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OhioBWC - Basics: (Policy library) - File

Policy Name:

Handicap Reimbursement

Policy #:

CP-08-01

Code/Rule Reference:

R.C. 4123.343 and 4123.63; O.A.C. 4123-3-35

Effective Date:

01/01/16

Approved:

Rick Percy, Chief of Operational Policy, Analytics and Compliance signature on file

Origin:

Claims Policy

Supersedes:

Any policy or procedure regarding handicap reimbursement that predates the effective date of this policy.

History:

New 01/18/13

 

 

I. POLICY PURPOSE

 

The purpose of this policy is to ensure BWC reduces costs to an employer’s risk by charging a percentage of the qualifying claim’s costs to the statutory surplus fund instead of to the employer’s experience when an employer hires and retains employees with a pre-existing handicapped condition or military service handicap.

 

II. APPLICABILITY

 

This policy applies to Field Operations, Legal, and Employer Services staff.

 

III. DEFINITIONS

 

Handicapped employee: for the purpose of this policy, an employee who is afflicted with or subject to a physical or mental impairment listed in R.C. 4123.343, whether congenital or due to an injury or disease, such that the impairment constitutes a handicap in obtaining employment or re-employment.

 

IV. POLICY

A.     It is the policy of BWC to charge a percentage of a qualifying claim’s costs to the statutory surplus fund instead of to the employer’s experience, upon application of the employer, when a handicapped employee as defined in R.C. 4123.343 or R.C. 4123.63 is injured, disabled or dies as a result of an injury or occupational disease sustained in the course of, or arising out of, his/her employment, and BWC finds either that the injury, occupational disease, or death would not have occurred but for the employee’s pre-existing handicapped condition, or that the injury, occupational disease, or death would have occurred without regard to the employee’s pre-existing handicapped condition, but the resulting disability or death was caused at least in part through aggravation of the employee’s pre-existing disability. Diseases or conditions as listed in R.C. 4123.343 are limited to:

1.    Epilepsy

2.    Diabetes

3.    Cardiac disease

4.    Arthritis

5.    Amputated foot, leg, arm or hand

6.    Loss of sight of one or both eyes or partial loss of uncorrected vision of more than seventy-five percent (75%) bilaterally

7.    Residual disability from poliomyelitis

8.    Cerebral palsy

9.    Multiple sclerosis

10.  Parkinson’s disease

11.  Cerebral vascular accident (stroke)

12.  Tuberculosis

13.  Silicosis

14.  Psycho-neurotic disability following treatment in a recognized medical or mental institution

15.  Hemophilia

16.  Chronic osteomyelitis

17.  Ankylosis of joints

18.  Hyperinsulinism

19.  Muscular dystrophies

20.  Arteriosclerosis

21.  Thrombophlebitis

22.  Varicose veins

23.  Cardiovascular pulmonary or respiratory diseases of firefighters or police officers employed by a municipal corporation or township as a regular member of a lawfully constituted police or fire department.

24.  Coal miner’s pneumoconiosis (“black lung disease”)

25.  Disability with respect to an individual who has completed a rehabilitation program conducted pursuant to sections R.C. 4121.61 through R.C. 4129.69.

 

B.    When an employee with an eligible handicap condition files an allowed workers’ compensation claim, the eligible employer or the employer’s representative may file an Application for Handicap Reimbursement form (CHP-4A) with supporting medical evidence.

1.    Eligible employers must:

a.  Hand deliver the CHP-4A application to:

BWC Customer Service

30 W. Spring St., Second Floor

Columbus, Ohio 43215; or

b.  Mail the CHP-4A application to

BWC, Attn: Handicap Reimbursement Unit L-26

30 W. Spring St.

Columbus, Ohio 43215-2256

2.    Eligible employers include:

a.  Public employer taxing districts;

b.  Private state-fund employers; 

d.  Any employer who has been granted a previous handicap reimbursement;

e.  Certain bankrupt employers as determined on a case-by-case basis.

3.    Ineligible employers include:

a.  Non-complying and/or out-of-business employers;

b. Self-insuring employers;

c. State agencies and universities.

 

C.   The CHP-4A must be filed while the claim is within the employer’s experience, as follows:

1.    For Private state-fund employer claims with a date of injury:

a.    On or before December 31, 2009, the CHP-4A must be filed by June 30 of the year no more than six years from the year of the date of injury or occupational disease.

b.    On or after January 1, 2010, the CHP-4A must be filed by June 30 of the year:

                                      i.        no more than six years from the year of the date of injury or occupational disease if the date of injury is between January 1 and June 30.

                                     ii.        no more than seven years from the year of the date of injury or occupational disease if the date of injury is between July 1 and December 31.

2.    For Public employer taxing district claims with a date of injury:

a.    On or before December 31, 2009, the CHP-4A must be filed by December 31 of the year no more than five years from the year of the date of the injury or occupational disease.

b.    On or after January 1, 2010, the CHP-4A must be filed by December 31 of the year no more than six years from the year of the date of the injury or occupational disease.

3.    For a claim involving a private state fund employer or a public employer taxing district employer participating in a retrospective rating plan, the application shall be filed within the time provided in section IV.(C)(1, 2), as applicable.

 

D.   An employer's application for handicap reimbursement does not result in or affect the IW’s right to any benefits or compensation to the IW, and the employee has the legal right to decline to provide information to an employer about any pre-existing handicap(s).

 

E.     Employers have several rights with respect to this policy.

1.    An employer may request that an informal conference be conducted regarding the application for handicap reimbursement. At the request of the employer or another party, the informal conference may be expedited or conducted by telephone.

2.    An employer may request withdrawal of the application at anytime, either in writing or verbally.

3.    Claims settlement does not affect the employer’s right to have a handicap reimbursement application considered.

4.    Pursuant to R.C. 4123.511, the employer may appeal a BWC Order on handicap reimbursement to the Industrial Commission, but the order is not appealable to court under R.C. 4123.512.

 

F.     BWC will only consider an application for handicap reimbursement when one of the following apply:

1.    BWC has awarded compensation to the IW for:

a.  Temporary total disability;

b.  Permanent total disability;

c.  Disabilities compensated under R.C. 4123.57(B); or

d.  Death benefits.

2.    The IW has received wages from the employer in lieu of compensation (salary continuation).

 

 


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