OhioBWC - Basics: Initial, subsequent or additional claim allowances
Initial, subsequent or additional claim allowances
For initial claim allowances, causal relationship is the physician's opinion that the injury sustained and the
mechanism of injury are compatible and addressed on the First Report of Injury (FROI). For subsequent or additional
claim allowances, it is the physician's opinion that the requested new condition is a result of the original
injury and/or previously allowed condition(s)/diagnoses in the claim. The physician requests additional conditions on
the Physician's Request for Medical Service or Recommendation for Additional Conditions for Industrial Injury or
Occupational Disease (C-9). This opinion of causality is essential
to directly link the alleged medical diagnosis to the workplace. Without this opinion from the physician, it is
difficult for our claims service specialists to process the request.
To assist treating physicians, BWC has provided on the FROI and C-9 an area to indicate whether or not the alleged
condition is causally related to the claim. In more complex cases, physicians may wish to provide an explanation in
the progress notes justifying their opinion.