Official Physician’s Request for Medical Service Reimbursement (C-9) effective April 15, 2026.

Q: What are the major changes in the 2026 C-9 Update?

A: The biggest change is the implementation of strict response timelines that vary by employer type.

Before this update, response times for medical authorization could be inconsistent. Now, the law is clear regarding the Physician’s Request for Medical Service Reimbursement (C-9) https://dam.assets.ohio.gov/image/upload/info.bwc.ohio.gov/forms/C-9.pdf  :

• State-Funded Claims: The MCO must respond within 3 business days.
• Self-Insured Claims: The employer must respond within 10 business days.

If these deadlines are missed, the medical service is “deemed approved” by law. This prevents employers from dragging their feet on your surgery, therapy, or specialized care.

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Q: What is the risk of an “Approved with Disclaimer” response?

A: This is a tactic used to shift financial risk onto the injured worker.

When an MCO marks a C-9 as “Approved with Disclaimer,” they are authorizing the service but refusing to guarantee payment unless the claim remains allowed. If your claim is contested later, you may be left holding the bill. This status is a major red flag that requires immediate legal review.

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Q: What happens if my doctor gets a C-9-A?

A: This is a “Request for Additional Information,” and the clock is ticking.

If the MCO or Employer sends a C-9-A, your physician has 10 business days to provide the requested medical documentation. If they fail to respond within that window, your request for treatment is automatically denied. It is critical that your medical providers are using the most current BWC C-9 Form (April 15, 2026) to avoid delays.