Maintenance Wage Loss
4121.67; O.A.C. 4123-18-21; 4125-1-01
Percy, Chief of Operational Policy, Analytics & Compliance (Signature on
#CP-12-02, effective 05/12/14
purpose of this policy is to ensure that BWC properly pays living maintenance wage
loss (LMWL) to eligible injured workers (IW).
policy applies to field staff.
Suitable employment in which the IW’s weekly rate of pay is equal to, or
greater than, the IW’s average weekly wage (AWW).
wage received while employed: The IW’s present earnings (actual weekly
earnings which are generated by gainful employment). It is a rebuttable
presumption that earnings from paid leave provided by the employer will be
included in present earnings.
return to work:
When the IW has returned to work within sixty days of closure of the IW’s
approved vocational rehabilitation plan, and the employment:
the physical and/or psychiatric limitations caused by the impairments resulting
from the allowed conditions in the claim in which the IW completed the
vocational rehabilitation plan, as documented by the IW’s physician of record,
in comparison with the return to work goals of the vocational rehabilitation
plan completed by the IW.
Work which is within the IW’s restrictions, and which may be performed by the
IW subject to all physical, psychiatric, mental, and vocational limitations to
which the IW was subject on the date of the injury, or on the date of
disability in occupational disease claims.
limitation of income: When an IW chooses to limit his or her income, by choosing
to work fewer hours or at wages below reasonable expectations for personal
reasons, as opposed to reasons related to the allowed conditions in the claim.
A. It is the policy of BWC
to provide LMWL payments to an IW who:
1. Has a date of injury on
or after August 22, 1986;
2. Completes an approved
vocational rehabilitation plan;
3. Successfully returns to
work within 60 days of closure of the IW’s vocational rehabilitation plan; and
4. Experiences a wage loss
while employed, as a consequence of the physical and/or psychiatric limitations
resulting from the allowed conditions of the claim.
B. It is the policy of BWC
to require an IW requesting LMWL payments to submit to BWC:
1. An application on an Authorization
for Living Maintenance Wage Loss (RH-18) or equivalent; and
2. Medical documentation
of the IW’s physical and/or psychiatric limitations resulting from the allowed
conditions of the claim as documented by the IW’s physician of record on a Physician’s
Report of Work Ability (MEDCO-14) or equivalent.
C. It is the policy of BWC
to send a notification letter to all parties of the claim of the IW’s
eligibility or non-eligibility for LMWL, which will include:
1. Any expectations for
2. Requirements for submitting
documentation to receive ongoing payments;
3. Any finding that the IW
has voluntarily limited his/her income and the resulting calculation of LMWL;
4. Notice of the limited
duration of LMWL; and
5. Language advising the
parties of the right to appeal the decision to the BWC Rehabilitation
Eligibility Appeal Unit within fourteen (14) days of the receipt of the letter.
D. BWC Requirements for
Documentation and Calculation of LMWL
1. BWC requires that the
IW provide proof of present earnings for the weeks the IW is requesting LMWL.
Proof of present earnings includes, but is not limited to:
a. Pay stubs;
b. Payroll reports; or
c. A Report of Earnings
for Living Maintenance Wage Loss (RH-94A) or equivalent, signed by the IW.
2. BWC will calculate the
amount of LMWL at sixty-six and two-thirds (66 2/3) percent of the difference
between the greater of the IW’s full weekly wage (FWW) or AWW for the claim in
which the IW participated in the vocational rehabilitation plan; and the weekly
wage (present earnings) the IW is receiving while employed.
3. Present earnings
a. Present earnings
payments, including stock given as a bonus;
holiday differential pay;
sharing paid to employees as payroll;
& Travel Allowance – if not paid as a reimbursement of expense;
replacement program fully funded by the employer, (i.e., long-term disability).
b. Present earnings do not
include payment of any kind funded in whole or part by the IW.
c. Self-employed present
earnings are the IW’s gross income minus expenses.
d. The Wages policy
may be referenced for further information regarding what is included and
excluded from present earnings.
4. If the IW voluntarily
limits his or her income by restricting the number of hours worked, or by
working at a wage below reasonable expectations when more appropriate jobs are
reasonably available, BWC will calculate the IW’s LMWL at:
a. Sixty-six and
two-thirds (66 2/3) percent of the difference between the greater of the IW’s
FWW or AWW for the claim in which the IW participated in the vocational rehabilitation
b. The income the IW would
have earned if he or she had not voluntarily limited his or her income.
5. BWC shall pay LMWL at
the amount calculated in section D.2. of this policy unless the
calculated amount exceeds the statewide average weekly wage (SAWW), in
which case BWC shall pay LMWL at the SAWW.
6. The IW must notify BWC
prior to changing jobs to determine if the change will result in a voluntary
limitation of income.
E. Ongoing Submission
1. It is the policy of BWC
that the IW submit subsequent applications for LMWL before the specified
end-date of the restrictions provided by the IW’s physician of record, or every
six months, whichever occurs first.
2. The IW must submit
proof of present earnings:
a. No less than every four
b. Quarterly, if the IW
has a substantial variation in income with a copy of his or her Federal
Estimated Tax for Individuals (1040-ES) quarterly payment voucher, if
3. It is the policy of BWC
to require the IW to make a good faith effort to search for more suitable
employment which is comparably paying work if:
a. The IW is in a job that
is below the reasonable expectations of the return to work goals of the
vocational rehabilitation plan; or
b. If the IW can
reasonably be expected to obtain different employment, for which earnings are
more comparable to those prior to the injury.
1. BWC will issue LMWL
payments following submission of proof of earnings.
2. Payments may continue
for up to a maximum of two hundred (200) weeks. The number of weeks an IW may
receive LMWL will be reduced by the number of weeks the IW receives wage loss,
pursuant to R.C. 4123.56(B).
3. LMWL will not be paid
when the IW is participating in a gradual return to work program, even if no
living maintenance is paid during the gradual return to work.
G. BWC may pay LMWL
retroactively if the IW did not receive working wage loss while participating
in vocational rehabilitation-related:
1. Transitional work;
2. On-the-job training;
3. Employer incentive; or
BWC staff may refer to
the corresponding procedure for this policy entitled “Procedure for Living Maintenance
Wage Loss” for further guidance.