General Employer Complaint Policy
Ohio Administrative Code (OAC) 4123-14-06.
May 5, 2018
The General Employer Complaint Policy dated January 11,
New policy: April 5, 2013. Revised March 2, 2018.
January 11, 2021
This policy will guide Ohio Bureau of Workers’ Compensation (BWC) staff
in resolving employer disputes with a BWC decision that requires additional
research and analysis to determine the proper resolution.
Employer complaints are
assigned to BWC business units, or in certain circumstances to the BWC claims
office. This policy applies to BWC business units, BWC service offices,
employers, and authorized representatives.
An employer dispute with a BWC decision, or application of a rule or policy,
that requires additional research and analysis to determine proper resolution.
Criteria: The requirements an employer must meet
to enter a
program or qualify for certain treatment under BWC employer policies. Eligibility
criteria are specified in each BWC program-specific policy.
Essential personnel: Employees responsible for the employer’s finances who
include, but are not limited to the owner, Chief Operating Officer and Chief
circumstance: A substantial reason, or mitigating
factor, that justifies granting the employer’s request for relief.
family: Means a person’s
spouse, significant other (or domestic partner), children, step-children,
grandchildren, parents, step-parents, father-in-law, mother-in-law,
brother-in-law, sister-in-law, son-in-law, daughter-in-law, grandparents,
brother, sister, step-siblings, and/or legal guardian or other person who
stands in the place of a parent.
requirements: The activities an employer must complete to receive a program
discount, which may include activities an employer must complete to remain in a
program from year-to-year. Examples of program requirements include (but are
not limited to) application for the program, program attendance, and reporting
requirements. Program requirements are specified in each BWC program-specific
of Complaint: BWC staff must investigate the employer’s complaint prior to
issuing a decision to ascertain:
The relief that the employer is requesting to resolve the complaint.
The reason the employer is requesting relief.
Whether the employer has met eligibility criteria and program requirements
related to the applicable program or policy.
Whether the employer meets the criteria for granting relief under an
extenuating circumstance in this policy or an extenuating circumstance that is
Whether the employer has filed the complaint within two years of receipt
of BWC’s decision giving rise to the complaint, unless a different time is
provided in rule or law. (OAC 4123-14-06(A)(2)).
for Granting Relief.
BWC staff cannot grant relief where the
employer fails to meet eligibility criteria and program requirements. Refer to the program specific EM policy to determine
whether the employer has met all eligibility criteria and program requirements.
Relief should be granted for the missing of a filing or report deadline
only if an extenuating circumstance can be verified through documentation.
The following do not qualify as extenuating circumstances for any
BWC employer program or policy:
Changes in the management staff within the
Change in personnel or CPA organization (other
than the scenarios described in section D.4 and D.5 below).
Bookkeeper or CPA error.
Ohio workers’ compensation laws or rules.
Implementation of a new computer system.
Circumstances for All BWC Programs and Policies: BWC has identified certain
“extenuating circumstances” that allow BWC staff to grant the employer’s
request for relief for any program or policy. These circumstances are outlined
in section D, below.
In each of the extenuating circumstances
outlined, there must be a causal relationship between the extenuating
circumstance and the event giving rise to the employer’s request for relief.
Examples of supporting documentation are
provided for each of the circumstances, but appropriate documentation is not
limited to the documentation listed below.
An extenuating circumstance may be
utilized only to extend the required timeframe to meet a specific
requirement. It cannot be used to allow non-completion of the specific
that Qualify as Extenuating Circumstances.
BWC or Ohio Attorney General Office (AGO) Error.
Extenuating Circumstance: BWC or AGO error
results in the employer being rejected from participation in an employer
program or prevents the employer from filing appropriate paperwork or
documentation in a timely manner. Examples:
BWC credited the wrong employer’s policy.
Technical difficulties make www.bwc.ohio.gov unavailable,
preventing an employer from completing a required task on BWC’s website.
BWC records to validate error.
Screen of error messages encountered by
Fraud or Gross Negligence by Employer’s Staff
Extenuating Circumstance: The fraudulent
action, illegal action, or gross negligence of an employee or agent that
prevents the employer from filing appropriate paperwork or documentation in a
timely manner. The employee or agent must have been directly involved with the
completion or oversight of functions related to the protested issue. Employer
relief is limited to those situations where the employer can verify
through documentation that it has initiated legal action against the employee
Supporting documentation: BWC staff should work through their supervisor to seek
advice from BWC Legal Division to determine if the documents presented by the
employer are valid legal documents for this circumstance.
or civil fraud or other illegal acts: Proof that the employer has filed formal
criminal charges or actively pursued legal action for civil fraud or other
illegal acts. A conviction is not required.
For gross negligence: Proof that the employer
has filed a civil complaint against the employee or agent for recovery in any
court. The employer is not required to prevail in the civil action. Acceptable
documentation may also include rulings from other state or federal governmental
agencies attesting that the action is considered gross negligence.
Unpredictable Significant Events.
Extenuating Circumstance: An unpredictable
event that was outside of the employer’s control that prevented the employer
from filing appropriate paperwork in a timely manner. Examples:
Acts of nature such as a tornado or flood.
events such as water line break or fire.
iv. Violence in workplace.
Outages such as network failure of an internet
service provider (ISP) or power outage.
News report, police report, or insurance claim
related to a natural disaster or significant event.
Statement from ISP provider or power company
verifying date(s) and times of outages.
Serious Illness, Injury or Death
of Essential Personnel or Immediate Family of
Extenuating Circumstance: Essential
personnel within the organization, or immediate family of essential personnel, suffers
a serious illness, injury or death that prevents the employer from filing
appropriate paperwork or documentation in a timely manner.
For serious illness or injury: A
physician’s verification must accompany the request. Such verification should
not include specific medical reasons for the absence. The physician
verification must include the dates the essential personnel, or a member of an
essential person’s immediate family, was treated, and the essential person missed
work for this serious illness or injury. For death: A death certificate. If
the death is for an immediate family member of an essential person, proof of
the relationship between the essential person and the deceased, and proof the
essential person missed work for the death, is required.
Documentation regarding essential
personnel’s responsibilities that relate to the employer’s request.
Essential Personnel Called to Active Military Duty
Extenuating Circumstance: Essential personnel
within the organization such as the owner, Chief Operating Officer, or Chief
Financial Officer, called to active military duty, preventing the employer from
filing appropriate paperwork in a timely manner.
Supporting documentation: Military order/call to active duty notice and documentation
regarding essential personnel’s responsibilities that relate to the employer’s
Extenuating Circumstances: Additional extenuating
circumstances may apply to a program or policy; see the “Resolution of
Complaints” section of the program-specific policy to determine if additional
extenuating circumstances exist to allow granting of the employer’s complaint.
Approval of Recommendations.
BWC staff must obtain management level sign-off on each recommendation
to approve or deny an employer’s request for relief.
Complaints that are more complex or involve larger financial impacts
will require additional management level sign-offs. Consult the Complaint
Tracker Approval Sign-Off Chart to determine the level of sign-off required for