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State Fund Workers' Compensation Services

As your Third Party Administrator for Ohio Workers’ Compensation, Hunter Consulting strives to provide the best designed and managed program available that will reduce your claims and premiums while protecting both your business and your employees.

Program Design and Implementation

Hunter Consulting works closely with the State of Ohio and your organization to manage claims efficiently and effectively. While the state is responsible for paying benefits to injured employees, we act on your behalf to ensure that claims are handled properly and costs are minimized. Our team coordinates with both parties to streamline the claims process, limit your financial exposure, and facilitate a quick and safe return to work for your employees.
State Fund Program Compatibility Chart

Statefund

Claim Management and Control

Many employers only aggressively approach the 5% of their claims that they feel are questionable and assume the remaining 95% will take care of themselves. This simply does not happen.

To control Workers’ Compensation costs in today’s environment, a company must control all of their claims, especially, the 95% of the legitimately injured employees.

At Hunter Consulting, we have developed what the average length of disability is by injury type. Every lost time claim is monitored to track this period of disability. And we contact the claimant’s doctor on any claim that exceeds the norm to discuss their prognosis and restrictions for return to work. We then discuss with you, the options available whether that may be modified work, independent medical exams, or rehabilitation.

As your service company, it is our responsibility to identify for you those claims that need attention and your operations that need safety reviews.

Hearings

Hunter utilizes a network of attorneys across ohio for employer representation at all hearings before the industrial commission.

All contested claims are reviewed by your dedicated Account Manager, who ensures that relevant information and documentation are in order. We communicate with your company to provide necessary background details and support. When a claim proceeds to the Industrial Commission and requires legal representation, we step back, and the process is managed by your attorney in collaboration with your team. Our role is to offer any additional information needed to assist your legal counsel.

We’ve Helped Many Clients Enroll

We have helped hundreds of employers enroll through our statewide network of sponsors. As new employers, you will have access to the same benefits as each of our established clients – including:
Experienced claims managers
Manual Classification Review
Attorney representation at the industrial commission
Semi-Annual Safety Training

Salary Continuation

Salary continuation, also known as Wages in Lieu of Temporary Total Disability (TTD), is a privilege granted by the BWC that allows employers to pay an injured worker their normal wages while they are unable to work due to a work-related injury.

Hunter Consulting will assist you in determining when this is appropriate.

  • Notify you of developments
  • Maintain proper file documentation
  • Coordinate efforts with appropriate parties

Purpose

When a lost-time claim occurs, a reserve is set. This reserve is added to the compensation and medical paid in a claim to develop your total modified losses (TML). The TML is used to determine an employer’s experience rate and subsequent premium. Payment of salary continuation avoids compensation from being paid by the BWC, and prevents a reserve from being established in the claim.pulvinar dapibus leo.

Benefits

  • Avoids costly reserves
  • Can lower premiums
  • Decreased wait time for workers’ compensation checks to begin
  • Supports communication between the employer and injured worker
  • May discourage injured worker from seeking legal advice

Risk

  • Initially, salary continuation may be recommended when lost time does not exceed 12 weeks. However, the cost of continuing an injured worker’s salary can sometimes outweigh potential savings. Hunter Consulting Company will make a recommendation on each specific situation.
  • Initially, salary continuation may be recommended when lost time does not exceed 12 weeks. However, the cost of continuing an injured worker’s salary can sometimes outweigh potential savings. Hunter Consulting Company will make a recommendation on each specific situation.
  • The injured worker is not required to accept salary continuation.

Process

  • Decision to pay salary continuation must be made at the onset of the claim, as it cannot be paid once the BWC has issued TTD.

  • The employer must notify the BWC within 48 hours and Hunter Consulting immediately that they are paying salary continuation.

  • The employer must report a return to work within 72 hours (3 business days). Failure to do so may impact the employer’s eligibility to participate in the salary continuation program.

Recommendation

It is important to practice a consistent policy of continuing wages in all claims that meet your list of parameters. You do not want to be accused of discrimination. You should consult with legal counsel to carefully develop a wage continuation policy appropriate for your company. We recommend that you contact your Account Manager at Hunter Consulting to review the specifics of the claims and ask any questions you may have regarding salary continuation.

  • Salary continuation must be paid immediately so there is no lapse in pay for the injured worker.

  • BWC form C-55 (Salary Continuation Agreement) must be completed by the employer and injured worker and provided to the BWC. The employer may be asked to submit payment summary and wage information in writing. The C-55 form, to document payment of salary continuation, can be obtained from the BWC claims service specialist (CSS), the BWC website or from Hunter Consulting.

  • The employer must notify the BWC immediately if salary continuation is stopped for any reason. The CSS will investigate to determine the injured worker’s continued eligibility to receive TTD.

Eligibility

Claims may be eligible for handicap reimbursement if they include payment of Temporary Total Disability, Permanent Total Disability, Death Benefits and Salary Continuation. Employers not eligible for the handicap reimbursement are:

Benefits

The percentage granted, ranging from 0 to 100 percent, is deducted from the experience of the employer and is subsequently charged to the statutory surplus fund.

Handicap Reimbursement

Purpose

Handicap reimbursement provides relief from a portion of the cost of claims where the injured worker has 1 of 26 pre-existing conditions. The employer must prove that the condition existed prior to the injury and prolonged the recovery or increased the cost of the claim. The employer may request that a percentage of the costs in the claim be removed from their experience.

Hunter Consulting will notify you if an injured worker meets this criteria.

  • Non-complying employers
  • Out-of-business employers
  • Self-insured employers who have opted out of the program and did not list the claim on the buyout agreement
  • Bankrupt employers (requests are reviewed on a case by case basis; some bankrupt employers may qualify for a reimbursement)
  • State agencies
  • Universities

Process

  • Hunter Consulting Account Managers review medical documentation to identify any preexisting condition in any claim with disability compensation and/or salary continuation payments.

  • If there is significant supporting documentation, Hunter Consulting will file an Application for Handicap Reimbursement (CHP-4A) for consideration by the BWC.

  • The BWC administrator decides the percentage of the reimbursement and issues an order directing the BWC’s Risk Technical Department to adjust the employer’s premium for the time the claim remains in the employer’s experience period. The percentage award is entered into the records of the employer’s state fund risk account.

  • If a qualifying condition is identified, Hunter Consulting begins to establish documentation to show the extent that the pre-existing condition prolonged or delayed normal recovery.

  • Hunter Consulting will represent the employer at a BWC administrative hearing to establish the relationship between the pre-existing condition and the subsequent injury, by way of aggravation or delayed recovery by medial proof on file.

Application Deadlines

  • State Fund Employer claims must be filed by 6/30 of the sixth year after the date of injury. Example: 2006 injury must have application filed by 6/30/2012​
  • Public Employer claims must be filed by 12/31 of the fifth year after the date of injury. Example: 2006 injury must have application filed by 12/31/2011​
  • Self-Insuring Employers still in the program must file claims within five years from the date of injury. Example: 2006 injury must be filed by date of injury in 2011.​
Let’s Get Started

Ready to Optimize Your Workers' Compensation Program?

Whether you’re looking to reduce costs, simplify your processes, or ensure you’re getting the most out of available incentive programs, Hunter Consulting is here to help. Our team of experts is ready to analyze your current situation and develop a customized strategy to meet your needs.
Take the first step towards a more efficient, cost-effective workers’ compensation program. Contact us today for a free consultation.

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