and Procedure Name:
Shannon, Chief of Claims Policy & Support
Management policies, procedures, directives and memos regarding IC
suspensions that predate the effective date of this procedure.
versions of this policy are available upon request.
I. POLICY PURPOSE
purpose of this policy is to ensure that BWC refers employer requests to
suspend claim activity to the Industrial Commission of Ohio (IC) and that BWC
executes IC orders granting suspension.
policy applies to BWC Claim Services staff.
refer to the IC all employer requests for claim suspension due to the injured
worker’s (IW) failure to appear for an employer-requested examination or
refusal to sign a medical release.
staff shall refer to the Standard
Claim File Documentation policy and procedure for
claim-note requirements and shall follow any other specific instructions
included in this procedure.
services staff shall refer the employer’s Motion (C-86) or request to suspend a
claim to the IC on a Notice of Referral (NOR) when the employer is claiming
that the IW:
1. Failed to appear for an
employer-requested exam; or,
2. Refused to sign a
services staff shall include in the NOR the employer’s reason for requesting
claim suspension. Claim services staff may refer to the Notice of Referral
policy and procedure for additional information.
the IC issues a compliance letter denying the claim suspension, claim services
staff shall continue to process the claim and address any pending applications.
If the IC issues a compliance letter suspending the claim, claim services
1. Enter a
note titled “IC suspension of all claim activity” including the status of all
allowed or disallowed conditions prior to updating the claim status reason.
2. In lost
a. Place any
pending indemnity payments on hold to prevent any payment authorizations from
Claim Dates, Stop Payment Dates, to ensure no indemnity payments are released.
3. Update the
claim status reason to “Suspended by IC”.
Removing a claim from suspension status.
1. Once the IW
satisfies the terms of the suspension, claim services staff shall remove the
suspension status. The IC will not issue additional correspondence.
2. Claim services
a. Enter a note
indicating the claim suspension is lifted.
b. Update the claim
status reason to the status prior to suspension of the claim.
c. Expire the
stop payment placed in Claim Dates, Stop Payment Dates, to ensure indemnity
payments can be released.
d. Process any
outstanding compensation requests and/or medical bills that were filed during the
period of the suspension.