FAQ
Frequently Asked Questions
Questions
Answers
Do we represent a state agency where an employee of that state agency has filed a workers’ compensation claim?
No. The Executive Agencies Section, Workers’ Compensation Defense Unit, of the Attorney General’s Office will represent that state agency.
Do we represent employers or claimants in workers’ compensation claims?
No. However, at times, our clients’ interest in the resolution of a dispute may be similar to a claimant’s or employer’s interest.
Do we represent the BWC in non-court proceedings?
Yes, but on a limited basis in administrative proceedings. We represent the BWC in disputes arising from decisions made through BWC’s Health Partnership Program (“HPP”). The HPP is a managed health care program designed for injured workers. A medical provider must be certified by the BWC before providing treatment to an injured worker. A managed care organization (“MCO”) must also be certified by the BWC before providing services in the HPP.
If the BWC decides to not certify, or decertify, a medical provider or MCO in the HPP, then the medical provider or MCO has the right to an appeal. During this administrative hearing process, our section prosecutes the matter on BWC’s behalf. If the medical provider or MCO receives an adverse decision, the medical provider or MCO may file an appeal in common pleas court.
For MCOs, in appropriate situations, the BWC may skip the administrative hearing process and instead terminate its contract with the MCO. If BWC terminates the contract, the MCO may file an action in the Court of Claims.
Do we represent the Commission in non-court proceedings?
No. We only represent the Commission in court proceedings.
How do we represent the BWC in the courts?
We represent the BWC in all cases appealed to any of the 88 common pleas courts in Ohio where the issue is whether the claimant is entitled to participate, or continue to participate, in the workers’ compensation fund for an injury or occupational disease. All parties have a right to a jury trial in these cases. If there is an appeal from the trial court, the section represents the BWC in the court of appeals and Ohio Supreme Court.
We also represent the BWC in other actions, including, but not limited to, declaratory judgment actions, injunctions, writs of prohibition, tort, fraud, child support, subpoena enforcement, and other miscellaneous actions filed in the various courts, including federal courts, throughout the state. Other sections of the Attorney General’s Office as well as private attorneys, referred to as Special Counsel, may also represent BWC depending on subject area or expertise.
How do we represent the Commission in the courts?
We primarily represent the Commission in mandamus actions, where an injured worker or employer alleges the Commission abused in discretion in rendering an administrative decision involving matters that, by law, cannot be appealed to a court of common pleas. These mandamus actions may only be filed in the Ohio Supreme Court, 10
th District Court of Appeals or the Franklin County Common Pleas Court.
What agencies do we represent?
Our clients are the Ohio Bureau of Workers’ Compensation (“BWC”) and the Industrial Commission of Ohio (“Commission”). The BWC is responsible for the collection, administration and distribution of the state workers’ compensation fund. The Commission decides disputes between parties in a workers’ compensation claim.
What is the Workers’ Compensation Fund?
Ohio employers must carry workers’ compensation insurance for their employees. Employers that pay premiums to BWC are considered state-fund employers. Employers can also apply to the BWC to be self-insured. If their application is granted, they are considered self-insured employers.
If an employee of a state-fund employer has an allowed claim for an injury or disease, the BWC then pays medical benefits and compensation to, or on behalf of, that employee. The BWC pays these benefits and compensation from the workers’ compensation fund.
If an employee of a self-insured employer has an allowed claim for an injury or disease, the employer pays medical benefits and compensation directly to, or on behalf of, their employee.
Once a claim is allowed, an employee may be entitled to different types of compensation, including, but not limited to, temporary total disability, wage loss, permanent partial, and permanent total disability.