State Fund Claim Procedures

KKSG & Associates, Inc.

 OHIO  WORKERS’ COMPENSATION - STATE FUND CLAIM PROCEDURES

  1. Seek qualified medical treatment for injuries that require other than first aid.

  2. Make sure the injured worker has an MCO identification card.  The treatment facility will complete the First Report of Injury (FROI) and electronically file it with your MCO.  A copy of the FROI will also automatically be sent to the BWC.  If the treatment facility does not complete the FROI, please inform KKSG and with your assistance, we can file it electronically or call it into the MCO.

  3. Instruct your injured worker to get a work release or written work restrictions before being discharged from the medical facility.  (The most common form used by the medical facilities for work injuries is the MEDCO-14 - Physician's Report of WORK ABILITY)

  4. Have the injured worker complete an accident report and get statements from witness/supervisor as soon as possible while the events of the incident are still easily recalled.

  5. Inform KKSG of the incident including return to work status and certification.  This can be done via phone call, e-mail, or by faxing the accident report.  Most accident reports do not contain return to work status or certification so be sure to include that somewhere in the fax.

  6. Timely complete all requests from the BWC and MCO, which would include claim certification, wage statement, and return to work date.

  7. Return the injured worker to work (regular or modified duty) as soon as possible to avoid or minimize claim charges and reserves.  Keep KKSG informed of work status.

  8. Options to consider in reducing claim costs:  Wage continuation and light duty.  Call us for the requirements and written guidelines.

  9. All medical bills should be forwarded to your Managed Care Organization (MCO).

  10. KKSG will provide representation for Industrial Commission hearings.  When circumstances arise that require hearing participation by the employer or legal counsel, we will timely contact and so advise.  We will send you a narrative report after each hearing.  Please make sure KKSG is listed on all hearing notices you receive.  If KKSG is not copied, please fax the notice to our office as soon as possible.

  11. Call our office at any time with your questions and concerns.