Reporting Work Related Injuries
Employees that have sustained a work related injury must complete a First Report of Injury (FROI) form. The provider must report an injury to the appropriate Managed Care Organization within 24 hours or one business day from the time of the initial visit. If the MCO information for the employer is not available, the provider can find the information on the Ohio BWC website.
Once the MCO receives the FROI, the MCO will successfully transmit the FROI to the Ohio Bureau of Workers' Compensation within 24 hours after receiving notice of the injury.
If a provider does not have an FROI for the injured worker to complete, the information may be given to the MCO and the MCO will complete the FROI and transmit to the BWC. Required information from the providers:
Injured Worker Information
- Name, address
- Telephone number
- Date of birth
- Gender
- Marital status
- Social Security Number
- Name of Employer
- Employer Address and Telephone number
Injury information
- Type of accident
- Date of injury
- Accident description
- Date of initial treatment
- Date last worked
- Return to work date
- Will injury likely result in more than 7 days off work?
- ICD-9 diagnosis codes
- ICD-9 site
- Injury description
- Is diagnosis causally related to this industrial accident?
Provider Information
- Initial treating provider name and BWC provider number
- Physician of record name and BWC provider number
For assistance, please call Health Management Solutions at 1-888-202-3515