West Virginia workers’ compensation insurance requirements that employers should know

Why is workers’ compensation coverage important?

Workers’ compensation offers valuable benefits such as medical care and wage benefits to employees who may be injured or become ill due to an occupational illness and are unable to work. But workers’ compensation insurance also protects employers from costly medical expenses when an employee is injured, shields your business from potential employee lawsuits as a result of an injury, and helps protect employers from penalties that can jeopardize your business.

Which employers are required to carry workers’ compensation insurance in West Virginia?

According to West Virginia statute, all employers are required to carry workers’ compensation insurance. This includes any of the following that employ another person for business purposes:

• Individuals
• Sole proprietors
• Firms
• Partnerships
• Limited partnerships
• Limited liability companies
• Joint ventures
• Associations
• Corporations
• Nonprofit organizations
• Receiverships
• Estates
• Trusts
• Administrators
• Government entities

Are there exemptions?

Any possible exemptions from West Virginia workers’ compensation requirements must apply for a letter of exemption by completing the Application for Verification of Statutory Exemption from West Virginia Workers’ Compensation Coverage. Employers that are possibly exempt from West Virginia workers’ compensation requirements include:

• Domestic servants
• Agricultural employers with five or fewer employees
• Churchs
• Employers engaged in professional sports activities
• Volunteer rescue squads
• Longshore and harbor workers
• Casual employees – businesses that employ less than three employees for less than ten days in a quarter
• Sole proprietors without employees
• Those designated as independent contractors by West Virginia Employment Law

How can an employer purchase workers’ compensation insurance in West Virginia?

The West Virginia workers’ compensation market has more than 330 insurance carriers that offer workers’ compensation policies. Employers may also apply to obtain self-insured status by completing an application and including three years of audited financial statements. The application fee is $2,500.

What does workers’ compensation insurance cover?

West Virginia workers’ compensation insurance offers the following benefits:

Medical costs

Any medical costs associated with an on-the-job injury are covered. This includes emergency room visits, follow-up care, surgery, and drug prescriptions. Any long term care such as physical therapy and rehabilitation services are also covered under workers’ compensation. Under the policy, travel expenses including meals and lodging may also be reimbursed when traveling for medical treatment is required.

Employee supplemental income benefits

For many business owners, it’s difficult to continue paying wages to an employee that has been injured and is unable to work. Workers’ compensation coverage offers wage replacement benefits for the employee unable to return to work for weeks or even months.

Short-term and long-term disability payment

Short-term disability pays for continued medical treatment for employees unable to return to their previous job. Disability benefits provide wage benefits while an employee recovers and provides wage replacement for those that are permanently disabled. Wage replacement benefits are usually available for those diagnosed with a short-term, long-term, or permanent disability. In addition to wage replacement benefits, those suffering a permanent disability may also be eligible for a lump-sum settlement payment, depending on the injury suffered.

Occupational illness

West Virginia workers’ compensation also covers environmental illnesses for employees that may have been exposed to chemicals or other toxic hazards, paying for all related medical bills and follow-up treatment.

Funeral expenses

As of July 1, 2022, the spouse or dependents of an employee who dies as a result of a workplace-related injury is eligible to receive up to $10,000 in funeral and related costs. Dependents can also file the Application for Fatal Dependents’ Benefits, for which the spouse and/or dependent children are eligible.

Are there penalties for not having workers’ compensation insurance?

West Virginia employers not in compliance can face steep penalties. Those found to be without the required coverage in place will be issued a written notice of the default, which will be posted in a conspicuous place in the business. Any person that attempts to remove the posted default notice will be convicted of a misdemeanor and fined $1,000. The business will also be fined up to $10,000, with any subsequent defaults resulting in an additional $10,000 penalty. A business in default will also have to pay a fee for the posting process.

Along with a monetary penalty, other enforcement methods include:

• Initiation of a civil action against the employer
• Filing of a lien or liens against all employer property
• A stop-work order may be issued
• A request to criminally prosecute of any person, firm, or corporation who is found to be non-compliant

How are on-the-job injuries reported?

Any injured worker should immediately seek emergency care if needed. Employees are required to provide written notice to their employer within two days of the injury date about any injury suffered. After notice has been given, employees will need to file a workers’ compensation claim or request that their employer do so. The employer is responsible for reporting any injury suffered by an employee on the job within five days of notification of the injury.

An employee injured on the job that finds out that their employer is not in compliance with West Virginia law can file the Employee’s Report of Occupational Injury and Proof of Employment, which works with the employee to provide workers’ compensation benefits while also pursuing legal action against the uninsured employer.

Any claims for a work-related injury must be filed within six months of the original date of injury or within three years from the date of diagnosis of an occupational disease or injury.

Can an injured employee use their own doctor for treatment?

In most cases, a West Virginia employee injured on the job can use their own physician for all follow-up care. However, if the employer currently uses a managed care organization or MCO, the employee will need to use an MCO approved physician for all treatment.

Additional West Virginia resources

West Virginia employers with questions can contact the State of West Virginia Offices of the Insurance Commissioner at (888) 879-9842 or by email. Additional workers’ compensation resources are listed below.

• Workers’ compensation claims information 
• Eligibility requirements and exemptions
• Self insurance rules and regulations 
• Letters of exemption from workers’ compensation coverage
• West Virginia workers’ compensation uninsured employer fund

Having workers’ compensation coverage keeps your business compliant

Employees are considered one of your most valuable resources. That’s why having the proper workers’ compensation insurance coverage is so important, since the right coverage protects your employees from the costly impact of an on-the-job injury. But workers’ compensation is just as valuable to employers, protecting them from costly litigation and penalties. If you have any questions about workers’ compensation or where to start, our team is here to help.

Please note all material in this article is for educational purposes only and does not constitute tax, benefits or legal advice. You should always contact a qualified tax, legal or financial professional, in your area for comprehensive tax or legal advice.