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Policy and Procedure Name:
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Wages
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Policy #:
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CP-23-01
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Code/Rule Reference:
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R.C. 4123.61, R.C. 4123.62, R.C. 4123.56(A)(E)(F), R.C.
4123.03, Joint Resolution R80-7-48 Computation of full weekly wage
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Effective Date:
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03/11/22
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Approved:
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Ann M. Shannon, Chief of Claims Policy and Support
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Origin:
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Claims Policy
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Supersedes:
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Policy # CP-23-01, effective 09/29/17 and Procedure #
CP-23-01.PR1 dated 06/06/19
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History:
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Previous versions of this policy are available upon
request
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Table of Contents
I. POLICY PURPOSE
II. APPLICABILITY
III. DEFINITIONS
Allowances
Average Weekly Wage (AWW)
AWW Earning Period
Best Available Evidence
Bonuses
Cafe 125
Deferred Compensation Deductions
Deferred Compensation Account
Disbursements
Earning Period
Employer Contributions to Employee
Health Care Plan
Foster Child Care Payments
Frequency of Earnings
Full Weekly Wage (FWW)
FWW Earning Period
Living Maintenance Wage Loss (LMWL)
Non-Working Wage Loss (NWWL)
Per Diem Payments
Reimbursements
Regular Earnings
Retirement Benefits
Self-Employment Earnings
Severance Pay
Social Security Benefits
Stipends
Tips
Temporary Total (TT)
Unemployment Benefits
Vacation Pay
Working Wage Loss (WWL)
IV. POLICY
A. Earnings and
Calculation of Wages
B. Unemployment Benefits
and Setting Wages
C. Calculating the FWW
D. Calculating the AWW
E. Wages Set by BWC or
Industrial Commission (IC) Order
F. Adjusting Previously
Paid Compensation
V. PROCEDURE
A. General Claim Note and
Documentation Requirements
B. Request for Earnings
C. Calculation of Wages:
General Information
D. Evaluating Earnings
Information
E. Earnings Included or
Excluded From Calculations
F. Converting Earnings to
a Weekly Rate
G. Calculating the FWW
H. Calculating the AWW
I. Setting Wages at
One-Third of the SAWW for the DOI, or DOD in OD Claims
J. Wages Set by BWC Order
K. Resetting Wages
L. Making Payment Based
on a BWC or IC Order
M. Adjusting Previously
Paid Compensation
The purpose of this policy is to ensure BWC calculates the full
weekly wage (FWW) and the average weekly wage (AWW) consistently and in
compliance with the law.
This policy applies to all BWC claims services staff.
Allowances:
Payments of a set amount made to an employee at given intervals for a specific
purpose. Allowances are paid without requiring proof that the employee spent
the allowance monies on the specific purpose. Common types of allowances
include payment for travel, uniforms, laundry and housing.
Average Weekly Wage (AWW): Basis upon
which to compute benefit payments for: temporary total compensation (disability)
and living maintenance compensation after the initial 12-week period of
disability; death benefits; permanent total disability benefits; percentage of
permanent partial disability benefits; wage loss compensation; and may be used
for payment of living maintenance wage loss if greater than the full weekly
wage (FWW).
AWW Earning
Period: The timeframe in which the injured worker’s earnings
are used to calculate the AWW which is the 52 weeks prior to the date of injury
or date of disability in occupational disease claims, excluding periods of
unemployment beyond the injured worker’s control (including but not limited to
sickness, industrial depression, strike, lockout).
Best
Available Evidence: For purposes of this policy, best
available evidence is defined as the more detailed earnings information for the
earning period (e.g., a payroll report from the employer is better evidence
than a W-2).
Bonuses:
Payments made to an employee by an employer, which are in addition to regular
earnings.
Cafe 125:
Non-taxable money set-aside from earnings that is generally used for employee
contributions towards health care, life insurance or daycare.
Deferred
Compensation Deductions: Deductions the employer makes from
an employee’s pay that the employee can receive at some later date.
Deferred
Compensation Account Disbursements: Retirement income paid
from previously deferred funds.
Earning
Period: Period of time used to identify earnings to be
included in the FWW and AWW wage calculations. Earning periods are generally
based on full pay periods prior to the date of injury or date of disability in
occupational disease claims (e.g., 52 full weekly pay periods).
Employer
Contributions to Employee Health Care Plan: Payments made by
the employer toward the purchase of a health care plan for the employee.
Foster Child
Care Payments: Payments made to foster parents to cover the
costs of care for a foster child.
Frequency of
Earnings: Schedule on which pay is received (e.g., weekly,
biweekly, monthly).
Full Weekly
Wage (FWW): Basis for payment of compensation for the first
12 weeks of temporary total compensation or living maintenance compensation and
may be the basis for living maintenance wage loss if it is greater than the
AWW.
FWW Earning
Period: The timeframe in which the injured worker’s earnings
are used to calculate the FWW. The FWW is ordinarily based on the injured
worker’s earnings when the injured worker has been continuously employed for
six weeks or seven days prior to the date of injury or date of disability in
occupational disease claims.
Living
Maintenance Wage Loss (LMWL): Compensation paid to an injured
worker who has completed a vocational rehabilitation program and returns to employment
but suffers a wage loss compared to the wage the injured worker was receiving
at the date of injury or date of disability in occupational disease claims.
Non-Working
Wage Loss (NWWL): The dollar amount of the diminishment in
wages sustained by an injured worker who has not returned to work because he or
she has been unable to find suitable employment. The extent of the diminishment
must be the direct result of physical and/or psychiatric restriction(s) caused
by the impairment that is causally related to an industrial injury or
occupational disease.
Per Diem
Payments: Payments made by the employer to the employee as a
daily expense allowance.
Reimbursements:
Payments made to an employee based on actual cost to the employee and may
require the submission of receipts to the employer (e.g., travel, uniforms,
laundry and housing).
Regular
Earnings: For purposes of this policy, regular earnings are
defined as the hourly rate times hours worked or a regular salary.
Retirement
Benefits: Pay to an employee who has left employment due to
reaching a specific age, or specific number of years of service, or at the
election of the employee.
Salary Continuation/Wages in Lieu of Temporary Total Compensation
(SC): Regular full wages and benefits the EOR pays the IW, in lieu of BWC
paying the IW temporary total compensation (TT) or living maintenance (LM).
This includes payment of sick leave and occupational injury leave (OIL).
Self-Employment
Earnings: Net income (income after expenses) an individual
earns in association with certain types of solely-owned or partially-owned
businesses.
Severance
Pay: Pay given to an employee upon termination of employment.
Social Security
Benefits: Payments made by the Social Security Administration
to an individual because of retirement, death or disability.
Stipends:
Allowance for daily living expenses paid by the employer.
Tips:
Money given by a patron to a servant, waiter, or other similarly related
individual for services rendered.
Temporary
Total Compensation (TT): Compensation paid to an injured
worker who is unable to return to the former position of employment on a
temporary basis due to the work-related injury or occupational disease and who
has not been found to have reached maximum medical improvement.
Unemployment
Benefits: Benefits paid by the Department of Job and Family
Services to an individual who has lost employment.
Vacation Pay:
Payment from an employer to an employee for a break or holiday from work.
Working Wage
Loss (WWL): The dollar amount of the diminishment in wages
sustained by an injured worker who has returned to employment which is not his
or her former position of employment. However, the extent of the diminishment
must be the direct result of physical and/or psychiatric restriction(s) caused
by the impairment that is causally related to an industrial injury or
occupational disease.
1. It is the policy
of BWC to calculate the FWW and AWW in a claim based on the best available
evidence.
2. Evidence of
earnings include, but is not limited to:
a. Payroll reports
from an employer;
b. Copies of check
stubs;
c. Income tax
returns signed by the injured worker (IW) or signed by another person who
prepared the taxes;
d. W-2s for the
year of and/or year prior to the date of injury (DOI), or date of disability
(DOD) in occupational disease (OD) claims;
e. 1099 forms for
the year of and/or year prior to the DOI, or DOD in OD claims when accompanied
by an Injured Worker Earnings Statement (Wages – IW) form, or equivalent
statement regarding expenses;
f. Social
security reports of earnings that include the IW’s name;
g. Employer Report
of Employee Earnings (Wages – Emp) form, or equivalent statement signed by
the employer;
h. Wages – IW form,
or equivalent signed by the IW.
i. BWC
requires wages being reported as income to also have been reported to the Internal
Revenue Service (IRS).
ii. If BWC
suspects that wages reported as income have not been reported to the IRS, BWC
may notify the IRS of any discrepancy (e.g., rental income, S-Corporation
profits and partnership profits) using IRS
Information Referral - Form 3949-A.
3.
It is the responsibility of the IW to provide earnings information for
the calculation of wages. The employer of record (EOR) may also provide
evidence of earnings to BWC.
4. BWC shall include
the following types of earnings in the calculation of wages, however the list
is not all-inclusive:
a. Gross regular
earnings, before deductions such as deferred compensation, Cafe 125, etc.;
b. Tips;
c. Self-employment
earnings (e.g., Form 1040 Schedule C);
d. Allowances;
e. Bonuses related
to direct and active participation in employment during the earnings period
(e.g., performance bonus);
f. Profit
sharing related to work activity (e.g., earned based on hours worked, product produced,
or other earnings related to work activity);
g. WWL or LMWL paid
in a prior workers’ compensation claim (in addition to earnings from an
employer);
h. Per diem or
stipend payments;
i. Vacation,
sick leave, and holiday pay for periods which fall within the earnings period;
j. Lump
sum payouts for vacation, sick, personal or other leave is included for AWW
calculation only;
k. Farm
income (e.g., Form 1040 Schedule F);
l. Earnings
reported on the IW’s federal income tax return that are specifically subject to
either social security withholding, Medicare withholding, or self-employment
tax (e.g., housing allowance);
m. Income specifically
subject to self-employment tax (Schedule SE);
n. Payment received
in lieu of receiving health insurance.
5.
BWC shall exclude the following types of earnings in the calculation of
wages, however the list is not all-inclusive:
a. Bonuses
unrelated to work activity (e.g., shareholder bonus, contract ratification);
b. Profit sharing
unrelated to work activity (e.g., owns stock, dividends);
c. Disbursements
from previously deferred compensation;
d. Retirement
benefits paid from social security or other retirement programs;
e. Employer
contributions to employee health care plans;
f. Payment
received for foster care of children;
g. Non-working wage
loss compensation paid in a prior workers’ compensation claim;
h. Reimbursement
for items such as travel, uniforms, etc.;
i. TT
or SC, including occupational injury leave (OIL), paid in a prior claim;
j. Unemployment
benefits;
k. Severance
pay; and
l. Other
forms of income reported on an IW’s tax return that are not subject to social
security withholding, Medicare or self-employment tax, including, but not
limited to:
i. Interest
income;
ii. Dividend
income;
iii. Taxable refunds
of state and local income taxes;
iv. Alimony received;
v. Capital
gains;
vi. Other gains reported
on Form 4797;
vii. IRA distributions;
viii. Pension distributions;
ix. Income reported on
Schedule E (including, but not limited to, rental real estate, royalties,
partnerships, S corporations, trusts);
x. Social
security benefits;
xi. Other income not
subject to self-employment tax (Schedule SE); and
xii. Tuition reimbursement
(1098T).
6. BWC shall request
and attempt to calculate wages:
a. In all lost time
claims;
b. When a claim
changes from medical only to lost time; or
c. Upon
receipt of an Application for Determination of Percentage of Permanent
Partial Disability or Increase of Permanent Partial Disability (C-92).
7. When setting
wages for compensation other than %PP, BWC shall set both the FWW and AWW.
8. When setting the
AWW for the purpose of paying %PP, BWC shall set:
a. Both the FWW and
the AWW when detailed earnings information is available; or
b. Only the AWW
when detailed 6 week and/or 7-day prior earnings are not available.
9.
BWC shall only set wages in a medical only claim upon a written request
(e.g., Motion (C-86), Wages – IW or Wages – Emp) with attached
supporting documentation.
10. It is the policy of BWC to
identify the earning periods as follows:
a. Generally, the
earning periods for the calculation of wages shall be determined based on full
pay periods prior to the DOI, or DOD in OD claims.
b. Earnings from
employers other than the EOR shall be determined based on pay periods for that
employer that fall within the 52-week earning period.
11. If confirmation of receipt
of salary continuation has been received but BWC is unable to obtain wage
information, it is the policy of BWC to set the FWW and AWW at $0. If
compensation becomes payable later, the FWW and AWW shall be set by order based
on the wages on file.
1. Periods during
which an IW receives unemployment benefits are generally excluded from AWW
calculation.
2. Seasonal workers
must demonstrate that they were looking for work during periods of unemployment.
Examples of ways an IW may demonstrate that they were looking for work include:
a. A signed
statement on the Wages – IW form, or its equivalent which describes the job
search activity, including type of work sought and method of job searches; or
b. Copies of
confirmation from on-line job searches; or
c. Copies of
correspondence with potential employers, job applications, resumes or other
evidence of contact with employers.
3. Weeks during
which an IW participated in job training or job seeking skills training for
which they were paid will be excluded. This does not include periods of job
training with an employer.
4. Periods during
which the IW received partial unemployment benefits while working, and the
earnings for those periods, will be excluded if the IW provides evidence that they
continued to seek work to return to full employment during that period in an
attempt to discontinue receipt of the partial unemployment benefits.
1. For IWs who have
been either continuously employed for six weeks prior to the DOI, or DOD in OD
claims, or worked at least seven days prior to the DOI, or DOD in OD claims,
the FWW shall be the higher amount of either:
a. The gross
earnings, including overtime pay, for the six weeks prior to the DOI, or
DOD in OD claims, divided by six; or
b. The gross
earnings, excluding overtime pay, for the seven days prior to DOI, or DOD
in OD claims.
2. For IWs who have
not been continuously employed for six weeks prior to the DOI, or DOD in OD
claims, and who have not worked for at least seven days prior to the DOI, or DOD
in OD claims, the FWW is calculated by multiplying the hourly rate times the
number of hours the IW was scheduled to work the week of the DOI, or DOD in OD
claims.
3. BWC may set the
FWW equal to one-third of the Statewide Average Weekly Wage (SAWW) for the DOI,
or DOD in OD claims, when the FWW cannot be determined as described above.
a. In the event the
FWW is later recalculated and determined as described above, BWC shall:
i. Adjust
previously paid FWW compensation and pay out the difference; or
ii. Set the IW
overpaid, if the adjustment creates an excess amount paid to the IW.
b.
Refer to the Overpayment
of Compensation policy and the Adjustment
of Overpaid Compensation policy for additional information.
1. The AWW is
calculated by dividing the total earnings for the 52 weeks prior to the DOI, or
DOD in OD claims, by 52 minus any weeks which should be excluded.
2. Periods of
unemployment due to reasons beyond the IW’s control shall be excluded from the
calculation.
a. Documentation is
required to support excluding weeks from the calculation.
b. Reasons to exclude
weeks include, but are not limited to:
i. Sickness
of the IW or a family member whom the IW had to care for;
ii. Pregnancy
or parental leave of the IW, excluding an extended period based on the IW’s
choice instead of medical necessity;
iii. Industrial depression;
iv. Strike or lockout;
v. Disability
related to a prior workers’ compensation claim;
vi. NWWL compensation was
paid in a prior workers’ compensation claim;
vii. IW was unemployed but was
seeking employment (note additional requirements for seasonal workers in Section
IV.B.2 above);
viii. IW is new to the work force (i.e.,
the IW recently graduated from high school or college).
3. If the IW has
not worked for reasons within their control (e.g., IW stayed home to care for
children or to go to college), those weeks are generally not excluded from the
calculation.
4. If the IW
presents special circumstances that make the method described in the Wages
policy and procedures unfair, BWC may use an alternative method for setting
wages to provide substantial justice.
5. BWC shall apply
special circumstances when setting the AWW, as appropriate. Examples of
situations where special circumstances may apply include when the IW is:
a. New to the work
force;
b. Self-employed
and suffered a loss of earnings due to an unsuccessful business; or
c. A
volunteer worker.
6. BWC may set the
AWW at $0 when no earnings are submitted to BWC to support an AWW calculation for
the 52 weeks prior to the DOI, or DOD in OD claims.
7. BWC will not set
wages without earnings information for the purpose of paying a %PP award as
there is no minimum award for this benefit type.
8. BWC will not set
wages without earnings information for the purpose of paying NWWL, WWL or LMWL
compensation, as earnings information is required to prove a loss of earnings
to be eligible for these benefits.
1. BWC shall issue
an order to set or reset wages in a claim when it is within BWC’s jurisdiction
to do so.
2. BWC shall set
the initial FWW and/or AWW in a claim.
3. BWC may reset
the FWW and/or AWW in a claim unless the IC has previously ruled on the setting
of wages.
a. When the IC has
not previously ruled on the setting of wages:
i. BWC
shall re-evaluate wages upon receipt of a written request to reset wages on a
C-86, Wages – IW or Wages – Emp, or the equivalent, which is accompanied by new
evidence that is better than that which was used in the prior calculation of
wages.
a) If BWC’s
evaluation results in a new FWW and/or AWW amount, BWC shall issue a BWC order
to allow the request to reset the wages and declare the new FWW and/or AWW
settings.
b) If BWC’s
evaluation results in no change to the FWW and/or AWW amount, BWC shall issue a
BWC order to deny the request to reset the wages.
c) If a request is
filed and the accompanying evidence is not better than the evidence previously
used to set wages, BWC shall issue a BWC order to deny the request to reset the
wages.
ii. BWC may
adjust the FWW and/or AWW even when the written request is only for one or the
other, but the evidence supports re-evaluation of both.
iii. BWC may issue a
BWC order to reset the FWW and/or AWW when an error in the prior calculation is
discovered.
b. When the IC has previously
ruled on the setting of wages, BWC shall refer the request to reset the FWW
and/or AWW to the IC with BWC’s recommendation regarding the resetting of
wages.
4. BWC shall make
payment in accordance with a BWC or IC order on wages as legally appropriate
1. BWC will adjust
previously paid compensation when wages are reset and a BWC or IC order has
been issued which includes language that orders the adjustment of previously
paid compensation.
2. When an
adjustment to wages is made based on a request from a party to the claim and the
result of the adjustment is that additional payment is due to the IW, the
adjustment will be limited to compensation paid within the two years prior to
the filing date of the request.
3. When an
adjustment to wages is made by BWC without a request from a party to the claim
and the result of the adjustment is that additional payment is due the IW, all
compensation paid in the claim will be adjusted.
4. All compensation
paid in the claim will be adjusted when the change in wages results in the IW
being overpaid.
a. The amount of
the overpayment will be determined after the order to reset the wages is final.
b. Refer to the Overpayment
of Compensation policy and the Adjustment
of Overpaid Compensation policy for information regarding declaring and
collecting an overpayment.
1. BWC staff shall
refer to the Standard
Claim File Documentation and Altered Documents policy and procedure for
claim note and documentation requirements; and
2. Shall follow any
other specific instructions for claim notes and documentation included in this procedure.
1. Medical Only Claims
a. If a C-86, Wages
– IW, or Wages – Emp, or the equivalent, is filed specifically requesting the
calculation of wages with supporting earnings information, claims services
staff shall refer the request to the wage team.
b. If earnings
information is received without a formal or written request, claims services
staff should contact the IW and/or IW representative to inform them that a
written request is required to have wages set in a medical only claim.
2. Lost Time Claims:
Initial Request for Wage Information
a. Claims services
staff shall do a complete investigation that includes requesting wages from the
EOR and IW and/or IW representative.
b. In the event
this investigation was not completed at the initial allowance; claims services
staff shall complete the investigation regardless of the stage in the claims
process.
i. Claims
services staff shall:
a) Make at least
one phone call to the parties to the claim. After at least one phone call
attempt (documented in claim notes), claims services staff may send a follow-up
letter via fax, email or mail.
b) Enter a detailed
claim note for all attempts to gather the earnings that includes, but is not
limited to:
i) Date/time
of call;
ii) First and
last name of the person claims services staff spoke with or contacted;
iii) Specific period of
earnings requested;
iv) Validation of, or
attempt to obtain, the hourly rate and number of hours IW was scheduled to work
the week of the DOI, or DOD in OD claims; and
v) Whether the IW
worked for more than one employer during the 52 weeks prior to the DOI, or DOD
in OD claims, and the names of all employers and the dates of employment.
ii. When claims
services staff has a conversation with the EOR, IW and/or their representatives,
claims services staff shall explain the detailed information (i.e., six weeks
prior and/or seven days prior to the DOI, or DOD in OD claims, excluding
overtime) that is needed for the calculation of FWW and may follow-up by sending
the appropriate form:
a) Wages – Emp;
b) Wages – IW.
iii. During contact
with the IW, claims services staff shall explain:
a) That it is the
IW’s responsibility to provide earnings information;
b) That BWC will
assist with obtaining earnings information from the EOR;
c) That earnings
information must be submitted in writing;
d) That earnings
from all employers who employed the IW during the 52 weeks prior to the DOI, or
DOD in OD claims, can be included in the calculation of wages and that BWC can
assist with obtaining earnings from other employers if the IW requests, in
writing, for BWC to assist with obtaining those earnings;
e) That the
earnings amount submitted should be the gross earnings for the IW, prior to any
deductions for taxes, insurance, or tax-deferred programs;
f) The
acceptable methods of submitting earnings information as described in this
policy;
g) That any unpaid
weeks during the earnings periods must be explained and submitted on an Injured
Worker Earnings Statement (Wages – IW) or Employer Report of Employee
Earnings (Wages – Emp) form, or equivalent statement;
h) That any
earnings other than hours worked multiplied by the hourly rate or a standard
salary (e.g., tips, commissions, bonuses, allowances, etc.) must be explained;
i) That
if annual earnings will be submitted, they must be for the year of and/or the
year prior to the DOI, or DOD in OD claims;
j) That
the Wages – IW form is available to be printed online at www.bwc.ohio.gov or can
be sent by mail to the IW if requested; and
k) How wages are
calculated and how any anticipated compensation is paid based on those wages.
iv. During contact with
the EOR, claims services staff shall:
a) Determine if the
IW was employed by the EOR for the 52-week period prior to the DOI, or DOD in OD
claims;
b) Request earnings
for the 52 weeks prior to the DOI, or DOD in OD claims, or for whatever portion
of that time the IW was employed by the EOR;
c) Explain that the
earnings amount submitted should be the gross earnings for the IW, prior to any
deductions for taxes, insurance, or tax-deferred programs;
d) Verify or obtain
the hourly rate and the scheduled work hours;
e) Explain the
detailed information needed regarding earnings other than hours worked
multiplied by the hourly rate or a standard salary (e.g., tips, commissions,
bonuses, allowances, etc.);
f) That the Wages
– Emp form is available to be printed online at www.bwc.ohio.gov or can
be sent to the EOR by mail if requested; and
g) Explain how
wages are calculated and how any anticipated compensation is paid based on
those wages.
v. If the Wages
– IW form submitted by the IW authorizes BWC to obtain clarification of
earnings from employers other than the EOR, claims services staff shall
document the IW’s permission to speak with the other employer(s) in notes prior
to contacting that employer for clarification of earnings.
vi. Claims services staff
shall set a work item in the claims management system for two business days to
follow-up on receipt of earnings information. If earnings information is not
received:
a) And the IW is
not represented, claims services staff shall follow-up with the IW by fax or
email to request the missing information and make one additional follow-up
phone call. If no fax number or email address is available, follow-up shall be
done by letter.
b) And the IW is
represented, claims services staff shall follow up with the IW representative
by a written request via fax or email and make one additional follow-up phone
call.
vii. If additional attempts as
noted above to obtain earnings information are not successful, claims services
staff shall ensure all attempts to obtain the missing information are documented
in claim notes and make a referral to the wage team.
c. Claims
services staff shall:
i. Wait
two business days prior to making a referral to the wage team. However, if wage
information is received and claims services staff determines it is usable, claims
services staff shall make a referral to the wage team immediately.
ii. Make an
additional attempt to obtain the earnings information when claims services
staff receives wage information and determines the information is not usable
and/or there are missing periods and wait two business days prior to making a
referral to the wage team.
d.
Claims Services Staff Referral to Wage Team
i. Claims
services staff shall send all claims to the wage team for computation of wages
and setting of the FWW and AWW. This includes setting the FWW at one-third of
the SAWW or wages at $0, except when it meets the following exception:
a) When the setting
of wages is necessary and an urgent issue (i.e., initial claim determination
and granting TT), the CSS shall staff with their supervisor and a supervisor
may set the FWW at one-third of the SAWW when the CSS has made two documented
attempts to the IW/IW representative and EOR/EMP representative for earnings.
b) The supervisor
will:
i) Verify
that no wage information is in the claim,
ii) Verify the
claim is in Pending Allowed status,
iii) Place a note titled
‘IMS reviewed FWW wage set at 1/3 SAWW’ in the claim authorizing the FWW to be
set at 1/3 of the SAWW.
c) When the CSS has
not made two documented attempts to request earnings, the CSS must make these
documented requests for wages prior to a supervisor setting the FWW at
one-third of the SAWW.
d) The supervisor
may not set the AWW at one-third of the SAWW.
e) The CSS will
publish the wage order.
ii. Claims
services staff shall not rely on the MCO note indicating wages are $0. This is
in the 148 transaction and the MCOs were instructed to enter $0. The MCO does
not request wages from the parties to the claim and the MCO is not responsible
for requesting wage information. This is not considered an attempt to obtain
wages.
iii. If the request
is a rush (e.g., initial claim determination, financial hardship, Ombud’s/constituent
affairs issues, significant processing delays, etc.), claims services staff
shall staff with their supervisor and email the wage team supervisor to advise
the wage team of the priority and importance of the referral.
3. Lost Time Claims
Within the Initial Claim Determination Appeal Period
a. When new
evidence is received without a formal request for recalculation during the
appeal period, and the new evidence may impact the wage calculation (e.g.,
detailed earnings vs. annual earnings = better information or missing earning
periods received), claims services staff shall:
i. Refer
the new evidence to the wage team for recalculation; and
ii. Email the
Wages CSS who did the initial wage calculation and copy the wage team
supervisor, notifying the Wages CSS that the recalculation has been referred
and the priority nature of the referral.
b. When new
evidence is received without a formal request for recalculation during the
appeal period and the new evidence will not impact the wage calculation (e.g.,
annual earnings vs. detailed earnings = not better information), claims
services staff shall not refer the new evidence to the wage team for
recalculation. Claims services staff shall staff any questions with their
supervisor.
4. Lost Time Claims
Outside of the Initial Claim Determination Appeal Period: Subsequent Wage Information
(Or Requests to Reset Wages)
a. When a request
to reset wages is submitted with additional wage information, claims services
staff shall review and determine if the wage information is new evidence that
will impact the wage (FWW and/or AWW) calculation.
i. When
the new evidence will impact the wage calculation (e.g., detailed earnings vs.
annual earnings = better information or missing earning periods received), claims
services staff shall refer to the wage team for recalculation.
ii. When the
new evidence will not impact the wage calculation (e.g., the wages were
previously set using evidence that is better than the new evidence provided), claims
services staff shall not grant the request to recalculate based on the new
evidence (e.g., the new evidence consists of general annual earnings
information whereas the wages were previously set based on 52 weeks of detailed
earnings).
iii. If a request to
reset wages is received and is not supported by documentation, claims services
staff shall try to obtain the supporting evidence.
a) If claims
services staff is unable to obtain any supporting documentation, claims
services staff shall dismiss the request using the BWC Miscellaneous Order.
b) If information
is submitted that is unclear, inconclusive or in conflict with other evidence, claims
services staff shall either:
i) Issue
a BWC order based on the wage team’s calculation; or
ii) Deny the
request if no change will be made.
c) If the IC
previously addressed the setting of wages, claims services staff shall refer
the matter to the IC and ensure that the notice of referral to the IC includes
BWC’s recommendation for setting of the wages when possible.
d) See Section V.K,
Resetting Wages.
iv. Claims services staff shall:
a) Refer the claim
to the wage team;
b) Enter a claim
note that a referral was completed and include any specific instructions to the
Wages CSS; and
c) Staff with their
supervisor as necessary.
b. When additional
wage information is received in the claim without a written request to adjust
the wage calculation, claims services staff shall:
i. Contact
the parties to the claim to inform them that a written request is necessary to
adjust the wage calculation (only when the additional wage information will
result in a wage adjustment);
ii. Document
in claim notes, the details of the conversation (i.e., requested written
request for adjustment of wages or that the additional wage information will
not impact the current FWW and/or AWW in the claim).
iii. Not refer to the
wage team when there is no written request received for the adjustment of
wages.
5. Wage Team Referrals
a. The Wages CSS
shall follow-up with the appropriate parties when additional wage information
or clarification is necessary, and claims services staff has made the initial
attempt for wage information.
i. The
Wages CSS shall wait two business days after follow-up attempt or clarification
for the wage information.
ii. The Wages
CSS shall enter a detailed note indicating who was contacted, why, and what was
requested.
b. If the Wages CSS
does not receive the requested wage information or obtain clarification, the
Wages CSS shall staff with their supervisor to determine next steps.
1. The Wages CSS
shall calculate or re-calculate the FWW and AWW as required by this policy.
2. When wage
information is on file or received after requested, the Wages CSS shall
calculate the FWW and/or AWW in the claim using the wage calculation tool. The
Wages CSS shall:
a. Calculate wages
within five days from the referral date;
b. Prioritize initial
claim determinations and rushes; and
c. Staff with
the wage team supervisor if they encounter any issues that will delay the wages
calculation.
3. Whenever
possible, the Wages CSS shall use the wage calculation tool worksheet to
calculate or re-calculate the FWW and/or AWW in a claim.
4. The Wages CSS
shall document the calculations used in the claim file by right-faxing into the
claim the wage calculation tool worksheet and supporting documentation used to
calculate or re-calculate the FWW and/or AWW in a claim. The imaged wage
calculation tool worksheet packet shall include:
a. The detail of
earnings used for the calculations, including the name of the employer;
b. The calculations
used based on those earnings;
c. The name
of the Wages CSS who completed the calculations; and
d. The date the
calculations were completed.
5. The Wages CSS
shall document in claim notes and on the wage calculation tool worksheet the
method (or special circumstances for alternate method) used for calculating the
FWW and/or AWW and shall enter the wages in the claims management system.
1. Claims services
staff shall review detailed earning information upon receipt to identify any
missing information or variations in earnings which require an explanation.
a. If detailed
earnings (e.g., weekly, biweekly, monthly) are provided, claims services staff
shall:
i. Identify
any variations in earnings (e.g., weeks where earnings are much higher or lower
than other weeks);
ii. Obtain an
explanation for any variations or unpaid periods identified by the EOR or IW; and
iii. Document the
explanation in notes and/or on the wage calculation worksheet.
b. Earnings
information submitted by the IW without supporting evidence (e.g., copies of
pay stubs) must be provided with a Wages – IW form, or equivalent statement.
c. If claims
services staff suspects that wages reported as income have not been reported to
the Internal Revenue Service (IRS), claims services staff may send notification
to the IRS of any discrepancy (e.g., rental income, S-Corporation profits and
partnership profits) using IRS
Information Referral - Form 3949-A.
d. Earnings
information submitted by an employer does not require a Wages – Emp form, or
equivalent statement.
2. If 52 weeks of
earnings are not on file and no explanation for the missing weeks has been
documented, claims services staff shall contact the IW to request additional
evidence regarding earnings or unpaid weeks.
3. If annual
earnings are received for two years and there is a significant variation
between the years, claims services staff shall contact the IW for clarification
(e.g., IW worked for the employer for less than a year).
4. If the earnings
information submitted includes a bonus, claims services staff shall ascertain
the nature of the bonus and the period over which the bonus was earned.
5. If the earnings
information includes commission payments, claims services staff shall ascertain
the period over which the commission was earned.
6. When 1099 tax
forms are submitted as earnings, claims services staff shall ensure that
accompanying evidence of expenses related to the earnings is provided or that a
Wages – IW form, or equivalent statement that indicates there were no expenses
related to the earnings has been provided.
7. When income tax
statements are provided, claims services staff shall:
a. Make certain the
documents are signed by the IW, signed by a tax preparer, or accompanied by a Wages
– IW form, or equivalent statement which declares that the documents submitted
are a true and accurate copy of what was filed with the IRS;
b. Obtain W-2s or a
Schedule C for self-employed IWs to support earnings amount;
c. Determine
if the return is a joint return, and if it is, verify that earnings for just
the IW can be identified; and
d. Redact sensitive
information provided for anyone other than the IW (e.g., spouse or children).
8. If a
self-employed IW submits a copy of their quarterly income tax report, claims
services staff shall verify that the report is signed by the IW, a tax
preparer, or accompanied by a Wages – IW form, or equivalent statement which
declares that the documents submitted are a true and accurate copy of what was
filed with the IRS.
9. Self-employed
IWs may submit monthly profit and loss statements prepared by a tax preparer as
proof of earnings.
10. IWs may report earnings on a
Wages – IW form, or equivalent statement without supporting documentation
(e.g., IW was paid in cash). The Wages CSS shall staff with a local BWC
attorney or supervisor as necessary to determine if earnings without supporting
documentation on a Wages – IW form or equivalent statement are appropriate to
use.
11. IWs may provide a Wages – IW
form, or equivalent to support periods of unemployment. The statement must
include an explanation of why the IW was not working and may require additional
supporting evidence.
a. Except for
seasonal employers, additional evidence to support periods during which the IW
received unemployment benefits is not required if BWC can verify the receipt of
unemployment benefits with the Ohio Department of Job and Family Services
(ODJFS).
b. Seasonal
employees must submit evidence of job search efforts for periods of
unemployment as follows:
i. A
signed statement on the Wages – IW form, or its equivalent which describes the
job search activity, including type of work sought and method of job searches;
or
ii. Copies of
confirmation from on-line job searches; or
iii. Copies of
correspondence with potential employers, job applications, resumes or other
evidence of contact with employers.
c. The EOR
may provide evidence to support periods of unemployment (e.g., plant shutdowns
or layoffs) without additional supporting documentation.
d. Claims services
staff shall staff with the supervisor to determine if additional supporting
evidence is needed.
12. If an IW submits evidence
that the IW was both working and receiving partial unemployment compensation
over the same period of time, claims services staff shall ask the IW if they
continued to seek employment during that period of time in an attempt to
discontinue receipt of the partial unemployment benefits.
a. If the IW
indicates that they did not continue a job search during that time period,
claims services staff shall include the earnings from the part-time employment
and the weeks in the calculation of wages.
b. If the IW
indicates that they did continue a job search during that time period, claims
services staff shall request that the IW submit evidence of job search efforts
as described in section V.D.11.b above. Upon receipt of such evidence the Wages
CSS shall exclude the earnings from the part-time employment and weeks from the
calculation of wages.
13. The Wages CSS may rely on
clarification of earnings, not actual amounts, obtained by phone if documented
in notes. For example:
a. An employer
submits earnings information and there is a variation in the earnings, claims
services staff can document the explanation for the variations in claim notes
and use the information in setting wages; or
b. An employer
submits biweekly earnings and it is necessary to obtain the breakdown of the seven
days prior to DOI, or DOD in OD claims, without overtime; or
c. Earnings
information is submitted via hard copy, but some numbers are not readable.
1. The Wages CSS
shall refer to Section IV.A to determine which earnings to include and exclude
in the calculation of wages.
2. The Wages CSS
may exclude passive income, such as income reported on IRS Schedule E,
retirement benefits, disbursements from a deferred compensation account, rental
property income or income from the stock market from calculation of wages, but
shall staff with a local BWC attorney or their supervisor as needed for
direction.
1. The Wages CSS
shall convert earnings that are paid with a frequency other than weekly or
biweekly to a weekly rate for calculation of wages.
2. Except for
annual earnings, conversion to a weekly rate shall be calculated by determining
the number of days over which earnings were earned, dividing that number into
the total earnings to calculate a daily rate and then multiplying the daily
rate times seven to determine the weekly rate. For example:
a. IW submitted
$1000 as earnings for the period of February 1 through February 28.
b. Earnings period
equals 28 days.
c. $1000
divided by 28 = $35.71 per day (rounded to the nearest whole cent).
d. $35.71 times seven
= $249.97 per week.
3. The Wages CSS
shall reduce the days included in the calculation by the appropriate number of
days when periods are to be excluded from the calculation. See Sections V.G, Calculating
the FWW, and V.H, Calculating the AWW, for more information on
excluding days.
4. When converting
annual earnings to a weekly rate, the Wages CSS shall divide the annual
earnings by 364 days (52 weeks), rounded to the nearest cent, and multiply by seven
for the weekly rate.
1. The Wages CSS
shall generally use earnings for the full pay periods prior to the DOI, or DOD
in OD claims, for the calculation of FWW; however, if the earnings amount for
the actual seven days prior to the DOI or DOD is available and is advantageous
to the IW, the Wages CSS shall use those earnings in the calculation of the FWW.
Earnings to be used for employers other than the EOR shall be determined based
on pay periods for those employers.
2. For IWs who have
worked a least one full week prior to the DOI, or DOD in OD claims, the FWW is
the higher amount of either:
a. The gross
earnings, including overtime pay, for the six weeks prior to the DOI, or
DOD in OD claims, divided by six; or
b. The gross
earnings, excluding overtime pay, for the seven days prior to DOI, or DOD
in OD claims.
3. For IWs who have
not worked a full week during the six weeks prior to the DOI, or DOD in OD
claims, the FWW is set at the hourly rate multiplied by the number of hours the
IW was scheduled to work the week of DOI, or DOD in OD claims.
4. The Wages CSS
shall clarify the earnings for the seven days prior to the DOI, or DOD in OD
claims, with the EOR if earnings are submitted with a frequency other than
weekly and/or it is not possible to determine if overtime is included in the
reported earnings. This clarification may be documented in notes. If
clarification cannot be obtained, efforts to obtain it will be documented in
notes and the Wages CSS shall calculate a weekly rate as described in Section V.F,
Converting Earnings to a Weekly Rate, above.
5. The Wages CSS
shall include all earnings it receives, including earnings from employers other
than the EOR for whom the IW worked during the six weeks prior to the DOI, or DOD
in OD claims, in the FWW calculation.
6. The total
earnings for the six weeks prior are divided by six, even if there were weeks
with no earnings.
7. The Wages CSS
may take into consideration when a factory, mine or other place of employment
is working short time in order to divide work among employees when calculating
the FWW. The Wages CSS shall review with a local BWC attorney when taking this
into consideration.
8. If there is no
evidence provided of earnings during the six weeks prior to the DOI, or DOD in OD
claims, the FWW may be set at one-third (1/3) of the SAWW.
1. The AWW is
calculated by dividing the total earnings for the 52 weeks prior to the DOI, or
DOD in OD claims, by 52 minus any weeks which should be excluded.
2. Periods of
unemployment due to reasons beyond the IW’s control shall be excluded from the
calculation. Documentation is required to support excluding weeks from the
calculation. A signed Wages – IW form is considered supporting documentation.
3. The Wages CSS
shall staff with a BWC attorney to determine if periods of unemployment that
were the result of the IW being incarcerated will be included or excluded from
the AWW calculation.
4. Calculating Earnings
for AWW Based on Annual Earnings
a. The Wages CSS
shall apportion annual earnings for the year of and the year prior to the DOI,
or DOD in OD claims, such that an average weekly rate for each year is used for
the portion of the 52 weeks prior to the DOI, or DOD in OD claims, that falls
in each of the two years. For example, if the DOI, or DOD in OD claims, is June
30, the earnings used for the calculation of the AWW shall be:
i. 26
weeks of the average weekly earnings for the year of the DOI, or DOD in OD
claims; and
ii. 26 weeks
of the average weekly earnings for the year prior to the DOI, or DOD in OD
claims.
b. When detailed
earnings are provided for the DOI, or DOD in OD claims, and annual earnings are
used for the year prior, the Wages CSS shall use the detailed earnings for the
year of the injury plus the average earnings for the year prior for the portion
of the 52 weeks that falls in the year prior. For example, if the DOI or DOD is
June 30, the earnings that shall be used for calculation of the AWW shall be:
i. The
detailed earnings for January 1 to June 30 of the year of injury, plus
ii. The
average weekly earnings for the year prior to the DOI, or DOD in OD claims, for
the remaining 26 weeks.
c. If the IW
had no earnings during the 52 weeks prior to the DOI, or DOD in OD claims, of
the earning period, the AWW shall be set at $0. This happens primarily in OD
claims where the IW retired prior to the DOD. The Wages CSS shall document the
investigation and evidence which supports the finding of no earnings in notes.
A calculation worksheet is not required.
5. Special AWW Setting
Scenarios
a. If the IW
presents special circumstances that make the method described above unfair, the
Wages CSS may use alternative methods for setting wages to provide substantial
justice but without providing a windfall to the IW.
b. The Wages CSS
shall staff special wage setting situations with their supervisor and/or a BWC
attorney.
c. The
following are examples to consider:
i. Earning
loss attributed to an unsuccessful business: Tax records are normally used to prove
an unsuccessful business, but a statement from a tax preparer can be used.
a) The Wages CSS
shall staff with a supervisor to determine if periods during which the IW
suffered a loss will be excluded from the calculation of AWW.
b) The Wages CSS
shall contact EM staff to compare reported earnings to payroll reported for
premium purposes. EM staff shall determine if an employer audit is necessary.
ii. New in the
labor market: If an IW was of a relatively young age and/or new to the job
market, and the Wages CSS determines earnings would be expected to increase,
then the Wages CSS may consider that in determining the AWW.
iii. Seasonal
employees: When the IW is a seasonal employee, the Wages CSS shall investigate
the nature of the seasonal employment and the IW’s intent to work beyond the
seasonal employment. If the seasonal employment is the IW’s choice and they did
not show a job search effort, then the period of unemployment would not be
excluded from the calculation. Registration and receipt of unemployment
benefits alone is not sufficient proof of a job search effort for seasonal
employees. See Section V.D, Evaluating Earnings Information above for
additional information regarding seasonal employees.
iv. School employees: The
AWW for teachers and school employees is calculated by dividing the entire
salary for 52 weeks (less any weeks otherwise excluded), whether the employee
elected to receive pay over 9 months or 12 months.
a) Weeks for the
summer break shall only be excluded if the employee regularly has other work
over summer break but did not work for reasons outside their control (no work
was available), or if the employee was disabled for the period.
b) Any wages from
summer break employment shall be included in calculating the AWW.
v. Volunteers:
The coverage contract between the employer and BWC shall specify what the AWW
is, or how it should be calculated.
a) In claims filed
by volunteers with no contractual arrangement regarding AWW and no earnings
from other employers, the Wages CSS shall staff the setting of wages with a BWC
attorney to consider setting wages at $0.
b) Wages for
volunteers shall include earnings from other employers if provided.
c) The Wages CSS
shall set wages in a claim for a volunteer only when compensation other than
scheduled loss will be paid. If only scheduled loss is paid it is not necessary
to set wages for the IW. Scheduled loss is paid based on the SAWW for the DOI
or date of disease in OD claims.
vi. Self-employed IWs:
a) When no earnings
are available, the Wages CSS shall set the AWW for self-employed IWs using the
minimum payroll reported for purposes of setting premium.
b) When earnings
are submitted, the Wages CSS shall staff with EM personnel to compare earnings
reported with payroll reported for premium.
i) If
earnings submitted are less than the payroll reported, wages shall be set based
on the earnings reported.
ii) If
earnings submitted are more than payroll reported, but appear to be legitimate,
the Wages CSS shall set wages based on the earnings submitted and staff with EM
to determine if a premium audit will be done.
iii) If earnings submitted
are more than the payroll report but there is some question regarding
legitimacy of the earnings, the Wages CSS shall make a referral to EM for a
premium audit.
vii. Injuries while involved in a
vocational rehabilitation plan:
a) The FWW and AWW
in claims that occur during participation in a vocational rehabilitation plan
will be set equal to the wages in the original injury claim.
b) Note that
compensation maximum and minimums are based on the DOI, or DOD in an OD claim,
in a newly filed claim.
6. See Section IV.D
above for additional information on periods of unemployment.
1. When TT or LM
compensation is payable and claims services staff has taken all necessary steps
to request earnings information and has not received the information, the IMS
may set the FWW at 1/3 of the SAWW following the guidelines in V.B.2.d above; or
2. Claims services
staff may refer to the wage team to set the FWW at 1/3 of the SAWW for the DOI,
or DOD in OD claims.
3.
Claims services staff shall not set AWW when earnings exist but have not
been submitted. The Wages CSS may set the AWW at $0 when there are no earnings
submitted prior to the DOI, or DOD in OD claims.
1. The initial
setting of wages shall be by BWC order.
2. Upon completion
of the calculation of wages by the wage team, claims services staff shall
include and exclude the appropriate wage in the claims management system prior
to completing the BWC order.
3. Claims services
staff shall include the setting of wages in the initial allowance BWC order
when sufficient wage information is available at the time the BWC order is
issued.
4. If the FWW has
been set at 1/3 of the SAWW, claims services staff shall include a statement in
the BWC order which informs the parties to the claim that the FWW has been set
based on the SAWW for the DOI, or DOD in OD claims.
5. Claims services
staff shall use the standard wage setting inserts provided in the BWC orders to
set wages and inform the parties to the claim the rate at which any anticipated
compensation will be paid.
6. Claims services
staff shall include the following statement in the BWC order when wages are
set: “BWC may reconsider the Full or Average Weekly Wage based upon information
currently on file or upon receipt of a written request to modify wages.”
1. In cases where
BWC set the current wages, claims services staff may increase or decrease wages
by BWC order.
a. Wages may be
reset based on the submission of new evidence along with a written request to
modify wages; or
b. Wages may be
reset when an error in a prior calculation is found.
i. Prior
to doing so, claims services staff must staff with a BWC attorney.
ii. The BWC
attorney may advise that the amount of the adjustment is too minimal, or the
time passed since the original setting of the wages is too great to support an adjustment.
2. When wages were
previously set by IC order, claims services staff shall not adjust wages. In
these cases:
a. A new wage
calculation tool worksheet may be completed if instructed by BWC Legal and claims
services staff shall refer the matter to the IC with BWC Legal’s recommendation.
b. A written
request shall be referred to the IC. Claims services staff shall indicate in
the notice of referral whether BWC recommends the request to recalculate wages
be allowed or denied, state the reasons underlying the recommendation (e.g.
that the wages were previously calculated based on better evidence), and cite
the specific evidence submitted to set wages, including the date the evidence
was received and from whom it was received.
3. Issuing a BWC Order
to Reset Wages
a. Claims services
staff may issue a BWC order resetting wages when the IC has not previously set
the wages.
b. Claims services
staff shall issue a BWC order to deny the request if wages were not set by the
IC and the written request to recalculate is not supported by the evidence on
file.
c. Claims
services staff shall include language which addresses the adjustment of
previously paid compensation in the BWC order to reset wages.
i. If a
closed period of compensation in the past will be adjusted, the BWC order shall
indicate the type of compensation and period that will be adjusted. For more
information, see Section V.M, Adjusting Previously Paid Compensation,
below.
ii. If
compensation is on-going and will be adjusted the BWC order will indicate the
type of compensation being adjusted, the start date of the adjustment and will
indicate that payments made prior to the order becoming final will be adjusted.
d. If an
overpayment will result from the change in wages, claims services staff shall
issue a separate BWC order establishing the overpayment amount once the wage
adjustment BWC order is final.
e. Claims services
staff shall include the following statement in the BWC order when wages are
set: “BWC may reconsider the Full or Average Weekly Wage based upon
information currently on file or upon receipt of a written request to modify
wages.”
1. Claims services
staff shall pay compensation based on a BWC order setting wages when:
a. The initial
allowance BWC order includes the granting of compensation and the setting of
wages and the claim is certified; or
b. The BWC order
setting wages and the BWC order for compensation are final or waiver of appeal
has been filed for each BWC order; or
c. The IC
order awarding compensation is issued, regardless of the wage order appeal
period.
2. Claims services
staff shall pay compensation that had been ordered to be paid but had not yet
been paid because wages had not been set, upon receipt of an IC order that sets
wages.
3. See Section V.M,
Adjusting Previously Paid Compensation, for information on adjusting
previously paid compensation based on a BWC or IC order which modifies wages.
1. Claims services
staff shall pay compensation and/or adjust previously paid compensation when
the appeal period for a BWC order which modifies wages expires and either:
a. No appeals were
filed; or
b. Waivers are
received.
2. Claims services
staff shall pay ongoing compensation at the new rate upon receipt of an IC
order that modifies wages.
3. If the IC order
specifically includes the adjustment of previously paid compensation claims
services staff shall adjust previously paid compensation and:
a. Release
additional payment due the IW upon receipt of the IC order; or
b. Issue the
appropriate notification of IC overpayment as specified in the Overpayment
of Compensation policy once the IC order is final.
4. If the BWC or IC
order does not specifically include the adjustment of previously paid
compensation claims services staff shall wait until the BWC or IC order is
final and then issue a BWC order to:
a. Adjust
previously paid compensation and release payment to the IW. Payment cannot be
made until the adjustment BWC order is final or waivers are received; or
b. Create an
overpayment as specified in the Overpayment
of Compensation policy and procedure. The overpayment cannot be
collected until the overpayment BWC order is final or waivers are received.
5. Depending on
what caused the wages to be reset, the period of an adjustment in compensation
varies.
a. If a request to
reset wages is filed by a party to the claim, and claims services staff
determined compensation is payable to the IW, adjustment is limited to any
compensation paid in the two years before the request to reset wages was filed
per State ex rel. Cobble v. IC. This adjustment is based on the date
payment is made, not the “from” and “to” dates for which compensation was paid.
For example, given the current date as 9/1/2013:
i. If
compensation was paid to the IW on 8/1/2013 for the period 1/1/2010 to
5/1/2010, that compensation would be adjusted because the date the payment was
made was within the last two years.
ii. If
compensation was paid to the IW on 6/1/2010 for the period 1/1/2010 to
5/1/2010, that compensation would not be adjusted because the payment was not
made within the last two years.
b. If no request
was made by a party to reset wages, all previously paid compensation affected may
be adjusted. These modifications to wages are commonly generated when an error
in calculation is discovered by BWC staff.
c. All
previously paid compensation may be adjusted if the change in wages results in
an overpayment.