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This version of the form is not currently in use and is provided for reference only. Download this version of
Form MEDCO-14 (BWC-3914)
for the current year.
Form MEDCO-14 (BWC-3914) Physician's Report of Work Ability - Ohio
What Is Form MEDCO-14 (BWC-3914)?
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 MEDCO-14 (BWC-3914)?
A: Form MEDCO-14 (BWC-3914) is a Physician's Report of Work Ability form used in Ohio.
Q: Who uses Form MEDCO-14 (BWC-3914)?
A: This form is used by physicians in Ohio to report an injured worker's ability to return to work.
Q: What information is required on Form MEDCO-14 (BWC-3914)?
A: The form requires information such as the injured worker's name, employer, date of injury, diagnosis, treatment, and the physician's assessment of the worker's ability to work.
Q: Is Form MEDCO-14 (BWC-3914) mandatory for all injuries in Ohio?
A: Yes, this form is mandatory for all injuries in Ohio that result in time lost from work or medical treatment beyond the first visit.
Form Details:
- Released on July 5, 2022;
- The latest edition provided by the Ohio Bureau of Workers' Compensation;
- Easy to use and ready to print;
- Quick to customize;
- Compatible with most PDF-viewing applications;
- Fill out the form in our online filing application.
Download a fillable version of Form MEDCO-14 (BWC-3914) by clicking the link below or browse more documents and templates provided by the Ohio Bureau of Workers' Compensation.
Download Form MEDCO-14 (BWC-3914) Physician's Report of Work Ability - Ohio
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