BWC Orders

A BWC Order is required for all initial determinations and some subsequent claims determinations.  BWC Orders provide a consistent, standard format that is user friendly and similar to the format and language used in IC Orders.  ORC 4121.36(B) 

 

A BWC Order is the written notification of a decision made by the BWC from the evidence gathered in a claim.  ORC 4123.511(A)(B) 

The purpose of the BWC Order is to:

·         Communicate claims decisions in clear language to the parties of the claim.

·         Provide due process to all parties of the claim.

 

Creating a BWC Order

The BWC Order is generated using V3 correspondence. The Order should be reviewed prior to publishing. The system will always display the order. The print location for this order defaults to Columbus, but “Print to S.O.” (Service Office) can be selected.  This should be selected only if it is necessary to attach additional documentation to the Order, which has not been previously provided to the parties of the claim.

 

All Orders display the BWC logo and a BWC Order watermark and the title “BWC ORDER” in bold print.  This format provides easy identification by our customers.

 

All BWC Orders have three sections that are called the Header, Body and Footer.  The Header and Footer display the same format for all BWC Orders.

 

Header Information

The following information is contained in the Header section of the Order:

·         Name and address of the injured worker

·         Mailing date of the Order

·         Claim number

·         Date of injury

·         Claim type (i.e., accident, occupational disease or death)

·         Employer’s name

·         Policy number

·         Manual number

 

Body of the BWC Order

The body of the BWC Order will include the decision that is made and the information that is used for the basis of that decision.

 

The body of the Order will display in various formats depending on the type of Order and the inserts that are selected.

 

V3 pre-formatted inserts can be selected to address specific issues on the Order.  Order inserts are categorized according to the common issues occurring during the life of a claim.  One or more inserts can be used to meet specific circumstances of the claim.

 

The following are examples of common issues that are categorized by inserts:

·         Types of compensations

·         Injury/Occupation Disease

·         Additional Condition(s)

·         Overpayments

·         MMI issues

·         Fraud

·         ADR disputes

·         Setting wages

·         POA on file

 

BWC will publish an Order to allow or deny a requested action within its jurisdication.

 

The evidence relied upon to make the determination must be stated in the Order including a detailed description of specific factual and/or medical evidence used as the basis for the decision.

 

Example of basis for the decision

“This decision is based on”: “Report received from Dr. Jones, dated 11/01/02, which states the diagnosis of lumbosacral sprain is due to falling 8ft. from a ladder today at work”.

 

The body of the Order concludes with information regarding the appeal period, such as:

·         The length of the appeal period – Ohio Law requires that BWC allow the employer or injured worker 14 days from the receipt of the Order to file an appeal.

·         How to waive the appeal period - The employer and injured worker may waive rights to an appeal. The waiver must be in writing or filed electronically at www.ohiobwc.com.  A Request for Waiver of Appeal (C-108 ) is a BWC form that is provided to the public to file a waiver.

Note:  E-mail waivers are not acceptable (no signature) because E-Mail is not secured nor can it be authenticated that the sender of the email is a party to the claim, (i.e., injured worker or employer).

·         How to appeal to the Industrial Commission: Appeal language automatically appears on every Order.  The Order will contain the location to file an appeal, including the IC Office name and address.  Appeals can be filed in writing or filed via the Internet at www.ohioic.com.

Note: E-mail appeals are not acceptable, (no signature,) because E-Mail is not secured nor can it be authenticated that the sender of the email is a party to the claim, (i.e., injured worker, employer or authorized representatives).

·         Consequence of not filing an appeal:  If a written or electronic appeal is not received within 14 days, the decision is final.  Notification of a party’s intention to appeal via telephone is not sufficient.

 

Footer Information

The footer contains contact information for the person who issuedthe order, the name of anyone copied (cc) on the Order and will include Fraud Unit Location, when applicable.