Appeals and Hearings
4121.36, 4121.35, 4123.57, 4123.512, 4123.511 and 4123.522
4121-3-09, 4123-3-18, 4121-3-30, 4123-3-09, 4123-3-36 and 4123-3-32
Chief of Operational Policy, Analytics & Compliance (Signature on File)
CP-15-01, effective 09/12/2014
The purpose of
this policy is to ensure that BWC publishes and/or executes orders, waivers and
appeals in compliance with law and administrative rules.
applies to all BWC staff.
Appeal: a formal request to a higher
authority requesting a change in or reconsideration of a decision.
Hearing: a meeting wherein the parties to a
claim are afforded an opportunity
to present evidence and be heard before the Industrial Commission (IC) of Ohio,
the statutorily-mandated adjudicatory body for workers’ compensation issues.
Order: the written notification of a
decision made by the BWC or the IC from the evidence gathered in a claim.
Parties to a claim: Injured Worker (IW),
IW representative, employer, employer representative and BWC.
Waiver: a document or formal statement
signed by parties to a claim giving up their appeal rights to orders issued by
BWC and the IC. The waiver does not affect any past or future orders
pertaining to the claim file; only the order currently being waived.
- It is BWC’s policy to process and publish BWC orders
and waivers, process appeals, and perfect IC Orders in accordance with
B. A BWC Order is required for all initial
determinations and subsequent determinations in claims in which BWC has
- Types of BWC Orders:
1. Initial Allowance Order
a. Published when granting the initial allowance of a
claim for payment of medical benefits and/or compensation.
i. For a medical only claim,
this order shall address claim allowance and the payment of medical benefits.
ii. For a lost time claim, this
order shall address claim allowance, the payment of medical benefits and
payment of compensation.
b. The following issues may also be addressed:
i. Setting of the full weekly
wage (FWW) and average weekly wage (AWW);
ii. Temporary Total Compensation
iii. First seven days of lost
iv. Non-complying employers (no
v. Scheduled Loss Compensation
Awards (loss of use, amputation, loss of vision, and loss of hearing);
vi. Salary Continuation.
2. Initial Auto Adjudication
a. Published systematically by the claims management
system when an initial claim meets a set of criteria that causes the claims
management system to automatically generate this allowance order;
b. The claim status is systematically updated to
3. Initial Denial Order – Published when denying an
initial allowance of a claim.
4. BWC Abate Order – Published
to notify the dependent that the claim application has been abated by the death
of the claimant.
5. Subsequent Allowance Order
a. Published when granting a request for action (written
or verbal) after the initial claim determination or when issues are identified
after the initial allowance of the claim;
b. Is only available for accident and occupational
c. BWC does not have jurisdiction to deny a subsequent
request per the Crabtree court decision except for requests for medical
treatment (via Alternative Dispute Resolution Order), lump sum advancement,
medication reimbursement and travel reimbursement (via Miscellaneous Order.) State
ex rel. Crabtree v. BWC (1994), 71 Ohio St.3d 504.
6. BWC Death Allow Order
a. Published to grant death
benefits and apportion benefits between dependents, either as the initial
decision in the claim or as a subsequent decision on an existing claim;
b. Published to reapportion
death benefits between dependents and to award accrued compensation in claims
where death benefits have been allowed.
7. BWC Death Denial Order - Published to communicate
BWC’s decision to deny death benefits, either as the initial decision in the
claim or as a subsequent decision in an existing claim
8. BWC Alternative Dispute Resolution
Published to communicate the determination of medical disputes.
9. BWC DWRF (Disabled Workers’
Relief Fund) Order
a. Published to communicate a decision on the IW’s
entitlement to DWRF benefits.
b. Types of issues that may be addressed in the BWC DWRF
i. Entitlement to DWRF;
ii. Non-entitlement to DWRF;
iii. Social Security Disability Rate;
iv. Permanent Total Disability (PTD) Declared Rate;
v. Adjustment for increase or decrease in the DWRF Rate;
vi. Overpayment of DWRF Benefits;
vii. Stopping DWRF.
10. BWC Tentative Order (TO) – Published to either grant
or deny an initial determination or subsequent increase of percentage of
permanent partial disability.
a. IW/Claimant and/or IW/Claimant representative;
b. Employer and/or Employer representative;
third party administrator (TPA) or other non-lawyer legally cannot independently
waive proper notice of hearing or waive the right to appeal on behalf of any
party. They may submit a waiver but the waiver shall indicate they are doing so
at the direction of the employer and not at the independent discretion of the
a. Waiver of Appeal Period (C-108);
b. Letter that contains all elements of the C-108;
c. Online at ohiobwc.com or ohioic.com.
4. How to submit waiver:
b. Scanned and emailed;
5. Parties to the claim must waive in writing in order
to release payment prior to the expiration of an appeal period. If the award
relates to compensation only, no waiver is required from the IW.
6. When all parties agree to waive the appeal rights on
an order, the appeal period automatically expires.
7. The waiver does not affect any past or future orders
pertaining to the claim.
E. Appeals to BWC
1. Who can appeal: A party to the claim who disagrees with the BWC
Order may appeal the decision to the IC, thereby asking that a hearing be held to further evaluate the merits of
2. How to Appeal:
a. Notice of Appeal (IC-12) form;
b. On a letter that contains all elements of the IC-12;
c. Online at www.ic.state.oh.us through the Industrial
Commission Online Network (I.C.O.N.);
d. All appeals shall be in writing.
3. The appeal periods for BWC Orders are:
a. Tentative Orders - The objection (appeal) period
expires twenty (20) days from the printing of the TO;
b. All other orders - 14 days after the date of receipt
of the Order.
4. Appeal timeline considerations:
not received by the IC or the BWC during core business hours shall be
considered received and filed on the next business day (core business hours are
from 8:00 a.m. to 5:00 p.m.);
b. When an
appeal is received at BWC, BWC sends appeal to IC and images supporting
documentation for review;
c. If evidence is submitted after an appeal is filed and
the appeal is not withdrawn, BWC no longer has jurisdiction. The documentation
shall be imaged and the IC shall obtain all claim information through a
systematic transfer of information prior to the IC hearing.
F. BWC will not
perfect a court order or an IC Court Unit memo until it receives the signed
order or memo.