4123.56, 4123.53; O.A.C. 4123-19-01, 4123-3-03, 4123-3-09, 4121-3-13,
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 claims:
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
2. Provide the claim
number and other information to the IW regarding the management of a claim
filed with an SI employer;
3. Ensure 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
i. Ninety-day exams; and
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
c. For 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.