4121.45 Workers' compensation ombudsperson system. - Ohio Statutes

4121.45 Workers' compensation ombudsperson system.

(A) There is hereby created a workers’ compensation ombudsperson system to assist claimants and employers in matters dealing with the bureau of workers’ compensation and the industrial commission. The industrial commission nominating council shall appoint a chief ombudsperson. The chief ombudsperson, with the advice and consent of the advisory commission, may appoint such assistant ombudspersons as the nominating council deems necessary. The positions of chief ombudsperson and assistant ombudspersons are for terms of six years. A person appointed to the position of chief ombudsperson or assistant ombudspersons may not be transferred, demoted, or suspended during the person’s tenure and may be removed by the nominating council only on the grounds of malfeasance or neglect of duty upon notice and public hearing. The ombudspersons shall devote their full time and attention to the duties of their office. The administrator of workers’ compensation shall furnish the ombudspersons with the office space, supplies, and clerical assistance that will enable the ombudspersons to perform their duties effectively. The ombudsperson program shall be funded out of the budget of the bureau and the chief ombudsperson and assistant ombudspersons shall be carried on the bureau payroll but shall be under the direction of the nominating council. The administrator and all employees of the bureau and the commission shall give the ombudspersons full and prompt cooperation in all matters relating to the duties of the ombudspersons.

(B) The ombudspersons shall:

(1) Answer inquiries or investigate complaints made by employers or claimants under this chapter and Chapter 4123. of the Revised Code as they relate to the processing of a claim for workers’ compensation benefits;

(2) Provide claimants and employers with information regarding problems which arise out of the functions of the bureau, commission hearing officers, and the commission and the procedures employed in the processing of claims;

(3) Answer inquiries or investigate complaints of an employer as they relate to reserves established and premiums charged in connection with the employer’s account.

For the purpose of carrying out the chief ombudsperson’s duties, the chief ombudsperson or the chief ombudsperson’s assistants, notwithstanding sections 4123.27 and 4123.88 of the Revised Code, has the right at all reasonable times to examine the contents of a claim file and discuss with parties in interest the contents of the file as long as the ombusdperson does not divulge information that would tend to prejudice the case of either party to a claim or that would tend to compromise a privileged attorney-client or doctor-patient relationship.

(C) The chief ombudsperson shall:

(1) Assist any service office in its duties whenever it requires assistance or information that can best be obtained from central office personnel or records;

(2) Annually assemble reports from each assistant ombudsperson as to their activities for the preceding year together with their recommendations as to changes or improvements in the operations of the workers’ compensation system. The chief ombudsperson shall prepare a written report summarizing the activities of the ombudsperson system together with a digest of recommendations. The chief ombudsperson shall transmit the report to the nominating council.

(D) No ombudsperson or assistant ombudsperson shall:

(1) Represent a claimant or employer in claims pending before or to be filed with the administrator, a district or staff hearing officer, the commission, or the courts of the state, nor shall an ombudsperson or assistant ombudsperson undertake any such representation for a period of one year after the ombudsperson’s or assistant ombudsperson’s employment terminates or be eligible for employment by the bureau or the commission or as a district or staff hearing officer for one year;

(2) Express any opinions as to the merit of a claim or the correctness of a decision by the various officers or agencies as the decision relates to a claim for benefits or compensation.

The chief ombudsperson and assistant ombudspersons shall receive compensation at a level established by the nominating council commensurate with the individual’s background, education, and experience in workers’ compensation or related fields. The chief ombudsperson and assistant ombudspersons are full-time permanent employees in the classified civil service of the state and are entitled to all benefits that accrue to such employees, including, without limitation, sick, vacation, and personal leaves.

Effective Date: 12-02-1996