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Completing form C-9 Physician s Request for Medical Service or Recommendation of Additional Conditions for Industrial Injury or Occupational Disease Instructions Have questions? Call: 1-800-OHIOBWC.

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U-3E - Application for Exemption from Ohio Workers' Coverage and Waiver of Benefits Employers use this form to apply for religious exemption from paying BWC premiums or assessments, or for self-insuring employers paying compensation and benefits directly to their employees who completed the form.

Ohio employers with one or more employees must have workers' compensation coverage. In Ohio, all employers with one or more employees must, by law, have workers' compensation coverage.

OhioBWC - Common - Form: (C-11) - Introduction. Injured workers, employers, medical providers or authorized representatives should use this form to appeal the managed care organization's (MCO's) medical treatment/service decision. This form initiates the alternative dispute resolution (ADR) process.

The penalty for failure to file a payroll report on time is 1 percent ($3 minimum - $15 maximum) of the premium due. Failure to pay premium on time will result in a $30 flat penalty charge as well as a penalty charge of up to 15 percent of the premium due depending on how late the payment is received.

The form is used to report the injury or illness to the Ohio Bureau of Workers' Compensation (BWC), and to seek medical benefits and other relief available under Ohio's workers' compensation law. The form must be completed by the injured worker, the employer, and any doctor who treated the worker.

This is the form medical providers use to request treatment, medical equipment or supplies in a workers' compensation claim. In addition to requests for treatment/services, the form also contains a section for the medical provider to indicate additional conditions that may be related to an industrial injury.

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© Copyright 1997-2025
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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
All Forms
Search all Forms
Industries
Forms in Spanish
Localized Forms
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