OH U-117 BWC-7623 2016-2025 free printable template

To notify BWC of changes to the information on your Ohio workers’ compensation policy.

How to fill out notification of policy update

How to fill out OH U-117 BWC-7623

1. Obtain the OH U-117 BWC-7623 form from the Ohio Bureau of Workers' Compensation website or your local office.
2. Begin by filling out the claimant information section, providing your full name, address, and contact information.
3. Enter the date of the injury or incident in the designated field.
4. Complete the section regarding the employer's information, including the employer's name and address.
5. Specify the nature of your injury or illness in the appropriate section, including any relevant medical conditions.
6. If applicable, provide details of any prior injuries or treatments related to the current claim.
7. Ensure all required supporting documents are attached to the form, such as medical records or incident reports.
8. Review the form for accuracy and completeness before submitting it.
9. Submit the completed form to the appropriate office as indicated on the form's instructions.

Who needs OH U-117 BWC-7623?

1. Any worker in Ohio who has sustained a work-related injury or illness and is seeking compensation or benefits through the Ohio Bureau of Workers' Compensation.

Instructions and Help about notification of policy update

People Also Ask about

What is the exemption form for Ohio workers comp?

U-3E - Application for Exemption from Ohio Workers' Coverage and Waiver of Benefits Employers use this form to apply for religious exemption from paying BWC premiums or assessments, or for self-insuring employers paying compensation and benefits directly to their employees who completed the form.

What does Ohio BWC do?

BWC pays medical benefits and lost wages to employees who are injured or contract an occupational disease on the job. We also pay death benefits to survivors when a death results from a work-related injury or disease. Ohio law requires employers to obtain workers' compensation insurance for all employees.

How do I report a claim to Ohio BWC?

Phone: Call BWC at 800-644-6292 from 7:30 a.m. to 5:30 p.m. (EST) or a local BWC customer service office. The customer service representative will ask the questions needed to complete the form and will submit it.

How do I get a BWC certificate in Ohio?

BWC issues certificates of coverage to employers after they submit an Application for Workers' Compensation Coverage (U-3) and pay a non-refundable application fee of $120. They'll also receive a new certificate at the beginning of each policy year.

How long is the waiting period for BWC in Ohio?

In terms of processing time, the BWC maintains a 28-day turnaround time for all Ohio workers' compensation claims. Within that 28-day period, the BWC will review the FROI and make a decision as to approval or denial of the underlying claim.

How much is the application fee for BWC in Ohio?

Coverage is not in effect until BWC receives the application and $120 non-refundable application fee. If you have all the required information on hand, simply click the start button to begin.

How do I get a copy of my workers comp certificate in Ohio?

Sedgewick maintains all of Ohio State's workers' compensation files. To request a copy of your file, you may contact Sedgwick. at (888) 647-3815 or fax your request to (855) 223-9836.

For pdfFiller’s FAQs

How can I get notification of policy update?

The premium subscription for pdfFiller provides you with access to an extensive library of fillable forms (over 25M fillable templates) that you can download, fill out, print, and sign. You won’t have any trouble finding state-specific notification of policy update and other forms in the library. Find the template you need and customize it using advanced editing functionalities.

How do I fill out notification of policy update using my mobile device?

The pdfFiller mobile app makes it simple to design and fill out legal paperwork. Complete and sign notification of policy update and other papers using the app. Visit pdfFiller's website to learn more about the PDF editor's features.

How do I complete notification of policy update on an iOS device?

Get and install the pdfFiller application for iOS. Next, open the app and log in or create an account to get access to all of the solution’s editing features. To open your notification of policy update, upload it from your device or cloud storage, or enter the document URL. After you complete all of the required fields within the document and eSign it (if that is needed), you can save it or share it with others.

What is OH U-117 BWC-7623?

OH U-117 BWC-7623 is a form used in Ohio for reporting workplace injuries and illnesses.

Who is required to file OH U-117 BWC-7623?

Employers in Ohio who have employees covered by the state's workers' compensation system are required to file OH U-117 BWC-7623 for any work-related injuries or illnesses.

How to fill out OH U-117 BWC-7623?

To fill out the OH U-117 BWC-7623, employers need to provide information regarding the injured employee, the nature of the injury, the date and time of the incident, and any medical treatment received.

What is the purpose of OH U-117 BWC-7623?

The purpose of OH U-117 BWC-7623 is to document work-related injuries and illnesses for monitoring purposes and to ensure compliance with workers' compensation laws.

What information must be reported on OH U-117 BWC-7623?

Information that must be reported on OH U-117 BWC-7623 includes the employee's name, job title, details of the injury or illness, the date and time of the incident, and any witnesses present.