4123.56, 4123.53; O.A.C. 4123-19-01, 4123-3-03, 4123-3-09, 4121-3-13,
Percy, Chief of Operational Policy, Analytics & Compliance
policies, directives or memos regarding self-insured claim management that
predate the effective date of this policy.
purpose of this policy is to ensure BWC’s role and responsibilities as liaison
between the injured worker (IW), self-insuring (SI) employer and the Industrial
Commission (IC) are identified and detailed.
policy applies to Field Operations staff.
An unresolved objection or non-response to a request.
Employers who have been granted the privilege by BWC of
administering their own workers’ compensation programs and who pay compensation
and benefits directly to the IW.
Applications for compensation and/or benefits filed after the initial
A. It is the policy
of BWC to properly fulfill and perform its responsibilities and role as liaison
between the IW, SI employer and the IC in a claim filed with a SI employer.
B. It is the policy
of BWC to carry out the following responsibilities in the processing of SI
1. Assign a claim
number and maintain information from an initial determination request, such as a
First Report of an Injury, Occupational Disease or Death (FROI), in the
claim management system;
2. Provide the
claim number and other information to the IW regarding the management of a
claim filed with an SI employer;
subsequent applications and other correspondence sent to BWC are directed to
the SI employer, as appropriate;
4. Ensure all
documentation and other information received by BWC is maintained in the claim
5. Refer disputed
issues to the IC;
6. Process a filed Application
for Determination of Percentage of Permanent Partial Disability or Increase of
Permanent Partial Disability (C-92) pursuant to the Percentage Permanent
Partial Awards policy;
7. Process requests
for artificial appliances/prosthetics pursuant to the Artificial Appliance
8. Ensure proper
handling of vocational rehabilitation claims;
9. Schedule independent
a. Upon the request
of the employer for:
ii. Two-hundred week
exams - to ensure the exam is completed prior to the end of the two hundred
weeks of temporary total disability compensation, the SI employer must request
at least sixty days prior to that date;
b. As instructed by
the IC; or
determination of percentage of permanent partial disability.
BWC staff may
refer to the corresponding procedure for this policy entitled “Procedure for Self-Insured
Claims Management” for further guidance.