Type of Employer
Two different types of employer exist in the Ohio workers’ compensation system: state fund employers and self-insured employers. Although an injured worker should receive the same compensation and benefits regardless of the type of employer, the way the system works differs.
State fund employers participate in the state insurance fund. They pay a premium, and do not pay workers’ compensation benefits directly. The state insurance fund pays workers’ compensation benefits for state fund employers.
The BWC processes state fund claims. An injured worker who has a state fund employer cannot receive payment without a Bureau or Commission order.
Self-insured employers do not pay premiums. They pay all compensation and benefits directly to the injured worker.
Because self-insurers pay compensation directly, they can pay compensation or benefits directly, without any order. Self-insurers make the initial decision on whether or not to pay a claim.
If the self-insurer chooses not to pay, then the issue can be contested through the hearings process. To get a hearing you must file a motion after the self-insurer refuses payment.
Another difference between state fund and self-insurers involves the application of the managed care medical system, for payment of benefits. This is explained in our Guide to Ohio Workers’ Compensation Medical Benefits.