|OhioBWC - Basics: Available Benefits|
BWC offers a variety of compensation types. If your claim has been allowed you may qualify for compensation even if you have not lost time from work as a result of your injury. Here are some of the types of compensation.
Temporary total (TT) - Provided to compensate an injured worker who is totally disabled from work for a short period of time due to the work related injury or occupational disease. TT is generally the initial award of compensation paid to compensate for lost wages.
Scheduled loss (SL) - A certain amount of permanent damage (called residual damage) may remain as a result of the injury. A scheduled loss award encompasses amputations and loss of use, including vision and hearing. A scheduled loss award is based on the loss suffered by the injured worker prior to treatment, not on the injured workers condition after treatment.
To apply for a scheduled loss award, file a Motion (C-86) with supporting medical evidence. Compensation for this type of award is based upon the nature of the injury as well as the year that the injury occurred.
BWC or the self-insuring employer will pay all initial awards of SL compensation under ORC 4123.57(B). This includes payment of all scheduled losses (amputations), loss of use, ankylosis, loss of vision and total loss of hearing. These awards are commonly referred to as "Paragraph B" awards.
An injured worker is entitled to an amputation award when s/he sustains a loss of a body part that's a result of severance through the bone due to a work related injury.
Permanent impairment of a member without severance usually entitles the injured worker to an award and is regarded as being the same as loss by severance.
Percentage of permanent partial award (%PP) - A certain amount of permanent damage (called residual damage) may remain as a result of the injury. %PP is commonly referred to as a C-92 award approved for residual impairment resulting from an allowed injury or occupational disease according to ORC 4123.57. For example, if an injured worker sustains a broken arm and can no longer extend it to the full degree, s/he would be eligible for an award based upon the residual loss. The permanent impairment may be physical or psychiatric.
%PP is not payable for any psychiatric condition(s) unless there is an allowed accompanying medical condition in the claim. C-92/C-92A awards are based on medical information and the findings of the exam/review. Their determination is supported by an independent exam and the examining physician will not contact the injured workers doctor/provider of record for medical information.
Permanent total disability (PTD) - The injured workers inability to perform sustained remunerative employment due to the allowed condition(s) in the claim. PTD benefits compensate the injured worker for impairment of earning capacity. Compensation for PTD is payable for life. When an injured worker applies for PTD, s/he must attend an Industrial Commission of Ohio examination and hearing to determine if s/he meets the eligibility criteria.
Disabled Workers Relief Fund (DWRF) - A separate supplemental fund established to provide relief to an injured worker who is receiving permanent total disability benefits by raising the cost of living level.
Change of occupation (COA) - Injured workers who have contracted silicosis, coal miners pneumoconiosis or asbestosis may be entitled to a change of occupation award according to ORC 4123.57(D). They have been medically advised to change occupations so as to substantially decrease further exposure to silica dust, asbestos or coal dust.
Firefighters and police officers who have contracted a cardiovascular and pulmonary disease as defined in ORC 4123.68 may be entitled to a change of occupation award according to ORC 4123.57(E). They have been medically advised to change their occupations so as to substantially decrease further exposure to smoke, toxic gases, chemical fumes and other toxic vapors.
The maximum amount payable for this type of award is $10,000 based upon the severity of the damage. FD awards are in addition to other types of partial disability compensation or scheduled loss awards paid according to ORC 4123.57. under and are paid in a lump sum.
Self-insuring employers are responsible for the determination and issuance of a FD award for their claims. BWC is responsible for SI bankrupt FD award claims.
Wage loss (WL) - Paid to an injured worker whose earnings are reduced as a direct result of restrictions from the allowed conditions in the claim. Wage loss is payable in claims with a date of injury or diagnosis on or after Aug. 22, 1986.
Two conditions must be met for eligibility.
Living maintenance wage loss (LMWL) - May be paid to an injured worker with a date of injury on or after Aug. 22, 1986. The injured worker must have completed a rehabilitation plan and continues to have physical restrictions and experiences a wage loss upon return to work.
Living maintenance (LM) - A type of compensation paid to an injured worker while actively participating in an approved rehabilitation plan. This section in the MCO Policy Reference Guide provides information about: living maintenance (LM) payments which are provided to the injured worker in place of temporary total compensation and suspending and terminating LM.
ORC 4121.63 states that BWC will issue this compensation for a period not to exceed six months in the aggregate, unless BWCs review reveals the injured worker will benefit by an extension. The claims service specialist can issue living maintenance upon receipt of the vocational rehabilitation agreement and plan.
Death claims - A dependent's right to death benefits does not begin until after the death of the worker. If the decedent settled a workers' compensation claim prior to their death, this will not stop the dependent's right to file a claim for death benefits. A death claim is filed by the dependents of an injured worker who died as a result of an industrial injury or occupational disease. Dependent death benefits will be based on the level of dependency or support each dependent had while the worker was living.
Death benefits can be divided into two categories. The first is when death results instantaneously as a result of an injury. The second is when death is not an instantaneous but a proximate result of an injury or occupational disease.
You can apply for death benefits in any one of the following ways:
Violation of specific safety requirement (VSSR) - No employer will violate a specific workplace safety requirement established by legislation or BWC. The injured worker or dependent, when there has been a fatality may file an application for a VSSR award if there is evidence that a violation has or may have occurred from the failure of the employer to comply with a specific safety requirement - Ohio Constitution Article II 35, ORC4121.47(A), OAC 4123-3-20.
The Industrial Commission maintains jurisdiction over the application and determination process. The staff hearing officer hears the request for a VSSR award and can assess a penalty ranging from 15 to 50 percent of the maximum workers compensation award established by law if the employer is found to be in violation of a specific safety requirement. To apply for a VSSR award, complete the Application for Additional Award for Violation of Specific Safety Requirement in a Workers' Compensation Claim (IC-8/9)
Lump sum settlement - Per Ohio Revised Code (ORC) 4123.65, a settlement can be initiated only by the injured worker/injured worker representative, employer/employer representative or BWC. The managed care organization (MCO) is not a party to the settlement; therefore, the MCO may not initiate nor advise the injured worker to settle. However, an MCO may identify potential candidates for pursuit of settlement based on treatment patterns/trends.
The injured worker or employer should use the The Settlement Agreement and Application for Approval of Settlement Agreement (C-240) for the settlement of state-fund claims. If the employer is self-insuring, use the Self-Insured Joint Settlement Agreement and Release (SI-42), and submit directly to the employer.
Lump sum advancement - The prepayment of future compensation. Advancement applications will be reviewed for meeting financial relief and rehabilitation purposes only. An injured worker or surviving spouse currently receiving permanent total, scheduled loss or death benefits may request advancements. Request an advancement with the Application for Lump Sum Advancement (C-32), IC-32A and OIC-3016.
Requests for financial relief, such as household bills, estimates of emergency repairs or purchases, school tuition, handicap lift installed in an existing or new van, etc. must have supporting documentation attached to the application. Determination of attorney fees remains with the Industrial Commission of Ohio (IC). All requests for advancement of attorney fees should be forwarded to the IC. After determination, the IC returns the request to the assigned BWC claims service specialist for processing.