OD- Form 58-22 (BWC-4463) Application for Adjustment of Claim in Case of Death Due to Occupational Disease - Ohio

What Is OD- Form 58-22 (BWC-4463)?

This is a legal form that was released by the Ohio Bureau of Workers' Compensation - a government authority operating within Ohio. As of today, no separate filing guidelines for the form are provided by the issuing department.

FAQ

Q: What is Form 58-22?
A: Form 58-22 is the Application for Adjustment of Claim in Case of Death Due to Occupational Disease in Ohio.

Q: Who uses Form 58-22?
A: This form is used by individuals who are applying for an adjustment of claim in case of death due to occupational disease in Ohio.

Q: What is the purpose of Form 58-22?
A: The purpose of Form 58-22 is to initiate the process of seeking compensation for the death of an individual due to an occupational disease in Ohio.

Q: What information do I need to provide on Form 58-22?
A: On Form 58-22, you will need to provide information about the deceased individual, the cause of death, and any relevant medical documentation or evidence.

Q: Are there any deadlines for submitting Form 58-22?
A: Yes, there are deadlines for submitting Form 58-22. It is important to file the application within the specified time frame to ensure eligibility for compensation.

Q: What happens after I submit Form 58-22?
A: After you submit Form 58-22, the Ohio Bureau of Workers' Compensation will review your application and supporting documentation to determine eligibility for compensation.

Q: Is there a fee for submitting Form 58-22?
A: No, there is no fee for submitting Form 58-22.

Q: Can I get legal assistance for filling out Form 58-22?
A: Yes, you may seek legal assistance for filling out Form 58-22 and navigating the compensation process.