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OhioBWC - Basics: (Policy library) - File

Policy and Procedure Name:

Authorization to Receive a Workers’ Compensation Payment

Policy #:

CP-01-06

Code/Rule Reference:

O.A.C. 4123-3-10; IC Joint Resolution R07-1-01

Effective Date:

11/14/16

Approved:

Rick Percy, Chief of Operational Policy, Analytics & Compliance (Signature on File)

Origin:

Claims Policy

Supersedes:

Policy CP-01-06, effective 06/20/14

History:

Rev. 06/20/14; New 08/20/2013

Review date:

06/20/19

 

 

I. POLICY PURPOSE

 

The purpose of this policy is to ensure BWC staff properly disburses the accrued portion of a workers’ compensation payment to the injured worker (IW) or other claimant or to another individual if the IW or other claimant provides written authorization to do so.

 

II. APPLICABILITY

 

This policy applies to all BWC staff.

 

III. DEFINITIONS

 

Authorization: A form or portion of a form that authorizes the issuance of a payment of workers’ compensation in the care of someone other than the IW or other claimant.

 

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

 

IV. POLICY

 

A.    It is the policy of BWC to disburse the accrued portion of a workers’ compensation payment to an individual properly authorized by an IW or other claimant.

 

B.    The IW or other claimant must sign, date and submit one of the following authorizations to permit an individual to receive a payment on the IW’s or other claimant’s behalf:

1.    An Authorization to Receive Workers’ Compensation Check (C-230);

a.    If an IW or other claimant has an award that is split between multiple claims, an original C-230 must be filed with each claim. If an original C-230 has not been filed with a claim, that portion of the award will be paid directly to the IW or other claimant.

b.    Multiple award types, related to one application, may be included on a C-230 if all stem from the same claim.

2.    For permanent partial disability, the “Authorization” portion of an Application for Determination of Percentage of Permanent Partial Disability or Increase of Percentage of Permanent Partial Disability (C-92); or

3.    For a lump sum settlement (LSS), the “Power of Attorney”(POA) portion of either:

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

b.    An Amended Settlement Agreement and Release (C-241).

 

C.   If an IW or claimant dies prior to BWC honoring an authorization, BWC considers the authorization cancelled and any authorization expires.

 

D.   Court-Ordered Settlements

1.    An LSS payment may be sent to the authorized individual listed in the claim or on the court-ordered settlement without a signed authorization.

2.    BWC will issue the payment to the IW or other claimant directly when an authorized individual cannot be identified in the claim or on the court order.

 

E.    Authorizations must:

1.    Have the IW or other claimant’s signature on the form;

2.    Have complete information;

3.    Be timely filed; and

4.    Have no alteration, unless the alteration has been initialed by the appropriate person. Refer to the Standard Claim File Documentation policy and procedure for further guidance.

 

F.    BWC will accept legible authorizations by fax, mail, or as an email attachment of the scanned, signed document.

 

G.   BWC will honor an authorization for the following types of accrued awards:

1.    Temporary total (TT);

2.    Wage loss (WL);

3.    Change of occupation;

4.    Scheduled loss;

5.    Permanent total disability (PTD);

6.    Death benefits;

7.    Impairment of earning capacity;

8.    Violation of a specific safety requirement (VSSR);

9.    Facial disfigurement (FD);

10.  Lump sum settlement (LSS);

11.  Percentage of permanent partial.

 

H.   Timeliness: Authorizations will be honored when the claimant has signed the authorization within eighteen (18) months of filing it with the application, even if the application or award is ultimately granted beyond 18 months; and

1.    On all types of compensation, (except percentage of permanent partial);

a.    Prior to a hearing;

b.    At a hearing; or

c.    Prior to the date of the payment of compensation whether the award of compensation was made at a hearing or made without a hearing.

2.    For a determination of percentage of permanent partial (%PP) or an increase of %PP:

a.    With the C-92;

b.    With the Agreement as to Compensation for Permanent Partial Disability (ICGC1);

c.    With an election related to temporary partial disability (TPD) and %PP;

d.    At the Industrial Commission (IC) hearing; or

e.    With the IC after the hearing, but prior to the mailing of the order.

 

I.      Scope of an Authorization

1.    BWC will honor an authorization for any hearing, appeal or reconsideration on the original application, including those that result in BWC disbursing an additional check for an accrued portion of a workers’ compensation payment after the authorization has initially been honored.

2.    BWC will not continue to honor an authorization after the award for which the authorization was filed has been paid and all appeal periods for the award have expired.

3.    The authorization will only be honored for the application it is filed for and only for the award(s) related to that application.

 

J.    Issuing Payment

1.    A warrant will be made payable to the IW or other claimant and sent in care of the authorized individual identified on the authorization.

2.    The warrant will be mailed to the address indicated by the IW or other claimant in the authorization, or arrangements may be made for pick-up.

3.    In a self-insured claim, the IW or other claimant and the employer may agree on a payment delivery method.

 

K.    Cancelling an Authorization to Receive a Workers’ Compensation Payment

1.    An IW or other claimant may cancel an authorization to receive a workers’ compensation payment by submitting a signed written notice to BWC prior to the issuance of an order by BWC or the IC awarding payment of compensation.

2.    It is the responsibility of the IW or other claimant to notify the individual previously authorized that the IW or other claimant has cancelled the authorization to receive a workers’ compensation payment.

 

V.    Procedure

 

A.    When an authorization is received by BWC, field staff shall review to ensure all necessary information is included, it is timely filed and it is properly signed by the IW or other claimant.

 

B.    To enable appropriate payment generated from the claims management system (“the system”), field staff shall:

1.    add the authorized individual as a customer in the system if he or she is not already a customer;

2.    once in the system as a customer, add the individual (now a customer) as a participant-alternate payee on the claim;

3.    select the alternate payee as the “Mail To” entity in the Payee Allocation screen; and

4.    expire the participant-alternate payee once the payment has been released.

 


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