Policy and Procedure Name:
Ann M. Shannon, Chief of Claims Policy and Support
Policy #CP-01-05, effective 07/20/18
Previous versions of this policy are available upon
Table of Contents
I. POLICY PURPOSE
B. Abatement Does Not
A. General Claim Note and
C. Issuing Abatement Order
D. Applications Filed After
The purpose of this policy is to ensure BWC accurately
abates a pending application(s) when the injured worker (hereafter the
“decedent”) or other claimant dies.
This policy applies to claims services staff.
To discontinue any further action on a pending application(s) in a claim at the
time of the decedent’s or other claimant’s death.
A form or other means of communicating to BWC the following:
Requests: Communications requesting an initial or subsequent
action be taken.
First Report of an Injury, Occupational Disease or Death (FROI);
Request for Temporary Total Compensation (C-84);
Authorizations: Communications that serve to grant permission.
Claimant Authorized Representative (R-2);
Authorization to Receive Workers’ Compensation Payment (C-230);
A Power of Attorney.
Agreements: Communications that serve as a contract between the
Settlement Agreement and Application for Approval of Settlement Agreement
Rehabilitation Agreement (RH-1).
One who asserts a right, demand or claim for workers’ compensation benefits.
Application: For purposes of this policy, an application that is not
in a final status, such as dismissed, allowed or denied when notice of death is
1. BWC shall abate
a pending application when:
a. Notice of
death for a decedent or other claimant is received; and
b. There is a
pending application(s) filed by a decedent or other claimant.
2. BWC shall
not abate a pending application
a. Related to
payment of medical services rendered as a result of a decedent’s allowed injury
or occupational disease claim; and
b. For a Settlement
Agreement and Application for Approval of Settlement Agreement (C-240)
and/or an Amended Settlement Agreement and Release (C-241), if the
decedent dies after issuance of the “LSS Approval” letter.
claimant(s) from filing an application(s) subsequent to the decedent’s death.
payment of approved medical services related to the decedent’s allowed injury
or occupational disease claim.
3. A BWC or
an employer’s appeal on an issue that is currently in process with the Industrial
1. BWC staff
shall refer to the Standard
Claim File Documentation and Altered Documents policy and procedure for
claim note and documentation requirements; and
follow any other specific instructions for claim notes and documentation
included in this procedure.
claims services staff receive notice of the death of a decedent or other
services staff shall verify the death through a Social Security cross match, a
death certificate, a published obituary, a police report or some other reliable
means consistent with the Death
Claims policy; and
Discontinue action on an application(s) filed by the decedent or other
claimant and pending at the time of the decedent’s or other claimant’s death,
except for what is listed in section IV.A.2.a.-b. above.
indemnity payments when a decedent or other claimant is receiving payments for
an award in the claim.
services staff shall issue an abatement order addressed to the surviving
spouse, or if no surviving spouse exists, to another dependent or family member
identified by claims services staff, as appropriate.
services staff shall utilize the “Abatement Adhoc Insert for Miscellaneous
Order” on COR when issuing a decision, except when the FROI is being abated.
The FROI abatement insert is available in CoreSuite documents.
3. The order
shall indicate the specific application that has been abated based on the
services staff may need to change the “Original Recipient” or add a “New
Participant” in the claims management system.
5. If claims
services staff is unable to identify a surviving spouse, another dependent or
family member, claims services staff shall use “Change Delivery Options” in the
claims management system and address the order to “The family of…” and mail it
to the decedent’s last known address.
services staff shall ensure a copy of the abatement order is sent to the
decedent’s authorized representative, by adding the decedent’s representative
as a recipient of the order.
services staff shall NOT immediately expire the decedent’s authorized
representative upon notice of death.
b. Refer to
Representatives policy for further instructions.
services staff shall:
a. Process an
application(s) filed subsequent to the death of the decedent; and
b. Refer to
the applicable policy for the request; and
Compensation policy; and/or
Claims policy for further information.
services staff shall refer any medical bills received for approved medical
services rendered as a result of the allowed injury or occupational disease
claim to the MCO for processing.