The Virginia Workers' Compensation Commission (VWC) is an agency of the U.S. state of Virginia that oversees the resolution of workers' compensation claims brought in that state, in accordance with the Virginia Workers' Compensation Act. The Commission has exclusive jurisdiction to adjudicate such claims. Its decisions may be appealed to the Virginia Court of Appeals. The Commission is led by a Senior Leadership team consisting of three Commissioners, an Executive Director and a Chief Deputy Commissioner. The Commissioners are appointed by the Virginia General Assembly and serve staggered six-year terms. Honorable Robert A. Rapaport, Honorable Wesley G. Marshall and Honorable R. Ferrell Newman currently serve as Commissioners. The Commissioners elect a Chairman for a term of three years. Commissioner Marshall currently serves as Chairman. Ms. Evelyn McGill is the Commission’s Executive Director and Honorable James J. Szablewicz is the Commission’s Chief Deputy Commissioner. The Commission is headquartered in Richmond, Virginia, and has offices and hearing locations at various places around the state.
The Commission is also directed by statute to administer two other programs. One is the Criminal Injuries Compensation Fund, which assists crime victims. The other is the Birth-Related Neurological Injury Program, which assists children who sustained certain kinds of injuries set forth in the statute at birth.
Authority
The Virginia Workers' Compensation Commission is an independent state agency established by the Virginia General Assembly pursuant to authority in the Constitution of Virginia. The General Assembly, through the legislative process, imparts responsibilities upon the Commission. Additionally, the Commission is authorized to issue rules and regulations to help it carry out its statutory responsibilities.
The Workers' Compensation Act provides for the annual payment of a tax up to 3.25 percent of the basic manual insurance premium calculated by applying the manual premium rates effective on January 1 of the calendar year payroll reporting period. The assessment rate may fluctuate from year to year depending on the Commission's operating costs and fund requirements. Assessment rates for 2015 and 2016 are 2.50% for the Administrative Fund, 0.20% for the Uninsured Employer's Fund, and 0.00% for the Second Injury Fund for a total assessment rate of 2.70%. (The respective maximum rates for the three funds are 2.5 percent, .50 percent, and .25 percent.)
The following titles of the Code of Virginia are pertinent to the VWC:
Title 65.2 - Workers' Compensation Generally Title 2.2 - Administration of Government Title 8.01 - Civil Remedies and Procedure Title 15.2 - Counties, Cities and Towns Title 17.1 - Courts of Record Title 19.2 - Criminal Procedure Title 27 - Fire Protection Title 38.2 - Insurance Title 45.1 - Mines and Mining Title 46.2 - Motor Vehicles Title 51.1 - Pensions, Benefits and Retirement Title 58.1 - Taxation Title 63.2 - Welfare (Social Services)
The following titles of the Virginia Administrative Code contain VWC regulations:
Title 16 - Labor and Employment Title 6 - Criminal Justice and Corrections Title 9 - Environment Title 11 - Gaming Title 12 - Health Title 14 - Insurance Title 18 - Professional and Occupational Licensing
History The Virginia Workmen's Compensation Act was enacted on March 21, 1918, over a veto by Governor Westmoreland Davis. Modeled on Indiana's statute, The Act created the Industrial Commission of Virginia and operations began on January 1, 1919.
The Industrial Commission of Virginia published and submitted its first Annual Report to Virginia Governor Westmoreland Davis on October 15, 1919. The report detailed that during the first nine months of operation, 10,920 accidents were reported to the Commission, out of which 144 were death claims. Of 2,911 cases involving claims for compensation, only 73 required adjustments through formal hearings and one claim was appealed from the Commission to the courts.
The Commission was statutorily directed by the General Assembly to administer the Uninsured Employer's Fund (UEF) effective July 1, 1977. The "Virginia Workmen's Compensation Act" was renamed "Virginia Workers' Compensation Act" in 1983. The Commission was statutorily directed by the General Assembly to administer the Birth-Related Neurological Injury Compensation Program which was created by The Virginia Birth-Related Neurological Injury Compensation Act in 1987. On October l, 1991, the Commission was renamed the Virginia Workers' Compensation Commission as part of a general recodification of the Virginia Workers' Compensation Act.
After a pattern of decisions by the Virginia Workers' Compensation Commission and the Court of Appeals of Virginia allowing workers' compensation benefits for workers with repetitive motion injuries, the Virginia Supreme Court issued a ruling prohibiting employees from receiving compensation for those type of injuries on November 5, 1993.
Office Locations The Commission's first permanent offices were in Richmond in the Old State Office Building, (now Washington Building) in the Capital Square Complex. The Commission expanded its operations on January 21, 1957, and relocated to a new headquarters office in the Blanton Building (now the Jefferson Building) in Richmond. The Commission, moved to 1000 DMV Drive in midtown Richmond, on November 3, 1984. On December 13, 2017, the Commission began full operations in its new agency headquarters, the former Media General building, located at 333 East Franklin Street in downtown Richmond. The Commission is currently headquartered in this location.
The Commission established regional offices in Lebanon (1980-2016), Bristol (2016-Present), Alexandria (1981-2004), Virginia Beach (1983–Present), Roanoke (1986–Present), Harrisonburg (1996–Present), Manassas (2004-Present), and Fairfax (2004–Present).
Services provided The VWC is charged with administering the Virginia workers' compensation program, which applies to most employers doing business in Virginia and most employees working in Virginia. Other organizations involved in Virginia workers' compensation program include insurance carriers, group self-insurance associations, professional employer organizations, and third-party administrators. Additionally, various vendors provide services to these organizations. Finally, attorneys represent these parties before the Commission.
The Commission provides various services to these persons and entities. These range from online services that facilitate meeting Commission requirements, to customer assistance services that provide specialized help, to adjudication and mediation services to parties with disputes, and everything in between.
Alternative Dispute Resolution In 2013 the Commission created the Alternative Dispute Resolution (ADR) Department to provide an alternative to litigation for the resolution of disputes. Any party to a claim may request alternative dispute resolution or mediation at any time. ADR can involve Issue mediation, Full and Final (Settlement) mediation and/or facilitation. The ADR program does not affect benefits to which an employee, dependents, or survivors may be entitled under the provisions of the Act.
Mediation
Mediation may be requested in addition to Adjudication.
Informal, cost-effective means of alternative dispute resolution Parties design their own solutions with the help of a Commission mediator Parties agree to mutually satisfactory solution Appropriate for any medical charge issue Initiated by written request filed with Commission in letter format or using the Commission's mediation request form.
Services for employers As a general rule, employers with more than two employees in the same business within Virginia are subject to the Virginia Workers' Compensation Act. Employees who suffer on-the-job injuries and diseases may be eligible for workers' compensation benefits. Employers must insure their liability for these benefits through a commercial insurance policy, a self-insurance program, or membership in a professional employer organization or group self-insurance association.
An employee suffering a workplace injury or disease should immediately notify his or her employer.
A report of an accident or disease must be filed with the Commission within ten days of knowledge of the accident or disease. To accomplish this, an employer should immediately notify its insurance carrier about the accident, and the insurance carrier will then file the appropriate reports with the Commission. Insurance carriers file these reports with the Commission electronically.
Services for injured workers Employees who suffer on-the-job injuries and diseases may be eligible for benefits under the Virginia Workers' Compensation Act. If injured, an employee (injured worker) should (1) report his/her injury to his/her employer immediately, and (2) file a claim with the Commission no later than two years after the accident. He/she should take similar immediate action if he/she is diagnosed with a work related disease.
Services for claim administrators Claim Administrators, or those organizations managing claims activity on behalf of employers and insurance carriers, play a vital role in the Virginia workers' compensation program. Under section 65.2-900 of the Code of Virginia, all workplace accidents that occur in the course of employment must be reported to the Commission. Additionally, certain events and transactions that occur in the course of handling claims relating to these accidents must be reported. The Commission uses electronic data interchange (EDI) to handle these reports.
Claim Administrators may access their files and conduct certain transactions through WebFile, the Commission's web-based file access portal. WebFile is also a tool available for eligible claim administrators seeking to report EDI information.
Services for medical providers Rights and remedies for medical providers Health care providers play a vital role in the claim process. Accordingly, they have certain rights and remedies available to them under the Virginia Workers' Compensation Act.
Generally, providers become involved in a claim shortly after a work-related accident. Section 65.2-603 of the Code of Virginia requires that the employer provide the claimant with a panel of physicians from which to choose. If the employer does not provide one within a reasonable time, the claimant can choose his own physician. Either way, the physician chosen by the claimant becomes the authorized treating physician. Generally, the following charges may be covered where treatment is related to the compensable injury: Charges billed but the authorized treating physician Charges billed by a physician to whom the claimant is referred by the authorized treating physician Charges for medically necessary treatment and diagnostic measures Prescriptions
Once the claimant has filed a claim which covers a specific charge, or once the Commission enters an award of compensation applicable to a charge, the health care provider may not attempt to bill the claimant for any part of the charge. However, if the Commission rules that the charge is not compensable under the Act, the provider may bill the claimant.
The Medical Care Provider Specialist provides workers' compensation claims information to medical care providers. The Medical Care Provider Specialist also assists providers with disputes over non-payment and underpayment of treatment by contacting appropriate parties and facilitating resolution.
Services for attorneys