Disability (PTD) and Disabled Workers’ Relief Fund (DWRF)
through 4123.417; 4123.58; 4123.62
Percy, Chief of Operational Policy, Analytics & Compliance
Management policies, directives and memos regarding PTD and DWRF that predate
the effective date of this policy.
The purpose of
this policy is to ensure that BWC calculates and pays permanent total
disability (PTD) compensation and Disabled Workers’ Relief Fund (DWRF) benefits
in compliance with the Ohio Revised Code and the Ohio Administrative Code.
applies to all field staff.
Relief Fund: A
fund, separate from the state fund, established to provide supplemental
benefits to injured workers (IW) who are receiving PTD compensation when the
total of the PTD compensation plus the social security disability (SSD) benefit
is less than the DWRF eligibility amount.
The threshold amount, adjusted annually based on the consumer price index, used
to determine an IW’s eligibility for DWRF benefits and established by the BWC DWRF
Unit and BWC’s Actuarial Department.
Compensation granted to an IW for the duration of his/her life when the Industrial
Commission of Ohio (IC) determines that the IW is unable to perform any sustained
remunerative employment or is statutory PTD as defined in R.C. 4123.58.
amount of the weekly PTD compensation payable to an IW prior to reduction for
repayment of any lump sum advancement (LSA).
PTD with SSD
maximum rate: For
IWs receiving SSD benefits, a rate equal to 2/3 of the statewide average weekly
wage (SAWW) for the date of injury, also known as the PTD offset rate.
SSD maximum rate:
For IWs not receiving SSD benefits, a rate equal to the SAWW for the date of
rate: A rate
equal to ½ of the SAWW for the date of injury, unless the average weekly wage
(AWW) for the claim is less than that amount; in that case, the PTD rate is
equal to the AWW.
weekly PTD benefit BWC pays to an IW; calculated by subtracting the amount being
collected to recoup any LSA(s) from the PTD declared rate.
Social security crossmatch: The
electronic receipt of information from the Social Security Administration (SSA)
which provides the name, date of birth, date of death (if applicable) and social
security benefits received (if any) associated with an SSN, used by BWC to
validate information in the claim file and/or to calculate temporary total compensation
(TT), permanent total disability (PTD) and/or Disabled Workers’ Relief Fund
(DWRF) payment rates.
Benefits paid by the SSA to persons who cannot work because they have a medical
condition that is expected to last at least one year or result in death.
BWC uses the SSD amount prior to any reduction for Medicare benefits in calculation
of PTD and/or DWRF. SSD is not used in the calculation of TT.
retirement (SSR): Benefits
paid by the SSA to persons who have met the eligibility requirements. SSR
benefits may begin as early as a person’s sixty-second birthday. SSD
benefits automatically convert to SSR at the person’s full retirement
age. BWC does not use SSR benefits in the calculation of PTD and/or DWRF,
but may use it in the calculation of TT.
Split PTD: PTD compensation
allocated by the IC to more than one claim for an injured worker.
The percentage for each claim is used to calculate the amount payable per
Statutory PTD: PTD compensation
payable based on the loss or loss of use of both hands or both arms, or both
feet or both legs, or both eyes, or of any two thereof.
When PTD is split among two or more claims, the total amount when the declared rate
for all claims in the split are added together.
intended to replace an IW’s earnings. This includes temporary total (TT),
living maintenance (LM), living maintenance wage loss (LMWL), wage loss
(working and non-working) (WL), PTD and salary continuation (SC).
security disability rate – DWRF (SSD-DWRF): The SSD amount used for calculation of
DWRF benefits. The rate is determined by the monthly SSD amount for the
time period being paid multiplied by 12 and divided by either 365 days, or 366
days in a leap year, and then multiplying the result by seven. This rate
is recalculated whenever there is a change in the SSD rate.
security disability rate – PTD (SSD-PTD): The SSD amount used for the calculation of
PTD compensation. For the initial payment of PTD the rate is determined by the
monthly SSD amount as of the PTD begin date being multiplied by 12 and
divided by 52. This rate is recalculated if the SSD decreases below the rate on
the PTD begin date, begins after the PTD begin date, changes from SSD to SSR,
or ends for another reason.
compensation amount (WWCA): A component of the PTD declared rate calculation that is
calculated as follows:
1. If 2/3 of the AWW is greater
than or equal to the PTD with SSD maximum rate, the PTD with SSD maximum rate
is the WWCA; or,
2. If the AWW is less than the
PTD minimum rate, the AWW is the WWCA; or,
3. If the AWW is greater than or
equal to the PTD minimum rate, but 2/3 of the AWW is less than the PTD minimum
rate, the PTD minimum rate is the WWCA; or,
4. If 2/3 of the AWW is more
than the PTD minimum rate, but less than the PTD with SSD maximum rate, 2/3 of
the AWW is the WWCA, not to exceed the PTD without SSD maximum rate.
A. It is the policy of BWC to
pay PTD compensation as ordered by the IC.
1. Payment shall be made:
a. Upon BWC’s receipt of a staff
hearing officer (SHO) order granting PTD compensation after a hearing;
b. Upon receipt of a waiver to
the objection period for a tentative order (TO) granting PTD compensation; or,
c. At the end of the objection
period for a TO granting PTD compensation with no objection having been filed.
2. BWC shall not pay PTD based
on an Agreement as to Award for Permanent Total Disability (IC-22), but
shall wait for an order from the IC to make payment.
3. BWC shall continue to pay PTD
compensation until the death of the IW or until BWC receives an IC order
4. BWC shall continue to pay PTD
to IWs who have been found PTD as the result of a traumatic brain injury and
who return to work in a sheltered workshop and who earn $2000 or less in any
5. It is the policy of BWC to
refer the issue of PTD suspension to the IC when the IW is incarcerated.
For additional information, refer to the Incarceration policy.
B. When an application for PTD
is pending with the IC, it is the policy of BWC to:
1. Process requests for TT
compensation (e.g., extending payment, make determination of IW having reached
maximum medical improvement);
2. Process an Application for
Determination of Percentage of Permanent Partial Disability or Increase of Permanent
Partial Disability (C-92) filed prior to the IC-2 filing date;
3. Suspend processing of a C-92 application
filed after the IC-2 filing date;
4. Process requests for the
allowance of additional conditions filed prior to the IC-2 filing date;
5. Suspend requests for the
allowance of additional conditions filed after the IC-2 filing date; and,
6. Process any Settlement Agreement
and Application for Approval of Settlement Agreement (C-240), regardless of
the filing date.
C. Statutory PTD
1. Depending on the date of
injury, BWC may refer a claim to the IC for the finding of statutory PTD when
BWC or the IC has granted, by final order, the loss or loss of use of both
hands, both arms, both feet, both legs, both eyes, or any combination of these.
a. For claims with dates of
injury on or after 08/25/06, the loss or loss of use of a single limb does not
constitute the loss of two body parts for purposes of determining statutory
PTD. For example, the loss of the arm does not constitute the loss of the
hand and the loss of the arm.
b. For claims with dates of
injury prior to 8/25/06 the loss or loss of use of a single limb constitutes
the loss of two separate entities of the limb. For example, the loss of
the arm constitutes the loss of the hand and the loss of the arm.
c. The standard for total loss
of vision for statutory PTD is greater than the standard for scheduled loss (State ex rel. Szatkowski v. Indus.
For example, an IW
may receive scheduled loss for 100% loss of vision but have some vision with correction.
Vision with correction may negate the IW’s eligibility for statutory PTD.
BWC staff shall staff
with a BWC attorney for questions regarding loss of vision and possible eligibility
for statutory PTD.
2. BWC shall refer requests for
statutory PTD filed by the IW to the IC for determination.
3. IWs who are statutorily PTD
may return to work and continue to receive PTD compensation. It is the
policy of BWC:
a. To not pay any type of wage
replacement compensation, except LM as noted in b. below, in a claim where the
IW was found to be statutorily PTD; and
b. For IWs who have been found
to be statutorily PTD and who enter into a vocational rehabilitation plan in
which LM is to be paid, to suspend payment of PTD while LM is being paid.
4. IWs who are statutorily PTD
may have claims other than the one in which the IW was found to be statutorily
PTD. It is the policy of BWC:
a. To pay TT or LM, as
appropriate, in claims other than the one in which the IW was found to be statutorily
b. To pay WL or LMWL, as
appropriate, in the claims other than the one in which the IW was found to be
statutorily PTD so long as the wage loss is caused by conditions other than
those which are the basis for statutory PTD.
D. PTD Declared Rate
1. BWC shall calculate the PTD
declared rate by combining the SSD-PTD weekly rate with the WWCA.
a. If the AWW is below the PTD
minimum rate, the AWW is the PTD declared rate; or,
b. If the AWW is above the PTD
minimum rate, but 2/3 of the AWW is under the PTD minimum rate, the PTD minimum
rate is the PTD declared rate; or,
c. If 2/3 of the AWW is above
the PTD minimum rate, but below PTD with SSD maximum, 2/3 of the AWW is the PTD
declared rate; or
d. If 2/3 of the AWW is above
the PTD with SSD maximum rate, SSD benefits must be considered to determine the
If the total of the
SSD weekly rate and the WWCA is above the SAWW for the DOI, the PTD declared
rate is the PTD with SSD maximum rate for the DOI; or,
If the total of the
SSD weekly rate and the WWCA is below the SAWW but greater than or equal to 2/3
of the SAWW, the PTD declared rate is 2/3 of the AWW, not to exceed the WWCA.
2. External customers may access
the PTD Rate Calculation Worksheet on bwc.ohio.gov on the “Tools for
Representatives” page; BWC staff may access the worksheet on the internal
Claims On-line Resource (COR).
3. No type of retirement benefit
will be considered when calculating the PTD declared rate.
4. BWC does not recalculate the
PTD declared rate when SSD increases. BWC only recalculates the PTD declared
a. The AWW in the claim changes;
b. The SSD rate decreases to a
rate lower than the IW was receiving on the PTD begin date; or,
c. The IW begins receiving SSD;
d. The IW stops receiving
E. PTD Payments
1. BWC shall pay PTD less other
wage replacement compensation and/or percentage of permanent partial impairment
paid over the same period.
2. The initial accrued payment
of PTD may be issued in care of the injured worker’s representative if a
properly completed Authorization to Receive Workers’ Compensation Check (C-230)
has been submitted prior to the initial payment. For additional information,
refer to the Authorization to Receive Workers’ Compensation Payment policy.
3. Multiple claims: When the IC
orders that PTD is to be paid in more than one claim, BWC shall calculate the
PTD rate for each claim individually and then apply the split percentage
ordered by the IC to determine the declared rate for each claim.
4. PTD payments, both accrued in
the past and scheduled biweekly into the future, shall be subject to weekly
family support withholding.
a. Accrued PTD payments are not
subject to lump sum processing for child support.
b. Refer to the Family Support
policy for additional information
5. PTD payments shall be subject
to collection of overpayments. Refer to the Adjustment of Compensation
policy for additional information.
F. BWC shall publish the initial
PTD declared rate in the original DWRF eligibility order.
G. BWC shall issue an order when
the PTD rate is changed, and shall include the PTD declared rate in subsequent
H. Injured workers may receive a
LSA from future PTD compensation. For additional information, refer to
the Lump Sum Advancement policy.
V. POLICY ON DWRF
A. It is the policy of BWC to:
1. Determine an IW’s eligibility
for DWRF benefits in state-funded and self-insured claims at the time PTD
compensation is granted; and,
2. If DWRF benefits are to be
awarded, pay those benefits in both state-funded and self-insured claims; and,
3. Bill self-insured employers
for the DWRF benefits paid in self-insured claims and in state-funded claims
where the employer is now self-insured for payments made after the employer
B. To receive DWRF benefits:
1. An IW must be receiving PTD
2. It is not necessary for an IW
to file an application. BWC will proactively determine if the IW is eligible to
receive the benefits.
C. BWC shall request from the
SSA information regarding benefits SSA is paying to the IW so that BWC can
either include or exclude those benefits from the DWRF benefit calculation.
1. SSD benefits are included in
the calculation of DWRF benefits.
2. SSR benefits are not included
in the calculation of DWRF benefits.
3. Widow’s benefits or other
benefits received by the IW under another person’s social security number are
not considered in the calculation of DWRF benefits.
D. DWRF Payments
1. BWC shall calculate DWRF
benefits as follows:
a. Add the total PTD declared
rate to the weekly SSD-DWRF rate.
b. Compare the total of a. above
to the DWRF eligibility amount. If the total is less than the DWRF
eligibility amount, the IW is entitled to DWRF benefits.
c. If the IW is entitled to DWRF
benefits, the DWRF rate is the lesser of the following calculations:
The DWRF eligibility
amount minus the total PTD declared rate; or,
The DWRF eligibility
amount minus the weekly SSD-DWRF rate.
d. For example:
eligibility amount for the current year is $350.
The IW’s PTD declared
rate is $100 per week and SSD-DWRF rate is $150 per week.
iii. The two rates combined equal
$250, which is below the DWRF eligibility amount for the current year, so the
IW is eligible for DWRF benefits.
iv. To calculate the DWRF weekly
rate the following comparison is made:
a) $350 (DWRF eligibility
amount) - $100 (PTD declare rate) = $250; and,
b) $350 (DWRF eligibility
amount) - $150 (SSD DWRF rate) = $200.
v. The DWRF rate is the lesser
of the two, or $200.
e. If PTD is split across
multiple claims, the DWRF amount is allocated across claims based on the split
PTD percentages. For example:
The IC has split
PTD across three claims, allocating 20% in claim one, 30% in claim two and 50% in
claim three; and,
The DWRF amount for
the IW is $200 per week; then
iii. BWC shall pay $40 in claim
one ($200 times 20%); $60 in claim two ($200 times 30%) and $100 in claim three
($200 times 50%).
2. BWC shall re-evaluate DWRF
eligibility and payment rate for IWs receiving PTD compensation when:
a. The PTD rate is changed; or,
b. The IW begins receiving SSD
c. The IW’s SSD-DWRF weekly rate
d. The IW stops receiving SSD
e. The DWRF eligibility amount
changes, usually January 1 each year.
3. BWC shall not make payment in
care of an IW’s attorney based on an Authorization to Receive Workers’
Compensation Check (C-230) or for any other request for fees to an attorney
or anyone who represented or assisted the IW in receiving DWRF benefits.
4. BWC shall not withhold any
amount from DWRF benefits for family support orders. DWRF benefits are not compensation,
but rather are a supplemental award, and therefore are not subject to family
support order withholding.
E. It is BWC’s policy to issue
an order to provide notice of the decision regarding DWRF benefits when the
initial evaluation is complete and anytime DWRF benefits change.
F. IWs may not receive a LSA
from future DWRF benefits. For additional information, refer to the Lump
Sum Advancement policy.
G. It is BWC’s policy to
calculate settlement of DWRF benefits separate from the settlement amount of
other portions of a claim as detailed in BWC’s Lump Sum Settlement policy.
H. DWRF Overpayments
1. If an overpayment of DWRF
benefits is identified, it is the policy of BWC to refer claim to the IC for:
a. The IC to determine if the IW
is overpaid; and,
b. To determine if the overpayment
will be collected from the IW.
2. If the IC determines that the
overpayment is to be collected, it is the policy of BWC to collect DWRF
overpayments only from future DWRF benefits according to Hearing Officer Memo
S2 – Overpayment Policy.
may refer to the corresponding procedure for this policy entitled “Procedure for
Permanent Total Disability (PTD) and Disabled Worker’s Relief Fund (DWRF)” for