Ohio Bureau of Workers' Compensation Forms
The Ohio Bureau of Workers' Compensation (BWC) is a state agency in Ohio that provides workers' compensation insurance to employers and benefits to injured workers. Its primary purpose is to ensure that injured workers receive appropriate medical care and compensation for lost wages due to work-related injuries or illnesses. The BWC also promotes workplace safety through education and prevention programs.
Documents:
289
This document is a fax cover sheet specifically for medical purposes in Ohio. It is used to transmit medical records or other related documents via fax.
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This form is used for physicians in Ohio to report on a patient's work ability.
This Form is used for obtaining temporary authorization in Ohio to review information.
This form is used for requesting reimbursement for medical services related to an industrial injury or occupational disease in Ohio. It can also be used to recommend additional conditions for the injury or disease.
This form is used for applying to the Drug-Free Safety Program in Ohio.
This form is used for employers and employees in Ohio who want to select a state other than Ohio as the exclusive remedy for workers' compensation claims.
This form is used for workers in Ohio who want to waive their workers' compensation benefits when participating in recreational or fitness activities.
This form is used for reporting accidents in Ohio.
This form is used for injured workers in Ohio to request reimbursement for travel expenses related to their workers' compensation claim.
This form is used for justifying the medical necessity of seating and wheeled mobility equipment in the state of Ohio.
This form is used for applying to become a disability evaluator in Ohio.
This form is used for requesting formulary medication in Ohio.
This form is used for requesting prior authorization of non-preferred medication in the state of Ohio. It allows individuals to submit a request to their health insurance provider for coverage of a medication that is not on their preferred drug list.
This Form is used for acknowledging the Self-insured Joint Settlement Agreement and Release in Ohio.
This Form is used for reporting the first occurrence of an injury, occupational disease, or death in Ohio.
This form is used for reporting labor lease transaction payroll information in the state of Ohio.
This form is used for requesting to add/change or terminate a permanent authorization in the state of Ohio.
This type of document is a BWC-0503 (AC-3) Temporary Authorization for Information Review - Ohio in Spanish.
Formulario BWC-1115 es utilizado para presentar una apelación sobre la resolución alternativa de disputa (ADR) de una decisión de servicio/tratamiento médico de la Organización de Cuidados Administrados (MCO) en Ohio.
This form is used for self-insurers in Ohio to agree on compensation payments in the event of a death.
