I. POLICY PURPOSE
The purpose of this policy is to provide general guidance
relating to the legal concepts of custody, guardianship, power of attorney
(POA) and incapacitation.
This policy applies to claim services staff.
Claimant: One who asserts a
right, demand or claim for workers’ compensation benefits.
guardian appointed by a probate court at the request of a mentally competent
adult who is physically unable to manage some aspects of life. Powers of
the Conservator are specified by the requestor of the conservatorship and set
forth in the probate court order.
Custody: Having the charge,
care and control of a person. Generally, a parent is presumed a natural
custodian of a child. However, even if a parent is alive, courts can appoint
another person (usually a relative) as a legal custodian of a child. As a legal
custodian, that person can generally sign contact letters or change banking
information on behalf of a child.
Guardian: A person who has a
court order and is charged with the duty of authorizing medical care, living
arrangements, and/or managing the financial affairs of another person because
the person is of minor age, or is incompetent and considered incapable of
administering his or her own affairs. Guardianship of the person
means they are responsible for the medical and/or living arrangements for the
individual. Guardianship of the estate means they see to the person’s
Court orders can encompass either or both types of
guardianship. The authority granted by the court order can be limited or
unlimited (e.g. financial only/medical needs only/all encompassing(medical and
financial). The guardian may be a conservator of that individual’s
Generally speaking, a custodial parent is a presumed guardian
of a minor and a spouse is a presumed next of kin for a person incapable of
acting on his/her own behalf.
A family member who is next of kin can make life sustaining medical
decisions on behalf of an incapacitated individual, but cannot make financial
decisions on their behalf.
Incapacitated: The inability
to make medical decisions, manage property or business affairs because the
individual has an impairment in the ability to receive and evaluate information
or make or communicate decisions even with the use of technological assistance.
POA: A written
document signed by the claimant that conveys the legal authority to act on
their behalf to another person. Generally, the document conveys authority to
sign on their behalf, attend to financial matters and/or make medical decisions
or living arrangements on behalf of the claimant. This legal authority can be
limited or unlimited (e.g. financial only/medical needs only/all
encompassing(medical and financial).
A durable power of attorney means that the authority
conveyed is either triggered by the inability of the individual to act on their
own behalf or it survives their incompetency and is in effect until the
individual dies or a court order replaces it. Unless specified in the document,
most POA’s in Ohio are considered durable.
is the policy of BWC to provide a claimant with all legal rights afforded by
law unless the authority to exercise such rights has been conveyed to another
via statute, court order or a legally binding written instrument executed by
the claimant (e.g., a POA).
is the policy of BWC that a minor who is injured or suffers an occupational
disease in the course and scope of employment has the legal capacity to file a
claim directly with BWC without the assistance of a parent or guardian. However,
BWC may only pay compensation to the legal guardian of the minor.
is the policy of BWC that if BWC or the Industrial Commission determines that
it is in the best interest of the claimant that a guardian be appointed to
receive benefits payable, payment shall be withheld until such guardian is
is the policy of BWC, in the event a claimant is unable to complete the first
report of injury (FROI) due to physical or mental disability, to allow the FROI
to be completed and filed by the claimant’s spouse, next friend, guardian or
1. BWC staff
shall refer to the Standard
Claim File Documentation and Altered Documents policy and procedure for
claim note and documentation requirements; and
follow any other specific instructions for claim notes and documentation
included in this procedure.
Right to Act on Behalf of Another
1. If claims
services staff receive documentation or otherwise learn that another person may
have some legal right to act on behalf of a claimant, claim services staff must:
the claimant and/or the person claiming such rights and request the supporting
legal documentation if it’s not already in the claim file;
b. Ensure the
submitted documentation is imaged into the claim file;
with the local BWC attorney to determine what specific rights the document(s)
the results of the staffing with the BWC attorney noting the following:
specific authority the legal document provides (e.g. financial only/medical
needs only/all encompassing(medical and financial)
of the person(s) given the legal authorization.
e. If the
authority received is limited or vague, claims services staff must attempt to
secure clarification and again consult with a BWC attorney.
general, documentation addressing the legal right one may have to act on behalf
of another person may include:
certificates or other documents relating to custody;
orders granting guardianship of the person or the estate or a conservatorship;
documents as determined necessary by the situation.
Information into the Claims Management System
services staff shall ensure any verified guardian:
a. Is entered
into the claims management system as a customer with the appropriate
relationship identified; and
into the claim as a participant.
services staff may refer to the CoreSuite Training Manual – Investigation and Documentation
for more information.
Filed By a Minor Child
services staff shall accept a FROI filed by a minor child on his or her own
2. If there
is any conflict or question regarding the minor child/claimant’s continued
capacity to act on his or her own behalf, claim services staff shall consult
with the BWC attorney.
staff shall pay compensation to the minor claimant’s legal guardian as provided
1. If claims
services staff receives a guardianship document or POA signed by the claimant, or
has reason to believe that a claimant may be incapacitated as defined by this
policy, claim services staff shall contact the local BWC attorney to determine
what, if any, action needs to be taken relating to the claim.
services staff shall not assume that the physical inability of a claimant to
sign a document, by itself, establishes incapacity and the need of a guardian.
See the Signature
Requirements on Applications policy and procedure for additional
staffing with a BWC attorney, BWC may withhold payment of compensation until a
guardian is appointed if the BWC attorney determines that this action is