BWC C-86 Form PDF Details

The C-86 Motion for BWC is the Ohio Bureau of Workers' Compensation's standard form for requesting specific actions that fall outside routine claims processing. Claimants, employers, and their legal representatives file it when standard BWC forms do not address the issue at hand. The BWC or the Industrial Commission of Ohio (IC) reviews each motion and schedules a hearing within 4 to 8 weeks of receipt.

Types of requests covered by the C-86 motion: The form covers a wide range of situations. Common uses include requesting the allowance of additional medical conditions related to an existing claim, seeking recognition of a psychiatric or psychological condition tied to a physical injury, disputing wage calculations and requesting recalculations, contesting decisions involving self-insured employer claims, and filing any request that does not fall under a different designated BWC form.

Who can file a C-86 motion: Any party to a workers' compensation claim can submit this form. This includes the injured worker, the employer, a third-party administrator acting on behalf of the employer, or an attorney representing either side. Healthcare providers and managed care organizations are not permitted to use the C-86. They must use the forms designated for their specific function in the claims process.

What documentation is required: Every C-86 submission must include supporting evidence. Accepted attachments include medical reports from treating physicians, independent medical examination (IME) results, wage statements and payroll records, earning history documentation, and any correspondence from managed care organizations relevant to the request. The filer must certify in writing that a copy of the completed motion and all attachments was provided to every party involved in the claim before submission.

Processing timeline: The BWC typically acknowledges receipt of a C-86 within 5 to 10 business days. After acknowledgment, a hearing officer is assigned and a hearing date is scheduled. Most hearings are set within 4 to 8 weeks from the filing date. Industrial Commission hearings for complex matters may take 6 to 12 weeks. Failing to appear at the scheduled hearing or failing to submit adequate documentation may result in the motion being denied without reconsideration.

QuestionAnswer
Form NameBWC C-86 Form
Form Length2 pages
Fillable?Yes
Fillable fields28
Avg. time to fill out6 min 10 sec
Other namesohio bwc form c86, ohio c 86, ohio bwc c86, c 86 form

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What Is the C86 Motion for BWC?

The C86 Motion for BWC is Ohio's official filing used to request a specific decision or action from the Bureau of Workers' Compensation or the Industrial Commission of Ohio. It is not a standard claim form. It is a motion, meaning it initiates a formal review process. Workers, employers, attorneys, and authorized representatives use it when an issue in a workers' compensation claim requires a hearing or a ruling beyond what routine claims processing provides. The form contains 28 fillable fields and takes approximately 6 minutes to complete. It covers requests such as adding medical conditions to a claim, adjusting wages, and disputing self-insured employer decisions.

How to Fill Out the Ohio BWC C-86 Form

Follow the six steps below to complete the C-86 form correctly and avoid delays in processing your motion.

Step 1: Enter Your BWC Claim Information

At the top of the form, enter your BWC claim number. This number appears on all letters and notices from the Ohio Bureau of Workers' Compensation. Also enter the injured worker's full legal name, the date the original injury occurred, and the name of the employer at the time of injury. Accuracy here is important. Incorrect claim numbers result in your motion being filed against the wrong case record.

Step 2: Identify the Party Filing the Motion

Check the box that identifies who is submitting this motion. Options include the injured worker, the employer, a third-party administrator, and a legal representative. If you are filing on behalf of another party, enter your full name and your role in the claim. Attorneys must include their Ohio bar registration number.

Step 3: Describe the Specific Action You Are Requesting

Clearly state what you are asking the BWC or Industrial Commission to do. Be precise. If you are requesting that an additional medical condition be added to your claim, name the exact diagnosis and cite the physician report or test result that supports it. Vague requests slow processing and are more likely to be denied at the hearing stage.

Step 4: List and Attach All Supporting Documents

Attach every document that supports your request. Accepted supporting materials include:

  • Medical reports from your treating physician
  • Independent medical examination (IME) results
  • Wage statements or employer payroll records for wage adjustment requests
  • Employment contracts or job descriptions relevant to your injury claim
  • Correspondence from managed care organizations regarding your treatment

Keep copies of all documents you submit. The BWC does not return original documents once a motion has been processed.

Step 5: Certify Service to All Involved Parties

Before submitting the C-86, you must certify that you sent a complete copy of the motion and all attachments to every party involved in the claim. This includes the employer, the employer's managed care organization, and any legal representatives on record. Use certified mail or another method that provides written delivery confirmation. The certification section at the bottom of the form requires your signature and the date of service.

Step 6: Submit the Completed Form

Submit the completed form and supporting documents to the correct BWC service office or Industrial Commission district hearing officer's office. The correct submission office depends on your claim's assigned jurisdiction. Confirm the mailing address on the Ohio BWC website before submitting. Keep your delivery confirmation as proof of submission.

Frequently Asked Questions About the C-86 Motion

What is the difference between the C-86 and the C-84 form?

The Ohio BWC C-84 form is a physician's certification of a period of temporary total disability for a specific date range. The C-86 is a formal motion filed by a claimant, employer, or attorney to request a specific action or ruling from the BWC or the Industrial Commission. They serve different functions in the Ohio workers' compensation process.

Can my employer file a C-86 motion against my claim?

Yes. Both the injured worker and the employer can file a C-86 motion. Employers commonly use it to dispute the allowance of additional medical conditions, to challenge wage calculations, or to contest a disability determination. Either party may initiate a motion at any active stage of a claim.

How long does it take for the BWC to schedule a hearing after a C-86 is filed?

The BWC typically acknowledges receipt within 5 to 10 business days. A hearing date is usually assigned within 4 to 8 weeks. Industrial Commission hearings for complex matters may take 6 to 12 weeks to schedule from the filing date.

Is an attorney required to file a C-86 motion?

No. You can file a C-86 without legal representation. However, for high-value wage disputes, contested psychiatric condition allowances, or complex self-insured employer disputes, consulting an Ohio workers' compensation attorney is advisable. Most workers' comp attorneys offer a free initial consultation.

What happens if I miss the hearing scheduled for my C-86 motion?

Missing a scheduled hearing without advance notice typically results in dismissal of the motion. You may be able to refile, but there is no guarantee that a new hearing will be scheduled quickly. Always notify the hearing officer's office as early as possible if you cannot attend, and request a continuance in writing.

Related Ohio Workers' Compensation Forms

Other forms frequently used alongside the C-86 include the Ohio BWC C-9 form for requesting medical services, the workers' compensation C-4 form for employer reports of workplace injuries, and the workers' compensation injury report form for documenting the details of the original incident.