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  • Employer Authorized Representative R 1 Form

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Employer Authorized Representative Instructions The employer and representative must complete this form and file it with BWC. You must possess a valid BWC representative ID number. To obtain a valid.

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OhioBWC - Employer - Form: (R-1) - Authorization of Representative of Employer. Employers and their representatives use this form to notify BWC of the employer�s authorized representative. Once the employer signs the form the named representative can act as the employer�s agent in the specified claim.

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.

With the Go-Green Rebate Program, employers can receive a one percent premium rebate, up to $2,000 each policy year.

How do you make a payment? You can guarantee we will receive your installment payments on time by paying online. Refer to Creating an e-account to get started. Once you have an e-account, sign-in to our website, and then click the Make a payment button.

Your managed care organization (MCO) is here to help you file and manage claims, and to ensure injured workers receive the quality medical care they deserve. Your MCO also helps facili- tate a quick and safe return to work, which benefits your company and your workforce.

Authorized representatives are individuals whom injured workers or employers select or hire to represent their interests during the life of the claim. Generally, they select attorneys, but representatives can be anyone.

OhioBWC - Worker - Form: (C-23) - Introduction. 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.

U-117 - Notification of Policy Update: Employers should use this form to notify BWC of changes to the information on their Ohio workers' compensation policies (e.g., update business information, address/contact information, request to cancel elective coverage and request to cancel Ohio workers' compensation coverage).

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© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232
Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
DMCA Policy
About Us
Blog
Affiliates
Contact Us
Privacy Notice
Delete My Account
Site Map
Industries
Forms in Spanish
Localized Forms
State-specific Forms
Forms Kit
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate workflows
DocHub
Instapage
Social Media
Call us now toll free:
1-877-389-0141
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232