OhioBWC - Basics: (Policy library) - File


Policy and Procedure Name:


Policy #:


Code/Rule Reference:

O.A.C. 4123-5-21

Effective Date:



Ann M. Shannon, Chief of Claims Policy and Support


Claims Policy


Policy #CP-01-05, effective 07/20/18


Previous versions of this policy are available upon request


Table of Contents








Pending Application


A.          Abatement

B.          Abatement Does Not Prohibit


A.          General Claim Note and Documentation Requirements

B.          Abatement

C.         Issuing Abatement Order

D.         Applications Filed After Death






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.




Abatement: 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.


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

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


a.             First Report of an Injury, Occupational Disease or Death (FROI);

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

c.             Motion (C-86).

2.      Authorizations: Communications that serve to grant permission.


a.             Claimant Authorized Representative (R-2);

b.             Authorization to Receive Workers’ Compensation Payment (C-230);

c.             A Power of Attorney.

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


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

b.             Rehabilitation Agreement (RH-1).


Claimant: One who asserts a right, demand or claim for workers’ compensation benefits.


Pending 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 received.





A.     Abatement

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.


B.     Abatement Does Not Prohibit

1.     Other claimant(s) from filing an application(s) subsequent to the decedent’s death.

2.     The 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 Commission.





A.     General Claim Note and Documentation Requirements

1.     BWC staff shall refer to the Standard Claim File Documentation and Altered Documents policy and procedure for claim note and documentation requirements; and

2.     Shall follow any other specific instructions for claim notes and documentation included in this procedure.


B.     Abatement

1.     When claims services staff receive notice of the death of a decedent or other claimant:

a.     Claims 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

b.     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.

2.     Discontinue indemnity payments when a decedent or other claimant is receiving payments for an award in the claim.


C.    Issuing Abatement Order

1.     Claims 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.

2.     Claims 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 decedent’s death.

4.     Claims 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.

6.     Claims 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.

a.     Claims services staff shall NOT immediately expire the decedent’s authorized representative upon notice of death.

b.     Refer to the Authorized Representatives policy for further instructions.


D.    Applications Filed After Death

1.     Claims 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

c.      Accrued Compensation policy; and/or

d.     Death Claims policy for further information.

2.     Claims 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.