Authorization Number : 855-0921
Agency Series No. : C-20-C
Status : Active
Agency Web Link :
Agency : BWC
Confidential Description : This record contains the injured workers’ claim file with personal information, address, telephone number, medical records, psychological records, social security numbers, provider numbers, employment records, employer policy numbers, payments made, etc.
Ohio Revised Code (ORC) 149.43A(1)(a)
Availability of public records for inspection and copying. ORC 4123.88 (B) Disclosure of record
Ohio Administrative Code 4121-3-22 (D) Inspection of Claim Files.
Division : BWCCLMS
Vital Description : Documents from the claim file include vital information, which may be needed for future reference or reconstruction in order to comply with processing of a claim for an injured worker. Prior to 2001 claim files were not imaged and the paper copy may be the only record.
Section :
Record Title : Deceased Injured Worker Claim file
Revision : 3
Record Description : The Deceased Injured Worker (here after known as DIW) Claim Files contains documents related to a claim for workers’ compensation benefits due to a work related injury resulting in the death of an employee. These Claim files may include (but are not limited to); Dependent death benefits, all correspondence, BWC Orders, IC Orders, Family Support Orders, Forms: FROI-1 the First Report of Injury, C-101 Authorization to Release Medical Information, C-86 Motion of Claimant, IC Hearing Documents, C-92 Percentage Applications and Awards, medical documents, Medical Peer Reviews, Medical and non medical Alternative Dispute Resolution (ADR) packets, x-ray interpretations, psychological reports, C-84 Request for Temporary Total Compensation, Permanent Total Disability Compensation Application, Vocational Rehabilitation Reports, Wage Loss Application (working and non-working wage loss), Living Maintenance Compensation Application, Complete Settlement Packets and Settlement Agreement, Employer Handicap Reimbursement Applications and Handicap Percentage Award Orders.
Retain DIW Claims
with date of injury on or after 08/25/2006
Medical Only Claim: Retain for 6 years from the last payment of a medical bill.
Lost Time Claim: Retain for 6 years from last payment; compensation or medical.
Retain DIW Claims
For date of injury on or after 10/20/1993 and before 08/25/2006. Medical Only Claim Retain for 6 years from last payment of a medical bill. Lost Time Claim Retain 10 years from last payment compensation or medical.
Retain DIW Claims
For date of injury 12/11/1967 through 10/19/1993 Medical Only Claims: Retain 6 years from date of injury regardless of when last medical bill was paid. Lost Time Claims retain 10 years from last payment of compensation or medical.
Retain DIW Claims
For Date of Injury Prior to 12/11/1967 Medical Only Claims: Retain 10 years from last payment medical. Lost Time Claims: Retain 10 years from last payment of compensation or medical.