Stewart Jaffy &: Assoc. Co., LPA, Attorneys at Law
A Legal Professional Association
306 E. Gay Street, Columbus, OH  43315  
Tel: 614/228-6148

Stewart Jaffy & Assoc Home Page Site Index About Stewart Jaffy & Associates Ohio Workers' Compensation Information Ohio AFL-CIO Workers' Compensation Manual Social Security Disability Links
Posted: May, 1998 Please read our legal notice.
Search
Stewart Jaffy & Assoc.
Firm Information
Our Lawyers
Directions
Ohio Workers' Compensation
Ohio Workers' Compensation Guide/FAQ
Rate Information
(1987 to present)
Current News
News Archives
(1996 to present)
Recent Ohio Supreme Court Decisions
Ohio Workers' Compensation Decision Summaries
(1998 to present)
Site Index
XML/RSS
The following information is provided courtesy of the Ohio Workers' Compensation Bulletin. For information about the Bulletin click here.

New BWC Medical "Treatment Plan Approval Guidelines"
(effective June 1, 1998)

Effective June 1, 1998, the BWC has new medical treatment plan approval guidelines. The highlights are:

  • treatment plan for non-emergency treatment must be submitted to MCO prior to initiating treatment;

  • use of C-9 form for presentation of plan is preferred, but another document may be used if it presents at least the same information as the C-9. C-161 Forms will not be sufficient and will be returned with a C-9;

  • MCO must review and respond to request within 72 hours or 3 business days. MCO must respond by fax if possible, if MCO cannot respond by fax it must call physician and follow up in writing;

  • If MCO needs more information or medical review, MCO has 5 days to make decision from receipt of additional information. If medical review results in decision to alter the plan, such decision must be made within the 5 days;

  • If
    1. the MCO does not timely communicate its decision to the physician, AND
    2. the treatment plan was completely and correctly documented on an appropriate document, AND
    3. there is proof of submission to the MCO, AND
    4. the treatment is for the allowed condition(s), AND
    5. the claim is payable

    Then the treatment plan is considered approved.

  • MCO must send copy of treatment plan, including the MCO's decision, to BWC for inclusion in claim file.
 


Stewart Jaffy & Associates Co., LPA | Attorneys at Law
306 E. Gay St. | Columbus, OH 43215
Telephone: (614) 228-6148 | Fax: (614) 228-6140
http://www.jaffylaw.com

.