(A) The bureau shall take measures and make
expenditures, as it deems necessary, to aid injured workers who have sustained
compensable injuries or contracted occupational diseases to remain at
work.
(B) Remain at work services.
(1) An injured worker is eligible to
participate in a
receive remain at work
program
services
when:
(a) The injury results in a medical
only claim which is certified by the employer or is allowed pursuant to a
bureau or industrial commission order or a lost time
claim with eight or more days of lost time due to a work related injury which
is certified by the employer or is allowed pursuant to a bureau or industrial
commission order, but the injured worker is not receiving and has not been
awarded temporary total compensation or salary continuation in the claim;
and,
(b) It is documented by the
employer, the injured worker, or
the physician of record that the injured worker
is experiencing problems that are work-related and result from the allowed
conditions in the claim.
(2) Services provided shall be charged to the
employer's risk.
(3) The MCO shall
determine the need for remain at work services.
(4)
Within five
business days of completion of services, the MCO shall submit a final report to
the bureau.
(5)
The bureau may audit the MCO's utilization of remain
at work services.
(C) Scope of remain at work services.
(1) Services provided in a remain at
work program.
(a) The MCO shall submit to the
bureau a final report at the completion of services within five business days
of final services.
(b)
(1) Remain at work
services may include ergonomic study, functional capacity evaluation, job
analysis, physical therapy (on site), occupational therapy (on site), physical
reconditioning, transitional work, gradual return to work, on the job training,
short term training, job modification, tools and
equipment, and remain at work case management.
(c)
(2) The bureau will
not reimburse an employer for remain at work services that are provided by the
employer (e.g., transitional work, on the job training, gradual return to
work).
(2)
(3) Remain at work services shall cease upon the
occurrence of any of the following:
(a) A
bureau, industrial commission or court order subsequently disallowing the
claim.
(b) The claim changes to a
lost time claim with eight or more days of lost time due to a work related
injury
and the injured worker receives temporary total
compensation or salary continuation in the claim.
A claim that changes to a lost time
claim with eight or more days of lost time due to a work related injury may be
referred for vocational rehabilitation services as provided under Chapter
4123-18 of the Administrative Code.
(c) The effective date of lump sum
settlement.
(3) The bureau may audit the MCO's
remain at work program.
(4)
A claim that
changes to a lost time claim with eight or more days of lost time due to a work
related injury may be referred for vocational rehabilitation services as
provided under Chapter 4123-18 of the Administrative Code if the injured worker
is receiving or has been awarded temporary total compensation or salary
continuation in the claim.
Notes
Ohio Admin. Code
4123-6-19
Effective:
11/13/2015
Five Year Review (FYR) Dates:
08/26/2015 and
08/25/2020
Promulgated
Under: 119.03
Statutory
Authority: 4121.12,
4121.121,
4121.30,
4121.31,
4121.44,
4121.441,
4123.05,
4123.66
Rule
Amplifies: 4121.12,
4121.121,
4121.44,
4121.441,
4123.66
Prior
Effective Dates: 1/1/01, 2/14/05, 7/1/12
