In the landscape of employment and compensation laws in Ohio, the Wage Agreement form serves as a critical instrument for both employers and employees navigating the complexities of wage advancements during periods of temporary disability. Essentially, this form is a safeguard designed to preclude potential overpayments to employees by the Bureau of Workers' Compensation (BWC) following a work-related injury. Before any payments are made by the BWC, the form requires completion and signatures from both the employer and the employee, underscoring a mutual understanding and agreement. It details the specifics of wage advancements—from the duration and amount per week to the total sum advanced. Moreover, the agreement outlines a reimbursement mechanism to the employer, should compensation be paid over the same timespan the advancements were made. Significantly, this agreement enables the BWC to issue compensation directly to the employee through the employer for up to the first 12 weeks post-injury, with provisions for extending this arrangement under special circumstances. By mandating personal endorsement of the compensation checks by the employee, it further ensures a level of personal accountability and direct involvement in the compensation process. This form not only facilitates a smoother financial management process during the employee's recovery period but also reflects a structured approach to handling wage advancements and compensations, aiming to balance the interests of both the employer and the injured employee.
| Question | Answer |
|---|---|
| Form Name | Wage Agreement Form Ohio |
| Form Length | 1 pages |
| Fillable? | No |
| Fillable fields | 0 |
| Avg. time to fill out | 15 sec |
| Other names | C 18 wage agreement form |
Wage Agreement
INSTRUCTIONS
•Submit this form prior to payment by BWC to avoid a possible overpayment to the employee.
•Employer and employee must sign and date this agreement.
•Mail or fax this completed form to your local BWC service ofice.
Employee name |
Date of injury |
Claim number |
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Employer name |
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Telephone number |
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The employer has paid or agrees to pay an advancement of wages to the above employee until the payment of temporary total compensation begins. Advancement of wages begin on
___________________ to ____________________ at a rate of $ ____________ per week for a total of
$______________ .
By signing this agreement, the employer and employee have entered into a wage agreement to reimburse the employer at least to the extent of any compensation paid to the employee over the same period in which the employer paid wages or made advancements.
This agreement shall grant BWC the authority to send warrants for temporary total compensation to the employee in care of the employer for no more than the irst 12 weeks of compensation closely following the date of injury. The warrants must be endorsed personally by the employee. BWC may pay a wage agreement beyond 12 weeks involving special circumstances.
Employee signature
Date
Employer signature and title
Date