Bwc ohio workers compensation 2026

1. Click ‘Get Form’ to open the bwc ohio workers compensation wage statement in the editor.
2. Begin by entering the injured worker's name, date of injury, and contact information including phone and cell numbers.
3. Fill in the employer's name and contact details, along with the claim number and email address.
4. Employers should complete the gross earnings section, ensuring to include all earnings prior to deductions. Report any bonuses or commissions as needed.
5. Injured workers must provide their employment history for the year prior to injury, including any other employers if applicable.
6. Complete the pay period dates and report regular and overtime earnings for the last pay period before the injury.
7. Finally, certify that all information is correct by signing and dating the form. Ensure that any affidavits are completed if necessary.

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