All Ohio Workers Compensation forms

Workers Compensation - Addresses

• Injured Worker Change of Address for Workers' Compensation OH-C77-WC

Workers Compensation - Appeals

• Request for Waiver of Appeal for Workers' Compensation OH-C108-WC
• Request to Appeal The MCO Medical Treatment - Service Decision for Workers' Compensation OH-C11-WC

Workers Compensation - Attorneys

• Permanent Authorization for Representation for Workers' Compensation OH-AC02-WC

Workers Compensation - Benefit Cards

• Enrollment Application for Electronic Benefit Card for Workers' Compensation OH-ENROLL-1-WC

Workers Compensation - Checks

• Authorization to Receive Workers Compensation Check for Workers' Compensation OH-C230-WC

Workers Compensation - Claims

• Checklists - Worker's Compensation Claims US-04076BG

Workers Compensation - Death Benefits

• Additional Information for Death Benefits for Workers' Compensation OH-C5-WC

Workers Compensation - Death Claims

• Self-Insurer's Agreement as to Compensation on Account of Death for Workers' Compensation OH-C59-WC
• Application for Adjustment of Claim in of Death Due to Occupational Disease for Workers' Compensation OH-OD5822-WC

Workers Compensation - Direct Deposit

• Direct Deposit ACT Bank Change for Workers' Compensation OH-A35-WC
• ACT Enrollment Form and Direct Deposit Authorization for Workers' Compensation OH-EFT-WC

Workers Compensation - Disability

• Objection to Tentative Order - Awarding Permanent Partial Disability Compensation for Workers' Compensation OH-C167-WC
• Application for Determination of Percentage of Permanent Partial Disability or Increase of Permanent Partial Disability for Workers' Compensation OH-C92-WC

Workers Compensation - Discovery

• Claimant's First Set of Requests for Production US-01366
• Requests for Production of Documents to Carrier US-01367
• Claimant's First Set of Interrogatories to Employer and Carrier US-01365

Workers Compensation - Injury and Claims

• Notice of Work-Related Injury and Claim for Worker's Compensation US-01495BG

Workers Compensation - Injury Reports

• Report of Injury by Employee to Employer to be Filed with Worker's Compensation Agency of State US-01494BG

Workers Compensation - Insurance

• Agreement of Employee Service Provider to Maintain Workers Compensation Insurance US-01625BG

Workers Compensation - Job Searches

• Injured Workers Record of Job Search Contacts for Workers' Compensation OH-RH10-WC

Workers Compensation - Job Training

• On The Job Training Agreement for Workers' Compensation OH-RH6-WC

Workers Compensation - Medical Records

• Authorization to Release Medical Information for Workers' Compensation OH-C101-WC

Workers Compensation - Motions

• Motion for Workers' Compensation OH-C86-WC

Workers Compensation - Physicians

• Notice to Change Physician of Record for Workers' Compensation OH-C23-WC

Workers Compensation - Questionnaires

• Workers Compensation Questionnaire US-Q1038

Workers Compensation - Rehabilitation

• Rehabilitation Agreement for Workers' Compensation OH-RH1-WC

Workers Compensation - Rehabilitation Equipment

• Loan - Release Agreement for Tools and Equipment for Workers' Compensation OH-RH7-WC

Workers Compensation - Reimbursements

• Gradual Return to Work Living Maintenance Reimbursement Method for Workers' Compensation OH-RH25-WC
• Gradual Return to Work Contract Employer Reimbursement Method for Workers' Compensation OH-RH24-WC

Workers Compensation - Reports

• First Report of Injury, Occupational Disease or Death for Workers' Compensation OH-FROI-WC

Workers Compensation - Representation

• Authorization of Representative of Injured Worker for Workers' Compensation OH-R2-WC

Workers Compensation - Self Insurer

• Filing of an Allegation Against a Self-Insured for Workers' Compensation OH-SI28-WC

Workers Compensation - Settlements

• Self Insured Joint Settlement and Release for Workers' Compensation OH-SI42-WC
• Acknowledgment of Self-Insured Joint Settlement Agreement and Release for Workers' Compensation OH-SI43-WC

Workers Compensation - Travel

• Injured Worker Statement for Reimbursement of Travel Expense for Workers' Compensation OH-C60-WC

Workers Compensation - Wages

• Authorization for Living Maintenance Wage Loss for Workers' Compensation OH-RH18-WC
• Application for Wage Loss Compensation for Workers' Compensation OH-C140-WC