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Preview - C 230 Ohio Form
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
•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
•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
Document Properties
| Fact Name | Description |
|---|---|
| Purpose | The C 230 Ohio form is used to authorize the Bureau of Workers' Compensation (BWC) to send compensation payments directly to an injured worker's attorney. |
| Filing Requirements | This form must be completed in full, including the correct claim number. A separate authorization is needed for each claim and application. |
| Time Limits | Authorization must be filed prior to the hearing or before compensation payment is issued. For certain applications, it should be filed with the application or at the hearing. |
| Validity Period | The authorization is valid for 18 months from the date of the injured worker's signature. It becomes invalid after BWC has paid the awarded amount unless there is a subsequent hearing or appeal. |
Documents used along the form
The C 230 Ohio form is essential for injured workers seeking to authorize the receipt of workers' compensation payments through their attorney. Several other forms and documents often accompany this form to ensure a smooth process in handling workers' compensation claims. Below is a list of related forms that may be necessary.
- C-92 Application for Percentage of Permanent Partial Disability: This form is used to apply for a percentage of permanent partial disability benefits, which compensates workers for lasting impairments resulting from workplace injuries.
- BWC-1360 Authorization for Release of Medical Records: This document allows the Bureau of Workers' Compensation (BWC) to obtain medical records necessary to process a claim, ensuring that all relevant health information is available.
- C-84 Application for Temporary Total Compensation: Injured workers use this form to apply for temporary total disability benefits, which provide financial support while they are unable to work due to their injury.
- C-140 Application for Permanent Total Disability: This form is submitted by workers who believe they are permanently unable to return to any form of employment due to their injury, seeking long-term benefits.
- C-144 Application for Wage Loss Compensation: Workers fill out this form to claim wage loss benefits, which are available when an injured worker is unable to earn their usual wages due to their injury.
- C-151 Request for Change of Occupation: This document is used when an injured worker seeks approval to change their job or occupation due to limitations caused by their injury.
- C-157 Application for Facial Disfigurement: This form is specifically for workers who have suffered facial disfigurement as a result of their injury, allowing them to seek additional compensation.
- C-22 Notice of Appeal: If a worker disagrees with a decision made by the BWC or the Industrial Commission, this form is used to formally appeal that decision.
- Quitclaim Deed: For more information on transferring property ownership in Georgia, you can refer to smarttemplates.net.
- IC-1 Application for Hearing: This document is submitted to request a hearing regarding a workers' compensation claim, often necessary when disputes arise over benefits or compensation amounts.
Each of these forms plays a critical role in navigating the complexities of workers' compensation claims in Ohio. Ensuring that the correct documents are filed in a timely manner can significantly impact the outcome of a claim.
Guidelines on Filling in C 230 Ohio
Completing the C 230 form is an essential step in the process of authorizing workers' compensation payments. Ensure that all information is accurate and complete to avoid any delays in processing. Follow these steps carefully to fill out the form correctly.
- Begin by entering the injured worker's name at the top of the form.
- Next, provide the attorney's name in the designated field.
- Fill in the claim number accurately. Double-check this number to ensure it matches your records.
- Enter the representative ID number if applicable.
- Complete the section that specifies the date of the application, request, motion, or order in the format of MM/DD/YYYY.
- In the compensation section, check all that apply from the list provided, including options like temporary total, wage loss, and permanent total disability.
- Sign the form in the injured worker’s/claimant’s signature section.
- Finally, write the date of your signature.
After completing the form, it is important to file it promptly to ensure compliance with the deadlines outlined. Ensure that you keep a copy for your records and submit the original to the appropriate office. This will help facilitate the payment process and ensure that your attorney receives the necessary compensation on your behalf.
Common mistakes
Completing the C 230 Ohio form can seem straightforward, but many individuals make critical mistakes that can delay their workers' compensation claims. One common error is failing to fill out the form in its entirety. Each section is designed to gather essential information, and omitting even a single detail can lead to complications. It's crucial to double-check that all required fields are completed, especially the claim number, which serves as a unique identifier for the case.
Another frequent mistake involves submitting multiple authorizations for the same claim without understanding the requirement for separate forms. Each application, motion, or order necessitates its own authorization. If a person mistakenly submits one form for multiple requests, it may not be honored by the Bureau of Workers' Compensation (BWC). This misunderstanding can lead to unnecessary delays in receiving payments.
Timeliness is also a significant factor. Many individuals neglect to file the authorization within the specified time limits. For instance, the form must be submitted prior to or at the hearing, or before the payment date. Missing these deadlines can result in the BWC rejecting the authorization outright. Therefore, it's vital to be aware of the timelines associated with different types of compensation.
Another common pitfall is altering the form without initialing the changes. If modifications are made to the C 230 form, the party making the changes must initial them to indicate acceptance. Failure to do so can lead to the BWC deeming the form invalid. This mistake often arises from a lack of understanding about the importance of maintaining the integrity of the document.
People often overlook the necessity of specifying the date of the application, request, motion, or order on the form. This detail is not merely a formality; it provides context for the authorization and helps the BWC process the claim efficiently. Omitting this information can create confusion and may result in delays or denials of benefits.
Additionally, individuals sometimes misinterpret the scope of the authorization. The form explicitly states that it does not grant the attorney the authority to cash or endorse checks on the injured worker's behalf. Misunderstanding this limitation can lead to frustration and complications in the payment process. It's essential to read and comprehend all parts of the form carefully.
Lastly, many individuals fail to recognize that the authorization is only valid for 18 months from the date of their signature. If the form is submitted after this period, it will be considered invalid. Keeping track of this timeframe is essential to ensure that the authorization remains in effect and that payments are received promptly.
FAQ
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What is the purpose of the C 230 Ohio form?
The C 230 Ohio form is used to authorize the Bureau of Workers' Compensation (BWC) to send workers' compensation payments directly to an attorney representing an injured worker. This ensures that the attorney receives the compensation payments related to the worker's claim.
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What information is required to complete the C 230 form?
To complete the C 230 form, you must provide the following details:
- The injured worker's name
- The attorney's name
- The claim number
- The representative ID number
Additionally, you must specify the date of the application, request, motion, or order, as well as check all applicable types of compensation.
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What are the time limits for filing the C 230 form?
The C 230 form must be filed prior to or at the hearing and before the payment of compensation for most claims. For claims related to permanent partial compensation (C-92), it must be filed with the application or agreement, at the hearing, or after the hearing but before the order is mailed. It is crucial to adhere to these time limits to ensure the authorization is valid.
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How long is the C 230 authorization valid?
The authorization provided in the C 230 form is valid only for 18 months from the date of the injured worker's signature. If the authorization is not filed within this timeframe, it will be considered invalid. Furthermore, the authorization does not remain in effect after the BWC has paid the awarded amounts unless there is a subsequent hearing, appeal, or reconsideration.