What to Expect When You Have an Injury

Employee instructions

1. Please notify your supervisor as soon as possible. You or they will complete the YMCA's online Incident Report.

2. Complete the first section of the BWC First Report of Injury (FROI) form from the Injury Packet as completely as possible.

3. Seek appropriate medical treatment if needed, and provide the Sedgwick ID card (in the injury packet or below) at all medical appointments.

4. Keep your supervisor informed of your medical status and return all completed claim documentation to HR promptly.

After a claim is filed

The YMCA of Central Ohio is a Sedgwick MCO (Managed Care Ohio) client.  Once Human Resources receives an Injury Report, we will send an Injury Reporting Form to Sedgwick, our MCO, and the claim is filed with the BWC (Ohio Bureau of Workers' Compensation). BWC will assign a claim number and review the FROI (First Report of Injury) form and all supporting documentation obtained by Sedgwick. BWC will determine if the claim and alleged conditions will be allowed. Claim adjudication is solely within the jurisdiction of BWC. The claim will remain in a pending "New Claim" or "Alleged" status until the final determination is made.

Sedgwick MCO may approve medically appropriate treatment on allowed claims if the supporting documentation/rationale has been received.

Sedgwick may approve medically appropriate treatment with a disclaimer on pending "New Claim" or "Alleged" status claims if the requested treatment is appropriate for the alleged conditions and they receive supporting medical documentation/rationale. The disclaimer indicates that the medical services will be paid only if BWC allows the claim. Sedgwick MCO is unable to authorize treatment on disallowed claims.

Early claims management 

After a claim is filed, the disability management team at Sedgwick contacts the employee, treating physician, and employer to discuss the injury, medical treatment, and return-to-work options. They will also contact the employer to confirm the return-to-work date, last date worked, job title, hire date, and demographic information.

Transitional Work Benefits Everyone

A safe and timely return to work is important! Together, we will explore opportunities for modified duty/transitional work that can accommodate any physical limitations to speed your recovery, ease your transition back to work, and minimize any hardship as a result of a workplace injury. Employee safety and recovery are the highest priorities. It's essential- and required- to keep Sedgwick MCO and your employer updated on your recovery status and work restrictions at all times.

Key contacts and additional information

Medical treatment questions, medical documentation, and billing issues

Contact Sedgwick Managed Care Ohio:

Phone: 888.627.7586

Fax: 888.627 .0074

Mail: P.O. Box 1040, Dublin, OH 43017

Prescription questions

Call 800.644.6292 and follow the prompts.

Ohio Bureau of Workers' Compensation (BWC)

Call 800.644.6292 or visit bwc.ohio.gov.

Medical options and provider search

If medical treatment is required, see a BWC-certified medical provider. For more information, see the Sedgwick MCO website at sedgwickmco.com.