Last updated: 1/29/2025
Report Of Earnings For Living Maintenance Wage Loss Compensation {BWC-3061}
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Description
BWC-3061 / RH-94A - REPORT OF EARNINGS FOR LIVING MAINTENANCE WAGE LOSS COMPENSATION. This form is used by injured workers to report their earnings when requesting living maintenance wage loss compensation from the Bureau of Workers' Compensation (BWC). It is used to provide details about the injured worker's earnings during a specific period, including gross earnings, the number of days and hours worked, and whether bonuses or additional payments were received. The form is necessary if payroll check stubs or other proof of earnings are not being submitted. The form must be completed and submitted to BWC or the self-insuring employer to support the worker's request for compensation. www.FormsWorkflow.com
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