Assigning a claim number
Once BWC receives the claim, the information is entered into our claims management system and a unique number is assigned to the claim. A claims service specialist (CSS) then begins processing the claim.
Shortly thereafter, the injured worker will receive a notification letter and a BWC ID card in the mail that contains specific information, such as the CSS's contact information. If you do not receive the letter, you can find the information here using claim assignment.
Completing the initial investigation
During the initial investigation of the work-related injury, a claims service specialist (CSS) or medical claims specialist (MCS) will request the following information:
- Medical documentation from all medical providers for the injury.
- If the injured worker has future work activity restrictions, a completed Physician's Report of Work Ability (MEDCO-14) is needed. The medical provider (doctor) must complete this form.
- If the worker is restricted from working for more than seven calendar days, a completed Request for Temporary Total Compensation (C-84) is needed. The injured worker must complete this form.
- An Injured Worker Earnings Statement showing wage documentation from the injured worker's employer(s) for the 52 weeks prior to the date of the injury. The employer will complete this statement. And, the injured worker can also submit paystubs, W-2s, or request the Employer Report of Employee Earnings (Wages-EMP) be completed by additional employers (other than the employer of record where the injury occurred) to prove their previous wages.
- The CSS or MCS will contact the injured worker's employer and give them the opportunity to certify (confirm an injury has occurred) or reject the claim. While the employer's claim certification or rejection is considered, it's not a determining factor for allowing or denying the claim.
Issuing a decision
Within 28 days from when the worker's compensation claim was filed, we'll complete the initial investigation and decide whether to allow or deny the claim.
The CSS will then issue a BWC Order (which is a written notice) showing the decision as allowed, denied or dismissed.
Note: Allowed, Approved, and Accepted are also terms used to show BWC approval status.
If the injured worker is employed by a self-insuring (SI) employer, refer to the Understanding Self-Insured Claims page.
If the claim is:
- Allowed – BWC has found the claim is payable (compensable) and the injured worker can receive benefits. Benefits are based on the injury diagnosis. This is called allowed conditions. The BWC Order identifies the allowed conditions for the injury and other important details related to BWC's decision. Read the BWC Order carefully. If you do not agree, refer to Appealing a claim decision.
- Denied – BWC has found the claim is not payable (compensable), and the injured worker cannot receive benefits. If the injured worker or the employer disagrees with this decision, either can file an appeal within 14 days from the date when the injured worker received the decision in the BWC Order. To file an appeal, complete the Notice of Appeal (IC-12). Refer to Appealing a claim decision for more information.
- Dismissed – The CSS will dismiss the claim if the injured worker voluntarily withdraws the application:
- Before the CSS issues a BWC Order.
- During an appeal.
Refiling a claim
The injured worker or other involved parties can refile a dismissed claim, but it must be refiled within a certain time frame. From the date of the work-related injury, there is up to:
- One year to refile for an injury claim or a death claim.
- Two years to refile for an occupational disease claim.
To refile a claim:
- Complete another First Report of Injury, Occupational Disease or Death (FROI).
- Send a letter to BWC telling them to refile the claim.