Form RH-94A (BWC-3061) Report of Earnings for Living Maintenance Wage Loss Compensation - Ohio

Form RH-94A (BWC-3061) Report of Earnings for Living Maintenance Wage Loss Compensation - Ohio

What Is Form RH-94A (BWC-3061)?

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.

FAQ

Q: What is Form RH-94A (BWC-3061)?
A: Form RH-94A (BWC-3061) is the Report of Earnings for Living Maintenance Wage Loss Compensation in Ohio.

Q: What is Living Maintenance Wage Loss Compensation?
A: Living Maintenance Wage Loss Compensation is a benefit provided in Ohio to workers who have suffered a work-related injury or occupational disease and have returned to work with restrictions that result in a loss of earning capacity.

Q: Who needs to fill out Form RH-94A (BWC-3061)?
A: The injured worker, along with their employer or authorized representative, needs to fill out Form RH-94A (BWC-3061).

Q: What information is required on Form RH-94A (BWC-3061)?
A: Form RH-94A (BWC-3061) requires information such as the injured worker's name and identification number, employer information, and details about the earnings and restrictions.

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Form Details:

  • Released on February 10, 2016;
  • The latest edition provided by the Ohio Bureau of Workers' Compensation;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a printable version of Form RH-94A (BWC-3061) by clicking the link below or browse more documents and templates provided by the Ohio Bureau of Workers' Compensation.

Download Form RH-94A (BWC-3061) Report of Earnings for Living Maintenance Wage Loss Compensation - Ohio

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