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OhioBWC - Basics: (Policy library) - File

 

Mailbox Rule

 

Policy Name:

Mailbox Rule

Policy #:

OP-13-01

Code/Rule Reference:

N/A

Effective Date:

06/30/2012

Approved:

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

Origin:

Operational Policy

Supersedes:

N/A

History:

New 06/30/12

 

 

I. POLICY PURPOSE

 

The purpose of this policy is to ensure that Bureau of Workers’ Compensation (BWC) staff recognize and apply the general legal concept of a “mailbox rule” to all documents it receives via U.S. regular mail for claims processing, unless specifically noted otherwise.

 

II. APPLICABILITY

 

This policy applies to BWC staff and managed care organizations (MCO) who accept documentation used in the course of claims processing.

 

III. DEFINITIONS

 

Mailbox Rule – generally accepted legal premise that assumes successful regular U.S. mail delivery within a prescribed number of days and which adds the prescribed number of days to the number of days allowed for filing or submitting documentation.

 

IV. POLICY

 

It is the policy of BWC to prescribe four (4) days or less as an acceptable time period for the U.S. postal service to execute mail delivery, unless the filing/submitting party can evidence extenuating circumstances that allow delivery to take longer than four (4) days.

 

The prescribed four (4) additional days accommodates U.S. postal service delivery time and is added to the specified timeframe provided on the appeal or the correspondence, unless noted otherwise.  Therefore, BWC staff shall consider all submissions or filings timely filed if the stated deadline on the appeal or the correspondence was on or within four (4) days of BWC’s receipt of the documentation, unless specifically noted otherwise in the appeal or the correspondence.

 

If documentation or an appeal is not timely filed, BWC shall:

                                                    1.        If it is an issue for which BWC has original jurisdiction, continue processing the claim or,

                                                    2.        If it is an issue for which the Industrial Commission (IC) could exercise jurisdiction, complete a Notice of Referral.

 

Examples:

1.    Injured worker (IW) receives a BWC Order on May 18 stating that the IW has fourteen (14) days to file an appeal to the order.  The filing deadline for an appeal to the BWC order is June 1.  The IW mails the document on June 1 and BWC receives the document via U.S. regular mail on June 5.  The submission is considered timely because the IW had fourteen (14) days to file the appeal and an additional four days for mailing per the mailbox rule.

2.    IW receives a letter dated September 1 stating that s/he must provide documentation to BWC within ten (10) days of the date of the letter.  The IW waits until September 10 to mail the documentation, and BWC receives it on September 14.  The submission is timely because the IW submitted the documentation within ten (10) days of the date of the letter and was permitted up to an additional 4 days for mail delivery by U.S. regular mail. 

3.    IW receives a BWC Order on May 18 stating that the IW has fourteen (14) days to file an appeal to the order.  The filing deadline for an appeal to the BWC Order is June 1.  The IW claims that the appeal was mailed on June 1 but BWC receives the document via U.S. regular mail on June 14.  Staff shall refer such matters to the IC so that the IC can determine if extenuating circumstances apply.

4.    BWC sends a letter to the employer specifically stating that the employer must submit information to BWC and that BWC has to receive the information within 10 days.  BWC sends the letter June 2.  The employer sends the information on June 12, and BWC receives the information on June 16.  This is an untimely submission because the correspondence specifically stated that BWC had to receive the information within 10 days, not that the employer had to submit the information within 10 days.

 


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