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Policy and Procedure Name:
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Authorization to Receive a Workers’ Compensation Payment
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Policy #:
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CP-01-06
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Code/Rule Reference:
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O.A.C. 4123-3-10; IC Joint
Resolution R07-1-01
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Effective Date:
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05/06/22
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Approved:
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Ann M. Shannon, Chief of Claims Policy and Support
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Origin:
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Claims Policy
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Supersedes:
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Policy CP-01-06, effective 01/07/22
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History:
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Previous versions of this policy are available upon
request
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Table of Contents
I. POLICY PURPOSE
II. APPLICABILITY
III. DEFINITIONS
Authorization
Claimant
IV. POLICY
A. Authorization
B. Court-Ordered
Settlements
C. C-230 Requirements
D. Honoring an
Authorization
E. Timeliness
F. Scope of an
Authorization
G. Issuing Payment
H. Cancelling an Authorization
V. PROCEDURE
A. General Claim Note and
Documentation Requirements
B. Validating
Authorization
C. Honoring the Authorization
D. Issuing Payment
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.
This 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.
Claimant:
One who asserts a right, demand or claim for workers’
compensation benefits.
1. 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 claimant.
2. The IW or claimant must sign, date and submit one of the
following authorizations to permit an individual to receive a payment on the
IW’s or claimant’s behalf:
a. An Authorization to Receive Workers’ Compensation
Check (C-230);
i. If
an IW or 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 timely with a claim, that portion of the award will be paid directly to
the IW or claimant.
ii. Multiple award types, related to one application, may be
included on a C-230 if all awards are generated from the same claim.
b.
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
c. The “Authorization” portion of a Settlement
Agreement and Application for Approval of Settlement Agreement (C-240).
3.
If an IW or claimant dies prior to BWC
honoring an authorization:
a.
BWC considers the authorization
cancelled and any authorization expires.
b. Any issues that arise from these situations must be staffed
with a BWC attorney.
1. A Lump Sum
Settlement 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 claimant directly when an authorized individual
cannot be identified in the claim or on the court order.
1. The C-230 must:
a.
Be signed by the IW or claimant;
b.
Include the correct claim number, the attorney’s name and
representative ID number;
c.
Specify the date of the application,
request, motion or order for which the authorization applies;
d.
Specify the type of compensation for
which the authorization applies;
e.
Be completed in its entirety;
f.
Be timely filed; and
g.
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.
2.
The authorizations submitted on a C-92
or C-240 must:
a.
Be signed by the IW or claimant;
b.
Include the date completed; and
c.
Include the attorney’s name and representative ID number.
3. BWC will accept legible authorizations by fax, mail, or as
an email attachment of the scanned, signed document.
1. BWC will
honor an authorization for the following types of accrued awards:
a.
Temporary total (TT);
b.
Wage loss;
c.
Change of occupation;
d.
Scheduled loss;
e.
Permanent total disability;
f.
Death benefits;
g.
Impairment of earning capacity;
h.
Violation of a specific safety
requirement (VSSR);
i.
Facial disfigurement;
j.
Lump sum settlement; and
k.
Percentage of permanent partial (%PP).
2. BWC will
not honor an authorization for the following awards:
a.
Ongoing TT;
b.
Ongoing PTD;
c.
Ongoing death benefits;
d.
Living maintenance; and
e.
Living maintenance wage loss.
3. BWC may
honor an ongoing award of compensation if not listed above in section 2.
a.
The authorization will be honored on a
bi-weekly basis only.
b.
Specialized schedule requests for
authorization of payments other than bi-weekly will not be honored (e.g.
requests for an authorization on every third check payable to the IW will not
be honored.)
c.
For questions on whether an ongoing
award is subject to an authorization, please contact a BWC attorney.
1. Authorizations will be honored when the IW or claimant has
signed the C-230 within 18 months of filing it with the application.
2. Authorizations
will be honored even if the application or award is
ultimately granted beyond 18 months; and
a.
On all types of compensation (except
%PP):
i. Prior
to a hearing;
ii. At a
hearing; or
iii. Prior to
the date of the payment of compensation whether the award of compensation was
made at a hearing or made without a hearing.
b.
For a determination of %PP or an
increase of %PP:
i. With
the application;
ii. With
the Agreement as to Compensation for Permanent Partial Disability
(ICGC1);
iii. With an
election related to temporary partial disability and %PP;
iv. At the
Industrial Commission (IC) hearing; or
v. With
the IC after the hearing, but prior to the mailing of the order.
1.
BWC will only honor the C-230
authorization for a single payment unless the issue is appealed and there is an
additional hearing on the same issue for which the request was honored.
2.
The authorization will only be honored
for the application it is filed for and only for the award(s) related to that
application, following the limitations outlined above.
1. A warrant
will be made payable to the IW or 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 claimant in the
authorization, or arrangements may be made for pick-up.
3. When two
authorizations for the same compensation award but different attorneys are
filed, the first authorization received will be honored if it was not cancelled
by the IW in writing.
1. An IW or
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 claimant to notify the individual previously
authorized that the IW or other claimant has cancelled the authorization to
receive a workers’ compensation payment.
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.
1.
When an authorization is received by
BWC, claims services staff must review the C-230 to ensure the authorization
contains all of the required information listed in Section IV.C.
2. Claims services staff must call the attorney and ask if a
C-230 will be filed when:
a. There is
an active IW attorney attached to the claim;
b. An initial
payment with accrued compensation is being paid; and
c. No
C-230 for the payment is on file.
3. If a new
authorization for a different attorney is filed for the same compensation award
previously filed:
a. Claims
services staff shall contact the IW upon receipt of the second authorization
request to clarify the IW’s intentions.
b. Claims
services staff shall request the IW provide clarification in writing.
c. If
the IW has not cancelled the previously filed authorization in writing, claims
services staff must honor the first authorization.
1.
BWC will only honor the C-230 authorization
for a single payment unless the issue is appealed and there is an additional
hearing on the same issue for which the request was honored.
a. If the
order that addressed the compensation issue is appealed, BWC would continue to
honor the same C-230.
b. Example –
DHO allows TT for a closed period, the DHO order is appealed and SHO allows for
an additional period of TT. In this case, we would honor the same C-230 for TT
payment for both the accrued period addressed by the DHO and SHO. This
disclaimer is also on the form.
2.
If the issue for which the request was honored
is not appealed, BWC will not continue to honor an
authorization after the award for which the authorization was filed has been
paid.
a. If evidence is on file that supports ongoing TT
beyond what was ordered by the IC, the claims services specialist (CSS) should
honor the C-230 for the entire accrued period up to and including the payment
date, if applicable. For example:
i. The
Industrial Commission (IC) hearing order dated 12/1/2021 ordered TT to be paid
from 9/15/2021 to 10/18/2021 and to continue upon submission of proof.
ii. Prior
to making payment on 12/3/2021 the claims service specialist notes a new C-84
has been filed along with a MEDCO-14 extending the IW’s disability period to
1/10/2022.
iii. The CSS
would honor the authorization for the entire accrued period of compensation
from 9/15/2021 to 12/3/2021.
b. If there is no additional evidence on file that
supports TT beyond what was ordered by the IC; the CSS should honor the C-230
only for the accrued period allowed by IC. For example:
i. The
Industrial Commission (IC) hearing order dated 12/1/2021 ordered TT to be paid
from 9/15/2021 to 10/18/2021 and to continue upon submission of proof.
ii. No
additional proof of disability is submitted.
iii. On
12/3/2021 the CSS honored the authorization for the entire accrued period of
compensation from 9/15/2021 to 10/18/2021.
iv. Additional
evidence of accrued TT was submitted on 12/10/2021 supporting TT from
10/19/2021 to 12/30/2021. The CSS would not continue to honor the previous
authorization because issue for which the authorization request was honored was
not appealed.
1. To
generate the payment appropriately when the entity or individual listed on the
C-230 is an existing participant in the claim, claims services staff shall:
a.
Ensure the payee status in the participant’s participation details in
the participation detail screen is in an approved status for indemnity; and
b. Select the
participant as the “Mail To” entity in the Payee Allocation screen.
2. To generate the payment appropriately when the entity or
individual listed on the C-230 is an existing customer in the claims management
systembut not attached to the claim, claims services staff shall:
a. Add the
customer as a participant-alternate payee on the claim;
b. Select the
alternate payee as the “Mail To” entity in the Payee Allocation screen; and
c. Expire
the participant-alternate payee once the payment has been released.
3. To enable
appropriate payment generated from the claims management system when the entity
or individual listed on the C-230 is not an existing participant listed in the
claims management system, claims services staff shall:
a. Add the
authorized individual as a customer in the system if they are not already a
customer;
b. Once in
the system as a customer, add the new customer as a participant-alternate payee
on the claim;
c. Select
the alternate payee as the “Mail To” entity in the Payee Allocation screen; and
d. Expire the
participant-alternate payee once the payment has been released.