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Injured workers must use this form to initiate or extend payment of temporary total disability benefits. The injured worker provides information about employment and benefits received during the time of disability.

After 12 weeks of missed work, TT Compensation benefits are paid at an average weekly-wage (AWW) rate. This rate is based on their earnings for the 52 weeks prior to the date of their injury. An average of these earnings is calculated, and TT Compensation is paid at 66 2/3 percent (66 2/3 %) of this average.

A PPD award is paid at the rate of 66 ? percent of the injured worker's average weekly wage in a one-time lump sum payment. Even though a PPD award is paid in a lump sum payment, the award is not a settlement of your claim. In fact, payment of a PPD award extends the life of your claim for an additional 5 years.

When you reach the level of maximum medical improvement after a workplace injury and nothing more can be done to improve your condition, if you are still partially disabled, a doctor will reevaluate you and assign you a permanent impairment rating (PIR) that ranges from one percent to one hundred percent.

What are the time limits (statute of limitations) to file a claim? A claimant must file a notice of injury or death with BWC or the Ohio Industrial Commission (IC) within one year of the injury or death.

The exact amount will be based on your wages at the time of your injury. For the first 12 weeks, you will receive 72% of your full weekly wage. After that, you will be paid 66 2/3% of your average weekly wage. Benefits will continue until you may return to your former position of employment.