BWC News

Alternative Dispute Resolution Works for Ohio

Alternative dispute resolution (ADR) is used to resolve disputes on medical issues in workers’ compensation. ADR enables an MCO, BWC, employer, injured worker and/or medical provider to resolve their disagreements without filing a formal appeal with the Industrial Commission of Ohio.

BWC and MCOs have a peer review process to hear disputes. Issues that can be addressed by ADR include: quality assurance, utilization review, determination that a service is or is not covered, and treatment/service necessity.

In 1998, BWC said, 86.5 percent of disputes heard through the ADR process were resolved without being appealed to the Industrial Commission. Without ADR, an additional 5,010 cases would have gone to the Industrial Commission for hearing in 1998, which would have delayed resolution of those cases and created a case backlog.