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Form C-110 (BWC-1233) Employer / Employee Agreement to Select Ohio as the State of Exclusive Remedy for Workers' Compensation Claims - Ohio
What Is Form C-110 (BWC-1233)?
This is a legal form that was released by the Ohio Bureau of Workers' Compensation - a government authority operating within Ohio. As of today, no separate filing guidelines for the form are provided by the issuing department.
FAQ
Q: What is Form C-110 (BWC-1233)?
A: Form C-110 (BWC-1233) is an Employer/Employee Agreement.
Q: What is the purpose of Form C-110 (BWC-1233)?
A: The purpose of Form C-110 (BWC-1233) is to select Ohio as the State of Exclusive Remedy for Workers' Compensation Claims.
Q: Who should use Form C-110 (BWC-1233)?
A: Both employers and employees can use Form C-110 (BWC-1233).
Q: What does it mean to select Ohio as the State of Exclusive Remedy for Workers' Compensation Claims?
A: Selecting Ohio as the State of Exclusive Remedy means that any workers' compensation claims will be handled exclusively under Ohio's laws.
Q: Is Form C-110 (BWC-1233) mandatory?
A: No, it is not mandatory. Employers and employees have the option to use this form to select Ohio as the State of Exclusive Remedy.
Q: What happens if I don't complete Form C-110 (BWC-1233)?
A: If you don't complete Form C-110 (BWC-1233), the default state's workers' compensation laws will apply.
Q: Can I change my selection after submitting Form C-110 (BWC-1233)?
A: Yes, you can change your selection by submitting a written request to the Ohio Bureau of Workers' Compensation (BWC).
Q: Are there any fees associated with submitting Form C-110 (BWC-1233)?
A: No, there are no fees associated with submitting Form C-110 (BWC-1233).
Form Details:
- Released on February 10, 2022;
- The latest edition provided by the Ohio Bureau of Workers' Compensation;
- Easy to use and ready to print;
- Quick to customize;
- Compatible with most PDF-viewing applications;
- Fill out the form in our online filing application.
Download a printable version of Form C-110 (BWC-1233) by clicking the link below or browse more documents and templates provided by the Ohio Bureau of Workers' Compensation.
