OhioBWC - Common - Form: (C-108)

OhioBWC - Common - Form: (C-108) - Introduction

Introduction
WAIVER of Appeal Period (C-108)
Injured workers, employers and/or their respective representatives should use this form to waive appeal rights on a BWC or IC order. Both parties must sign the waiver to waive (or cancel) the appeal period. A waiver signed by only one of the parties will not cause an appeal period to be canceled. Once BWC receives the waiver, we can pay any pending compensation or medical bills. Waiving the right to appeal an order does not prohibit the right to appeal any future orders pertaining to a claim.

Required information
Date of the BWC or IC order being waived Name of the party filing the waiver, i.e., injured worker, injured worker representative, employer, employer representative Name of person completing form

Complete the forms
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Are you missing some of the required information? If so, you may return here at a later time when you have all the information you need, and complete this online form. Or, you may print a blank copy of the form to complete by hand and either mail or fax it to BWC. Print a blank form.