OhioBWC - Worker - Form: (A-21)

OhioBWC - Worker - Form: (A-21) - Introduction

Introduction
Electronic Benefit Card (A-21)
Injured workers receiving disability benefits are eligible for an electronic benefit card. That means BWC will deposit your benefits into a special account, and you will use your MasterCard benefit card to access your account 24 hours a day at any automated teller machine that accepts MasterCard. You also can make purchases anywhere worldwide that accepts MasterCard. Additionally, you'll receive monthly statements from the bank and will have access to your account balance 24 hours a day. Note: If you're already receiving benefits through a benefit card, you may not use this form or the Direct Deposit ACT Change (A-35).

Required information Electronic signature on the Electronic Benefit Card agreement
If you have all the required information on hand, simply click the start button to begin.