable expenses associated with the ninety
			 day examination.
(F) Medical
			 examinations scheduled under this rule shall not operate to limit medical
			 examinations provided for in other provisions of Chapter 4121. or Chapter 4123.
			 of the Revised Code.