THE OHIO INDUSTRIAL COMMISSION
Request for Proposal
The Ohio Industrial Commission (OIC) is responsible for the adjudication of disputed Workers’
Compensation claims in a fair and equitable manner. The OIC conducts hearings on appeals and
motions at offices located in Columbus, Cincinnati, Dayton, Akron, Youngstown, Toledo, Lima,
Logan, Cleveland, Cambridge, Mansfield, and Portsmouth.
l. SCOPE OF WORK.
A. Exam / File Review Functions
1. Protocol Management
A. Develop, implement, and administer medical examination/addenda and file
review completion procedures.
i. General Procedural Outline
ii. Specifically required elements
a) By specialty
b) By issue – e.g., permanent total disability, compensation accrued at
the time of death
iii. Assist in development and maintenance of questions used in examination
B. Develop, implement, and administer procedures for depositions and
C. Develop medical examination and file review scheduling criteria and
i. Specialty selection process
ii. Geographical regions
D. Develop and maintain the OIC Medical Examination Manual.
E. Assist in the development and implementation of Information Technology
applications and procedures that support medical programs.
2. Quality Assurance
A. Work in collaboration with the Director of Medical Services on quality
i. Provisional and extended review needs
ii. Annual peer review system
iii. Injured worker survey data
B. Review and evaluate selected reports of medical examination and file reviews.
i. Standard format
ii. Required content
iii. Unequivocal opinion
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C. Participate in monitoring and reviewing examination procedures and activities.
i. Independent practitioner / provider activities
ii. OIC medical exam and review procedures
D. Develop and communicate (with Commission Members’ approval) OIC medical
E. Assist in review and evaluation of performance of existing specialists on a
regular (not less than annual) basis.
F. Assist the Director of Adjudication with review and evaluation of sufficiency of
medical information as hearing evidence.
G. Develop (with assistance of Director of Adjudication) input mechanisms for
Hearing Officers on medical issues discovered during the hearing process.
3. Tracking and Evaluation
A. Assist Management Planning with the development of data capture
mechanisms and measurement criteria.
i. Individual provider
ii. Overall program
B. Assist Management Planning and/or Director of Medical Services with
development of reports for tracking and analysis of medical program and
C. Review reports, as well as data, and provide analysis with activity plans to the
Director of Adjudication.
4. Ongoing Needs Analysis
A. Review workers’ compensation-related information and analyze for impact on
OIC medical programs.
i. Medical reports and information
ii. Commission Member decisions
iii. Legal and adjudicatory information
iv. Committee participation
B. Develop proposed program and procedures on a proactive basis to address
B. Panel Development / Maintenance
A. Develop qualification criteria for OIC specialists.
i. General qualifications
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ii. Specialty specific qualifications
B. Assist in reviewing specialist candidates’ qualifications.
C. Provide recommendation in the selection of qualified candidate(s) (with
Commission Members’ approval).
2. Resource Development / Maintenance
A. Analyze need for specialists.
i. By geographic zone and region
ii. By specialty
B. Provide recommendations for the development, implementation, and
administration of the specialist recruitment program.
C. Assist with development of training program for specialists.
D. Actively recruit and train specialists.
E. Assist in review and maintenance of existing specialists’ credentialing
F. Provide recommendation on renewal applications of existing specialists on our
panel on a five-year rotation basis.
G. Recommend removal of deficient providers (with Commission Members’
i. Deficient by reason of performance evaluation
ii. Deficient by Commission Members or Provider Review Panel decision
3. Utilization Management
A. Assist in development of regional medical scheduling criteria (provider
B. Assist in the implementation and administration of examination and review
scheduling programs (rotation procedures, etc.).
C. Assist with review and analysis of utilization experience and program needs.
i. Payment history – individuals
ii. Expense history – program
iii. Scheduling history (frequency) – individuals
iv. Exam frequency – program
D. Assist Information Technology, Regional Operations, Medical Services, and
Hearing Services (when required) in the evaluation and refinement of provider
4. Program Support Assistance
A. Development (with assistance of the Chief Communications Director) and
maintenance of training materials for specialist examiners.
B. Assist with maintenance of medical information files.
i. Specialist applications with support documentation
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ii. Agency medical program information
iii. Provider utilization information
5. Staff Development Assistance
A. Assist (when required) with training of support staff (claim examiners, word
processors, clerical staff, etc.) and hearing officers in areas relating to Medical
C. Program Management
1. Fee Schedule Management
A. Recommend appropriate compensation (fee) schedules for medical
examinations and reviews.
2. Procedural Development
A. Assist with the development of Information Technology and Management
Planning applications relating to medical examinations.
3. Inquiry / Complaint Response
A. Respond to inquiries and complaints regarding OIC specialist examiners.
i. Inquiries and complaints from interested parties
ii. Inquiries and complaints from OIC management
iii. Inquiries and complaints regarding Medical Services examination / review
B. Investigate complaints.
C. Suggest or initiate appropriate follow-up activity subsequent to complaints or
1. Advisory Activity
A. Advise the Commission and OIC management on issues requiring medical
2. General Participation and Assistance in matters involving medical issues.
II. WORK SCHEDULE
The Medical Advisor will be free to set their own work schedule in order to accomplish the
duties set forth above, however, the Commission may direct the Medical Advisor to perform
specific duties at designated times and locations. Most duties are required to be performed
in the OIC Columbus Office.
III. CONTRACT TERM
The initial contract is anticipated to begin on or about 01/01/2019 and end on or about
06/30/2021 with total hours limited to 1560 for the term. The contract will include an option
to renew the contract for no more than two additional years. Any subsequent contract
entered into shall be limited to 1040 hours for each fiscal year.
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IV. MINIMUM QUALIFICATIONS
The OIC will only accept proposals from individuals that can demonstrate the following:
A. Must have a current and valid driver’s license;
B. Must have board certification as Medical Doctor (M.D.) as recognized by the American
Board of Medical Specialties or as Doctor of Osteopathy (D.O.) as recognized by the
American Osteopathic Association;
C. Must have a current unrestricted license to practice by the State of Ohio Medical Board
with no suspension, public reprimand, or probation from professional practice within the
past five years;
D. Must have a minimum of ten (10) years of full time, clinical practice experience within
E. Must have a minimum of ten (10) years of direct patient care in workers’ compensation
medicine or work injury medicine, including performance of medical examinations and
preparation of reports used to determine impairment;
F. Must have documentation regarding eight hours of Continuing Medical Education
credits specific to impairment rating, completed within the last five years; and
G. Must have a current unrestricted Drug Enforcement Administration (DEA) certificate.
These requirements are necessary to meet the demands of the many responsibilities
pertinent to this contract. The successful proposer must be independent from any other
employers/contractors or other professional commitments in order to maintain the
impartiality of the guidance provided in review of contested workers’ compensation claims.
The successful proposer must maintain practice specialty certification, as well as, a current
unrestricted license to practice by the state of Ohio Medical Board throughout the duration of
the contract. Contractor must not have any actions against their professional license, in any
state or country, including, but not limited to, voluntary/involuntary restrictions, denial,
revocation, suspension, surrender, or cancellation throughout the duration of the contract.
The successful proposer must maintain current unrestricted DEA certificate and a valid
driver’s license throughout the duration of the contract.
V. PROPOSAL REQUIREMENT
The proposal shall include a minimum of the following information:
A. Education - include college level degrees with the name of the applicable institutions and
the type of degree received. Also include continuing education related to workers'
compensation, industrial medicine, or related fields.
B. Work experience - List work experience since receiving your medical degree. Give
specific information about your medical experience as it relates to workers'
compensation or work injury. If your experience is in a field related to workers'
compensation or work injury medicine, provide specific narrative regarding the
relationship and your specific involvement in that area of medicine. The description of
your experience shall include the amount of time spent practicing medicine in workers'
compensation or work injury medicine. A description of your experience should also
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