Self-insuring claims
In a self insuring claim, your employer makes the initial determination and subsequent decisions regarding allowances in your claim. If you or your employer has a dispute regarding your claim, either party may file a Motion (C-86) to request a hearing before the Industrial Commission of Ohio (IC).
The Industrial Comission
The IC is a separate agency from the BWC and hears all disputed issues in your claim. A hearing will be scheduled within 45 days from the date of referral to the IC.
Resolving medical issues
Your employer will pay fees for health-care services directly related to your workplace injury. Prior authorization is usually required for medical services, such as hospital stays, surgery and physical therapy, except for emergency situations. Your employer has 10 days to respond to your request. The provider or injured worker must submit all medical bills within two years of the date of service to be considered for payment. Employers must pay medical bills within 30 days of receipt, unless additional information is needed or the bill is being denied. If your employer denies a medical bill or a request for treatment, you may fi le a C-86 to request a hearing before the IC. If the health-care provider treats you for a condition not recognized in your claim, payment is not the responsibility of your employer or BWC. If you believe the condition is related to your claim, you may request it be recognized in your claim by filing a request with your employer. If your employer denies the request, you will need to submit a request to the IC. Attach copies of the employer’s decision.
Claim file availability
Your employer is required to make your claim file available to you or your authorized representative within 72 hours of receiving a written request. You are entitled to a copy of your claim file.
Rehabilitation services
If you are interested in vocational rehabilitation services, please contact the Law Offices of Thomas Tootle. Your employer is required to provide rehabilitation services that are equal to or greater than BWC.
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