Total Disability (PTD) and Disabled Workers’ Relief Fund (DWRF)
4123.411 through 4123.417; 4123.58; 4123.62
Percy, Chief of Operational Policy, Analytics & Compliance
Injury Management policies, directives and memos regarding PTD and DWRF that
predate the effective date of this policy.
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
policy applies to all field staff.
Workers’ 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.
The amount of the weekly PTD compensation payable to an IW prior to reduction
for repayment of any lump sum advancement (LSA).
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.
without SSD maximum rate: For IWs not receiving SSD benefits, a rate equal
to the SAWW for the date of injury.
minimum 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.
The 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.
security disability (SSD): 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.
security 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.
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
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.
PTD declared rate:
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.
Replacement Compensation: Compensation 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
social 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.
social 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.
worker’s 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
POLICY ON PTD
A. It is the policy
of BWC to pay PTD compensation as ordered by the IC.
1. Payment shall be
a. Upon BWC’s receipt
of a staff hearing officer (SHO) order granting PTD compensation after a
b. Upon receipt of
a waiver to the objection period for a tentative order (TO) granting PTD compensation;
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 terminating PTD.
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 calendar quarter.
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
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;
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;
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
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. Comm).
i. 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
ii. 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
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 PTD; and,
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
1. BWC shall
calculate the PTD declared rate by combining the SSD-PTD weekly rate with the
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 PTD rate:
i. 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,
ii. 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
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 rate when:
a. The AWW in the
claim changes; or,
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; or,
d. The IW stops
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
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 DWRF orders.
H. Injured workers
may receive a LSA from future PTD compensation. For additional information,
refer to the Lump Sum Advancement policy.
V. POLICY ON
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;
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 became self-insured.
receive DWRF benefits:
1. An IW must be
receiving PTD compensation.
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
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
i. The DWRF
eligibility amount minus the total PTD declared rate; or,
ii. The DWRF
eligibility amount minus the weekly SSD-DWRF rate.
d. For example:
i. The DWRF eligibility
amount for the current year is $350.
ii. 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:
i. The IC has split
PTD across three claims, allocating 20% in claim one, 30% in claim two and 50%
in claim three; and,
ii. 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
a. The PTD rate is
b. The IW begins
receiving SSD benefits; or,
c. The IW’s SSD-DWRF
weekly rate changes; or,
d. The IW stops
receiving SSD benefits; or,
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
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
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
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.
staff may refer to the corresponding procedure for this policy entitled “Procedure
for Permanent Total Disability (PTD) and Disabled Worker’s Relief Fund (DWRF)”
for further guidance.