Get Oh Oic Ic-2 2015-2025

Filling out the OH OIC IC-2 form for permanent total disability compensation can seem complex, but this guide provides clear and supportive step-by-step instructions. Whether you are a first-time applicant or have experience with similar forms, this guide will help you navigate the process effectively.

Follow the steps to successfully complete the OH OIC IC-2 form.

1. Click the ‘Get Form’ button to access the OH OIC IC-2 form and open it for editing.
2. Enter your claim number at the top of the form. This should correspond to the most recent date of injury or diagnosis to ensure proper processing.
3. Fill in the injured worker’s information section by providing your name, date of birth, address, telephone number, and fax number.
4. If applicable, complete the injured worker’s representative information with their ID number, name, telephone, and fax.
5. In the 'Consider All Claims' section, indicate the claim numbers you wish to include in this application, ensuring to specify claims with similar body parts.
6. Attach the required medical documentation that supports your application for permanent total disability. This documentation should be dated from within the last twenty-four months.
7. Complete the medical history section, listing all physicians seen in the last five years, their addresses, and the conditions treated.
8. Document all surgeries and procedures you have undergone, noting the physician's name and date for each.
9. Answer questions related to your daily activities, such as driving capabilities, walking distance, and any assistance needed for personal care.
10. Fill out the other disability benefits section if applicable, providing information about any Social Security Disability benefits you have applied for or received.
11. Detail your vocational rehabilitation history, education background, and work history. Be as specific and thorough as possible.
12. In the special factors section, include any additional comments or explanations that may strengthen your application.
13. Sign and date the application, certifying that all information is accurate to the best of your knowledge.
14. Finally, review the entire application for completeness, ensuring all necessary documents are attached before submitting.

Complete your OH OIC IC-2 form online to ensure your application is processed efficiently.