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Thursday, January 27, 2005

Have you been overcharged...?

The Ohio Revised Code provides that medical benefits will be paid in a claim upon a Staff Hearing Officer’s Order or after the matter is finally adjudicated in court. The practice of the Bureau of Workers’ Compensation is to pay medical benefits after a Staff Hearing Officer awards payment of those benefits in any claim on behalf of the claimant. Those benefits are then charged to the state fund insured employer’s risk account and are made part of the employer’s experience for purposes of calculating their experience modification rate and ultimately their workers’ compensation premium. As you are aware, such charges can adversely affect your status within a group or your individual premium.

On December 22, 2004, the Ohio Supreme Court issued a decision in the case of Arth Brass & Aluminum Castings, Inc. v. Conrad. A copy of this decision can be found at 104 Ohio St. 3d 547 (2004). In this case, Arth argued that its employee had filed a workers’ compensation claim for bilateral carpal tunnel syndrome. Both the District and Staff Hearing Officers at the Industrial Commission allowed the employee’s claim for this condition. The company appealed the decision allowing the claim to the Cuyahoga Court of Common Pleas pursuant to Ohio Revised Code § 4123.512(H).

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