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OhioBWC - Basics:  Claims status screen

Claim status

Claim status defines what stage each claim is in at a given time. The various claim statuses are listed as follows:

  • New claim –the claim has been filed with BWC and is in the initial investigation stage to determine whether the claim meets BWC criteria and is valid. At this time the claim has not yet been coded with any ICD-9 codes for injuries.
  • Pending – claim is still in the investigation stage but has been coded with ICD-9 codes for specific injuries.
  • Allowed/appeal – investigation has been completed and it appears that the claim meets BWC criteria for allowance. A BWC order has been issued granting the claim allowance; however, the claim is still within the appeal period. Any party to the claim can file an appeal during the appeal period.
  • Allowed – a BWC order has been written granting the allowance of the claim. The appeal period has expired with no appeal filed or the claim has been allowed via hearing order.
  • Hearing – an appeal has been filed to the BWC order which allowed/disallowed the claim. The claim has been referred to BWC’s sister agency, the Industrial Commission for a formal hearing.
  • Hearing-district hearing officer (DHO) – The Industrial Commission of Ohio (IC) has allowed the claim at the first hearing level, but the claim is still within the appeal period. BWC can pay compensation; however, the injured worker cannot receive medical benefits until the appeal period has ended or the claim goes to the next hearing level.
  • Disallowed/appeal - investigation has been completed and it appears that the injury does not meet the BWC guidelines for allowance. A BWC order has been issued denying the claim but the claim is still within the appeal period. At this time any party to the claim may file an appeal to the claim denial.
  • Disallowed - a BWC order has been written denying the allowance of the claim. The appeal period has expired with no appeal filed or the claim has been denied via hearing order.
  • Dismissed - You or your authorized representative has voluntarily withdrawn your claim before BWC made a decision. Withdrawing this claim will not have a negative effect on any future claims you file.
  • Pending settled – medical and indemnity – a settlement agreement has been generated to settle claim in its entirety. The claim is held for 30 days before the settlement can be finalized. During the hold period any party to the claim may withdraw from the settlement.
  • Pending settled - indemnity - an agreement among all parties has been generated settling the indemnity (compensation) portion of the claim. The medical portion of the claim will remain open. The claim is held for 30 days before the settlement can be finalized. During the hold period any party to the claim may withdraw from the settlement.
  • Pending settled - medical - an agreement among all parties has been generated settling the medical portion of the claim. The indemnity (compensation) portion of the claim will remain open. The claim is held for 30 days before the settlement can be finalized. During the hold period any party to the claim may withdraw from the settlement.
  • Settled – medical and indemnity – the claim has been closed out in its entirety in exchange for a sum of money. No additional medical treatment or compensation can be paid out in a claim once it has been settled.
  • Settled medical - the medical portion of the claim has been closed out in its entirety in exchange for a sum of money. No additional medical treatment can be paid out in a claim once it has been settled.
  • Settled indemnity - the indemnity (compensation) portion of the claim has been closed out in its entirety in exchange for a sum of money. No additional compensation can be paid out in a claim once it has been settled.
  • Active/Inactive - the claim has had recent activity and/or ongoing services are being provided. An inactive claim is where there has been no payment of compensation, no paid date of service and no manual reactivation in excess of 24 months.



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