A well-functioning workers’ compensation insurance system should provide for the needs of workers who are injured on the job while shielding employers from exorbitant premiums and unnecessary litigation. West Virginia (WV) has made progress in balancing these priorities in recent years although there is still work to do. Businesses can take proactive steps to protect their interests by understanding WV employer workers’ compensation rights and duties and by implementing policies and procedures that align with WV workers’ compensation rules.
An Overview of WV Employer Workers’ Compensation Rights and Duties
WV workers’ compensation requirements for employers—and the protections offered when these obligations are met—fall into three primary categories: policy, procedural, and reporting requirements; management of claims and employment practices related to workers’ compensation; and rights and responsibilities in disputes and litigation.
WV Code § 23-2-1 defines which employers are subject to the WV workers’ compensation rules set forth under the law. While some employers may be exempt or choose to self-insure if they qualify, the WV employer workers’ compensation rights and responsibilities discussed here apply to the majority of the state’s employers.
An experienced WV employer workers’ compensation attorney can help you determine how state laws apply to your business and provide counsel and representation as you manage policies, procedures, claims, and litigation.
WV Workers’ Compensation Requirements: Policies, Procedures, and Reporting
Under WV Code §§ 23-2-2(a) and 23-2C-15(a), employers are required to maintain workers’ compensation insurance as well as records related to that coverage on an ongoing basis. The WV Offices of the Insurance Commissioner may request information related to policies, activities, rates, and risks, and employers must respond to these inquiries within the timeframe noted. Employers must also post a notice of their workers’ compensation insurer and contact information in a place that is conspicuous and visible to employees.
When an employer meets its obligations related to workers’ compensation insurance coverage, the business and its officers, managers, agents, and representatives are protected from additional recovery actions related to on-the-job injuries. Employees may file for additional damages only when an injury or death occurring on the job results from an employer’s “deliberate intention” to cause harm, as defined in WV Code § 23-4-2.
An employer that is in default on its workers’ compensation insurance payments, however, is not afforded the liability protections offered to employers that are compliant with WV workers’ compensation requirements. These employers can also be subject to a fine of up to $10,000 by the WV Insurance Commission.
WV Employer Workers’ Compensation Rights and Duties Related to Claims
Employers in WV are required to report work-related injuries to their insurer or other responsible parties within five days of becoming aware that an injury occurred. This report should include a statement as to whether the employer agrees or disagrees that a claim related to the injury should be compensable. However, this statement does not waive the employer’s right to later contest compensability or benefits related to the claim.
If an employer believes an employee was at fault in his or her injury or intoxicated at the time an injury occurred, the related workers’ compensation claim can be questioned. In cases of suspected intoxication, the employer has the right to obtain evidence of on-the-job drug or alcohol use through drug testing. When it is determined that an employee was intoxicated at the time the injury occurred, a claim for workers’ compensation benefits may be deemed non-compensable.
By filing a workers’ compensation claim, an employee waives the right to patient-doctor confidentiality. Employers have the right to receive and review the medical history and records related to the claim. An employer also has the right to request an independent medical evaluation, performed by a physician of its choice, and receive a report of the findings of that evaluation.
WV Workers Compensation Rules Regarding Objections, Settlement, and Subrogation
Multiple sections of WV workers’ compensation code allow employers to object to and request hearings regarding disputed claim decisions at various stages. The timeframes for objection, protest, and requests for modifications of awards vary and must be specified in the claim decision notice provided to all parties to the claim.
Settlement of WV workers’ compensation claims is permitted during both the administrative and appellate stages of a claim. WV Code § 23-5-7 sets forth the requirements for these agreements, and claims that are settled may not be reopened once finalized under the law.
Under WV Code § 23-2A-1, an employer or its insurer also has the right to subrogation when a third party is determined to be at fault in a workers’ compensation injury.
A WV employer workers’ compensation attorney can help you navigate objections and hearings, pursue settlement of claims, and determine if a third party is liable for an injury sustained by an employee, pursuing recovery of related costs under the law.
Contact an Experienced WV Employer Workers’ Compensation Attorney
The counsel and representation of a knowledgeable WV employer workers’ compensation attorney are invaluable to businesses at all stages of workers’ compensation management, from obtaining a suitable policy to developing employment procedures to managing and litigating claims.
James “Mac” Heslep serves clients throughout WV from the Clarksburg office of Jenkins Fenstermaker, PLLC. To discuss how your business can fulfill its responsibilities and ensure the protection of its WV employer workers’ compensation rights, contact Mac by calling (304) 521-6120 or completing the firm’s online contact form.