OhioBWC - Worker - Service:  Miscellaneous claim information

Miscellaneous claim information

Injured workers, employers, their representatives and their designees can view miscellaneous claim information online.

  • Statutory closure date – The statutory closure date is the date that no payments of benefits are allowed due to statutory closure under Ohio law according to ORC4123.52. The date of injury is the primary factor for determining the date a claim expires.
    • Date of injury on or after Aug. 25, 2006 - five years from the date of injury, the date of payment of compensation, wages in lieu of compensation or medical bill payment, whichever is later.
    • Date of injury from Dec. 11, 1967 to Aug. 24, 2006 and the claim is lost-time - 10 years from the date of last compensation, wages in lieu of compensation or medical bill payment.
    • Date of injury from Oct. 20, 1987 to Aug. 24, 2006 and the claim is medical only - six years from the date of injury or last medical bill payment.
    • Date of injury from Dec. 11, 1967 to Oct. 19, 1987 and the claim is medical only - six years from the date of injury.
    • Date of injury prior to Dec. 11, 1967 - 10 years from the date of injury, payment of compensation, wages in lieu of compensation or medical bill payment.
  • Benefit type - indicates whether the claim is medical only or lost time
    • Medical-only claims are identified as minor injuries that may or may not include lost time from the workplace up to seven days. Some minor injuries (always medical-only claims) do not necessarily require medical evidence for us to determine if the claim is compensable. These include: First degree burns, less than 10 percent of the body; superficial lacerations/contusions; Insect stings; minor animal/human bites; superficial foreign body in eye; corneal abrasion; conjunctivitis; dermatitis; blisters; and superficial injury/abrasion.
    • Lost-time claims are those where an injured worker misses more than eight days due to the work-related injury. If you miss 14 days or more due to your allowed injury or illness, you'll be compensated for the entire period of time you're disabled as a result of your injury/occupational disease. We pay compensation for lost wages after we receive medical evidence that supports your disability and issue an order approving payment.
  • Accident type – refers to the type of injury the injured worker sustained in the course of employment. The three options include:
    • Accident (ACC) – a sudden, unusual, unexpected occurrence happening at a particular time and place, not in the usual or expected course of events;
    • Occupational disease (OD) – a disease peculiar to a particular industrial process to which an employee is not generally subjected or exposed and contracted in the course of employment. This process usually occurs over a course of time;
    • Death (DTH) – death has occurred as a result of an industrial accident. A date of death is included.
  • Coverage type - indicates the status of the employer’s policy at the time the claim was filed and should not affect compensability of the claim. Abbreviations for coverage type are as follows:
    • COV – policy which had coverage at the time of injury as a result of timely payment of premiums;
    • NO COV – period of time where an employer did not have coverage as a result of failure to pay premiums timely;
    • NO REC – BWC shows there was no record of coverage for this employer;
    • BKRP – an account status that shows the employer’s business is bankrupt.
  • Fund type - indicates the fund from which payments are issued. Abbreviations for fund type are as follows:
    • OSIF - State Fund;
    • PE - Public Employer;
    • SI - Self-Insured;
    • BL - Black Lung;
    • MF - Marine Fund;
    • APP – Apprentice;
    • CD - Civil Defense;
    • CDF - Contract Coverage;
    • ONG - Ohio National Guard;
    • PWRE - Public Worker Relief Employee.
  • 15K Program - This program allows state-fund employers with active coverage to choose to pay the first $15,000 of a medical-only claim (a claim with seven or fewer lost days from work). Once employers have enrolled, all of their medical-only claims with a date of injury past the date of enrollment will be automatically included in the program.

    BWC processes a 15K Program claim the same way we do any other medical-only claim.

    Employers can have an individual claim removed from the program at any time. They must notify BWC, the injured worker, provider and the MCO that they no longer want to be responsible for the bills and provide the last date of service they will pay. BWC will enter this as the 15K end date. However, you should submit any bills not paid by the employer, regardless of date of service, to the MCO.
  • 15K start date – The date the employer enrolled in the program.
  • 15K end date – The date the claim was removed from the program making the MCO responsible for medical management of the claim.

If you have additional questions, contact your claims service specialist.

If you know your claim number, click here to access the above information for your claim.