The workers' compensation and employers liability policy and the general principles of no-fault benefits and exclusive remedy are covered in the national Workers' Compensation guide. Ohio is a monopolistic state. Private insurers can't write workers' compensation in Ohio. Employers either pay premium into the state insurance fund administered by the Bureau of Workers' Compensation (BWC) or qualify to self-insure (R.C. Chapter 4123). This guide covers how that system works.

The state insurance fund

• Who is covered: every person, firm or private corporation with one or more employees regularly in the same business is an employer under the law (R.C. 4123.01(B)).
• Private employers pay premium into the state insurance fund. The Administrator sets the premium from the classifications, rules and rates the Administrator publishes (R.C. 4123.35(A)). Estimated annual premium is paid in June before the policy year, with installment options.
• A private employer that hires a subcontractor is liable for the subcontractor's unpaid premium on the payroll for that work.
• Self-insurance: an employer with enough financial strength may pay compensation directly. Factors include at least two years of operation in Ohio, assets, CPA-certified financial statements and an administration plan, and a surety bond is required (R.C. 4123.35(B)).
• Insuring workers' compensation is void: a contract that insures an employer against its compensation liability is void. The narrow exception is excess coverage for a self-insurer above at least $50,000 per event, and the excess insurer can't represent the employer in claims (R.C. 4123.82). The BWC or an other-states insurer may still provide other-states coverage for Ohio employers.
• Religious exemption: members of a recognized religious sect opposed to insurance benefits may apply for exemption, with affidavits from employer and employees (R.C. 4123.15).

Exclusive remedy and defenses

• A complying employer isn't liable for damages at common law or by statute for work injuries, occupational diseases or deaths (R.C. 4123.74).
• A noncomplying employer loses the defenses of the fellow-servant rule, assumption of risk and contributory negligence (R.C. 4123.77).

What's covered

• Injured workers receive compensation, medical, nursing and hospital services and medicines, and funeral expenses in case of death (R.C. 4123.54(A)).
• Not covered: injuries purposely self-inflicted, or caused by intoxication or non-prescribed controlled substances that were the proximate cause. Ordinary negligence doesn't bar benefits.
• "Injury" excludes disability caused mainly by natural deterioration, and psychiatric conditions unless they arise from a physical injury or occupational disease, or from forced sexual conduct (R.C. 4123.01(C)).
• An occupational disease must come from a hazard that sets the job apart from employment generally (R.C. 4123.01(F)).

Benefits

• Waiting period: no compensation for the first week unless total disability lasts two continuous weeks or more, in which case the first week is paid after the second. Medical benefits have no waiting period (R.C. 4123.55).
• Temporary total disability: for the first 12 weeks, 72% of the full weekly wage, capped at the lesser of the statewide average weekly wage or 100% of net take-home pay. After that, 66 2/3% of the average weekly wage, up to the statewide average weekly wage and subject to a minimum (R.C. 4123.56).

Claims and appeals

• A claim is barred unless, within one year, written notice of the injured body parts is filed with the Industrial Commission or BWC (or the employer pays wages in lieu of compensation, among other events) (R.C. 4123.84).
• Appeals of Administrator orders go to an Industrial Commission district hearing officer, then a staff hearing officer, then the Commission. Each appeal is due within 14 days of receiving the order. The staff hearing officer holds a hearing within 45 days (R.C. 4123.511).

Common exam traps

• Ohio is monopolistic. Private carriers can't write Ohio workers' compensation; employers use the state fund or self-insure.
• Excess coverage for self-insurers (at least $50,000 per event) is the narrow exception.
• One employee makes an employer subject to the law.
• 72% for the first 12 weeks, then 66 2/3%.
• First week paid only if total disability lasts two weeks or more.
• One year to file; 14 days to appeal.