• Filing a Claim
• General Claim Questions
• Processing a Claim
• Hearing Process

• Physicians
• Treatment and/or Medical Bills
• Managed Care Organizations (MCOs)
• Prescriptions

• General Compensation Questions
• Checks

1A. An injured worker can file a claim by manually completing the First Report of Injury (FROI) and mailing it to any BWC service office, or the FROI can be completed on-line.
Most Ohio workers’ compensation claims are filed by the managed care organization (MCO) after being notified of the work-related injury or occupational disease by the health-care provider or the employer. If you have been treated for a work-related injury, a claim may have been filed for you already. To check this you may contact BWC.
Click here to file a claim online

2A. Injured workers, employers, authorized representatives and designees can file claims with BWC. MCO's and medical providers can also file claims.

1A. Yes, injured workers can look up claim information using their Social Security number.

2A. Injured worker representatives and designees, employers, their designees and their representatives, as well as medical providers can enter a Social Security number and view the claims that are associated with that number. However, they will be limited to viewing only the claims that they are associated with.

3A. If a claim has been combined, only the surviving claim will be displayed.

4A. Immediately after receiving the First Report of Injury, BWC begins the process of gathering information and investigating the claim. A decision will be made to allow or deny the claim within 28 days.

5A. All injured workers with allowed workers' compensation claims are entitled to payment of medical bills for treatment related to the injury or occupational disease. Following are five of the most common compensation benefits injured workers with allowed workers' compensation claims may be entitled to:

• Payment of temporary total compensation for injured workers who are 100 percent disabled for a temporary period of time as a result of the injury or occupational disease;
• Payment of wage loss compensation to injured workers who are working with restrictions caused by the injury which cause a reduction in earnings or who are actively seeking but are not able to find work within their physical capabilities;
• Payment of a percentage of permanent partial disability award for residual impairment resulting from an injury or occupational disease;
• Payment of permanent total disability (PTD) compensation to injured workers who have been declared permanently and totally disabled by the Industrial Commission of Ohio. A declaration of PTD means that the injured worker is not capable of returning to the former position of employment or of engaging in any sustained remunerative employment;
• Payment of a lump sum settlement award to injured workers who have agreed with their employer to settle the workers' compensation claim.

To learn more about additional benefits that may be available, click below.
Available Benefits to Injured Workers

6A. The name and contact number of the BWC CSS is included on the injured worker identification card that was attached to the claim number notification letter.
Or if you know your claim number you can view your claim assignment online. Click here to find your assigned CSS.
Claim Assignment

7A. Injured workers can change their address online by linking to claim demographics. However, due to security limitations, only an injured worker can update an address online. A designee or authorized representative does not have authorization to update an address online.
To link to demographics and change your address, click here.
Demographics Information
Or you can change your address by calling BWC’s customer assistance line at 1-800-OHIOBWC, and follow the options. Or you can complete BWC form Change of address notification (C-77) and mail to:

BWC 30 W. Spring St. Columbus, OH, 43215-2256 or fax the form to 1-877-520-6446

8A. The claim number, injured worker name, claim status, benefit type, employer policy number, employer name, MCO and date of injury are all displayed. A user can link to additional information specific to a particular claim from this window.

9A. The date of injury refers to the date an injured worker sustained an injury, occupational disease or death in a given claim.

10A. Yes. Per ORC 4123.85, an occupational disease claim must be filed according to the following guidelines:

• Two years after the disability due to the disease began (i.e., date of disability - see below);
• Six months after the date of diagnosis by a physician;
• Two years after a death due to the disease.

Date of disability due to occupational disease begins on the most recent of the following dates:

• When the injured worker first became aware of the disease through medical diagnosis;
• When the injured worker was first treated for the disease;
• When the injured worker first quit work due to the disease.

11A. The statute of limitations on a claim is determined by the date of injury, disability or death, and the claim type.

• Medical-only claims with dates of injury prior to Oct. 20, 1993, are statutorily closed six years from the date of injury.
• Medical-only claims with dates of injury from Oct. 20, 1993, to August 2006 are statutorily closed six years from the date of last payment of medical benefits.
• Lost-time claims with dates of injury prior to August 2006 are statutorily closed 10 years from date of last payment of medical benefits or compensation, or from the date of death.
  
• Medical-only AND lost-time claims with dates of injury after August 2006 are statutorily closed five years from the last medical bill or compensation paid

12A. An occupational disease is a disease peculiar to a particular industrial process to which an employee is not generally subjected or exposed and is contracted in the course of employment. Occupational diseases are generally contracted in the course of and arising out of employment, usually occuring over a period of time. An example of an occupational disease is asbestosis.

14A. Check to make sure BWC has your correct mailing address.

1A. The answer to this question will vary based on each individual claim and circumstances. The following information is usually needed to make a claim determination:

• Name and address of injured worker;
• Employer name and workers’ compensation policy number;
• Detailed accident description;
• Medical diagnosis of an injury;
• Medical documentation to support the relationship of the treatment to the work-related injury or occupational disease;
• Information regarding disability.

2A. The MCO serves as the link between BWC and the health-care provider in obtaining and sending in medical information. However, BWC will accept information from any source, whether it’s the injured worker, a legal representative, a health-care provider or the employer.

1A. The answer to this question will vary based upon the individual circumstances in the claim. If a claim is denied, it is often because of a lack of information. BWC has 28 days to issue a decision. If the information received at that time is not sufficient to allow the claim, then the claim will be disallowed. The specific reason for the disallowance should be documented on the BWC order. If you need assistance understanding the order you may contact BWC.

2A. Once you receive the BWC order, you have 14 days to file an appeal if you disagree with the decision. You can file the appeal online through the Industrial Commission Online Network (I.C.O.N). Just follow the log in instructions. You also can file the appeal in writing. Download and print the Notice of Appeal (IC-12), fill it out and send it to any Industrial Commission service office. In addition, the form is available from any IC our BWC customer service office, or by calling 1-800-OHIOBWC and following the options. Once the IC receives your appeal, the IC will notify you of the time, date and location of your hearing.

3A. A waiver allows the appeal period to be cancelled and any benefits payable as a result of the order can be immediately approved.
Click here to access Waiver of Appeal (C-108).

1A. An injured worker wishing to change physicians should notify the managed care organization of this request. Note: If your employer is self-insured the request to change physicians should be sent directly to the employer.
Click here to access Notice to Change Physician of Record (C-23).

2A. The rules governing the HPP program provide that an injured worker has the right to be treated by the doctor of their choice as long as the doctor is a BWC certified provider. Note: If your employer is self-insured, you should contact the employer to obtain information concerning choosing a physician.

3A. You can contact BWC to see if a doctor is certified or you can click below to access BWC’s Certified Provider Look-up.
Certified Provider Look-up

4A. Contact the MCO for assistance in finding a physician.

5A. Contact BWC or the MCO to find out the doctor of record.

6A. To see if your C-84 has been received, click here.
Issue tracking

1A. Once the claim is allowed the providers (other than pharmacies) who have treated you for the work-related injury should submit their bills to the MCO. The MCO reviews and prices the bills and forwards them electronically to BWC. BWC pays the MCO who in turn disburses payment to the providers.
To view your medical bill payment history, click here.
Medical Payment Information

2A. Contact the provider who sent you the bill and advise that the treatment was for a work-related injury. Give the provider the name and billing address of the MCO and request that a bill be sent to them.

3A. Contact the MCO to obtain this information. Requests for treatment are forwarded to the MCO for consideration.

4A. Contact the MCO to obtain this information. The MCO reviews all medical treatment requests and issues approval or denial.

1A. BWC is the State of Ohio government agency responsible for Ohio’s workers’ compensation system.
The MCOs are private companies selected by or assigned to each state-funded Ohio employer to medically manage the employer’s workers’ compensation claims.
BWC makes decisions regarding claim allowances and issues benefit payments. The MCOs coordinate medical care and make treatment decisions.

2A. The name, address and phone number of the MCO is printed on the injured worker identification card that was attached to the claim number notification letter. You may contact BWC or your employer for the MCO information or you can access this information through BWC's Employer/MCO Look-up.
Or if you know your claim number you can find your MCO by clicking here.
Claim parties' contact info

1A. If the pharmacist sent the bill information to the PBM when dispensing your prescription you do not need to do anything. You will be reimbursed once your claim is allowed.
If you paid for your prescription as a "cash customer" and the bill information was not sent to the PBM, then you would need to have your pharmacist complete BWC Outpatient Medication Invoice (C-17).

2A. No. Any prescriptions relating to the work injury should be submitted to the PBM. BWC cannot reimburse you for co-payments.

3A. The prescriber should contact BWC's Pharmacy Benefits Manager, ACS State Healthcare at 1-800-644-6292, and listen to the options, or click Medical Providers, Forms on this website to print the MEDCO-31 or MEDCO-32.

1A. You will be eligible for lost time benefits if you lose more than seven days of work. Also, the first seven days are not payable until you lose 14 consecutive days. Other than these exceptions, most injured workers are usually paid for the entire period of time they are off. If an injured worker is off work for three months (90 days) a medical exam may be scheduled. Continued payment of temporary total disability will be dependent on the outcome of the independent medical exam.

2A. Compensation rates are based on your earnings prior to the injury taking into account the minimum and maximum rates applicable to the year you were injured. For claim specific rate inquiries contact BWC.

3A. As implied by the name, the expectation is that the injured worker’s inability to work is permanent. Should an injured worker who has been declared PTD return to work, the injured worker must notify BWC immediately. Benefit payments would cease at that time. Continued receipt of PTD benefits after a return to work is illegal in most cases and could subject the injured worker to prosecution for workers’ compensation fraud.

4A. A lump sum advancement is an advancement of funds for a specified purpose available to injured workers who are receiving PTD or scheduled loss awards. A lump sum advancement may be used to pay attorney fees ($8000 maximum) or to pay miscellaneous expenses such as household bills, purchases and repairs. The payment of a lump sum advancement results in a rate reduction.

5A. The rate reduction that occurs after a lump sum advancement is paid is permanent. The reduction is based on the existing rate, the amount of the advancement, the injured worker’s age and life expectancy.

6A. DWRF is an acronym that stands for Disabled Workers Relief Fund. This fund was created to assist injured workers who have been declared permanently and totally disabled whose compensation rates have not kept pace with inflation and the cost of living. DWRF eligibility is determined automatically for every injured worker who is declared PTD. No action on the part of the injured worker is needed. DWRF eligibility is based on the combined total of permanent total disability and Social Security disability received by the injured worker.

1A. If you know your claim number, you can click here to see if your check has been mailed.
Compensation payment history
If you have specific question regarding your check, contact BWC.

2A. There are many reasons why the amounts of your workers’ compensation checks may vary. Generally, workers’ compensation benefits checks are paid in two-week increments. Sometimes due to the beginning and ending dates on the form completed by your physician, there may be a variance in the amount of the checks received.
Also, after the first 12 weeks of temporary total the rate usually changes, and this will cause the check amount to be different.
*(Ohio Revised Code 4123.56) Many types of workers’ compensation benefits are subject to family support, and this will cause a rate reduction as well.
Also, different types of compensation benefits have different applicable rates. If you have a specific question about the amount of your check or the period of time it is paying for, contact BWC.

3A. To sign up for direct deposit, complete the ACT Enrollment and Direct Deposit Authorization (A-12).

4A. Once BWC processes the authorization, it takes about six business days for your bank to verify the bank account information. We will send you a letter explaining the effective date of your authorization. After that date, any payments made to you by BWC will be deposited into your account.

5A. Complete and submit BWC form Direct Deposit ACT Bank Change (A-35). Wait until you receive confirmation of the change before closing the old account.

6A. Most benefit types are eligible for direct deposit. An exception to this would be death benefits that are being paid to an injured worker’s dependents.