FEE SCHEDULE NEWS:

• The state has adopted the Virginia Workers' Compensation Medical Fee Schedules with an effective date of January 1, 2018. The fee schedule includes rates for physician and facility services.

REGULATORY ACTIVITY:

• Beginning July 1, 2020 and in accordance with § 65.2-601.2, the Virginia Workers' Compensation Commission will issue a 30-Day Order Claim Filed on all claims filed pursuant to § 65.2-601. A response to the order will be considered a required report under § 65.2-902. A failure to timely file the required report may result in the assessment of a $500 civil penalty for each failure and up to $5,000 if such failure is determined to be willful.
• The Commission is currently experiencing limited mediator availability statewide as we focus on conducting hearings which were canceled this spring due to COVID-19. The Alternative Dispute Resolution Department is currently working with a waiting list and is encouraging mediation by telephone or video conference. On May 21, 2020, the Commission entered an order setting forth the conditions under which in-person hearings may occur. Those same conditions apply to in-person mediations and include temperature checks and screening prior to entering a Commission facility and wearing a mask at all times while being in a Commission facility. Additionally, all persons must remain six feet apart and no more than ten persons may occupy any given space. The Commission will not be providing candy or water for mediations, as offered in the past. In order to comply with these requirements, in-person mediation availability is limited and cannot be guaranteed. We have had success with mediating by video and telephone using WebEx. More information on WebEx may be found at http://www.workcomp.virginia.gov/documents/joining-webex-meeting?utm_source=Master+List&utm_campaign=7086c83b12-EMAIL_CAMPAIGN_2018_08_31_07_27_COPY_01&utm_medium=email&utm_term=0_287c6e9cba-7086c83b12-80132883.%20We%20appreciate%20your%20patience%20and%20understanding.

REGULATORY ACTIVITY:

• VWC Converts All Hearings Scheduled May 1-June 10 to Video Hearings.  To view the announcement, go to http://www.workcomp.virginia.gov/news/VWC-Converts-All-Hearings-Scheduled-May-1-June-10-to-Video-Hearings.

LEGISLATIVE ACTIONS:

• House Bill 169The enacted legislation adds correctional officers and full-time sworn members of the enforcement division of the Department of Motor Vehicles to the list of public safety employees who are entitled to a presumption that certain infectious diseases are compensable occupational diseases. Effective Date July 1, 2020.
• House Bill 438The enacted legislation provides that post-traumatic stress disorder incurred by a law-enforcement officer or firefighter is compensable under the Virginia Workers' Compensation Act if a mental health professional examines a law-enforcement officer or firefighter and diagnoses the individual as suffering from post-traumatic stress disorder as a result of the individual's undergoing a qualifying event, defined as an incident or exposure occurring in the line of duty on or after July 1, 2020, (i) resulting in serious bodily injury or death to any person or persons; (ii) involving a minor who has been injured, killed, abused, or exploited; (iii) involving an immediate threat to life of the claimant or another individual; (iv) involving mass casualties; or (v) responding to crime scenes for investigation. Other conditions for compensability include (a) if the post-traumatic stress disorder resulted from the law-enforcement officer or firefighter acting in the line of duty and, in the case of a firefighter, such firefighter complied with certain federal Occupational Safety and Health Act standards; (b) if the law-enforcement officers or firefighters undergoing of a qualifying event was a substantial factor in causing his post-traumatic stress disorder; (c) if such qualifying event, and not another event or source of stress, was the primary cause of the post-traumatic stress disorder; and (d) if the post-traumatic stress disorder did not result from any disciplinary action, work evaluation, job transfer, layoff, demotion, promotion, termination, retirement, or similar action of the officer or firefighter. The measure also establishes requirements for resilience and self-care technique training. Effective Date July 1, 2020.

• House Bill 617The enacted legislation directs the Virginia Workers' Compensation Commission to engage an independent and reputable national research organization to examine the implications of covering workers' injuries caused by repetitive motion through the Virginia workers' compensation system. Effective Date July 1, 2020.
• House Bill 1558The enacted legislation authorizes the Virginia Workers' Compensation Commission to create an Ombudsman program and appoint an ombudsman to administer such program. The program's purpose is to provide neutral educational information and assistance to persons who are not represented by an attorney, including those persons who have claims pending or docketed before the Commission. Effective July 1, 2020.
• Senate Bill 561The enacted legislation provides that post-traumatic stress disorder incurred by a law-enforcement officer or firefighter is compensable under the Virginia Workers' Compensation Act if a mental health professional examines a law-enforcement officer or firefighter and diagnoses the individual as suffering from post-traumatic stress disorder as a result of the individual's undergoing a qualifying event, defined as an incident or exposure occurring in the line of duty on or after July 1, 2020, (i) resulting in serious bodily injury or death to any person or persons; (ii) involving a minor who has been injured, killed, abused, or exploited; (iii) involving an immediate threat to life of the claimant or another individual; (iv) involving mass casualties; or (v) responding to crime scenes for investigation. Other conditions for compensability include (a) if the post-traumatic stress disorder resulted from the law-enforcement officer or firefighter acting in the line of duty and, in the case of a firefighter, such firefighter complied with certain federal Occupational Safety and Health Act standards; (b) if the law-enforcement officers or firefighters undergoing of a qualifying event was a substantial factor in causing his post-traumatic stress disorder; (c) if such qualifying event, and not another event or source of stress, was the primary cause of the post-traumatic stress disorder; and (d) if the post-traumatic stress disorder did not result from any disciplinary action, work evaluation, job transfer, layoff, demotion, promotion, termination, retirement, or similar action of the officer or firefighter. The measure also establishes requirements for resilience and self-care technique training. Effective Date July 1, 2020.

REGULATORY ACTIVITY:

• The Commission is aware of two issues that may prevent the submission of webforms through WebFile. The “Claim Form” and the “Employer’s Application for Hearing” webform options under the “Submit Web Forms” tab are affected. The IS Team is working to deploy a solution to these issues as soon as possible.

Claim Form Webform

• Issue #1: The “Secondary Street Address” fields of the "Claim Form" webform are limited to 15 characters. When data from an existing JCN is pre-populated into these fields the system allows more than 15 characters to appear without displaying an error or warning and the user is unable to click the “Next” button to proceed with submitting the form. Solution: Reduce the characters in the “Secondary Street Address” fields to 15 characters or less by moving some or all of the address to the “Primary Street Address” fields. The Claim Form can also be filed by fax to 804-823-6957 or by mail to 333 E. Franklin St., Richmond, VA 23219.
• Issue #2: The “Phone (Home)” field under the "Injured Worker's Phone" heading on the "Claim Form" webform is limited to 10 characters. When data from an existing JCN is pre-populated into this field the system allows more than 10 characters to appear without displaying an error or warning and the user is unable to click the “Next” button to proceed with submitting the form. Solution: Reduce the characters in the “Phone (Home)” field to 10 characters or less. This can usually be done by deleting any dashes or parentheses. The Claim Form can also be filed by fax to 804-823-6957 or by mail to 333 E. Franklin St., Richmond, VA 23219.

REGULATORY ACTIVITY:

• The 2020 Medical Fee Schedules begin January 1, 2020. The Commission has developed a new drop-down option in the Medical Fee Schedule Reference Tool to select which year of the Schedule you need to reference. This feature will simplify the fee lookup process. The tool fetches reimbursement amounts directly from the medical fee schedule based on the fee year, determines region information and more. To view the updated look up tool, go to http://medicalfeeschedule.workcomp.virginia.gov/ .

FEE SCHEDULE NEWS:

• Posted notice in the state register that the Virginia Workers' Compensation Commission has finalized the regulation adopting a new fee schedule for 2020.  The regulation becomes effective December 25, 2019.  The fee schedule is effective from January 1, 2020 through December 31, 2021.  To view the notice in the register, go to http://register.dls.virginia.gov/toc.aspx?voliss=36:07.

REGULATORY ACTIVITY:

• Published administrative insurance order 12089 regarding approval of  NCCI Item Filing E-1406 Revisions to the ERM-14 Form and Rule 3-A in the Experience Rating Plan Manual for use with policies effective on or after 2/01/2020. This item filing also revises rule 3 A, to reflect the ERM-14 form's revised title. To view the order, go to https://www.scc.virginia.gov/boi/adminords/2019.aspx.

FEE SCHEDULE NEWS:

• A new Medical and Facility fee schedule has been adopted with an effective date of January 1, 2020.

REGULATORY ACTIVITY:

• As the Commission continues to upgrade WebFile, several enhancements will soon go into effect. One of the enhancements will require and prompt all WebFile users to create new passwords and new answers to security questions. Please know this is part of our upgrade plan and is expected system behavior. NOTE: You will not be able to reuse your existing password or passwords used within the last twelve months. To view this notice, go to http://www.workcomp.virginia.gov/news/WebFile-Special-Notice

REGULATORY ACTIVITY:

• The proposed changes and proposed medical fee schedule to be adopted January 1, 2020 have been published. A comment period is open until August 30, 2019.
• Released the 2018 Annual Report.  To view the report, go to http://www.workcomp.virginia.gov/news/VWC-Annual-Report

REGULATORY ACTIVITY:

• The Virginia Workers’ Compensation Commission proposes to amend subsection B of Commission Rule 2.3, Expedited Hearings, as recommended by the Workers’ Compensation Inns of Court Advisory Conference. The Commission also proposes to repeal Commission Rule 14, Medical Communities, in light of amendments to Va. Code Sec. 65.2-605 enacted in 2016 that define “medical community,” superseding the definition set forth in Rule 14. To view this notice, go to http://www.vwc.state.va.us/news/Proposed-Amendment-and-Repeal.
• Posted notice regarding update to the Medical Fee Schedule Transition Review Timeline.  To view this notice, go to http://www.vwc.state.va.us/news/Medical-Fee-Schedules-Special-Notices.

REGULATORY ACTIVITY:

Published new compensation and cola rates effective in 2019.

• Effective October 1, 2019 the cost of living (COLA) rate will be 1.85%
• Effective July 1, 2019 the maximum compensation rate will be $1,102
• Effective July 1, 2019 the minimum compensation rate will be $275.50

To view this notice, go to http://www.vwc.state.va.us/news/New-Compensation-and-COLA-Rates.