Ohio Bureau of Workers' Compensation Forms

This Form is used for reporting earnings to claim Living Maintenance Wage Loss Compensation in Ohio.

This type of document is a "Formulario C-108-ES (BWC-1231) Renuncia Al Periodo De Apelacion" which is used in Ohio. It is a form used to waive the appeal period.

This Form is used for authorizing the receipt of compensation checks for work-related accidents in Ohio.

This Form is used for recording job search contacts as part of the vocational rehabilitation plan in Ohio.

This form is used for reporting the closure of a vocational rehabilitation program in Ohio.

This form is used for applying for the certification of a Qualified Health Plan (QHP) in the state of Ohio.

This form is used for applying for reimbursement for handicap-related expenses in the state of Ohio. It is also known as Form CHP-4A (BWC-3527).

This document is used for designating an employer authorized representative in the state of Ohio.

This form is used for employers in Ohio to report the earnings of employees who are eligible for wage loss compensation.

This Form is used for the Pre-Audit Questionnaire in Ohio.

This Form is used for self-insured professional employer organizations (PEOs) in Ohio to notify their clients about the client relationship.

This document is for requesting exemption from workers' compensation coverage in Ohio and waiving benefits. It is in Spanish.

This form is used for requesting a change in provider information in the state of Ohio.

This document is used for physicians in Ohio to request treatment for their patients.

This Form is used for appointing an authorized representative for a claimant in the state of Ohio.

This Form is used for requesting total temporary compensation in Ohio.