Amendment No. am_136_0253

H. B. No. 81

As Introduced

__________________________ moved to amend as follows:

In line 1 of the title, after "4121.13" insert ", 4121.41, 4121.45"

In line 12, after "4121.13" insert ", 4121.41, 4121.45"

After line 645, insert:

"Sec. 4121.41. (A) The administrator of workers' compensation shall operate a program designed to inform employees and employers of their rights and responsibilities under Chapter 4123. of the Revised Code and as part of that program prepare and distribute pamphlets, which clearly and simply explain at least all of the following:

(1) The rights and responsibilities of claimants and employers;

(2) The procedures for processing claims;

(3) The procedure for fulfilling employer responsibility;

(4) All applicable statutes of limitation;

(5) The availability of services and benefits;

(6) The claimant's right to representation in the processing of a claim or to elect no representation.

The administrator shall ensure that the provisions of this section are faithfully and speedily implemented.

(B) The bureau of workers' compensation shall maintain an ongoing program to identify employers subject to Chapter 4123. of the Revised Code and to audit employers to ensure an optimum level of premium payment. The bureau shall coordinate such efforts with other governmental agencies which have information as to employers who are subject to Chapter 4123. of the Revised Code.

(C) The administrator shall handle complaints through the service offices, the claims section, and the ombudsperson programworkers' compensation customer advocacy office. The administrator shall provide toll free telephone lines for employers and claimants in order to expedite the handling of complaints. The bureau shall monitor complaint traffic to ensure an adequacy of telephone service to bureau offices and shall compile statistics on complaint subjects. Based upon those compilations, the bureau shall revise procedures and rules to correct major problem areas and submit data and recommendations annually to the appropriate committees of the general assembly.

Sec. 4121.45. (A) There is hereby created a the workers' compensation ombudsperson system customer advocacy office 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 ombudspersoncustomer advocate. The chief ombudspersoncustomer advocate, with the advice and consent of the nominating council, may appoint such assistant ombudspersons advocates as the nominating council deems necessary. The position of chief ombudsperson customer advocate is for a term of six years. A person appointed to the position of chief ombudsperson customer advocate shall serve at the pleasure of the nominating council. The chief ombudsperson customer advocate may not be transferred, demoted, or suspended during the person's tenure and may be removed by the nominating council only upon a vote of not fewer than nine members of the nominating council. The chief ombudsperson customer advocate shall devote the chief ombudsperson's customer advocate's full time and attention to the duties of the ombudsperson's chief customer advocate's office. The administrator of workers' compensation shall furnish the chief ombudsperson customer advocate with the office space, supplies, and clerical assistance that will enable the chief ombudsperson customer advocate and the ombudsperson system customer advocacy office staff to perform their duties effectively. The ombudsperson program office shall be funded out of the budget of the bureau and the chief ombudsperson customer advocate and the ombudsperson system customer advocacy office staff shall be carried on the bureau payroll. The chief ombudsperson customer advocate and the ombudsperson system customer advocacy office shall be under the direction of the nominating council. The administrator and all employees of the bureau and the commission shall give the ombudsperson system customer advocacy office staff full and prompt cooperation in all matters relating to the duties of the chief ombudspersoncustomer advocate.

(B) The ombudsperson system customer advocacy office staff 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;

(4) Comply with Chapter 102. and sections 2921.42 and 2921.43 of the Revised Code and the nominating council's human resource and ethics policies;

(5) Not 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.

For the purpose of carrying out the chief ombudsperson's customer advocate's duties, the chief ombudsperson customer advocate or the ombudsperson system customer advocacy office staff, 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 ombudsperson customer advocate 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 relationship, physician-patient relationship, or advanced practice registered nurse-patient relationship.

(C) The chief ombudsperson customer advocate 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 customer advocate 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 customer advocate shall prepare a written report summarizing the activities of the ombudsperson system customer advocacy office together with a digest of recommendations. The chief ombudsperson customer advocate shall transmit the report to the nominating council.

(3) Comply with Chapter 102. and sections 2921.42 and 2921.43 of the Revised Code and the nominating council's human resource and ethics policies.

(D) No ombudsperson customer advocate or assistant ombudsperson customer advocate 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 a customer advocate or assistant ombudsperson customer advocate undertake any such representation for a period of one year after the ombudsperson's customer advocate's or assistant ombudsperson's customer advocate'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.

(E) The chief ombudsperson customer advocate and assistant ombudspersons customer advocates 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 customer advocate and assistant ombudspersons customer advocates are full-time permanent employees in the unclassified service of the state and are entitled to all benefits that accrue to such employees, including, without limitation, sick, vacation, and personal leaves. Assistant ombudspersons customer advocates serve at the pleasure of the chief ombudspersoncustomer advocate.

(F) In the event of a vacancy in the position of chief ombudspersoncustomer advocate, the nominating council may appoint a person to serve as acting chief ombudsperson customer advocate until a chief ombudsperson customer advocate is appointed. The acting chief ombudsperson customer advocate shall be under the direction and control of the nominating council and may be removed by the nominating council with or without just cause."

In line 2231, after "4121.13" insert ", 4121.41, 4121.45"

The motion was __________ agreed to.

SYNOPSIS

Workers' Compensation Customer Advocacy Office

R.C. 4121.41 and 4121.45

Renames the "workers' compensation ombudsperson system" the "Workers' Compensation Customer Advocacy Office."

Changes the titles of "chief ombudsperson" and "assistant ombudspersons" to "chief customer advocate" and "assistant customer advocates," respectively.