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The legal State entity which administers claims, collects premiums and monitors compliance with the Ohio Revised Code and the Administrative Code. A fund established by the State to compensate a worker who has been injured or has contracted an occupational disease in the course of and arising out of employment.
The IC is the adjudicating body in the Ohio Workers' Compensation system. The IC adopts rules (Ohio Administrative Code) governing the conduct of hearings and rendering decisions by any of the three levels of hearings, the District Hearing Officer (DHO), Staff Hearing Officer (SHO) and Commissioners
BWC and the private-sector managed care organizations (MCOs) must work together to provide comprehensive claims-management and medical-management services. BWC is responsible for claim determinations and allowances, paying lost time compensation, second level of dispute resolution. The MCOs are responsible for provider management, utilization review, first level of dispute resolution, determining reimbursement eligibility and paying providers for services.
Maximum Medical Improvement (MMI) is a treatment plateau in each person's healing process. It can mean that the patient has fully recovered from the injury or that the patient's medical condition has stabilized to the point that no major medical or emotional change can be expected in the injured workers' condition. This occurs despite continuing medical treatment or rehabilitative programs the injured worker partakes in.
The legal time limitations set by the legislature for an employee to file a workers' compensation claim. If it is an injury claim, the time limitation is two years from the date of injury or death. The time limitation on an occupational disease claim is two years from the date of the diagnosis, disability or death, or six months from date of disability or diagnosis, whichever is later.
