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OhioBWC - Basics: (Policy library) - File

Change of Address and-or Change of Name for the Injured Worker

Policy and Procedure Name:

 

Change of Address and/or Change of Name for the Injured Worker

 

Policy #:

CP-03-11

Code/Rule Reference:

None

Effective Date:

11/14/16

 

Approved:

Rick Percy, Chief of Operational Policy, Analytics and Compliance (Signature on File)

Origin:

Claims Policy

Supersedes:

Policy and Procedure # CP-03-11, effective 01/30/2015

 

History:

Revised 11/14/2016

 

 

I. POLICY PURPOSE

 

This purpose of this policy is to ensure that BWC efficiently processes an injured worker’s (IW) request to change an address and/or a name. 

 

II. APPLICABILITY

 

This policy and procedure applies to Field Operations staff.

 

III. DEFINITIONS

 

None

 

IV.  POLICY

 

A.    It is the policy of BWC to process an IW’s request to change an address and/or name whether the request is received in writing, by phone, in person or through the Internet.

 

B.    Parties may submit requests for change of address and/or change of name on the Injured Worker Change of Address Notification (C-77) or equivalent form.

 

C.   Once the IW or field staff updates the address and/or name in a claim, the claims management system will automatically make the same changes in all claims attached to the IW’s Social Security Number.

 

D.   When an IW’s social security number (SSN) has already been systematically verified via the Social Security Administration (SSA) cross match, the IW will not be able to change a name via the Internet but must do so in person or in writing, providing proof of identification that the name was changed with the SSA.

 

 

V.    PROCEDURE

 

A.    Staff shall verify the identity of the IW

1.    Requests received by telephone

a.    When an IW makes a request for a change of address and/or name via telephone, field staff shall verify and confirm all of the following:

i.      Claim number; 

ii.     Date of injury;

iii.    Social security number; 

iv.   Date of birth; and,

v.    Previous address.

b.    If the IW cannot provide all of the above information, field staff shall inform the IW that the IW must:

i.      File a written request using the C-77 or equivalent form; or,

ii.     Change the information via the Internet; or,

iii.    File the request in person.

2.    Requests Made In-Person

a.    An IW may request a change of address and/or name at any local BWC Service Office.

b.    Field staff shall verify the IW’s identity by requiring the IW to provide two forms of identification (e.g., driver’s license, picture ID card, BWC identification card, social security card).

3.    Internet and written requests: Field staff is not required to investigate identity when requests are made via the Internet or in writing.

 

B.    Field staff shall process the request

1.    Requests for Change of Name Made Via the Internet

a.    If  an IW’s SSN has already been systematically verified via the SSA cross match, field staff shall inform the IW that the request must be made in person or in writing, with proof that the name was changed with SSA.

b.    If the SSN has not yet been verified, field staff shall receive notification in the claims management system that the IW has changed his or her name via the Internet.

c.    The claims management system will trigger an automatic request for SSN cross match when an IW’s name is changed. 

2.    Requests for Change of Address Made Via the Internet

a.    When an IW makes an update, a systematic task will be posted to the assigned field staff worklist. 

b.    When this task is received, field staff shall review the file to determine if there are recently mailed orders or pending exams that may require additional action as a result of the address change.  Field staff shall address these issues with the Injury Management Supervisor.

c.    Staff shall check the user ID in the address history window to determine if the address was changed by the IW via the Internet.

3.    For requests made in all manners other than the Internet, which automatically updates all claims for the IW, field staff shall process the request by;

a.    Expiring the previous address,

b.    Entering the updated address information in all capital letters into the claims management system.

4.    Field staff shall never edit a valid address however, clerical errors with the existing address may be modified.

5.    Staff shall enter an address and/or name change in the claims management system, and the system will automatically update all other claims attached by the social security number of the IW.

6.    When an IW’s SSN has already been systematically verified via the Social Security Administration cross match, field staff shall not change a name in the claims management system. See the Social Security Numbers policy for more information.

7.    When field staff enters a change of address, the claims management system will automatically send the “Notice of Address Change” letter to the IW’s old address. The letter advises the IW to contact BWC at 1-800-644-6292 if the address has not changed. This correspondence may be viewed at the customer level. 

 

C.   Validating IW address when BWC receives return mail

1.    If correspondence sent to the IW is returned by the post office due to incorrect mailing address, field staff shall attempt to find a new address for the IW by:

a.    Contacting the IW by phone; and/or

b.    Contacting the IW’s representative by phone; and/or

c.    Contacting the employer of record; and/or

d.    Contacting the MCO; and/or

e.    Contacting a treating provider; and/or

f.     Review claims documents filed within the last 30 days to determine if a current address is noted; and/or

g.    Researching the Internet and phone books.

2.    If field staff has exhausted all reasonable effort as listed above and is not able to obtain a valid current address, field staff shall work with his/her supervisor to determine next steps.

 

D.   Field staff shall contact the Special Investigations Unit if fraudulent activity is suspected.

 

 

 


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