Fill a Valid Ohio Os 24 Form

The Ohio OS 24 form is a comprehensive list of forms and publications provided by the Ohio Bureau of Workers' Compensation (BWC). This form serves as a resource for individuals and businesses seeking various documents related to workers' compensation. Understanding the OS 24 form is essential for navigating the complexities of Ohio's workers' compensation system.

Get This Document Online

Article Guide

Different PDF Templates

Free Cdl Training Ohio - Applicants need to report any past accidents and their involvement in them.

Ohio Cat Annual Minimum Tax - Communicate with your tax representative throughout the process.

Felony 2 Sentencing in Ohio - Falsification of information on the application can lead to denial of the permit.

Preview - Ohio Os 24 Form

OFﬁCE SERVICES FORMS & PUBLICATIONS 3655 Brookham Drive Grove City, Ohio 43123

Call: 1-800-OHIOBWC, and listen to the options Fax: 614-621-5746

Please provide your physical address.

Due to United Parcel Services’ shipping regulations, we cannot to make deliveries to post ofﬁce boxes.

Date	Customer ID number	Contact name			Telephone number

Company name					Email address

Address			City	State	ZIP code

FORMS AVAILABLE

Quantity Form no.	Title
AC-3	Temporary Authorization
C-5	Additional Information for Death Beneﬁts
C-9	Physician’s Report/Treatment Plan for Industrial
	Injury or Occupational Disease
C-9A	Request for Additional Medical Documentation for C-9
C-11	Request to Appeal MCO Medical Treatment/
	Service Decision
C-17	Pharmacy Invoice
C-18	Wage Agreement
C-19	Service Invoice
C-23	Change of Doctor Request
C-32	Application for Lump Sum Advancement
C-44	Physician’s Certiﬁcate in Proof of Death
C-58	Application for Adjustment of Claim in Case of Fatal
	Injury
C-59	Self-Insurer’s Agreement as to Compensation on
	Account of Death
C-60	Injured Worker Statement for Reimbursement of Travel
	Expense
C-77	Injured Workers’ Change of Address
C-84	Request for Temporary Total Compensation
C-86	Motion
C-92	Application for Determination of the Percentage of
	Permanent Partial Disability or Increase of Permanent
	Partial Disability
C-94A	Wage Statement
C-101	Authorization to Release Medical Information
C-108	Request for Waiver of Appeal
C-110	Agreement to Select The State of Ohio as the
	State of Exclusive Remedy
C-112	Agreement to Select a State Other than Ohio as
	the State of Exclusive Remedy
C-140	Application for Wage Loss Compensation
C-141	Wage Loss Statement for Job Search
C-143	DEP Physician’s Report of Work Ability
C-159	Waiver of Workers’ Compensation Beneﬁts for
	Recreational or Fitness Activities

Quantity	Form no.	Title
	C-190	Justiﬁcation of Medical Necessity for Seating/
		Wheeled Mobility
	C-230	Authorization to Receive Workers’ Compensation
		Check
	C-240A	Notice of Exception to Employer’s
		Signature Requirement
	C-240	Notice of Exception to Employer’s
		Signature Requirement
	C-241	Amended Settlement Agreement and Release
	CHP-4A	Application for Handicapped Reimbursement
	FROI-1	First Report of Injury, Occupational Disease or Death
	MEDCO-13	Application for Provider Enrollment and Certiﬁcation
	MEDCO-13A	Application for Provider Enrollment-Non Certiﬁcation
	MEDCO-14	Report of Work Ability
	R-1	Authorization of Representative of Employer
	R-2	Authorization of Representative of Injured Worker
	RH-1	Rehabilitation Agreement
	RH-2	Individualized Vocational Rehabilitation Plan
	RH-5	Trainer’s Report
	RH-6	On-The-Job Training Agreement
	RH-7	Loan/Lease Agreement for Tools and Equipment
	RH-10	Injured Worker’s Record of Job Search Contacts
	RH-18	Authorization for Living Maintenance Wage Loss (LMWL
	RH-19	Employer Incentive Contract
	RH-21	Vocational Rehabilitation Closure Report
	RH-24	Gradual Return to Work Contract Employer
		Reimbursement Method
	SI-28	Filing of an Allegation Against a Self-Insured Employer
	SI-42	Self-Insured Joint Settlement Agreement and Release
	SI-43	Acknowledgment of the Self-Insured Joint
		Settlement Agreement and Release
	U-3	Application for Ohio Workers’ Compensation Coverage
	U-3S	Application for Optional Supplemental Coverage
	U-117	Application for Optional Supplemental Coverage
	U-118	Notiﬁcation of Business
		Acquisition/Merger or Purchase/Sale

BWC-5026 (REV. 12/03/2013)

OS-24

PUBLICATIONS AVAILABLE

Quantity	Form number	Title
	CD 106	BWC Medical Guide
	FB	Fraud Brochure
	FBLW	Fraud Brochure Law
	FBMCO	Fraud Brochure MCO
	FBSI	Fraud Brochure Self Insured
	FFFI	Fraud Flyer Financial

Quantity	Form number	Title
	FFPH	Fraud Flyer Pharmacy
	FP 01	Fraud Poster
	FS 01	Fraud Sticker
	FS 01	Fraud Sticker
	OS-24	Forms & Publications List
	PERRP	Safety and Health Protection on the Job Poster

Prepared by

Agent number	Initials

Forms that are not listed here are not available through BWC ofﬁce services forms and publications.

You may obtain Industrial Commission of Ohio (IC) forms by calling the IC forms and

publications number at 614-644-8009.

BWC-5026 (REV. 12/03/2013)

OS-24

Document Properties

Fact Name	Fact Description
Form Purpose	The Ohio OS-24 form is used to request various forms and publications related to workers' compensation.
Governing Law	This form is governed by Ohio Revised Code Chapter 4123, which outlines the state's workers' compensation laws.
Physical Address Requirement	Applicants must provide a physical address for delivery, as post office boxes are not accepted.
Contact Information	Users must include their customer ID, name, telephone number, company name, email address, and full address.
Available Forms	The OS-24 form lists numerous available forms, such as the AC-3 Temporary Authorization and C-5 Additional Information for Death Benefits.
Submission Methods	Forms can be submitted via fax or phone. The fax number is 614-621-5746, and assistance is available by calling 1-800-OHIOBWC.
Updates	The OS-24 form was last revised on December 3, 2013, indicating the need to check for updates periodically.

Documents used along the form

The Ohio OS-24 form is a vital document used in various workers' compensation processes. Alongside this form, several other documents may be necessary to support claims, provide additional information, or facilitate communication between parties. Below is a list of forms and documents commonly used in conjunction with the Ohio OS-24 form, each with a brief description to clarify its purpose.

AC-3 Temporary Authorization: This form allows for temporary authorization for medical treatment or services related to a workplace injury.
C-5 Additional Information for Death Benefits: Used to provide supplementary information when claiming death benefits due to a work-related incident.
C-9 Physician’s Report/Treatment Plan: A detailed report from a physician outlining the treatment plan for an injured worker.
C-11 Request to Appeal MCO Medical Treatment Decision: This document is utilized when appealing a decision made by a Managed Care Organization regarding medical treatment.
C-44 Physician’s Certificate in Proof of Death: A certificate confirming the death of an individual, necessary for processing death benefits.
C-84 Request for Temporary Total Compensation: A request form for temporary total compensation due to an inability to work following an injury.
FROI-1 First Report of Injury: The initial report documenting an injury, occupational disease, or death that occurs in the workplace.
U-3 Application for Ohio Workers’ Compensation Coverage: This application is for employers seeking coverage under Ohio's workers' compensation system.
RH-1 Rehabilitation Agreement: An agreement outlining the terms and conditions for vocational rehabilitation services for injured workers.

These documents are essential for ensuring that all necessary information is provided and that claims are processed efficiently. It is crucial to have the correct forms completed and submitted in a timely manner to avoid delays in benefits or services. Always consult with a professional if you have questions about any specific form or its requirements.

Guidelines on Filling in Ohio Os 24

After completing the Ohio OS-24 form, you will submit it to the appropriate office to request the forms and publications you need. Ensure all information is accurate to avoid delays.

Start by entering the date in the designated field at the top of the form.
Provide your Customer ID number in the next box.
Fill in your contact name and telephone number below the Customer ID.
Next, write the company name if applicable.
Enter your email address in the corresponding field.
Provide your physical address, including street address, city, state, and ZIP code. Remember, do not use a P.O. Box.
In the section for forms available, list the quantity of each form you need by filling in the form number and title next to it.
Finally, review all information for accuracy before submission.

Common mistakes

When filling out the Ohio OS-24 form, individuals often make several common mistakes that can lead to delays or complications in processing their requests. One frequent error is providing an incorrect or incomplete physical address. It is essential to remember that deliveries cannot be made to post office boxes due to shipping regulations. Ensuring that the physical address is accurate and complete, including the city, state, and ZIP code, is crucial for timely processing.

Another mistake occurs when applicants fail to include necessary contact information. The form requires a contact name and telephone number, yet many individuals overlook this requirement. Without this information, the processing office may have difficulty reaching out for clarification or additional information, which can slow down the entire process.

Additionally, people sometimes neglect to check the quantity of forms they need. The OS-24 form allows users to request multiple forms, but if the quantity is left blank or inaccurately filled out, it can result in receiving fewer forms than needed. This oversight can lead to frustration and additional time spent re-submitting requests.

Some individuals also make the mistake of not reviewing the specific form numbers and titles before submission. Each form has a designated number that corresponds to its purpose. Failing to select the correct form number can lead to receiving the wrong documentation, which may not meet the applicant's needs.

Moreover, applicants often forget to sign the form. A signature is a critical component of the OS-24 form, as it verifies that the information provided is accurate and complete. Submitting the form without a signature can result in immediate rejection, causing delays in processing.

Lastly, individuals may overlook the importance of checking for any updates or changes to the form requirements. Regulations and forms can change, and it is vital to ensure that the most current version of the OS-24 form is being used. Using outdated forms can lead to confusion and potential issues with processing requests.

FAQ

What is the Ohio OS-24 form?
The Ohio OS-24 form is a comprehensive list of available forms and publications related to workers' compensation in Ohio. It serves as a resource for individuals and businesses needing specific documentation for claims, appeals, and other related processes.
How can I obtain the Ohio OS-24 form?
You can obtain the Ohio OS-24 form by contacting the Office of Workers' Compensation. The office is located at 3655 Brookham Drive, Grove City, Ohio 43123. You can also call 1-800-OHIOBWC for assistance or send a fax to 614-621-5746. Please ensure that you provide a physical address, as deliveries cannot be made to post office boxes.
What types of forms are listed on the OS-24?
The OS-24 includes a variety of forms designed for different purposes. For instance, it lists forms for temporary authorizations, medical documentation requests, appeals, and wage loss compensation applications. Each form serves a specific function in the workers' compensation process, making it essential to select the correct one for your needs.
Can I obtain forms not listed on the OS-24?
Forms not included in the OS-24 are not available through the Bureau of Workers' Compensation. However, you can obtain Industrial Commission of Ohio forms by calling their forms and publications number at 614-644-8009. It is important to ensure you have the correct form for your specific situation to avoid delays in processing.