Ohio Form C-3 is the First Report of an Injury, Occupational Disease, or Death (FROI) that an injured worker, employer, medical provider, or authorized representative files with the Ohio Bureau of Workers’ Compensation to open a workers’ compensation claim. Filing this form is the only way to start a claim, and missing the statutory deadline under Ohio Revised Code 4123.84 can permanently bar a worker from receiving benefits.
The current revision date on the official BWC form is BWC-1101 (Rev. 7/2023), so confirm you are using that version before you write anything. Ohio BWC processes more than 85,000 new injury claims a year, and BWC’s own data shows that roughly 1 in 5 claims is initially returned, delayed, or denied because of missing or incorrect information on the C-3.
Here is what you will learn in this guide:
- 📝 How to complete every field of the official C-3 form line by line
- 🏥 Which medical records, wage records, and ID numbers to gather before you start
- 🚚 Three real-world filer scenarios (warehouse injury, carpal tunnel, construction fall)
- ⏰ The exact deadlines under R.C. 4123.84 and 4123.85 and what happens if you miss them
- ⚠️ The 10 most common mistakes that trigger a BWC suspension or denial
What the Form Is and Who Must File It
Ohio Form C-3 is the official First Report of Injury used by the Ohio Bureau of Workers’ Compensation to open a workers’ compensation claim file. The form captures the basic facts of the injury, the employer of record, the body parts hurt, the medical diagnosis, and the wages of the injured worker. Once BWC receives a C-3, the agency assigns a claim number, routes the file to the correct Managed Care Organization (MCO), and begins the allowance decision under Ohio Revised Code Chapter 4123.
Any of the following parties may file a C-3: the injured worker (or their surviving dependents in a death claim), the employer, the treating physician or hospital, the worker’s attorney, or a third-party administrator (TPA) acting for the employer. The form is not optional. If a worker is hurt on the job and wants benefits, someone must file the C-3 within the statutory window or the claim is gone forever under R.C. 4123.84.
The C-3 covers three event types: a traumatic injury (a slip, a fall, a struck-by), an occupational disease (carpal tunnel, hearing loss, silicosis), and a death caused by a workplace event. Each event type has its own deadline and its own evidence rules under Ohio Administrative Code 4123-3. Self-insured employers in Ohio do not send the C-3 to BWC; they handle the claim in-house but still must use the same form data and report the claim through the BWC self-insured portal.
The form is paired with several others. The MEDCO-14 captures the doctor’s work-ability opinion, the C-84 requests temporary total disability compensation, and the C-86 motion lets a party ask the Ohio Industrial Commission to decide a contested issue. Knowing how the C-3 fits with these companion forms helps filers avoid the common error of stopping at the C-3 and never requesting actual lost-wage benefits.
Before You Start: Documents and Information You Need
Before you open the C-3 PDF or log into the BWC online filing portal, gather every document below. Filing without these items is the single biggest reason claims sit in suspended status for weeks. BWC will not decide a claim it cannot read, and a missing field is treated the same as a blank one under O.A.C. 4123-3-09.
Use this pre-filing checklist:
- Injured worker’s full legal name, Social Security number, date of birth, and current address. BWC cross-checks the SSN against state records, and a one-digit error sends the claim into manual review.
- Employer’s exact legal name and BWC policy number. The policy number is on the employer’s BWC certificate of coverage; using a DBA name without the policy number causes the claim to be filed against the wrong entity.
- Date, time, and exact location of the injury. Without a precise location BWC cannot verify that the event happened in the course of employment, which is the core test under R.C. 4123.01(C).
- Detailed narrative of how the injury happened. Vague answers like “hurt my back at work” are the number-one reason claims are denied for failure to prove causation.
- List of body parts injured and the ICD-10 diagnosis codes. The treating physician supplies the codes, and BWC allows only the codes that match the medical evidence.
- Treating physician or hospital name, address, and provider number. BWC needs this to request medical records and to assign the MCO under O.A.C. 4123-6.
- Wage information for the 52 weeks before the injury. Wage records set the average weekly wage (AWW) and full weekly wage (FWW) that drive every dollar of compensation.
- Names and contact information of any witnesses. Witness statements protect the claim if the employer later disputes that the event happened.
- Photo ID and direct-deposit information. BWC pays benefits through electronic funds transfer, and a missing routing number delays the first check.
- Prior claim numbers, if any. Old claims affect the current AWW calculation and the flow-through of pre-existing conditions.
Marcus, a forklift operator, learned this the hard way. He filed without his employer’s policy number, and his claim sat in pending for 27 days while BWC searched for the right policy. Five minutes of prep on the front end would have saved nearly a month of lost wages.
Where to Get the Form and How to Access It
The official Form C-3 lives on the BWC website as a fillable PDF. Download it directly from the BWC forms library or use the direct PDF link. Always pull a fresh copy each time you file because BWC updates the form when statutes or codes change, and an outdated version may be rejected under O.A.C. 4123-3-03.
You can also file the C-3 entirely online without ever touching the PDF. Log into the BWC e-account portal and choose File a Claim from the injured-worker dashboard. The online wizard asks the same questions as the PDF, validates each field in real time, and assigns a claim number on submission. Online filing is the fastest channel and is strongly recommended by BWC’s how-to-file-a-claim page.
If you prefer paper, print the PDF on letter-size paper, complete it in black ink or by typing in the fillable fields, sign it in ink, and mail or fax it to BWC. Hospitals and physicians often submit the C-3 on the worker’s behalf through their MCO, which then transmits the form to BWC electronically through the BWC provider portal.
Spanish-language and large-print versions are available on request through BWC customer service at 1-800-644-6292. Filers who need a reasonable accommodation under the ADA can ask BWC to take the report by phone, and a customer service specialist will fill the form out for them.
Step-by-Step: How to Fill Out Ohio Form C-3 Line by Line
The C-3 is a two-page form divided into three parts: Part 1 – Injured Worker Information, Part 2 – Injury/Disease/Death Information, and Part 3 – Employer Information. Work top to bottom and never skip a field. A blank field is treated as an unanswered question under O.A.C. 4123-3-09, and BWC will suspend the claim until the missing data arrives.
Part 1, Box 1 – Injured Worker’s Name
This box asks for the worker’s full legal name as it appears on a Social Security card. Write the last name first, then the first name, then the middle initial in all capital letters. For example, LOPEZ, MARIA E is how Maria Lopez enters her name. If the worker has a hyphenated surname, include the hyphen exactly as it appears on the SSA record. A common mistake is using a nickname like Mike instead of Michael, which causes BWC’s SSN cross-check to fail and triggers a 10-day cure letter. Many filers think a married name is automatic; it is not, because BWC matches the name to the SSN on file with the Social Security Administration.
Part 1, Box 2 – Social Security Number
Enter the worker’s nine-digit SSN in the format 123-45-6789. Do not use a tax ID, ITIN, or employer-assigned ID in this box. Maria Lopez writes 234-56-7890 in this field. If the worker has no SSN (for example, an undocumented worker who is still entitled to benefits under State ex rel. Reyna v. Natural Beauty Landscaping), BWC will issue a temporary claim number; you must still mark the box and write None – pending BWC ID. The most common error is transposing two digits, which generates a no match hit and a manual review. A widespread misconception is that BWC reports the SSN to immigration authorities; it does not, because BWC is bound by R.C. 4123.88 confidentiality.
Part 1, Box 3 – Date of Birth
Write the date of birth in MM/DD/YYYY format. Maria, born March 14, 1985, writes 03/14/1985. Do not abbreviate the year to two digits because BWC’s system reads 85 as 2085 in some legacy fields. If the worker does not know the exact date (rare, but it happens with some older immigrants), use 01/01/YYYY and attach a note explaining the estimate. The most common mistake is swapping month and day, which usually surfaces as an age out of range warning. Filers sometimes think date of birth is optional for adults; it is not, because age drives certain death-claim and dependency calculations under R.C. 4123.59.
Part 1, Box 4 – Home Address
Enter the worker’s current residential address, including apartment or unit number, city, county, state, and ZIP. Maria writes 4421 OAK ST APT 3B, COLUMBUS, FRANKLIN, OH 43215. If the worker uses a P.O. Box for mail, list both the physical address and the P.O. Box separated by a slash. The most common mistake is leaving the county blank; BWC uses the county to assign the regional service office and to set venue for any later Industrial Commission hearing. A misconception is that an out-of-state address kills the claim; it does not, because Ohio jurisdiction follows the location of the injury, not the worker’s residence.
Part 1, Box 5 – Telephone Number and Email
List a daytime phone number and a working email. BWC uses both to send 10-day cure letters and benefit notices. Write (614) 555-1212 and maria.lopez@email.com. If the worker has no email, write None rather than leaving it blank, because a blank field is read as missing data. The biggest mistake here is listing a disconnected number, which causes BWC notices to bounce and deadlines to pass without the worker knowing. Many filers think email is optional; while technically true, an email on file shaves an average of 9 days off claim processing because BWC sends most correspondence electronically.
Part 2, Box 6 – Date and Time of Injury
Write the exact date and time the injury happened. Maria writes 04/02/2026 at 10:15 AM. For an occupational disease, write the date of diagnosis or the date the worker first knew the disease was work-related, whichever applies under R.C. 4123.85. The most common mistake is using the date the worker reported the injury to a supervisor rather than the date the event happened, which can shorten the statute-of-limitations window by days or weeks. A misconception is that a guess is fine; it is not, because the date of injury anchors every deadline in the case.
Part 2, Box 7 – Location of Injury
Describe the exact place the injury happened, including the employer’s address and the specific area inside the workplace. Aisha, a nurse, writes Memorial Hospital, 500 Main St, Cleveland, OH 44101 – Room 312, East Wing. If the injury happened off-site (a delivery driver, a traveling salesperson), list the off-site address and add a note that the worker was in the course of employment. The biggest mistake is writing only the city, which fails to prove the work-connection element. Many filers think the parking lot does not count; it often does, under the zone of employment doctrine recognized in Marlow v. Goodyear Tire & Rubber Co..
Part 2, Box 8 – How Did the Injury Happen?
Write a detailed narrative of the mechanism of injury. Describe what the worker was doing, what object or force caused the harm, and what body parts were affected. Carlos, a roofer, writes I was carrying a 50-pound bundle of shingles up a ladder when the ladder slipped on wet decking. I fell approximately 12 feet to the ground, landing on my right side. I felt immediate pain in my right hip, low back, and right wrist. Vague answers are the number-one cause of denial under the causation test of R.C. 4123.01(C). A misconception is that more drama wins; what wins is specifics, because the BWC adjudicator and any later Industrial Commission hearing officer will compare this narrative to the medical records word for word.
Part 2, Box 9 – Body Parts Injured and ICD-10 Diagnosis Codes
List every body part that hurts and the matching ICD-10 code from the treating physician. Carlos lists Right hip contusion (S70.01XA), Lumbar strain (S39.012A), Right wrist sprain (S63.501A). Only the conditions listed and supported by medical evidence will be allowed in the claim; conditions not listed must be added later by motion under O.A.C. 4123-3-15. The most common mistake is listing a body part with no diagnosis code, which BWC treats as not requested. A misconception is that you can add conditions any time; you can, but each addition requires a new C-86 motion and often a new exam.
Part 2, Box 10 – Treating Physician and Hospital
Enter the doctor or hospital that first treated the injury, including the BWC provider number. Janet, an office worker, writes Dr. Patel, Riverside Methodist Hospital, 3535 Olentangy River Rd, Columbus, OH 43214, Provider #1234567. The provider must be BWC-certified under O.A.C. 4123-6-02.2 for bills to be paid. The biggest mistake is listing an emergency-room doctor as the ongoing provider when the worker is actually following up with a different physician; BWC will route records to the wrong provider for months. A misconception is that any doctor will do; they will not, because non-certified providers cannot bill the claim.
Part 3, Box 11 – Employer Name and BWC Policy Number
Enter the employer’s exact legal name and BWC policy number. Marcus writes ABC Logistics LLC, Policy #1234567-0. Pull the policy number from the certificate of coverage on the employer’s wall or from the BWC employer lookup. The most common mistake is using a DBA or a parent company name that does not match the policy, which routes the claim against the wrong entity and creates a non-complying employer issue under R.C. 4123.75. A misconception is that the staffing agency and the worksite host are interchangeable; they are not, because the staffing agency is almost always the employer of record for BWC purposes.
Part 3, Box 12 – Wages Earned
List the worker’s gross wages for the 52 weeks before the date of injury, the rate of pay, and the hours worked per week. Maria writes $52,000 over 52 weeks at $25/hour, 40 hours per week. BWC uses these numbers to set the average weekly wage (AWW) and the full weekly wage (FWW) under R.C. 4123.61. Underreporting wages is the most expensive mistake on the form because every benefit check is calculated from these numbers for the life of the claim. A misconception is that overtime does not count; it does, and so do shift differentials, bonuses, and second-job wages in some cases.
Part 3, Box 13 – Date Employer Notified
Enter the date the worker first told the employer about the injury. Carlos writes 04/02/2026 at 11:00 AM, told supervisor John Smith. Late notice is a defense the employer can raise at the Industrial Commission, so the closer this date is to the date of injury, the better. The most common mistake is leaving this blank because the worker is embarrassed about a delay; honesty is safer because the employer will produce its own records anyway. A misconception is that a 30-day delay automatically kills the claim; it does not, because Ohio has no statutory notice rule, only the one-year filing deadline under R.C. 4123.84.
Signature Block – Signature and Date
Sign the form in ink (paper) or click Sign and Submit (online). The signature attests that the information is true under penalty of workers’ compensation fraud, a felony in Ohio. Print the name beneath the signature and write the date in MM/DD/YYYY format. The biggest mistake is an unsigned form, which BWC must reject; a signature on the wrong line is treated as no signature. A misconception is that an electronic signature is weaker than ink; it is not, because Ohio’s Uniform Electronic Transactions Act gives both equal legal weight.
Three Filled-Out Examples Using Real Scenarios
Scenario 1: Marcus, Warehouse Worker With a Back Injury
Marcus is a 38-year-old forklift operator who hurt his low back lifting a 75-pound box on April 2, 2026.
| Form Section | What Marcus Enters |
|---|---|
| Box 1 – Name | JOHNSON, MARCUS T |
| Box 2 – SSN | 345-67-8901 |
| Box 3 – Date of Birth | 07/15/1987 |
| Box 4 – Address | 228 Maple Dr, Dayton, Montgomery, OH 45402 |
| Box 6 – Date/Time of Injury | 04/02/2026 at 2:30 PM |
| Box 8 – How It Happened | Lifting a 75-lb box from floor to chest height; felt sharp pain in low back |
| Box 9 – Body Parts/ICD-10 | Lumbar strain (S39.012A), Lumbar disc displacement (M51.26) |
| Box 11 – Employer/Policy | ABC Logistics LLC, Policy #2345678-0 |
| Box 12 – Wages | $48,000 / 52 weeks / $23/hr / 40 hrs |
Scenario 2: Aisha, Office Worker With Carpal Tunnel (Occupational Disease)
Aisha is a 45-year-old data entry clerk diagnosed with bilateral carpal tunnel syndrome on March 18, 2026.
| Form Section | What Aisha Enters |
|---|---|
| Box 1 – Name | WILLIAMS, AISHA M |
| Box 2 – SSN | 456-78-9012 |
| Box 3 – Date of Birth | 11/02/1980 |
| Box 4 – Address | 612 Elm St, Cincinnati, Hamilton, OH 45202 |
| Box 6 – Date of Diagnosis | 03/18/2026 |
| Box 8 – How It Happened | Repetitive keyboard and mouse use 8 hrs/day for 12 years caused bilateral CTS |
| Box 9 – Body Parts/ICD-10 | Bilateral carpal tunnel syndrome (G56.03) |
| Box 11 – Employer/Policy | Tri-State Insurance Co, Policy #3456789-0 |
| Box 12 – Wages | $58,500 / 52 weeks / $28.13/hr / 40 hrs |
Scenario 3: Carlos, Construction Worker With a Fall and Lost Time
Carlos is a 29-year-old roofer who fell 12 feet from a ladder on April 2, 2026, and missed three weeks of work.
| Form Section | What Carlos Enters |
|---|---|
| Box 1 – Name | RAMIREZ, CARLOS J |
| Box 2 – SSN | 567-89-0123 |
| Box 3 – Date of Birth | 09/22/1996 |
| Box 4 – Address | 45 Pine Ave, Toledo, Lucas, OH 43604 |
| Box 6 – Date/Time of Injury | 04/02/2026 at 10:15 AM |
| Box 8 – How It Happened | Carrying shingles up ladder; ladder slipped on wet decking; fell 12 ft |
| Box 9 – Body Parts/ICD-10 | Right hip contusion (S70.01XA), Lumbar strain (S39.012A), Right wrist sprain (S63.501A) |
| Box 11 – Employer/Policy | BuildRight Roofing Inc, Policy #4567890-0 |
| Box 12 – Wages | $46,800 / 52 weeks / $30/hr / 30 hrs avg |
How to File the Completed Form
Ohio BWC accepts the C-3 through four channels, and each has its own processing time and proof-of-filing rules. Choose the channel that fits the filer’s comfort level and urgency, but online is consistently the fastest under BWC’s published service-level data.
Online filing. Go to the BWC e-account portal, log in or create an account, and click File a Claim. There is no fee to file. Submission is instant and BWC issues a claim number within minutes. Save the confirmation page or email as proof of filing. Average decision time is 21 days under O.A.C. 4123-3-09.
By mail. Mail the signed PDF to Ohio Bureau of Workers’ Compensation, 30 W. Spring St., Columbus, OH 43215-2256. There is no fee. Send by certified mail with return receipt so you have proof of the postmark date, which controls the statute of limitations. Expect 30–45 days to a decision because mail must be scanned and indexed.
By fax. Fax to 1-866-336-8352, the BWC central fax. There is no fee. Keep the fax confirmation sheet and the original signed form. Processing time is similar to mail, around 30 days.
Through a Managed Care Organization or medical provider. A BWC-certified provider can submit the C-3 electronically through the BWC provider portal. The MCO transmits the form within 24 hours of the office visit, and BWC issues a claim number within 3–7 days. There is no fee to the worker. The proof of filing is the claim number the MCO supplies.
For all channels, payment of benefits arrives by direct deposit through BWC’s EFT enrollment, and the worker should set this up the same day the C-3 is filed.
What Happens After You File
Once BWC receives the C-3, the agency assigns a claim number, mails a Notice of Receipt to the worker and the employer, and routes the file to a claims service specialist at the regional service office. The specialist has 28 days under O.A.C. 4123-3-09 to issue an initial allowance or denial order. During that window, BWC requests medical records, verifies wages with the employer, and may schedule an independent medical exam.
The employer receives a copy of the C-3 and has the right to certify or reject the claim. If the employer certifies, BWC almost always issues an allowance order. If the employer rejects, BWC still investigates and issues an order based on the evidence, which either party can appeal to the Ohio Industrial Commission within 14 days under R.C. 4123.511.
If the claim is allowed, the worker can begin receiving medical benefits immediately and temporary total disability (TT) compensation after seven calendar days of lost time, with the first seven days paid only if disability lasts more than 14 days under R.C. 4123.55. To turn on TT, the worker must file a C-84 and a MEDCO-14 signed by the treating physician.
If the claim is denied, the worker has 14 days to appeal to a District Hearing Officer at the Industrial Commission. Most contested claims are resolved at the DHO level within 45 days of the appeal. A second appeal to a Staff Hearing Officer, and a final appeal to the Commission itself, are both available under R.C. 4123.511.
Mistakes to Avoid When Filling Out the Form
Form C-3 errors are the leading cause of claim delays in Ohio. Each mistake below carries a specific consequence that can cost benefits or kill the claim outright.
- Filing after the one-year deadline. R.C. 4123.84 bars the claim forever; no equitable extension exists.
- Listing a DBA instead of the legal employer name. BWC routes the claim to the wrong policy and may flag the real employer as non-complying.
- Vague injury narrative in Box 8. BWC denies for failure to prove a causal connection between the work and the injury.
- Missing ICD-10 codes in Box 9. Conditions without codes are not allowed, so medical bills go unpaid until a C-86 motion adds them.
- Wrong date of injury. A wrong date can shorten the statute window and create a credibility problem at the Industrial Commission.
- Underreporting wages in Box 12. Every TT, PT, and PP check is calculated from this number for the life of the claim.
- Unsigned form. BWC must reject an unsigned C-3, and the cure can take 30 days.
- Using a non-certified provider. Bills will not be paid until the worker switches to a BWC-certified provider.
- Leaving the county blank in Box 4. BWC cannot assign the regional service office, which delays the entire file.
- Skipping witness names. If the employer disputes the injury, the worker has no corroborating evidence at hearing.
- Filing the C-3 but no C-84. The claim is allowed but no lost-wage check ever issues because TT was never requested.
- Mixing up traumatic-injury and occupational-disease deadlines. The two-year rule under R.C. 4123.85 applies only to disease, not to injury.
Do’s and Don’ts
Do’s
- Do download a fresh PDF every time, because BWC updates the form when statutes change.
- Do describe the injury in concrete sensory detail, because adjudicators reward specifics.
- Do list every body part that hurts, even minor ones, because adding conditions later requires a motion.
- Do save the confirmation number or certified-mail receipt, because it is your proof of filing.
- Do set up direct deposit the same day, because the first benefit check cannot issue without it.
- Do ask the treating physician for ICD-10 codes in writing, because the codes drive the allowance.
- Do report wages from all jobs in the 52 weeks before injury, because second-job wages can raise the AWW.
Don’ts
- Don’t guess at the date of injury, because every deadline flows from it.
- Don’t sign a blank form for an attorney or anyone else, because you are attesting under fraud penalty.
- Don’t use a nickname in Box 1, because the SSN cross-check fails.
- Don’t leave any field blank; write None or N/A instead, because blanks read as missing.
- Don’t wait for the employer to file, because the worker bears the risk if no one files in time.
- Don’t rely on the emergency-room doctor as the ongoing provider unless they are BWC-certified.
- Don’t delete or alter the form’s revision date, because BWC may reject an outdated version.
Pros and Cons of Filing on Your Own vs. With Help
Pros of filing pro se (without a lawyer or rep)
- No fee. The worker keeps 100% of the benefits because there is no attorney percentage under R.C. 4123.06.
- Faster start. A worker can file online in 20 minutes without waiting for an intake appointment.
- Direct control. The worker hears from BWC first and can correct errors immediately.
- Simple claims rarely need a lawyer. A clean traumatic injury with a certifying employer is easy.
- BWC ombuds office is free. The Ohio Industrial Commission Ombuds Office helps pro se workers at no cost.
Cons of filing pro se
- Missed deadlines are fatal. Most pro se claims that fail do so on a deadline, not the merits.
- Wage calculation is technical. Few non-lawyers know to include overtime, second-job wages, and bonuses.
- Contested claims require hearings. A DHO hearing has rules of evidence and cross-examination.
- Settlement offers are easy to undervalue. Insurers settle low when no lawyer is on the other side.
- Permanent partial awards need an exam strategy. Pro se workers often pick the wrong C-92 timing and lose thousands.
Form C-3 vs. Form FROI-1: Which One Do I Use?
| Feature | Form C-3 |
|---|---|
| Purpose | Original BWC paper/PDF first report of injury |
| Filer | Worker, employer, provider, or attorney (state-fund claims) |
| Statute | R.C. 4123.84 / 4123.85 |
| Filing channel | Online, mail, fax, MCO |
| Self-insured employers | No – use FROI-1 instead |
| Feature | Form FROI-1 |
|---|---|
| Purpose | Electronic first report of injury (IAIABC standard) |
| Filer | Self-insured employers and TPAs |
| Statute | R.C. 4123.35 self-insured rules |
| Filing channel | EDI through BWC self-insured portal |
| State-fund employers | No – use C-3 instead |
FAQs
Is there a fee to file a C-3?
No. BWC charges no filing fee for a C-3 in any channel. The agency is funded by employer premiums under R.C. 4123.34, not by worker fees.
Can I file a C-3 for a co-worker?
No. Only the injured worker, a surviving dependent, the employer, the treating provider, or an authorized representative may sign the C-3. A co-worker without authorization cannot.
What is the deadline to file a C-3 for a traumatic injury?
No later than one year from the date of injury under R.C. 4123.84. Missing this deadline bars the claim forever, with no equitable tolling available in Ohio.
What is the deadline for an occupational disease?
No later than two years from the date of disability or diagnosis, whichever comes first, under R.C. 4123.85. Some diseases like silicosis have additional rules.
Do I write my maiden name or married name in Box 1?
Yes, write the name that appears on your Social Security card. BWC cross-checks the SSN against SSA records, and a mismatch suspends the claim.
Do I list overtime in the wages box?
Yes. Overtime, shift differentials, and bonuses count toward the average weekly wage under R.C. 4123.61. Leaving them out lowers every benefit check.
Can I add body parts later if I forget some in Box 9?
Yes, by filing a C-86 motion with supporting medical evidence. The Industrial Commission will hold a hearing to decide whether to add the new conditions.
Is an electronic signature valid on the C-3?
Yes. Ohio’s Uniform Electronic Transactions Act under R.C. Chapter 1306 gives e-signatures the same legal force as ink signatures.
Do I need a lawyer to file a C-3?
No. Most workers file pro se. A lawyer becomes valuable when the claim is denied, the employer rejects it, or settlement is on the table.
Can I file a C-3 if I am undocumented?
Yes. Ohio courts have held that immigration status does not bar workers’ compensation benefits, and BWC keeps SSN data confidential under R.C. 4123.88.
What if my employer refuses to give me the policy number?
Yes, you can still file. Look the employer up in the BWC employer search or call BWC at 1-800-644-6292 for help.
Does the C-3 turn on lost-wage benefits automatically?
No. The C-3 only opens the claim. To receive temporary total compensation, you must also file a C-84 with a MEDCO-14 signed by your treating physician.
What if I make a mistake on the C-3 after I submit it?
Yes, you can correct it. Send a signed letter or a corrected C-3 to your claims service specialist as soon as possible to update the file before the allowance order issues.
Can a family member file the C-3 if the worker died?
Yes. A surviving spouse or dependent may file a death claim under R.C. 4123.59 within two years of the death, using the C-3 with the death-claim section completed.
Related reading
- How to Fill Out New York Form C-3 (w/Examples) + FAQs
- How to Fill Out Ohio Form C-1 (w/Examples) + FAQs
- How to Fill Out Ohio Form C-110 (w/Examples) + FAQs
- How to Fill Out Virginia VWC Employer’s First Report (w/Examples) + FAQs
- How to Fill Out Colorado WC Employer’s First Report of Injury + FAQs
- How to Fill Out Colorado’s Worker’s Claim for Compensation (Form WC 15) + FAQs
- How to Fill Out California WCAB DWC-AD 1 (w/Examples) + FAQs