(A) Proof and discovery.
(1) In every instance the proof shall be of sufficient quantum and probative value
to establish the jurisdiction of the commission to consider the claim and determine
the rights of the employee to an award. Proof may be presented by affidavit,
deposition, oral testimony, written statement, document, or other forms of
(a) The parties or their representatives shall provide to each other, as soon as
available and prior to hearing, a copy of the evidence the parties intend to submit
at a commission proceeding.
(b) In the event a party fails to comply with paragraph (A)(1)(a) of this rule, the
hearing officer may in his discretion continue the claim to the end of the hearing
docket, or to a future date with instructions to the parties or their
representatives to comply with the rule.
(2) The free pre-hearing exchange of information relevant to a claim is encouraged
to facilitate thorough and adequate preparation for commission proceedings. If a
dispute arises between the parties regarding the exchange of information, the
hearing administrator, pursuant to paragraph (B) of this rule to consider the
dispute. At the conclusion of the pre-hearing conference, the hearing administrator
may issue a compliance letter, which becomes part of the claim file and which shall
be adhered to by the parties.
(3) The claimant must provide, when requested, a current signed medical release as
required by division (B) of section 4121.651 of the Revised Code. Should a claimant
refuse to provide a current signed medical release as requested, then the claim
shall be referred to the hearing administrator so that an order suspending the
claim may be placed pursuant to division (C) of section 4123.651 of the Revised
(4) The commission may, at any point in the processing of an application for
benefits, require the employee to submit to a physical examination or may refer a
claim for investigation.
(5) The employer may require a medical examination of the employee as provided in
section 4123.651 of the Revised Code under the following circumstances:
(a) In no event will the claimant be examined more than one time at the request of
the employer on any issue that is asserted by the claimant or which is to be
considered by the commission, during the time that the specific matter asserted or
that is in controversy remains pending final adjudication before the bureau or
The exercise of this right of an examination shall not be allowed to delay the
timely payment of benefits or scheduled hearings. The cost of any examination
initiated by employer shall be paid by the employer including any fee required by
the physician, and the payment of all of the claimant's traveling and meal
expenses, in a manner and at the rates as established by the administrator from
time to time. If employed, the claimant will also be compensated for any loss of
wages arising from the scheduling of an examination. All reasonable expenses shall
be paid by the employer immediately upon receipt of the billing, and the employer
shall provide the claimant with a proper form to be completed by the claimant for
reimbursement of such expenses. The employer shall reimburse the claimant for lost
wages within thirty days of the submission of proof of lost wages.
The employer shall promptly inform the commission, as well as the claimant's
representative, as to the time and place of the examination, and the questions and
information provided to the doctor. A copy of the examination report shall be
submitted to the commission and to the claimant's representative upon the
employer's receipt of the report from the doctor.
The procedure set forth in paragraph (A)(4)(a) of this rule shall be applicable to
claims where the date of injury or the date of disability in occupational disease
claims occur on or after August 22, 1986.
Emergency treatment does not constitute examination for the purpose of this rule.
Treatment by a company doctor does not constitute an examination for this rule.
Treatment by a company doctor does not constitute an examination for this rule.
[FN1] However, if following an examination the company doctor renders an opinion
as to causation, extent of disability, or other medical opinion on a workers'
compensation matter that is asserted by the claimant, or which is to be considered
by the commission, then that examination does constitute an examination for
purposes of this rule.
(b) If after a medical examination of the claimant under paragraph (A)(4)(a) of
this rule on an issue that remains in controversy and has not been finally
adjudicated, an employer asserts that an additional medical examination by a doctor
of the employer's choice is essential in the defense of the claim by the employer,
written request for such an examination shall be submitted to the hearing
administrator only in cases where there is a dispute as to the request for
additional examination. Written request for such an examination in a claim which
has been set for a hearing with notice must be filed immediately upon the receipt
of the notice or within such time as will be adequate for notification of the
parties of the continuance of the hearing. The request shall state the date of the
last examination of the claimant by a doctor of employer's choice on the question
pending and the reasoning for such additional examination.
(c) All reasonable expenses of such examination, including any travel expense shall
be paid by the employer immediately upon the receipt of the billing. Payment for
traveling expenses shall not require an order of the bureau or commission, unless
there is a dispute. The employer shall provide the claimant with a proper form to
be completed by the claimant for reimbursement for traveling expenses. The employer
shall reimburse the claimant for lost wages within thirty days of the submission of
proof of lost wages.
(6) Procedure for obtaining the oral deposition of, or submitting interrogatories
to, an examining physician.
(a) A request to take the oral deposition of or submit interrogatories to a
physician who has examined an injured or disabled worker or reviewed the claim
file and issued an opinion shall be submitted in writing to the hearing
administrator within ten days from the receipt of the examining or reviewing
physician's report and the applicant shall simultaneously mail a copy of the
request to all parties, or if represented, to the representatives of the parties.
(b) The request must set out the reasons for the request and affirm that the
applicant will pay all costs of the deposition or interrogatories including the
payment of a reasonable fee, as defined below, to the physician and will furnish a
copy of the deposition or the interrogatory to the opposing party and to the
(c) If the hearing administrator finds that the request is a reasonable one, he
shall issue a compliance letter that will set forth the responsibilities of the
party that makes the request. The following items shall be set forth in the
(i) A statement of the responsibility of the party that requests the taking of
deposition or answering of interrogatories concerning payment to the physician of a
reasonable fee as established from time to time by commission resolution.
Additionally, should a party cancel a deposition within two days of the scheduled
time, a minimum cancellation fee will be charged as set by the industrial
(ii) A statement of the responsibility of the party that makes the request to
provide written notice of the date and time of the deposition to be provided by the
requesting party to all opposing parties and their representatives, the bureau of
workers' compensation and the industrial commission.
(iii) A statement setting forth a date by which the transcript of the deposition or
the answers to the interrogatories is to be submitted to the industrial commission
for inclusion within the claim file folder and to be served upon opposing parties.
(d) The factors to be considered by the hearing administrator when determining the
reasonableness of the request for deposition and interrogatories include whether a
substantial disparity exists between various medical reports on the issue that is
under contest, whether one medical report was relied upon to the exclusion of
others, and whether the request is for harassment or delay. If the request is made
by an employer the hearing administrator shall also determine whether the
relied-upon medical report(s) considered non-allowed conditions.
(e) The party seeking the deposition may request that the hearing administrator
issue a subpoena to secure the attendance of the physician.
If a witness who has been issued a subpoena fails to appear, the hearing
administrator shall certify this fact to the office of the attorney general who
shall take appropriate action to compel the witness to obey the subpoena.
(f) The applicant shall furnish the opposing party and the industrial commission
with a copy of the deposition or the completed interrogatories. The applicant shall
also furnish the industrial commission with proof of payment of the court reporter
and the physician.
(B) Prehearing conferences.
(1) At any time prior to the hearing the hearing administrator may, for good cause,
hold a prehearing conference to consider matters that would tend to expedite the
(2) At the conclusion of a prehearing conference, the hearing administrator shall
prepare a compliance letter listing the subjects considered and the agreements
reached at the prehearing conference. The compliance letter shall be made part of
the claim file to be reviewed by the adjudicator and also be provided to the
parties in attendance at the pre-hearing conference. The parties must adhere to the
provisions of the compliance letter.
(3) A prehearing conference may be held by telephone conference call or in person,
as determined by the hearing administrator.
(C) Hearings before the industrial commission, its staff hearing officers, and the
district hearing officers, and the rendering of their decision.
(1) Contested claims matters, disputed issues or claims, and appeals under section
4123.511 of the Revised Code shall be set for hearing before the district hearing
officers, staff hearing officers or the industrial commission. Contested claim
matters shall be assigned to hearing officers through a system which ensures that
each hearing officer hears a representative sample of the issues under contest,
dispute, or appeal. Hearing officers shall review all claim files prior to
(2) Notice of the date, time and place of such hearings shall be given to the
employee and the employer, and their respective representatives of record by mail,
and to the administrator by inter-office mail, in advance of the hearing date. The
mailing of the notice, unless it is an emergency hearing, shall precede the hearing
date by a period of time which will reasonably afford the parties opportunity to be
present and participate in the hearing. This shall not be less than fourteen days
following the date of the mailing of the notice.
(3) Representation of employees and employers before the bureau and the commission
is a matter of individual free choice. This includes hearings before the designated
hearing officers. The commission does not require representation nor does it
prohibit it. No employee of the commission shall in any way make statements tending
to limit such free choice. No one, other than an attorney at law, authorized to
practice in the state of Ohio, shall be permitted to represent claimants for a fee
before the commission.
(4) If no appearance is made at a hearing, with notice, the claim will be heard and
disposed of upon the proof on file, if such proof is sufficient for that purpose.
If such proof is insufficient, the hearing may be continued to a specific date for
the attendance of the parties or for the purpose of obtaining additional proof or
for any other justifiable reason.
(5) At hearings with notice, consideration shall be confined to the issues
presented in the adjudication of the claim and the parties shall be prepared to
fully present their respective positions in regard to such issues.
(6) In claims where a hearing with notice is required, parties may waive notice of
hearing in writing, or by appearance and oral motion at the hearing, if such waiver
is presented in advance of the hearing.
(7) Hearing officers of the commission and the commission itself, insofar as is
practicable, shall announce the decision on the issues presented in the hearing at
its conclusion. Upon announcement of the decision or upon the hearing officer
taking the issues under advisement, where that is required, the hearing shall be
(8) Hearings with notice before the district hearing officers on contested claims
matters, disputed issues or claims, and appeals from a decision of the
administrator shall be conducted in the industrial commission service office that
is closest to the claimant's residence, which shall be presumed to be the office
that houses the claim file unless otherwise directed. Hearings for out-of-state
claimants who live more than one hundred miles from a [sic] industrial commission
service office will be in Columbus, unless otherwise directed. If within one
hundred miles, then the hearing will be at the nearest industrial commission
service office. Other hearings before the commission or its hearing officers, shall
be at the places designated by the commission in the notices of hearing.
(a)(i) Requests for continuances shall be addressed to the hearing administrator.
The party that requests a continuance must state the reason for the request and
whether the other parties' representatives or, if there is no representative, the
opposing parties, have been informed that the request is being made and the reason
therefore. Requests for continuances shall be in writing except in extraordinary
circumstances where time does not permit a written request, and should be submitted
on the "request for continuance" form available from the commission.
(ii) In the absence of a hearing administrator, due to extended illness or vacancy,
the regional manager or his designee shall be assigned the responsibility placed on
the hearing administrator for granting or denying requests for continuances.
(b)(i) Mutually agreed requests for continuances will be granted upon the written
representation that the parties to the claim have agreed to the continuance and
have further agreed to waive the time frames for hearing and issuance of an order
that are set forth within section 4123.511 and other applicable provisions of the
Revised Code. If a representative of a party requests a continuance, the
representative shall certify that he has informed his client of the time frames set
forth within section 4123.511 of the Revised Code and that his client has agreed to
waive the time frames for hearing and issuance of an order set forth in section
4123.511 of the Revised Code.
(ii) Mutually agreed requests for continuances are to be made no later than five
calendar days prior to the date of hearing. Where a mutually agreed request for
continuance is granted, the case will not be identified as a claim that has not met
the time limits set forth within section 4123.511 of the Revised Code in the
reports required to be prepared pursuant to division (H)(2)(a) of section 4121.36
of the Revised Code.
(c)(i) Where the parties fail to agree on the request for continuance, fail to
waive the time frame for hearing and issuance of an order set forth within section
4123.511 of the Revised Code, or if a mutually agreed request for continuance is
submitted less than five calendar days prior to the date of hearing, the claim
shall remain on the hearing docket as scheduled. The adjudicator that is assigned
to the hearing shall review the request and make a recommendation as to whether the
continuance should be granted or denied. The reasons in support of the
recommendation shall be noted on the hearing worksheet or on the file copy of the
notice of hearing, if a hearing worksheet is not available. The hearing
administrator shall retain jurisdiction to determine whether to grant or deny
requests for continuances until the day of the scheduled hearing for which a
continuance has been made.
(ii) If a request for continuance has not been decided prior to the date of
hearing, the adjudicator assigned to hold the hearing shall publish an order either
granting or denying the request for continuance. If the adjudicator determines to
grant the continuance, the order shall list the party that requested the
continuance, the reason for granting the continuance, and the fact that the claim
is to be continued, in progress, and reset on the next available docket. Such
requests for continuances shall be granted only in exceptional circumstances and
not as a matter of course. If the adjudicator grants such a request for
continuance, the order shall be interlocutory in nature and is not subject to
appeal. Such claims shall remain subject to the reporting provisions under division
(H)(2)(A) of section 4121.36 of the Revised Code, as well as the requirement of the
timely hearing and issuance of an order under section 4123.511 of the Revised Code.
(d) No hearing will be continued for purposes of discovery unless good cause is
shown as determined by the hearing administrator or the adjudicator where a request
for continuance is made at the hearing.
(e) In cases where the hearing is to be scheduled before the members of the
industrial commission, requests for continuances will be considered and determined
by a majority of the members of the industrial commission.
(10) All final decisions of the district hearing officers, staff hearing officers
or commission upon hearing with notice shall be reduced to writing and copies
mailed to the parties and to all authorized representatives of record of each
party, and to the administrator.
Written decisions shall be signed by the adjudicator(s) who conducted the hearing.
When schedules or traveling do not permit a hearing officer to sign his orders,
another hearing officer will be designated to sign the order. The designated signer
should ensure that the order conforms to the hearing worksheet of the hearing
officer that made the decision. If a designated signer has a question regarding the
contents of the order, the order must be returned to the hearing officer that made
the decision prior to its publication.
(11) All hearings before a district hearing officer, staff hearing officer and the
industrial commission shall be public.
(12) The hearing administrator, hearing officer, or industrial commission may
compel the attendance or testimony of witnesses on their own motion or at the
request of any party.
(13) The assignment of a staff hearing officer or district hearing officer to a
hearing shall be made by the regional manager.
(D) Final decisions of the district hearing officer, staff hearing officer or the
industrial commission shall be in writing and shall include:
(1) Description of the part of the body and the nature of the disability recognized
in the claim.
(2) A concise statement of the order or award.
(3) A notation as to the notice furnished and as to the appearances of the parties.
(4) Signatures of each commissioner participating in the hearing, shall be affixed
to the original order verifying his vote.
(5) Signatures of each hearing officer participating in the hearing shall be
affixed to the original order verifying his vote, which will be made part of the
(E) All matters which at the request of one of the parties or on the initiative of
the administrator and any commissioner are to be expedited, shall require at least
forty-eight hours notice of a public hearing and a statement of such order of the
circumstances that justified such expeditious hearing.
(F) All original memoranda, orders and decisions of the commission shall be
compiled in a journal to be made available to the public with sufficient indexing
to allow orderly review of documents. The journal shall indicate the vote of each
(G) All orders, rules, memoranda and decisions of the commission shall contain the
signature of two of the three commissioners and shall state whether adopted at a
meeting of the commission or by circulation to individual commissioners. Any
facsimile or secretarial signature, initials of commissioners and delegated hearing
officers and any printed record of "yes" and "no" vote of a district or staff
hearing officer, or commission member is invalid.
(H) Claim inquiries.
(1) The industrial commission shall maintain a public information section, which
will be charged with the responsibility of handling claim inquiries by or on behalf
of claimants, employers and their respective representatives.
(2) Requests, whether in writing, in person, or by telephone, concerning the status
of a claim and/or any action necessary to maintain the claim shall be directed to
the public information section.
(3) The public information section shall promptly answer such request(s) or may
refer the matter for response to the office or section before which the matter is
currently pending. If the matter is so referred, the public information section
shall follow-up the inquiry to ensure that it has been expeditiously answered.
(4) Should the filing of a supplemental application, affidavit or other form(s) be
necessary, it shall be forwarded by the office answering the inquiry.
(5) The public information section shall maintain a record of all inquiries
received in order that statistics be developed to indicate problem areas and to
serve as a basis for appropriate measures.
(I) Processing claims in an orderly, uniform and timely fashion.
(1) Each section of the industrial commission shall perform the tasks necessary to
discharge its responsibilities for the processing of claims in accordance with the
procedures adopted by such section and approved by the industrial commission.
(2) The discharge of these responsibilities, whether involving claims pertaining to
state fund, self-insured or other employers shall be accomplished within the
reasonable time parameters as set forth by the procedures of each section.
(3) It shall be the responsibility of the regional manager and hearing administrator
to monitor the performance of tasks being carried on within their jurisdiction and
to ensure that such assigned tasks are being performed in an orderly, uniform and
timely manner, as established by the procedures of that section.
(4) Should it be determined that the assigned tasks were not being performed
according to the adopted procedures, it shall be the responsibility of the regional
manager and hearing administrator to adopt such corrective measures as may be
indicated under the circumstances.
(J) In the absence of the hearing administrator, due to extended illness or
vacancy, the regional manager or his designee shall assume the responsibilities
placed on the hearing administrator by this rule