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OhioBWC - Basics: What if I disagree with the decision?
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What if I disagree with the decision?
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With BWC's decision?
If you and/or your employer disagree with a decision made on your workers'
compensation claim, you may file an appeal with the Industrial Commission of
Ohio (IC) within 14 days of the decision. The IC holds hearings to resolve
disputes. Employers and employees may appeal decisions of the IC to the Ohio
Common Pleas Court system. For more information on the hearing process, contact
the Industrial Commission at 1-800-521-2691 or visit their Web site.
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With the managed care organization's (MCO's) decision?
Dispute resolution is also known as the alternative dispute resolution (ADR) process.
ADR affords due process regarding conflicts in medical issues but does
not include billing grievances. OAC 4123-6-16
ADR is intended to resolve disputes in medical issues that arise between the
MCO, BWC, employer, injured worker and/or provider. Issues that can be addressed
by ADR include, but are not limited to:
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Quality assurance;
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Utilization review;
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Determination that a service is or is not covered;
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Treatment/service necessity;
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Issues involving health-care providers.
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