When a work-related injury occurs, it's important for all involved parties to assist with the claim and the return-to-work efforts. Below is a list of involved parties who play an active role in the workers' compensation process, along with some of their high-level activities.
Injured workers are responsible for:
- Reporting a workplace injury to their employer.
- Notifying their employer if a workers' compensation claim has been filed.
- Providing BWC and/or the managed care organization (MCO) with all requested information related to their claim. To release medical information, the injured worker completes the Authorization to Release Medical Information (C-101).
Normally for workers' compensation claims, injured workers use the C-101 to ask providers to release medical information. However, sometimes providers, due to HIPPA concerns, will require a provider's proprietary medical release form. To address this potential issue, we're making Medicaid's medical release form available for download.
Note: Before you begin, download the instructions.
- Following the medical restrictions their doctor recommends.
- Keeping their employer informed of their progress and any obstacles encountered.
Employers are responsible for:
- Reporting all workplace injuries to their MCO.
- Investigating all workplace accidents promptly.
- Informing BWC of their decision to certify (confirm an injury has occurred) or reject the workers' compensation claim. Employers can notify BWC of their decision by:
- Completing a First Report of Injury, Occupational Disease or Death (FROI).
- Entering that information in their e-account online.
- Contacting their MCO or BWC claims service specialist (CSS).
- 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.
BWC is responsible for:
- Investigating reported work-related injuries.
- 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.
MCOs are 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.
Third-party administrators (TPAs) are responsible for:
- Assisting an employer in managing their claims.
The Ohio Industrial Commission (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.