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Workers' Compensation
FAQS
Claims - Filing a Claim
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Who can file a claim with BWC?
Claims - General Claim Information
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How long does it take to process my claim?
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How do I know what I'm eligible for?
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Who is the BWC Customer Service Specialist
that is handling my claim?
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What does the date of injury mean?
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Is there a statute of limitations for
filing an occupational disease claim?
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Is there a statute of limitations on the
lifetime of my claim once it's been filed?
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What is an occupational disease?
Claims - Hearing process
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Why was my claim disallowed?
Medical - Physicians
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Can I go to any doctor I want?
Medical - Treatment and/or medical
bills
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How do my medical bills get paid?
Medical - Managed care organizations
(MCOs)
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What's the difference between BWC and an
MCO?
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Who is the MCO for my claim?
Medical - Prescriptions
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How do I get reimbursed for prescriptions
I paid for?
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What if I paid more for the prescription
than I am reimbursed?
Compensation - General Compensation
Questions
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Will I be paid for the entire period of
time I'm off work?
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How does BWC determine how much I will be
paid while I am off work?
Compensation - Checks
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Why do the amounts of my checks vary?
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How do I sign up for direct deposit?
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How long before my money goes directly to
my bank?
Claims - Filing a Claim
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Who can file a claim
with BWC? -
Injured workers, employers, authorized
representatives and designees can file claims with BWC. MCO's
and medical providers can also file claims.
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Claims - General Claim Information
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How long does it take
to process my claim? -
Immediately after receiving the First Report of Injury, BWC
begins the process of gathering information and investigating
the claim. A decision will be made to allow or deny the claim
within 28 days.
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How do I know what
I'm eligible for? -
All
injured workers with allowed workers' compensation claims are
entitled to payment of medical bills for treatment related to
the injury or occupational disease. Following are five of the
most common compensation benefits injured workers with allowed
workers' compensation claims may be entitled to:
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Payment of temporary total compensation for injured
workers who are 100 percent disabled for a temporary
period of time as a result of the injury or
occupational disease;
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Payment of wage loss compensation to injured workers
who are working with restrictions caused by the
injury which cause a reduction in earnings or who
are actively seeking but are not able to find work
within their physical capabilities;
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Payment of a percentage of permanent partial
disability award for residual impairment resulting
from an injury or occupational disease;
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Payment of permanent total disability (PTD)
compensation to injured workers who have been
declared permanently and totally disabled by the
Industrial Commission of Ohio. A declaration of PTD
means that the injured worker is not capable of
returning to the former position of employment or of
engaging in any sustained remunerative employment;
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Payment of a lump sum settlement award to injured
workers who have agreed with their employer to
settle the workers' compensation claim.
To
learn more about additional benefits that may be available,
click below.
Available Benefits to Injured
Workers.
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Who is the BWC Customer Service Specialist that is
handling my claim? -
The name and contact number of the BWC CSS
is included on the injured worker identification card that was
attached to the claim number notification letter. Or if you know
your claim number you can view your claim assignment online.
Click here to find your assigned CSS.
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- What does the
date of injury mean? -
The
date of injury refers to the date an injured worker sustained an
injury, occupational disease or death in a given claim.
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- Is there a
statute of limitations for filing an occupational disease claim?
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Yes. Per ORC
4123.85, an occupational disease claim must be filed
according to the following guidelines:
- Two
years after the disability due to the disease began
(i.e., date of disability - see below);
- Six
months after the date of diagnosis by a physician;
- Two
years after a death due to the disease.
Date of
disability due to occupational disease begins on the most recent
of the following dates:
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When the injured worker first became aware of the
disease through medical diagnosis;
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When the injured worker was first treated for the
disease;
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When the injured worker first quit work due to the
disease.
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- Is there a
statute of limitations on the lifetime of my claim once it's
been filed? -
The statute of limitations on a claim is
determined by the date of injury, disability or death, and the
claim type.
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Medical-only claims with dates of injury prior to
Oct. 20, 1993, are statutorily closed six years from
the date of injury.
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Medical-only claims with dates of injury on or after
Oct. 20, 1993, are statutorily closed six years from
the date of last payment of medical benefits.
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Lost-time claims are
statutorily closed 10 years from date of last
payment of medical benefits or compensation or from
the date of death.
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What is an
occupational disease? -
An occupational disease is a disease
peculiar to a particular industrial process to which an employee
is not generally subjected or exposed and is contracted in the
course of employment. Occupational diseases are generally
contracted in the course of and arising out of employment,
usually occurring over a period of time. An example of an
occupational disease is asbestosis.
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Claims - Hearing process
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Why was my claim
disallowed? -
The answer to this question will vary
based upon the individual circumstances in the claim. If a claim
is denied, it is often because of a lack of information. BWC has
28 days to issue a decision. If the information received at that
time is not sufficient to allow the claim, then the claim will
be disallowed. The specific reason for the disallowance should
be documented on the BWC order. If you need assistance
understanding the order you may contact BWC.
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Medical - Physicians
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Can I go to any
doctor I want? -
An injured worker has the right to be
treated by the doctor of their choice as long as the doctor is a
BWC certified provider.
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Medical - Treatment and/or medical
bills
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How do my medical
bills get paid? -
Once the claim is allowed the providers
(other than pharmacies) who have treated you for the
work-related injury should submit their bills to the MCO. The
MCO reviews and prices the bills and forwards them
electronically to BWC. BWC pays the MCO who in turn disburses
payment to the providers.
To view your medical bill payment history, click here.
Medical Payment Information
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Medical - Managed care
organizations (MCOs)
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What's the difference
between BWC and an MCO? -
BWC
is the State of Ohio government agency responsible for Ohio’s
workers’ compensation system.
The MCOs are private companies selected by or assigned
to each state-funded Ohio employer to medically manage the
employer’s workers’ compensation claims. BWC makes decisions
regarding claim allowances and issues benefit payments. The MCOs
coordinate medical care and make treatment decisions.
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Who is the MCO for my
claim? -
The name, address and phone number of the
MCO is printed on the injured worker identification card that
was attached to the claim number notification letter.
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Medical - Prescriptions
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How do I get
reimbursed for prescriptions I paid for? -
If the pharmacist sent the bill information to the PBM when
dispensing your prescription you do not need to do anything. You
will be reimbursed once your claim is allowed.
If you paid for your prescription as a "cash customer"
and the bill information was not sent to the PBM, then you would
need to have your pharmacist complete BWC Form
C-17, Outpatient Medication Invoice.
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What if I paid more
for the prescription than I am reimbursed? -
BWC reimburses for all medical services
according to the approved fee schedule. If you paid more for
your prescription than what is reimbursed, you will want to
contact your pharmacy.
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Compensation - General Compensation
Questions
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Will I be paid for
the entire period of time I'm off work? -
You will be eligible for lost time benefits if you lose more
than seven days of work. Also, the first seven days are not
payable until you lose 14 consecutive days. Other than these
exceptions, most injured workers are usually paid for the entire
period of time they are off. If an injured worker is off work
for three months (90 days) a medical exam may be scheduled.
Continued payment of temporary total disability will be
dependent on the outcome of the independent medical exam.
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How does BWC
determine how much I will be paid while I am off work? -
Compensation rates are based on
your earnings prior to the injury taking into account the
minimum and maximum rates applicable to the year you were
injured.
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Compensation - Checks
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Why do the amounts of
my checks vary? -
There are
many reasons why the amounts of your workers’ compensation
checks may vary. Generally, workers’ compensation benefits
checks are paid in two-week increments. Sometimes due to the
beginning and ending dates on the form completed by your
physician, there may be a variance in the amount of the checks
received. Also, after the first 12 weeks of temporary total the
rate usually changes, and this will cause the check amount to be
different.
*(Rule
4123.56) Many types of workers’
compensation benefits are subject to family support, and this
will cause a rate reduction as well.
Also, different types of compensation benefits have
different applicable rates. If you have a specific question
about the amount of your check or the period of time it is
paying for, contact BWC.
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How do I sign up for
direct deposit? -
To sign up
for direct deposit, complete the
ACT enrollment form,
attach a voided check or deposit slip and mail to:
Accounts Payable ACT
Bureau of Workers' Compensation
PO Box 15429
Columbus OH 43215-9609
or fax the form to:
1-614-752-8439
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How long before my
money goes directly to my bank? -
Once BWC processes the authorization, it takes about six
business days for your bank to verify the bank account
information. We will send you a letter explaining the effective
date of your authorization. After that date, any payments made
to you by BWC will be deposited into your account.
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