Our self-insured department will investigate the issue and resolve it promptly and fairly.
An injured worker (or representative) can file a complaint as a party to the claim using the Allegation Against a Self-Insuring Employer (SI-28) or a clear written statement. The statement should clearly outline the issue(s) and provide supporting documentation. Then submit to BWC.
Mail: Bureau of Workers' Compensation
Attn: Self-Insured Department
30 W. Spring St
Columbus, OH 43215-2256
Upon receipt of a complaint, our self-insured staff sends a notification letter to the employer's designated administrator, assigned representatives, injured worker and injured worker's representative. We request the employer provide a written response to the allegation within 14 days of receipt. The employer may, with good cause, request an extension for providing a response by contacting the assigned BWC representative.
We will investigate the allegation(s) to determine the validity of the complaint and send notification to all parties to the claim. Within 14 days of receipt of the BWC decision, all parties to a complaint may file a written request for reconsideration. The reconsideration must include evidence of new or changed information not considered in the initial decision.
In these cases, we conduct a second-level administrative review to address the complaint reconsideration and notifies all parties to the complaint of the outcome of this reconsideration investigation and evaluation.
Any unresolved issues and appeals to the administrator's designee’s finding will go to Self-Insured Employers Evaluation Board (SIEEB). View past SIEEB decisions.
BWC maintains a record of all findings which will be included in evaluating the employer's fitness to maintain its self-insuring privilege. Ohio Administrative Code 4123-19-09 governs the complaint process pertaining to self-insuring employers.