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OhioBWC - Basics: (Policy library) - File

Policy and Procedure Name:

Authorized Representatives

Policy #:

CP-01-01

Code/Rule Reference:

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

Effective Date:

05/24/17

Approved:

Kevin R. Abrams, Chief Operating Officer

Origin:

Claims Policy

Supersedes:

Policy and Procedure CP-01-01, effective 11/14/2016; 12/27/13

History:

New 12/27/13; Rev. 11/14/16

Review date:

12/27/2018

 

 

I.      BWC staff shall refer to the Standard Claim File Documentation and Altered Documents policy and procedure for claim-note requirements and shall follow any other specific instructions included in this policy and procedure.

 

II.    POLICY PURPOSE

 

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

 

III.   APPLICABILITY

 

This policy applies to claim services staff.

 

IV.  DEFINITIONS

 

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

 

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

 

Insured Representative: A type of authorized representative designated by an employer to represent the employer on a specific claim.

 

V.    POLICY

 

A.    It is the policy of BWC to recognize representatives properly designated and authorized by a claimant or an employer, including providing electronic access to the claim and notices of claim actions.

 

B.    Representative Identification Number (RIN)

1.    All authorized representatives of claimants or employers must have a BWC-issued RIN, obtained by filing an Application for Representative Identification 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.   Claimant Representative Authorization

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

a.    The claim number;

b.    The date of injury;

c.    The name of the employer at the time of injury;

d.    The claimant’s name, address and phone number;

e.    The representative’s name, address and phone number; and

f.     The representative’s RIN.

2.    The authorization must be signed by the claimant. Only the claimant may authorize a representative except when the claimant has a guardian. See the Custody, Guardianship, Power of Attorney and Incapacitation policy for more information.

3.    A claimant may have multiple authorized representatives but only one legal representative (one attorney or one law firm) and/or one union representative.

4.    A claimant may update his or her  authorized representative information by:

a.    Telephone - a claimant may contact BWC by telephone to update his or her authorized representative information, but must follow up with submission of a new R-2 or signed equivalent;

b.    Fax - the updated information may be faxed to BWC;

c.    Letter – the claimant may mail the updated information to BWC;

d.    Email – the claimant may scan a signed, written notification of updated information and email it to BWC.

5.    The submission of an authorization for a new legal or union authorized representative will replace any prior legal or union representative. If a legal or union representative withdraws or is removed by the claimant, the claimant must file a new authorization; prior authorized representatives will not automatically be reinstated.

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

7.    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, the claimant must cancel in writing any previously filed C-230 and 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.

8.    Having representative authorization from BWC does not excuse the representative from complying with all Industrial Commission 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).

 

VI.  PROCEDURE

 

A.    Representative Identification Numbers

1.    The BWC Customer Service Desk (also known as the “Attorney Representative desk”) 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 when the representative submits a completed Application for Representative Identification Number (R-4) and other required documentation.

a.    If a W-9 is submitted with the R-4, customer service 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.

b.    If the representative is an out-of-state attorney not admitted to the Bar in Ohio, customer service 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.

2.    The customer service staff will notify the representative if there is any discrepancy between a submitted W-9 and the information provided on the R-4, or if the necessary W-9 has not been provided. BWC will not issue an RIN until all the needed taxpayer information and documentation is complete.

3.    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, customer service staff shall consult with a BWC attorney to determine appropriate action.

 

B.    Claimant Authorized Representative

1.    Claim services staff shall add 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.

2.    Claim services staff shall also update the participant record to indicate the participant type as Legal Representative or Union Representative.

3.    Claim services staff shall update a claimant’s authorized representative information when the claimant submits written notification of a change. If the claimant is changing legal representatives, claim services staff shall ensure the previous legal representative is “expired” in the claims management system as a participant on the claim.

 

C.   Employer Authorized Representative: Upon receipt of an R-1 form, claim services staff shall enter or update the employer representative authorized for a specific claim in the claims management system. If the claims management system does not allow the R-1 information to be entered into a claim, claim services staff shall contact the Customer Service Desk (also known as the Attorney Representative desk) to resolve.   


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