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Free C 230 Ohio Template

The C-230 Ohio form, officially titled "Authorization to Receive Workers' Compensation Payment," serves as a vital document for injured workers who wish to authorize the direct payment of their compensation to their attorneys. This form must be completed with attention to detail, including the correct claim number, and it is essential for representing each claim specifically. Failure to complete or timely file this form, as stipulated by the instructions, could result in the non-honor of the authorization by the Bureau of Workers' Compensation (BWC).

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Understanding the intricacies of workers' compensation processes can be overwhelming for those who find themselves navigating these waters for the first time. Among the various forms and documents required, the C-230 Ohio form stands out for its critical role in the compensation receipt process for injured workers. This form, titled "Authorization to Receive Workers' Compensation Payment," acts as a formal request permitting the Bureau of Workers' Compensation (BWC) to directly mail compensation payments to an injured worker's attorney. It encompasses all types of compensation awards, barring those related to an application for a percentage of permanent partial compensation (C-92), which have their unique filing requirements. Complete and accurate submission of the C-230 form, including the correct claim number and adherence to specific time limits for filing based on the nature of the compensation, is non-negotiable for its acceptance by the BWC. Incompatibilities such as incomplete forms, unauthorized alterations, or untimely filings can result in non-honor of the authorization. The form mandates clear specification of the application, request, motion, or order date, alongside the identification of the type(s) of compensation sought. Importantly, this authorization limits the attorneys to receiving payments on behalf of the claimants without the ability to cash or endorse checks. Its validity extends until the BWC processes the specified award(s) from the original application unless further hearings, appeals, or reconsiderations necessitate extended authorization. However, it's essential to note that the effectiveness of this authorization ceases 18 months from the date of the claimant's signature, emphasizing the significance of timely actions and accurate documentation in the workers' compensation claim process.

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Authorization to Receive Workers' Compensation Payment

Injured worker's name

Attorney's name

Claim number

Representative ID number

Instructions for completion

You must complete this form in its entirety, including the correct claim number.

You must file a separate authorization for each claim and for each application, motion or order.

BWC will not honor an authorization that is not completed in its entirety, is altered but not initialed by the party altering the form or is not timely filed.

Time limits for filing are as follows:

On all types of compensation, other than an application for the percentage of permanent partial compensation (C-92), you must file the authorization to receive workers’ compensation payment:

Prior to or at the hearing;

Prior to the date of the payment of compensation (before the award is issued) whether the award of compensation was made at a hearing or made without a hearing.

On any compensation paid pursuant to a C-92 application or an agreement of the parties to a percent permanent partial award, you must file the authorization:

With the application or the agreement for permanent partial disability;

With the application for the election of permanent partial from temporary partial;

With the Industrial Commission of Ohio at the hearing;

After the hearing but prior to the date of mailing of the hearing officer order.

I hereby authorize and direct BWC to mail directly to my attorney the compensation payment in the above numbered claim for the accrued portion of my award as specified below. You must specify the date of the application, request, motion or order.

Application, request, motion or order dated _____/_____/_____ for the type(s) of compensation listed below.

Check all that apply.

Temporary total

Impairment of earning capacity

Wage loss

Violation of specific safety

Change of occupation

Facial disfigurement

Scheduled loss

Lump sum settlement

Permanent total disability

Percentage permanent partial

Death benefits

Lump sum advancement

This authorization does not give my attorney the authority to cash or endorse a check on my behalf.

This authorization shall not continue in effect after BWC has paid said award(s) on the original application noted above unless there is a subsequent hearing, appeal or reconsideration after payment was made.

This authorization is not valid if it is filed beyond 18 months from the date of my signature.

Injured worker’s/claimant’s signature

Date

BWC-1360 (Rev. June 4, 2014)

C-230

Document Specifications

Fact Name Description
Purpose of Form C-230 This form authorizes the Bureau of Workers' Compensation (BWC) to send compensation payments directly to the injured worker's attorney.
Completion Requirements The form must be completed in its entirety, including the correct claim number. An authorization must be filed for each claim, application, motion, or order, and must not be altered unless initialed by the altering party.
Filing Deadlines Authorizations for receiving payments must be filed prior to or at the hearing, or before the compensation payment date. For C-92 applications or percentage of permanent partial awards, the authorization must be filed with the application or at the hearing but before the mailing date of the hearing officer's order.
Governing Law The form is governed by the Ohio Workers' Compensation laws, specifically regulated by the Ohio Revised Code and the Bureau of Workers' Compensation (BWC) guidelines.

How to Use C 230 Ohio

Filling out the C-230 Ohio form, titled "Authorization to Receive Workers' Compensation Payment," is a critical step for injured workers who wish for their compensation payments to be directed to their attorneys. This process ensures that any compensation award pertaining to a workers' compensation claim is managed appropriately and arrives at its intended destination, simplifying the handling of funds during what can be a challenging time. To ensure that your form is accepted without issue, it's crucial to follow the specific requirements laid down by the Ohio Bureau of Workers' Compensation (BWC).

Steps for Completing the C-230 Ohio Form:

  1. Injured worker's name: Enter the full name of the person who sustained the injury at work.
  2. Attorney's name: Provide the full name of the attorney authorized to receive the compensation payment on behalf of the injured worker.
  3. Claim number: Accurately enter the specific claim number associated with the workers' compensation claim.
  4. Representative ID number: If applicable, fill in the ID number of the representative handling the claim.
  5. Application, request, motion or order date: Indicate the date related to the application, request, motion, or order you're authorizing for compensation, using the format MM/DD/YYYY.
  6. Type(s) of compensation: Check all boxes that apply to the types of compensation being sought. These can range from temporary total impairment to permanent total disability, among others.
  7. Signature and Date: The injured worker or claimant must sign the form, signifying authorization, and date their signature. Remember, the signature must occur within 18 months from the day of signing for the authorization to be valid.

After completing the C-230 Ohio form, it should be submitted in accordance with the instructions provided, ensuring it is fully completed and not altered in any unauthorized manner. It's crucial to file the form timely, based on the type of compensation and relevant deadlines as outlined in the form's instructions. Doing so will help facilitate the smooth processing of the authorization, paving the way for the workers' compensation payments to be correctly and expediently directed to the authorized attorney.

Crucial Questions on This Form

What is the purpose of the C-230 Ohio form?

The C-230 Ohio form, also known as the Authorization to Receive Workers' Compensation Payment form, facilitates the process wherein the Bureau of Workers' Compensation (BWC) is authorized by an injured worker to direct compensation payments to their attorney. This form specifically applies to the payment of accrued portions of awards and stems from a variety of compensation types related to workers' compensation claims in Ohio.

How should the C-230 form be properly filled out?

To correctly complete the form, the injured worker must provide comprehensive details including their name, their attorney's name, the claim number, and the representative ID number. It is imperative to indicate the date of the application, request, motion, or order and check the applicable type(s) of compensation being sought. The form must be filled out in its entirety without any omissions, and any alterations must be initialed by the person making the changes to be considered valid.

Are there specific deadlines for filing the C-230 form?

Yes, there are strict timelines within which the C-230 form must be filed to be recognized by the BWC. For most types of compensation, the authorization must be submitted either prior to or at the time of the hearing, or before the date of payment issuance. For compensations resulting from a C-92 application or an agreement regarding percent permanent partial awards, the form needs to be filed alongside the application or agreement, during the Industrial Commission of Ohio hearing, or after the hearing but before the issuance of the hearing officer's order.

Can an attorney cash or endorse a check on behalf of an injured worker with this authorization?

No, the C-230 form does not grant attorneys the authority to cash or endorse checks on behalf of the injured worker. The authorization is strictly for directing the BWC to mail compensation payments to the attorney, and any further actions involving the funds would require separate authorization.

Does this authorization indefinitely allow for payment redirection?

The authorization provided through the C-230 form is not indefinite. It is only valid for the payment of awards based on the original application mentioned in the form. If there are subsequent hearings, appeals, or reconsiderations after the initial payment, a new authorization will need to be submitted to cover these events.

Is there a validity period for the C-230 form?

Yes, the authorization declared in the C-230 form becomes invalid if filed more than 18 months after the date it was signed by the injured worker or claimant. Therefore, attention to the signing and submission dates is crucial to ensure the form's validity for directing payment.

What happens if the C-230 form is not completed correctly?

If the C-230 form is not completed in its entirety, is altered without proper initialization, or is not filed within the prescribed time limits, the BWC will not honor the authorization. This means that compensation payments will not be redirected as intended until a correctly completed form is submitted within the allowable timeframe.

Are separate authorizations required for different claims or types of compensation?

Yes, a separate C-230 form must be filed for each distinct claim as well as for each application, motion, or order regarding different types of compensation. This ensures clear and proper direction of payments for the various aspects of workers' compensation claims administered by the BWC.

Common mistakes

When filling out the C-230 Ohio form, which is an Authorization to Receive Workers' Compensation Payment form, individuals often make mistakes that could potentially delay or complicate the processing of their claims. To ensure a smooth and efficient handling of your claim, it's crucial to be aware of and avoid the following common errors:

  1. Not completing the form in its entirety: Every section of the form needs to be filled out accurately. Leaving out information, especially the correct claim number, can lead to delays in processing.

  2. Filing a single authorization for multiple claims: A separate authorization must be filed for each claim and for each application, motion, or order. Combining claims on one form can result in none of them being processed.

  3. Making alterations without initialing: If any part of the form is altered after being filled out, those alterations must be initialed by the person making the change. Unauthorized alterations can invalidate the form.

  4. Missing the filing deadlines: The authorization to receive workers’ compensation payment must be filed within specific time limits, depending on the type of compensation. Filing too late can mean the authorization is not honored.

  5. Not specifying the date of the application, request, motion, or order: It is required to specify the date for which the authorization is being granted. Failure to do so could result in unclear instructions to the BWC, leading to processing delays.

  6. Filing the authorization beyond 18 months from the date of signature: The authorization is not valid if filed more than 18 months after it has been signed. This time limit is crucial to ensure the timely processing of your authorization.

By paying close attention to these areas when completing the C-230 form, individuals can help ensure their authorization to receive workers' compensation payments is processed without unnecessary delay. This attention to detail will contribute to a smoother, more straightforward claims process.

Documents used along the form

When dealing with workers' compensation claims in Ohio, particularly involving the C-230 form for authorizing payments to an attorney, there are several essential documents and forms you might encounter. These documents ensure proper handling and processing of your claim, covering various aspects from initial injury reporting to specific claims for compensation types.

  • FROI-1 (First Report of Injury): This is the initial form submitted by an employer when an employee gets injured at work. It kickstarts the claim process in the workers' compensation system.
  • C-84 (Request for Temporary Total Compensation): This form is used by the injured worker to apply for temporary total disability benefits when they are completely unable to work due to their injury.
  • C-92 (Application for Determination of Percentage of Permanent Partial Disability or Increase of Permanent Partial Disability): Submitted by the worker to claim permanent partial disability benefits based on the extent of their impairment.
  • MCO-14 (Medical Service Statement): Used by medical providers to detail the services provided to the injured worker, crucial for the reimbursement of medical expenses.
  • R-2 (Wage Statement): Employers submit this form to report the injured worker's earnings, which helps in calculating compensation benefits.
  • C-86 (Motion): Filed to request specific actions within a claim or to alter previous decisions, allowing for adjustments based on new evidence or circumstances.
  • IC-2 (Notice of Appeal): Utilized when a party disagrees with a decision made by the Ohio Bureau of Workers' Compensation (BWC) or the Managed Care Organization (MCO) and wishes to appeal to the Industrial Commission.
  • C-64 (Certificate of Attending Physician): Completed by the physician, this form provides a comprehensive report of the injury, treatment, and prognosis, which is vital for the claims process.
  • SH-2 (Safety Violation Report): Used if the injury resulted from a workplace safety violation. It’s crucial for claims involving violations of specific safety requirements.
  • C-137 (Claim Reimbursement form): Submitted for reimbursement of costs directly paid by the injured worker or employer related to the claim, such as travel expenses to medical appointments.

Each document plays a unique role in navigating the workers' compensation system, from establishing the basis of the claim to securing the appropriate benefits. Accurate completion and timely submission of these forms can significantly impact the effectiveness and outcome of the compensation process.

Similar forms

The C-230 Ohio form, focusing on the authorization to receive workers' compensation payment, shares similarities with the IRS Form 8821, Tax Information Authorization. Similar to the C-230, the Form 8821 grants a third party the authorization to obtain and inspect an individual’s tax information. Both forms do not allow the designated third party to act on behalf of the individual but rather to access specific information or payments. They require detailed completion and specify the scope and limitations of the authorization, noting that the authority granted does not extend to cashing or endorsing checks in the C-230’s case, or filing taxes on behalf of someone in Form 8821's.

The HIPAA Release Form mirrors the C-230 in that it allows for the sharing of personal information to a specified third party. In the context of the C-230, this pertains to workers' compensation payments and related claim information. The HIPAA form, similarly, permits the release of a person's health information to others, specifying who can receive the information and the types of information that can be shared. Both necessitate explicit consent from the person to whom the information belongs and highlight the importance of informed authorization before personal details can be released or payments directed to a third party.

Another comparable document is the Power of Attorney (POA), albeit the C-230 has a more narrow focus. A POA enables someone to act on another person's behalf in various legal or financial matters, which could include receiving payments. However, unlike a general POA, the C-230 specifically limits the authority to receiving workers' compensation payments without the capacity to endorse or cash checks. It pinpoints the requirement for specific authorization for each claim and delineates the conditions under which the authorization is deemed effective, similar to how a POA outlines the extent and limitations of the agent's powers.

The Direct Deposit Authorization forms that many banks and employers use also share a foundational similarity with the C-230 form. These forms authorize the direct deposit of funds, such as payroll or government benefits, into a specified bank account. Like the C-230, they necessitate the account holder’s consent for the transactions and specify the details of where the funds are directed. Both forms focus on the precise direction of funds to a designated party; however, the C-230 is specific to workers' compensation payments to an attorney, whereas direct deposit forms are more universal in their application to various types of transactions.

Dos and Don'ts

When completing the C 230 Ohio form, Authorization to Receive Workers' Compensation Payment, it is essential to follow instructions closely to ensure the document is filed correctly. Here are some important dos and don'ts:

  • Do ensure you complete the form in its entirety. Every section of the form is important for the proper processing of your authorization.
  • Do include the correct claim number. This is essential to match your authorization with your specific case.
  • Do file a separate authorization for each claim, application, motion, or order. The system is designed to handle each case individually.
  • Do adhere to the time limits for filing. Submitting your form in a timely manner is crucial for the processing of your workers' compensation payment.
  • Don't leave any section incomplete. Missing information can delay or prevent the processing of your claim.
  • Don't alter the form without initialing any changes. This is required to verify that any adjustments are acknowledged by you.
  • Don't disregard the specific filing instructions related to different types of compensation or stages in the process.
  • Don't wait to file your authorization until after the specified deadlines. Late submissions may not be honored, affecting your compensation.

By following these guidelines, you can help ensure your C 230 Ohio form is properly completed and submitted, assisting in the smooth processing of your workers' compensation payment.

Misconceptions

When dealing with the C-230 Ohio form, which is used for authorizing the receipt of workers' compensation payments, there are several misconceptions that can create confusion. Understanding these can help ensure that the process goes smoothly for injured workers and their representatives.

  • It's just a formality and doesn't need to be filled out carefully. Every section of the C-230 form is important and requires careful attention. This form authorizes the direct payment of workers' compensation benefits to an attorney or representative, which is a crucial step in the compensation process. An incomplete or incorrectly filled-out form can delay payments.

  • One authorization covers all claims. You must file a separate C-230 form for each claim and for each application, motion, or order relating to that claim. This specificity ensures that payments are properly authorized and processed for each individual case, reducing the chances of errors or mix-ups.

  • The form gives attorneys the authority to cash checks. Contrary to what some might think, filling out the C-230 form does not grant attorneys the ability to cash or endorse compensation checks on behalf of the injured worker. It merely directs the Bureau of Workers' Compensation (BWC) to mail the compensation payments directly to the attorney for the specified claim.

  • There's no deadline for submission. The form has clear deadlines that must be met for the authorization to be valid. For most types of compensation, the authorization must be filed either before or at the time of the hearing, or prior to the date of payment of compensation. Failure to meet these timelines can result in non-payment.

Understanding the importance, specific requirements, and limitations of the C-230 form ensures that injured workers and their representatives can navigate Ohio's workers' compensation system more effectively. Paying close attention to the details and deadlines associated with this form is crucial for the timely receipt of benefits.

Key takeaways

Completing and utilizing the C-230 form in Ohio for authorization to receive workers' compensation payments involves understanding specific requirements and procedural steps to ensure compliance and proper payment processing. This outline captures the crucial takeaways for effectively handling this form:

  1. To start, accurate completion of the form is mandatory. This includes providing the injured worker's name, attorney's name, claim number, and representative ID number in the designated sections.

  2. Filing a separate authorization for each claim, application, motion, or order is required, as the Bureau of Workers' Compensation (BWC) will not accept a single authorization for multiple items.

  3. The form mandates that no alterations are made unless they are initialed by the party making the change. This ensures the integrity and accuracy of the information provided.

  4. Adherence to time limits for filing the authorization is crucial. Depending on the type of compensation, these limits vary and are explicitly outlined to ensure timely processing.

  5. For types of compensation other than the C-92 application, the authorization must be filed either before the hearing or before the compensation payment date.

  6. Regarding compensation arising from a C-92 application or an agreement on a permanent partial award, the form should be filed either with the application, at the hearing, or after the hearing but before the mailing date of the hearing officer's order.

  7. The form explicitly states that it does not grant authority for an attorney to cash or endorse a check on behalf of the claimant. This limitation is crucial for maintaining financial control.

  8. The authorization's validity extends until BWC has paid the awarded compensation based on the original application, unless a subsequent hearing, appeal, or reconsideration occurs after the payment.

  9. Lastly, time-bound validity of the authorization is set at 18 months from the date of the claimant's signature, underscoring the importance of timely action and updates to the authorization as necessary.

Proper adherence to these guidelines will ensure that the authorization process for receiving workers' compensation payments through the C-230 form in Ohio is smoothly executed, facilitating timely and correct payment to the entitled parties.

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