OhioBWC - Basics: (Policy library) - File

Policy and Procedure Name:

Authorized Representatives

Policy #:

CP-01-01

Code/Rule Reference:

RC 4123.06; 4123.88; O.A.C. 4121-2-01; 4123-3-22; 4123-3-24

Effective Date:

01/22/2020

Approved:

Ann M. Shannon, Chief of Claims Policy & Support

Origin:

Claims Policy

Supersedes:

Policy # CP-01-01, effective 07/17/18

History:

Previous versions of this policy are available upon request.


 

Table of Contents

 

I. POLICY PURPOSE

II. APPLICABILITY

III. DEFINITIONS

Authorized Representative

Demographic Information

Employer Representative

IV. POLICY

A.          General Policy Statements

B.          Representative Identification Numbers (RIN)

C.         Representative Assignment to Claim

D.         Employer Authorized Representative

V. PROCEDURE

A.          Standard Claim File Documentation

B.          Representative Identification Numbers (RIN)

C.         Claimant Requests Assignment of Authorized Representative

D.         Representative Assignment to Claim

E.          Employer Authorized Representative

F.          Claimant Representative Demographic Changes

G.         Structural Business Changes for Claimant Representatives

H.         Representative Death or Attorney Disbarment

 

 


 

I. POLICY PURPOSE

 

The purpose of this policy is to ensure that BWC staff properly identify and enter into the claims management system an authorized representative of a claimant and employer.

 

II. APPLICABILITY

 

This policy applies to claims services and attorney representative desk staff.

 

III. DEFINITIONS

 

Authorized Representative: An individual, company, union or firm designated by the claimant or employer to represent his or her interests before BWC and the Industrial Commission.

 

Demographic Information: For purposes of this policy, demographic information refers to the representative’s business address, contact information (e.g., phone and fax numbers, and email address).

 

Employer Representative: A type of authorized representative designated by an employer to represent it in policy or claim-related matters associated with the employer’s policy number.

 

IV. POLICY

 

A.     General Policy Statements

1.     It is the policy of BWC to recognize representatives properly designated and authorized by a claimant or an employer.

2.     BWC shall ensure authorized representatives receive:

a.     Electronic access to the claim; and

b.     Notices of claim actions.

3.     Representative Demographic and Structural Business Changes

a.     It is the policy of BWC to maintain up to date records pertaining to the demographics and business structure (e.g., mergers and splits) of representatives; and

b.     To make timely updates to all affected customer records.

4.     Death or Disbarment of a Representative: It is the policy of the BWC to update customer records when BWC receives notification of a representative’s death or disbarment. 

 

B.     Representative Identification Numbers (RIN)

1.     All authorized representatives of claimants or employers must have a BWC-issued RIN, obtained by filing an Application for Representative Number (R-4) with BWC.

2.     If the representative anticipates payment from BWC, the representative must provide a Request for Taxpayer Identification Number and Certification (IRS form W-9) with the R-4. The name and taxpayer identification number provided on the R-4 must match the name and number on the W-9. BWC will make payment based on the taxpayer identification number provided on the R-4 and W-9.

3.     If the applicant is an out-of-state attorney, the attorney must also submit a “Certificate of Pro Hac Vice Registration” from the Supreme Court of Ohio’s Office of Attorney Services.

 

C.    Representative Assignment to Claim

1.     A claimant must file an Injured Worker Authorized Representative (R-2) form or equivalent with BWC to appoint an authorized representative.

a.     The authorization must include the:

i.       Claim number;

ii.      Date of injury;

iii.     Claimant’s name, address, and phone number;

iv.    Representative’s name, address and phone number; and

v.      Representative’s RIN

b.     The authorization must be signed by the claimant.

i.       Only the claimant may authorize a representative except when the claimant has a guardian.

ii.      See the Custody, Guardianship, Power of Attorney and Incapacitation

policy for information.

2.     Upon request, a claimant may have multiple authorized representatives.

a.     A claimant may have only one legal representative, one attorney or law firm.

b.      In addition to a legal representative, a claimant may have a union representative at the same time.

c.      This request shall be documented in claim notes.

3.     A claimant may change or dismiss an authorized representative at any time.

a.     The submission of an authorization for a new legal or union representative will replace any prior legal or union representative.

b.     If a representative withdraws or is removed by the claimant and the claimant hires a new representative, the claimant must file a new authorization.

4.     It is the responsibility of the claimant to notify new and former authorized representatives of any changes.

5.     The changing of an authorized representative does not automatically update any previously filed Authorization to Receive Workers’ Compensation Payment (C-230).

a.     If the claimant desires the new authorized representative to also receive a workers’ compensation payment on behalf of the claimant, the claimant must:

i.       Cancel, in writing, any previously filed C-230; and

ii.      File a new C-230 identifying the newly authorized representative as authorized to receive a workers’ compensation payment.

b.     See the Authorization to Receive Workers’ Compensation Payment policy for further information.

6.     Having representative authorization from BWC does not excuse the representative from complying with all Industrial Commission (IC) requirements for representation. 

 

D.    Employer Authorized Representative

1.     An employer may appoint an authorized representative for an individual claim by filing an Authorization of Representative of Employer (R-1) with BWC.

2.     The R-1 must be signed by an individual within the business with the authority to make such authorizations (e.g., Human Resource Manager, Safety Director, Chief of Operations).

 

 

V. PROCEDURE

 

A.     Standard Claim File Documentation

1.     BWC staff shall refer to the Standard Claim File Documentation and Altered Documents policy and procedure for claim note requirements; and

2.     Shall follow any other specific instructions for claim notes included in this procedure.

 

B.     Representative Identification Numbers (RIN)

1.     When a representative submits a completed Application for Representative Identification Number (R-4) and other required documentation requesting a RIN, the BWC attorney representative desk staff shall verify that no current record exists for the requestor, and if not, issue an RIN and enter the representative as a business customer into the claims management system .

2.     If a W-9 is submitted with the R-4, BWC attorney representative desk staff shall ensure that the name and taxpayer identification number on the R-4 matches the name and taxpayer identification number on the W-9.

a.     The BWC attorney representative desk staff shall notify the representative if there is a discrepancy between a submitted W-9 and the information provided on the R-4, or if the necessary W-9 has not been provided.

b.     BWC will not issue an RIN until all the needed taxpayer information and documentation is complete.

3.     If the representative is an out of state attorney not admitted to the Bar in Ohio, BWC attorney representative desk staff shall ensure that a “Certificate of Pro Hac Vice Registration” from the Supreme Court of Ohio’s Office of Attorney Services is included with the R-4.

4.     If the attorney registration number or a registration certificate is not provided and has not been supplied upon request, or if there is any other reason to question the attorney’s credentials, BWC attorney representative desk staff shall consult with a BWC attorney to determine appropriate action.

 

C.    Claimant Requests Assignment of Authorized Representative

1.     Claimant may use an R-2 or signed equivalent form to request an authorized representative be attached to a claim.

2.     This request may be completed via fax, letter, or email attachment.

 

D.    Representative Assignment to Claim

1.     Attorney representative desk staff shall:

a.     Add or update an authorized representative as a “Claimant Representative” or “Dependent Representative” participant (as appropriate) to a claim when the claimant has filed an R-2 form or equivalent to BWC that meets the requirements in section V.C.

b.     Update the participant record to indicate the participant type as Legal Representative or Union Representative.

c.      If the claimant is changing legal representatives, attorney representative desk staff shall ensure the previous legal representative is expired in the claims management system as a participant on the claim.

2.     When a claimant dies, claims services staff shall set a task for thirty (30) days from the date BWC received notice of the death to expire the dependent’s authorized representative in the claim.

a.     When a new request is filed (typically for death benefits or accrued compensation) during the 30-day period, attorney representative desk staff shall:

i.       Review the file to determine if the decedent’s authorized representative has been chosen to represent the filing party. For the decedent’s authorized representative to represent the new claimant, the new claimant must sign and submit a new R-2 (the representative will then be identified in the claims management system as the representative of the spouse or other dependent);

ii.      Review the file to determine if another authorized representative has been selected with a new R-2, or whether the new claimant does not have an authorized representative;

iii.     In either event, attorney representative desk staff shall immediately expire the decedent’s previously authorized representative. An authorization made by the decedent does not carry over to apply to the new claimant (i.e., surviving spouse or dependent child) unless the new claimant chooses to designate and authorize the same representative to represent them.

b. In the event the 30-day period expires and no new R2 is filed, claims services staff shall make the authorized representative inactive in the claims management system within the identified claim.

 

E.     Employer Authorized Representative

1.     Upon receipt of an R-1 form, attorney representative desk staff shall enter or update the employer’s representative authorized for a specific claim in the claims management system.

2.     For more information, BWC staff may refer to the Employer Authorized Representative policy.

 

F.     Claimant Representative Demographic Changes

1.     Upon written notice from a claimant representative of a demographic change request, the attorney representative desk staff shall update the customer record for the representative in the claims management system.

2.     A representative may request an update to their demographics by attaching and sending the request via fax, letter, or email correspondence.

3.     Attorney representative desk staff shall reference the Authorized Representative job aid and follow the steps outlined to complete the necessary changes.

 

G.    Structural Business Changes for Claimant Representatives

1.     Upon written notice to change information related to a RIN due to a structural business change (e.g., a law firm splitting up into two or more entities) the attorney representative desk staff shall review the notice to determine if the following information has been submitted:

a.     Name of original business entity;

b.     Name of new business entity;

c.      Any changes to demographic information for the new business entity;

d.     Claims that are affected by this change;

e.     Any other information that may be necessary to address the structural business change.

2.     If there are any questions regarding the representative’s request, the attorney representative desk shall attempt to contact the representative in order to address.

3.     Attorney representative desk staff shall reference the Authorized Representative job aid and follow the steps outlined to complete the necessary changes.

 

H.    Representative Death or Attorney Disbarment

1.     When BWC is notified of an authorized representative’s death or disbarment the attorney representative desk staff shall review the notice to determine if all the necessary information has been submitted.

2.     Attorney representative desk staff shall reference the Authorized Representative job aid and follow the steps outlined to remove the representative from the claims management system.