and Procedure Name:
to Receive a Workers’ Compensation Payment
O.A.C. 4123-3-10; IC Joint
Chief of Operational Policy, Analytics & Compliance (Signature on File)
CP-01-06, effective 06/20/14
06/20/14; New 08/20/2013
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
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 permanent
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
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
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 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.