Ohio state fund TPA resources
Forms
- Permanent Authorization (AC2)
- Temporary Authorization to Review Information (AC-3)
- Salary Continuation Agreement
- Request for Temporary Total Compensation
- Wage Statement
- First Report of Injury, Occupational Disease or Death
- Physician’s Report of Work Ability
- Application for One Claim Program
- Application for Drug-Free Safety Program
- Application for Deductible Program
- Application for Ohio Workers’ Compensation Coverage
Participation agreements
Private employer
- 2019 CareWorks Comp Group Rating Participation Agreement
- 2019 CareWorks Comp Group Retrospective Rating Plan Participation Agreement
- 2020 CareWorks Comp Group Rating Participation Agreement
- 2020 CareWorks Comp Group Retrospective Rating Participation Agreement
- 2021 CareWorks Comp Group Rating Participation Agreement
- 2021 CareWorks Comp Group Retrospective Rating Participation Agreement
Public employer
- 2019 CareWorks Comp Group Rating Participation Agreement
- 2019 CareWorks Comp Group Retrospective Rating Plan Participation Agreement
NFIB group rating and group retrospective rating
- 2022 NFIB Group Amendment
- 2022 NFIB Group Participation Agreement (starting 1/1)
- 2022 NFIB Group Participation Agreement (starting 3/1)
- 2022 NFIB Group Retro Participation Agreement (starting 1/1)
- 2022 NFIB Group Retro Participation Agreement (starting 3/1)
- 2023 NFIB Group Amendment
- 2023 NFIB Group Participation Agreement (starting 1/1)
- 2023 NFIB Group Participation Agreement (starting 3/1)
- 2023 NFIB Group Retro Participation Agreement (starting 1/1)
- 2023 NFIB Group Retro Participation Agreement (starting 3/1)
NFIB select program plus
- 2022 NFIB Select Program Plus Amendment
- 2022 NFIB Select Program Plus Participation Agreement (starting 1/1)
- 2022 NFIB Select Program Plus Participation Agreement (starting 3/1)
- 2023 NFIB Select Program Plus Amendment
- 2023 NFIB Select Program Plus Participation Agreement (starting 1/1)
- 2023 NFIB Select Program Plus Participation Agreement (starting 3/1)
Safety resources
- Group Rating Safety Accountability Letter
- BWCs FY CY20 Guidelines for Group Rating Training
- BWCs FY CY21 Guidelines for Group Rating Training
- Great Lakes OSHA Education Center
- OSHA National Safety Stand-Down To Prevent Falls in Construction
- Ohio BWC Division of Safety & Hygiene — Training Center courses
- OSHA News Releases
OSHA recordkeeping
- OSHA injury and illness recordkeeping and reporting requirements
- OSHA online reporting of injury and illness data
- OSHA recordkeeping FAQs
Public employers/PERRP
Two-hour safety training
Additional safety links
Toolbox talks
- Basic Personal Protective Equipment (PPE)
- Conveyors and other running equipment/machines
- Diffusing workplace violence
- Distracted driving
- Emergency evacuation plans
- Eye safety
- Hazardous chemicals: routes of entry
- Hearing protection
- Heat illness
- Hierarchy of controls
- Janitorial safety
- Ladder safety
- Lifting safely
- Long hair hazards
- Maintenance shop hazards
- OSHA incident fact sheet
- Parking lot safety
- Preventing falls
- Seated work
- Shift work safety: fatigue
- Shipping and receiving safety
- Winter weather and cold stress safety
- Working in the sun
Webinars
- PERRP Recordkeeping — Jan. 2023
- OSHA Recordkeeping — Jan. 2023
- Recordkeeping Roundtable – Ask the Experts — Dec. 2022
- OSHA Recordkeeping — Dec. 2022
- PERRP Recordkeeping — Dec. 2022
- Winter weather and holiday safety — Nov. 2022
- Fire prevention planning/emergency action plans — Aug. 2022
- OSHA top ten violations and developing a safety program — May 2022
- Online submission and OSHA log updates — Feb. 2022
