Industrial Commission Medical Specialist Resources

Report Templates and Instructions

The Ohio Industrial Commission report templates and instructions are intended to provide streamlined information regarding our report standards and legal requirements needed to help guide examiners effectively through the permanent total disability (PTD) independent medical examination (IME) report publishing process.

A fillable Word template for all of the below reports can be obtained by calling IC Medical Services at 614-387-3898 or emailing the Peer Review Coordinator at Sara.Castle@ic.ohio.gov.

For Our Mental and Behavioral Specialists:

Mental and Behavioral Instructions for Using the Template NEW!

For Our Musculoskeletal Specialists:

Musculoskeletal Instructions for Using the Template NEW!

For Our Dental Specialists:

Dental Instructions for Using the Template NEW!

For Our ENT Specialists:

ENT Instructions for Using the Template NEW!

For Our Vision Specialists:

Vision Instructions for Using the Template NEW!

 

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