OhioBWC - Basics: (Policy library) - File

Signature Requirements on Applications

Policy and Procedure Name:

Signature Requirements on Applications

Policy #:


Code/Rule Reference:

R.C. 1306.01; O.A.C. 4125-1-02

Effective Date:



Kevin R. Abrams, Chief Operating Officer


Claims Policy


Signature Requirements on Applications policy and procedure dated 05/24/17.


Rev. 05/24/17; New 04/08/2013





The purpose of this policy is to ensure that claim services staff are informed of the required signatures on applications and the appropriate action to take when a required signature is missing.




This policy applies to all claim services staff involved in the processing of applications.




Application: A form or other means of communicating to BWC the following:

1.    Requests: Communications requesting an initial or subsequent action be taken.


a.  Application for Payment of Lump Sum Advancement (C-32);

b.  Request for Temporary Total Compensation (C-84);

c.   Motion (C-86).

2.    Authorizations: Communications that serve to grant permission.


a.  A Power of Attorney;

b.  Injured Worker Authorized Representative (R-2);

c.   Authorization to Receive Workers’ Compensation Check (C-230);          or,

3.    Agreements: Communications that serve as a contract between the parties.


a.  Settlement Agreement and Application for Approval of Settlement          Agreement (C-240);

b.  Rehabilitation Agreement (RH-1).

Electronic signature: An electronic sound, symbol, or process attached to or logically associated with a record and executed or adopted by a person with the intent to sign a record.

Signature: Any symbol executed or adopted with the intention to indicate knowledge, approval, acceptance, receipt or obligation. In most cases this will be an individual signing his or her name to a document, but may include stamped signatures and various forms of electronic acknowledgement.


Subject-Matter Specific Policy: A BWC policy that addresses a particular topic and may include specific direction and requirements for the signatures required on related applications (e.g., Medical Evidence for Diagnosis Determinations).




A.    It is the policy of BWC to ensure all submitted applications are signed by the appropriate individual, consistent with the applicable subject-matter specific policy or the instructions on the applicable form.


B.    To the extent a subject-matter specific policy or form does not exist or does not address signature requirements, the signature requirements of this policy shall apply.


C.   General Application Signature Requirements:

1.    Requests shall be signed by the party or individual seeking the benefit of the request (e.g., the injured worker (IW) must sign a Request for Temporary Total Compensation (C-84) form).

2.    Authorizations shall be signed by the party or individual making the authorization (e.g., the IW is the only individual that can authorize an attorney as the IW’s representative).

3.    Agreements shall be signed by the parties to the agreement (i.e., those parties or individuals that intend to be bound by the agreed terms).


D.   Unless a subject-matter specific policy provides otherwise, an application not signed by the appropriate party or individual shall be dismissed.


E.    It is the policy of BWC to accept documents that are scanned, faxed, photographed, or otherwise electronically submitted, and which contain an image of the hand-written signature of the appropriate party or individual.


F.    BWC may accept electronic signatures on applications when the electronic signature is submitted in a manner expressly provided for and approved by BWC or the Industrial Commission (IC) (e.g., when an injured worker (IW) signs into his or her e-account at BWC's website and submits a BWC form).


G.   It is the policy of BWC that if a party is physically unable to provide a signature but is otherwise competent to act on his/her own behalf:


1.    BWC will accept any mark (e.g., an “x”) the party is able to produce; or

2.    If the party cannot physically provide any type of signature, another person may sign on behalf of the party, with a statement that the party is physically unable to sign. BWC will contact the party to validate any such signature;




A.      When claim services staff receives an application, he or she shall review the application to confirm it has been properly signed by the party or individual whose signature is required by:

1.    Law (primarily Ohio Revised Code and Ohio Administrative Code);

2.    The subject-matter specific policy;

3.    The instructions on the form, as applicable; or

4.    Absent a subject matter specific policy or form, this policy.


B.  Claim services staff shall attempt to contact a party whenever there is a missing signature or the validity of a signature is in question. Claim services staff shall:

1.    Request a properly signed document if the required signature is missing;

2.    Verify that the signature in question was provided by the party indicated; or

3.    If the application was signed by another individual with the indication the party is unable to sign, verify that the party is in agreement and aware that the other party signed on his/her behalf.


C. Absent subject-matter specific policy instructions to the contrary, if claim services staff is unable to obtain a properly signed application after making reasonable attempts to do so, BWC shall dismiss the application.