ORC 4123.95
"Sections 4123.01 to 4123.94, inclusive of the Revised Code shall be liberally construed in favor of the employee.
Effective Date: 11-02-1959"
Hearing Officers violate the Revised Code everyday when they are told by the Injured Worker or their representative that an IME DEP doctor didn't do what he claimed to have done according to their medical report, which is an alleged falsified medical record (insurance fraud).
ORC2913.48 Workers' compensation fraud
(A) No person, with purpose to defraud or knowing that the person is facilitating a fraud, shall do any of the following:
(3) Alter, falsify, destroy, conceal, or remove any record or document that is necessary to fully establish the validity of any claim filed with, or necessary to establish the nature and validity of all goods and services for which reimbursement or payment was received or is requested from, the bureau of workers’ compensation, or a self-insuring employer under Chapter 4121., 4123., 4127., or 4131. of the Revised Code;
OAC 4123-6-54 Employer participation in the QHP system - QHP certification application.
Under C(9)&(10) it states:
(9) A description of the QHP’s employee education program. The description shall include but shall not be limited to: a description of the process to be used to educate employees regarding their rights and responsibilities in the QHP system; a description of the process to be used to explain the time, place and manner of services to be delivered under the QHP; and a description of the process to be used to explain options available to injured workers, including the process for changing providers within the QHP and referral and transfer to the HPP; and
(10) A description of the plan satisfactory to the bureau to be implemented by the QHP in the event a final order to revoke certification, or to refuse to recertify a QHP is issued by the administrator, pursuant to rule 4123-6-55 of the Administrative Code, that includes, but is not limited to, a plan that describes continuation and continuity of care of injured workers; a plan that describes payment of providers for medical services rendered prior to revocation of certification or refusal to certify. The injured worker may continue receiving medical services from the same provider or may choose a provider in a new approved plan for delivery of medical services, both of whom shall accept medical management of the medical services through the employer’s new approved plan.
