West Virginia requires all businesses to have workers comp for employees, with only a few exceptions.
Workmans compensation insurance typically pays medical bills and a percentage of lost income for a worker who's injured while doing a job-related task. The types of injuries that can be covered by workers comp ranges from carpal tunnel to burns to broken bones.
West Virginia workers compensation law outline many details of the limits of workers comp payments, who can be exempt from coverage and who must be covered. Below are many of the specifics contained in the workers comp law in West Virginia. The West Virginia Offices of the Insurance Commissioner also has a page with helpful information for employers.
Who has to be covered by West Virginia workers compensation?
Can any employees opt out of West Virginia workers compensation with a waiver?
Yes - corporate officers can opt out. Sole proprietors can elect to be covered.
Is self-insurance for workers comp allowed in West Virginia?
Yes, for individual employers, groups of employers and political subdivisions. Political subdivisions in West Virginia are typically the state or a city, county, special district, school district or public agency.
By self-insuring, a business assumes responsibility for paying their own workers comp claims. A self-insured company typically hires a claims service company to handle claims administration and other services.
Are there exclusions for:
Small employers? Three part-time employees can be excluded, but all full-time employees must be covered.
Agricultural employers? Yes, if there are five or fewer full-time employees.
Domestic employers? Yes, domestic servant performing work in or about a private home of the person by whom they are employed.
Independent contractors? Yes.
Casual employees? Yes.
Volunteers? Yes.
Professional athletes? Yes.
West Virginia workers comp medical benefits
Is there a West Virginia workers comp fee schedule?
Yes, maximum medical reimbursement for those not participating in an approved workers compensation managed health care plan.
Fee schedules define payments for surgery, radiology, hospital services, chiropractic care, ambulance service, prescription drugs and other medical services for an injured worker.
Are there limits on medical treatment?
Yes, treatment must be causally related to the work injury.
Who makes the initial choice of treating physician?
The employee, unless the employer has a managed health care plan (approved by the insurance commissioner); in those cases, the employee must choose from physicians in the plan or approved by the plan.
Disability payments for workers compensation insurance in West Virginia
Workers comp generally pays a worker some of their lost wages if they cannot work because of a job-related injury. State laws stipulate certain limits on the disability payment length and amounts, based on both permanent and temporary disability.
How are temporary total disability (TTD) payments calculated?
66 2/3% of the employee's pre-injury weekly wage, not to exceed 100% of the statewide average weekly wage (SAWW).
Weekly minimum: $754.81
Weekly maximum: 100% of the SAWW.
Maximum length of TDD benefits: 500 weeks.
How are permanent total disability (PTD) payments calculated?
66 2/3% of the employee's pre-injury weekly wage, not to exceed 100% of the statewide average weekly wage (SAWW).
Weekly minimum: Federal minimum wage.
Weekly maximum: $711.38
Are there cost of living increases for PTD payments? No.
Maximum length of PTD benefits: Payable to age 70 for all PTD awards granted on or after July 1, 2003.
How are permanent partial disability (PPD) payments calculated?
66 2/3% of the employee's pre-injury weekly wage, not to exceed 70% of the statewide average weekly wage (SAWW).
Weekly minimum: Federal minimum wage.
Weekly maximum: $497.97
Fatality benefits under West Virginia workers compensation law
Maximum burial benefit: $7,000
Dependency benefits, weekly minimum: Federal minimum wage.
Dependency benefits, weekly maximum: $754.81
When do children's dependency benefits end? At age 18; age 25 if the child is a student; benefits can continue for life if child is disabled.
Other injuries covered by West Virginia workers compensation
Mental stress with no physical injury? No.
Cumulative trauma (such as injuries caused by repeated exposure or repetitive motion)? Yes.
Occupational hearing loss? Yes.
Disfigurement? Yes.
Source: Workers Compensation Research Institute, May 2016 report