WordMill Ohio Workers' Comp. Software
Price for new license: $179.00 / price to update existing license: $60.00
NOTE: Quantity discounts are available. Updates are free within one year of purchase/last update. Call 1-800-WORDMILL for more details.

Ver. 2 software (9.4MB)
For Windows 3.11, 95, 98, ME, 2000, and XP. NOTE: It is not necessary to update a new installation.


(5.9MB)
Original release date: 12/18/1998 - Last updated: 5/31/2004

Form Name:	Rev:
AC-2 Permanent Authorization	7/2/1997
AC-3 Temporary Authorization to Review Information	7/2/1997
C-108 Request for Waiver of Appeal	9/1/1997
C-110 Agreement to Select the State of Ohio as the State of Exclusive Remedy	10/23/1997
C-133 Lost Warrant Affidavit	11/1/1979
C-140 Application for Wage Loss Compensation	8/14/1997
C-140 Pg. 2 Medical Report
C-141 Wage Loss Statement For Job Search	8/12/1997
C-167-T Objection to Tentative Order Awarding Permanent Partial Disability Compensation	12/5/1997
C-17 Pharmacy Invoice	2/1/1992
C-181 Fee Bill Inquiry	12/1/1990
C-19 Service Invoice	7/23/1997
C-23 Change of Physician Notice	8/22/1997
C-230 Authorization to Receive Workers' Compensation Check	8/14/1997
C-240 Settlement Agreement and Application for Approval of Settlement Agreement	3/23/1998
C-241 Amended Settlement Agreement and Release	3/23/1998
C-44 Physician's Certificate in Proof of Death	12/1/1992
C-5 Additional Information for Death Benefits	9/9/1996
C-58 Application for Adjustment of Claim in Case of Fatal Injury	10/1/1991
C-59 Self-Insurers' Agreement as to Compensation on Account of Death	2/1/1986
C-60 Travel Expense Statement	6/19/1997
C-77 Injured Worker's Change of Address Notification	11/12/1997
C-84 Request for Temporary Total Compensation	9/24/1997
C-84 Instructions
C-86 Motion	10/21/1998
C-9 Physician's Report/Treatment Plan for Industrial Injury or Occupational Disease	4/21/1998
C-92 Application for the Determination of the Percentage of Permanent Partial Disability	10/30/1997
C-92-A Application for Increase in Percentage of Permanent Partial Disability	9/24/1997
C-94-A Wage Statement	9/2/1997
FROI-1 First Report of an Injury, Occupational Disease or Death	2/1/1998
IC-MED-5 Affidavit	1/1/1985
MEDCO-8 Pg 2 Self-Insured Employer/Injured Worker Screening	8/30/1995
MEDCO-8 Pg. 1 Self-Insured Employer/Injured Worker Screening	8/30/1995
O-D-4A Attending Physician's Report of Occupational Disease
OD-58-22 Application for Adjustment of Claim in Case of Death Due to Occupational Disease	7/1/1993
OIC 1004 Request for Continuance	2/1/1998
OIC 3000 Notice of Appeal	7/1/1998
OIC 3003 Application for Lump Sum Payment	5/1/1984
OIC 3012 Application for Compensation for Permanent Total Disability	8/1/1998
OIC 3017 Application for Payment of Compensation Accrued at Time of Death	5/1/1984
OIC 3018 Application for Additional Award for Violation of Specific Requirements in a Workers' Comp. Claim	7/1/1988
OIC 3019 Application for Additional Awards for Violation of Specific Requirement	3/1/1989
OIC 3022 Certificate for Lump Sum Payment of Attorney Fees	11/1/1990
OIC 3050 Request for .522/.52 Relief	1/1/1998
OIC-1084 Settlement of Alleged Violation of a Specific Safety Requirement	7/1/1991
OIC-2013 Agreement as to Compensation for Permanent Disability	1/6/1994
OIC-2020 Pg. 1 Report of Special Eye Examination	12/1/1986
OIC-2020 Pg. 2 Report of Special Eye Examination	12/1/1986
OIC-3002 IC-90 Employee's Notice of Election to Receive Compensation for Partial Disability	5/1/1984
OIC-3004 IC-88 Application for Reconsideration	9/1/1995
R-1 Authorization of Representative of Employer	12/1/1988
R-2 Authorization of Representative of Claimant	3/10/1998
R-3 Request to Inspect Claim File or to Obtain Screens	12/1/1988
SI-28 Filing of Complaint Against a Self-Insured Employer	4/30/1996
SI-42 Self Insured Joint Settlement Agreement and Release	12/1/1997
SI-43 Acknowledgement of the Self Insured Joint Settlement Agreement and Release	10/1/1997
U-136 Request for Election of Coverage for Ministers or Associate Ministers	12/2/1996
U-3 Application for Coverage	6/26/1997
U-3-B Application for Household Domestic Employees Only	11/17/1995
U-9 Application for Transfer of Workers' Compensation Account and Premium Obligation to Succeeding Employer	1/1/1988

Product update history (by date, descending order):

Date of Change	Change(s) Made
8/4/2001 6:01:58 AM	upgraded print routine
10/5/2000 3:34:18 PM	fixed Win2000 Epson printing problem
8/23/2000 4:02:52 PM	added 5 forms
8/3/2000 11:43:01 AM	Fixed form names on 108, 181, 42 & 43
6/14/2000 4:47:59 PM	fixed defaults
6/14/2000 2:35:36 PM	created speed form for form 3012
6/12/2000 5:42:25 PM	added OIC 3012
6/1/2000 4:31:23 PM	Updated C-86, minor change on C-240
5/31/2000 11:15:10 AM	Speed forms added for 3018, 3019
5/31/2000 8:16:24 AM	Added forms C-133, OIC-1004, 3000, 3017, 3018, 3019, 3022, 3050, O-D-4a
5/26/2000 5:53:18 PM	added forms 7242, 7243, 1231, 1308
5/16/2000 5:22:49 PM	fixed form 240
5/16/2000 2:43:38 PM	spelling corrections
5/16/2000 11:38:17 AM	fixed 5 forms
5/16/2000 10:05:58 AM	cosmetic changes to several forms
5/15/2000 6:03:15 PM	multiple forms now working
5/11/2000 4:46:39 PM	c-110, c-140
5/9/2000 6:16:01 PM	all forms worked over, template, robot
5/4/2000 1:54:44 PM	NT page width issue
4/30/2000 4:56:34 PM	requery before print