Commonwealth of Virginia Workers' Compensation Services
Saturday, March 25, 2017
Total Program Management
Frequently Asked Questions
FAQs offers introductory answers to frequently asked questions about a variety of topics on worker's compensation services. Links throughout the answers will guide you to further information on our website or from other sources. Also, you can review the Online Claims Guide for the steps necessary to follow when filing a workers' compensation claim.
Should you have any further questions, please consult our Contact Us page.
1. What is the e-mail address to send documents to the claims people?
2. Can I send documents just to the Benefit Coordinator (BC)?
No. Always copy the imaging center also – firstname.lastname@example.org. Nothing goes directly to a BC anymore without going through imaging.
3. What specific wage information is required to confirm an employee’s wages?
Gross wages plus any perquisites like bonuses, meals, lodging or uniforms.
4. What period must this wage information cover?
Gross wages for the 52 weeks prior to the date of injury plus any perquisites like bonuses, meals, lodging or uniforms. If the employee has worked less than 12 months, then report wages since the date of hire. The Benefit Coordinator may request the wages of a similar employee if the employee has worked less than 60 days.
5. In what circumstances do we need to submit photographs with a new claim? How do we submit these?
Photographs should be submitted when confirmation of a hazard is needed to support an injured worker’s claim, i.e., areas of slips, falls, defects, etc. Photographs should be submitted to email@example.com.
6. When does an agency have to submit a Supplementary Report on a claim?
A Supplementary Report is needed any time there is a change in the injured worker’s work status which results in lost time or return to work and will affect the amount of indemnity benefits the injured worker is owed. The Supplementary Report should be submitted to MCI at the same time the lost work hours or return to work is reported to HR/payroll.
7. Who is required to pay for OSHA-mandated blood testing on a blood borne pathogen exposure claim?
If the claim is accepted as compensable for an occupational disease then initial testing and six-month follow-up for testing will be covered under workers' compensation. However, OSHA has separate guidelines for post exposure evaluations and follow-ups for all employees who had an exposure incident at work. The requirements established by OSHA are separate from workers' compensation.
8. How does an agency representative report a new claim?
Claims are reported electronically through Visual Liquid Web (VLW).
9. What information should an agency send in on new claims?
All the information you have in your possession at the time the claim is submitted through Visual Liquid Web. The comments field should be used to document any additional information that will not be a part of the Employer’s Accident Report. Please make sure to include either a direct line phone number for the agency contact or the extension of the contact person.
10. How does an agency or interested party report suspicious activity on a claim, or that an injured employee is suspected of working?
This information can be reported directly to the Benefit Coordinator assigned to the claim.
11. What is the difference between Commonwealth of Virginia Claims Office reviewing my claim and Virginia Workers’ Compensation Commission reviewing my claim?
They are both state agencies. The Commonwealth of Virginia Department of Human Resource Services (COV-DHRM) manages with its partner, MC Innovations (MCI), the Workers’ Compensation claims made by employees of the Commonwealth of Virginia. If a workers’ compensation claim related disagreement arises between a COV Agency employee and MCI, the Virginia Workers’ Compensation Commission (VWCC) will review the claim. VWCC has authority over Workers’ Compensation claims within Virginia from both COV and non-COV employers / employees.
12. What is a valid Physician Panel?
A valid physician panel will include three physicians for each specialty listed who are not within the same practice.
13. What if the agency physician panel needs to be updated?
Feel free to contact Client Services to assist in the creating and verification of a panel. Please contact Client Services by emailing ClientServices@rhgnet.com or by calling 800.734.4460 for assistance.
14. What Workers’ Compensation claim type – Record Only, Medical Only, Lost Time should I use when inputting a claim?
If the injured worker has been taken out of work for over 7 days due to the incident, or if there is a serious injury for which you have not received medical documentation but anticipate that the time missed from work will be over 7 days, the claim should be classified as Indemnity. Feel free to contact Client Services to assist in the creating and verification of a panel. Please contact Client Services by emailing ClientServices@rhgnet.com or by calling 800.734.4460 for assistance.
If there has been medical treatment but no time missed from work or 7 days or less missed from work, the claim should be classified as Medical Only. Medical treatment includes any visits to any doctor’s office or to an emergency room.
If there has been no medical treatment nor anticipated, then the claim should be classified as Record Only.
If an employee alleges an injury at work, but has received no medical treatment, the claim should be reported as Indemnity or Medical Only based on the amount of time lost from work as noted above.
15. How can I receive help on establishing a physician panel?
It is up to each agency to make up their own panels. If help is needed, contact Client Services by emailing ClientServices@rhgnet.com or by calling 800.734.4460.