When a work-related injury occurs, it’s important for all involved parties to assist with the workers’ compensation claim and their return-to-work efforts. Below is a list of involved parties who will play an active role in the workers’ compensation process, along with some of their high-level activities.
An injured worker is responsible for:
- Reporting a workplace injury to their employer.
- Notifying their employer if a workers’ compensation claim has been filed.
- Providing Bureau of Workers’ Compensation (BWC) and/or the Managed Care Organization (MCO) with all requested information related to their claim. To release medical information, the injured worker will complete the (C-101) Authorization to Release Medical Information form.
- Following the medical restrictions their doctor recommends.
- Keeping their employer informed of their progress and any obstacles encountered.
The employer is responsible for:
- Reporting all workplace injuries to their Managed Care Organization (MCO).
- Investigating all workplace accidents promptly.
- Informing BWC of their decision to certify (confirm an injury has occurred) or reject the workers’ compensation claim. An employer can notify BWC of their decision by:
- Monitoring the status of the injured worker, including during any time when the employee is not working.
- Coordinating remain-at-work /return-to-work strategies with the injured worker, MCO, medical providers and BWC.
The Bureau of Workers’ Compensation (BWC) is responsible for:
- Investigating reported work-related injury claims.
- Making work-related injury claim determinations.
- Determining allowed conditions, which means BWC issues a claim decision based on the injury’s diagnosis.
- Managing and paying workers’ compensation benefits.
- Determining eligibility for rehabilitation services.
- Assisting with bringing a claim to resolution.
The Managed Care Organization (MCO) is responsible for:
- Managing the medical aspects of the workers’ compensation claim.
- Approving or denying treatment requests.
- Paying the injury-related medical bills.
- Working closely with the employer and BWC to return the injured employee to work as quickly and safely as possible.
The Third-Party Administrator (TPA) is responsible for:
- Assisting an employer in managing their claims.
The Industrial Commission of Ohio (IC) is responsible for:
- Resolving appeals filed by an injured worker or employer who disagrees with a claim decision. Refer to Appealing a claim decision for more information.