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10/02/2024

Bureau of Workers Compensation (BWC) Fee Schedule & Rule Update

 

The BWC recently released the following information:

The updated rules take effect on Oct. 1, 2024.

  • Eligibility criteria updates (OAC 4123-18-03)
    • Removal of the criteria based on catastrophic injury, as it is covered by other criteria.
    • Allowing a state agency or state university to support participation in an allowed claim, rather than a certified claim.

  • Living maintenance updates (OAC 4123-18-04)
    • Medical hold maintains an injured worker’s approval to participate in a vocational rehabilitation plan, rather than just maintaining eligibility.
    • The medical hold period is shortened to six months.

  • Maximum benefit increases (OAC 4123-18-11)
    • Relocation expenses increased to $4,000.
    • Benefits for non-allowed conditions increased to $3,000.

  • Vocational rehabilitation provider fee schedule (OAC 4123-18-09):
  • How to recommend an additional allowance

If you're a treating physician recommending an additional allowance for an injured worker’s claim, here's what you need to know:

You can use BWC’s Request for Medical Service Reimbursement or Recommendation for Additional Conditions (C-9) form. Section III, items 6 and 7, along with supporting information, are specifically for this purpose.

Ensure your recommendation includes:

Diagnosis: Provide a narrative description with location and site (e.g., Superior Glenoid Labral Tear, Left Shoulder).

Supporting Documentation: In section 7, include a statement explaining how the condition is related to the work injury, supported by objective evidence (e.g., MRI results).

For more details, please review our fact sheet on How a Medical Provider Recommends an Additional Condition. You can download and share it with your office.

 


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