Ohio Workers Compensation

Ohio workers compensation coverage plays an important role in helping businesses handle work-related injuries and illnesses. Ohio requires that employers obtain workers compensation coverage through a state-run system or self-insure if they qualify. Employers with employees in OH can find important workers compensation requirements information here and how a third-party administrator (TPA) may help.

Understanding workers compensation in Ohio: Bureau of Workers’ Compensation (BWC)

Ohio sits at the heart of the nation. The traffic veins of major interstate highways connect the “3Cs” (Cleveland, Columbus and Cincinnati) and serve as arteries for national commerce. As a vital and populus state, Ohio is home to a workforce of millions that drive its thriving commercial economy. A workforce of this scale depends on a broad supportive network to stay protected and productive.

The state of Ohio has chosen to help protect their workforce with employer-mandated state workers compensation insurance through the Ohio Bureau of Workers’ Compensation (BWC). For eligible self-insurers, Travelers can bring an extra layer of support through our affiliate Constitution State Services (CSS). With customizable claim services and industry benchmarking, CSS can give Ohio businesses a full-service and high-performance workers comp third-party administrator (TPA) offering.

Who is required to carry workers compensation insurance in Ohio?

Ohio operates as a monopolistic workers compensation state, meaning employers with one or more employees must obtain workers compensation coverage from the Ohio Bureau of Workers’ Compensation (BWC).

Employers have two coverage options: state-funded and self-insured.

State-funded employers are required to pay premiums, determined based on payroll and industry classification, to the Ohio BWC.
Self-insured employers must apply for self-insurance status and meet specific financial and administrative criteria. These employers are responsible for managing and paying claims directly or contracting with a TPA for these services.

Ohio requirements to consider

It is crucial for employers to maintain coverage, as failure to do so can result in penalties, fines, criminal prosecution for workers compensation fraud and civil liability for employee work-related injury costs.
Ohio Bureau of Workers’ Compensation (BWC) can seek to recover all unpaid premiums from uninsured employers for the period of time there was a lapse in coverage. Failure to pay BWC can result in a lien on an employer’s property and legal action in civil and/or criminal court.
Employers should be aware that state-issued workers compensation policies do not include employer liability insurance, which provides coverage for lawsuits filed by employees for work-related injuries. Employers liability insurance coverage can be secured separately by an employer with an employers liability (stop gap) coverage from private insurers such as Travelers.

The role of third-party administrators (TPAs) in monopolistic states

In Ohio, the Bureau of Workers’ Compensation (BWC) is the exclusive provider of workers compensation insurance. However, businesses that qualify and elect to self-insure can contract with a third-party administrator (TPA), to manage their claims. A TPA such as the Travelers affiliate – Constitution State Services (CSS) – can help better serve employees through the claim process and manage employer costs more effectively.

How using CSS as a TPA can help businesses in Ohio

Stability, expertise and experience: Dedicated Claim professionals help provide optimal employee and employer outcomes.
Data and analytics: Customizable industry benchmarking dashboard for effective risk management.
Solutions for managing severity: Advanced predictive models that identify outliers sooner for quicker intervention.
Investigation and fraud prevention: Our industry leading investigators work with Claim professionals to detect, investigate and deter fraudulent activity.
Resources for injured employees: Personalized support with virtual visits and nurse case management.

Overview of workers compensation requirements in Ohio

Understanding Ohio workers compensation is essential for employers. Being aware of state requirements helps employers comply with the law and support employees. This is an overview of the fundamentals of qualified self-insured employer responsibilities and the benefits employees may receive under OH workers compensation law.

Ohio workers compensation employer responsibilities overview

Compensable injuries

Generally, injuries arising out of and in the course of employment, regardless of whose fault it is, have potential for workers compensation benefits. This includes occupational diseases.

Posting notices

Self-insured employers who have secured workers compensation through the Ohio Bureau of Workers Compensation must post in conspicuous locations around the workplace(s) or electronically where accessible to employees a “Certificate of Premium Payment,” “Certificate of Ohio Workers’ Compensation Coverage,” “Rebuttable Presumption” notice (Form DP-29) and “Notice to Employees.” The “Certificate of Ohio Workers Compensation coverage” must be posted with the “Rebuttable Presumption” notice.

Providing medical treatment 

Self-insured employers in Ohio can have a Bureau of Workers’ Compensation-certified Qualified Health Plan (QHP) or equivalent plan to manage the medical treatment of injured employees.

Injured employees of self-insured employers with a QHP must select their initial treating physician from the QHP.
Employers should prominently display information about their designated QHP and provide clear instructions for reporting workplace injuries.

Providing lost wages (indemnity) 

Wage loss benefits are available to an injured employee unable to work due to a work-related injury or illness.

Benefits may also be payable to those who experience a reduction in earnings due to restrictions resulting from an allowed condition in their claim.

Prompt reporting and forms

Employers should encourage employees to promptly notify them of any accident or injury. Once aware of a work-related injury, the employer should make sure the injured employee understands they can seek medical treatment if needed.

Self-insured employers or their third-party administrator (TPA) and the treating physician may need to report claim information throughout the claim process.

Prompt reporting is essential to avoid penalties and provide timely benefits for injured employees.

Employers with coverage through the Ohio Bureau of Workers’ Compensation (BWC) should familiarize themselves with BWC requirements.

Record keeping

Employers should maintain thorough documentation, including details about what happened, when, where and witnesses involved. Accurate record keeping and prompt reporting to the Ohio Bureau of Workers' Compensation (BWC) can play a key role in a timely and complete investigation and handling of the claim.

The employer should continue to maintain and provide necessary information to the BWC or their third-party administrator throughout the claim process as it is vital for efficient claim handling and compliance with the workers compensation law.

Penalties

Employers who fail to comply with workers compensation laws may face penalties and fines.

Ohio workers compensation employee benefits overview

Full Weekly Wage (FWW) & Average Weekly Wage (AWW) in Ohio

A Full Weekly Wage (FWW) calculation includes total gross wages and overtime earned in the 6 weeks before the injury. After 12 weeks, the benefit rate shifts to a calculation based upon the employee’s Average Weekly Wage (AWW). An employee’s AWW is a set calculation based on Ohio state requirements and helps to determine workers compensation wage benefits after 12 weeks.

Employers must provide accurate wage records to determine the employee’s FWW and AWW.

Temporary Total Disability (TTD) benefits

Temporary Total Disability (TTD) benefits in Ohio workers compensation are available to injured employees certified by an Ohio Bureau of Workers’ Compensation (BWC) provider as unable to work due to injury.

For the first 12 weeks, compensation is calculated at 72% of the employee’s Full Weekly Wage (FWW). After 12 weeks, the benefit rate is 66 2/3% of the Average Weekly Wage (AWW).
Benefit amounts are subject to minimum and maximum limits set annually by the BWC.
A 7-day waiting period applies before benefits begin, but if the disability lasts 14 consecutive calendar days, compensation for those first 7 days becomes payable.
There is no limit on TTD benefits, provided the injured employee remains under medical certification.
Benefits are payable upon receipt of written certification from the physician of record confirming the employee is temporarily and totally disabled.
TTD benefits may terminate when the physician releases the employee to full duty or determines the employee has reached Maximum Medical Improvement (MMI).

Wage loss benefits

An employee may be eligible for wage loss benefits when the employee has:

returned to work in a position other than their former one,
been unable to find employment consistent with their disability, or
experienced a decrease in earnings as a direct result of physical or psychiatric restrictions caused by the injury.

There are two types of wage loss benefits: 

- Working Wage Loss: When they have returned to employment that is not their former position 
- Non-Working Wage Loss: When they have not returned to work because they have been unable to find suitable employment

Benefits are 66 2/3% of the difference between the pre-injury Average Weekly Wage (AWW) and post-injury earnings, subject to the state maximum. Capped at the number of weeks set by statute for a combination of working and non-working wage loss.

Permanent Partial Disability (PPD) benefits

Permanent Partial (PPD) benefits compensate employees for permanent impairments resulting from a work-related injury or illness. The Bureau of Workers’ Compensation (BWC) will determine the necessary action upon receipt of an “Application for Determination or Increase of Percentage of Permanent Partial Disability” (Form C-92).

The compensation rate is based on the percentage of impairment and the statewide Average Weekly Wage (AWW).
Benefits are determined through medical evaluation and Ohio Bureau of Workers’ Compensation guidelines.
Maximum number of weeks are set by statute for scheduled body parts.

Permanent Total Disability (PTD) benefits

Permanent Total Disability (PTD) benefits are provided to employees permanently unable to perform any sustained remunerative employment due to a work-related injury or illness.

Compensation is paid at a rate of 66 2/3% of the Average Weekly Wage (AWW), subject to minimum and maximum limits.
These benefits are payable for the lifetime of an injured employee.
Eligibility may result from the loss of both hands, arms, feet, legs, eyes, or any combination of two, as well as from other conditions that prevent the injured employee from engaging in sustained employment.

Death claim benefit

Wholly dependent persons of injured workers whose death is caused by the work injury or occupational disease may be eligible for a death claim benefit.

Benefits are 66 2/3% of the AWW, subject to state minimum and maximum rates.
If there is more than one wholly dependent person, the BWC apportions the amount payable among the dependent persons.
A surviving spouse and children under 18, or up to 25 if enrolled full-time in an accredited educational institution, or physically or mentally incapacitated, are presumed by statute to be wholly dependent.

Vocational rehabilitation

If requested by the employee with a significant impediment to employment, self-insured employers are required to provide vocational rehabilitation services at least equal in quality and content to services administered by the Ohio Bureau of Workers’ Compensation (BWC).

Medical benefits

Medical treatment coverage includes services necessary to treat a work-related injury or occupational disease. If the self-insured employer has a Qualified Health Plan (QHP), the injured employee must choose the initial provider from within the QHP.

Subject to limited exception, providers must be selected from a BWC-certified pool of providers.
Medical doctors (MDs), doctors of osteopathic medicine (Dos) and doctors of chiropractice (DCs) are considered “physicians”.
Once a provider is deemed the employee’s physician of record, changing providers requires written notice.

Legislative updates

Regulations, laws and potential changes that can shift your course

As the nation’s largest writer of workers compensation insurance, Travelers is committed to understanding new and evolving legislation, regulations and trends at the state level. Our employees serve on regional and national associations, boards and committees to advocate on behalf of our customers and the industry. We educate stakeholders on the impact legislation can have on businesses. By taking an active role in the legislative process, we participate in the important dialog around worker safety and advocate for best practices industry-wide so all can benefit from our workers compensation expertise.

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Constitution State Services

Third-Party Administration (TPA) workers compensation claim services

Travelers affiliate Constitution State Services (CSS) Claim professionals bring the stability and expertise needed to deliver optimal workers compensation outcomes.

Every injured employee receives a personalized recovery experience.

Dedicated Claim professionals integrate with business teams to accurately understand organizational needs.

Capabilities are aligned to the unique demands of a business – meaning businesses only pay for the services chosen.

Industry-leading practices and resources help contain claim costs.

Explore CSS

Information for Ohio businesses

Resources

Constitution State Services (a TPA affiliate of The Travelers Companies, Inc.)

Travelers workers compensation hub

Travelers workers compensation claim process

TravPay®/Pay-as-you-go billing

Premium Audit

Risk Management Information Services (RMIS)

Travelers Risk Control

Government links

Ohio Bureau of Workers’ Compensation (BWC)

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Sources
https://info.bwc.ohio.gov/

Ohio Workers Compensation

Who is required to carry workers compensation insurance in Ohio?

Ohio requirements to consider

Compensable injuries

Posting notices

Providing medical treatment

Providing lost wages (indemnity)

Prompt reporting and forms

Record keeping

Penalties

Full Weekly Wage (FWW) & Average Weekly Wage (AWW) in Ohio

Temporary Total Disability (TTD) benefits

Wage loss benefits

Permanent Partial Disability (PPD) benefits

Permanent Total Disability (PTD) benefits

Death claim benefit

Vocational rehabilitation

Medical benefits

Workplace Safety Resources

Workplace Safety Resources

Workplace Safety Resources

Workplace Safety Resources

Resources

Government links

Workplace Safety Resources

Employee Wellness Resources

Workplace Safety Resources

Providing medical treatment 

Providing lost wages (indemnity) 

Full Weekly Wage (FWW) & Average Weekly Wage (AWW) in Ohio