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OhioBWC - Basics: What will happen after I file a claim?
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What will happen after I file a claim?
No matter what the injury, each claim at BWC goes through specific steps in the claim process.
Once you have reported an injury:
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BWC assigns an accident specific claim number which acts as the tracking
number for the life of your claim. You, your employer and your physician will receive
a letter containing your claim number.
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BWC gathers the facts and makes an initial decision
to allow or deny the claim within 28 days. Then BWC issues
a written legal notice, called a BWC
Order, to you, your employer and both of your representatives.
Self-insuring employers make an initial decision whether or not
to pay the claim within 30 days.
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If you or your employer disagrees with the decision,
either of you may file an appeal with the Industrial Commission of Ohio
within 14 days of the date you received the decision.
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If your claim is ultimately allowed, BWC will pay your 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 percent of the wages you have lost. Self-insuring employers
will pay medical and compensation benefits.
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If your claim is disallowed, you may file an appeal with the
Industrial Commission of Ohio within 14 days of the date you
receive the decision.
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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.
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Rehabilitation Programs - Anyone can refer you
to a rehabilitation program with services tailored to your
individual needs. Such programs are
coordinated by the MCOs.
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Return to Work - The CSS works with the provider and MCO to
coordinate a medical treatment plan that will enable you
to return to work as soon as you are able to resume your
job duties.
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The ultimate goal - safe return to work.
When your claim is reported to BWC, it will be assigned to the closest
BWC service office based on your zip code or your employer's zip code
if you live outside Ohio.
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A Customer Service Specialist located in the assigned service
office will be assigned to handle your workers' compensation claim.
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If both you and your employer are located outside of Ohio, your claim
will be handled by the Special Claims Unit located in the William
Green Building, Columbus, OH.
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