Average Weekly Wage Certification {AWW-1}

Form AWW-1 - AVERAGE WEEKLY WAGE CERTIFICATION. This form is used in workers’ compensation claims to calculate and certify an employee’s average weekly wage. Adopted January 1, 1997, this form requires information about the claimant’s injury or exposure date, method of wage payment (hourly, daily, weekly, monthly, yearly, or output-based), and employment status (part-time, full-time, seasonal, probationary, etc.). It also documents employer-provided benefits such as housing, board, or fuel, as well as overtime, gratuities, and paid vacations or holidays. Employers must list weekly wage details for up to 52 weeks, including hours worked, hourly rate, and overtime, with averages computed over 13-week periods. The form must be certified by the employer and filed with the Commissioner, with copies sent to counsel of record and the assigned Administrative Law Judge. www.FormsWorkflow.com