Ohio Administrative Code › Title 4123 - Bureau of Workers' Compensation › Chapter 4123-3 - Claims Procedure › Section 4123-3-18 - Appellate procedure

Current through all regulations passed and filed through July 1, 2024
(A) Administrative appeals.
(1) The right of an administrative appeal is
			 limited to the claimant, the dependents of a deceased worker, the employer, and
			 the administrator, where the administrator or the administrator's
			 representative appeals on behalf of the state insurance fund and/or the surplus
			 fund.
(2) The
			  eligible appellants may appeal
			 decisions of the district hearing officers, or staff hearing
			 officers.
(3) Decisions of district
			 hearing officers are appealable to the staff hearing officers. Decisions of the
			 staff hearing officers are appealable to the industrial commission.
(4) Appeals shall be filed in accordance with
			 rule
			 4121-3-18
			 of the Administrative Code.
(5)
			 Appeal applications shall be signed by the party appealing or by authorized
			 representative on behalf of such party. The same applies to the administrator
			 when filing an appeal.
(6) Such
			 applications may be filed with any office of the bureau or of the industrial
			 commission.
(7) The same time
			 limits apply to appeals filed from the decision of the staff hearing officers
			 to the industrial commission.
(8)
			 Appellate review and determination of claims being within the exclusive
			 jurisdiction of the industrial commission, the conduct of hearings and other
			 incidental matters are governed by the rules of the industrial
			 commission.
(9) The bureau's legal
			 division shall act as attorney in appeals filed by the bureau on behalf of the
			 state insurance fund; it may also act as a representative of the administrator
			 in appeals filed by the bureau on behalf of the surplus fund. As a party to the
			 proceedings, the bureau's legal division shall be entitled to proper notice of
			 any action taken by the appellate body on appeals filed by the
			 bureau.
(10) The bureau shall make
			 payment of an award of compensation in a claim at the earliest time provided in
			 division (H) of section
			 4123.511
			 of the Revised Code, except that, in all cases of a determination made under
			 division (A) of section
			 4123.57
			 of the Revised Code for percentage permanent partial disability compensation,
			 no payment shall be made to the claimant until a final decision on
			 reconsideration allows such compensation.
(11) In all other cases, if the decision of
			 the district hearing officer is appealed by the employer or the administrator,
			 the bureau shall withhold medical benefits during the course of appeal to the
			 staff hearing officer, but where the staff hearing officer rules in favor of
			 the claimant, medical benefits shall be paid by the bureau immediately upon the
			 receipt of the order, regardless of whether or not further appeal is taken. In
			 self-insuring employers' claims, payment shall be made in accordance with
			 applicable laws and rules.
(12)
			 Payments of an award of compensation and/or benefits made by the bureau
			 pursuant to a decision of a staff hearing officer shall commence immediately
			 upon the bureau's receipt of the order.