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The C-110 designates Ohio as the state of exclusive remedy for the filing of a workers' compensation claim and the employer must report the payroll to BWC. BWC must receive this form within 10 days of signature to be legally valid. Therefore, it is strongly encouraged to fax completed forms to 614-621-1435.

Ohio Statute of Limitations on Workers' Compensation Claims You have one year from the date of your injury or learning of a work-related condition to file a workers' compensation claim for benefits. The clock begins to run the day you are injured, or if your injury was hidden, the day you discovered you were injured.

BWC policy allows services rendered within 72 hours of the date of injury to be reimbursed even if the billed diagnosis is not an allowed code in the claim, or is on BWC's invalid code list. The MCO is still responsible for determining that the services were related to the industrial injury.

Introduction. This form allows an employer to grant temporary authorization to a third-party administrator to review information. Note: There must be a hard copy of the AC-3 on site at the employer's before you can submit the form here online.

Injured workers use the form to request a change of physician and send it to their managed care organization (MCO) for processing. They must select a BWC-certified medical provider. And only those medical services related to the allowed conditions in the claim will be reimbursed.

The exact amount will be based on your wages at the time of your injury. For the first 12 weeks, you will receive 72% of your full weekly wage. After that, you will be paid 66 2/3% of your average weekly wage. Benefits will continue until you may return to your former position of employment.

What are the time limits (statute of limitations) to file a claim? A claimant must file a notice of injury or death with BWC or the Ohio Industrial Commission (IC) within one year of the injury or death.

When you reach the level of maximum medical improvement after a workplace injury and nothing more can be done to improve your condition, if you are still partially disabled, a doctor will reevaluate you and assign you a permanent impairment rating (PIR) that ranges from one percent to one hundred percent.

A PPD award is paid at the rate of 66 ? percent of the injured worker's average weekly wage in a one-time lump sum payment. Even though a PPD award is paid in a lump sum payment, the award is not a settlement of your claim. In fact, payment of a PPD award extends the life of your claim for an additional 5 years.