maria_schedulingFiling A Claim

MedWork reports your injury to the MCO (Managed Care Organization) or TPA (Third Party Administrator) whichever applies.

The MCO reports the injury to the BWC (Bureau of Workers’ Compensation). If a TPA manages the claim independently, no claim number is issued.

The BWC assigns a claim number and sends written notice of claim number to the injured worker.

MedWork sends medical documentation supporting the injury.

BWC/TPA makes claim determination and notifies injured worker of claim status.

Claim Status

  • Pending (a.k.a. alleged) – Claim is still under investigation.
  • Allowed/appeal – BWC has issued an order allowing your claim; however, the claim is still within the appeal period.  Any party to the claim can file an appeal during the appeal period.
  • Allowed – BWC has issued an order allowing your claim.
  • Hearing – A party to the claim has filed an appeal which allowed/disallowed your claim.  The claim has been referred for a formal hearing.
  • Disallowed/appeal – The investigation has been completed and the injury does not meet the BWC guidelines for allowance.  At this time, any party to the claim may file an appeal to the claim denial.
  • Disallowed – BWC has issued an order denying your claim.

Forms Completed at MedWork

  • BWC Forms (Completed by Workers’ Comp Specialist)
    • C-9:  Request for treatment (7-10 day wait for approval/denial).
    • C-84:  Wage continuation. Injured worker must be off of work completely for at least 7 consecutive days to qualify. Please allow 7-10 days for processing. Questions should be directed to the BWC.
    • C-23:  Change of Physician
  • Misc. Forms* (Completed by Admin. Support)
    • FMLA:  Family Medical Leave Act
    • Insurance Forms:  Includes AFLAC
    • Disability Forms

*There is a fee for all misc. forms.  Fee is due before paperwork can be processed.  Allow 10-14 days for processing.