|
|
|
OhioBWC - Basics: What will happen AFTER I file a claim?
|
|
What will happen AFTER I file a claim?
|
|
No matter what the injury, each claim at BWC goes through certain
steps to determine compensability.
Once you have reported an injury
-
BWC assigns a claim number. This is a tracking number. The injured
worker, employer and treating physician receive a letter notifying them of that
number.
-
BWC gathers the facts and makes an initial decision to allow
or deny the claim. BWC makes a decision within 28 days. Then BWC issues a
written legal notice, called a BWC Order, to the injured worker, employer and
their representatives. Self-insuring employers make an initial decision whether
or not to pay the claim within 30 days.
-
If the injured worker or employer disagrees with the decision,
either may file an appeal with the Industrial Commission of Ohio
within 14 days of that decision.
-
If your claim is ultimately allowed, BWC will pay your managed care organization (MCO) who will pay
your doctor for medical services related to the allowed condition. If you are
so seriously injured that you cannot return to work for eight or more days, BWC
may also pay a percentage of the wages you have lost. Self-insuring employers will
pay medical and compensation benefits.
-
If your claim is disallowed, you will be responsible for any
medical bills that incur as a result of your injury or occupational disease. In addition, you will
not be eligible for any types of compensation available through BWC.
-
If you are disabled for 90 days or more, medical exams may
be scheduled to evaluate your progress. These exams are done to ensure that you
are getting the proper treatment and to determine whether you can return to
work.
-
Rehabilitation programs: anyone can refer an injured worker to a rehabilitation program
with services tailored to the individual needs of the injured worker. Such
programs are coordinated by the MCOs.
-
The ultimate goal - safe return to work.
|
 
|
|