of Overpaid Compensation
Reference: Industrial Commission of Ohio (IC)/Ohio Bureau of Workers’
Compensation (BWC) Joint Resolution R89-3-27
Percy, Chief of Operational Policy, Analytics and Compliance (Signature on
Injury Management policies, directives and memos regarding adjustment of overpaid
compensation that predate the effective date of this policy
purpose of this policy is to ensure that compensation is entered and adjusted correctly
in the claims management system when compensation is overpaid, and overpayments
are collected according to Ohio law and applicable case law.
policy applies to BWC Field Operations staff.
individual seeking workers’ compensation benefits, typically the injured
worker (IW) or a dependent of a deceased IW.
purposes of this policy, when the claimant, including IW, employer, and BWC take
action on a compensation decision in the claim based on the belief that all
relevant and necessary information was available at the time the decision was
made, and all parties were acting reasonably and with an honest belief that
compensation was lawfully due.
A. It is BWC’s policy
to adjust compensation when:
1. A claimant’s full
weekly wage (FWW) and/or average weekly wage (AWW) are reset (refer to the Wages
policy for more information regarding FWW and AWW); or
2. A claimant
receives compensation that he/she is no longer entitled to receive.
B. It is BWC’s policy
to adjust payment of compensation and, if applicable, collect an overpayment from
any past, present, or future workers’ compensation claims according to Ohio
1. The claim meets
the criteria for non-collection, as outlined in this policy;
2. The overpayment is
waived in a lump sum settlement agreement; or
3. The IC has
C. BWC may not
collect an overpayment when field staff, in consultation with a BWC attorney, determines
that the claimant, employer and BWC all believed, in good faith, at the time
the payments were made, that compensation was lawfully due.
1. When an
overpayment is created by some means other than a reversal, upon appeal, of a
decision to pay compensation (e.g., duplicate payment, wage adjustment, etc.), BWC
is not bound by R.C. 4123.511(K); however, it is BWC’s policy to recoup the overpayment
according to R.C. 4123.511(K) as this recoupment method is reasonable to
recover overpaid funds.
2. It is BWC’s policy
a. An overpayment from
any amount of compensation the claimant may receive in any past, present, or
future claim in accordance with Ohio law, even if the claimant has arranged to
make payments to BWC’s Collection Department to reduce the overpayment; and
according to the percentages listed in the chart on www.bwc.ohio.gov titled
“Absorption Rates for Overpayments.”
and external customers may refer to BWC Library/About BWC/Tools for Authorized
Reps/Resources to locate the chart on www.bwc.ohio.gov.
ii. Internal customers
will find the chart on Claims Online Resources (COR)/Adjustment of Overpaid Compensation/Tips
3. BWC will not
absorb an overpayment from the first 12 weeks of payment of temporary total
compensation (TT), except when the overpayment is due to a finding of fraud,
but will absorb the overpayment following payment of the first 12 weeks of TT.
4. Refer to the Overpayment
of Compensation policy on www.bwc.ohio.gov for more
information regarding overpayments.
1. When the Court of
Common Pleas issues a decision that reverses a previous BWC or IC claim
allowance or compensation payment decision, it is BWC’s policy to seek recovery
of any compensation paid (set the IW up overpaid).
2. When an appeal on
the allowance of the claim or payment of compensation is filed and the Court of
Appeals or the Supreme Court reverses the appealed decision, BWC will not seek recovery
of any compensation paid (IW is not set up overpaid), except for claims
assigned to a public employer-state (PES).
a. The employer’s
risk will be adjusted, if compensation has been paid; and
b. Any overpayment
that occurs due to the reversal of the claim allowance or compensation payment will
be charged to the Surplus Fund.
c. For claims
assigned to a PES employer:
employer’s risk will not be adjusted; and
ii. Any overpayment
that occurs due to the reversal of the claim allowance or compensation payment
will not be charged to the Surplus Fund.
3. Refer to the Orders,
Waivers, Appeals and Hearings policy on www.bwc.ohio.gov for more
information regarding appeals to court.
is BWC’s policy to send periodic notice to the claimant when a subsequent reduction
is made to a declared overpaid balance due to the receipt of a personal check,
returned warrant, or issuance of an award for a new period of compensation.
of travel expenses is a reimbursement of previously paid expenses, not a form
of compensation; therefore, BWC will not collect compensation overpayments from
travel expense reimbursement. Refer to the Travel Reimbursement policy
and procedure for more information regarding reimbursement of travel expenses.
claimant may contact BWC’s Collections Department to set up a schedule of
payments to reduce the overpayment.
1. The claimant may
send payments for non-fraud collections to:
Ohio Bureau of
P. O. Box 89492
Cleveland, OH 44101-6492.
2. Fraud collections
are to be sent to:
Ohio Bureau of
P.O. Box 15187
3. A check(s) or
money order(s) must be payable to Ohio Bureau of Workers’ Compensation or BWC.
BWC staff may
refer to the corresponding procedure for this policy entitled “Adjustment of Overpaid
Compensation” for further guidance.