Effective April 15, 2026: The New C-9 Form (Request for Medical Authorization)
The updated C-9 form (officially the Physician’s Request for Medical Service Reimbursement or Recommendation for Additional Conditions) went into effect on April 15, 2026. This is the primary form used for Request for Medical Authorization in Ohio.
The redesign was implemented by the BWC to create a unified process for both State-Fund and Self-Insured claims.
Key Differences: Prior vs. Current Form
| Feature | Prior Form (Pre-2026) | Current Form (Effective 4/15/26) |
|---|---|---|
| Response Deadlines | Varying timelines for MCOs and SI employers. | Strict Timelines. MCOs must respond in 3 business days; SI employers in 10 days. If missed, treatment is “deemed approved.” |
| Approved with Disclaimer | Used broadly by MCOs to avoid financial risk. | Restricted Use. Only permitted if the claim or condition is currently being adjudicated. Cannot be used for already allowed claims. |
| Self-Insured Claims | Barriers often prevented using C-9 for additional allowances. | Unified Process. Universal tool for medical authorization regardless of employer status. |
⚠️ The “Approved with Disclaimer” Risk
If your C-9 is returned as “Approved with Disclaimer,” the MCO is only authorizing treatment if the BWC ultimately allows the claim. If the claim is later denied, the injured worker may be held financially responsible for the bill.
What This Means for Ohio Injury Victims
If your doctor is requesting a new treatment or surgery, they must use this updated version. Outdated forms can lead to automatic denials or significant delays in your recovery process.
Watch out for the C-9-A: This is a “Request for Additional Information.” Your doctor has 10 business days to respond or the request is automatically denied.
Need Help Navigating the Process?
Make sure you are up to date on the New Forms. If you need legal representation for your Ohio Workers’ Compensation Claim, contact Mike Gruhin for your Free, No-Obligation Consultation.
Or call us directly: 216-861-5555
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