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OhioBWC - Basics: (Policy library) - File

Policy Name:

Accrued Compensation

Policy #:

CP-01-04

Code/Rule Reference:

R.C. 4123.60

Effective Date:

07/12/17

Approved:

Kevin R. Abrams, Chief Operating Officer

Origin:

Claims Policy

Supersedes:

Policy CP-01-04, effective 01/05/16

History:

Rev. 03/21/16; 01/05/16; New 07/01/13

 

 

I. POLICY PURPOSE

 

The purpose of this policy is to ensure BWC properly identifies and pays accrued compensation to the dependent(s), a provider that rendered services pertaining to the decedent’s death or to the estate of a deceased injured worker (the “decedent”) consistent with applicable rules and statutes.

 

II. APPLICABILITY

 

This policy applies to claim services 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.

 

Accrued compensation: The unpaid portion of an award of compensation in an allowed claim due to the decedent at the time of his or her death, regardless of whether the death was the result of an allowed injury or occupational disease.

 

Dependent: A member of the family of the decedent, or bears to the decedent the relation of surviving spouse, lineal descendant, ancestor, or brother or sister who relied on the decedent for financial support.

 

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

 

IV. POLICY

 

A.    It is the policy of BWC to pay accrued compensation the decedent was entitled to, up to and including the date of death:

1.    To a dependent; or

2.    To a provider or individual that rendered services pertaining to the decedent’s death; or

3.    If there is no eligible dependent, provider or individual, to the estate of a decedent.

 

B.    The dependent, a provider or individual, or the estate, must make an application to BWC to receive accrued compensation.

1.    The claimant may use an Application for Accrued Compensation (C-6) form, available on the BWC website, or an equivalent.

2.    A dependent must provide proof of dependency.

3.    A provider or individual who rendered or paid for services pertaining to the decedent’s death must provide an invoice, proof of payment or other credible documentation.

4.    The executor of a decedent’s estate must provide proof of executor status and the estate’s tax identification number.

 

C.   Timeframes:

1.    A dependent, a provider or individual that rendered services pertaining to the decedent’s death or the estate has two (2) years from the date of the decedent’s death to file an application for payment of accrued compensation from a benefit that was awarded to the decedent prior to death.

2.    Application for accrued compensation from an application abated due to decedent’s death or a benefit that the decedent was lawfully entitled to have applied for at the time of his or her death must be filed within one (1) year from the date of decedent’s death.

 

D.   Percentage Permanent Partial Disability and Scheduled Loss

When an award for a percentage of permanent partial disability or scheduled loss is made pursuant to R.C. 4123.57 prior to the death of the decedent, BWC will pay unpaid installments accrued or to accrue under the provisions of the award to the surviving spouse, or if there is no surviving spouse, to the dependent children of the decedent, and if there are no dependent children surviving, then to other dependents as determined by BWC.

 

E.    Lump Sum Settlement: Lump sum settlements will be handled consistent with the Lump Sum Settlement policy.

 

F.    Existing Overpayment and Accrued Compensation

Any overpayment existing at the time of the decedent’s death will be recouped from accrued compensation consistent with the Overpayment of Compensation policy.

 

G.   Accrued Compensation and Death of Dependent

1.    If a dependent was awarded accrued compensation from a scheduled loss pursuant to R.C. 4123.57(B), and the dependent dies, only the accrued compensation payable to that dependent, up to and including the date of the dependent’s death, shall be paid to the dependent’s estate.

2.    When death benefits have been awarded to a dependent and the dependent dies before the funds are disbursed, accrued benefits for the period between the IW’s death and the dependent’s death shall be paid to the dependent’s estate.

 

H.   A claimant may designate and authorize a representative for them self by filing a Claimant Authorized Representative (R-2) form, consistent with the Authorized Representatives policy. An authorization made by the decedent does not carry-over and apply to a new claimant.

 

I.      Orders, Appeals, and Payment

1.    An order shall be used to issue decisions on applications for accrued compensation.

2.    A party may appeal an order consistent with the Orders, Waivers, Appeals and Hearings policy.

3.    Any awarded accrued compensation shall be paid at the expiration of the appeal period if an appeal has not been filed.

 

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


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