© 2012, Gruhin & Gruhin Attorney's. All rights reserved.

Just an FYI to anyone who has an Ohio Workers’ Compensation Claim – your medical providers MUST be Ohio BWC Certified Providers.  You are entitled to go to any doctor you want, however, the BWC does not have to pay for medical services rendered by a doctor who is not a Certified BWC Provider.

Click here to make sure your doctor is a Certified Medical Provider for the OhioBWC.

Mike Gruhin is a Board Certified Ohio Workers’ Compensation Specialist Attorney – you have OhioBWC questions? Mike Gruhin has the answers.  You should have a Certified Specialist representing your legal rights at the Ohio BWC and the Ohio Industrial Commission.

© 2011, Gruhin & Gruhin Attorney's. All rights reserved.

Anyone who is returned to work after an OhioBWC work injury, with restrictions imposed by their doctor of record,  can apply for wage loss, if they earn less than the amount set as the Average Weekly Wage (AWW) in their claim.

There are several types of wage loss non-working wage loss working wage loss Vocational Rehabilitation wage loss
Wage loss can be granted by an OhioBWC Tentative Order, which if not appealed, will start payment of wage loss. However, if the injury employer appeals the granting of wage loss there will be a hearing at the Industrial Commission of Ohio.

If the Injured Worker is denied wage loss by the Ohio BWC, then if appealed by the Injured Worker, a hearing will be scheduled at the Industrial Commission of Ohio.

If you have an allowed Ohio Workers’ Comp Claim, you need to consult with a Board Certified Ohio BWC Specialist Attorney.  Call Mike Gruhin to discuss any questions you have related to Ohio Work Comp Wage Loss or any other issue involving your Ohio BWC claim.

© 2011, Gruhin & Gruhin Attorney's. All rights reserved.

Hard to believe, but the legislature in Ohio is about to give Emergency Room doctors a free pass. They won’t be held accountable to uphold the minimum standard of care if this bill passes. SHOUT LOUD AND SHOUT HARD TO GET THIS BILL DEFEATED.

Today the Ohio Senate introduces Senate Bill 129, a bill that would grant immunity to physicians who provide emergency medical services.

Proposed Legislation Needlessly Raises Taxes and Endangers Public

Currently, Ohio has some of the best medical care in the country. Senate Bill 129 will undermine that accomplishment by giving immunity to all physicians who provide emergency medical services. This proposed Bill will require taxes to be raised, will reduce the quality of medical care in Ohio, and will invite bad doctors to practice in Ohio. Under the proposed law, if any physician is negligent in the emergency room setting and causes injury to a patient, the doctor and/or hospital (and their private insurance companies) will not have to pay for the harm caused. Instead, the patient (or the taxpayer) will be required to pay for the financial harm that the medical errors caused, including lost wages and further medical treatment and expenses. This proposed law provides no incentive for emergency rooms to be staffed with the best and most qualified health care professionals. For the first time in Ohio’s history, preventable medical errors will cost hospitals nothing, but patients everything.

Further, the proposed legislation will undermine Governor’ Kasich’s promise to fix Ohio’s financial crisis.  On a national level, medical errors cost Medicare approximately $4.4 Billion annually (U.S. Dept. of Health and Human Services, Office of the Inspector General).  Preventable medical errors that do not result in the patients’ death almost always require the injured patients to seek further care, and in many instances render the patients unable to work or earn a living. The cost of that medical care and lost income will regularly be passed on to the taxpayers through increased state Medicaid spending and other governmental safety-net programs, thus adding to Ohio’s budget crisis. Ohio law has always required that the responsible party must pay for the medical care and lost income caused by the malpractice, not transfer that obligation to the taxpayer. SB 129 will turn 208 years of common sense law upside down.

History has shown proposed SB 129 to be a bad idea. In Texas and Georgia, for example, where such laws have passed–allowing emergency doctors to practice with little to no accountability, the quality of emergency care plummeted.  According to the American College of Emergency Physicians Report Card on Access to Emergency Care, both Texas and Georgia received failing grades for access to emergency care. Ohio‘s grade exceeds the grade of all five states that currently have emergency room immunity laws.

Studies have proven that over 98,000 preventable deaths occur each year in America’s hospitals. This number does not include people who were severely injured and left with a life time of disabilities, medical bills, and lost wages. Lack of accountability will attract doctors to Ohio who had difficulty buying insurance elsewhere because of a history of significant medical mistakes.  Ohio does not want to attract bad doctors to the state.

Because proposed SB 129 will increase the tax burden to Ohio’s taxpayers, attract bad doctors to Ohio, and decrease the quality of care delivered in Ohio’s emergency rooms and urgent care centers, the Bill is a bad idea and should be defeated.

Proponents suggest the Bill is necessary because emergency doctors sometimes have to make quick decisions.  But that is exactly how ER doctors are trained, and why they are paid well. Proponents also suggest that this bill is limited to circumstances where a disaster strikes Ohio.  That is simply not true. Immunity under SB 129 is conferred to all doctors who see patients in the ER setting, even under routine circumstances. 

Currently, under Ohio law, doctors and hospitals have plenty of protection from unnecessary lawsuits. A lawsuit cannot be filed against a doctor or hospital unless a competent physician reviews the records, comes to an opinion about the care, and executes an affidavit under oath stating that the care failed to meet acceptable medical standards. So, only physicians can trigger a medical malpractice lawsuit in Ohio.  Further, there are caps on the amount of damages a hospital or doctor can pay, irrespective of how badly injured the patient was.  And, the number of claims against doctors in Ohio is at a historic low.

© 2011, Gruhin & Gruhin Attorney's. All rights reserved.

According to Ohio Workers’ Compensation Rules, your doctor must be a Bureau Certified Provider or the BWC will not pay the medical charges.  But, how do you find a certified provider?

There are several ways in which to find a certified provider. Many times, an injured worker is referred to a follow up doctor by the emergency room. Your lawyer can also recommend several doctors near your home or work in order to assist you in finding a Bureau Certified Provider whose location is convenient for you.

But there are times where an injured worker moves out of state and needs to find a doctor for continuing treatment. So then what? Check out the Ohio BWC Certified Provider Look-up.

Remember, after 13 months without medical treatment your claim will become medically inactive. At that point, the BWC will make you prove all over again that the medical treatment you seek is related to the original  work injury. The longer you go without treatment, the harder proving that relationship becomes.

© 2009, Gruhin & Gruhin Attorney's. All rights reserved.

I was called by a prospective client about her BWC claim and the fact that she could not get authorized for treatment. After talking to her for a few minutes it became obvious that I needed to speak with her doctor. So, I call the doctor and ask about the treatment that he requested on the C9 authorization form.  I was dumbfounded by his comments during the conversation! Here is the skinny on our discussion.

First I ask him what he filled out on the form. He told me that  he asked for permission to provide therapy modalities over a multi week period. It was apparent to me, during the conversation with the prospective client and the doctor, that the claim was medically inactive. The request should have asked for claim reactivation.

If you are an injured worker, you must be informed and know that if you have an allowed BWC claim and you do not obtain medical treatment for a period of 14 months, your claim becomes inactive. Once that happens, you may have to prove – all over again - that your needed treatment is related to the original work injury. The doctor’s mistake was not requesting reactivation of the claim.

But now for the clincher to the conversation . . . . Then I ask the doctor when he sent the C9 Form to the MCO (Medical Care Organization). His reply, on the 5th (today is the 13th).  I ask if he has a fax transmittal sheet to prove that he sent it on the 5th and that the MCO received the C9 on the 5th.  He seemed surprised by the question. Well, if he was surprised by the question, I was dumbfounded that a medical provider – an OhioBWC Certified Medical Provider at that – would not be aware of the simple rules governing the time limits pertaining to authorization of treatment requested via the C9 Form.

I explain that there are rules and that the rules are printed right on the form. A state funded employer’s MCO has 3 days to respond to a C9. If there is no response, guess what – the requested treatment is authorized. For a self insured employer, there is a 10 day response time. I can’t tell y0u how many times MCO’s blow the response time.  A C9 Form is attached to this article via hyperlink below so you can see it for yourselves.

In this instance, the doctor could not prove that he sent the C9 form to the MCO over 7 days before, without response.

Who suffers? The injured worker because here she is waiting for necessary treatment that could have started days before.

I then explained to the doctor that there is a rule regarding the submission of medical bills. A medical bill must be submitted to the MCO or OhioBWC within 2 years of the date of service. If the bill isn’t filed within the 2 year period, the BWC doesn’t have to pay the bill, even if the treatment was rendered for allowed claim conditions,  because the bill is time barred. Who suffers in such situation? Both the doctor and the injured worker. But then I suppose the doctor eventually would sue the injured worker for payment of the bill even though the doctor failed to file his bill in a timely fashion.

Bottom Line – The Importance of a Fax Transmittal Sheet - I explained that the doctor needed to set his fax machine to spit out a transmittal sheet so he can prove when and to whom he sent the C9 for treatment approval and also to prove when and to whom he submitted his medical bills for payment.

Hopefully, the doctor learned what needs to be done.

Please check with your doctor to make sure that he/she can prove when documents, office notes, C9 authorization requests, and bills were filed with the BWC.

Check out the C9 Form and see the rule for yourselves. Why don’t the doctors read the forms they use every day?

If you have any questions about your Ohio Workers’ Compensation claim, please give us a call. We would like to help you receive all of the benefits to which you are entitled.

To make sure your claim is being handled correctly, call Mike Gruhin Board Certified Ohio Workers’ Compensation Specialist at 216-861-5555.  Get the protection you need and all of the compensation benefits and money you deserve.

© 2009, Gruhin & Gruhin Attorney's. All rights reserved.

Prescription medication errors and medication mistakes cause injuries and deaths every year.

These injuries, which are avoidable, are usually caused by a doctor prescribing the medications incorrectly or the pharmacy filling the wrong medication or dispensing an incorrect dosage.

Medication and prescription errors are a prevelant medical problem and numerous Ohioans suffer serious injuries or die every year as a result.

Even worse, under legal loopholes, pharmacies are able to replace certain prescription medication with generics that are similar but not of the same theraputic value as the medication your doctor may want you to have. These switches in medications by the pharmacy, in many cases, are prompted by higher profit margins for drugs that they use in the switch.

Discuss with your doctor whether generic medications would cause a negative health effect in your situation. Importantly, the doctor should mark the prescription as DISPENSE AS WRITTEN, known as DAW.

If you think that you are a victim of a prescription error, please call Gruhin & Gruhin to discuss your injuries and the facts of your case.  Let us evaluate whether you have the right to seek a money award for the injury & damages you sustained as a result of your accident. The call is free.

© 2009, Gruhin & Gruhin Attorney's. All rights reserved.