and Procedure Name:
and Translation Services
Americans With Disabilities Act of 1990, Pub. L. No. 101-336,
104 Stat. 328 (1990);
Joint Resolution R88-1-200
Percy, Chief of Operational Policy, Analytics & Compliance (Signature on
and Procedure CP-09-03, with an effective date of 10/03/16.
10/03/16; 11/05/14; 07/08/13; New 10/15/12
purpose of this policy is to ensure that BWC provides interpreters for injured
workers and employers and properly translates claim documents that are in a
language other than English, as necessary and appropriate.
policy applies to all Field Operations and managed care organization (MCO)
Sign Language (ASL): A
complete, complex language that employs signs made with the hands and other
movements, including facial expressions and posture of the body, used primarily
by people in North America who are hard of hearing.
Interpreter: An individual or device
that converts any spoken material from one language into a different language.
For purposes of this policy, the term “interpreter” includes both an ASL
interpreter and a foreign-language interpreter, unless otherwise noted.
Translation: Conversion of written
material from one language to another.
1. It is the policy of BWC
to provide necessary and appropriate interpreter services upon the request of
an injured worker (IW) or when the need is otherwise identified, to facilitate:
a. Expediting treatment in
b. Filing or investigating
a claim or an action pending in a claim; or
c. Medical specialist
consultations requested by the physician of record (POR) or treating physician
and approved by the managed care organization (MCO).
2. ASL interpretation
only, shall be approved for claim-related:
a. Routine office visits
with a POR;
b. Communication with
durable medical equipment suppliers; and
c. Physical or occupational
3. BWC will not pay for
a. For hospital-based
b. For services not
contracted or approved by BWC or the Industrial Commission (IC); or
c. When family members,
friends, health care providers, vocational service providers, or community
volunteers provide interpretation for the IW.
4. It is the policy of BWC
that any interpreter provided by BWC must be able to interpret effectively,
accurately and impartially, both receptively and expressively, using any necessary
specialized vocabulary appropriate to the circumstances.
1. It is the policy of BWC
that a foreign-language document containing information relevant to making a claim
decision be appropriately translated to English (e.g., letter from a surviving
spouse; birth certificate of a dependent; marriage certificate of an IW).
2. If the foreign-language
document is relied upon to make a claim determination, BWC shall utilize the
services of a professional translator that has:
a. Native or near native
fluency in the language being translated and in English; and
b. Experience or expertise
in the subject-matter of the document, adequate to provide a reliable translation
(e.g., legal or medical terms).
A. Interpreter Services
1. If at any time during
the life of a claim, field staff becomes aware that an IW is incapable of
communicating in English, field staff shall:
a. Check the “Primary
Language” field at the customer level of the case management system; and
b. Choose the IW’s primary
conversational language from the dropdown box.
2. Processing a Request
for Interpreter Services
c. The CSS or DMC shall
address a request for interpreter services promptly to prevent any delays in
d. The CSS or DMC shall
notify parties to the claim and any applicable service provider of approval or
denial of interpreter services via the Interpreter Services Approval/Denial
e. If the CSS or DMC has
not received the request for an interpreter until shortly before the
interpreter is needed, and the Interpreter Services Approval/Denial letter is
not likely to be received timely, the CSS or DMC shall contact the parties by telephone
to notify them of the decision, in addition to sending the letter.
shall include notice that if a party to the claim objects to the decision, he
or she may file a Motion (C-86).
g. The CSS or DMC shall
enter a claim note which includes the following details:
or disapproval of the request;
approved, the specific type of interpreter being approved (e.g., ASL
interpreter, Spanish interpreter);
iii. The date and event approved
for interpreter services; and
iv. The name and contact
information of the service provider.
3. Identifying an
Interpreter, Arranging Services and Payment
a. When reasonable and
effective interpreting services cannot be provided by the IW’s family or
friends, the CSS or DMC shall investigate other resources available that have
no additional cost to BWC. Such resources may include:
staff at the Customer Contact Center;
staff identified on BWC’s internal website;
Relay Service (In Ohio dial 7-1-1);
iv. A health care provider
or vocational rehabilitation service provider fluent in the language of the IW
(The health care provider or vocational rehabilitation service provider will
not be additionally reimbursed for interpreter services); or
b. If the CSS or DMC
determines an interpreter service provider is necessary, the CSS or DMC shall:
if there is a provider with a state contract identified on COR. If so, the CSS
or DMC shall contact that provider first.
If a state
contract provider is not identified on COR or is unable to provide the
necessary service, the CSS or DMC shall reference the “Interpreter Services
Enrolled Providers” list on COR.
c. If the need cannot be
sufficiently met using a state contract provider or an enrolled provider, but
an interpreter has been otherwise identified (e.g., the IW or the IW’s attorney
has identified an interpreter), the CSS or DMC shall assist the provider with
The CSS or
DMC shall send or direct the provider to the Application for Provider
Enrollment Non-Certification (Medco-13A) form available on COR and in the
medical provider forms section of www.bwc.ohio.gov.
The CSS or
DMC shall then communicate the following information to the BWC Provider
a) The name and telephone
number of the provider applying for enrollment;
b) Approval of the
provider by the CSS or DMC; and
c) The IW’s name and claim
iii. BWC Provider Relations
will enroll the provider and send an email to the CSS or DMC confirming
iv. The CSS or DMC shall
provide BWC payment instructions to the approved interpreter provider.
d. Upon request, members
of Claims, Medical or Vocational Rehabilitation Policy shall be available to
staff cases with the CSS or DMC to assist in determining what interpreter
services are necessary and appropriate and to identify an appropriate provider.
e. In cases of
catastrophic claims, the catastrophic nurse advocate shall work with the CSS or
DMC to review available options and determine whether interpreter services are
provider is identified, the CSS or DMC shall make the appropriate arrangements
for the interpreter services.
g. Payment for interpreter
services shall be made from the Surplus fund.
employer is non-complying, interpreter services costs shall be recouped from
employer is self insuring (SI), the SI employer shall
pay for any needed interpreter services, except for interpreter services for
examinations related to an Application for Determination of Percentage of
Permanent Partial Disability (C-92), which shall be paid from the Surplus
h. Payment for interpreter
services shall be made pursuant to a Service Invoice (C-19), completed
by the provider.
Billing and Adjustments (MB&A) receives the C-19 directly:
shall review the claim for the claim note and letter approving interpreter
MB&A is unable to locate adequate documentation of approval by the CSS or
DMC in the claim, MB&A shall forward the C-19 to the CSS or DMC, and copy
the CSS or DMC’s supervisor, advising the CSS or DMC to provide the necessary
information so that payment may be processed.
receipt of the C-19, either directly from the provider or from MB&A, the
CSS or DMC shall:
that the services were provided and the information is correct;
or her “A” number in Box 9 on the completed C-19 before it is imaged;
iii. Index the document as a
iv. Update the approval in
k. The C-19 will appear on
the MB&A work list.
will also process for payment all interpreter service invoices received from
m. BWC shall not pay for
interpreter services that are not approved by BWC or the IC.
4. Hospital-Based Services
a. If an IW has been
approved for hospital-based services and the CSS or DMC is aware that the IW
will require interpreter services, the CSS or DMC shall notify hospital social
services or another hospital department designated for obtaining interpreters
of the need.
b. The CSS or DMC shall
also request that the hospital notify him or her if interpreter services will
be required soon after the IW is discharged, to prevent interruption of care
and facilitate return to work.
5. Interpreter Services
for Industrial Commission (IC) Proceedings
a. If the CSS is referring
an issue to the IC on a Notice of Referral (NOR) or there is an appeal to a BWC
order, the CSS shall ensure the “Primary Language” field is marked in the
claims management system, which will automatically alert the IC that the IW
need interpreter services.
b. Consistent with IC/BWC
Joint Resolution R88-1-200, the IC is responsible for ordering and scheduling
interpreters for IC related hearings, medical examinations, or for other
similar circumstances involving individuals who could not otherwise communicate
due to a hearing impairment or limited English proficiency. The CSS or DMC
shall refer any questions from parties to the claim to IC Customer Service for
6. Interpreter Services
Required by Vocational Rehabilitation
a. The DMC shall ensure
that an IW receives necessary and appropriate interpreter services,
particularly at critical stages in the rehabilitation process,
including, but not limited to:
initial interview with the IW;
meeting to discuss and sign the rehabilitation agreement;
iii. When the plan
expectations are discussed; and
iv. When there is a change
in the case direction.
b. BWC Vocational
Rehabilitation Policy staff will be available to help staff cases, upon request
of the DMC.
7. Interpreter Services
Required by the MCO
a. If an IW needs an
interpreter for an examination that is required and scheduled by the MCO, the
MCO is responsible for payment of both the examination and the interpreter
services. The MCO may use its own interpreter service or may request assistance
from BWC or the IC, as applicable.
b. If the IW needs
interpreter services related to an Alternative Dispute Resolution (ADR), the
MCO will contact the IW’s assigned CSS or DMC to make the arrangements. BWC
will pay for interpreter services for ADRs as often as necessary.
c. Staff shall place a
note in the claim reflecting the discussion with the MCO and their agreement as
to the entities responsible for payment.
d. If an MCO approves
interpreter services in error, without BWC approval, the MCO shall be
responsible for reimbursement to the provider. Payment will be transferred from
the MCO’s administrative account into the provider account to cover the exact
payment issued from the provider account to pay for the interpreter services.
Supporting documentation for the transaction must be maintained for audit
B. Translation Services
1. The CSS or DMC shall
obtain a translation of documents that appear to be:
a. Communications from, or
on behalf of a party to the claim; or
b. Evidence in a claim.
2. The CSS or DMC may
consult with a bilingual BWC staff member regarding a document to determine the
nature of the document and its general contents.
3. If the document appears
to provide information or evidence upon which a claim decision will be made,
the CSS or DMC shall arrange for a professional to provide a translation.
a. The CSS or DMC shall
reference COR to determine if there is a provider with a state contract
available to provide the service.
b. The CSS or DMC may staff
with the supervisor, and/or other BWC staff when needed, to provide direction
on obtaining document translation.
c. The CSS or DMC shall
ensure the translation is imaged into the claim file.