Last updated on Feb 20, 2026
OH-C23-WC free printable template
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This is one of the official workers' compensation forms for the state of Ohio.
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What is OH-C23-WC
The OH-C23-WC is a workers' compensation claim form used to report workplace injuries in Ohio.
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Who needs OH-C23-WC?
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OH-C23-WC is needed by:
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Employees reporting workplace injuries
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Employers facilitating claims
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Insurance agents processing claims
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Legal representatives assisting injured workers
OH-C23-WC form: A comprehensive guide to changing your physician of record
What is the OH-C23-WC form?
The OH-C23-WC form is a crucial document used in Ohio's workers' compensation system to officially request a change of physician. This form plays a vital role in ensuring that your new physician is recognized by the Bureau of Workers' Compensation (BWC). Filling out the OH-C23-WC form correctly is essential to avoid complications in your treatment and claim process.
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The OH-C23-WC form is designed specifically for injured workers who wish to change their treating physician.
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This form allows workers to document their choice of a new physician in the workers' compensation program.
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Completing the form accurately ensures that the BWC updates its records, allowing timely access to appropriate medical treatment.
How do complete the OH-C23-WC form?
Filling out the OH-C23-WC form is straightforward if you follow detailed instructions. Start by accurately filling out Part I of the form, where you will need to provide essential information about the injured worker and the injury itself. Ensure you fill in the date of injury, the injured worker’s name, and the claim number correctly.
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This section requires personal details and specifics about the injury.
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Make sure to include the date of injury, the injured worker's name, and the claim number.
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Accurately represent both your current physician's and your new physician's details.
Why would someone change their physician?
Changing your physician is sometimes necessary for various reasons. Acceptable reasons include dissatisfaction with the current physician's treatment or if the physician has relocated. It is also important to provide a clear explanation for the change when submitting the OH-C23-WC form.
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If you are unhappy with the quality of care, that's a valid reason to change your physician.
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If your current physician moves, you will need to choose a new one.
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Ensure your new physician complies with BWC guidelines to avoid delays in your treatment.
What role does the MCO play in changing my physician?
Managed Care Organizations (MCOs) play a critical role in processing your request to change physicians. After you submit the OH-C23-WC form, it is the MCO's responsibility to notify the BWC of the change and facilitate your transition to your new healthcare provider.
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Your MCO is responsible for reviewing and submitting your request.
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They must act quickly to minimize treatment disruptions.
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Timely notification helps in ensuring continuous and appropriate medical care.
What are best practices for submitting the OH-C23-WC form?
Before submitting the OH-C23-WC form, review it thoroughly. Having a checklist can help ensure that all required fields and signatures are completed accurately. Keeping copies for your records is also recommended as it serves as proof of your submission.
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Check the form for completeness and accuracy before submitting it.
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Verify that all necessary signatures are included to avoid delays.
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Making copies of the submitted form ensures you have a record of your request.
How do track my change of physician request?
After submitting your change request, it’s essential to know what steps to take next. You should anticipate a confirmation from your MCO regarding the status of your request. Maintaining communication with your MCO is critical, especially if you experience any delays.
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Expect to receive confirmation from your MCO once they process your request.
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Stay in touch for updates on the progress of your request.
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Know your options if your request is not processed in a timely manner.
What are common challenges when changing my physician?
Changing your physician can come with its share of challenges. Some common difficulties include incomplete forms or timely communication issues with the MCO. Utilizing resources like pdfFiller can simplify the process by providing easy access to the required forms and document management tools.
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Issues often arise from incomplete submissions or poor communication with the MCO.
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Thoroughly review forms and maintain open lines of communication with your MCO.
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Using tools like pdfFiller can help streamline your form filling and management efforts.
How to fill out the OH-C23-WC
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1.Open the PDF file of the OH-C23-WC form on pdfFiller.
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2.Begin by entering the employee's personal information, including their full name, address, and date of birth.
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3.Next, provide the employer's name and address, along with the date of the injury or illness.
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4.Answer the questions regarding the nature of the injury or illness, including how it occurred and where it happened.
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5.Fill out the details about the medical treatment received, including the name of the treating physician and dates of treatment.
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6.Indicate if the employee has missed work due to the injury by checking the appropriate box.
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7.Review all entered information for accuracy and completeness.
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8.Once confirmed, save the form and print it if necessary for physical signatures.
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9.Submit the completed form to the appropriate employer or insurance claims department as required.
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