This version of the form is not currently in use and is provided for reference only. Download this version of Form C-140 (BWC-1267) for the current year.
This is a legal form that was released by the Ohio Bureau of Workers' Compensation - a government authority operating within Ohio. As of today, no separate filing guidelines for the form are provided by the issuing department.
Q: What is Form C-140 (BWC-1267)?
A: Form C-140 (BWC-1267) is the initial application for Wage Loss Compensation in Ohio.
Q: What is Wage Loss Compensation?
A: Wage Loss Compensation is a benefit offered to workers who have suffered a permanent loss of earning capacity due to a work-related injury or occupational disease.
Q: Who can apply for Wage Loss Compensation?
A: Workers who have a permanent loss of earning capacity as a result of a work-related injury or occupational disease can apply for Wage Loss Compensation.
Q: What should I include in the application?
A: You should include detailed information about your injury or occupational disease, the impact it has had on your ability to earn a living, and any supporting medical documentation.
Q: What is the deadline for submitting the application?
A: The application must be submitted within two years from the date of the injury or the date on which you became aware of the occupational disease.
Q: What happens after I submit the application?
A: Once your application is received, the Ohio Bureau of Workers' Compensation will review the information provided, and if approved, you will begin receiving Wage Loss Compensation.
Q: How much Wage Loss Compensation will I receive?
A: The amount of Wage Loss Compensation you receive will depend on various factors, including the severity of your loss of earning capacity and your pre-injury or pre-occupational-disease wages.
Form Details:
Download a printable version of Form C-140 (BWC-1267) by clicking the link below or browse more documents and templates provided by the Ohio Bureau of Workers' Compensation.