Ohio Workers Comp Claims Against Self-Insured Employers

A good number of employers in Ohio are “self-insured” for purposes of workers’ compensation. Such privileged employers must agree to abide by Ohio Bureau of Workers’ Compensation (BWC) and Industrial Commission rules and regulations as found in Ohio Administrative Code Section 4123-19-03 and Ohio Revised Code Section 4123.35.

One of the primary differences from a claimant’s perspective between a self-insured claim and a “state fund” claim is that in a self-insured claim the employer makes the initial determinations rather than the Bureau of Workers’ Compensation. If a dispute arises, then a c-86 motion may be filed in order to compel the Industrial Commission to hear the matter and render a formal decision. Much of our work at McKenzie & Snyder is done at the Industrial Commission. It is there that one is able to reverse a decision made by a self-insured employer. This includes decisions about compensation, medical treatment and allowances.

How Does an Employer Qualify for Self-Insurance?
Several requirements must be met to become self insured, including, but not limited to: 1) Having a minimum of 500 employees in Ohio; 2) being financially stability; 3) having the ability to administer a self-insured program; and 4) having a qualified BWC certified Qualified Health Plan (QHP).

The BWC has a self-insured department to help address concerns with a self-insured employer. One may also contact our office at 513-737-5180 to address such issues.

McKenzie & Snyder represents injured individuals in the Greater Cincinnati and Dayton areas, including: Cheviot, Western Hills, Hamilton, Fairfield, Mt Healthy, Forest Park, Reading, Springboro, Lebanon, Mason, West Chester, Monroe, Colerain, Springdale, Loveland, Madeira, Milford, Batavia, Amelia, College Hill, Northside, Clifton, Ross, Oxford and more.

Written by Andrew Tobergte