Employer Forms

• First Report of Injury, Occupational Disease or Death
• Change of Provider Information (MEDCO-12)
• Notice to Change Physician of Record (C-23)
• C-9 Physician's Request for Medical Service or Recommendation for Additional Conditions for Industrial Injury or Occupational Disease
• MEDCO-14 Physician's Report of Work Ability
• Instructions for MEDCO-14
• Application for Provider Enrollment (MEDCO-13)
• Request for Ohio BWC 2004 Fee Schedule