Form C-159 (BWC-159) Download Printable PDF or Fill 2026

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The document is a waiver form for employees to voluntarily relinquish their rights to workers' compensation coverage while participating in employer-sponsored recreational activities or fitness programs. It requires the employee to list the activities, sign and date the form, and acknowledges that the waiver is valid for two years. The employer must retain a copy and submit it only if a claim arises from an injury during these activities.

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Click ‘Get Form’ to open it in the editor.
Begin by entering the Claim number at the top of the form. This is essential for tracking your waiver.
In the designated area, list all employer-sponsored recreational activities and fitness programs for which you wish to waive workers’ compensation coverage. Ensure that you make a line through any blank spaces.
Fill in your name, date, employer name, and policy number accurately to avoid any processing issues.
Read through the waiver statement carefully. By signing and dating this form, you acknowledge your voluntary participation and waive rights to workers’ compensation benefits for listed activities.
Finally, ensure that your signature is clear and dated before submitting the form. The employer will retain the original and provide a copy to you.

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What is the penalty for not having workers compensation in Ohio?

Any employer that fails to pay its premium or fails to apply for workers compensation coverage is considered a non-complying employer. Non-complying employers may have a lien placed on both business property and tangible personal property until all monies due have been paid.

How to cancel Ohio BWC?

Canceling coverage Cancel your policy online. Submitting a Request to Cancel Workers Compensation Coverage (U-114) (PDF) Phone by an authorized representative or employer contact on the policy. Sending a letter to BWC that includes the date you last had an employee and the date you want to cancel the coverage.

Am I required to have workers comp insurance in Ohio?

Yes. Ohio companies with any employeeseven if they just have one person working for themmust purchase workers compensation insurance to protect their employees when they suffer work-related injuries.

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Is Ohio BWC mandatory?

As an Ohio employer with one or more employees, Ohio law requires you to have workers compensation coverage.

How is workers comp calculated in Ohio?

Ohios workers compensation law covers Ohio employees who temporarily work out of state through Ohios existing extraterritorial coverage provisions. Extraterritorial coverage refers to the extension of Ohio law for workplace injuries occurring outside Ohio.

What is the BWC in Ohio?

Established in 1912, the Ohio Bureau of Workers Compensation is the exclusive provider of workers compensation insurance in Ohio, serving 258,000 public and private employers. With over 1,600 employees and assets of approximately $23 billion, BWC is one of the largest state-run insurance systems in the United States.

Form C-159 (BWC-159) Download Printable PDF or Fill 2026

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