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Simplifying the Work of Workers' Compensation



West Virginia Workers' Compensation Information

  • Home
  • States
  • Workers' Compensation Information


  • State Telephone Numbers
  • State Forms
  • State Rules & Statutes

Please Note: for Claims assistance or questions about coverage and exemptions You will need to call one of the numbers listed below.

Also be aware that the Workers' Compensation Assistance Offices in different states may go by different names such as "Industrial Accidents".
These are the only numbers that we are aware of and have available for West Virginia Workers' Compensation.


West Virginia Workers' Compensation Telephone Directory


West Virginia Division of Labor: 304 558-7890

Workers' Compensation Board of Review : 304-558-5230

Self Insurance - Mailing Address : 304-558-6279

Workers' Compensation Claims Services Division: 304-558-5838

WC Claims Services Div. - Mailing Address - Toll Free: 888-879-9842

Fraud: 304-558-5241

Division of Rehabilitation Services - Toll Free: 800-642-8207

Employer Coverage Unit: 304-414-0539

Revenue Recovery : 304-558-1200

WC Managed Health Care Plans - Mailing Address: 304-414-7750

Document & Imaging Services (Old Fund WC Documents) - Phone & Mailing): 304-558-5838

Office of Judges - Mailing Address, Phone, Fax & Email Address: 304-558-0852

Office of Judges : 304-558-1686

Uninsured Employers Fund: 888-TRY-WVIC

Pharmacy Benefit Manager (PBM) - Phone & Email Address: 304-558-6279x48494

Professional Employer Organization (PEO) - Phone & Email Address: 304-558-6279x47748

EDI Reporting - Phone, Fax & Email Address: 304-558-5320

Fraud - Special Investigation Unit - Toll Free: 800-779-6853

Workers' Compensation Appeals: 304-558-2364

WC Appeals (Supreme Court) Clerk of Court: 304-558-2601

WC Appeals Public Information Office - Supreme Court: 304-340-2305

WC Appeals (Supreme Court) Administrative Office: 304-558-0145

Office of Insurance (State) Commisioner : 888-879-9842

Office of (State) Insurance Commissioner James A. Dodrill - Mailing Address: 888-TRY-WVIC

Division of Rehabilitation Services: 304-356-2060

OSHA - Charleston Area Ofc. - Federal OSHA covers private Employers/Employees in WV: 304-347-5937

WC OIC Legal Division: 304-558-0401

Forms & Publications


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Some "Revision Dates" may be displayed as part of the Description.

(OIC-WC-2) Employers' Report of Occupational Injury or Disease N/D
(OIC-WC-1) Employees' and Physicians' Report of Occupational Injury or Disease N/D
(OIC-WC-1HL) Employees' and Physicians' Report of Occupational Hearing Loss N/D
(OIC-WC-1OP) Employees' Report of Occupational Pneumoconiosis N/D
(OIC-WC-20P) Employer's Report of Occupational Pneumoconiosis 1/15
(OIC-WC-30P) Physician's Report of Occupational Pneumoconiosis - Includes ILO Form 1/15
(OIC-WC-201) Application for Fatal Dependents' Benefits 1/11
(OIC-WC-202) Application for 104 Weeks Dependents' Benefits 1/11
(claimallinfo) Notification Regarding Claims Allocation 1/06
(wc complaint form) Workers' Compensation Complaint Form 1/08
(exemption-application) Application for Exemption from WV Workers' Compensation Coverage 2/11
(microfiche) Request for File Record Copies 7/16
(citizen report) Suspected Insurance Fraud Citizen Reporting Form N/D
(fraud-company-contact-form) Insurance Company Fraud Contact Form N/D
(fraud uniform form) Uniform Suspected Insurance Fraud Reporting N/D
(occ-lung-exam) Carrier's Request for Occupational Lung Center Examination 7/21
(rsr1) Request for Settlement Review 6/10
(complaint-form) Workers' Self-Insurance Compensation Complaint Form N/D
(term-cov) Termination of Coverage 3/13
(travel-expense-notice) Payment for Travel Expenses Notice 1/06
(UninsuredFundApplication) Employee's Report of Occupational Injury and Proof of Employment 1/06
(Direct-Deposit-Form) Workers" Compensation Direct Deposit Form N/D
(Notice) POSTER - Generic Notice to Employees poster. N/D
(sedgwickbro) Understanding The West Virginia Workers N/D
(healthsmartbro) Understanding The West Virginia Workers N/D
(Low Back Examination) Low Back Examination N/D
(Perm Tot Dia Rev) Carrier/Self-Insured/TPA Request for Permanent Total Disability Review N/D
(origxray) Request for Original X-Rays 1/17
(xrayrequest) Request for X Rays 1/17
(reopenapp) Claim Re-Opening Application for Permanent Partial Disability 5/16
  • West Virginia Rules
  • West Virginia Statutes

Title 85 - EXEMPT LEGISLATIVE RULE - WORKERS' COMPENSATION RULES OF THE WEST VIRGINIA INSURANCE COMMISSIONER

85-1. Claims Management and Administration


  • 85-1-1. General.

  • 85-1-2. Definitions.

  • 85-1-3. Claimant's Report of Injury and Application for Compensation.

  • 85-1-4. Employer's Report of Injuries.

  • 85-1-5. Special Rules for Temporary Total Disability Claims.

  • 85-1-6. Special Rules for Permanent Partial Disability Claims.

  • 85-1-7. Notice and Litigation.

  • 85-1-8. Special Rules for Permanent Total Disability Claims.

  • 85-1-9. Special Rules for Non-Awarded Partial Benefits.

  • 85-1-10. Time Standards.

  • 85-1-11. Child Support and Spousal Support Orders.

  • 85-1-12. Overpayments.

  • 85-1-13. Occupational Pneumoconiosis and Occupational Disease Claims.

  • 85-1-14. Procedures for Suspension for Claimant Abuse.

  • 85-1-15. Travel Expenses-Medical Examination and Treatment.

  • 85-1-16. Complaints.

  • 85-1-17. Expert Witness Appearances.

  • 85-1-18. Implementation and Stay of Orders from the Office of Judges.

  • 85-1-19. Miscellaneous Administrative Matters.

  • 85-1-20. Preferred Drug List.
  • 85-2. Workers' Compensation Claims Index.


  • 85-2-1. General.

  • 85-2-2. Purpose.

  • 85-2-3. Definitions.

  • 85-2-4. Claims Index.

  • 85-2-5. Access to Claims Index.

  • 85-2-6. Duty to Timely Report Claims Data.
  • 85-4. Attorney's Fees


  • 85-4-1. General.

  • 85-4-2. Definitions.

  • 85-4-3. Denial Rulings; Types.

  • 85-4-4. Payment of Awards.

  • 85-4-5. Appeals of Office of Judges' Decisions.

  • 85-4-6. Severability.
  • 85-5. Permanent Total Disability


  • 85-5-1. General.

  • 85-5-2. Definitions.

  • 85-5-3. Completion and Support of PTD Application.

  • 85-5-4. Program to Update Disability Status of Those Receiving PTD Benefits as of July 1, 2003.

  • 85-5-5. Monitoring of PTD Recipients.

  • 85-5-6. Termination of the Commission.

  • 85-5-7. Severability.
  • 85-6. Workers' Compensation Debt Reduction Fund Assessments And Regulatory Surcharges


  • 85-6-1. General.

  • 85-6-2. Purpose of Rule.

  • 85-6-3. Definitions.

  • 85-6-4. Surcharges on Private Carrier Premiums.

  • 85-6-5. Surcharges on the Self-insured Employer Community.

  • 85-6-6. Surcharge and Assessment Methodology for Collections of Surcharges Made Pursuant to W. Va. Code 23-2C-3(f)(3).
  • 85-7. Rules For Selected Hearings


  • 85-7-1. General.

  • 85-7-2. Definitions.

  • 85-7-3. Article Two Decisions.

  • 85-7-4. Administrative Hearings; Notice; and Place.

  • 85-7-5. Parties and Conduct of Hearings.

  • 85-7-6. Correction of the Record.

  • 85-7-7. Subpoenas.

  • 85-7-8. Discovery.

  • 85-7-9. Hearing Officers.

  • 85-7-10. Concluding the Hearing.

  • 85-7-11. Pending petitions.

  • 85-7-12. Termination of the Commission.

  • 85-7-13. Severability.
  • 85-8. Workers' Compensation Policies, Coverage Issues And Related Topics


  • 85-8-10. Rating Organizations.

  • 85-8-11. Rate Making.

  • 85-8-1. General.

  • 85-8-2. Purpose of Rule.

  • 85-8-3. Definitions.

  • 85-8-4. Employers Required to Maintain Workers' Compensation Insurance; Exemptions; Application for Letter of Exemption.

  • 85-8-5. Auditing; Inspections; and Payroll Reporting.

  • 85-8-6. Employees Covered; Independent Contractors; Coverage Elections; Assignment.

  • 85-8-7. Extraterritorial Coverage and Related Issues.

  • 85-8-8. The Workers' Compensation Insurance Policy.

  • 85-8-9. Notification of Issuance, Renewal or Termination of Coverage.
  • 85-9. Workers' Compensation Uninsured Employers' Fund


  • 85-9-1. General.

  • 85-9-2. Definitions.

  • 85-9-3. Application for Benefits from the UEF.

  • 85-9-4. Subrogation.

  • 85-9-5. Employer Liability.

  • 85-9-6. Methods for Determining and Collecting Employer Liabilities Owed to the UEF.

  • 85-9-7. Methods for Determining Assessments for the UEF.
  • 85-10. Primary Contractor Liability


  • 85-10-1. General.

  • 85-10-2. Purpose of Rule.

  • 85-10-3. Definitions.

  • 85-10-4. Primary Contractor's Liability; Generally.

  • 85-10-5. Avoiding Primary Contractor Liability.

  • 85-10-6. Extent of Liability.

  • 85-10-7. Collections Efforts.

  • 85-10-8. Appeal Process.

  • 85-10-9. Severability
  • 85-11. Employer Default, Enforcement, Collections And Related Matters


  • 85-11-1. General.

  • 85-11-2. Definitions.

  • 85-11-3. Default Employer not Permitted to Dissolve or Withdraw.

  • 85-11-4. Notice to Employees of Default Employers.

  • 85-11-5. Audits of Employers.

  • 85-11-6. Methods of Collection of Payments and Enforcement.

  • 85-11-7. Statutory Lien.

  • 85-11-8. Civil Actions.

  • 85-11-9. Injunctions From Carrying On Business.

  • 85-11-10. Receivership and Insolvency Proceedings; Bankruptcy.

  • 85-11-11. Payment Agreements.

  • 85-11-12. Administrative Hearings.

  • 85-11-13. Interest.

  • 85-11-14. Reserved.

  • 85-11-15. Criminal Penalties.

  • 85-11-16. Freedom of Information Act.

  • 85-11-17. Placement on Workers' Compensation Default List; Due Process and Hearing.

  • 85-11-18. Removal From the Default List.

  • 85-11-19. Uninsured Fines.

  • 85-11-20. Employer Violator System.
  • 85-12. Compromise & Settlement Of Workers’ Compensation Issues


  • 85-12-1. General.

  • 85-12-2. Purpose.

  • 85-12-3. Definitions.

  • 85-12-4. Parties.

  • 85-12-5. Issues Subject to Settlement.

  • 85-12-6. Manner of Payment.

  • 85-12-7. Dependent's Benefits.

  • 85-12-8. Settlement Not to be Considered an Admission Against Interest.

  • 85-12-9. Effective Date of Settlement.

  • 85-12-10. Minor Dependents and Claimants.

  • 85-12-11. Death of Claimant.

  • 85-12-12. Deductions From Settlement Awards.

  • 85-12-13. Settlement Terms.

  • 85-12-14. Insurance Commissioner Review.

  • 85-12-15. Severability.
  • 85-13 Procedural Rules For The Industrial Council


  • 85-13-1. General.

  • 85-13-2. Application and Enforcement.

  • 85-13-3. Definitions.

  • 85-13-4. Meetings; Rules of Order; Selection of Vice-Chairperson.

  • 85-13-5. Agenda.

  • 85-13-6. Opening the Meeting.

  • 85-13-7. Discussion.

  • 85-13-8. Motions; Voting.

  • 85-13-9. Proceeding to be Open; Exceptions; Executive Session Permitted.

  • 85-13-10. Citizen's Right to Address Council.

  • 85-13-11. Subcommittees.

  • 85-13-12. Minutes.

  • 85-13-13. Records of the Council -Public.
  • 85-14. Procedural Rules For The Workers' Compensation Board Of Managers


  • 85-14-1. General.

  • 85-14-2. Application and Enforcement.

  • 85-14-3. Definitions.

  • 85-14-4. Meetings; Rules of Order; Selection of Vice-Chairperson.

  • 85-14-5. Agenda.

  • 85-14-6. Opening the Meeting.

  • 85-14-7. Discussion.

  • 85-14-8. Motions; Voting.

  • 85-14-9. Proceeding to be Open; Exceptions; Executive Session Permitted.

  • 85-14-10. Citizen's Right to Address Board.

  • 85-14-11. Subcommittees.

  • 85-14-12. Minutes.

  • 85-14-13. Records of the Board - Public.
  • 85-15. Vocational And Physical Rehabilitation


  • 85-15-1. General.

  • 85-15-2. Purpose of Rule; Cooperation.

  • 85-15-3. Definitions.

  • 85-15-4. Priorities.

  • 85-15-5. Identification of Rehabilitation Candidates; the Rehabilitation Assessment/ Evaluation Process.

  • 85-15-6. Implementation of the Rehabilitation Plan.

  • 85-15-7. Payment of Indemnity Benefits.

  • 85-15-8. Rehabilitation Closure Report.

  • 85-15-9. Registration of Rehabilitation Providers.

  • 85-15-10. Payment for Physical and Vocational Rehabilitation Services.

  • 85-15-11. Trial Return to Work.

  • 85-15-12. Employer-Preferred Vocational Rehabilitation Services.

  • 85-15-13. Transfer to the Insurance Commissioner.

  • 85-15-14. Severability.
  • 85-17. Electronic Submittal Of Invoices And Receipt Of Payments


  • 85-17-1. General.

  • 85-17-2. Purpose of These Rules.

  • 85-17-3. Definitions.

  • 85-17-4. Electronic Submission of Invoices.

  • 85-17-5. Payment by Electronic Means.

  • 85-17-6. Exemptions.

  • 85-17-7. Private Carriers and Self-Insured Employers
  • 85-18 Self Insurance, Self Administration and Third Party Administrators


  • 85-18-1. General.

  • 85-18-2. Purpose of Rule.

  • 85-18-3. Definitions.

  • 85-18-4. Self Insurance Status.

  • 85-18-5. Application for Self Insurance.

  • 85-18-6. Reconciliation and Settlement of Applicant's Account.

  • 85-18-7. Coverage for catastrophic occurrences.

  • 85-18-8. Security and Bond.

  • 85-18-9. Self-insured Employer's Modification of Business.

  • 85-18-10. Voluntary Termination of Self-Insured Status.

  • 85-18-11. Self-Administration of Claims.

  • 85-18-12. Payroll Reports, Assessments and Surcharges.

  • 85-18-13. Auditing, Monitoring and Inspections; Record Keeping.

  • 85-18-14. Maintaining Self-Insured Status; Annual Review.

  • 85-18-15. Involuntary revocation of self-insurance status.

  • 85-18-16. Name and Address of Employer; Legal Notice; Publications; Employer Correspondence.

  • 85-18-17. Third Party Administrators.

  • 85-18-18. Administrative Protests and Hearings.
  • 85-19 Self Insurance Risk Pools


  • 85-19-1. General.

  • 85-19-2. Purpose of Rule.

  • 85-19-3. Definitions.

  • 85-19-4. Self Insurance Pools; Establishment; Application of Funds.

  • 85-19-5. Participation.

  • 85-19-6. Surety Requirements.

  • 85-19-7. Security Pool Funding.

  • 85-19-8. Security Pool Assessments Pursuant to W. Va. Code 23-2-9(e).

  • 85-19-9. Guaranty Pool Funding.

  • 85-19-10. Converting to Insured Employer Status or Becoming Inactive.
  • 85-20. Medical Management Of Claims, Guidelines For Impairment Evaluations, Evidence, And Ratings, And Ranges Of Permanent Partial Disability Awards


  • 85-20-1. General.

  • 85-20-2. Purpose of Rule.

  • 85-20-3. Definitions.

  • 85-20-4. Adoption of Standards and Acceptance of Rules.

  • 85-20-5. Qualified Providers and Registration.

  • 85-20-6. The Role of the Treating Physician.

  • 85-20-7. Initial Reporting of Injury.

  • 85-20-8. Additional Reporting Requirements.

  • 85-20-9. Coverage and Billing Provisions.

  • 85-20-10. Supplies.

  • 85-20-11. Vision Care.

  • 85-20-12. Psychiatric compensability, treatment and impairment ratings. (Effective Date: January 20, 2006.)

  • 85-20-13. Coverage Medication Checks.

  • 85-20-14. Medication/Injections.

  • 85-20-15. Dental Services.

  • 85-20-16. Experimental Procedures.

  • 85-20-17. Unusual treatment.

  • 85-20-18. Organ Transplants.

  • 85-20-19. Other Non-Covered Services.

  • 85-20-20. Payment for appearance at hearings.

  • 85-20-21. Treatment of unrelated conditions.

  • 85-20-22. Consultations.

  • 85-20-23. Miscellaneous Coverage and Reimbursement Issues.

  • 85-20-24. Treatment Guidelines: Post Concussion Syndrome.

  • 85-20-25. Treatment Guidelines: Corneal Abrasion.

  • 85-20-26. Treatment Guidelines: Corneal Foreign Body.

  • 85-20-27. Treatment Guidelines: Hyphema.

  • 85-20-28. Treatment Guidelines: Eyelid Laceration.

  • 85-20-29. Treatment Guidelines: Canalicular Laceration.

  • 85-20-30. Treatment Guidelines: Orbital Contusion.

  • 85-20-31. Treatment Guidelines: Orbital Fracture.

  • 85-20-32. Treatment Guidelines: Corneoscleral Lacerations.

  • 85-20-33. Treatment Guidelines: Chemical Ocular Injuries.

  • 85-20-34. Treatment Guidelines: Functional Capacity Evaluations: Work Conditioning and Work Hardening Rehabilitation Programs. (Effective Date: February 1, 2005)

  • 85-20-35. Treatment Guidelines: Cervical Musculoligamentous Injury (Sprain/Strain).

  • 85-20-36. Treatment Guidelines: Acute Herniated Cervical Disc.

  • 85-20-37. Treatment Guidelines: Low Back Musculoligamentous Injury (Sprain/Strain).

  • 85-20-38. Treatment Guidelines: Herniated Lumbar Disc.

  • 85-20-39. Treatment Guidelines: Lumbar Fusion.

  • 85-20-40. Treatment Guidelines: Shoulder Injury Guidelines.

  • 85-20-41. Treatment Guidelines: Carpal Tunnel Syndrome.

  • 85-20-42. Treatment Guidelines: Injuries to the Knee.

  • 85-20-43. Treatment Guidelines: Knee Sprains.

  • 85-20-44. Treatment Guidelines: Meniscal Injuries.

  • 85-20-45. Treatment Guidelines: Foot and Ankle Injuries.

  • 85-20-46. Treatment Guidelines: Physical Medicine.

  • 85-20-47. Treatment Guidelines, Protocols and Procedures for Performing Audiological Examinations and Evaluations in Workers' Compensation Claims for Noise-Induced Hearing Loss.

  • 85-20-48. Reserved.

  • 85-20-49. Treatment Guidelines: Multi-Disciplinary Pain Management.

  • 85-20-50. Treatment Guidelines: Interventional Management of Chronic Pain.

  • 85-20-51. Treatment Guidelines: Complex Regional Pain Syndrome.

  • 85-20-52. Procedure in Occupational Pneumoconiosis Cases.

  • 85-20-53. Long-Term Opioid Therapy Guideline.

  • 85-20-54. Drugs with Specific Limitations.

  • 85-20-55. Drugs and Medications: Actions.

  • 85-20-56. Physician's Records of Medication.

  • 85-20-57. Payment for oral opioid treatment for chronic, noncancer pain.

  • 85-20-58. Required authorization for treatment of chronic, noncancer pain with opioids.

  • 85-20-59. Required documentation to be submitted for continued coverage of opioids to treat chronic, noncancer pain.

  • 85-20-60. Duration of payment for opioids to treat chronic, noncancer pain.

  • 85-20-61. Denial of payment of opioid medications used to treat chronic, noncancer pain.

  • 85-20-62. Payment for nonopioid medications for the treatment of chronic, noncancer pain; Chelation therapy.

  • 85-20-63. Expected period of time to reach maximum medical improvement.

  • 85-20-64. Ranges of partial disability awards for common injuries and diseases.

  • 85-20-65. Adoption of Standards.

  • 85-20-66. Evidentiary Requirements.

  • 85-20-67. Exceptions to the Guides.

  • 85-20-68. Payment for Evaluations.

  • 85-20-69. Violation and Penalties:

  • 85-20-70. Injured Employee's Responsibilities Concerning Medical Examination and Treatment. (Effective Date: --February 1, 2005.)

  • 85-20-71. Severability.

  • Supporting Tables - TABLE 85-20A. Impairment of Pulmonary Function.
  • 85-21. Managed Care Health Plans


  • 85-21-1. General.

  • 85-21-2. Purpose of Rule; Cooperation.

  • 85-21-3. Definitions.

  • 85-21-4. Minimum Plan Standards.

  • 85-21-5. Application Process.

  • 85-21-6. Approval by the Commission.

  • 85-21-7. Plan Modifications.

  • 85-21-8. Suspension or Revocation of Certification.

  • 85-21-9. Other Administrative Provisions.

  • 85-21-10. Minimum Grievance Standards.

  • 85-21-11. Reporting Requirements.

  • 85-21-12. Provider Verification.

  • 85-21-13. Injured Worker Opt-Out Standards.

  • 85-21-14. Severability.
  • 85-26. Health Care Advisory Panel


  • 85-26-1. General.

  • 85-26-2. Definitions.

  • 85-26-3. Appointments.

  • 85-26-4. Chair; Vice Chair, Secretary.

  • 85-26-5. Meetings; Conduct of Business.

  • 85-26-6. Sub-panels.

  • 85-26-7. Minutes.

  • 85-26-8. Majority Vote Required; Vote by Proxy Prohibited.

  • 85-26-9. Records of the Panel - Public.

  • 85-26-10. Resignation.

  • 85-26-11. Preferred Drug List.

  • 85-26-12. Transition.

  • 85-26-13. Severability.
  • 85-27. Qualified Rehabilitation Provider.


  • 85-27-1. General.

  • 85-27-2. Purpose of Rule.

  • 85-27-3. Definitions.

  • 85-27-4. Minimum Education and Experience Requirements.

  • 85-27-5. Acceptable Employment Experience.

  • 85-27-6. Continuing Education.

  • 85-27-7. Other Requirements.

  • 85-27-8. Severability.
  • 85-28. Rules For Health Care Vendor Hearings.


  • 85-28-1. General.

  • 85-28-2. Definitions.

  • 85-28-3. Overpayments: Notification and Reconsideration.

  • 85-28-4. Suspension or Termination.

  • 85-28-5. Final decision; Petition for Hearing.

  • 85-28-6. Hearings; General Provisions.

  • 85-28-7. Parties and Conduct of Hearings.

  • 85-28-8. Burden of Proof.

  • 85-28-9. Standard for Medically Unsupported Treatment.

  • 85-28-10. Correction of the Record.

  • 85-28-11. Subpoenas.

  • 85-28-12. Hearing Officers.

  • 85-28-13. Conclusion of Hearing.

  • 85-28-14. Pending Petitions.

  • 85-28-15. Notices.

  • 85-28-16. Transition.

  • 85-28-17. Severability.
  • 85-31. Employee Leasing


  • 85-31-1. General.

  • 85-31-2. Purpose of Rule.

  • 85-31-3. Definitions.

  • 85-31-4. PEO Workers' Compensation Insurance Policies.

  • 85-31-5. Data Collection and Proof of Coverage Reporting.

  • 85-31-6. Scope of Coverage for Master Policies.

  • 85-31-7. Notice of Coverage and Cancellation.
  • 85-32. State Agency Revocation Or Refusal To Grant, Issue Or Renew Contracts, Licenses, Permits, Certificates Or Other Authority To Conduct A Trade, Profession Or Business To Or With An Employing Unit In Default Of Its Workers' Compensation Obligations.


  • 85-32-1. General.

  • 85-32-2. Definitions.

  • 85-32-3. General Prohibition.

  • 85-32-4. Timing of Review.

  • 85-32-5. Revocation.

  • 85-32-6. Procedure for Petitioning for Exemption.

  • 85-32-7. Procedures for Implementation.
  • Title 93 - PROCEDURAL RULE - WORKERS' COMPENSATION OFFICE OF JUDGES

    93-1 Litigation of Protests


  • 93-1-4. Purpose.

  • 93-1-1. General

  • 93-1-2. Index.

  • 93-1-3. Definitions.

  • 93-1-5. Representation of Parties.

  • 93-1-6 . Litigation Process.

  • 93-1-7. Evidence; Exchange and Filing.

  • 93-1-8. Administrative Hearing Procedures; Generally.

  • 93-1-9. Expedited Adjudication Process.

  • 93-1-10. Failure to Prosecute Protest.

  • 93-1-11. Occupational Pneumoconiosis.

  • 93-1-12. Motions, Objections, and Correspondence.

  • 93-1-13. Depositions.

  • 93-1-14. Dismissals of Claims and Protests.

  • 93-1-15. Adding or Dismissing Chargeable Employers.

  • 93-1-16. Decisions; Other Resolutions; and Motions to Reconsider.

  • 93-1-17. Mediation.

  • 93-1-18. Expedited Process for Failure of Administrator to Timely rule on Application, Petition, or motion.

  • 93-1-19. Unreasonable Denials and Attorney Fees.

  • 93-1-20. Disputes Between Claim Administrators: Reopening Versus New Injury Issues

  • 93-1-21. Severability.
  • 93-2 Rules On Time standards For The Workers' Compensation Office Of Judges


  • 93-2-1. General.

  • 93-2-2. Definitions.

  • 93-2-3. Implementation of Rule.

  • 93-2-4. Motions.

  • 93-2-5. Hearings.

  • 93-2-6. Time Standards.

  • 93-2-7. Issuance of Decisions.

  • 93-2-8. Severability.
  • Title 102 - PROCEDURAL RULE - WORKERS' COMPENSATION BOARD OF REVIEW

    102-01 Rules of Practice and Procedure


  • 102-1-1. General.

  • 102-1-2. Purpose.

  • 102-1-3. Appeal Process; Generally.

  • 102-1-4. Initiation of the Appeal Process.

  • 102-1-5. Briefs.

  • 102-1-6. Hearings and Decisions.

  • 102-1-7. Motions.

  • 102-1-8. Stay of Orders from the Office of Judges.

  • 102-1-9. Settlements and Stipulations.

  • 102-1-10. Application of Rules.
  • ARTICLE 1. GENERAL ADMINISTRATIVE PROVISIONS


  • 23-1-1. Workers' Compensation Commission created; findings.

  • 23-1-1a. Repealed.

  • 23-1-1b. Executive Director; qualifications; oath; seal; removal; powers and duties.

  • 23-1-1c. Payment withholding; interception; penalty.

  • 23-1-1d. Rules of former division of workers' compensation.

  • 23-1-1e. Transfer of assets and contracts; ability to acquire, own, lease and otherwise manage property.

  • 23-1-1f. Authority of Insurance Commission to exempt employees from classified service; exemption from purchasing rules.

  • 23-1-1g. Legislative intent to create a quasi-public entity.

  • 23-1-1h. Powers and duties of Office of Judges transferred to Board of Review; definition of certain terms effective July 1, 2022.

  • 23-1-2. Oversight of the workers' compensation commission.

  • 23-1-3. Payment of salaries and expenses generally; manner; limitation.

  • 23-1-4. Office hours; records; confidentiality; exceptions.

  • 23-1-4a. Bond for executive director and associate director.

  • 23-1-5. Office of executive director; hearings.

  • 23-1-6. Employment of associate director and other assistants; compensation and travel expenses.

  • 23-1-7. Associate director to act during executive director's absence or inability to act and in case of vacancy; bond of associate director.

  • 23-1-8. Authority of executive director and employees as to oaths and evidence.

  • 23-1-9. Compelling compliance with order or subpoena.

  • 23-1-10. Fee of officer serving subpoena; fees and mileage of witnesses.

  • 23-1-11. Depositions; investigations.

  • 23-1-12. Copies of proceedings as evidence.

  • 23-1-13. Rules of procedure and evidence; persons authorized to appear in proceedings; withholding of psychiatric and psychological reports and providing summaries thereof.

  • 23-1-14. Forms.

  • 23-1-15. Procedure before commission.

  • 23-1-16. Repealed.

  • 23-1-17. Annual report by the Insurance Commissioner and Occupational Pneumoconiosis Board.

  • 23-1-18. Commission employees not subject to subpoena for workers' compensation hearings.

  • 23-1-19. Civil remedies.

  • 23-1-20. Employment preference for employees in workers' compensation litigation unit.
  • ARTICLE 2. EMPLOYERS AND EMPLOYEES SUBJECT TO CHAPTER; EXTRATERRITORIAL COVERAGE


  • 23-2-1. Employers subject to chapter; elections not to provide certain coverages; notices; filing of business registration certificates.

  • 23-2-1a. Employees subject to chapter.

  • 23-2-1b. Special provisions as to premiums.

  • 23-2-1c. Extraterritorial coverage; approval and change of agreements.

  • 23-2-1d. Prime contractors and subcontractors liability.

  • 23-2-2. Commission to be furnished information by employers, State Tax Commissioner and division of unemployment compensation; secrecy of information; examination of employers, etc.; violation a misdemeanor.

  • 23-2-3. Report forms and other forms for use of employers.

  • 23-2-4. Classification of industries; rate of premiums; authority to adopt various systems; accounts.

  • 23-2-5. Application; payment of premium taxes; gross wages; payroll report; deposits; delinquency; default; reinstatement; payment of benefits; notice to employees; criminal provisions; penalties.

  • 23-2-5a. Collection of premiums from defaulting employers; interest and penalties; civil remedies; creation and enforcement of lien against employer and purchaser; duty of Secretary of State to register liens; distraint powers; insolvency proceedings; Secretary of State to withhold certificates of dissolution; injunctive relief; bond; attorney fees and costs.

  • 23-2-5b. Repealed.

  • 23-2-5c. Statute of limitations; effective date for new payments; previous payments due not affected.

  • 23-2-5d. Uncollectible receivables; write-offs.

  • 23-2-6. Exemption of contributing employers from liability.

  • 23-2-6a. Exemption from liability of officers, managers, agents, representatives or employees of contributing employers.

  • 23-2-7. Benefits of chapter may not be waived by contract or regulation.

  • 23-2-8. Liability of employer electing not to pay or defaulting in payment of premiums; certain common-law defenses prohibited; exceptions.

  • 23-2-9. Election of employer or employers' group to be self-insured and to provide own system of compensation; exceptions; self administration; rules; penalties; regulation of self-insurers.

  • 23-2-10. Application of chapter to interstate commerce.

  • 23-2-11. Partial invalidity of chapter.

  • 23-2-12. Effect of repeal or invalidity of chapter on action for damages.

  • 23-2-13. Interest on past-due payments; reinstatement agreements.

  • 23-2-14. Sale or transfer of business; attachment of lien for premium, etc.; payments due; criminal penalties for failure to pay; creation and avoidance or elimination of lien; enforcement of lien; successor liability.

  • 23-2-15. Liabilities of successor employer; waiver of payment by commission; assignment of predecessor employer's premium rate to successor.

  • 23-2-16. Acceptance or assignment of premium rate.

  • 23-2-17. Employer right to hearing; content of petition; appeal.

  • 23-2-18. Repealed.

  • 23-2-9. Election of employer or employers' group to be self-insured and to provide own system of compensation; exceptions; self administration; rules; penalties; regulation of self-insurers.
  • ARTICLE 2A. SUBROGATION


  • 23-2A-1. Subrogation; limitations.

  • 23-2A-2. Repealed.
  • ARTICLE 2B. OCCUPATIONAL SAFETY AND HEALTH PROGRAMS


  • 23-2B-1. Occupational safety and health activities; voluntary compliance; consultative services.

  • 23-2B-2. Mandatory programs; safety committees; requirements; rules; exceptions.

  • 23-2B-3. Premium rate credits; qualified loss management program; loss management firms; penalties; rules.
  • ARTICLE 2C EMPLOYERS' MUTUAL INSURANCE COMPANY.


  • 23-2C-1. Findings and purpose.

  • 23-2C-2. Definitions.

  • 23-2C-3. Creation of employers' mutual insurance company as successor organization of the West Virginia Workers' Compensation Commission.

  • 23-2C-3a. Employers' mutual insurance company - additional provisions enacted in November 2005.

  • 23-2C-4. Governance and organization.

  • 23-2C-5. Creation of the industrial council; duties.

  • 23-2C-6. Creation of new fund, old fund, mutualization transition fund, uninsured employer fund, self-insured employer guaranty risk pool, self-insured employer security risk pool, private carrier guaranty fund, and assigned risk fund.

  • 23-2C-7. Custody, investment and disbursement of funds.

  • 23-2C-8. Workers' Compensation Uninsured Employer Fund.

  • 23-2C-9. Repealed.

  • 23-2C-10. West Virginia adverse risk assignment.

  • 23-2C-11. Transfer of assets from new fund to the mutual insurance company established as a successor to the commission; transfer of commission employees.

  • 23-2C-12. Certain personnel provisions governing employees laid-off by the mutual during its initial year of operation.

  • 23-2C-13. Certain retraining benefits to those employees laid-off by the mutual during its first year of operation.

  • 23-2C-14. Certain benefits provided to commission employees.

  • 23-2C-15. Mandatory coverage; changing of coverage.

  • 23-2C-16. Administration of Old Fund, Uninsured Employer Fund, Self-Insured Employer Guaranty Risk Pool, Self-Insured Employer Security Risk Pool and Private Carrier Guaranty Fund.

  • 23-2C-17. Administration of a competitive system.

  • 23-2C-18. Ratemaking; Insurance Commissioner.

  • 23-2C-18a. Designation of rating organization.

  • 23-2C-19. Premium payment; employer default; special provisions as to employer default collection.

  • 23-2C-20. Claims administration issues.

  • 23-2C-21. Limitation of liability of insurer or third-party administrator; administrative fines are exclusive remedies.

  • 23-2C-22. Rules.

  • 23-2C-23. Transfer of assets and contracts.

  • 23-2C-24. Surplus note or other loan arrangement for new fund.
  • ARTICLE 2D. WORKERS' COMPENSATION DEBT REDUCTION BONDS.


  • 23-2D-1. Short title.

  • 23-2D-2. Legislative findings; legislative intent.

  • 23-2D-3. Definitions.

  • 23-2D-4. Workers' Compensation debt reduction revenue bonds; amount; when may issue.

  • 23-2D-5. Special account created; use of moneys in the Fund.

  • 23-2D-5a. Excess regular coal severance taxes.

  • 23-2D-6. Creation of Debt Service Fund; disbursements to pay debt service on Workers' Compensation debt reduction revenue bonds.

  • 23-2D-7. Covenants of state.

  • 23-2D-8. Workers' compensation debt reduction revenue bonds lawful investments.

  • 23-2D-9. Refunding bonds.

  • 23-2D-10. Approval and payment of all necessary expenses.
  • ARTICLE 3. WORKERS' COMPENSATION FUND


  • 23-3-1. Compensation Fund; catastrophe and catastrophe payment defined; compensation by employers.

  • 23-3-1a. Transfer of silicosis fund to workers' compensation fund; claims under former article six.

  • 23-3-2. Custody, investment and disbursement of funds.

  • 23-3-3. Investment of surplus funds required.

  • 23-3-4. Deposits and disbursements considered abandoned property; disposition of property.

  • 23-3-5. Authorization to require the electronic invoices and transfers.

  • 23-3-6. Emergency fiscal measures.
  • ARTICLE 4. DISABILITY AND DEATH BENEFITS


  • 23-4-1. To whom compensation fund disbursed; occupational pneumoconiosis and other occupational diseases included in "injury" and "personal injury"; definition of occupational pneumoconiosis and other occupational diseases; rebuttable presumption for cardiovascular injury and disease or pulmonary disease for firefighters.

  • 23-4-1a. Report of injuries by employee.

  • 23-4-1b. Report of injuries by employers.

  • 23-4-1c. Payment of temporary total disability benefits directly to claimant; payment of medical benefits; payments of benefits during protest; right of commission, successor to the commission, private carriers and self-insured employers to collect payments improperly made.

  • 23-4-1d. Method and time of payments for permanent disability.

  • 23-4-1e. Temporary total disability benefits not to be paid for periods of correctional center or jail confinement; denial of workers' compensation benefits for injuries or disease incurred while confined.

  • 23-4-1f. Certain psychiatric injuries and diseases not compensable.

  • 23-4-1g. Weighing of evidence.

  • 23-4-2. Disbursement where injury is self-inflicted or intentionally caused by employer; legislative declarations and findings; "deliberate intention" defined.

  • 23-4-3. Schedule of maximum disbursements for medical, surgical, dental and hospital treatment; legislative approval; guidelines; preferred provider agreements; charges in excess of scheduled amounts not to be made; required disclosure of financial interest in sale or rental of medically related mechanical appliances or devices; promulgation of rules to enforce requirement; consequences of failure to disclose; contract by employer with hospital, physician, etc., prohibited; criminal penalties for violation; payments to certain providers prohibited; medical cost and care program; payments; interlocutory orders.

  • 23-4-3a. Repealed.

  • 23-4-3b. Creation of health care advisory panel.

  • 23-4-3c. Suspension or termination of providers of health care.

  • 23-4-4. Funeral expenses; wrongfully seeking payment; criminal penalties.

  • 23-4-5. Benefits for first three days after injury.

  • 23-4-6. Classification of and criteria for disability benefits.

  • 23-4-6a. Benefits and mode of payment to employees and dependents for occupational pneumoconiosis; further adjustment of claim for occupational pneumoconiosis.

  • 23-4-6b. Occupational hearing loss claims.

  • 23-4-6c. Benefits payable to certain sheltered workshop employees; limitations.

  • 23-4-6d. Benefits payable to part-time employees.

  • 23-4-7. Release of medical information to employer; legislative findings; effect of application for benefits; duty of employer.

  • 23-4-7a. Monitoring of injury claims; legislative findings; review of medical evidence; recommendation of authorized treating physician; independent medical evaluations; temporary total disability benefits and the termination thereof; mandatory action; additional authority; suspension of benefits.

  • 23-4-7b. Trial return to work; Insurance Commissioner to develop rules.

  • 23-4-8. Physical examination of claimant.

  • 23-4-8a. Occupational Pneumoconiosis Board; composition; term of office; duties; quorum; remuneration.

  • 23-4-8b. Occupational Pneumoconiosis Board; procedure; autopsy.

  • 23-4-8c. Occupational Pneumoconiosis Board; reports and distribution thereof; presumption; findings required of board; objection to findings; procedure thereon; limitations on refilings; consolidation of claims.

  • 23-4-8d. Occupational pneumoconiosis claims never closed for medical benefits with exception of settled claims.

  • 23-4-8e. Repealed.

  • 23-4-8f. Repealed.

  • 23-4-9. Physical and vocational rehabilitation.

  • 23-4-9a. Repealed.

  • 23-4-9b. Preexisting impairments not considered in fixing amount of compensation.

  • 23-4-10. Classification of death benefits; "dependent" defined.

  • 23-4-11. To whom death benefits paid.

  • 23-4-12. Application of benefits.

  • 23-4-13. Effect of abandonment of spouse.

  • 23-4-14. Computation of benefits.

  • 23-4-15. Application for benefits.

  • 23-4-15a. Nonresident alien beneficiaries.

  • 23-4-15b. Determination of nonmedical questions; claims for occupational pneumoconiosis; hearing.

  • 23-4-15c. Repealed.

  • 23-4-16. Jurisdiction over case continuous; modification of finding or order; time limitation on awards; reimbursement of claimant for expenses; reopening cases involving permanent total disability; promulgation of rules.

  • 23-4-16a. Interest on benefits.

  • 23-4-17. Commutation of periodical benefits.

  • 23-4-18. Mode of paying benefits generally; exemptions of compensation from legal process.

  • 23-4-19. Repealed.

  • 23-4-20. Postmortem examinations.

  • 23-4-21. Severability.

  • 23-4-22. Permanent disability evaluations; limitations; notice.

  • 23-4-23. Permanent total disability benefits; reduction of disability benefits; reduction of benefits; application of section; severability.

  • 23-4-24. Permanent total disability awards; retirement age; limitations on eligibility and the introduction of evidence; effects of other types of awards; procedures; requests for awards; jurisdiction.

  • 23-4-25. Permanent total disability benefits; reduction of disability benefits for wages earned by claimant.
  • ARTICLE 4A. DISABLED WORKERS' RELIEF FUND


  • 23-4A-7. Repealed.

  • 23-4A-8. Disabled workers' relief fund; how funded.

  • 23-4A-9. Transfer of authority to the Insurance Commissioner.

  • 23-4A-1. Disabled Workers' Relief Fund created.

  • 23-4A-2. To whom benefits paid.

  • 23-4A-3. Computation of benefits.

  • 23-4A-4. Mode of payment.

  • 23-4A-5. Employers providing own system of compensation.

  • 23-4A-6. Powers of commission over disabled workers' relief fund.
  • ARTICLE 4B. COAL-WORKERS' PNEUMOCONIOSIS FUND


  • 23-4B-1. Purpose.

  • 23-4B-2. Coal-Workers' Pneumoconiosis Fund established.

  • 23-4B-3. To whom benefits paid.

  • 23-4B-4. Who may subscribe.

  • 23-4B-5. Payment of benefits.

  • 23-4B-6. Coal-workers' pneumoconiosis fund; how funded.

  • 23-4B-7. Administration.

  • 23-4B-8. Separable from workers' compensation fund.

  • 23-4B-8a. Legislative findings; transfers to the state; maximum transfer authorization; purpose for which moneys transferred may be disbursed and expended; maximum amount of transfer authorization; terms and conditions for repayment; premiums to be set without regard to transfers; creation of special account in State Treasury.

  • 23-4B-8b. Transfer of funds to workers' compensation fund.

  • 23-4B-9. Closure of Coal-Workers' Pneumoconiosis Fund and coverage provided by the successor of the commission.
  • ARTICLE 4C. EMPLOYERS' EXCESS LIABILITY FUND


  • 23-4C-1. Purpose.

  • 23-4C-2. Employers' excess liability fund established.

  • 23-4C-3. Payment of excess damages from fund.

  • 23-4C-4. Employers' excess liability fund; how funded.

  • 23-4C-5. Administration.

  • 23-4C-6. Novation to the successor of the commission.
  • ARTICLE 5. REVIEW


  • 23-5-1. Notice by commission or self-insured employer of decision; procedures on claims; objections and hearing; effective until June 30, 2022.

  • 23-5-1a. Notice by commission or self-insured employer of decision; procedures on claims; objections and hearing; effective July 1, 2022.

  • 23-5-2. Application by employee for further adjustment of claim; objection to modification; hearing.

  • 23-5-3. Refusal to reopen claim; notice; objection; objection; effective until June 30, 2022.

  • 23-5-3a. Refusal to reopen claim; notice; objection; effective July 1, 2022.

  • 23-5-4. Application by employer for modification of award; objection to modification; hearing.

  • 23-5-5. Refusal of modification; notice; objection; effective until June 30, 2022.

  • 23-5-5a. Refusal of modification; notice; objection; effective July 1, 2022.

  • 23-5-6. Time periods for objections and appeals; extensions; effective until June 30, 2022.

  • 23-5-6a. Time periods for objections and appeals; extensions; effective July 1, 2022.

  • 23-5-7. Compromise and settlement.

  • 23-5-8. Designation of office of administrative law judges; powers of chief administrative law judge.

  • 23-5-8a. Transfer of powers and duties of the Office of Administrative Law Judges to the Workers' Compensation Board of Review; powers of the Workers' Compensation Board of Review in relation to review of objections; effective July 1, 2022.

  • 23-5-8b. Transfer of jurisdiction to review objections to Workers' Compensation Board of Review; termination of Office of Judges; appeals of board decisions to Intermediate Court of Appeals; effective July 1, 2022.

  • 23-5-9. Hearings on objections to Insurance Commissioner; private carrier or self-insured employer decisions; mediation; remand; effective until June 30, 2022

  • 23-5-9a. Hearings on objections to Insurance Commissioner; private carrier, or self-insured employer decisions; mediation; remand; effective July 1, 2022.

  • 23-5-10. Appeal from administrative law judge decision to appeal board; effective until June 30, 2022

  • 23-5-10a. Appeal from a Workers' Compensation Board of Review decision to the Intermediate Court of Appeals; effective July 1, 2022.

  • 23-5-11. Workers' Compensation Board of Review generally; effective until June 30, 2022

  • 23-5-11a. Workers' Compensation Board of Review generally; administrative powers and duties of the board; effective July 1, 2022.

  • 23-5-12. Appeal to board; procedure; remand and supplemental hearing.

  • 23-5-12a. Appeal of board decisions to the Intermediate Court of Appeals; procedure; remand and supplemental hearing; effective July 1, 2022.

  • 23-5-13. Continuances and supplemental hearings; claims not to be denied on technicalities.

  • 23-5-13a. Continuances and supplemental hearings; claims not to be denied on technicalities; effective July 1, 2022.

  • 23-5-14. Disqualification of board members.

  • 23-5-15. Appeals from final decisions of Board to Supreme Court of Appeals; procedure; costs.

  • 23-5-16. Fees of attorney for claimant; unlawful charging or receiving of attorney fees; effective until June 30, 2022.

  • 23-5-17. Repealed.

  • 23-5-18. Repealed.
  • ARTICLE 5A. DISCRIMINATORY PRACTICES


  • 23-5A-1. Discriminatory practices prohibited.

  • 23-5A-2. Discriminatory practices prohibited -- Medical insurance.

  • 23-5A-3. Termination of injured employee prohibited; reemployment of injured employees.

  • 23-5A-4. State employees to accrue increment pay during absence due to work-related injuries; legislative rules.
  • ARTICLE 6. SEVERABILITY


  • 23-6-1. Severability.

  • 23-6-2. Legislative intent.

  • 23-6-3. Operative date for particular enactment.
  • Chapter 33 Insurance (Misc. Statutes)


  • 33-41-5. Reporting of insurance fraud or criminal offenses otherwise related to the business of insurance.

  • 33-41-6. Immunity from liability.

  • 33-2-22. Authority of Insurance Commissioner regarding employers in default to workers' compensation funds; injunctions against defaulting employers.

  • ARTICLE 10A. REHABILITATION SERVICES (18-10A-1 - 18-10A-15)

  • ARTICLE 12. MISCELLANEOUS PROVISIONS (31B-12-1201 - 31B-12-1207)




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