Where is the winning for Employers in Ohio workers’ compensation?
ANSWER: For an Employer, having a worker injured on the job is an immediate loss to both the Injured Worker and the Employer. The Employers I represent are not in the business to injure workers, and understand that when the system is working as it is intended the Injured worker receives the treatment they require, they heal and they return to work.
QUESTION: But what about those contested claims?
ANSWER: As an attorney, I have one job when involved in a claim:
1) get it denied, 2) get it settled and 3) get it closed.
My focus is always bringing a claim to its conclusion quickly. The longer the claim continues, the more treatment, the more compensation, and more importantly the more litigation costs can result in an unmanageable claim. If an outright denial cannot be secured it’s important that defense strategies are put in place to limit treatment/compensation.
All attorneys get unfavorable decisions, but it’s a challenge to continue to work through one in a creative way to achieve the goal. The focus in defending workers’ compensation claims should not be on a single issue or single hearing, but on the projected mapping of the life of the claim; what happens between and after hearings is every bit as important as what takes place at the hearings.
Find an attorney that’s more focused on concluding the war, rather than winning the battle.
Legislative News: Senate Bill 106
Senate Bill 106 was introduced on April 11, 2023 for consideration. This Bill would add physicians and registered nurses as qualifying professions under the state’s existing law providing testing for first responders exposed to chemicals or bodily fluids who are provided “post-exposure medical diagnostic services, consistent with the standards of medical care existing at the time of the exposure, to investigate whether an injury or 16 occupational disease was sustained.”
State ex Rel Friendship Supported Living, Inc. v. Ohio Bur. Of Workers’ Comp., Slip Opinion No. 2023-Ohio-957.
The Supreme Court found in this case that the BWC had abused its discretion by failing to sufficiently account for the factors required in determining whether in-home direct-care workers were employees rather than independent contractors. The Appellee Friendship Supported Living Inc. underwent a premium audit in 2008 and the BWC classified their workers as independent contractors. An audit in 2017 yielded the exact opposite result, the BWC classifying their direct-care workers as employees, and not independent contractors.
Friendship Supported Living Inc. protested the BWC’s audit findings to the Adjudicating Committee who determined that they had the “right to control the workers.” They appealed further the Administrator’s Designee who again cited “sufficient control” over the workers to classify them as employees. Friendship Supported Living Inc. filed a complaint for a writ of mandamus requesting that the workers be classified as independent contractors and reimburse them for the premiums it had incurred as the result of the BWC’s classification. The Court of Appeals granted the writ and ordered that BWC to vacate its order classifying the workers as employees and ordered the BWC to return any premium payments paid on that classification. Rather than adopt the Court of Appeals decision, the Supreme Court noted that the BWC orders’ were not sufficient because they did not consider the totality of circumstances in the light of the relevant factors and order a limited writ to return to the issue to the BWC to specifically, address compliance and quality, workers’ freedom to work for other entities, and routes traveled and length of employment factors.
State Ex rel. Ohio-Kentucky-Indiana Regional Council of Govts. V. Bur. Of Workers’ Comp. Slip Opinion No. 2022-Ohio-3058
The Court found that the BWC abused its discretion classifying OKI as a special public authority without explaining why the classification change. In 2018, the BWC reclassified OKI as a “special public authority” which resulted in a much higher premium. Historically, OKI had been assigned two manual classifications, 1) 8742 “council of government staff members office and away from office and 2) 8810 “clerical office employees, no outside duties for others.
The BWC advised OKI that its prior classifications were for private employers only and OKI should be moved to manual classification 9443 which would result in a workers’ compensation premium 14 times higher than it had been. OKI appealed because it was neither a public employer nor a taxing district, both of which are required as criteria for the new classification. The BWC order did not specifically address why OKI’s employees are exposed to similar hazards to those which fall in the new 9443 classification. The Court issued a limited writ of Mandamus for the BWC to address the degree of hazard which supported the new classification.
The Supreme Court finally begins to question the BWC’s “Discretion” in Mandamus cases where the standard is “abuse of discretion.”
In two recent decisions it appears that the Supreme Court is taking the BWC to task for what was historically attributed to the BWC’s wide discretion in classifying employers for premium purposes. The Supreme Court is requiring that BWC orders addressing premiums set forth the basis for their decisions rather than pronouncing classification changes.