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The Injured Worker’s Guide — Gruhin & Gruhin, LLC

How a BWC Claim
Actually Works

A step-by-step roadmap of your Ohio workers’ compensation claim — from the moment of injury through final resolution — plus a complete breakdown of the IC hearing process.

Most injured workers feel completely lost because no one ever gives them a map. Here is exactly what happens in an Ohio workers’ compensation claim — from the moment you are hurt to the final resolution.

The 5-stage claim roadmap

How your Ohio BWC claim actually works

1

The Injury

Day 1
1

Report Immediately

Tell your supervisor and a co-worker right away. Ask for a written incident report, complete it, and keep a copy.

2

Get Medical Care

Go to an emergency room or urgent care. Tell every provider you were injured at work, exactly how it happened, and list every body part that hurts — even minor ones.

3

FROI Is Filed

Usually the medical provider files the First Report of Injury electronically with the BWC. If they do not, file it yourself or have an attorney file it.

2

Claim Opens

Days 1–14
4

Claim Number Assigned

The BWC reviews the FROI and assigns a claim number and BWC ID card. Use this card for all prescriptions related to your allowed conditions.

5

MCO Assigned

A Managed Care Organization (MCO) is assigned to manage medical authorizations. Your doctor must submit a C-9 form to the MCO for approval before most treatments.

6

BWC Issues an Initial Order

Within days to a few weeks, the BWC issues an order either allowing or denying the claim.

CRITICAL: You have only 14 days from receipt to appeal a denial to the Industrial Commission. Missing this deadline permanently closes your claim. Contact an attorney immediately.

3

Active Treatment

Weeks 1 Through MMI
7

Medical Treatment Begins

Your treating doctor (physician of record) directs your care. All treatment must be by a BWC-certified provider and pre-authorized by your MCO via C-9 forms.

8

TTD Begins (If Off Work)

If your doctor certifies you cannot work, TTD payments begin on the 8th day you miss work. You can recover days 1–7 if you miss 14 or more total days. Payments are biweekly.

9

BWC or Employer Sends Their Doctor

The BWC or your employer may schedule an IME to evaluate your condition — often to terminate TTD or deny additional conditions. Contest unfavorable IME findings with a rebuttal report from your own physician.

10

MMI Declared

When a doctor finds you have reached Maximum Medical Improvement, TTD stops. You may then pursue Permanent Partial Disability (PPD) awards.

4

Hearings & Disputes

As Needed
11

Industrial Commission Hearing

Any disputed issue — claim denial, TTD termination, additional conditions, PPD percentage — is heard at the IC. The three-level hearing process is detailed below.

12

Additional Conditions Added

If your injury causes flow through problems (knee injury causes back strain; injury pain causes depression), a motion can be filed to add such flow through conditions to your claim.

5

Resolution

Final Stage
13

MMI — Return to Work — Wage Loss — VocRehab — PTD

Once you reach MMI, you return to work (or possibly (1) add a flow through condition to your claim; (2) pursue VocRehab or wage loss compensation; (3) apply for Permanent Partial Disability compensation (PPD — lump sum injury award which does not close your claim); (4) continue medical care if needed; (5) in the worst injury scenario, you seek Permanent Total Disability (PTD).

14

Settlement

At any point while the Ohio BWC claim is alive, you may negotiate a lump-sum settlement to close the entire claim — including future medical benefits or an indemnity only settlement, which keeps the medical component open. Never settle without an attorney evaluating the full value and explaining potential pitfalls to settlement.


The hearing system

The 3-level IC appeal process

When you, the BWC, or your employer disputes any aspect of your claim, the dispute goes to the Ohio Industrial Commission (IC). There are three levels — each with a strict 14-day appeal window from receipt of the IC order.

LevelWho DecidesAppeal WindowWhat to Know
Level 1 — DHOSingle District Hearing Officer14 days from receiptBoth sides present medical evidence and arguments. The employer’s attorney will be there — you should have an attorney too.
Level 2 — SHOStaff Hearing Officer14 days from receiptReviews the record and can affirm, modify, or reverse the DHO order. Often the most critical level.
Level 3 — Full CommissionThree-Member IC Panel14 days to request reviewMay refuse to hear the appeal (making SHO order final) or conduct a full hearing. If the Commission declines or issues a final order, you have 60 days to appeal to Court.
Court AppealOhio Court of Common Pleas60 days from final IC orderAfter exhausting IC levels, certain issues may be appealed to either Common Pleas Court or (in certain cases) the 10th District Court of Appeals.
“At every hearing, the employer or BWC will have an experienced attorney representing their interests. Representing yourself against a trained Ohio Workers’ Compensation attorney places you and your claim at an enormous disadvantage. The hearing officer cannot help you or give you legal advice.”

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DISCLAIMER: THIS IS NOT LEGAL ADVICE.

By accessing any website page or website post, the reader agrees that (1) The information above is general in nature and is not legal advice; (2) No attorney-client relationship is created; (3) Each claim is unique and must be carefully evaluated on its specific facts under current Ohio law and the most recent court decisions; and, (4) Such evaluations require advice from an experienced Ohio Workers' Compensation Attorney.