Ohio Workers’ Comp System Looking Better, WCRI Study Says

Significant changes in Ohio have enhanced the performance of the state’s workers’ comp system, particularly in speeding the payments of benefits to injured workers, but there are opportunities for further progress, according to a recent study by the Workers Compensation Research Institute.

The WCRI study found tremendous improvement in the speed of reporting and payment of claims by the state’s exclusive workers’ comp fund, the Bureau of Workers’ Compensation. It also found the dispute resolution system to be prompt and accessible. “Ohio should…be commended for its successful use of innovative managed care programs emphasizing return to work,” said Dr. Richard Victor, executive director of WCRI. However, he noted, there are certain areas that call for improvement. “In particular, the state should find ways to reduce its high level of litigiousness.”

Ohio has several special features compared to the typical workers’ comp system. First, injured workers initiate the majority of state fund claims and have more responsibility for producing information to support a claim than do workers in other states WCRI has studied. Second, Ohio’s dispute resolution system features a blend of de novo review and brief arbitration at all administrative levels and a greater involvement of the courts than in most states. Third, the state has a hybrid benefit structure that combines elements of impairment-based and wage-loss systems. And finally, Ohio has no private insurance, relying exclusively on a state insurance fund or self-insurance by larger employers.

According to the study, state fund claims are reported much faster than in the past, with the period from injury to filing for indemnity claims down from an average of 85 days in 1993 to 45 days in 1999. The time from injury to first payment fell from an average of 181 days in 1993 to 104 days in 1998.

“This improvement is due primarily to faster processing of claims by the Bureau of Workers’ Comp, coupled with faster reporting of claims,” Victor said.

The study identified lessons for other states from Ohio’s system: faster scheduling of initial conferences or hearings, coupled with strict enforcement of rules for continuance, can speed resolution; reliance on medical reports, rather than deposition or live testimony, is both expeditious and efficient; and Ohio’s issue-specific hearing process reduces the time to final resolution of claims.

There are several system features that contribute to litigiousness. The study found that permanent partial disability determination relies heavily on state fund-assigned doctors, whose objectivity is questioned by some worker advocates and some employers. Also, the law does not mandate a consistent set of guidelines when evaluating PPD ratings used to determine benefits. In addition, hearing officers commonly split the difference between adversarial ratings, creating incentives for participants to choose partisan experts. The WCRI, based in Cambridge, Mass., is a not-for-profit membership organization that conducts public policy research on workers’ comp, health care and disability issues.

Topics Claims Workers' Compensation Ohio