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Physician’s Report of Work Ability

Last update
July 2, 2019

The Ohio Bureau of Workers' Compensation requires that healthcare providers file a medical report on the MEDCO-14 form within 1 working day an injured worker’s initial treatment and following any treatment thereafter, according to Rule 4123-6-02.8 of the Ohio Administrative Code, except when:

– the injured worker has been awarded permanent and total disability;

– has returned to work without restrictions within 7 seven days of the injury;

– or is being treated after the treating physician has released him/her to his/her former position without restrictions.

Providers must supply the injured worker with a copy of the form during their office visit and are also required to fax a copy to the payer—either the responsible Managed Care Organization (MCO) or to employer if they are self-insured.

Document Requirements

A Physician’s Report of Work Ability provides information about the injured worker’s status. Providers must submit this form or their own equivalent document whenever they see an injured worker.

When submitting such a report, the document must contain the data elements required on this form at a minimum. If this information has already been submitted and remains unchanged, indicate the report that “reflects the injured worker’s current condition, e.g., May 15, 2015, office note.”

Additional medical documentation such as diagnostic test results and a treatment plan may be attached to the form.

NOTE: Failure to provide complete detailed information may delay or suspend compensation payments to the injured worker.

Report Form

The Ohio Bureau of Workers' Compensation requires providers to use the MEDCO-14 Form or an equivalent for a complete Physician’s Report of Work Ability.


For additional information related to reporting please refer to DaisyBill’s
Ohio Billing Guide, and the Ohio Administrative Code, and the BWC’s Provider Billing and Reimbursement Manual.

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