Ohio Forms C-110 & C-112
Ohio permits a worker to accept Ohio's act (Form C-110) or another state's act (Form C-112)
Forms C-110 and C-112
The state of Ohio workers compensation act (R.C. 4123.54) permits a worker to agree to be bound by Ohio's act (form C-110) or by another state's act (form C-112). The form must be signed by the employer and employees, and is intended to be signed by several employees.
To use Form C-110, a worker's employment must be "localized" in Ohio and the employer must have current Ohio workers compensation coverage. A worker's state of residence is a factor to be considered but is not controlling as to whether the employee is covered by the Ohio workers compensation law.
To use Form C-112, the employer must attach a certificate of coverage for the state(s) selected. The employer must still obtain an Ohio Workers Compensation account to validate this agreement.
The WC Board of Indiana is not bound to recognize the use of another state's forms. The Board would still look to find if the facts support an employer/employee relationship in Indiana to award Indiana benefits.
Other States Coverage
Effective March 1, 2016, a new workers' compensation coverage insurance option is now available to eligible Ohio businesses for their employees who work in other states. The new offering will simplify workers' comp for these employers, ensuring their employees are protected without the need to manage policies in multiple states with varying laws. Effective today, employers can apply for this coverage through policies issued by the Ohio Bureau of Workers' Compensation (BWC) through a program with United States Insurance Services (USIS) and Zurich Insurance.
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