Duration of Wage Loss Payments

The following information applies to claims with dates of injury on or after August 25, 2006.  According to RC  4123.56 (B)  the IW may receive a maximum of 200 weeks of wage loss however, the 200-week maximum may be extended up to 226 weeks if 26 weeks of Non-Working Wage Loss (NWWL) is paid.  The 226-week maximum may be extended in some circumstances and may include Working and Non-Working Wage Loss (WWL and NWWL) and Living Maintenance Wage Loss (LMWL).  Refer to examples below.

 

NWWL is limited to 52 total weeks.  The first 26 weeks of NWWL are excluded from the 200 week max, meaning that if an IW receives 200 weeks of Working Wage Loss (WWL) and/or LMWL, they are also entitled to an additional 26 weeks of NWWL making the total wage loss maximum 226 weeks. V3 will calculate the maximum number of weeks of WWL, NWWL and LMWL and will prompt the user to send a letter, titled  “Notice of Expiration of Wage Loss”,informing the injured worker of such.

 

The following examples illustrate some possible combinations in which an IW may reach the maximum number of weeks of wage loss payable:

 

Example One:

IW receives 52 weeks of NWWL.

IW may receive an additional 174 weeks of WWL OR receive a 148 weeks of LMWL.

 

Example Two:

IW receives 31 weeks of NWWL (the first 26 weeks are excluded from the 200-week max for WWL therefore only 5 of these weeks count toward the 200 week max of WWL).

195 weeks of WWL, OR

21 weeks of NWWL and 174 weeks of WWL, OR

169 weeks of LMWL if no additional wage loss paid before LMWL is awarded; later 21 weeks of NWWL could potentially be awarded.

 

Example Three:

IW receives 200 weeks of WWL and/or LMWL.

The IW may receive 26 weeks of NWWL.

 

Example Four:

IW initially receives 15 weeks of NWWL.

IW may receive 200 weeks of WWL or 185 weeks of LMWL and an additional 11 weeks of NWWL, OR

IW may receive 37 additional weeks of NWWL and 174 weeks of WWL, OR

IW may receive 185 weeks of LMWL if no additional wage loss is paid.

 

Example Five:

IW receives 20 weeks of NWWL then changes to LMWL

IW may receive 180 weeks of LMWL (for the maximum of 200 weeks)

IW may receive an additional 26 weeks of NWWL(52 weeks max not used and not to exceed max of 226 combined NWWL and WWL) or 200 weeks of WWL (200 weeks max of WWL not met)

 

Living Maintenance Wage Loss

The following information applies to claims with dates of injury on or after August 22, 1986.  According to RC  4121.67 , the IW may receive the maximum of 200 weeks of Living Maintenance Wage Loss (LMWL) minus any weeks of NWWL and/or WWL.  Refer to examples below.

 

The following information applies to claims with dates of injury on or after August 25, 2006:  Senate Bill 7 (SB 7) did not directly affect RC  4121.67 , the section of the code that addresses LMWL but some indirect effects in duration of compensation may be seen when NWWL and LMWL are received.  Refer to examples above.

 

If an injured worker desires to transition from LMWL to wage loss, they must comply with the requirements of Rule  4125-1-01 .  If the injured worker meets the requirements as outlined in the rule, an order will be issued to publish the allowance decision.  If they do not meet the requirements, the issue will be referred to the Industrial Commission.

 

Duration of Wage Loss Payments - DOI Prior to August 25, 2006

An injured worker may receive a maximum of 200 weeks of wage loss (WL), regardless of the number of Living Maintenance Wage Loss (LMWL) weeks that were previously paid in the claim.

 

Example:  WL-LMWL-WL Combination

Sequence

Type of Wage Loss Paid

Period Paid

Number of Weeks Paid

 

200

-52

ç148

1

WL

1994

52

2

LMWL

1995-1998

148

3

WL

1999-2001

148

 

4

Maximum Total

348

 

 

1.  The IW first received the 52 weeks of WL.

2.  Later, the IW became eligible for LMWL.

The number of WL weeks previously paid (52) is deducted from the maximum number of LMWL weeks (200).

The IW received the maximum remaining weeks of LMWL (148), in this claim.

3.  The IW again became eligible for WL.  The remaining amount of WL weeks payable to the IW is 148 weeks because the IW had previously received 52 weeks of WL.

The number of LMWL weeks previously paid does not reduce the maximum number of WL weeks.  The IW has now received the total maximum WL weeks (200), payable in this claim.

4.  No further WL or LMWL compensation is payable in this claim.

 

Example: LMWL and WL combination:  LMWL Paid First

Sequence

Type of Wage Loss Paid

Period Paid

Number of Weeks Paid

1

LMWL

1990-1993

200

2

WL

1995-1998

200

3

Maximum Total

400

 

1.  The IW initially received the maximum weeks of LMWL, (200 weeks).

2.  Later, the IW received the maximum weeks of WL, (200 weeks).

3.  Since LMWL was paid prior to the receipt of WL, there is no reduction of LMWL weeks.  The IW has received the maximum amount of LMWL and WL compensation that is payable in this claim.

 

LMWL Maximum Weeks

An IW may receive the maximum of 200 weeks of LMWL, but those weeks will be reduced by any weeks of Wage Loss (WL) that were previously paid in the claim.  This includes if the IW received LMWL first, then WL, and then goes back to LMWL.

 

Example:  WL-LMWL-WL Combination

Sequence

Type of Wage Loss Paid

Number of Weeks

 

1

LMWL Paid

125

 

2

WL Paid

25

 

3

Max number of LMWL weeks

200

 

4

Subtract the number of LMWL and WL weeks already paid

-150

          

          200

        -150

5

Max LMWL weeks that can be paid

50

ç       50

 

1.  The IW initially received 125 weeks of LMWL.

2.  Later, the IW received 25 weeks of WL.

3.  The LMWL max number of weeks is 200 weeks.

4.  The total LMWL and WL weeks previously paid are 150 weeks.  Subtract 150 weeks previously paid from the LMWL max of 200 weeks.

5. There are 50 weeks of potential LMWL that can be paid to reach the 200 weeks LMWL max.