Unfortunately, confirmation alone of a positive test for drugs or alcohol is not solely enough to obtain a denial of a workers’ compensation claim. Per Ohio statute (ORC 4123.54), there are several specific qualifications that must be met prior to the ultimate denial of a claim.
There are four “statutory hurdles” that an employer must clear in order to have a claim denied in which the claimant tested positive for illegal substances:
Hurdle No. 1
The employer must post a written notice indicating that failure to take a post-accident test could “affect their eligibility for compensation for injuries.” This statement is provided with your workers’ compensation certificate, and should be posted in a common area accessible to all employees. The key to this requirement is that it must be in clear view to any employee at any time. Additionally, we highly recommend that you consult with your GMS Account Manager to ensure that your company policy clearly spells out the effects of a positive drug test on employment.
Hurdle No. 2
The employer must obtain a “qualifying chemical test.” This test must “exceed the positive test level” established by statute. In addition, a blood alcohol test must be administered within eight hours after the injury occurs. A valid controlled substance test should be administered no more than 32 hours after an injury occurs. This step is critical in proving that the substance was the cause of the incident (and resulting injury).
Hurdle No. 3
The employer needs to demonstrate “reasonable cause” that required an employee to undergo a post-accident screen. According to this aspect, suspicion must exist on the employer’s behalf that the claimant was under the influence. This suspicion must be documented, and testimony from the employer is necessary as well.
Hurdle No. 4
The employer is also required to create “rebuttable presumption,” which includes the opinion of a physician that indicates “the injury would not have occurred had the employee not been under the influence of drugs or alcohol.” Rebuttable presumption is simply placing the burden on the employee to prove that their intoxication or drug use was not the cause of the incident and resulting injury.
Handling a Positive Test
With a situation such as this, it is important to remember that the process merely begins with a positive test for illegal drugs or alcohol. As indicated above, there are several requirements that must be met before a claim can be denied at the administrative level. Despite the difficulty of doing so, claims such as these can be successfully denied when following the procedures outlined above.
While each of the “hurdles” may appear overwhelming, GMS and its team of workers’ compensation specialists will help you skillfully navigate through this process. Contact us today to learn more.