It has injured worker information, prescriber information, medication name and strength, treating diagnosis for this request, and a justification.
Post-surgical: for post-surgical medication requests, documentation of surgery approval is needed.
Opioids: requests for opioids must include supporting documentation per OAC 4123-6-21.
Justification: provide a detailed explanation of how the requested medication(s) is related to the treatment of the work-related injury and allowed conditions.
Office notes: include recent office visit notes.
Questions: call BWC pharmacy department at 1-877-543-6446.
| Question | Answer |
|---|---|
| Form Name | MEDCO-31 |
| Form Length | 1 page |
| Fillable? | Yes |
| Fillable fields | 19 |
| Avg. time to fill out | 4 min |
| Edition | Mar. 9, 2026 |
| Where to send | Fax to 1-866-213-6066 |
| Who signs | The physician, provider or authorized signer |
| Matches the agency's file | Yes, checked October 2, 2026 |
| Other names | MEDCO-31, MEDCO31, MEDCO 31, Medco 31 form, BWC-3931 |
| Official source | MEDCO-31 (Rev Mar. 9, 2026), Ohio Bureau of Workers' Compensation |
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