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Employer Report of Employee Earnings (Wages-EMP)

Employers or their authorized representatives must submit a report a of earnings for an injured worker, so BWC can set wages, and then pay lost-time benefits. This online form allows authorized users to enter contact information in order to receive an email with instructions for submitting the Employer Report of Employee Earnings (Wages-EMP)

Important: If you report income to BWC to set wages but have not reported the income to the Internal Revenue Service (IRS) as wages, BWC may notify the IRS of the discrepancy.

Once you click on the documents link in the email, you can fill out the form or upload wage documents using the icon in the upper, left-hand corner.

Required information

  • Injured worker name
  • Date of injury
  • Date of hire
  • Employer name
  • Employer phone number
  • Employer address
  • Employer email address
  • Number of hours scheduled week of injury
  • Hourly rate 
  • BEGINNING date of the last pay period prior to the date of injury/disability
  • END date of the last pay period prior to the date of injury/disability
  • Whether payment is: Weekly    Biweekly    Bimonthly    Monthly
  • Regular earnings the last seven calendar days of that pay period
  • Overtime earnings the last seven calendar days of that pay period  

However you provide the wage information, you must enter your name and job title, and then click Sign.


If you have all the required information at hand, simply click the start button to begin.

 

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