Request for Temporary Total Compensation

Ohio Bureau of Workers’ Compensation

Please download the Request for Temporary Total Compensation, fill out the editable fields, save the PDF, and email to westlakeinjurycenter@gmail.com.

If you are using a tablet or mobile phone, you may need to download an app that will allow you to fill out the PDF form.

Let our expert staff address your health needs, call 440-835-6263 or request an appointment today.