Navigating the Ohio workers’ compensation system can be difficult and confusing, especially if you have never had to file a claim before. With the stress of the injury and recovery, finding the time and energy to research the details of the process can be overwhelming. To help you better understand workers’ compensation, we provide information about some of the most common terms you may read or hear while trying to obtain care and compensation for your work injury.
Average Weekly Wage (AWW) – The average weekly wage is the total earnings for the year prior to injury from all employment divided by the total weeks worked (up to 52). In Ohio, TTD after the first 12 weeks of disability is paid at 2/3 of the worker’s average weekly wage.
Bureau of Workers’ Compensation (BWC) – Ohio’s workers’ compensation system is state-run, and the Ohio Bureau of Workers’ Compensation is the agency that handles the administration and payment of work injury claims on behalf of workers whose employers pay premiums into it. It is also known as the state insurance fund.
First Report of Injury (FROI) – To request compensation or benefits for job-related injuries, a claim must be filed with the BWC. The FROI is the form used to make this report, and it includes information such as your name, employer, date of injury, description of the accident, the cause of injury, and type of injury.
Full Weekly Wage (FWW) – Your earnings for the six weeks prior to injury divided by 6 or the seven days prior to injury (excluding overtime), whichever is greater. The first 12 weeks of TTD is paid at 72% of the FWW.
Independent Medical Examination (IME) – This exam can be required to determine eligibility for benefits. The BWC or an employer typically request it, and its purpose is to evaluate the condition of the worker and the extent to which his injury affects his ability to work. If requested by the employer, it is more properly termed a Defense Medical Examination (DME) as there is little that is "independent" about it. Defense examiners are well-known in the workers' compensation community and often render reports supportive of an employer's interests.
Industrial Commission (IC) – The Industrial Commission is a state administrative agency which serves as the governing body for workers’ compensation. If there is a dispute in your claim, the IC will hear your case and make a ruling about your benefits. While it is not a court of law, the decisions of the IC are binding.
Lump sum settlement – Workers’ compensation benefits are typically paid every other week. Sometimes it is advantageous to settle a case with one larger payment. These settlements are typically final and negate any future rights to compensation and medical benefits for that same injury. Note: a settlement does NOT prohibit filing a claim for another injury to the same part of the body.
Managed Care Organization (MCO) – In Ohio, benefits are coordinated by the BWC and an MCO. The MCO establishes the provider networks and helps to arrange medical care.
Maximum Medical Improvement (MMI) – For some workers, a complete recovery from a work injury is impossible. However, temporary total disability benefits may be payable until the injured worker has reached maximum medical improvement, the state in which the worker has likely recovered as fully as is possible.
Permanent Partial Disability (PPD) – Permanent partial disability compensation is payable to those who suffer permanent loss of bodily function following an injury regardless of ability to return to work.
Permanent Total Disability (PTD) – These benefits are available for those whose injuries are so severe that they cannot return to work in any capacity after their injury. It is illegal to work while receiving PTD unless PTD has been awarded based upon a statutory basis (such as loss of two legs, an arm and a leg, blindness, etc.).
Self-Insured Employer (SI) – These are larger employers who have met certain statutory requirements and been authorized by the state to pay compensation and benefits directly to an injured worker. SI employers, not the BWC, administer these claims.
State-Funded Employer – This term refers to nearly all Ohio employers who pay premiums into the state insurance fund to obtain statutorily mandated workers' compensation coverage for their employees.
Temporary Total Disability (TTD) – Temporary total disability is a very common benefit. It provides care and compensation for those who suffer an injury that prevents them from working while they recover. TTD is payable until an injured worker returns to work, is released to return to work, is deemed to have reached MMI or has refused a legitimate offer of work within her restrictions. It is "temporary" because it is payable during recovery from an injury and "total" in that the injury prohibits a complete return to the former position of employment.
Statute of Limitations (SOL) – Workers in Ohio must report their injuries to their employers soon. And state law provides workers one year from injury, or two years for claims involving occupational disease, to file a claim for benefits with the BWC. If an injured worker attempts to obtain benefits after the statute of limitations deadline, they will be denied, even if s/he has a valid claim.
The workers’ compensation system can seem confusing, but injured workers have rights that can be protected. At Monast Law Firm, our experienced Ohio legal team can help ensure that you and your family can obtain the care and compensation you need. If you have questions about your rights or you are still unsure about the process, request a free copy of our book, The Worker’s Guide to Injury Compensation in Ohio, or call our Upper Arlington office to speak with a member of our team.