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Workers’ Compensation – Understanding The Terminology

Workers’ Compensation – Understanding The Terminology

Understanding Temporary Total Disability, (And Arcane Concepts Like “Full Weekly Wage,” “Average Weekly Wage,” “Statewide Average Weekly Wage” And “Maximum Medical Improvement”).

Note: This article is about Ohio law. Other states may differ. These general concepts may not apply to your individual situation.

Temporary Total Disability (TTD)

Temporary Total Disability (TTD) is paid as compensation for lost earnings during the period of time the work injury prevents the claimant from returning to the position of employment the claimant held at the time of injury. TTD is paid for the entire period off work if the claimant misses 15 or more days of work; for days 8 through 14 if there are 15 or less days of lost time; and no TTD payment if the claimant misses 7 days or less.

For the first 12 weeks of lost time, TTD is paid at the rate of 72% of the full weekly wage (FWW), and for every week of benefits after the first 12 weeks, 2/3 of the average weekly wage (AWW). If the claimant’s FWW and AWW exceed the statewide average weekly wage (SAWW) TTD payments are limited to the SAWW. As a minimum TTD benefit, if the FWW and AWW are less than 1/3 of the SAWW, the claimant receives the full FWW and/or full AWW (unreduced by 72% and 2/3 respectively). (Please see below for definitions of FWW, AWW and SAWW).

TTD generally terminates when the claimant returns to work, is offered a job within the physical restrictions or when the claimant reaches maximum medical improvement (MMI). To receive TTD, the claimants must be under the care of a physician who certifies (most often using Bureau form C-84) that the claimant cannot return to employment due to the allowed condition(s) in the claim, and the claimant must not be working.

Maximum Medical Improvement (MMI) is defined by the Ohio Administrative Code as “a treatment plateau (static or well stabilized) at which no fundamental functional or physiological change can be expected within reasonable medical probability in spite of continuing medical or rehabilitative procedures.” Voluntary abandonment of the workforce or retirement, dismissal for violation of a work rule and incarceration, with some limitations, are employer defenses to payment of TTD.

Procedure

When an award of benefits is payable, the Bureau will calculate the average weekly wage (AWW) and full weekly wage (FWW) using wage documentation that has been added to the claim file by the employer/and/or claimant. Usually the employer provides wage information (W2 forms, payroll records, check stubs) after the initial claim application. Employers or claimants can submit (with payroll records, check stubs W2 forms or other federal earnings reports) on Bureau form C-94-A.

Statewide Average Weekly Wage (SAWW)

The statewide average weekly wage (SAWW) for the year in which the injury occurred is the maximum rate payable for all forms of workers’ compensation. The Bureau sets the rate based on the average weekly earnings of Ohio employees who are covered by unemployment compensation.

Full Weekly Wage (FWW)

The full weekly wage (FWW) is the average of the claimant’s earnings (including overtime) during the six week period immediately preceding the injury, or the actual earnings (excluding overtime) for the last seven days prior to the date of injury. The claimant can choose the calculation that results in the higher FWW. The FWW is set at the claimant’s hourly rate times the number of hours the claimant was scheduled to work during the week of injury if the claimant worked less than seven days prior to the date of injury.

Average Weekly Wage (AWW)

The average weekly wage (AWW) is calculated by dividing the claimant’s total gross earnings from all employers during the year prior to injury by 52 weeks. Earnings may include in kind payments that the claimant would normally treat as income but not in kind payments that are merely reimbursement for advanced expenses. Periods of involuntary unemployment may be excluded from the calculation.

The information on this article is for general reference only. To apply the information to an individual situation, you must consult a qualified professional. Unless you contract for specific services from us, there is no attorney-client relationship established.