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Managing the aftermath of a workplace injury in Ohio demands a comprehensive understanding of the bureaucratic process, which often involves navigating through a maze of paperwork. Among the essential documents that play a critical role in this process is the Ohio OS 24 form, a comprehensive list detailing the forms and publications available from the Office Services of the Bureau of Workers' Compensation (BWC). Located at 3655 Brookham Drive in Grove City, Ohio, and accessible by phone or fax, this resource provides vital documents needed for various claims and procedures related to workers' compensation. The Ohio OS 24 form outlines a variety of forms including, but not limited to, the AC-3 Temporary Authorization, the C-9 Physician’s Report/Treatment Plan, and the MEDCO-13 Application for Provider Enrollment and Certification, each catering to specific aspects of workplace injuries and illnesses. Additionally, it contains documents necessary for financial and legal aspects such as the C-59 Self-Insurer's Agreement as to Compensation on Account of Death and the SI-42 Self-Insured Joint Settlement Agreement and Release. This breadth of documentation underscores the multifaceted nature of managing workers' compensation claims, offering a structured pathway for employers, injured workers, and healthcare providers to navigate the complexities of the system. Moreover, the availability of publications such as the BWC Medical Guide and various fraud awareness resources highlights the BWC's commitment to transparency and education in managing workers' compensation. As a gateway to accessing these necessary documents, the Ohio OS 24 form serves a fundamental purpose in streamlining the workers' compensation process, ensuring that all parties have access to the required forms and information to uphold the rights and responsibilities outlined within Ohio's workers' compensation guidelines.

Example - Ohio Os 24 Form

OFCE SERVICES FORMS & PUBLICATIONS 3655 Brookham Drive Grove City, Ohio 43123

Call: 1-800-OHIOBWC, and listen to the options Fax: 614-621-5746

Please provide your physical address.

Due to United Parcel Services’ shipping regulations, we cannot to make deliveries to post office boxes.

Date

Customer ID number

Contact name

 

 

Telephone number

 

 

 

 

 

 

Company name

 

 

 

 

Email address

 

 

 

 

 

 

Address

 

 

City

State

ZIP code

 

 

 

 

 

 

FORMS AVAILABLE

Quantity Form no.

Title

AC-3

Temporary Authorization

C-5

Additional Information for Death Benefits

C-9

Physician’s Report/Treatment Plan for Industrial

 

Injury or Occupational Disease

C-9A

Request for Additional Medical Documentation for C-9

C-11

Request to Appeal MCO Medical Treatment/

 

Service Decision

C-17

Pharmacy Invoice

C-18

Wage Agreement

C-19

Service Invoice

C-23

Change of Doctor Request

C-32

Application for Lump Sum Advancement

C-44

Physician’s Certificate in Proof of Death

C-58

Application for Adjustment of Claim in Case of Fatal

 

Injury

C-59

Self-Insurer’s Agreement as to Compensation on

 

Account of Death

C-60

Injured Worker Statement for Reimbursement of Travel

 

Expense

C-77

Injured Workers’ Change of Address

C-84

Request for Temporary Total Compensation

C-86

Motion

C-92

Application for Determination of the Percentage of

 

Permanent Partial Disability or Increase of Permanent

 

Partial Disability

C-94A

Wage Statement

C-101

Authorization to Release Medical Information

C-108

Request for Waiver of Appeal

C-110

Agreement to Select The State of Ohio as the

 

State of Exclusive Remedy

C-112

Agreement to Select a State Other than Ohio as

 

the State of Exclusive Remedy

C-140

Application for Wage Loss Compensation

C-141

Wage Loss Statement for Job Search

C-143

DEP Physician’s Report of Work Ability

C-159

Waiver of Workers’ Compensation Benefits for

 

Recreational or Fitness Activities

Quantity

Form no.

Title

 

C-190

Justification of Medical Necessity for Seating/

 

 

Wheeled Mobility

 

C-230

Authorization to Receive Workers’ Compensation

 

 

Check

 

C-240A

Notice of Exception to Employer’s

 

 

Signature Requirement

 

C-240

Notice of Exception to Employer’s

 

 

Signature Requirement

 

C-241

Amended Settlement Agreement and Release

 

CHP-4A

Application for Handicapped Reimbursement

 

FROI-1

First Report of Injury, Occupational Disease or Death

 

MEDCO-13

Application for Provider Enrollment and Certification

 

MEDCO-13A

Application for Provider Enrollment-Non Certification

 

MEDCO-14

Report of Work Ability

 

R-1

Authorization of Representative of Employer

 

R-2

Authorization of Representative of Injured Worker

 

RH-1

Rehabilitation Agreement

 

RH-2

Individualized Vocational Rehabilitation Plan

 

RH-5

Trainer’s Report

 

RH-6

On-The-Job Training Agreement

 

RH-7

Loan/Lease Agreement for Tools and Equipment

 

RH-10

Injured Worker’s Record of Job Search Contacts

 

RH-18

Authorization for Living Maintenance Wage Loss (LMWL

 

RH-19

Employer Incentive Contract

 

RH-21

Vocational Rehabilitation Closure Report

 

RH-24

Gradual Return to Work Contract Employer

 

 

Reimbursement Method

 

SI-28

Filing of an Allegation Against a Self-Insured Employer

 

SI-42

Self-Insured Joint Settlement Agreement and Release

 

SI-43

Acknowledgment of the Self-Insured Joint

 

 

Settlement Agreement and Release

 

U-3

Application for Ohio Workers’ Compensation Coverage

 

U-3S

Application for Optional Supplemental Coverage

 

U-117

Application for Optional Supplemental Coverage

 

U-118

Notification of Business

 

 

Acquisition/Merger or Purchase/Sale

 

 

 

BWC-5026 (REV. 12/03/2013)

OS-24

PUBLICATIONS AVAILABLE

Quantity

Form number

Title

 

CD 106

BWC Medical Guide

 

FB

Fraud Brochure

 

FBLW

Fraud Brochure Law

 

FBMCO

Fraud Brochure MCO

 

FBSI

Fraud Brochure Self Insured

 

FFFI

Fraud Flyer Financial

Quantity

Form number

Title

 

FFPH

Fraud Flyer Pharmacy

 

FP 01

Fraud Poster

 

FS 01

Fraud Sticker

 

FS 01

Fraud Sticker

 

OS-24

Forms & Publications List

 

PERRP

Safety and Health Protection on the Job Poster

Prepared by

Agent number

Initials

 

 

Forms that are not listed here are not available through BWC office services forms and publications.

You may obtain Industrial Commission of Ohio (IC) forms by calling the IC forms and

publications number at 614-644-8009.

BWC-5026 (REV. 12/03/2013)

OS-24

Document Properties

Fact Name Description
Issuing Agency The Ohio OS 24 form is issued by the Bureau of Workers' Compensation (BWC).
Primary Purpose Used to request forms and publications related to workers' compensation and workplace safety from the Ohio BWC.
Delivery Restrictions Due to United Parcel Services' (UPS) shipping regulations, deliveries cannot be made to post office boxes; a physical address is required.
Contact Information Required Requesters must provide their customer ID number, contact name, telephone number, company name, email address, and physical address for processing.
Governing Law The form and its use are governed by Ohio state laws related to workers' compensation.

Detailed Instructions for Using Ohio Os 24

Filling out the Ohio OS 24 form is an important step in obtaining the necessary forms and publications from the Ohio Bureau of Workers' Compensation (BWC). This step-by-step guide aims to make the process straightforward and stress-free. After you have completed and submitted your OS 24 form, the BWC will process your request. You can expect to receive the forms and publications you've ordered at the physical address you provided, conforming to United Parcel Services' delivery regulations. Remember, delivery to post office boxes is not possible due to these regulations.

  1. Locate the section at the top of the Ohio OS 24 form titled "Office Services Forms & Publications."
  2. Enter the current Date in the designated space provided.
  3. Provide your Customer ID number in the next field; this is crucial for the BWC to identify your account.
  4. Fill in the Contact name with the name of the person who the BWC can contact regarding this order.
  5. Add the Telephone number of the contact person for any follow-up or clarification calls.
  6. State the Company name associated with this request, ensuring it matches the records with BWC.
  7. Include a valid Email address to receive confirmations or updates about your order electronically.
  8. Provide your full physical address, including Address, City, State, and ZIP code, for delivery purposes.
  9. Under the "Forms Available" section, enter the Quantity of each form you need in the corresponding space next to the form number and title.
  10. If you require any publications listed under "PUBLICATIONS AVAILABLE," specify the Quantity for each as well in the space provided next to the publication number and title.

Once you've filled out all the necessary fields on the Ohio OS 24 form, double-check the information for accuracy to ensure timely and correct delivery of your requested documents. You can then submit the completed form via fax to the number provided on the form or call 1-800-OHIOBWC if you have any questions or prefer to submit your request by phone. It's advisable to keep a copy of the submitted form for your records.

What You Should Know About Ohio Os 24

What is the Ohio OS-24 form?

The Ohio OS-24 form is an order form provided by the Office Services Forms & Publications for the Bureau of Workers' Compensation (BWC) in Ohio. It allows individuals and companies to request various forms and publications related to workers' compensation, including applications for compensation, medical treatment requests, and vocational rehabilitation forms. The form lists the available documents that can be ordered and requires the requester's contact information and shipping address.

How can I obtain the Ohio OS-24 form?

The OS-24 form can be accessed by contacting the Ohio Bureau of Workers' Compensation directly at 1-800-OHIOBWC or by visiting their official website. Additionally, the form might be available through your employer if they handle workers' compensation claims or through legal representatives specializing in workers' compensation.

Are there any costs associated with ordering forms using the OS-24?

Generally, the Bureau of Workers' Compensation provides these forms and publications at no charge to ensure that employers and employees have access to necessary resources for managing workers' compensation claims. However, it's advisable to confirm any potential costs or fees directly with the BWC when placing an order.

Can I submit the OS-24 form online?

As of the last update, the form needs to be submitted either via fax to 614-621-5746 or by calling the BWC at 1-800-OHIOBWC for further instructions. It's important to check the latest submission guidelines directly with the Bureau as they may update their processes.

What information do I need to provide when ordering forms with the OS-24?

You need to provide your customer ID number (if available), contact name, telephone number, company name, email address, and a physical shipping address. Note that deliveries cannot be made to post office boxes due to shipping regulations.

How long will it take to receive the forms once ordered through the OS-24?

Delivery times can vary depending on the shipping method and destination. The Bureau of Workers' Compensation aims to process and dispatch orders as efficiently as possible. For specific delivery timelines, it's best to inquire directly at the time of ordering.

Can anyone order forms using the Ohio OS-24, or is it restricted to businesses?

Both individuals and businesses can order forms through the OS-24. This includes employees seeking workers' compensation benefits, employers managing claims, and legal representatives or consultants working on workers' compensation matters.

Is it possible to request multiple copies of a particular form using the OS-24?

Yes, you can request multiple copies of a specific form. The quantity needed for each form must be specified in the appropriate section on the form before submission.

What should I do if the form I need is not listed on the OS-24?

If the form you require is not listed on the OS-24, it may not be available through BWC Office Services Forms & Publications. Some forms may only be obtained through the Industrial Commission of Ohio (IC). For those forms, you can contact the IC forms and publications number at 614-644-8009 for more information.

Common mistakes

When filling out the Ohio OS-24 form, individuals often make several common mistakes. These errors can delay the process of obtaining necessary forms and publications related to workers' compensation and other vital services. Recognizing and avoiding these mistakes ensures smoother transactions with the Office Services Forms & Publications. Here are four common mistakes:

  1. Not Providing a Physical Address: Due to United Parcel Services’ shipping regulations, deliveries cannot be made to post office boxes. A frequent mistake is providing a P.O. Box instead of a physical address, causing delays in shipping.

  2. Incomplete Customer Information: Another common error is leaving out essential details such as the Customer ID number, contact name, or telephone number. This information is crucial for processing the request and facilitating communication.

  3. Forgetting to Specify Quantity of Forms Needed: Individuals often list the forms they require without mentioning the quantity of each form. This omission can lead to receiving an incorrect number of forms, necessitating additional requests and delays.

  4. Incorrectly Identifying Form Numbers and Titles: With a comprehensive list of forms available, it is easy to confuse form numbers or titles. Providing incorrect information can result in receiving the wrong documentation, hindering progress on workers’ compensation or related matters.

To ensure a successful request when dealing with the Ohio OS-24 form, individuals should double-check their information, provide complete and accurate details, and review their form selections carefully. Recognizing these common mistakes and taking steps to avoid them helps streamline the process for everyone involved.

Documents used along the form

When dealing with the intricacies of workers' compensation in Ohio, the Ohio OS 24 form serves as a vital tool for employers to access various necessary forms and publications. To complement the usage of the Ohio OS 24 form, there are other essential documents and forms that stakeholders should be familiar with, each playing a critical role in ensuring seamless navigation through workers' compensation processes.

  • FROI-1 First Report of Injury, Occupational Disease or Death: This form is crucial for reporting an employee's injury or illness that arises out of work. It initiates the claims process, enabling the injured worker to seek benefits. Timely and accurate completion of the FROI-1 is essential for prompt claims processing.
  • MEDCO-14 Report of Work Ability: This document is completed by the healthcare provider and outlines the injured worker’s capabilities and restrictions. It is vital for determining the type of work the employee can perform while recovering, facilitating their return to work when appropriate.
  • RH-18 Authorization for Living Maintenance Wage Loss (LMWL): This authorization is necessary for workers undergoing vocational rehabilitation who are unable to return to their former job due to their injury. It provides them with a portion of their lost wages, supporting them financially during their retraining period.
  • U-3 Application for Ohio Workers’ Compensation Coverage: Employers new to Ohio or newly required to carry workers' compensation insurance must complete this form to obtain coverage. It's the first step in complying with Ohio’s laws regarding workers' compensation, ensuring that both employers and employees are protected in case of a work-related injury or illness.

To ensure comprehensive compliance and support for employees in the event of workplace injuries or illnesses, it is imperative for employers to be well-versed with these documents, in addition to the Ohio OS 24 form. Leveraging these forms effectively ensures not only legal compliance but also the well-being and swift recovery of employees, thereby maintaining a productive and protected workforce.

Similar forms

The Ohio AC-3 Temporary Authorization form resembles other power of attorney documents in its function to temporarily transfer certain rights or powers from one party to another. Like a general power of attorney, the AC-3 allows a business to designate an individual or entity to act on its behalf for a specific purpose, facilitating the management of workers' compensation claims without the need for direct intervention from the company's leaders. This similarity lies in the essence of delegating authority, a common legal practice to ensure operations continue smoothly in various contexts.

Similar to the Ohio C-9 Physician’s Report/Treatment Plan for Industrial Injury or Occupational Disease form, medical consent forms also play a crucial role in healthcare. Both documents focus on the patient's health status and proposed medical actions. However, while the C-9 form specifically pertains to workplace injuries and diseases, detailing the treatment plan required for an injured worker, medical consent forms broadly apply to any medical treatment or procedure, seeking patient approval before proceeding. This shows a shared emphasis on documenting medical intentions and obtaining necessary approvals.

The C-101 Authorization to Release Medical Information form shares a key purpose with other HIPAA release forms. These documents are all designed to ensure that a patient's medical information is shared in compliance with privacy laws, particularly the Health Insurance Portability and Accountability Act (HIPAA) in the United States. Whether for the purpose of workers' compensation claims, as in the case of the C-101, or for general healthcare, consent to release medical information forms protect patient privacy by requiring explicit authorization before health information is disclosed.

The Ohio C-84 Request for Temporary Total Compensation form is akin to disability claim forms used outside the realm of workers' compensation. Both form types aim to provide financial assistance to individuals unable to work due to injury or illness. However, whereas the C-84 specifically addresses injuries sustained in the workplace, general disability forms apply to a broader range of non-occupational circumstances. This delineation underscores the similar intent of supporting individuals during periods of incapacitation, albeit through different systems.

Lastly, the RH-24 Gradual Return to Work Contract shares its foundation with customized employment agreements, which also include modified work arrangements. These documents facilitate an employee's transition back to work, either post-injury or after a significant absence, by outlining temporary or permanent adjustments to the job role or schedule. The RH-24, specifically, focuses on rehabilitating injured workers back into the workforce with provisions that meet their current capabilities, mirroring the adaptability seen in personalized employment contracts to ensure mutual benefit for both employer and employee.

Dos and Don'ts

When filling out the Ohio OS 24 form, there are specific actions that should be taken to ensure the process is completed correctly and efficiently. Conversely, there are also actions to avoid to prevent errors or delays. Below is a list of things you should and shouldn't do.

Things You Should Do:

  1. Review the entire form before beginning to ensure you understand all requirements.
  2. Provide your physical address accurately to comply with United Parcel Services’ shipping regulations.
  3. Ensure that your contact information, including your telephone number and email address, is correct to facilitate any necessary communication.
  4. Clearly print or type information to prevent misunderstandings or delays.
  5. Include your Customer ID number if available, to expedite the processing of your form.
  6. Check the boxes for the forms or publications you require, making sure not to leave out any that are needed.
  7. Specify the quantity of each form or publication you are requesting.
  8. Sign and date the form where required, as an unsigned form may not be processed.
  9. Keep a copy of the completed form for your records.
  10. Contact the BWC at 1-800-OHIOBWC or check online for any updates or changes to available forms.

Things You Shouldn't Do:

  • Do not provide a post office box as your address, as deliveries cannot be made to P.O. boxes per shipping regulations.
  • Avoid leaving sections of the form blank. If a section does not apply, mark it as "N/A" (not applicable).
  • Do not guess on specific details or information; verify facts when uncertain.
  • Avoid using informal language or abbreviations that may not be understood by the BWC.
  • Do not submit the form without reviewing it for errors or omissions.
  • Avoid folding or damaging the form, as this could affect processing.
  • Do not request forms or publications that are not listed, as they are not available through BWC office services.
  • Do not send the form without your contact name, as it is crucial for follow-up.
  • Refrain from sending original documents or materials that are not requested or required.
  • Avoid rushing through the form, as this increases the likelihood of mistakes.

Misconceptions

There are several misconceptions about the Ohio OS-24 form, which can lead to confusion for individuals looking to request forms and publications from the Office Services of the Ohio Bureau of Workers' Compensation (BWC). It is important to clarify these misconceptions to ensure accurate understanding and use of the OS-24 form.

  1. All workers' compensation forms can be requested through the OS-24 form. This is incorrect. The OS-24 form specifically lists the forms and publications available through BWC office services. Forms not listed on the OS-24 cannot be obtained using this method. For forms not available through BWC office services, individuals should contact the Industrial Commission of Ohio (IC).

  2. The OS-24 form can be used to make delivery requests to a post office box. This statement is false. Due to United Parcel Service (UPS) shipping regulations, deliveries requested through the OS-24 form cannot be made to post office boxes. A physical address must be provided.

  3. Email is the only way to submit the OS-24 form. This misconception could limit users from utilizing other available submission methods. The OS-24 form can be faxed or called in, in addition to being emailed to the BWC office services.

  4. You must know your Customer ID number to use the OS-24 form. While it is helpful to provide your Customer ID number when requesting forms and publications, not knowing it does not prevent you from submitting an OS-24 request. Other contact information can be used to process requests.

  5. There is a limit on the quantity of forms you can request through the OS-24 form. The form itself does not impose a maximum quantity that can be requested. However, reasonable quantities are expected to be requested based on need. It is at the discretion of BWC office services to determine if a requested quantity is reasonable and can be fulfilled.

Clarifying these misconceptions ensures that individuals and companies can use the OS-24 form effectively to obtain the necessary forms and publications from the Ohio Bureau of Workers' Compensation (BWC) office services.

Key takeaways

Filling out the Ohio OS 24 form might seem daunting at first, but understanding its purpose and the process can make it much more manageable. Here are seven key takeaways that could help in navigating this form effectively:

  • The Ohio OS 24 form is your gateway to acquiring various workers' compensation forms and publications provided by the Office Services Forms & Publications in Grove City, Ohio. It simplifies the process of requesting necessary paperwork related to workers' compensation.
  • You must provide a physical address when filling out the form. Due to shipping regulations by United Parcel Services, deliveries cannot be made to post office boxes. This is crucial for ensuring that you receive the documents without any hitches.
  • The form encompasses a wide array of documents, ranging from applications for wage loss compensation (C-140) to various authorization and notice forms like the C-230 Authorization to Receive Workers’ Compensation Check. It’s tailored to cover virtually all needs one might encounter in workers' compensation scenarios.
  • To use the form effectively, identify the specific documents you need ahead of time. The form includes quantifiable spaces next to each document title, making it necessary to know the quantity of each form you require.
  • For those seeking to manage a workers' compensation claim, various forms such as the FROI-1 (First Report of Injury, Occupational Disease or Death) and the C-92 (Application for Determination of the Percentage of Permanent Partial Disability or Increase of Permanent Partial Disability) are available and can be requested through this form.
  • The OS 24 form also offers publications related to workers' compensation, such as guides, brochures about fraud, and safety and health protection posters. These resources can be incredibly useful for both employers and employees looking to navigate the complexities of workers' compensation thoroughly.
  • Lastly, if you require forms that are not listed on the OS 24, it directs you to obtain Industrial Commission of Ohio (IC) forms by contacting their forms and publications number. This ensures you have a path to access any document not readily available through the OS 24 request process.

Understanding these aspects of the Ohio OS 24 form can significantly streamline the process of requesting the necessary forms and publications for managing workers' compensation. Whether you're an employer, injured worker, or a representative, having this knowledge helps in efficiently navigating the system.

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