When it comes to workers' compensation claims, the Physician's Request for Medical Services or Recommendation for Additional Conditions for Industrial Injury or Occupational Disease (C-9) form is an important tool used by medical providers to request treatment, medical equipment, or supplies. It also serves as a means for medical providers to indicate additional conditions related to an industrial injury. This is important because the BWC will only pay for treatment (and disability payments can only be linked to) medical conditions that are "allowed" in your claim. "Allowed" status means that all interested parties agree (or it has been determined by a hearing officer when the parties disagree) that a medical diagnosis relates to the workplace injury by proximate cause. When an injured worker seeks treatment or payment for medical diagnoses that are NOT "Allowed" in their claim, those requests will be denied.
If you are an injured worker and your doctor has submitted a C-9 form, it's important to understand what information is required and how it affects your workers' compensation claim.
Here is a breakdown of the required information for the C-9 form:
• BWC claim number: This is a unique identification number assigned to your workers' compensation claim. Make sure to include this on the form to ensure proper processing.
• Treating diagnosis and ICD-9 code(s): This refers to the specific medical condition or injury for which treatment is being requested. It's important to include the appropriate ICD-9 code(s) for accurate record keeping.
• Dates of service requested: This includes the beginning and end date of the requested treatment or service.
• List of requested services: The specific type, frequency, and duration of the requested treatment or service should be listed on the form.
• Diagnosis and ICD-9 code(s) for additional conditions: If the medical provider is recommending additional conditions that may be related to your industrial injury, the diagnosis and appropriate ICD-9 code(s) should be included on the form.
• Explanation of causal relationship: The medical provider should explain how the additional condition(s) are related to the industrial injury or occupational disease.
• Physician information: The name, mailing address, and provider number of the medical provider should be included on the form.
• Physician's written signature and date: The medical provider must sign and date the form to certify the information provided.
It's important to note that the C-9 form is considered a formal request for treatment or additional conditions. If the Bureau of Workers' Compensation obtains medical evidence indicating that the conditions requested are not related, a referral to the Industrial Commission of Ohio may be necessary, and a hearing may be scheduled to resolve the matter.
Resources for Injured Workers
If you have been injured on the job in Ohio, there are many resources available to help you navigate the workers' compensation system. The following links provide information and resources for injured workers:
Ohio Bureau of Workers' Compensation: The BWC is the state agency responsible for administering workers' compensation benefits in Ohio. Their website provides information on filing a claim, appealing a decision, and other aspects of the workers' compensation system.
Ohio Industrial Commission: The Industrial Commission is responsible for resolving disputes related to workers' compensation claims. Their website provides information on the appeals process and other resources for injured workers.
If you have been injured on the job in Ohio, the workers' compensation system can provide important benefits to help you recover. The C9 form is an important step in the process of obtaining these benefits, so it is important to file the form promptly and provide as much detail as possible. If you need help navigating the workers' compensation system, call NRS Injury Law today at 855.468.4878 or fill out our online contact form