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OhioBWC - Basics: (Policy library) - File

Policy Name:

Abatement

Policy #:

CP-01-05

Code/Rule Reference:

O.A.C 4123-5-21

Effective Date:

07/01/13

Approved:

Rick Percy, Chief of Operational Policy, Analytics & Compliance

Origin:

Claims Policy

Supersedes:

All policies and procedures, directives or memos regarding abatement that predate the effective date of this policy

History:

New

 

 

I. POLICY PURPOSE

 

The purpose of this policy is to ensure BWC properly abates pending applications when an injured worker (IW) or other claimant dies.

 

II. APPLICABILITY

 

This policy applies to BWC staff.

 

III. DEFINITIONS

 

Abatement: For BWC purposes, to discontinue any further action on applications pending in a claim at the time of an injured worker’s or other claimant’s death.

 

Application: A form or other means of communicating to BWC the following:

1.    Requests: Communications requesting an initial or subsequent action be taken.

Examples:

a.  Application for Payment of Lump Sum Advancement (C-32);

b.  Request for Temporary Total Compensation (C-84);

c.  Motion (C-86).

2.    Authorizations: Communications that serve to grant permission.

Examples:

a.  A Power of Attorney;

b.  Injured Worker Authorized Representative (R-2);

c.  Authorization to Receive Workers’ Compensation Check (C-230);          or,

3.    Agreements: Communications that serve as a contract between the parties.

Examples:

a.  Settlement Agreement and Application for Approval of Settlement           Agreement (C-240);

b.  Rehabilitation Agreement (RH-1).

 

Other Claimant: An individual other than the IW that has filed an application in a claim (typically a surviving spouse, dependent or the decedent’s estate).

 

IV. POLICY

 

A.    It is the policy of BWC to abate applications pending in a claim when the injured worker (IW) or other claimant dies, except for:

1.    Applications related to payment of medical services rendered as a result of the IW’s allowed injury or occupational disease; and

2.    A Settlement Agreement and Application for Approval of Settlement Agreement (C-240) and/or an Amended Settlement Agreement and Release (C-241), IF THE IW OR OTHER CLAIMANT DIES AFTER ISSUANCE OF THE “LSS APPROVAL” LETTER. See the Lump Sum Settlement policy and Accrued Compensation policy for further information.

 

B.    Abatement of applications pending in a claim does not prohibit:

1.    The surviving spouse, other dependents or the estate from filing applications subsequent to the IW’s or other claimant’s death; see the Death Claims policy and Accrued Compensation policy for further information.

2.    The payment of approved medical services related to the IW’s allowed injury or occupational disease.

 

BWC staff may refer to the corresponding procedure for this policy entitled “Procedure for Abatement” for further guidance.


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