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OhioBWC - Basics: (Policy library) - File

Transitional Work Grants

 

Policy Name:

Transitional Work Grants

Policy #:

EP-20-01

Code/Rule Reference:

OAC 4123-17-55, 4123-6-01.

Effective Date:

July 1, 2016

Origin:

Employer Policy

Supersedes:

All EM policies and procedures regarding the transitional work grants process that predate the effective date of this policy.

History:

Revised December 29, 2016; May 5, 2015; April 21, 2014. New policy issued October 30, 2013.

Review Date:

July 1, 2021

 

 

I.       Policy Purpose

 

The Ohio Bureau of Workers’ Compensation (BWC) will provide Transitional Work Development Grants to eligible employers in accordance with the applicable laws and rules.

 

II.     Applicability

 

This policy applies to employers, employer authorized representatives, BWC Employer Programs, BWC Transitional Work Unit, and transitional work developers.

 

III.    Definitions

A.     Transitional work: A work-site program that provides an individualized interim step in the recovery of an injured worker with job restrictions resulting from the allowed conditions in the claim. Developed in conjunction with the employer and the injured worker, or with others as needed, including, but not limited to the collective bargaining agent (where applicable), the physician of record, rehabilitation professionals, and the managed care organization (MCO), a transitional work program assists the injured worker in progressively performing the duties of a targeted job. OAC 4123-6-01(AA)

B.     Transitional work developer: The provider who develops the employer’s transitional work program. OAC 4123-17-55(A)(6)

IV.   Policy

A.     Eligibility Criteria: To qualify for the program the employer must be a state-fund private employer (PA) or public employer taxing district employer (PEC). The employer must meet the following eligibility criteria:

1.     At the time BWC reviews the employer’s grant application, the employer must:

a.     Be current with respect to all payments due BWC, as defined in OAC 4123-17-14.

b.     Be in an active policy status. “Active policy status” does not include an employer with a coverage status of “no coverage” or “lapsed.”

2.     The employer cannot have cumulative lapses in workers’ compensation coverage in excess of forty (40) days within the twelve (12) months preceding the application date. Employers applying online will only be allowed to complete their application if they meet this requirement.

3.     As of the application date, the employer must timely report actual payroll for the preceding policy year and pay any premium due upon reconciliation of estimated premium with actual premium. An employer will be deemed to have met this requirement if BWC receives the payroll report and the employer pays premium associated with such report before the expiration of any grace period. See the Payroll True-Up policy for additional information.

4.     The employer must continue to meet all eligibility requirements listed in sections IV.A.1 to IV.A.3 of this policy during its participation in the program.

5.     An employer is eligible for no more than one transitional work grant per policy number.

6.     An employer who previously received a grant from BWC for transitional work program development under its own policy number, or a predecessor’s policy number, is not eligible to receive another grant. However, BWC may provide direct assistance to the employer to update its transitional work program developed with a previous transitional work grant.

7.     BWC has final authority to determine the employer’s eligibility for the grant and to determine the amount of the grant.

8.     The following employers are not eligible to receive a Transitional Work Grant:

a.     State agencies.

b.     Self-insuring employers.

c.      Employers paying only the minimum administrative charge for the applicable payroll reporting period.

d.     Employers who have elective coverage only.

e.     Sole proprietors with zero payroll.

B.     Application Requirements / BWC evaluation of application.

1.     An employer that wishes to apply for a Transitional Work Grant can utilize BWC’s web site www.bwc.ohio.gov, or submit an Application for Transitional Work Grant Program (TWG-1).

2.     The employer’s application must be signed by the chief executive officer or designated management representative certifying the employer will comply with all program requirements.

3.     An employer that has multiple policy numbers must disclose all policy numbers associated with the business to BWC on the application.

4.     Generally, grant applications will be processed on a first come, first serve basis.

5.     An employer who submits inaccurate information in its application may be subject to civil and criminal penalties.

6.     See Medical Policy’s Transitional Work Developer; Transitional Work Grant & Transitional Work Bonus policy for additional information.

C.    Operation of program.

1.     BWC may prioritize a grant application for an employer with eleven (11) or more employees, as reported on the employer’s last payroll report.

a.     BWC is unable to complete the processing of an employer’s Transitional Work Grant application if the number of employees was not reported on the employer’s last payroll report. However, if the employer subsequently updates the number of employees for its last payroll report, BWC may resume processing the employer’s grant application.

b.     If the employer applies for a Transitional Work Grant online, it will not be able to complete the online application if it did not report number of employees on its last payroll report.

2.     If multiple policy numbers are involved, BWC will work with the employer and transitional work developer to develop a transitional work plan at a corporate level.

3.     BWC may approve an associated policy number for grant monies based on corporate organization. The associated policy number must submit an application and meet all Transitional Work Grant eligibility requirements under its own policy number.

4.     BWC will notify the employer of grant approval and the maximum amount of the grant prior to expenditure by the employer.

5.     If an employer applies for a grant and meets the eligibility criteria, but funding is not available, BWC will notify the employer.

a.     The employer does not need to reapply for the grant.

b.     Upon the availability of funding, BWC will process the employer’s application.

c.      BWC will reevaluate the employer to determine if it continues to meet all eligibility requirements for a Transitional Work Grant.

6.     BWC will notify employers whose Transitional Work Grants were denied. An employer BWC determined to be ineligible may reapply for a grant when ineligibility is addressed.

7.     If the employer does not use all the funding BWC approved, it may subsequently submit transitional work services for reimbursement until its individual grant limit is reached, as long as BWC has Transitional Work Grant funding available.

8.     The employer must have and maintain continuous active state fund coverage for a period of one year from the date BWC disburses the grant funds. BWC may recover the entire grant if the employer fails to maintain coverage as required.

D.    Removal / exit from program.

1.     If for any reason the employer participating in the program fails to satisfy the requirements of the program in a timely manner, the employer may be disqualified from the Transitional Work Grant Program.

2.     BWC may require an employer disqualified from the Transitional Work Grant Program to reimburse BWC up to the full amount of the grant.

3.     If the employer uses grant monies for some other purpose, it must immediately return the full amount to BWC and BWC reserves the right to recover the grant money.

4.     BWC will consider the grant money misappropriated if an employer fails to implement the program within one year of receiving a grant and require the employer to repay the amount of the grant immediately.

5.     Methods BWC may use to recover grant money include:

a.     Billing the employer.

b.     Set-off.

c.      Recoupment.

d.     Forwarding the matter to the Ohio Attorney General for collection.

e.     Any other means as provided by law.

E.     Resolution of complaints.

1.     Employer complaints should be processed under the General Employer Complaint Policy. BWC has not identified any program-specific extenuating circumstances that apply to the Transition Work Grant Program.

2.     Employer complaints filed due to program eligibility issues (e.g. lapse days, coverage status, True-Up) will be addressed by the Employer Programs Unit. Employer complaints filed due to transitional work plan issues (e.g. the amount of the employer’s grant, reimbursement for transitional work services) will be addressed by the Transitional Work Unit.

F.     Scenarios.

1.     The employer received a transitional work grant from BWC. Subsequently, an injured worker filed a lost-time claim. Is the employer required to offer transitional work to the injured worker?

 

Answer: No. This is not a condition of the grant program.

 

2.     The employer paid for transitional work services prior to applying for the Transitional Work Grant Program. Can the employer still apply for the grant and receive reimbursement?

 

Answer: No. Transitional work services incurred by the employer prior to its application for, and BWC approval of, a transitional work grant will not be reimbursed.


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