Ohio
Workers Comp
Employers
Last updated: 1/30/2025
Request To Correct Employer And Or Policy Number Assignment {BWC-1396}
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Description
BWC-1396 / C-264 - REQUEST TO CORRECT EMPLOYER AND/OR POLICY NUMBER ASSIGNMENT. Complete this form when alleging BWC or another party incorrectly named you as the employer on a claim or assigned the claim to the incorrect policy number. Please note: You cannot use this form in lieu of an appeal to a decision to allow a claim. www.FormsWorkflow.com
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