Ohio Admin. Code 4123-3-02 - Forms

(A) Printed forms for all applications, reports, notices, proofs, etc., necessary for perfecting any claim before the bureau or commission will be furnished without charge by the bureau. Such forms may be obtained online or from any office of the bureau or commission.
(B) Each employer shall maintain a sufficient supply of forms as required by section 4123.07 of the Revised Code, and make the forms available to the employees who sustain industrial injuries or contract occupational diseases.
(C) Such forms should be used in all claims and the information required thereon Any required form or equivalent must be furnished in with sufficient detail to facilitate the prompt and accurate adjudication of the questions presented.
(D) Where reference is made to designated forms in these rules, such reference shall be to the form as it exists at the time of the adoption of these rules and as such form may be revised, combined with other forms or deleted in the future.
(D) (E) The bureau shall furnish to the public without charge printed forms for use in filing applications for benefits or compensation, or for submitting other necessary proof in any claim before the bureau and the industrial commission.
(F) Each office in charge of furnishing forms shall keep a record of requests to obtain forms to serve for statistical and control purposes.


Ohio Admin. Code 4123-3-02
Five Year Review (FYR) Dates: 6/6/2019 and 06/01/2024
Promulgated Under: 119.03
Statutory Authority: 4121.31, 4121.30, 4121.13, 4121.121, 4121.12
Rule Amplifies: 4121.11, 4123.05, 4121.121
Prior Effective Dates: 01/01/1964, 09/01/1996, 04/01/2014
Effective: 4/1/2014
R.C. 119.032 review dates: 01/07/2014 and 04/01/2019
Promulgated Under: 119.03
Statutory Authority: 4121.12, 4121.13, 4121.30, 4121.31
Rule Amplifies: 4121.11, 4121.121, 4123.05
Prior Effective Dates: 1/1/64, 9/1/96

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