If Your Claim is Approved Medical Only Claims You may be eligible for a medical only claim if you are unable to work for seven days or less. If your medical only claim is allowed, your Managed Care Organization will pay your health care provider for authorized treatments. Prescription Drugs The Bureau of Workers' Compensation contracts with a pharmacy benefits manager (PBM) vendor in order to process pharmacy benefits. If your claim is allowed, any approved prescription medications will be covered by the Bureau of Workers' Compensation's (BWC) PBM. You must provide your BWC PBM participating pharmacist with your BWC claim number, your Social Security number and your date of injury so that your pharmacist can bill BWC's PBM for the cost of your prescriptions. If you need a prescription but you have not received your claim number from BWC, you may be required to pay your pharmacy for the cost of the prescription. Once you receive your claim number, give it to your pharmacy, which will then ask BWC's PBM to reimburse you for your out-of-pocket expenses. If you have questions about your pharmacy benefits, call 1-800-OHIO BWC. Lost Time Claims If your attending physician determines that your injury or illness will prevent you from working for eight calendar days or more, you may be eligible to receive lost time benefits. If approved for benefits, the Bureau of Workers' Compensation (BWC) will begin paying your benefits on the eighth day unless you are off work 15 days or more. If you are off work 15 days or more, the BWC may begin payment with the first day you missed work due to your work-related absence. Under some bargaining unit contracts, you may receive your regular pay for the first seven consecutive days of absence. Check your bargaining unit contract to determine if you are eligible for payment for the first seven days. If you should be paid by BWC for the same period you were paid by your agency, you are responsible for reimbursing your agency for the benefit they paid. You may receive temporary total compensation which is equal to 72 percent of your weekly wages. Your weekly wages are calculated based on your earnings in the six weeks before your injury. These wages may be paid for up to 12 weeks. You will receive checks for temporary total compensation directly from the Bureau of Workers' Compensation. If your injury or illness prevents you from working for more than 12 weeks, your temporary total compensation will be reduced to 66 2/3 percent, two-thirds of your weekly wages, based on your prior year's earnings. You will receive checks for temporary total compensation directly from BWC. Lost time benefits are subject to a weekly maximum amount and are not taxable. Medical Examinations After 45 days of workers' compensation benefits, medical exams may be scheduled by BWC. These exams serve to evaluate your progress, ensure you are getting the proper treatment and determine whether you are able to return to work or participate in a rehabilitation program. Health Insurance You may continue to be eligible for health insurance while you are receiving workers' compensation. While on workers' compensation or waiting for the initial decision on your claim, the state may pay a portion or all of your health care premiums according to certain bargaining unit agreements and the Family Medical Leave Act (FMLA). Refer to your union contract to determine the cost, if any, of continuing your health insurance. If you are required to pay for any portion of your health care premiums, you should give the payment(s) to your personnel officer. The state has the right to recover any health care premiums paid on your behalf, if your workers' compensation claim is denied.

TYPES OF LOST TIME COMPENSATION