A treatment plan is submitted with BWC form C-9 to the managed care organization (MCO) by either the injured workers’ physician of record or treating physician prior to the initiation of any non-emergency treatment. Ohio Administrative Code (OAC) 4123-6-20(C) requires that, at a minimum, treatment plans include at least this information:
- A plan of care detailing the frequency, duration and expected outcomes of medical interventions, treatments and procedures;
- The injured worker’s projected return-to-work date;
- Factors that are unrelated to the work-related conditions, but are impacting the injured worker’s recovery.
Treatment plans must be modified and updates provided to the injured worker’s MCO whenever there are changes that impact the management of the claim. Updated treatment plans must describe the injured worker’s current prognosis, progress to date and expected treatment outcomes. Changes requiring an updated treatment plan include:
- Treatment is extended, changed, modified, completed, added, deleted or canceled;
- Additional allowances;
- Authorization of expenditures from the surplus fund;
- Return to modified or alternate work;
- Maximum medical improvement;
- Any new injury sustained while receiving treatment.