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Policy
and Procedure Name:
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Authorization
to Receive a Workers’ Compensation Check
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Policy
#:
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CP-01-06
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Code/Rule
Reference:
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O.A.C. 4123-3-10
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Industrial
Commission (IC) Resolution/Memo
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IC Joint Resolution R07-1-01
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Effective
Date:
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10/25/24
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Approved:
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Shawn
Crosby, Chief Operating Officer
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Origin:
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Claims
Policy
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Supersedes:
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Policy
CP-01-06, effective 05/06/22
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History:
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Previous
versions of this policy are available upon request
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Table
of Contents
I.
POLICY PURPOSE
II. APPLICABILITY
III. DEFINITIONS
Authorization
Claimant
IV. POLICY
A. Authorization
B. Court-Ordered
Settlements
C. Authorization
Requirements
D. Honoring an
Authorization
E. Timeliness
F. Issuing Payment
G. Cancelling an
Authorization
V. PROCEDURE
A. General Claim
Note and Documentation Requirements
B. Validating
Authorization
C. Honoring the
Authorization
D. Issuing Payment
The purpose of this policy is to ensure BWC staff properly sends a
workers’ compensation check to an individual properly authorized by an injured
worker (IW) or claimant.
This policy applies to all claims services staff.
Authorization: Written
notice executed
on a form provided by BWC that authorizes the delivery of the check by mail to the
address indicated by the injured worker or claimant in the authorization
request.
Claimant: One
who asserts a right, demand or claim for workers’ compensation benefits. A
claimant may be an injured worker, a dependent of a deceased employee, or any
person who is awarded compensation under the Ohio Workers’ Compensation Act.
1. It
is the policy of BWC to mail the check for the due and payable portion
of a workers’ compensation payment to an individual properly
authorized by an IW or claimant.
2. An
IW or claimant must complete and submit one of the following for an
authorization to be valid:
a. An Authorization
to Receive Workers’ Compensation Check (C-230);
b. The
“Authorization” portion of an Application for Determination of
Percentage of Permanent Partial Disability or Increase of Percentage of
Permanent Partial Disability (C-92); or
c. The
“Authorization” portion of a Settlement Agreement and Application for
Approval of Settlement Agreement (C-240).
3. An
authorization will only be honored for the application it is filed for and only
for the award(s) related to that application, following the limitations
outlined in Sections IV.C-E of this policy.
4. Upon
the death of an IW or claimant, BWC considers the authorization cancelled and
any authorization expires.
5. BWC will not
honor any authorization that is:
a. Incomplete;
b. Altered but not
initialed by the party altering the form; or
c. Filed outside
the proper time periods specified in the procedures below.
1. A court-ordered
settlement payment will be sent without a signed authorization to the
authorized individual listed:
a. On the court
order; or
b. In the claim,
only when an individual is not listed on the court order.
2. BWC will disburse
the payment to the IW or claimant directly when an authorized individual cannot
be identified in the claim or on the court order.
1. C-230
a. The
C-230 must:
i.
Include
the correct claim number and the IW’s name;
ii. Include the
attorney’s name or law firm, and representative ID number;
iii. Specify
the date of the application, request, motion or order for which the
authorization applies;
iv. Specify
the type of compensation for which the authorization applies;
v. Be
signed and dated by the IW or claimant;
vi. Be
timely filed, as detailed in Section IV.E of this policy; and
vii. Have
no alteration, unless the alteration has been initialed by the appropriate
person. Refer to the Standard Claim
File Documentation and Altered Documents policy and
procedure for further guidance.
b. If
an IW or claimant has an award that is split between multiple claims, an
original C-230 must be filed with each claim. If an original C-230 has not been
filed timely with a claim, that portion of the award will be paid directly to
the IW or claimant.
c. Multiple
award types, related to one application, may be included on a C-230 if all
awards are generated from the same claim.
2. The
authorizations submitted on a C-92 or C-240 must:
a. Be
signed and dated by the IW or claimant; and
b. Include the
attorney’s name and representative ID number.
3. BWC
will accept legible authorizations by fax, mail, or as an email attachment of
the scanned, signed document.
1. For
the following types of awards, BWC will only honor the C-230 authorization for
a single payment unless the issue is appealed and there is an additional
hearing on the same issue for which the request was honored:
a. Temporary
total (TT);
b. Wage
loss;
c. Change
of occupation;
d. Scheduled
loss;
e. Permanent
total disability (PTD);
f.
Death benefits;
g. Impairment
of earning capacity;
h. Violation
of a specific safety requirement (VSSR);
i.
Facial disfigurement;
j.
Lump sum settlement; and
k. Percentage
of permanent partial (%PP).
2. BWC will not
honor an authorization for the following awards:
a. Ongoing
TT;
b. Ongoing
PTD;
c. Ongoing
death benefits;
d. Living
maintenance; and
e. Living
maintenance wage loss.
3. BWC may honor
an ongoing award of compensation if not listed above in Section IV.D.2 above.
a. The
authorization will be honored on a bi-weekly basis only.
b. Specialized
schedule requests for authorization of payments other than bi-weekly will not
be honored (e.g. requests for an authorization on every third check payable to
the IW will not be honored.)
c. For
questions on whether an ongoing award is subject to an authorization, please
contact a BWC attorney.
1. C-230
a. Authorizations
will be honored when the IW or claimant has signed and dated the C-230 within
18 months of filing it with the application.
b. Authorizations
will be honored even if the application or award is ultimately granted beyond 18
months on all types of compensation (except %PP):
i.
Prior
to a hearing;
ii. At a hearing;
or
iii. Prior to the
date of the payment of compensation whether the award of compensation was made
at a hearing or made without a hearing.
2. C-92:
For a determination of %PP or an increase of %PP, an authorization must be
included:
a. With the
application;
b. With the Agreement
as to Compensation for Permanent Partial Disability (ICGC1);
c. With an
election related to temporary partial disability and %PP;
d. At the
Industrial Commission (IC) hearing; or
e. With the IC
after the hearing, but prior to the mailing of the order.
3. C-240: An
authorization for a settlement is included on the C-240.
1. A check will be
made payable to the IW or claimant and sent in care of the authorized
individual identified on the authorization.
2. The check will
be mailed to the address indicated by the IW or claimant in the authorization,
or arrangements may be made for pick up.
3. When two
authorizations for the same compensation award but different attorneys are
filed, the first authorization received will be honored if it was not cancelled
by the IW or claimant in writing.
1. An IW or
claimant may cancel an authorization to receive a workers’ compensation payment
by submitting a signed written notice to BWC prior to the issuance of a BWC or
IC order awarding payment of compensation.
2. It is the
responsibility of the IW or claimant to notify the individual previously
authorized that the IW or claimant has cancelled the authorization to receive a
workers’ compensation payment.
1. BWC staff will refer
to the Standard Claim
File Documentation and Altered Documents policy and procedure for claim
note and documentation requirements; and
2. Must follow any
other specific instructions for claim notes and documentation included in this
procedure.
1. When
an authorization is received by BWC, claims services staff must review it to
ensure the authorization:
a. Contains
all of the required information listed in Section IV.C of this policy
b. Applies
to the compensation types listed in Section IV.D of this policy; and
c. Is
filed timely, as described in Section IV.E of this policy.
2. If
an active IW attorney is attached to the claim and there is no C-230 already on
file, claims services staff must call the IW attorney and ask if a C-230 will
be filed when:
a. An application
for compensation has been filed; or
b. An initial
payment that is due and payable is being paid (except for C-92) and the IW
attorney was not contacted about this issue at the time the application was
filed.
3. If a new
authorization for a different attorney is filed for the same compensation award
previously filed claims services staff must:
a. Contact the IW
or claimant upon receipt of the second authorization request to clarify the IW
or claimant’s intentions;
b. Request the IW
or claimant provide clarification in writing; and
c. Honor the first
authorization, if the IW or claimant has not cancelled the previously filed
authorization in writing.
1. BWC
will only honor the C-230 authorization for a single payment unless the issue
is appealed and there is an additional hearing on the same issue for which the
request was honored.
a. If the order
that addressed the compensation issue is appealed, BWC would continue to honor
the same C-230.
b. Example: The
District Hearing Officer (DHO) allows TT for a closed period, the DHO order is
appealed and the Staff Hearing Officer (SHO) extends the closed period of TT.
In this case, we would honor the same C-230 for TT payment for both periods
addressed by the DHO and SHO. This disclaimer is also on the form.
2. Claims
services staff must staff any the following with a BWC attorney:
a. Issues
that may impact honoring an authorization, including changes of attorney due to
death, change of business (merger, acquisition); or
b. Other
issues regarding ongoing authorizations.
3. If
the issue for which the request was honored is not appealed, BWC will not continue to honor an authorization after the
award for which the authorization was filed has been paid.
a. If evidence is on
file that supports ongoing TT beyond what was ordered by the IC, claims
services staff should honor the C-230 for the entire period due and payable at
the time of payment, if applicable. For example:
i.
The
IC hearing order dated 12/1/2021 ordered TT to be paid from 9/15/2021 to
10/18/2021 and to continue upon submission of proof.
ii. Prior to making
payment on 12/3/2021 the claims service specialist notes a new C-84 has been
filed along with a Physician’s Report of Work Ability (MEDCO-14)
extending the IW’s disability period to 1/10/2022.
iii. Claims services
staff would honor the authorization for the entire period of compensation due
and payable from 9/15/2021 to 12/3/2021.
b. If
there is no additional
evidence on file that supports TT beyond what was ordered by the IC; claims
services staff should honor the C-230 only for the period due and payable at
the time of payment allowed by IC. For example:
i.
The
IC hearing order dated 12/1/2021 ordered TT to be paid from 9/15/2021 to
10/18/2021 and to continue upon submission of proof.
ii. No additional
proof of disability is submitted.
iii. On 12/3/2021 claims
services staff honored the authorization for the entire period of compensation
due and payable at the time of payment from 9/15/2021 to 10/18/2021.
iv. Additional
evidence of TT was submitted on 12/10/2021 supporting TT from 10/19/2021 to
12/30/2021. Claims services staff would not continue to honor the previous
authorization because issue for which the authorization request was honored was
not appealed.
1. To generate the
payment appropriately when the entity or individual listed on the authorization
is an:
a. Existing
participant in the claim, claims services staff will select the participant as
the “Mail To” entity in the Payee Allocation screen.
b. Existing
customer in the claims management systembut
not a participant to the claim, claims services staff will:
i.
Add
the customer as a participant-alternate payee on the claim;
ii. Create the
scheduled payment, select the alternate payee as the “Mail To” entity in the
Payee Allocation screen; and
iii. Expire the
participant-alternate payee when the payment is in paid status.
2. To generate the
payment appropriately when the entity or individual listed on the authorization
is not an existing participant in the claims management system, claims services
staff will:
a. Contact the
team responsible for adding customers to the claims management system; and
b. Follow the
steps outlined in V.D.1.b immediately above.