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Este formulario se utiliza cuando el empleador sucesor desea mantener la póliza existente del empleador precedente y debe ser firmado por ambas partes. No se debe utilizar para combinar dos o más

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Obtain the BWC-7621 form from the appropriate source.

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Who needs bwc-7621?

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Individuals or entities seeking to report a claim or request assistance related to workers' compensation.

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Employers managing workers' compensation claims for their employees.

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Healthcare providers billing for services rendered related to workers' compensation cases.

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What is bwc-7621?

BWC-7621 is a form used for reporting information related to workers' compensation claims in Ohio.

Who is required to file bwc-7621?

Employers in Ohio who have employees and are required to report claims for workers' compensation must file BWC-7621.

How to fill out bwc-7621?

To fill out BWC-7621, employers must complete the form by providing information about the claim, including details about the injured employee and the nature of the injury.

What is the purpose of bwc-7621?

The purpose of BWC-7621 is to facilitate the reporting process for employers to the Ohio Bureau of Workers' Compensation regarding workplace injuries.

What information must be reported on bwc-7621?

BWC-7621 requires information such as the employee's name, date of injury, type of injury, and details regarding lost time from work, among other relevant data.

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