4123.511(A); O.A.C. 4123-3-16; 4123-3-09(C); 4121-3-34(C)(3)(c)
Chief of Operational Policy, Analytics & Compliance (Signature on file)
injury management policies, directives and memos regarding motions and
subsequent decisions that predate the effective date of this policy
of this policy is to ensure that BWC consistently and appropriately processes
motions received by BWC.
policy applies to BWC staff.
Application: A form or other means
of communicating to BWC a request, authorization or agreement.
Motion: For purposes of this
policy, a written request, typically submitted on BWC form Motion
(C-86), requesting an action from BWC or the Industrial Commission (IC).
to a claim:
The injured worker (IW), IW representative, employer, employer representative
A review and evaluation of the medical documentation in a claim by a qualified medical
specialist who has met BWC credentialing requirements to conduct independent
of the evidence:
A standard of proof which is met when a party’s evidence on a fact indicates
that it is “more likely than not” that the fact is as the party alleges it to
A. It is the policy of BWC that a motion shall be
1. In writing;
2. By a party to the
3. To request an action on
4. On any matter that is
not otherwise addressed by statute or rule with its own procedure and/or form
requirements (e.g., an application for approval of a lump sum settlement;
motions for drug related issues).
B. Pursuant to O.A.C. 4123-3-16 it is the
applicant’s responsibility to:
1. Not use a motion as a
substitute for a timely filed appeal;
2. Clearly and fully state
the issue and the requested action;
3. Include with the motion
substantial competent proof to support the request as established by O.A.C
4. Provide citations to
any legal authority relied upon;
5. Ensure the motion is
signed by the applicant or the applicant’s authorized representative;
6. Establish entitlement
to the request by a preponderance of the evidence; and
7. Unless the issue
addressed in the motion does not affect the rights of the non-filing party,
mail a copy of the motion to the non-filing party and provide acknowledgement
to BWC or the IC that a copy has been so mailed.
C. Processing the Motion
1. Upon the filing of a motion BWC will
comply with any specific requirements based on the subject matter of the
2. Absent specific requirements for the
a. BWC will notify the non-filing party
that a motion has been filed;
b. If the non-filing party has not been
provided a copy of the motion by the filing party or for any other reason the
non-filing party requests, BWC will provide a copy of the motion and any
accompanying proof to the non-filing party. BWC may also direct the non-filing
party to www.bwc.ohio.gov to view the motion and accompanying
c. BWC will provide the non-filing party
the opportunity to respond and submit any proof within its possession bearing upon
the issue to BWC within ten (10) days from:
notified by BWC of the motion by phone; or
date of any mailed, faxed or emailed notification from BWC.
d. BWC may require the filing of additional
proof or legal citations by either party.
e. BWC may conduct any other additional
investigation, including requesting a physician file review or independent
BWC will issue a decision
(28) days of receipt of the motion; or
physician file review or IME has been requested, within fourteen (14) days of
receipt of the report.
3. Motions Filed Prior to Initial
Determination of the Claim Becoming Final
a. When a motion is filed after an order
has been issued but before the expiration of the appeal period and no appeal
has been filed, BWC may:
initial order and issue a new order which includes decision on the motion; or
acting on the motion until final determination of the claim (all appeal periods
b. When a motion is filed
after an order has been issued and an appeal has been filed BWC will suspend
acting on the motion until the initial determination has become final.
b. If action on the motion has been
suspended and the claim is subsequently disallowed, BWC will dismiss the motion
4. Motion Suspended Pending Resolution of
Other Related Issue:
a. If an action requested in a motion
cannot be determined until a related pending issue is resolved or determined,
BWC will suspend the motion.
b. Once the related issue is resolved or
determined, BWC will process the motion.
5. Referral to the MCO: BWC will refer
motions requesting medical treatment or vocational services to the MCO for
resolution. If a motion requests medical treatment or vocational services as
well as other issues, the medical treatment or vocational issues will be
referred to the MCO and BWC will process the remaining issues.
6. Dismissed and Reinstated Motions:
a. BWC will dismiss a motion via letter to
the parties when:
party has requested to withdraw the motion;
does not comply with the requirements of this policy and OAC 4123-3-16,
including but not limited to when:
a) There is no evidence to
support the request, even after reasonable attempts to obtain evidence; or
b) The requested action is
not clear, despite reasonable attempts to clarify the request.
b. It is the policy of BWC that a filing
party may request in writing reinstatement of a dismissed motion within 30 days
from the date of the dismissal letter without the need of refilling the same
motion or filing a new motion on the same subject matter.
7. Issuing an Order: BWC will issue an
order if the request in the motion is within the jurisdiction of BWC and there
is no conflict of evidence. See the Orders, Waivers, Appeals and Hearings
policy for further information.
8. IC Referral
a. BWC will refer the motion to the IC
request is not within the jurisdiction of BWC;
There is a
conflict of evidence; or
iii. Multiple issues have been
presented in one motion and one or more of the issues are not within the
jurisdiction of BWC.
b. See the Notice of Referral policy
for further information.
BWC staff may refer to
the corresponding procedure for this policy entitled “Motions” for further