and Procedure Name:
to Receive a Workers’ Compensation Payment
O.A.C. 4123-3-10; IC Joint
Percy, Chief of Operational Policy, Analytics & Compliance (Signature on
CP-01-06, effective 06/20/14
06/20/14; New 08/20/2013
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.
policy applies to all BWC staff.
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.
who asserts a right, demand or claim for workers’ compensation benefits.
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
b. Multiple award types,
related to one application, may be included on a C-230 if all stem from the
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.
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
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
F. BWC will accept legible
authorizations by fax, mail, or as an email attachment of the scanned, signed
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
6. Death benefits;
7. Impairment of earning
8. Violation of a
specific safety requirement (VSSR);
9. Facial disfigurement
10. Lump sum settlement
11. Percentage of
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
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
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.
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
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.