If an employee is injured at work, an Employee Incident Report [PDF] MUST be completed within 24 hours of the incident. If the injured worker is unable to complete the form, his/her immediate supervisor must do so to the best of his/her knowledge.
The employee may seek treatment at OhioHealth WorkHealth or the local Emergency Department. However, the injured worker has the right to select the physician or medical facility he/she desires as long as they are BWC certified, if more than one visit is required.
In order to file a claim, a First Report of Injury (FROI) must be completed and filed with Ohio University's Third Party Administrator (TPA) Charles Taylor, formerly Matrix. Let the medical facility know that Ohio University's TPA is Charles Taylor, formerly Matrix, so they can file the FROI. Effective September 29, 2017, an injured worker has one year from the date of injury to file a Workers' Compensation claim, but only has 24 hours to submit the Employee Incident Report [PDF] . Claims with a date of injury prior to September 29, 2017, an injured worker has two years from the date of injury to file a Workers' Compensation claim.
Please remember that the First Report of Injury form that is completed at the physician's office or hospital is NOT the same form as the Employee Incident Report [PDF] . This form needs to be completed immediately and emailed to insurance@ohio.edu to prevent any delays in your workers compensation claim.
Once a claim has been submitted to the University's TPA, the injured worker will begin to receive paperwork via postal mail regarding the claim. The paperwork will provide important information such as claim number, claims examiner, general information, etc. A claim will be designated as "medical only" or "lost time."
A medical only claimis if the injured worker missed 0-7 days (calendar days, not business days) of work. A lost time claimis when 8 or more consecutive days of work are missed.
If an injured worker missed 8-13 consecutive days of work, he/she may be eligible to receive lost wages for days 8-13 only. If the injured worker missed 14 consecutive days of work, he/she may be eligible to receive wages from the first day forward of missed work. Lost wages will only be paid (if it is an allowed claim) if the following types of time are used during the injured workers absence:
- vacation,
- comp. time,
- personal time and/or
- leave without pay.
Lost wages will NOTbe paid to an injured worker if SICK TIMEwas used during the leave. The injured worker may use any type of time while on leave (if applicable).
Again, the lost wages will NOTbe paid if SICK TIMEhas been used; however, the injured worker may use sick time if he/she desires.
A claim will either be allowed or disallowed. If an employee disagrees with a decision, that employee may file an appeal with BWC. If it is a medical only claim and it is allowed, the medical bills will be reviewed and paid by Charles Taylor, formerly Matrix. If a claim is disallowed, the injured worker has 14 days from the day he/she received the order to submit an appeal in writing to BWC. Failure to submit an appeal within the time frame will result in permanent disallowance of the claim. The injured worker will receive written notification of the date, time, and place the appeal will be heard.
If the injured worker and their medical doctor feel that the employee cannot return to work, the employee MUSTobtain a doctor's note to include the following:
- date(s) to be off work,
- diagnosis (why taking off work),
- restrictions (if any) and
- estimated return to work.
The employee MUSTprovide the appropriate medical documentation from their physician that they are capable of returning to work.