Required information to file a claim with the Ohio BWC.

If you are an injured worker in Ohio Ohio BWC Attorney Meetingwith clients about their case

  • Injured Worker Name
  • Injured Worker SSN
  • Injured Worker Mailing Address
  • Injured Worker Home or Work Phone Number
  • Date of Birth
  • Date of Injury/Disease
  • Gender
  • Occupation or Job Title
  • Description of Accident
  • Type of Injury/Disease and Part(s) of Body Affected
  • Employer Policy Number (look-up function provided)