Bureau of Worker's Compensation
Assessments and treatment of psychologically allowed claims. (C-9, C-19, and C-84 forms). General Mental Health issues including but not limited to Depression, Anxiety, Growth and Developmental issues, and Self-Esteem.
According to www.ohiobwc.com:
C-9: Request for Medical Service Reimbursement or Recommendation for Additional Conditions for Industrial Injury or Occupational Disease (C-9). Medical providers use this form to supply information to managed care organizations (MCOs) or self-insuring employers and to request authorization for additional treatment. Information includes: the current diagnosis; additional conditions felt to be related to the industrial accident/exposure; causal relationship of conditions to the accident/exposure; preexisting conditions, disability and treatment plan.
Request for Temporary Total Compensation (C-84)Injured workers must use this form to initiate or extend payment of temporary total disability benefits. The injured worker provides information about employment and benefits received during the time of disability. The physician provides additional information on the Physician's Report of Work Ability (MEDCO-14).