
ENROLLED
Senate Bill No. 2013
(By Senators Kessler, Ross, Snyder, Harrison, Smith and Weeks)
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[Passed June 14, 2003; in effect from passage.]
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AN ACT
to repeal sections one, two, three, four, five, six and seven,
article three, chapter twenty-one-a of the code of West Virginia,
one thousand nine hundred thirty-one, as amended; to repeal
section five-b, article two, chapter twenty-three of said code;
to repeal section seven, article four-a of said chapter; to amend
and reenact section thirty-three-d, article three, chapter five-a
of said code; to amend and reenact sections four and five,
article three, chapter five-b of said code; to amend and reenact
section one, article two, chapter five-f of said code; to amend
and reenact section seven, article twelve, chapter eleven of said
code; to amend and reenact section four, article one-a, chapter
twelve of said code; to amend and reenact section six, article
six of said chapter; to amend and reenact section ten, article
two, chapter fifteen of said code; to amend and reenact section
fifteen, article one, chapter sixteen of said code; to amend and
reenact section three, article twenty-nine-d of said chapter; to
amend and reenact section three, article thirty-six of said
chapter; to amend and reenact section twenty-six, article nine-a,
chapter eighteen of said code; to amend and reenact section
twelve-a, article ten-a of said chapter; to amend and reenact section two, article ten-k of said chapter; to amend and reenact
section three, article three-a, chapter twenty-one of said code;
to amend and reenact section four, article one, chapter twenty-
one-a of said code; to amend and reenact sections six, six-c and
thirteen, article two of said chapter; to amend and reenact
section eleven, article ten of said chapter; to amend and reenact
section eight, article three, chapter twenty-two of said code; to
amend and reenact sections one, two, three, four, five, six,
seven, eight, nine, ten, eleven, twelve, thirteen, fourteen,
fifteen, seventeen and eighteen, article one, chapter twenty-
three of said code; to further amend said article by adding
thereto eight new sections, designated sections one-a, one-b,
one-c, one-d, one-e, one-f, four-a and nineteen; to amend and
reenact sections one, one-c, one-d, two, three, four, five, five-
a, five-c, five-d, six, nine, ten, eleven, twelve, thirteen,
fourteen, fifteen, sixteen and seventeen, article two of said
chapter; to amend and reenact section one, article two-a of said
chapter; to amend and reenact sections one, two and three,
article two-b of said chapter; to amend and reenact sections one,
one-a, two, three and five, article three of said chapter; to
further amend said article by adding thereto a new section,
designated section six; to amend and reenact sections one, one-a,
one-b, one-c, one-d, one-e, two, three, three-b, three-c, four,
five, six, six-a, six-b, six-d, seven, seven-a, seven-b, eight,
eight-a, eight-b, eight-c, nine, nine-b, ten, eleven, twelve,
fourteen, fifteen, fifteen-a, fifteen-b, sixteen, sixteen-a,
seventeen, eighteen, twenty, twenty-two, twenty-three, twenty-four and twenty-five, article four of said chapter; to further
amend said article by adding thereto a new section, designated
section one-f; to amend and reenact sections one, three, five,
six and eight, article four-a of said chapter; to amend and
reenact sections two, five, six and seven, article four-b of said
chapter; to further amend said article by adding thereto a new
section, designated section eight-b; to amend and reenact
sections two, three, four and five, article four-c of said
chapter; to amend and reenact sections one, two, three, four,
five, six, seven, eight, nine, ten, eleven, twelve, fifteen,
seventeen and eighteen, article five of said chapter; to amend
and reenact section two, article eight, chapter twenty-six of
said code; to amend and reenact sections one hundred twenty-five
and one hundred thirty-one, article eighteen, chapter forty-eight
of said code; and to amend and reenact sections twenty-four-e,
twenty-four-f and twenty-four-g, article three, chapter sixty-one
of said code, all relating to workers' compensation generally;
repealing provisions relating to the compensation programs
performance council; repealing provisions relating to default
settlement; repealing provisions relating to employees and
payment of salaries from the disabled workmen's relief fund;
removing workers' compensation from the bureau of employment
programs; directing certain reports to be filed quarterly;
providing legislative findings; creating workers' compensation
commission as an independent agency assuming all duties of
division; creating the workers' compensation board of managers;
establishing composition of board; establishing qualifications for membership; establishing appointment procedures for members;
providing for compensation and travel expenses; setting forth the
powers and duties of board; establishing position, powers and
duties of executive director; establishing qualifications;
establishing procedure for removal; providing violator system to
prohibit certain persons from obtaining state licenses,
certificates and permits in certain circumstances;
providing for
payment withholding and interception of moneys of certain
employers; providing penalties for failure to withhold or
intercept payments; authorizing interagency agreements for the
bureau of employment programs and workers' compensation
commission; providing for the adoption of workers' compensation
rules by commission; transferring assets and contracts;
establishing fraud and abuse investigation and prosecution unit;
providing powers and duties of unit; providing for legislative
oversight of commission; providing for salaries and expenses of
commission; requiring bond and insurance for the executive
director and associate director; authorizing the executive
director to hire an associate director and other employees;
providing for associate director to assume authority in absence
of executive director; authorizing certain commission employees
to administer oaths; providing for issuance and enforcement of
agency subpoenas; providing additional civil remedies for
violations of law; allowing certain elected local officials not
to participate in workers' compensation; providing that limited
liability companies may elect to not provide workers'
compensation coverage to certain members; clarifying that extraction of natural resources is provision of services;
requiring promulgation of rule to prevent contractors from
avoiding liability for workers' compensation premiums; creating
ongoing duty to provide information to commission; authorizing
rate reductions for safety and loss prevention and drug-free
workplace initiatives; requiring rates, surcharges and
assessments to be financially sound and sufficient to meet needs
of the funds; establishing rate caps; authorizing the commission
to require employers to pay premium taxes more often than
quarterly; extending time for commission to collect from
defaulting or delinquent employers; establishing statute of
limitations; allowing specified groups of employers to self-
insure their obligations to the commission; requiring self-
insured employers to administer claims; requiring self-insured
employers to comply with the law and commission rules;
establishing components of self-insured premium tax; requiring
employers that self-insure second injury benefits to continue to
be responsible for the claims; providing that self-insured
employers who fail to make benefit payments are in default in
certain circumstances; authorizing the commission to determine
self-insured rates; authorizing self-insured employers to obtain
third-party insurance for catastrophic claims and requiring copy
of policy; prohibiting self-insured employers from contracting
with third-party administrators who have not been approved by the
commission; allowing for subrogation of medical benefits and
authorizing reasonable attorney fees and reasonable portion of
costs; eliminating second injury awards and the second injury reserve fund for certain claims; providing for management of the
deficit; authorizing emergency fiscal measures; reporting
requirements of self-insurers; requiring commission to adopt
standards for evaluation of whole-body impairment with regard to
certain occupational diseases; providing an expedited appeal to
the office of judges where self-insured denies compensability;
requiring assessment of claimant's return-to-work potential;
providing assistance in return-to-work efforts; authorizing
repayment of overpayments from future benefits and providing for
liability of attorney for certain fees and expenses; prohibiting
a claimant from receiving certain workers' compensation benefits
and private benefits in certain circumstances; requiring award of
permanent partial disability benefits be made as expeditiously as
possible; requiring medical providers to submit timely requests
for payment; authorizing certain employers with managed health
care plans to require employees to use the plan for treatment of
compensable injuries; exceptions; authorizing the commission to
establish managed health care plans;
requiring commission to
propose legislative rules governing use of managed health care
plans; providing for weighing of evidence; providing for
suspension or termination of health care providers; requiring
commission to set standards for medical management of claims;
providing benefits for cemetery expenses; eliminating annual
increases in benefits; reducing certain benefit rates;
establishing new criteria for eligibility for benefits for
certain injuries and diseases; increasing to fifty percent the
percentage of whole body impairment for eligibility for consideration for a permanent total disability award;
establishing internal operative dates; requiring the executive
director to promulgate a rule to establish requirements for an
application for permanent total disability benefits; specifying
application required for claim for permanent total disability
benefits; providing for the establishment of an onset date for
permanent total disability benefits; providing for increase of
minimum aggregation of percentages of permanent disability or
medical impairment prior to applying for permanent total
disability award; providing for prior disability awards excluded
from calculation; providing that ability to acquire skills may be
considered in permanent total disability determination; providing
that neither certain proximity of employment nor comparison of
wages may be considered when determining permanent total
disability; terminating permanent total disability benefits at
age seventy in certain circumstances; eliminating the five-
percent presumptive award of occupational pneumoconiosis;
authorizing application for occupational pneumoconiosis benefits
within three years of determination of impairment; providing that
the commission may suspend benefits to a claimant for refusing,
without good cause, treatment or examination by a physician;
providing for a trial work period; modifying provisions for
vocational rehabilitation services; authorizing reopening and
review of claims; establishing duty to provide information to
commission; expanding monitoring in injury claims; authorizing
suspension or termination of benefits in certain circumstances;
removing certain offset provisions; providing certain incentives for premium discounts; providing that certain portion of rate
increase not be subject to collection; expanding sources from
which overpayment of benefits and awards may be collected;
providing for further examinations of certain disability benefit
recipients; providing for transfer of certain funds from and to
coal-workers' pneumoconiosis fund; permitting certain employers
to self-insure certain obligations; providing for the settlement
of claims; providing a statute of limitations on employer
liability in certain circumstances; requiring certain security or
bond from employers; administration of claims by self-insured
employers; requiring certain additional amounts to be paid to the
commission by employers; providing circumstances in which
employers are in default in obligations to the commission;
requiring commission approval of employer use of third-party
administrator; requiring electronic transfer of funds; providing
time limitation for certain payments; authorizing rule to permit
employers to contract with certain providers of services in
certain circumstances; providing for payments of certain benefits
during participation in certain rehabilitation plans; providing
for the termination of or limitation on certain benefits in
certain circumstances; requiring rules for certain administrative
functions; requiring expedited hearings in certain circumstances;
providing for finality of certain administrator decisions;
providing standards of review; providing for mediation; providing
for removal of chief administrative law judge; providing for
appeals; establishing time frames for appeals; establishing
standards for appeal; creating the workers' compensation board of review; providing for appointment of members of board by the
governor; establishing qualifications of judges; establishing
position of chief judge; authorizing rules of procedure;
authorizing clerk and other employees; providing for remand of
cases; providing for standards for appeals to the West Virginia
supreme court of appeals; providing civil and criminal penalties
and judgments for restitution; making technical corrections and
removing archaic language throughout; and providing conforming
amendments.
Be it enacted by the Legislature of West Virginia:
That sections one, two, three, four, five, six and seven, article
three, chapter twenty-one-a of the code of West Virginia, one thousand
nine hundred thirty-one, as amended, be repealed; that section five-b,
article two, chapter twenty-three of said code be repealed; that
section seven, article four-a of said chapter be repealed; that section
thirty-three-d, article three, chapter five-a of said code be amended
and reenacted; that sections four and five, article three, chapter
five-b of said code be amended and reenacted; that section one, article
two, chapter five-f of said code be amended and reenacted; that section
seven, article twelve, chapter eleven of said code be amended and
reenacted; that section four, article one-a, chapter twelve of said
code be amended and reenacted; that section six, article six of said
chapter be amended and reenacted; that section ten, article two,
chapter fifteen of said code be amended and reenacted; that section
fifteen, article one, chapter sixteen of said code be amended and
reenacted; that section three, article twenty-nine-d of said chapter
be amended and reenacted; that section three, article thirty-six of said chapter be amended and reenacted; that section twenty-six, article
nine-a, chapter eighteen of said code be amended and reenacted; that
section twelve-a, article ten-a of said chapter be amended and
reenacted; that section two, article ten-k of said chapter be amended
and reenacted; that section three, article three-a, chapter twenty-one
of said code be amended and reenacted; that section four, article one,
chapter twenty-one-a of said code be amended and reenacted; that
sections six, six-c and thirteen, article two of said chapter be
amended and reenacted; that section eleven, article ten of said chapter
be amended and reenacted; that section eight, article three, chapter
twenty-two of said code be amended and reenacted; that sections one,
two, three, four, five, six, seven, eight, nine, ten, eleven, twelve,
thirteen, fourteen, fifteen, seventeen and eighteen, article one,
chapter twenty-three of said code be amended and reenacted; that said
article be further amended by adding thereto eight new sections,
designated sections one-a, one-b, one-c, one-d, one-e, one-f, four-a
and nineteen; that sections one, one-c, one-d, two, three, four, five,
five-a, five-c, five-d, six, nine, ten, eleven, twelve, thirteen,
fourteen, fifteen, sixteen and seventeen, article two of said chapter
be amended and reenacted; that section one, article two-a of said
chapter be amended and reenacted; that sections one, two and three,
article two-b of said chapter be amended and reenacted; that sections
one, one-a, two, three and five, article three of said chapter be
amended and reenacted; that said article be further amended by adding
thereto a new section, designated section six; that sections one, one-
a, one-b, one-c, one-d, one-e, two, three, three-b, three-c, four,
five, six, six-a, six-b, six-d, seven, seven-a, seven-b, eight, eight-a, eight-b, eight-c, nine, nine-b, ten, eleven, twelve, fourteen,
fifteen, fifteen-a, fifteen-b, sixteen, sixteen-a, seventeen, eighteen,
twenty, twenty-two, twenty-three, twenty-four and twenty-five, article
four of said chapter be amended and reenacted; that said article be
further amended by adding thereto a new section, designated section
one-f; that sections one, three, five, six and eight, article four-a
of said chapter be amended and reenacted; that sections two, five, six
and seven, article four-b of said chapter be amended and reenacted;
that said article be further amended by adding thereto a new section,
designated section eight-b; that sections two, three, four and five,
article four-c of said chapter be amended and reenacted; that sections
one, two, three, four, five, six, seven, eight, nine, ten, eleven,
twelve, fifteen, seventeen and eighteen, article five of said chapter
be amended and reenacted; that section two, article eight, chapter
twenty-six of said code be amended and reenacted; that sections one
hundred twenty-five and one hundred thirty-one, article eighteen,
chapter forty-eight of said code be amended and reenacted; and that
sections twenty-four-e, twenty-four-f and twenty-four-g, article three,
chapter sixty-one of said code be amended and reenacted, all to read
as follows:
CHAPTER 5A. DEPARTMENT OF ADMINISTRATION.
ARTICLE 3. PURCHASING DIVISION.
§5A-3-33d. Grounds for debarment.
Grounds for debarment are:
(1) Conviction of an offense involving fraud or a felony offense
in connection with obtaining or attempting to obtain a public contract or subcontract;
(2) Conviction of any federal or state antitrust statute relating
to the submission of offers;
(3) Conviction of an offense involving embezzlement, theft,
forgery, bribery, falsification or destruction of records, making false
statements or receiving stolen property in connection with the
performance of a contract;
(4) Conviction of a felony offense demonstrating a lack of
business integrity or business honesty that affects the present
responsibility of the vendor or subcontractor;
(5) Default on obligations owed to the state, including, but not
limited to, obligations under the West Virginia workers' compensation
act, the West Virginia unemployment compensation act and West Virginia
state tax and revenue laws. For purposes of this subsection, a vendor
is in default when, after due notice, the vendor fails to submit a
required payment, interest thereon or penalty, and has not entered into
a repayment agreement with the appropriate agency of the state or has
entered into a repayment agreement but does not remain in compliance
with its obligations under the repayment agreement. In the case of a
vendor granted protection by order of a federal bankruptcy court or a
vendor granted an exemption under any rule of the bureau of employment
programs or the workers' compensation commission, the director may
waive debarment under section thirty-three-f of this article: Provided,
That in no event may debarment be waived with respect to any vendor who
has not paid all current state obligations for at least the four most
recent calendar quarters, excluding the current calendar quarter, or
with respect to any vendor who is in default on a repayment agreement with an agency of the state;
(6) The vendor is not in good standing with a licensing board, in
that the vendor is not licensed when licensure is required by the law
of this state, or the vendor has been found to be in violation of an
applicable licensing law after notice, opportunity to be heard and
other due process required by law; and
(7) Violation of the terms of a public contract or subcontract
for:
(A) Willful failure to substantially perform in accordance with
the terms of one or more public contracts;
(B) Performance in violation of standards established by law or
generally accepted standards of the trade or profession amounting to
intentionally deficient or grossly negligent performance on one or more
public contracts;
(C) Use of substandard materials on one or more public contracts
or defects in construction in one or more public construction projects
amounting to intentionally deficient or grossly negligent performance,
even if discovery of the defect is subsequent to acceptance of a
construction project and expiration of any warranty thereunder;
(D) A repeated pattern or practice of failure to perform so
serious and compelling as to justify debarment; or
(E) Any other cause of a serious and compelling nature amounting
to knowing and willful misconduct of the vendor that demonstrates a
wanton indifference to the interests of the public and that caused, or
that had a substantial likelihood of causing, serious harm to the
public.
CHAPTER 5B. ECONOMIC DEVELOPMENT ACT OF 1985.
ARTICLE 3. WEST VIRGINIA ECONOMIC DEVELOPMENT STRATEGY: A VISION
SHARED.
§5B-3-4. Commission review of procedural rules, interpretive rules and
existing legislative rules.
(a) The joint commission on economic development may review any
procedural rule, interpretive rule or existing legislative rule and
make recommendations concerning the rules to the Legislature.
(b) The development office and the tourism commission established
pursuant to article two of this chapter, the economic development
authority established pursuant to article fifteen, chapter thirty-one
of this code, the bureau of employment programs established pursuant
to article four, chapter twenty-one-a of this code, the workers'
compensation commission established pursuant to article one, chapter
twenty-three of this code, the workforce investment commission
established pursuant to article two-c of this chapter, West Virginia
jobs investment trust, regional planning and development councils, West
Virginia rural development council, governor's office of technology and
West Virginia clearinghouse for workforce education shall each file a
copy of its legislative rules with the commission as provided for in
this section. Each agency that proposes legislative rules in
accordance to the provisions of article three, three-a or three-b,
chapter twenty-nine-a of this code relating to economic development or
workforce development shall file the rules with the joint commission
at the time the rules are filed with the secretary of state prior to
the public comment period or public hearing required in said chapter.
§5B-3-5. Joint commission on economic development studies.
(a) The joint commission on economic development shall study the
following:
(1) The feasibility of establishing common regional
configurations for such purposes as local workforce investment areas,
regional educational service agencies and for all other purposes the
commission considers feasible. The study should review the existing
levels of cooperation between state and local economic developers,
complete an analysis of possible regional configurations and outline
examples of other successful regional systems or networks found
throughout the world. If the study determines that the common regional
configurations are feasible, the commission shall recommend legislation
establishing common regional designations for all purposes the
commission considers feasible. In making the designation of regional
areas, the study shall take into consideration, but not be limited to,
the following:
(A) Geographic areas served by local educational agencies and
intermediate educational agencies;
(B) Geographic areas served by post-secondary educational
institutions and area vocational education schools;
(C) The extent to which the local areas are consistent with labor
market areas;
(D) The distance that individuals will need to travel to receive
services provided in the local areas; and
(E) The resources of the local areas that are available to
effectively administer the activities or programs;
(2) The effectiveness and fiscal impact of incentives for
attracting and growing businesses, especially technology-intensive companies; and
(3) A comprehensive review of West Virginia's existing economic
and community development resources and the recommendation of an
organizational structure, including, but not limited to, the
reorganization of the bureau of commerce and the development office
that would allow the state to successfully compete in the new global
economy.
(b) In order to effectuate in the most cost-effective and
efficient manner the studies required in this article, it is necessary
for the joint commission to assemble and compile a tremendous amount
of information. The development office will assist the joint
commission in the collection and analysis of this information. The
tourism commission established pursuant to article two of this chapter,
the economic development authority established pursuant to article
fifteen, chapter thirty-one of this code, the bureau of employment
programs established pursuant to article four, chapter twenty-one-a of
this code, the workers' compensation commission established pursuant
to article one, chapter twenty-three of this code, the workforce
investment commission established pursuant to article two-c of this
chapter, West Virginia jobs investment trust, regional planning and
development councils, West Virginia rural development council,
governor's office of technology and West Virginia clearinghouse for
workforce education all shall provide a copy of the agency's annual
report as submitted to the governor in accordance with the requirements
set forth in section twenty, article one, chapter five of this code to
the West Virginia development office. The development office shall
review, analyze and summarize the data contained in the reports, including its own annual report, and annually submit its findings to
the joint commission on or before the thirty-first day of December.
(c) The legislative auditor shall provide to the joint commission
a copy of any and all reports on agencies listed in subsection (b) of
this section, which are required under article ten, chapter four of
this code.
(d) The joint commission shall complete the studies set forth in
this section and any other studies the joint commission determines to
undertake prior to the first day of December of each year and may make
recommendations, including recommended legislation for introduction
during the regular session of the Legislature.
CHAPTER 5F. REORGANIZATION OF THE EXECUTIVE BRANCH OF STATE
GOVERNMENT.
ARTICLE 2. TRANSFER OF AGENCIES AND BOARDS.
§5F-2-1. Transfer and incorporation of agencies and boards; funds.
(a) The following agencies and boards, including all of the
allied, advisory, affiliated or related entities and funds associated
with any agency or board, are transferred to and incorporated in and
administered as a part of the department of administration:
(1) Building commission provided for in article six, chapter five
of this code;
(2) Public employees insurance agency and public employees
insurance agency advisory board provided for in article sixteen,
chapter five of this code;
(3) Governor's mansion advisory committee provided for in article
five, chapter five-a of this code;
(4) Commission on uniform state laws provided for in article one-
a, chapter twenty-nine of this code;
(5) Education and state employees grievance board provided for in
article twenty-nine, chapter eighteen of this code and article six-a,
chapter twenty-nine of this code;
(6) Board of risk and insurance management provided for in
article twelve, chapter twenty-nine of this code;
(7) Boundary commission provided for in article twenty-three,
chapter twenty-nine of this code;
(8) Public defender services provided for in article twenty-one,
chapter twenty-nine of this code;
(9) Division of personnel provided for in article six, chapter
twenty-nine of this code;
(10) The West Virginia ethics commission provided for in article
two, chapter six-b of this code; and
(11) Consolidated public retirement board provided for in article
ten-d, chapter five of this code.
(b) The department of commerce, labor and environmental resources
and the office of secretary of the department of commerce, labor and
environmental resources are abolished. For purposes of administrative
support and liaison with the office of the governor, the following
agencies and boards, including all allied, advisory and affiliated
entities, are grouped under two bureaus and one commission as follows:
(1) Bureau of commerce:
(A) Division of labor provided for in article one, chapter
twenty-one of this code, which includes:
(i) Occupational safety and health review commission provided for in article three-a, chapter twenty-one of this code; and
(ii) Board of manufactured housing construction and safety
provided for in article nine, chapter twenty-one of this code;
(B) Office of miners' health, safety and training provided for in
article one, chapter twenty-two-a of this code. The following boards
are transferred to the office of miners' health, safety and training
for purposes of administrative support and liaison with the office of
the governor:
(i) Board of coal mine health and safety and coal mine safety and
technical review committee provided for in article six, chapter twenty-
two-a of this code;
(ii) Board of miner training, education and certification
provided for in article seven, chapter twenty-two-a of this code; and
(iii) Mine inspectors' examining board provided for in article
nine, chapter twenty-two-a of this code;
(C) The West Virginia development office provided for in article
two, chapter five-b of this code, which includes:
(i) Economic development authority provided for in article
fifteen, chapter thirty-one of this code; and
(ii) Tourism commission provided for in article two, chapter
five-b of this code and the office of the tourism commissioner;
(D) Division of natural resources and natural resources
commission provided for in article one, chapter twenty of this code.
The Blennerhassett historical state park provided for in article eight,
chapter twenty-nine of this code is under the division of natural
resources;
(E) Division of forestry provided for in article one-a, chapter nineteen of this code;
(F) Geological and economic survey provided for in article two,
chapter twenty-nine of this code;
(G) Water development authority and board provided for in article
one, chapter twenty-two-c of this code;
(2) Bureau of employment programs provided for in article one,
chapter twenty-one-a of this code; and
(3) Workers' compensation commission provided for in article one,
chapter twenty-three of this code.
(c) Bureau of environment is abolished and the following agencies
and boards, including all allied, advisory and affiliated entities, are
transferred to the department of environmental protection for purposes
of administrative support and liaison with the office of the governor:
(1) Air quality board provided for in article two, chapter
twenty-two-b of this code;
(2) Solid waste management board provided for in article three,
chapter twenty-two-c of this code;
(3) Environmental quality board, or its successor board, provided
for in article three, chapter twenty-two-b of this code;
(4) Surface mine board provided for in article four, chapter
twenty-two-b of this code;
(5) Oil and gas inspectors' examining board provided for in
article seven, chapter twenty-two-c of this code;
(6) Shallow gas well review board provided for in article eight,
chapter twenty-two-c of this code; and
(7) Oil and gas conservation commission provided for in article
nine, chapter twenty-two-c of this code.
(d) The following agencies and boards, including all of the
allied, advisory, affiliated or related entities and funds associated
with any agency or board, are transferred to and incorporated in and
administered as a part of the department of education and the arts:
(1) Library commission provided for in article one, chapter ten
of this code;
(2) Educational broadcasting authority provided for in article
five, chapter ten of this code;
(3) Joint commission for vocational-technical-occupational
education provided for in article three-a, chapter eighteen-b of this
code;
(4) Division of culture and history provided for in article one,
chapter twenty-nine of this code; and
(5) Division of rehabilitation services provided for in section
two, article ten-a, chapter eighteen of this code.
(e) The following agencies and boards, including all of the
allied, advisory, affiliated or related entities and funds associated
with any agency or board, are transferred to and incorporated in and
administered as a part of the department of health and human resources:
(1) Human rights commission provided for in article eleven,
chapter five of this code;
(2) Division of human services provided for in article two,
chapter nine of this code;
(3) Bureau for public health provided for in article one, chapter
sixteen of this code;
(4) Office of emergency medical services and advisory council
thereto provided for in article four-c, chapter sixteen of this code;
(5) Health care authority provided for in article twenty-nine-b,
chapter sixteen of this code;
(6) Commission on mental retardation provided for in article
fifteen, chapter twenty-nine of this code;
(7) Women's commission provided for in article twenty, chapter
twenty-nine of this code; and
(8) The child support enforcement division provided for in
chapter forty-eight of this code.
(f) The following agencies and boards, including all of the
allied, advisory, affiliated or related entities and funds associated
with any agency or board, are transferred to and incorporated in and
administered as a part of the department of military affairs and public
safety:
(1) Adjutant general's department provided for in article one-a,
chapter fifteen of this code;
(2) Armory board provided for in article six, chapter fifteen of
this code;
(3) Military awards board provided for in article one-g, chapter
fifteen of this code;
(4) West Virginia state police provided for in article two,
chapter fifteen of this code;
(5) Office of emergency services and disaster recovery board
provided for in article five, chapter fifteen of this code and
emergency response commission provided for in article five-a of said
chapter;
(6) Sheriffs' bureau provided for in article eight, chapter
fifteen of this code;
(7) Division of corrections provided for in chapter twenty-five
of this code;
(8) Fire commission provided for in article three, chapter
twenty-nine of this code;
(9) Regional jail and correctional facility authority provided
for in article twenty, chapter thirty-one of this code;
(10) Board of probation and parole provided for in article
twelve, chapter sixty-two of this code; and
(11) Division of veterans' affairs and veterans' council provided
for in article one, chapter nine-a of this code.
(g) The following agencies and boards, including all of the
allied, advisory, affiliated or related entities and funds associated
with any agency or board, are transferred to and incorporated in and
administered as a part of the department of tax and revenue:
(1) Tax division provided for in article one, chapter eleven of
this code;
(2) Racing commission provided for in article twenty-three,
chapter nineteen of this code;
(3) Lottery commission and position of lottery director provided
for in article twenty-two, chapter twenty-nine of this code;
(4) Agency of insurance commissioner provided for in article two,
chapter thirty-three of this code;
(5) Office of alcohol beverage control commissioner provided for
in article sixteen, chapter eleven of this code and article two,
chapter sixty of this code;
(6) Board of banking and financial institutions provided for in
article three, chapter thirty-one-a of this code;
(7) Lending and credit rate board provided for in chapter forty-
seven-a of this code; and
(8) Division of banking provided for in article two, chapter
thirty-one-a of this code.
(h) The following agencies and boards, including all of the
allied, advisory, affiliated or related entities and funds associated
with any agency or board, are transferred to and incorporated in and
administered as a part of the department of transportation:
(1) Division of highways provided for in article two-a, chapter
seventeen of this code;
(2) Parkways, economic development and tourism authority provided
for in article sixteen-a, chapter seventeen of this code;
(3) Division of motor vehicles provided for in article two,
chapter seventeen-a of this code;
(4) Driver's licensing advisory board provided for in article
two, chapter seventeen-b of this code;
(5) Aeronautics commission provided for in article two-a, chapter
twenty-nine of this code;
(6) State rail authority provided for in article eighteen,
chapter twenty-nine of this code; and
(7) Port authority provided for in article sixteen-b, chapter
seventeen of this code.
(i) Except for powers, authority and duties that have been
delegated to the secretaries of the departments by the provisions of
section two of this article, the existence of the position of
administrator and of the agency and the powers, authority and duties
of each administrator and agency are not affected by the enactment of this chapter.
(j) Except for powers, authority and duties that have been
delegated to the secretaries of the departments by the provisions of
section two of this article, the existence, powers, authority and
duties of boards and the membership, terms and qualifications of
members of the boards are not affected by the enactment of this chapter
and all boards which are appellate bodies or were otherwise established
to be independent decisionmakers will not have their appellate or
independent decision-making status affected by the enactment of this
chapter.
(k) Any department previously transferred to and incorporated in
a department created in section two, article one of this chapter by
prior enactment of this section in chapter three, acts of the
Legislature, first extraordinary session, one thousand nine hundred
eighty-nine, and subsequent amendments means a division of the
appropriate department. Wherever reference is made to any department
transferred to and incorporated in a department created in section two,
article one of this chapter, the reference means a division of the
appropriate department and any reference to a division of a department
so transferred and incorporated means a section of the appropriate
division of the department.
(l) When an agency, board or commission is transferred under a
bureau or agency other than a department headed by a secretary pursuant
to this section, that transfer is solely for purposes of administrative
support and liaison with the office of the governor, a department
secretary or a bureau. The bureaus created by the Legislature upon the
abolishment of the department of commerce, labor and environmental resources in the year one thousand nine hundred ninety-four will be
headed by a commissioner or other statutory officer of an agency within
that bureau. Nothing in this section extends the powers of department
secretaries under section two of this article to any person other than
a department secretary and nothing limits or abridges the statutory
powers and duties of statutory commissioners or officers pursuant to
this code.
CHAPTER 11. TAXATION.
ARTICLE 12. BUSINESS REGISTRATION TAX.
§11-12-7. Display of registration certificate; injunction; public
information, reciprocal exchange of information.
Any person to whom a certificate of registration has been issued
under the provisions of section four of this article shall keep the
certificate posted in a conspicuous position in the place where the
privilege of the business is exercised. The certificate of
registration shall be produced for inspection whenever required by the
tax commissioner or by any law-enforcement officers of this state,
county or municipality in which the privileges to conduct business are
exercised.
No injunction shall issue from any court in the state enjoining
the collection of any business registration certificate tax required
in this section; and any person claiming that any business certificate
is not due, for any reason, shall pay the tax under protest and
petition the tax commissioner for a refund in accordance with the
provisions of section fourteen, article ten of this chapter.
If any person engaging in or prosecuting any business, or trade, contrary to any other provisions of this article, whether without
obtaining a business certificate therefor before commencing the same,
or by continuing the same after the termination of the effective period
of the business certificate, the circuit court, or the judge thereof
in vacation, of the county in which the violation occurred shall, upon
proper application in the name of the state, and after ten days'
written notice thereof to such person, grant an injunction prohibiting
that person from continuing the business, activity or trade until he
or she has fully complied with the provisions of this article. The
remedy provided in this section is in addition to all other penalties
and remedies provided by law.
The tax commissioner shall make available, when requested,
information as to whether a person is registered to do business in the
state of West Virginia.
The tax commissioner shall deliver to the commissioner of the
bureau of employment programs and the executive director of the
workers' compensation commission the information contained in the
business franchise registration certificate when this information is
used to implement and administer a single point of registration program
for persons engaging in any business activity in the state of West
Virginia. The single point of registration program shall provide that,
once an individual has received a business franchise registration
certificate, the tax commissioner shall notify the commissioner of the
bureau of employment programs and the executive director of the
workers' compensation commission of the names, addresses and other
identifying information of that individual or entity. Upon receiving
this information, the commissioner of the bureau of employment programs and the executive director of the workers' compensation commission
shall contact all businesses receiving a business franchise
registration certificate and provide all necessary forms and paperwork
to register a business within the bureau and commission pursuant to
subsection (b), section six-b, article two, chapter twenty-one-a of
this code and subsection (c), section two, article two, chapter twenty-
three of this code.
Notwithstanding the provisions of section five, article ten of
this chapter, the tax commissioner may enter into a reciprocal
agreement with the governor's office of community and industrial
development and other departments or agencies of this state for the
exchange of information contained in the application for a business
franchise registration certificate filed under section four of this
article when the purpose for the exchange is to implement and
administer a single-point of registration program for persons engaging
in business in this state. The other departments and agencies may
enter into a reciprocal exchange agreement for this purpose
notwithstanding any provision of this code to the contrary.
CHAPTER 12. PUBLIC MONEYS AND SECURITIES.
ARTICLE 1A. WEST VIRGINIA SMALL BUSINESS LINKED DEPOSIT PROGRAM.
§12-1A-4. Applications for loan priority; loan package; counseling.
(a) An eligible lending institution that desires to participate
in the linked deposit program shall accept and review loan applications
from eligible small businesses that have been prepared with the advice
of the small business development center. The lending institution
shall apply all usual lending standards to determine the credit worthiness of each eligible small business and whether the loan
application meets the criteria established in this article.
(b) An eligible small business shall certify on its loan
application that: (1) The small business is in good standing with the
state tax division, the workers' compensation commission and the bureau
of employment programs as of the date of the application; (2) the
linked deposit loan will be used to create new jobs or preserve
existing jobs and employment opportunities; and (3) the linked deposit
loan shall not be used to refinance an existing debt.
(c) In considering which eligible small businesses should receive
linked deposit loans, the eligible lending institution shall give
priority to the economic needs of the area in which the business is
located, the number of jobs to be created and preserved by the receipt
of the loan, the reasonable ability of the small business to repay the
loan and other factors considered appropriate by the eligible financial
institution.
(d) A small business receiving a linked deposit loan shall
receive supervision and counseling provided by the small business
development center when applying for the loan. The services available
from the small business development center include eligibility
certification, business planning, quarterly financial statement review
and loan application assistance. The state tax division, the bureau
of employment programs and the workers' compensation commission shall
provide the small business development center with information as to
the standing of each small business loan applicant. The small business
development center shall include these certifications with the loan
application.
(e) The eligible financial institution shall forward to the
treasurer a linked deposit loan package in the form and manner
prescribed by the treasurer. The treasurer shall forward notice of
approval of the loan to the small business development center at the
same time it is furnished to the eligible financial institution.
ARTICLE 6. WEST VIRGINIA INVESTMENT MANAGEMENT BOARD.
§12-6-6. Annual audits; reports and information to constitutional and
legislative officers, council of finance and administration,
consolidated public retirement board, workers' compensation fund
and coal-workers' pneumoconiosis fund; statements and reports
open for inspection.
(a) The board shall cause an annual financial and compliance
audit of the assets managed by the board to be made by a certified
public accounting firm which has a minimum staff of ten certified
public accountants and which is a member of the American institute of
certified public accountants and, if doing business in West Virginia,
a member of the West Virginia society of certified public accountants.
The financial and compliance audit shall be made of the board's books,
accounts and records with respect to its receipts, disbursements,
investments, contracts and all other matters relating to its financial
operations. Copies of the audit report shall be furnished to the
governor, state treasurer, state auditor, president of the Senate,
speaker of the House of Delegates, council of finance and
administration and consolidated public retirement board.
(b) The board shall produce monthly financial statements for the
assets managed by the board and cause them to be delivered to each member of the board and the executive secretary of the consolidated
public retirement board as established in sections one and two, article
ten-d, chapter five of this code and to the executive director of the
workers' compensation commission as administrator of the workers'
compensation fund and coal-workers' pneumoconiosis fund as provided in
section one-b, article one, chapter twenty-three of this code and
section one, article three of said chapter and section seven, article
four-b of said chapter.
(c) The board shall deliver in each quarter to the council of
finance and administration and the consolidated public retirement board
a report detailing the investment performance of the 401(a) plans.
(d) The board shall cause an annual audit of the reported returns
of the assets managed by the board to be made by an investment
consulting or a certified public accounting firm meeting the criteria
set out in subsection (a) of this section. The board shall furnish
copies of the audit report to the governor, state treasurer, state
auditor, president of the Senate, speaker of the House of Delegates,
council of finance and administration and consolidated public
retirement board.
(e) The board shall provide any other information requested in
writing by the council of finance and administration.
(f) All statements and reports with respect to participant plans
required in this section shall be available for inspection by the
members and beneficiaries and designated representatives of the
participant plans.
CHAPTER 15. PUBLIC SAFETY.
ARTICLE 2. WEST VIRGINIA STATE POLICE.
§15-2-10. Uniforms; authorized equipment, weapons and supplies; local
headquarters; quarters for members; life insurance; medical and
hospital fees for injuries and illnesses of members incurred in
line of duty.
(a) The standard uniform to be used by the West Virginia state
police after the effective date of this article shall be as follows:
Forestry green blouse with West Virginia state police emblem on sleeve;
black shoulder strap one-inch black stripe around sleeve, four inches
from end of sleeve; forestry green breeches with one-inch black stripe
down the side; trousers (slacks) with one-inch black stripe down the
side for officers and clerks regularly enlisted in the state police;
forestry green shirts with West Virginia state police emblem on sleeve;
black shoulder straps; forestry green mackinaw with West Virginia state
police emblem on sleeve; black shoulder straps; one-inch black stripe
around sleeve four inches from end of sleeve; campaign hat of olive
drab color; black Sam Browne belt with holster; black leggings and
shoes; the officer's uniform will have one and one-quarter inch black
stripe around the sleeve of blouse and mackinaw four inches from end
of sleeve circumposed with one-half inch gold braid, also black collars
on blouse, with two silver shoulder bars for captains, one silver
shoulder bar for first lieutenant, one gold shoulder bar for second
lieutenant. For noncommissioned officers the uniform blouse and shirt
will have thereon black chevrons of the appropriate rank.
(b) The superintendent shall establish the weapons and
enforcement equipment which are authorized for use by members of the
state police and shall provide for periodic inspection of the weapons and equipment. He or she shall provide for the discipline of members
using other than authorized weapons and enforcement equipment.
(c) The superintendent shall provide the members of the state
police with suitable arms and weapons and, when he or she considers it
necessary, with suitably equipped automobiles, motorcycles, watercraft,
airplanes and other means of conveyance to be used by the West Virginia
state police, the governor and other officers and executives in the
discretion of the governor, in times of flood, disaster and other
emergencies, for traffic study and control, criminal and safety work
and in other matters of official business. He or she shall also
provide the standard uniforms for all members of the state police, for
officers, noncommissioned officers and troopers provided for in this
section. All uniforms and all arms, weapons and other property
furnished the members of the state police by the state of West Virginia
are and remain the property of the state.
(d) The superintendent may purchase and maintain on behalf of
members group life insurance not to exceed the amount of five thousand
dollars on behalf of each member.
(e) The superintendent may contract and furnish at state police
expense medical and hospital services for treatment of illness or
injury of a member which shall be determined by the superintendent to
have been incurred by the member while engaged in the performance of
duty and from causes beyond control of the members. Notwithstanding
any other provision of this code, the superintendent has the right of
subrogation in any civil action or settlement brought by or on behalf
of a member in relation to any act by another which results in the
illness, injury or death of a member. To this end, the superintendent may initiate an action on behalf of the state police in order to
recover the costs incurred in providing medical and hospital services
for the treatment of a member resulting from injury or illness
originating in the performance of official duties. This subsection
shall not affect the power of a court to apply ordinary equitable
defenses to the right of subrogation.
The superintendent may also consult with the executive director
of the workers' compensation commission in an effort to defray the cost
of medical and hospital services. In no case will the compensation
rendered to health care providers for medical and hospital services
exceed the then current rate schedule in use by the workers'
compensation commission.
Third-party reimbursements received by the superintendent after
the expiration of the fiscal year in which the injury, illness or death
occurred will be deposited to a nonexpiring special revenue account.
Funds deposited to this account may be used solely for defraying the
costs of medical or hospital services rendered to any sworn members as
a direct result of an illness, injury or death resulting from the
performance of official duties.
(f) The superintendent shall establish and maintain local
headquarters at those places in West Virginia that are in his or her
judgment suitable and proper to render the West Virginia state police
most efficient for the purpose of preserving the peace, protecting
property, preventing crime, apprehending criminals and carrying into
effect all other provisions of this article. The superintendent shall
provide, by acquisition, lease or otherwise, for local headquarters,
for housing and quarters for the accommodation of the members of the West Virginia state police, and for any other facilities necessary or
useful for the effective operation of the West Virginia state police
and shall provide all equipment and supplies necessary for the members
of the West Virginia state police to perform their duties.
CHAPTER 16. PUBLIC HEALTH.
ARTICLE 1. STATE PUBLIC HEALTH SYSTEM.
§16-1-15. Investigations and hearings; power to administer oaths,
subpoena witnesses, etc.; use of information and material
acquired.
(a) The secretary, the commissioner, any officer or employee of
the department designated by the secretary, or any other individual
designated by the secretary may hold investigations, inquiries and
hearings concerning matters covered by the laws of this state
pertaining to public health and within the authority and the rules and
orders of the secretary. Hearings shall be open to the public and
shall be held upon any call or notice considered advisable by the
secretary.
(b) Each individual designated to hold any inquiry, investigation
or hearing may administer oaths and affirmations, certify to all
official acts, issue subpoenas and order the attendance and testimony
of witnesses in the production of papers, books and documents. In case
of the failure of any person to comply with any subpoena or order
issued under the authority of this section, the secretary or his or her
authorized representative may invoke the aid of any circuit court of
this state. The court may thereupon order that person to comply with
the requirements of the subpoena order or to give evidence as to the matter in question. Failure to obey the order of the court may be
punished by the court as a contempt of court.
(c) Subject to the provisions of subsections (a) and (b) of this
section, the secretary may in his or her discretion make available to
appropriate federal, state and municipal agencies information and
material developed in the course of its investigation and hearings:
Provided, That information obtained from studies or from any
investigation made or hearing held pursuant to the provisions of this
article may not be admissible in evidence in any action at law to
recover damages for personal injury or in any action under the workers'
compensation act, but the information, if available, shall be furnished
upon request to the executive director of the workers' compensation
commission for the sole purpose of adjusting claims presented to the
commission.
ARTICLE 29D. STATE HEALTH CARE.
§16-29D-3. Agencies to cooperate and to provide plan; contents of
plan; reports to Legislature; late payments by state agencies and
interest thereon.
(a) All departments and divisions of the state, including, but
not limited to, the bureau of employment programs; the division of
health and the division of human services within the department of
health and human resources; the public employees insurance agency
within the department of administration; the division of rehabilitation
services; the workers' compensation commission; or the other department
or division as shall supervise or provide rehabilitation; and the
university of West Virginia board of trustees, as the governing board for the state's medical schools, are authorized and directed to
cooperate in order, among other things, to ensure the quality of the
health care services delivered to the beneficiaries of the departments
and divisions and to ensure the containment of costs in the payment for
services.
(b) It is expressly recognized that no other entity may interfere
with the discretion and judgment given to the single state agency which
administers the state's medicaid program. Thus, it is the intention
of the Legislature that nothing contained in this article shall be
interpreted, construed or applied to interfere with the powers and
actions of the single state agency which, in keeping with applicable
federal law, shall administer the state's medicaid program as it
perceives to be in the best interest of that program and its
beneficiaries.
(c) The departments and divisions shall develop a plan or plans
to ensure that a reasonable and appropriate level of health care is
provided to the beneficiaries of the various programs including the
public employees insurance agency and the workers' compensation fund,
the division of rehabilitation services and, to the extent permissible,
the state medicaid program. The plan or plans may include, among other
things, and the departments and divisions are hereby authorized to
enter into:
(1) Utilization review and quality assurance programs;
(2) The establishment of a schedule or schedules of the maximum
reasonable amounts to be paid to health care providers for the delivery
of health care services covered by the plan or plans. The schedule or
schedules may be either prospective in nature or cost reimbursement in nature, or a mixture of both: Provided, That any payment methods or
schedules for institutions which provide inpatient care shall be
institution-specific and shall, at a minimum, take into account a
disproportionate share of medicaid, charity care and medical education:
Provided, however, That in no event may any rate set in this article
for an institutional health care provider be greater than the
institution's current rate established and approved by the health care
cost review authority pursuant to article twenty-nine-b of this
chapter;
(3) Provisions for making payments in advance of the receipt of
health care services by a beneficiary, or in advance of the receipt of
specific charges for the services, or both;
(4) Provisions for the receipt or payment of charges by
electronic transfers;
(5) Arrangements, including contracts, with preferred provider
organizations; and
(6) Arrangements, including contracts, with particular health
care providers to deliver health care services to the beneficiaries of
the programs of the departments and divisions at agreed-upon rates in
exchange for controlled access to the beneficiary populations.
(d) The director of the public employees insurance agency shall
contract with an independent actuarial company for a review every four
years of the claims experience of all governmental entities whose
employees participate in the public employees insurance agency program,
including, but not limited to, all branches of state government, all
state departments or agencies (including those receiving funds from the
federal government or a federal agency), all county and municipal governments or any other similar entity for the purpose of determining
the cost of providing coverage under the program, including
administrative cost, to each governmental entity.
(e) Nothing in this section shall be construed to give or reserve
to the Legislature any further or greater power or jurisdiction over
the operations or programs of the various departments and divisions
affected by this article than that already possessed by the Legislature
in the absence of this article.
(f) For the purchase of health care or health care services by a
health care provider participating in a plan under this section on or
after the first day of September, one thousand nine hundred
eighty-nine, by the public employees insurance agency, the division of
rehabilitation services and the workers' compensation commission, a
state check shall be issued in payment thereof within sixty-five days
after a legitimate uncontested invoice is actually received by the
division, commission or agency. Any state check issued after
sixty-five days shall include interest at the current rate, as
determined by the state tax commissioner under the provisions of
section seventeen-a, article ten, chapter eleven of this code. The
interest shall be calculated from the sixty-sixth day after the invoice
was actually received by the commission or agency until the date on
which the state check is mailed to the vendor.
ARTICLE 36. NEEDLESTICK INJURY PREVENTION.
§16-36-3. Needlestick injury prevention advisory committee.
(a) There is established a needlestick injury prevention advisory
committee to advise the director in the development of rules required
under this article.
(b) The committee shall meet at least four times a year for the
initial two years after the effective date of this article and on the
call of the director thereafter. The director shall serve as the chair
and shall appoint thirteen members, one representing each of the
following groups:
(1) A representative of the health insurance industry;
(2) The executive director of the workers' compensation
commission, or his or her designee;
(3) Five nurses who work primarily providing direct patient care
in a hospital or nursing home, at least one of which is employed in a
state-operated facility;
(4) A phlebotomist employed in a hospital or nursing home;
(5) Two administrators of different hospitals operating within
the state;
(6) A director of nursing employed in a nursing home within the
state;
(7) A licensed physician practicing in the state; and
(8) An administrator of a nursing home operating within the
state.
(c) Members of the committee serve without compensation. Each
member shall be reimbursed for actual and necessary expenses incurred
for each day or portion thereof engaged in the discharge of official
duties, in a manner consistent with guidelines of the travel management
office of the department of administration.
(d) A majority of all members constitutes a quorum for the
transaction of all business. Members serve for two-year terms and may
not serve for more than two consecutive terms.
CHAPTER 18. EDUCATION.
ARTICLE 9A. PUBLIC SCHOOL SUPPORT.
§18-9A-26. Allowance for workers' compensation for unpaid student
work-based learning.
(a) The workers' compensation commission shall create a
classification and calculate a base premium tax rate for students
participating in an unpaid work-based learning experience off school
premises as a part of the school curriculum with employers other than
the county board of education. The workers' compensation commission
shall report to the state department of education:
(1) The amount of the base premium tax rate for the class; and
(2) The amount of wages per student to be used to provide the
minimum weekly benefits required by section six, article four, chapter
twenty-three of this code.
(b) The state department of education shall communicate the
amount of the premium to the governor and Legislature by the first day
of December of each year.
(c) The base premium tax rate reported to the state department of
education shall be that which was published by the workers'
compensation commission prior to the first day of the immediately
preceding July. The workers' compensation commission shall make no
merit rate adjustment, as otherwise provided for in paragraph (A),
subdivision (1), subsection (a), section four, article two, chapter
twenty-three of this code for the members of the class required to be
created by subsection (a) of this section.
(d) Notwithstanding anything to the contrary in any rules adopted to implement the provisions of section four, article two, chapter
twenty-three of this code and for the sole purpose of this section, the
workers' compensation commission shall permit any county board of
education affected by this section to be classified in accordance with
this section and to be also classified as otherwise required by any
rules adopted to implement the provisions of section four, article two,
chapter twenty-three of this code.
(e) Subject to an appropriation by the Legislature, funds shall
be provided to the department of education to distribute to the county
boards. If the appropriation is less than the total premium
calculated, the county boards, individually, shall either reduce the
number of students participating in work-based learning experiences off
school premises or the county boards shall pay the difference between
the amount of the premium calculated by the workers' compensation
commission and the amount allocated to the county board by the
department of education.
ARTICLE 10A. REHABILITATION SERVICES.
§18-10A-12a. Workers' compensation for clients participating in unpaid
work-based training programs.
(a) The workers' compensation commission shall create a
classification and calculate a base premium tax rate for clients of the
division of rehabilitation services participating in unpaid work-based
training programs within integrated community-based settings. The
workers' compensation commission shall report to the division of
rehabilitation services:
(1) The amount of the base premium tax rate for the class; and
(2) The hourly wages per client to be used to provide the minimum
weekly benefits required by section six, article four, chapter twenty-
three of this code.
(b) The base premium tax rate reported annually to the division
of rehabilitation services by the workers' compensation commission
shall not be effective until the first day of July and shall remain in
effect through the last day of the next June.
(c) The division of rehabilitation services and the participating
entity shall be considered the joint employers of record of the clients
while the clients are participating in unpaid work-based training
programs in integrated community-based settings: Provided, That the
participating entity shall not be held responsible for any liability
due the workers' compensation commission. The clients shall be
considered to be paid the amount of wages sufficient to provide the
minimum workers' compensation weekly benefits required by section six,
article four, chapter twenty-three of this code.
ARTICLE 10K. WEST VIRGINIA TRAUMATIC BRAIN AND SPINAL CORD INJURY
REHABILITATION FUND ACT.
§18-10K-2. Board created, membership, terms, officers and staff.
(a) There is hereby established the West Virginia traumatic brain
and spinal cord injury rehabilitation fund board.
(b) The board shall consist of twenty-three members. The members
shall include:
(1) The secretary of the department of education and the arts, ex
officio, or his or her designee;
(2) The secretary of health and human resources, ex officio, or his or her designee;
(3) The state superintendent of schools, ex officio, or his or
her designee;
(4) The secretary of the department of military affairs and
public safety, ex officio, or his or her designee;
(5) The director of the bureau of behavioral health within the
department of health and human resources, ex officio, or his or her
designee;
(6) The director of the division of rehabilitation services, ex
officio, or his or her designee;
(7) The director of the bureau of medical services, ex officio,
or his or her designee;
(8) The director of the office of emergency services, ex officio,
or his or her designee;
(9) The executive director of the workers' compensation
commission, ex officio, or his or her designee;
(10) Seven members appointed by the governor to represent public
and private health organizations or other disability coalitions or
advisory groups; and
(11) Seven members appointed by the governor who are either
survivors of traumatic brain or spinal cord injury or family members
of persons with traumatic brain or spinal cord injury.
(c) The citizen members shall be appointed by the governor for
terms of three years, except that of the members first appointed, two
of the representatives of public and nonprofit private health
organizations, disability coalitions or advisory groups and two of the
representatives of survivors or family members of persons with traumatic brain or spinal cord injuries shall serve for terms of one
year, two of the representatives of each of those respective groups
shall serve for terms of two years and the remaining three
representatives of each of those respective groups shall serve for
terms of three years. All subsequent appointments shall be for three
years. Members shall serve until the expiration of the term for which
they have been appointed or until their successors have been appointed
and qualified. In the event of a vacancy, the governor shall appoint
a qualified person to serve for the unexpired term. No member may
serve more than two consecutive three-year terms. State officers or
employees may be appointed to the board unless otherwise prohibited by
law.
(d) In the event a board member fails to attend more than twenty-
five percent of the scheduled meetings in a twelve-month period, the
board may, after written notification to that member and the secretary
of education and the arts, request in writing that the governor remove
the member and appoint a new member to serve his or her unexpired term.
(e) The board shall elect from its membership a chairperson,
treasurer and secretary as well as any other officer as appropriate.
The term of the chairperson is for two years in duration and he or she
cannot serve more than two consecutive terms.
CHAPTER 21. LABOR.
ARTICLE 3A. OCCUPATIONAL SAFETY AND HEALTH ACT.
§21-3A-3. Division of occupational safety and health; coordination of
activities with workers' compensation commission.
(a) There is continued in the labor department a division of occupational safety and health comprised of a subdivision for safety,
a subdivision for health and the other subdivisions the commissioner
considers necessary. This division shall administer all matters
pertaining to occupational safety and occupational health.
(b) The labor commissioner may require the assistance of other
state agencies and may enter into agreements with other state agencies
and political subdivisions of the state for the administration of this
chapter.
(c) The labor commissioner shall provide for coordination between
the division of occupational safety and health and the workers'
compensation commission including, but not limited to, the
establishment of standardized procedures and reportings.
CHAPTER 21A. UNEMPLOYMENT COMPENSATION.
ARTICLE 1. UNEMPLOYMENT COMPENSATION.
§21A-1-4. Bureau of employment programs created; division; "bureau"
defined.
There is continued an agency designated as the bureau of
employment programs, composed of a division of unemployment
compensation, a division of employment service, a division of job
training programs and any other divisions or units that the
commissioner determines are necessary.
Wherever within this chapter the term "department", "bureau" or
"fund" is used, it shall be taken to mean bureau of employment programs
unless otherwise indicated.
The bureau shall be administered pursuant to subsection (b),
section one, article two, chapter five-f of this code.
ARTICLE 2. THE COMMISSIONER OF THE BUREAU OF EMPLOYMENT PROGRAMS.
§21A-2-6. Powers and duties generally.
The commissioner is the executive and administrative head of the
bureau and has the power and duty to:
(1) Exercise general supervision for the governance of the bureau
and propose rules for promulgation in accordance with the provisions
of article three, chapter twenty-nine-a of this code to implement the
requirements of this chapter;
(2) Prescribe uniform rules pertaining to investigations,
departmental hearings and propose rules for promulgation;
(3) Supervise fiscal affairs and responsibilities of the bureau;
(4) Prescribe the qualifications of, appoint, remove and fix the
compensation of the officers and employees of the bureau, subject to
the provisions of section ten, article four of this chapter, relating
to the board of review;
(5) Organize and administer the bureau so as to comply with the
requirements of this chapter and to satisfy any conditions established
in applicable federal law or regulation;
(6) Make reports in the form and containing information required
by the United States department of labor and comply with any
requirements that the United States department of labor finds necessary
to assure the correctness and verification of the reports;
(7) Make available to any agency of the United States charged
with the administration of public works or assistance through public
employment, upon its request, the name, address, ordinary occupation
and employment status of each recipient of unemployment compensation
and a statement of the recipient's rights to further compensation under this chapter;
(8) Keep an accurate and complete record of all bureau
proceedings, record and file all bonds and contracts and assume
responsibility for the custody and preservation of all papers and
documents of the bureau;
(9) Sign and execute in the name of the state, by the "Bureau of
Employment Programs", any contract or agreement with the federal
government, its agencies, other states, their subdivisions or private
persons;
(10) Prescribe a salary scale to govern compensation of
appointees and employees of the bureau;
(11) Make the original determination of right in claims for
benefits;
(12) Make recommendations and an annual report to the governor
concerning the condition, operation and functioning of the bureau;
(13) Invoke any legal or special remedy for the enforcement of
orders or the provisions of this chapter;
(14) Exercise any other power necessary to standardize
administration, expedite bureau business, assure the establishment of
fair rules and promote the efficiency of the service;
(15) Keep an accurate and complete record and prepare a monthly
report of the number of persons employed and unemployed in the state.
The report shall be made available upon request to members of the
public and press;
(16) Provide at bureau expense a program of continuing
professional, technical and specialized instruction for the personnel
of the bureau;









(17) (A) Propose for promulgation rules under which agencies of
this state shall not grant, issue or renew any contract, license,
permit, certificate or other authority to conduct a trade, profession
or business to or with any employing unit whose account is in default
with the commissioner with regard to the administration of this
chapter. The term "agency" includes any unit of state government such
as officers, agencies, divisions, departments, boards, commissions,
authorities or public corporations. An employing unit is not in
default if it has entered into a repayment agreement with the
unemployment compensation division of the bureau and remains in
compliance with its obligations under the repayment agreement.
(B) The rules shall provide that, before granting, issuing or
renewing any contract, license, permit, certificate or other authority
to conduct a trade, profession or business to or with any employing
unit, the designated agencies shall review a list or lists provided by
the bureau of employers that are in default. If the employing unit's
name is not on the list, the agency, unless it has actual knowledge
that the employing unit is in default with the bureau, may grant, issue
or renew the contract, license, permit, certificate or other authority
to conduct a trade, profession or business. The list may be provided
to the agency in the form of a computerized database or databases that
the agency can access. Any objections to the refusal to issue or renew
shall be reviewed under the appropriate provisions of this chapter.
The rules provided for by this subdivision shall be promulgated pursuant to the provisions of article three, chapter twenty-nine-a of
this code. The prohibition against granting, issuing or renewing any
contract, license, permit, certificate or other authority under this
subdivision shall continue in full force and effect until the revised
rules are promulgated and are in effect.
(C) The rules may be promulgated or implemented in phases so that
specific agencies or specific types of contracts, licenses, permits,
certificates or other authority to conduct trades, professions or
businesses will be subject to the rules beginning on different dates.
The presumptions of ownership or control contained in the division of
environmental protection's surface mining reclamation regulations
promulgated under the provisions of article three, chapter twenty-two
of this code are not applicable or controlling in determining the
identity of employing units who are in default for the purposes of this
subdivision. The rules shall also provide a procedure allowing any
agency or interested person, after being covered under the rules for
at least one year, to petition the bureau of employment programs to be
exempt from the provisions of the rules. Rules subjecting all
applicable agencies and contracts, licenses, permits, certificates or
other authority to conduct trades, professions or businesses to the
requirements of this subdivision that were promulgated prior to the
first day of October, two thousand three, shall be revised and
submitted for legislative review no later than the first day of June,
two thousand four;
(18) Deposit to the credit of the appropriate special revenue
account or fund, notwithstanding any other provision of this code and
to the extent allowed by federal law, all amounts of delinquent payments or overpayments, interest and penalties thereon, and
attorneys' fees and costs collected under the provisions of this
chapter. The amounts collected shall not be treated by the auditor or
treasurer as part of the general revenue of the state; and
(19) Enter into interagency agreements to assist in exchanging
information and fulfilling the provisions of this article.
§21A-2-6c. Payment withholding and interception.
(a) All state, county, district and municipal officers and agents
making contracts on behalf of the state of West Virginia or any
political subdivision thereof shall withhold payment in the final
settlement of contracts until the receipt of a certificate from the
commissioner to the effect that all payments, interest and penalties
thereon accrued against the contractor under this chapter have been
paid or that provisions satisfactory to the commissioner have been made
for payment. Any official violating this subsection is guilty of a
misdemeanor and, on conviction thereof, shall be fined not more than
one thousand dollars or confined in a county or regional jail for not
more than one year, or both fined and confined.
(b) Any agency of the state, for the limited purpose of
intercepting, pursuant to section sixteen, article five of this chapter
and pursuant to section five-a, article two, chapter twenty-three of
this code, any payment by or through the state to an employer who is
in default in payment of contributions, premiums, deposits, interest
or penalties under the provisions of this chapter or of chapter twenty-
three of this code, shall assist the commissioner in collecting the
payment that is due. For this purpose, disclosure of joint delinquency
and default lists of employers with respect to unemployment compensation and workers' compensation as provided in section one-c,
article one, chapter twenty-three of this code contributions, premiums,
interest, deposits or penalties is authorized. The bureau and the
workers' compensation commission may enter into an interagency
agreement to effect the provisions of this section. The lists may be
in the form of a computerized database to be accessed by the auditor,
the department of tax and revenue, the department of administration,
the division of highways or any other appropriate state agency or
officer.
§21A-2-13. Deputies.
For the original determination of claims under this chapter, the
commissioner shall appoint a necessary number of deputies as his or her
representatives.
ARTICLE 10. GENERAL PROVISIONS.
§21A-10-11. Reporting requirements and required information; use of
information; libel and slander actions prohibited.
(a) Each employer, including labor organizations as defined in
subsection (i) of this section, shall, quarterly, submit certified
reports on or before the last day of the month next following the
calendar quarter, on forms to be prescribed by the commissioner. The
reports shall contain:
(1) The employer's assigned unemployment compensation
registration number, the employer's name and the address at which the
employer's payroll records are maintained;
(2) Each employee's social security account number, name and the
gross wages paid to each employee, which shall include the first eight
thousand dollars of remuneration and all amounts in excess of that amount, notwithstanding subdivision (1), subsection (b), section
twenty-eight, article one-a of this chapter;
(3) The total gross wages paid within the quarter for employment,
which includes money wages and the cash value of other remuneration,
and shall include the first eight thousand dollars of remuneration paid
to each employee and all amounts in excess of that amount,
notwithstanding subdivision (1), subsection (b), section twenty-eight,
article one-a of this chapter; and
(4) Other information that is reasonably connected with the
administration of this chapter.
(b) Information obtained may not be published or be open to
public inspection to reveal the identity of the employing unit or the
individual.
(c) Notwithstanding the provisions of subsection (b) of this
section, the commissioner may provide information obtained to the
following governmental entities for purposes consistent with state and
federal laws:
(1) The United States department of agriculture;
(2) The state agency responsible for enforcement of the medicaid
program under Title XIX of the Social Security Act;
(3) The United States department of health and human services or
any state or federal program operating and approved under Title I,
Title II, Title X, Title XIV or Title XVI of the Social Security Act;
(4) Those agencies of state government responsible for economic
and community development; secondary, post-secondary and vocational
education; vocational rehabilitation, employment and training,
including, but not limited to, the administration of the Perkins Act and the Job Training and Partnership Act;
(5) The tax division, but only for the purposes of collection and
enforcement;
(6) The division of labor for purposes of enforcing the wage bond
and the contractor licensing provisions of chapter twenty-one of this
code;
(7) Any agency of this or any other state, or any federal agency,
charged with the administration of an unemployment compensation law or
the maintenance of a system of public employment offices;
(8) Any claimant for benefits or any other interested party to
the extent necessary for the proper presentation or defense of a claim;
and
(9) The workers' compensation commission for purposes of
collection and enforcement: Provided, That the workers' compensation
commission shall provide similar information to the bureau of
employment programs.
(d) The agencies or organizations which receive information under
subsection (c) of this section shall agree that the information shall
remain confidential as not to reveal the identity of the employing unit
or the individual consistent with the provisions of this chapter.
(e) The commissioner may, before furnishing any information
permitted under this section, require that those who request the
information shall reimburse the bureau of employment programs for any
cost associated for furnishing the information.
(f) The commissioner may refuse to provide any information
requested under this section if the agency or organization making the
request does not certify that it will comply with the state and federal law protecting the confidentiality of the information.
(g) A person who violates the confidentiality provisions of this
section is guilty of a misdemeanor and, upon conviction thereof, shall
be fined not less than twenty dollars nor more than two hundred dollars
or confined in a county or regional jail not longer than ninety days,
or both.
(h) No action for slander or libel, either criminal or civil,
shall be predicated upon information furnished by any employer or any
employee to the commissioner in connection with the administration of
any of the provisions of this chapter.
(i) For purposes of subsection (a) of this section, the term
"labor organization" means any organization of any kind, or any agency
or employee representation committee or plan, in which employees
participate and which exists for the purpose, in whole or in part, of
dealing with employers concerning grievances, labor disputes, wages,
rates of pay, hours of employment or conditions of work. It includes
any entity, also known as a hiring hall, which is used by the
organization and an employer to carry out requirements described in 29
U. S. C. §158(f)(3) of an agreement between the organization and the
employer.
CHAPTER 22. ENVIRONMENTAL RESOURCES.
ARTICLE 3. SURFACE COAL MINING AND RECLAMATION ACT.
§22-3-8. Prohibition of surface mining without a permit; permit
requirements; successor in interest; duration of permits; proof
of insurance; termination of permits; permit fees.
No person may engage in surface mining operations unless he or
she has first obtained a permit from the director in accordance with the following:
(1) All permits issued pursuant to the requirements of this
article shall be issued for a term not to exceed five years: Provided,
That if the applicant demonstrates that a specified longer term is
reasonably needed to allow the applicant to obtain necessary financing
for equipment and the opening of the operation, and if the application
is full and complete for the specified longer term, the director may
extend a permit for a longer term: Provided, however, That subject to
the prior approval of the director, with the approval being subject to
the provisions of subsection (c), section eighteen of this article, a
successor in interest to a permittee who applies for a new permit, or
transfer of a permit, within thirty days of succeeding to the interest,
and who is able to obtain the bond coverage of the original permittee,
may continue surface mining and reclamation operations according to the
approved mining and reclamation plan of the original permittee until
the successor's permit application or application for transfer is
granted or denied.
(2) Proof of insurance is required on an annual basis.
(3) A permit terminates if the permittee has not commenced the
surface mining operations covered by the permit within three years of
the date the permit was issued: Provided, That the director may grant
reasonable extensions of time upon a timely showing that the extensions
are necessary by reason of litigation precluding commencement, or
threatening substantial economic loss to the permittee, or by reason
of conditions beyond the control and without the fault or negligence
of the permittee: Provided, however, That with respect to coal to be
mined for use in a synthetic fuel facility or specific major electric generating facility, the permittee shall be considered to have
commenced surface mining operations at the time the construction of the
synthetic fuel or generating facility is initiated.
(4) Each application for a new surface mining permit filed
pursuant to this article shall be accompanied by a fee of one thousand
dollars. All permit fees and renewal fees provided for in this section
or elsewhere in this article shall be collected by the director and
deposited with the treasurer of the state of West Virginia to the
credit of the operating permit fees fund and shall be used, upon
requisition of the director, for the administration of this article.
(5) Prior to the issuance of any permit, the director shall
ascertain from the commissioner of the division of labor whether the
applicant is in compliance with section fourteen, article five, chapter
twenty-one of this code. Upon issuance of the permit, the director
shall forward a copy to the commissioner of the division of labor, who
shall assure continued compliance under the permit.
(6) (A) Prior to the issuance of any permit the director shall
ascertain from the commissioner of the bureau of employment programs
and the executive director of the workers' compensation commission
whether the applicant is in compliance with the provisions of section
six-c, article two, chapter twenty-one-a of this code and section five,
article two, chapter twenty-three of this code with regard to any
required subscription to the unemployment compensation fund or to the
workers' compensation fund, the payment of premiums and other charges
to the fund, the timely filing of payroll reports and the maintenance
of adequate deposits. If the applicant is delinquent or defaulted, or
has been terminated by the bureau or the commission, the permit shall not be issued until the applicant returns to compliance or is restored
by the bureau or the commission under a reinstatement agreement:
Provided, That in all inquiries the commissioner of the bureau of
employment programs and the executive director of the workers'
compensation commission shall make response to the division of
environmental protection within fifteen calendar days; otherwise,
failure to respond timely is considered to indicate the applicant is
in compliance and the failure will not be used to preclude issuance of
the permit.
(B) It is a requirement of this article that each operator
maintain continued compliance with the provisions of section five,
article two, chapter twenty-three and section six-c, article two,
chapter twenty-one-a of this code and provide proof of compliance to
the director on a quarterly basis.
CHAPTER 23. WORKERS' COMPENSATION.
ARTICLE 1. GENERAL ADMINISTRATIVE PROVISIONS.
§23-1-1. Workers' compensation commission created; findings.
(a) The Legislature finds that a deficit exists in the workers'
compensation fund of such critical proportions that it constitutes an
imminent threat to the immediate and long-term solvency of the fund.
The Legislature further finds that addressing the workers' compensation
crisis requires the efforts of all persons and entities involved.
Modification to the rate system, alteration of the benefit structure,
improvement of current management practices and changes in perception
must be merged into a unified effort to make the workers' compensation
system viable and solvent. It is the intent of the Legislature that
the amendments to this chapter enacted in the year two thousand three be applied from the date upon which the enactment is made effective by
the Legislature. The Legislature finds that an emergency exists as a
result of the combined effect of this deficit, other state budgetary
deficits and liabilities and other grave social and economic
circumstances currently confronting the state and that unless the
changes provided by the enactment of the amendments to this chapter,
as well as other legislation designed to address the problem are made
effective immediately, the fiscal stability of this state will suffer
irreparable harm. Accordingly, the Legislature finds that the need of
the citizens of this state for the protection of the state treasury and
the solvency of the workers' compensation funds requires the
limitations on any expectations that may have arisen from prior
enactments of this chapter.
(b) It is the further intent of the Legislature that this chapter
be interpreted so as to assure the quick and efficient delivery of
indemnity and medical benefits to injured workers at a reasonable cost
to the employers who are subject to the provisions of this chapter.
It is the specific intent of the Legislature that workers' compensation
cases shall be decided on their merits and that a rule of "liberal
construction" based on any "remedial" basis of workers' compensation
legislation shall not affect the weighing of evidence in resolving such
cases. The workers' compensation system in this state is based on a
mutual renunciation of common law rights and defenses by employers and
employees alike. Employees' rights to sue for damages over and above
medical and health care benefits and wage loss benefits are to a
certain degree limited by the provisions of this chapter and employers'
rights to raise common law defenses such as lack of negligence, contributory negligence on the part of the employee, and others, are
curtailed as well. Accordingly, the Legislature hereby declares that
any remedial component of the workers' compensation laws is not to
cause the workers' compensation laws to receive liberal construction
that alters in any way the proper weighing of evidence as required by
section one-g, article four of this chapter.
(c) The "workers' compensation division of the bureau of
employment programs" is, on or after the first day of October, two
thousand three, reestablished, reconstituted and continued as the
workers' compensation commission, an agency of the state. The purpose
of the commission is to ensure the fair, efficient and financially
stable administration of the workers' compensation system of the state
of West Virginia. The powers and duties heretofore imposed upon the
workers' compensation division and the commissioner of the bureau of
employment programs as they relate to workers' compensation are hereby
transferred to and imposed upon the workers' compensation commission
and its executive director in the manner prescribed by this chapter.
§23-1-1a. Workers' compensation board of managers; appointment;
composition; qualifications; terms; chairperson; meetings and
quorum; compensation and travel expenses; powers and duties.
(a) On the first day of October, two thousand three, the
compensation programs performance council heretofore established in
article three, chapter twenty-one-a of this code is hereby abolished
and there is hereby created the "workers' compensation board of
managers", which may also be referred to as "the board of managers" or
"the board".
(b)(1) The board shall consist of eleven voting members as follows:
(A) The governor or his or her designee;
(B) The chief executive officer of the West Virginia investment
management board; if required to attend more than one meeting per
month, he or she may send a designee to the additional meetings;
(C) The executive director of the West Virginia development
office; if required to attend more than one meeting per month, he or
she may send a designee to the additional meetings; and
(D) Eight members appointed by the governor with the advice and
consent of the Senate who meet the requirements and qualifications
prescribed in subsections (c) and (d) of this section: Provided, That
the members serving on the compensation programs performance council
heretofore established in article three, chapter twenty-one-a of this
code on the effective date of the enactment of this section in two
thousand three are hereby appointed as members of the board of managers
subject to the provisions of subdivision (1), subsection (c) of this
section.
(2) Two members of the West Virginia Senate and two members of
the West Virginia House of Delegates shall serve as advisory members
of the board and are not voting members. The governor shall appoint
the legislative members to the board. No more than three of the
legislative members may be of the same political party.
(c)(1) The initial eight appointed voting members of the board of
managers shall consist of the members appointed under the provisions
of paragraph (D), subdivision (1), subsection (a) of this section and
the remaining members appointed pursuant to the provisions of
subsection (d) of this section. The term of each of the initial appointed members shall expire on the thirty-first day of December, two
thousand four.
(2) Eight members shall be appointed by the governor with the
advice and consent of the Senate for terms that begin the first day of
January, two thousand five, and expire as follows:
Two members shall be appointed for a term ending the thirtieth
day of June, two thousand six;
Three members shall be appointed for a term ending the thirtieth
day of June, two thousand seven; and
Three members shall be appointed for a term ending the thirtieth
day of June, two thousand eight.
(3) Except for appointments to fill vacancies, each subsequent
appointment shall be for a term ending the thirtieth day of June of the
fourth year following the year the preceding term expired. In the
event a vacancy occurs, it shall be filled by appointment for the
unexpired term. A member whose term has expired shall continue in
office until a successor has been duly appointed and qualified. No
member of the board may be removed from office by the governor except
for official misconduct, incompetency, neglect of duty or gross
immorality.
(4) No appointed member may be a candidate for or hold elected
office. Members may be reappointed for no more than two full terms.
(d) Except for those initially appointed under the provisions of
paragraph (D), subdivision (1), subsection (a) of this section, each
of the appointed voting members of the board shall be appointed based
upon his or her demonstrated knowledge and experience to effectively
accomplish the purposes of this chapter. They shall meet the minimum qualifications as follows:
(1) Each shall hold a baccalaureate degree from an accredited
college or university: Provided, That no more than three of the
appointed voting members may serve without a baccalaureate degree from
an accredited college or university if the member has a minimum of
fifteen years' experience in his or her field of expertise as required
in subdivision (2) of this subsection;
(2) Each shall have a minimum of ten years' experience in his or
her field of expertise. The governor shall consider the following
guidelines when determining whether potential candidates meet the
qualifications of this subsection: Expertise in insurance claims
management; expertise in insurance underwriting; expertise in the
financial management of pensions or insurance plans; expertise as a
trustee of pension or trust funds of more than two hundred
beneficiaries or three hundred million dollars; expertise in workers'
compensation management; expertise in loss prevention and
rehabilitation; expertise in occupational medicine demonstrated by
licensure as a medical doctor in West Virginia and experience, board
certification or university affiliation; or expertise in similar areas
of endeavor.
(3) At least one shall be a certified public accountant with
financial management or pension or insurance audit expertise; at least
one shall be an attorney with financial management experience; and one
shall be an academician holding an advanced degree from an accredited
college or university in business, finance, insurance or economics.
(e) Each member of the board shall have a fiduciary
responsibility to the commission and all workers' compensation funds and shall assure the proper administration of the funds in a fiscally
responsible manner.
(f) The board shall elect one member to serve as chairperson.
The chairperson shall serve for a one-year term and may serve more than
one consecutive term. The board shall hold meetings at the request of
the chairperson or at the request of at least three of the members of
the board, but no less frequently than once every three months. The
chairperson shall determine the date and time of each meeting. Six
members of the board constitute a quorum for the conduct of the
business of the board. No vacancy in the membership of the board shall
impair the right of a quorum to exercise all the rights and perform all
the duties of the board. No action shall be taken by the board except
upon the affirmative vote of six members of the board.
(g) Notwithstanding any provision of article seven, chapter six
of this code to the contrary, the board shall establish the salary of
the executive director. The board shall establish a set of performance
measurements to evaluate the performance of the executive director in
fulfilling his or her duties as prescribed in this chapter and shall
annually rate the executive director's performance according to the
established measurements and may adjust his or her annual salary in
accordance with that performance rating.
(h)(1) Each voting appointed member of the board shall receive
compensation of not more than three hundred fifty dollars per day for
each day during which he or she is required to and does attend a
meeting of the board.
(2) Each voting appointed member of the board is entitled to be
reimbursed for actual and necessary expenses incurred for each day or portion thereof engaged in the discharge of official duties in a manner
consistent with guidelines of the travel management office of the
department of administration.
(i) Each member of the board shall be provided appropriate
liability insurance, including, but not limited to, errors and
omissions coverage, without additional premium, by the state board of
risk and insurance management established pursuant to article twelve,
chapter twenty-nine of this code.
(j) The board of managers shall:
(1) Review and approve, reject or modify recommendations from the
executive director for the development of overall policy for the
administration of this chapter;
(2) In consultation with the executive director, propose
legislation and establish operating guidelines and policies designed
to ensure the effective administration and financial viability of the
workers' compensation system of West Virginia;
(3) Review and approve, reject or modify rules that are proposed
by the executive director for operation of the workers' compensation
system before the rules are filed with the secretary of state. The
rules adopted by the board are not subject to sections nine through
sixteen, inclusive, article three, chapter twenty-nine-a of this code.
The board shall follow the remaining provisions of said chapter for
giving notice to the public of its actions and for holding hearings and
receiving public comments on the rules;
(4) In accordance with the laws, rules and regulations of West
Virginia and the United States government, establish and monitor
performance standards and measurements to ensure the timeliness and accuracy of activities performed under the workers' compensation laws
and rules;
(5) Review and approve, reject or modify all classifications of
occupations or industries, premium rates and taxes, administrative
charges, rules and systems of rating, rating plans, rate revisions,
deficit management and deficit reduction assessments and merit rating
for employers covered by this chapter. The executive director shall
provide all information required for the board's review;
(6) In conjunction with the executive director initiate, oversee
and review all independent financial and actuarial reviews of the
commission. The board shall employ an internal auditor for the purpose
of examining internal compliance with the provisions of this chapter.
The internal auditor shall be employed directly by the board. The
internal auditor shall submit copies of all reports prepared by the
internal auditor for the board to the joint committee on government and
finance within five days of submitting or making the report to the
board, by filing the report with the legislative librarian;
(7) Approve the allocation of sufficient administrative resources
and funding to efficiently operate the workers' compensation system of
West Virginia. To assure efficient operation, the board shall direct
the development of a plan for the collections performed under section
five-a, article two of this chapter. The plan for collections shall
maximize ratio of dollars potentially realized by the collection
proceeding to the dollars invested in collection activity;
(8) Review and approve, reject or modify the budget prepared by
the executive director for the operation of the commission. The budget
shall include estimates of the costs and necessary expenditures of the commission in the discharge of all duties imposed by this chapter as
well as the cost of providing offices, furniture, equipment and
supplies to all commission officers and employees;
(9) In consultation with the executive director, approve the
designation of health care providers to make decisions for the
commission regarding appropriateness of medical services;
(10) Require the workers' compensation commission to develop,
maintain and use an effective program of return-to-work services for
employers and workers;
(11) Require the workers' compensation commission to develop,
maintain and use thorough and efficient claims management procedures
and processes and fund management in accordance with the generally
accepted practices of the workers' compensation insurance industry;
(12) Consider such other matters regarding the workers'
compensation system as the governor, executive director or any member
of the board may desire;
(13) Review and approve, reject or modify standards recommended
by the executive director to be considered by the commission in making
decisions on all levels of disability awards. The standards should be
established as an effective means to make prompt, appropriate decisions
relating to medical care and methods to assist employees to return to
work as quickly as possible;
(14) Appoint, if necessary, a temporary executive director;
(15) Employ sufficient professional and clerical staff to carry
out the duties of the board. Employees of the board shall serve at the
will and pleasure of the board. The board's employees are exempt from
the salary schedule or pay plan adopted by the division of personnel; and
(16) Study the feasibility of, provide a plan for and provide a
proposal for a request for proposals from the private sector for,
privatizing the workers' compensation system of this state, including,
but not limited to, a plan for privatizing the administration of the
workers' compensation system of this state and a plan for allowing
employers to obtain private insurance to insure their obligations under
the workers' compensation system of this state; study the effect, if
any, of attorneys fees on the cost of administering the workers'
compensation system; study the extent to which fraud or abuse on the
part of employees, providers and others have an effect on the cost of
administering the workers' compensation system; study the extent, if
any, that the rates and amounts of disability awards exceed the rates
and amounts of such awards in other states; study the comparative
desirability of alternative permanent disability administration in
those other states, and alternative deficit management strategies,
including nontraditional funding;
study the feasibility of authorizing
a plan of multiple rate classifications by individual employers for
employers who have different or seasonally diverse job classifications
and duties: Provided, That no such plan may be implemented until
adopted by the Legislature; and, in consultation with the director of
the division of personnel, study the feasibility of establishing a work
incentive program to place unemployed qualified recipients of workers'
compensation benefits in state or local government employment
. On or
before the first day of January, two thousand six, the commission shall
report the findings and conclusions of each study, the plans and
proposals, and any recommendations the commission may have as a result of the study to the joint committee on government and finance.
§23-1-1b. Executive director; qualifications; oath; seal; removal;
powers and duties.
(a) The executive director shall be hired by the board of
managers for a term not to exceed five years and may be retained based
on overall performance for additional terms: Provided, That the
executive director of the division of workers' compensation on the date
of the enactment of this section in the year two thousand three shall
serve as the initial executive director of the commission and shall
receive the same salary and benefits as received as the executive
director of the division of workers' compensation through and until the
board of managers establishes his or her salary and benefits as the
executive director of the commission. The position of executive
director shall be full-time employment. Except for the initial
executive director, candidates for the position of executive director
shall have a minimum of a bachelor of arts or science degree from an
accredited four-year college or university in one or more of the
following disciplines: Finance; economics; insurance administration;
law; public administration; accounting; or business administration.
Candidates for the position of executive director will be considered
based on their demonstrated education, knowledge and a minimum of ten
years' experience in the areas of workers' compensation, insurance
company management, administrative and management experience with an
organization comparable in size to the workers' compensation commission
or any relevant experience which demonstrates an ability to effectively
accomplish the purposes of this chapter.
(b) The executive director shall not be a candidate for or hold any other public office or trust, nor shall he or she be a member of
a political committee. If he or she becomes a candidate for a public
office or becomes a member of a political committee, his or her office
as executive director shall be immediately vacated.
(c) The executive director, before entering upon the duties of
his or her office, shall take and subscribe to the oath prescribed by
section five, article IV of the state constitution. The oath shall be
filed with the secretary of state.
(d) The executive director shall have an official seal for the
authentication of orders and proceedings, upon which seal shall be
engraved the words "West Virginia Workers' Compensation Commission" and
any other design prescribed by the board of managers. The courts in
this state shall take judicial notice of the seal of the commission and
in all cases copies of orders, proceedings or records in the office of
the West Virginia workers' compensation commission are equal to the
original in evidence.
(e) The executive director shall not be a member of the board of
managers.
(f) The executive director shall serve until the expiration of
his or her term, resignation or until removed by a two thirds vote of
the full board of managers. The board of managers and the executive
director may, by agreement, terminate the term of employment at any
time.
(g) The executive director shall have overall management
responsibility and administrative control and supervision within the
workers' compensation commission and has the power and duty to:
(1) Establish, with the approval of the board of managers, the overall administrative policy of the commission for the purposes of
this chapter;
(2) Employ, direct and supervise all employees required in the
connection with the performance of the duties assigned to the
commission by this chapter and fix the compensation of the employees
in accordance with the provisions of article six, chapter twenty-nine
of this code: Provided, That the executive director shall identify
which members of the staff of the workers' compensation commission
shall be exempted from the salary schedules or pay plan adopted by the
state personnel board and further identify such staff members by job
classification or designation, together with the salary or salary
ranges for each such job classification or designation and shall file
this information with the director of the division of personnel no
later than the thirty-first day of December, two thousand three, and
thereafter as changes are made or at least annually;
(3) Reorganize the work of the commission, its divisions,
sections and offices to the extent necessary to achieve the most
efficient performance of its functions. All persons employed by the
workers' compensation division in positions that were formerly
supervised and directed by the commissioner of the bureau of employment
programs under chapter twenty-one-a of this code are hereby assigned
and transferred in their respective classifications to the workers'
compensation commission effective the first day of October, two
thousand three. Further, the executive director may select persons
that are employed by the bureau of employment programs on the effective
date of the enactment of this section in the year two thousand three
to be assigned and transferred to the workers' compensation commission in their respective classifications, such assignment and transfer to
take effect no later than the thirty-first day of December, two
thousand three. Employees in the classified service who have gained
permanent status as of the effective date of this article will not be
subject to further qualifying examination in their respective
classifications by reason of any transfer required by the provisions
of this subdivision. Due to the emergency currently existing at the
commission and the urgent need to develop fast, efficient claims
processing, management and administration, the executive director is
hereby granted authority to reorganize internal functions and
operations and to delegate, assign, transfer, combine, establish,
eliminate and consolidate responsibilities and duties to and among the
positions transferred under the authority of this subdivision. The
division of personnel shall cooperate fully by assisting in all
personnel activities necessary to expedite all changes for the
commission. Nothing contained in this subdivision shall be construed
to either abridge the rights of employees within the classified service
of the state to the procedures and protections set forth in article
six, chapter twenty-nine of this code or to preclude the
reclassification or reallocation of positions in accordance with
procedures set forth in article six, chapter twenty-nine of this code;
(4) Exempt no more than twenty-five of any of the newly created
positions from the classified service of the state, the employees of
which positions shall serve at the will and pleasure of the executive
director. The executive director shall report all exemptions made
under this subdivision to the director of the division of personnel no
later than the first day of January, two thousand four, and thereafter as the executive director determines to be necessary;
(5) With the advice and approval of the board of managers,
propose operating guidelines and policies to standardize
administration, expedite commission business and promote the efficiency
of the services provided by the commission;
(6) Prepare and submit to the board of managers information the
board requires for classifications of occupations or industries; the
basis for premium rates, taxes, surcharges and assessment for
administrative charges, for assessments related to loss experience, for
assessments of prospective risk exposure, for assessments of deficit
management and deficit reduction costs incurred, for other deficit
management and deficit reduction assessments, for rules and systems of
rating, rate revisions and merit rating for employers covered by this
chapter; and information regarding the extent, degree and amount of
subsidization between the classifications. The executive director
shall obtain, prepare and submit any other information the board of
managers requires for the prompt and efficient discharge of its duties;
(7) Keep accurate and complete accounts and records necessary to
the collection, administration and distribution of the workers'
compensation funds;
(8) Sign and execute in the name of the state, by "The Workers'
Compensation Commission", any contract or agreement;
(9) Make recommendations and an annual report to the governor
concerning the condition, operation and functioning of the commission;
(10) Invoke any legal or special remedy for the enforcement of
orders or the provisions of this chapter;
(11) Prepare and submit for approval to the board of managers a budget for each fiscal year, including estimates of the costs and
necessary expenditures of the commission in the discharge of all duties
imposed by this chapter as well as the costs of furnishing office space
to the officers and employees of the commission;
(12) Ensure that all employees of the commission follow the
orders, operating guidelines and policies of the commission as they
relate to the commission's overall policy-making, management and
adjudicatory duties under this chapter;
(13) Delegate all powers and duties vested in the executive
director to his or her appointees and employees; but the executive
director is responsible for their acts;
(14) Provide at commission expense a program of continuing
professional, technical and specialized instruction for the personnel
of the commission. The executive director shall consult with and
report at least annually to the legislative oversight commission on
workforce investment for economic development to obtain the most
appropriate training using all available resources;
(15) (A) Contract or employ counsel to perform all legal services
for the commission including, but not limited to, representing the
executive director, board of managers and commission in any
administrative proceeding and in any state or federal court.
Additionally, the commission may, but shall not be required to, call
upon the attorney general for legal assistance and representation as
provided by law. The attorney general shall not approve or exercise
authority over in-house counsel or contract counsel hired pursuant to
this section;
(B) In addition to the authority granted by this section to the executive director and notwithstanding any provision to the contrary
elsewhere in this code, use any attorney regularly employed by the
commission or the office of the attorney general to represent the
commission, the executive director or the board of managers in any
matter arising from the performance of its duties or the execution of
its powers under this chapter. In addition, the executive director,
with the approval of the board of managers, may retain counsel for any
purpose in the administration of this chapter relating to the
collection of any amounts due from employers to the commission:
Provided, That the allocation of resources for the purpose of any
collections shall be pursuant to the plan developed by the board of
managers. The board of managers shall solicit proposals from counsel
who are interested in representing the commission under the terms of
this subdivision. Thereafter, the board of managers shall select any
attorneys it determines necessary to pursue the collection objectives
of this subdivision:
(i) Payment to retained counsel may either be hourly or by other
fixed fee, or as determined by the court or administrative law judge
as provided for in this section. A contingency fee payable from the
amount recovered by judgment or settlement for the commission is only
permitted, to the extent not prohibited by federal law, when the assets
of a defendant or respondent are depleted so that a full recovery plus
attorneys' fees is not possible;
(ii) In the event that any collections action, other than a
collections action against a claimant, initiated either by retained
counsel or other counsel on behalf of the commission results in a
judgment or settlement in favor of the commission, the court or, if there was no judicial component to the action, the administrative law
judge, shall determine the amount of attorneys' fees that shall be paid
by the defendants or respondents to the retained or other counsel
representing the commission. If the court is to determine the amount
of attorneys' fees, it shall include in its determination the amount
of fee that should be paid for the representation of the commission in
pursuing the administrative component, if any, of the action. The
amount so paid shall be fixed by the court or the administrative law
judge in an amount no less than twenty percent of its recovery. Any
additional amount of attorneys' fees shall be determined by use of the
following factors:
(I) The counsel's normal hourly rate or, if the counsel is an
employee of the commission or is an employee of the office of the
attorney general, an hourly rate the court or the administrative law
judge determines to be customary based upon the attorney's experience
and skill level;
(II) The number of hours actually expended on the action;
(III) The complexity of the issues involved in the action;
(IV) The degree of risk involved in the case with regard to the
probability of success or failure;
(V) The overhead costs incurred by counsel with regard to the use
of paralegals and other office staff, experts and investigators; and
(VI) The public purpose served or public objective achieved by
the attorney in obtaining the judgment or settlement on behalf of the
commission;
(iii) Notwithstanding the provisions of paragraph (B) of this
subdivision, if the commission and the defendants or respondents to any administrative or judicial action settle the action, the parties may
negotiate a separate settlement of attorneys' fees to be paid by the
defendants or respondents above and beyond the amount recovered by the
commission. In the event that a settlement of attorneys' fees is made,
it must be submitted to the court or administrative law judge for
approval;
(iv) Any attorney regularly employed by the commission or by the
office of the attorney general may not receive any remuneration for his
or her services other than the attorney's regular salary. Any
attorneys' fees awarded for an employed attorney are payable to the
commission;
(16) Propose rules for promulgation by the board of managers
under which agencies of this state shall revoke or refuse to grant,
issue or renew any contract, license, permit, certificate or other
authority to conduct a trade, profession or business to or with any
employing unit whose account is in default with the commission with
regard to the administration of this chapter. The term "agency"
includes any unit of state government such as officers, agencies,
divisions, departments, boards, commissions, authorities or public
corporations. An employing unit is not in default if it has entered
into a repayment agreement with the commission and remains in
compliance with its obligations under the repayment agreements;
(A) The rules shall provide that, before granting, issuing or
renewing any contract, license, permit, certificate or other authority
to conduct a trade, profession or business to or with any employing
unit, the designated agencies shall review a list or lists provided by
the commission of employers that are in default. If the employing unit's name is not on the list, the agency, unless it has actual
knowledge that the employing unit is in default with the commission,
may grant, issue or renew the contract, license, permit, certificate
or other authority to conduct a trade, profession or business. The
list may be provided to the agency in the form of a computerized
database or databases that the agency can access. Any objections to
the refusal to issue or renew shall be reviewed under the appropriate
provisions of this chapter. The prohibition against granting, issuing
or renewing any contract, license, permit, certificate or other
authority under this subdivision shall remain in full force and effect
as promulgated under section six, article two, chapter twenty-one-a of
this code until the rules required by this subsection are promulgated
and in effect;
(B) The rules shall also provide a procedure allowing any agency
or interested person, after being covered under the rules for at least
one year, to petition the commission to be exempt from the provisions
of the rules;
(17) Deposit to the credit of the appropriate special revenue
account or fund, notwithstanding any other provision of this code and
to the extent allowed by federal law, all amounts of delinquent
payments or overpayments, interest and penalties thereon and attorneys'
fees and costs collected under the provisions of this chapter. The
amounts collected shall not be treated by the auditor or treasurer as
part of the general revenue of the state;
(18) Recommend for approval of the board of managers rules for
the administration of claims management by self-insured employers and
third-party administrators including regulation and sanctions for the rejection of claims and for maintaining claim records and ensuring
access to all claim records by interested claimants, claimant
representatives, the commission and the office of judges;
(19) Recommend for approval of the board of managers, rules to
eliminate the ability of an employer to avoid an experience
modification factor by virtue of a reorganization of a business;
(20) Submit for approval of the board of managers rules setting
forth procedures for auditing and investigating employers, including
employer premium audits and including auditing and investigating
programs of self-insured employers and third-party administrators,
employees, health care providers and medical and vocational
rehabilitation service providers;
(21) Regularly audit and monitor programs established by self-
insured or third-party administrators under this chapter to ensure
compliance with the commission's rules and the law;
(22) Establish and maintain a fraud and abuse investigation and
prosecution unit. This unit has the responsibility and authority for
investigating and controlling fraud and abuse of the workers'
compensation system of the state of West Virginia. The fraud and abuse
unit shall be under the supervision of an inspector general, who shall
be appointed by the executive director of the workers' compensation
commission;
(A) The inspector general shall, with the consent and advice of
the executive director, employ all personnel as necessary for the
institution, development and finalization of procedures and
investigations which serve to ensure that only necessary and proper
workers' compensation benefits and expenses are paid to or on behalf of injured employees and to insure employers subscribe to and pay the
proper premium to the West Virginia workers' compensation commission.
Qualification, compensation and personnel practice relating to the
employees of the fraud and abuse unit, including that of the position
of inspector general, shall be governed by the provisions of the
statutes, rules and regulations of the classified service pursuant to
article six, chapter twenty-nine of this code. The inspector general
shall supervise all personnel, which collectively shall be referred to
in this chapter as the fraud and abuse unit;
(B) The fraud and abuse unit shall have the following powers and
duties:
(i) The fraud and abuse unit shall propose for promulgation by
the board of managers rules for determining the existence of fraud and
abuse as it relates to the workers' compensation system in West
Virginia;
(ii) The fraud and abuse unit will be responsible for the
initiation, development, review, and proposal for promulgation by the
board of managers of rules regarding the existence of fraud and abuse
as it relates to the workers' compensation system in West Virginia;
(iii) The fraud and abuse unit will take action to identify and
prevent and discourage any and all fraud and abuse;
(iv) The fraud and abuse unit, in cases of criminal fraud, has
the authority to review and prosecute those cases for violations of
sections twenty-four-e, twenty-four-f, twenty-four-g and twenty-four-h,
article three, chapter sixty-one of this code, as well as any other
criminal statutes that may be applicable. In addition the fraud and
abuse unit not only has the authority to prosecute and refer cases involving criminal fraud to appropriate state authorities for
prosecution, but it also has the authority, and is encouraged, to
cooperate with the appropriate federal authorities for review and
possible prosecution, by either state or federal agencies, of cases
involving criminal fraud concerning the workers' compensation system
in West Virginia;
(v) The fraud and abuse unit, in cases which do not meet the
definition of criminal fraud, but would meet a reasonable person's
definition of an abuse of the workers' compensation system, shall take
the appropriate action to discourage and prevent such abuse.
Furthermore, the fraud and abuse unit shall assist the commission to
develop evidence of fraud or abuse which can be used pursuant to the
provisions of this chapter to suspend, and where appropriate,
terminate, a claimant's benefits. In addition, evidence developed
pursuant to these provisions can be used in hearings before the office
of judges on protests to commission decisions terminating, or not
terminating, temporary total disability benefits; and
(vi) The fraud and abuse unit, is expressly authorized to
initiate investigations and participate in the development of, and if
necessary, the prosecution of any health care provider, including a
provider of rehabilitation services, alleged to have violated the
provisions of section three-c, article four of this chapter;
(C) Specific personnel, designated by the inspector general,
shall be permitted to operate vehicles owned or leased for the state
displaying Class A registration plates;
(D) Notwithstanding any provision of this code to the contrary,
specific personnel designated by the inspector general may carry handguns in the course of their official duties after meeting
specialized qualifications established by the governor's committee on
crime, delinquency and correction, which qualifications shall include
the successful completion of handgun training provided to law-
enforcement officers by the West Virginia state police: Provided, That
nothing in this subsection shall be construed to include the personnel
so designated by the inspector general to carry handguns within the
meaning of the term law-enforcement official as defined in section one,
article twenty-nine, chapter thirty of this code;
(E) The fraud and abuse unit is not subject to any requirement of
article nine-a, chapter six of this code and the investigations
conducted by the fraud and abuse unit and the materials placed in the
files of the unit as a result of any such investigation are exempt from
public disclosure under the provisions of chapter twenty-nine-b of this
code;
(F) In the event that a final judicial decision adjudges that the
statewide prosecutorial powers vested by this subdivision in the fraud
and abuse unit may only be exercised by a public official other than
an employee of the fraud and abuse unit, then to that extent the
provisions of this subdivision vesting statewide prosecutorial power
shall thenceforth be of no force and effect, the remaining provisions
of this subdivision shall continue in full force and effect and
prosecutions hereunder may only be exercised by the prosecuting
attorneys of this state and their assistants or special assistant
prosecuting attorneys appointed as provided by law;
(23) Enter into interagency agreements to assist in exchanging
information and fulfilling the default provisions of this chapter;
(24) Notwithstanding any provision of this code to the contrary,
the executive director, under emergency authorization:
(A) May expend up to fifty thousand dollars for purchases of and
may contract for goods and services without securing competitive bids.
This emergency spending authority expires on the first day of July, two
thousand five; and
(B) May expend such sums as the executive director determines are
necessary for professional services, contracts for the purchase of an
automated claims administration system and associated computer hardware
and software in the administration of claims for benefits made under
provisions of this chapter and contracts for technical services and
related services necessary to develop, implement and maintain the
system and associated computer hardware and software. The provisions
of article three, chapter five-a of this code relating to the
purchasing division of the department administration shall not apply
to these contracts. The director shall award the contract or contracts
on a competitive basis. This emergency spending authority expires on
the thirty-first day of December, two thousand six;
(25) Establish an employer violator system to identify
individuals and employers who are in default or are delinquent on any
premium, assessment, surcharge, tax or penalty owed to the commission.
The employer violator system shall prohibit violators who own, control
or have a ten percent or more ownership interest, or other ownership
interest as may be defined by the commission, in any company from
obtaining or maintaining any license, certificate or permit issued by
the state until the violator has paid all moneys owed to the commission
or has entered into and remains in compliance with a repayment agreement;
(26) Propose the designation of health care providers to make
decisions for the commission regarding appropriateness of medical
services; and
(27) Study the correlation between premium tax merit rating for
employers and the safety performance of employers. This study shall
be completed prior to the first day of July, two thousand four, and the
results thereof provided to the board of managers.
§23-1-1c. Payment withholding; interception; penalty.
(a) All state, county, district and municipal officers and agents
making contracts on behalf of the state of West Virginia or any
political subdivision thereof shall withhold payment in the final
settlement of contracts until the receipt of a certificate from the
commission to the effect that all payments, interest and penalties
thereon accrued against the contractor under this chapter have been
paid or that provisions satisfactory to the commission have been made
for payment. Any official violating this subsection is guilty of a
misdemeanor and, on conviction thereof, shall be fined not more than
one thousand dollars or confined in the county or regional jail for not
more than one year, or both fined and confined.
(b) Any agency of the state, for the limited purpose of
intercepting, pursuant to section five-a, article two of this chapter,
any payment by or through the state to an employer who is in default
in payment of contributions, premiums, deposits, interest or penalties
under the provisions of this chapter, shall assist the commission in
collecting the payment that is due. For this purpose, disclosure of
joint delinquency and default lists of employers with respect to unemployment compensation as provided in section six-c, article one,
chapter twenty-one-a of this code and workers' compensation
contributions, premiums, interest, deposits or penalties is authorized.
The commission and the bureau of employment programs may enter into an
interagency agreement to effect the provisions of this section. The
lists may be in the form of a computerized database to be accessed by
the auditor, the department of tax and revenue, the department of
administration, the division of highways or other appropriate state
agency or officer.
§23-1-1d. Rules of former division of workers' compensation.
Except as otherwise provided for in this chapter, all rules
applicable to the former workers' compensation division of the bureau
of employment programs are hereby adopted and made effective as to the
operation of the workers' compensation commission under this chapter
to the extent that they are not in conflict with the current law. The
board of managers shall review and approve, modify or replace all
existing rules no later than the first day of July, two thousand six.
§23-1-1e. Transfer of assets and contracts.
With the establishment of the workers' compensation commission,
all assets and contracts, along with rights and obligations thereunder,
obtained or signed on behalf of the workers' compensation division of
the bureau of employment programs in furtherance of the purposes of
this chapter, are hereby transferred and assigned to the workers'
compensation commission.
§23-1-1f. Continuation.
The workers' compensation division shall continue to exist
pursuant to article ten, chapter four of this code through the thirtieth day of September, two thousand three, at which time all
powers and duties are transferred to the workers' compensation
commission. The workers' compensation commission shall continue to
exist, pursuant to said article until the first day of July, two
thousand six, unless sooner terminated, continued or reestablished
pursuant to the provisions of that article.
§23-1-2
. Oversight of the workers' compensation commission.
(a) In addition to any other oversight of the commission
exercised by the Legislature, the commission shall report at least
quarterly to the joint committee on government and finance and the
joint commission on economic development. The commission shall collect
data and report on claims and injuries and on the costs and outcomes
of injuries by standard codes for medical treatment, vocation
rehabilitation services, return-to-work services, other benefits
payable to or on behalf of employees, efforts to eliminate fraud and
abuse and the impact of judicial and quasijudicial rulings on the
administration of the workers' compensation system and the solvency of
the fund. The workers' compensation commission shall provide to the
joint committee on government and finance and the joint commission on
economic development an action plan for improving the workers'
compensation system. This plan shall include detail on any
administrative changes undertaken by the commission, a report on the
anticipated outcome of the changes, a cost-benefit analysis of the
changes and time frames for commencement and completion of these
changes. Subsequent reports to the joint committee on government and
finance and the joint commission on economic development shall report
on the progress of these changes. The administrative changes shall include, but are not limited to, claims processing, reorganization,
staff development and training, return-to-work programs, workplace
alternatives for injured workers, safety programs and medical and
vocational services.
(b) The commission shall also report on the current status of the
workers' compensation fund and the coal-workers' pneumoconiosis fund.
This analysis shall include the current balances in the fund and
revenue generated and expended in relationship to the liabilities and
assets of the funds and estimates of any debt reduction relative to the
fund over the next reporting period.
(c) The commission shall further report on the impact on the
workers' compensation system of the amendments to subdivision (2),
subsection (n), section six, article four of this chapter enacted
during the year two thousand three, including, but not limited to, an
analysis of any litigation resulting from the amendments
and the
availability of health care to injured workers resulting from the
amendments.
(d) The commission shall further report on methodologies used to
establish all types of assessments and rates.
(e) The commission shall further report on legislative action
that may be required to further improve the operation of the
commission.
(f) The commission shall further report on efforts to eliminate
fraud and abuse including a statistical breakdown of investigations
being conducted and their outcomes. The commission shall report to the
joint committee on government and finance on a monthly basis until the
first day of July, two thousand four on fraud and abuse and quarterly thereafter.
§23-1-3. Payment of salaries and expenses generally; manner;
limitation.
(a) All expenses peculiar to the administration of this chapter
and, when on official business, the travel and incidental expenses of
the executive director and salaries or other compensation, traveling
and other expenses of all officers or employees of the commission and
all expenses for furniture, books, maps, stationery, appliances,
property of all kinds and dues for membership in all organizations
pertaining to workers' compensation, safety maintenance or professional
designation in which the executive director considers it advisable to
maintain membership shall be paid out of the workers' compensation
fund.
(b) All payments of salaries and expenses in the administration
of this chapter shall be made by the state treasurer upon requisition
signed by the executive director, directed to the auditor of the state,
who shall draw his or her warrant therefor, and the payment shall be
charged to the workers' compensation fund: Provided, That the total
charges against the fund under this section for any one fiscal year
shall not exceed the amount appropriated for the administration of this
chapter.
§23-1-4. Office hours; records; confidentiality; exceptions.
(a) The offices of the workers' compensation commission shall be
open for the transaction of business between the hours of eight-thirty
o'clock a.m. and five o'clock p.m. of each and every day, excepting
Saturdays, Sundays and legal holidays, and be open upon any additional
days and at any additional times elected by the commission. The executive director is the chief executive officer of the workers'
compensation commission.
(b) Except as expressly provided for in this subsection,
information obtained regarding employers and claimants pursuant to this
chapter for the purposes of its administration is not subject to the
provisions of chapter twenty-nine-b of this code unless the provisions
are hereafter specifically made applicable, in whole or in part. The
information that is reasonably necessary may be released in formal
orders or opinions of any tribunal or court which is presented with an
issue arising under this chapter as well as in the presentations of the
parties before the tribunal or court. Similarly, claimants or other
interested parties to an issue arising under this chapter may, upon
request, obtain information from the commission's records to the extent
necessary for the proper presentation or defense of a claim or other
matter. Information may be released pursuant to the provisions of
chapter twenty-nine-b of this code only if all identifying information
has first been eliminated from the records. Nothing in this subsection
shall prevent the release of information to another agency of the state
or of the federal government for the legitimate purposes of those
agencies: Provided, That the agency shall guarantee the confidentiality
of the information provided to the fullest extent possible in keeping
with its own statutory and regulatory mandates. Nothing in this
section shall prevent the commission from complying with any subpoena
duces tecum: Provided, however, That the issuing tribunal or court
shall take such actions as proper to maintain the confidentiality of
the information.
The commission may release, pursuant to a proper request under the provisions of chapter twenty-nine-b of this code, the following
information:
(1) The base premium tax rate for a specific employer;
(2) Whether or not a specific employer has obtained coverage
under the provisions of this chapter;
(3) Whether or not a specific employer is in good standing or is
delinquent or in default according to the commission's records and the
time periods thereof; and
(4) If a specific employer is delinquent or in default, what the
payments due the commission are and what the components of that payment
are, including the time periods affected.
§23-1-4a. Bond for executive director and associate director.
(a) The executive director and associate director of the workers'
compensation commission shall give bond in an amount determined by the
board of managers conditioned for the faithful management of the fund
and performance of their duties. The bond shall be approved by the
attorney general as to form. The surety of the bond may be a bonding
or surety company, in which case the premium shall be paid out of the
workers' compensation fund.
(b) The executive director and associate director shall be
provided appropriate insurance, including, but not limited to, errors
and omission coverage, without additional premium, by the state board
of risk and insurance management established pursuant to article
twelve, chapter twenty-nine of this code.
§23-1-5. Office of executive director; hearings.
The executive director shall keep and maintain his or her office
at the seat of government and shall provide a suitable room or rooms, necessary office furniture, supplies, books, periodicals, maps and
other equipment. After due notice, showing the time and place, the
executive director may hold hearings anywhere within the state, or
elsewhere by agreement of claimant and employer, with the approval of
the executive director.
§23-1-6. Employment of associate director and other assistants;
compensation and travel expenses.
(a) The executive director may employ an associate director,
actuary, accountants, inspectors, examiners, experts, clerks,
stenographers and other assistants, and fix their compensation, which
shall be paid as provided in section three of this article. The
associate director shall be hired with the approval of the board of
managers and serves at the will and pleasure of the executive director.
(b) The associate director, supervisory officers, actuaries,
accountants, inspectors, examiners, experts, clerks, stenographers and
other assistants who may be employed are entitled to receive from the
workers' compensation fund their necessary expense while traveling on
business of the commission. Travel reimbursement shall be paid in
accordance with the travel guidelines established by the department of
administration. All expenses shall be itemized and sworn to by the
person who incurred the expense, and are subject to the approval of the
executive director: Provided, That the expenses of the executive
director shall be subject to the approval of the board of managers.
§23-1-7. Associate director to act during executive director's absence
or inability to act and in case of vacancy; bond of associate
director.
Whenever it appears that the executive director will be absent or unable to act for one week or more, the associate director of the
commission may be designated by the executive director to act during
his or her absence or inability to act, and during that period he or
she shall have all the duties and powers of the executive director.
In the event a vacancy occurs in the office of executive director, the
associate director shall have all the duties and powers of the
executive director until an executive director or a temporary executive
director is hired by the board of managers. The board of managers may
determine the amount of additional compensation the associate director
may receive as acting executive director.
§23-1-8. Authority of executive director and employees as to oaths and
evidence.
The executive director, associate director and other employees
appointed by the executive director may, for the purpose contemplated
by this chapter, administer oaths, certify official acts, take
depositions, issue subpoenas and compel the attendance of witnesses and
the production of pertinent books, accounts, papers, records, documents
and testimony.
§23-1-9. Compelling compliance with order or subpoena.
In case of failure or refusal of any person to comply with the
order of the executive director, or subpoena issued by him or her, the
associate director, or duly appointed employee, or on the refusal of
a witness to testify to any matter regarding which he or she may be
lawfully interrogated, or refusal to permit an inspection as aforesaid,
the circuit judge of the county in which the person resides, on
application of the executive director, associate director or any duly
appointed employee, shall compel obedience by attachment proceedings as for contempt, as in the case of disobedience of the requirements of
a subpoena issued from the court on a refusal to testify in the court.
§23-1-10. Fee of officer serving subpoena; fees and mileage of
witnesses.
Each officer who serves subpoenas on behalf of the commission
shall receive the same fee as a sheriff and each witness who appears
in obedience to a subpoena before the executive director, associate
director or duly appointed employee shall receive for his or her
attendance the fees and mileage provided for witnesses in civil cases
in the circuit court, which shall be audited and paid out of the
workers' compensation fund in the same manner as other expenses are
audited and paid, if the witness was subpoenaed without the request of
either claimant or employer at the instance of the executive director,
associate director or duly appointed employee. The witness fees and
mileage of any witness subpoenaed by, or at the instance of, either
claimant or employer shall be paid by the party who subpoenas the
witness.
§23-1-11. Depositions; investigations.
(a) In an investigation into any matter arising under articles
one through five, inclusive, of this chapter, the commission may cause
depositions of witnesses residing within or without the state to be
taken in the manner prescribed by law for like depositions in the
circuit court, but the depositions shall be upon reasonable notice to
claimant and employer or other affected persons or their respective
attorneys. The commission shall designate the person to represent it
for the taking of the deposition.
(b) The commission also has discretion to accept and consider depositions taken within or without the state by either the claimant
or employer or other affected person, provided due and reasonable
notice of the taking of the depositions was given to the other parties
or their attorneys, if any: Provided, That the commission, upon due
notice to the parties, has authority to refuse or permit the taking of
depositions or to reject the depositions after they are taken, if they
were taken at a place or under circumstances which imposed an undue
burden or hardship upon the other parties. The commission's discretion
to accept, refuse to approve or reject the depositions is binding in
the absence of abuse of the discretion.
§23-1-12. Copies of proceedings as evidence.
A transcribed copy of the evidence and proceedings, or any
specific part thereof, on any investigation or hearing, taken by a
stenographer appointed by the executive director and certified and
sworn to by the stenographer to be a true and correct transcript of the
testimony in the investigation or hearing, or of a particular witness,
or of a specific part thereof, or to be a correct transcript of the
proceedings had on the investigation or hearing purporting to be taken
and subscribed, may be received in evidence by the executive director
with the same effect as if the stenographer were present and testified
to the facts certified. A copy of the transcript shall be furnished
on demand to any party upon payment of the fee prescribed in the rules
and policies of the commission. The fee shall not exceed that
prescribed for transcripts in the circuit court.
§23-1-13. Rules of procedure and evidence; persons authorized to
appear in proceedings; withholding of psychiatric and
psychological reports and providing summaries thereof.
(a) The workers' compensation commission shall adopt reasonable
and proper rules of procedure, regulate and provide for the kind and
character of notices, and the service of the notices, in cases of
accident and injury to employees, the nature and extent of the proofs
and evidence, the method of taking and furnishing of evidence to
establish the rights to benefits or compensation from the fund
hereinafter provided for, or directly from employers as hereinafter
provided, as the case may require, and the method of making
investigations, physical examinations and inspections and prescribe the
time within which adjudications and awards shall be made.
(b) At hearings and other proceedings before the commission or
before the duly authorized representative of the commission, an
employer who is a natural person may appear, and a claimant may appear,
only as follows:
(1) By an attorney duly licensed and admitted to the practice of
law in this state;
(2) By a nonresident attorney duly licensed and admitted to
practice before a court of record of general jurisdiction in another
state or country or in the District of Columbia who has complied with
the provisions of rule 8.0--admission pro hac vice, West Virginia
supreme court rules for admission to the practice of law, as amended;
(3) By a representative from a labor organization who has been
recognized by the commission as being qualified to represent a claimant
or who is an individual otherwise found to be qualified by the
commission to act as a representative. The representative shall
participate in the presentation of facts, figures and factual
conclusions as distinguished from the presentation of legal conclusions in respect to the facts and figures; or
(4) Pro se.
(c) At hearings and other proceedings before the commission or
before the duly authorized representative of the commission, an
employer who is not a natural person may appear only as follows:
(1) By an attorney duly licensed and admitted to the practice of
law in this state;
(2) By a nonresident attorney duly licensed and admitted to
practice before a court of record of general jurisdiction in another
state or country or in the District of Columbia who has complied with
the provisions of rule 8.0--admission pro hac vice, West Virginia
supreme court rules for admission to the practice of law, as amended;
(3) By a member of the board of directors of a corporation or by
an officer of the corporation for purposes of representing the interest
of the corporation in the presentation of facts, figures and factual
conclusions as distinguished from the presentation of legal conclusions
in respect to the facts and figures; or
(4) By a representative from an employer service company who has
been recognized by the commission as being qualified to represent an
employer or who is an individual otherwise found to be qualified by the
commission to act as a representative. The representative shall
participate in the presentation of facts, figures and factual
conclusions as distinguished from the presentation of legal conclusions
in respect to the facts and figures.
(d) The commission or its representative may require an
individual appearing on behalf of a natural person or corporation to
produce satisfactory evidence that he or she is properly qualified and authorized to appear pursuant to this section.
(e) Subsections (b), (c) and (d) of this section shall not be
construed as being applicable to proceedings before the office of
judges pursuant to the provisions of article five of this chapter.
(f) At the direction of a treating or evaluating psychiatrist or
clinical doctoral-level psychologist, a psychiatric or psychological
report concerning a claimant who is receiving treatment or is being
evaluated for psychiatric or psychological problems may be withheld
from the claimant. In that event, a summary of the report shall be
compiled by the reporting psychiatrist or clinical doctoral-level
psychologist. The summary shall be provided to the claimant upon his
or her request. Any representative or attorney of the claimant must
agree to provide the claimant with only the summary before the full
report is provided to the representative or attorney for his or her use
in preparing the claimant's case. The report shall only be withheld
from the claimant in those instances where the treating or evaluating
psychiatrist or clinical doctoral-level psychologist certifies that
exposure to the contents of the full report is likely to cause serious
harm to the claimant or is likely to cause the claimant to pose a
serious threat of harm to a third party.
(g) In any matter arising under articles one through five,
inclusive, of this chapter in which the commission is required to give
notice to a party, if a party is represented by an attorney or other
representative, then notice to the attorney or other representative is
sufficient notice to the party represented.
§23-1-14. Forms.
The commission shall prepare and furnish free of cost forms (and provide in his or her rules for their distribution so that they may be
readily available) of applications for benefits for compensation from
the workers' compensation fund, or directly from employers, as the case
may be, notices to employers, proofs of injury or death, of medical
attendance, of employment and wage earnings, and any other forms
considered proper and advisable. It is the duty of employers to
constantly keep on hand a sufficient supply of the forms.
§23-1-15. Procedure before commission.
The commission is not bound by the usual common-law or statutory
rules of evidence, but shall adopt formal rules of practice and
procedure as herein provided, and may make investigations in a manner
that in his or her judgment is best calculated to ascertain the
substantial rights of the parties and to carry out the provisions of
this chapter.
§23-1-17. Annual report by commission and occupational pneumoconiosis
board.
Annually, on or about the fifteenth day of September in each
year, the executive director and the occupational pneumoconiosis board
shall make a report as of the thirtieth day of June addressed to the
governor, which shall include a statement of the causes of the injuries
for which the awards were made, an explanation of the diagnostic
techniques used by the occupational pneumoconiosis board and all
examining physicians to determine the presence of disease, the extent
of impairment attributable thereto, a description of the scientific
support for the diagnostic techniques and a summary of public and
private research relating to problems and prevention of occupational
diseases. The report shall include a detailed statement of all disbursements, and the condition of the fund, together with any
specific recommendations for improvements in the workers' compensation
law and for more efficient and responsive administration of the
workers' compensation law, which the executive director considers
appropriate. Copies of all annual reports shall be filed with the
secretary of state and shall be made available to the Legislature and
to the public at large.
§23-1-18. Commission employees not subject to subpoena for workers'
compensation hearings.
No employee of the workers' compensation commission shall be
compelled to testify as to the basis, findings or reasons for any
decision or order rendered by the employee under this chapter in any
hearing conducted pursuant to article five of this chapter.
§23-1-19. Civil remedies.
(a) Any person, firm, corporation or other entity which
willfully, by means of false statement or representation, or by
concealment of any material fact, or by other fraudulent scheme, device
or artifice on behalf of himself, itself or others, obtains or attempts
to obtain benefits,
payments, allowances or reduced premium costs or
other charges
, including workers' compensation coverage under the
programs of the workers' compensation commission to which he or it is
not entitled, or in a greater amount than that to which he or it is
entitled, shall be liable to the workers' compensation commission in
an amount equal to three times the amount of such benefits, payments
or allowances to which he or it is not entitled and shall be liable for
the payment of reasonable attorney fees and all other fees and costs
of litigation.
(b) No criminal action or indictment need be brought against any
person, firm, corporation or other entity as a condition for
establishing civil liability hereunder.
(c) A civil action under this section may be prosecuted and
maintained on behalf of the workers' compensation commission by the
attorney general and his assistants or by any attorney in contract with
or employed by the workers' compensation commission to provide such
representation.
(d) Venue for a civil action under this section shall be either
in the county in which the defendant resides or in Kanawha County, as
selected by the commission.
(e) The remedies and penalties provided in this section are in
addition to those remedies and penalties provided elsewhere by law.
ARTICLE 2. EMPLOYERS AND EMPLOYEES SUBJECT TO CHAPTER;
EXTRATERRITORIAL COVERAGE.
§23-2-1. Employers subject to chapter; elections not to provide
certain coverages; notices; filing of business registration
certificates.
(a) The state of West Virginia and all governmental agencies or
departments created by it, including county boards of education,
political subdivisions of the state, any volunteer fire department or
company and other emergency service organizations as defined by article
five, chapter fifteen of this code, and all persons, firms,
associations and corporations regularly employing another person or
persons for the purpose of carrying on any form of industry, service
or business in this state, are employers within the meaning of this
chapter and are required to subscribe to and pay premium taxes into the workers' compensation fund for the protection of their employees and
are subject to all requirements of this chapter and all rules
prescribed by the workers' compensation commission with reference to
rate, classification and premium payment: Provided, That rates will be
adjusted by the commission to reflect the demand on the compensation
fund by the covered employer.
(b) The following employers are not required to subscribe to the
fund, but may elect to do so:
(1) Employers of employees in domestic services;
(2) Employers of five or fewer full-time employees in
agricultural service;
(3) Employers of employees while the employees are employed
without the state except in cases of temporary employment without the
state;
(4) Casual employers. An employer is a casual employer when the
number of his or her employees does not exceed three and the period of
employment is temporary, intermittent and sporadic in nature and does
not exceed ten calendar days in any calendar quarter;
(5) Churches;
(6) Employers engaged in organized professional sports
activities, including employers of trainers and jockeys engaged in
thoroughbred horse racing; or
(7) Any volunteer rescue squad or volunteer police auxiliary unit
organized under the auspices of a county commission, municipality or
other government entity or political subdivision; volunteer
organizations created or sponsored by government entities, political
subdivisions; or area or regional emergency medical services boards of directors in furtherance of the purposes of the emergency medical
services act of article four-c, chapter sixteen of this code: Provided,
That if any of the employers described in this subdivision have paid
employees, to the extent of those paid employees, the employer shall
subscribe to and pay premium taxes into the workers' compensation fund
based upon the gross wages of the paid employees but with regard to the
volunteers, the coverage remains optional.
(c) Notwithstanding any other provision of this chapter to the
contrary, whenever there are churches in a circuit which employ one
individual clergyman and the payments to the clergyman from the
churches constitute his or her full salary, such circuit or group of
churches may elect to be considered a single employer for the purpose
of premium payment into the workers' compensation fund.
(d) Employers who are not required to subscribe to the workers'
compensation fund may voluntarily choose to subscribe to and pay
premiums into the fund for the protection of their employees and in
that case are subject to all requirements of this chapter and all rules
and regulations prescribed by the commission with reference to rates,
classifications and premium payments and shall afford to them the
protection of this chapter, including section six of this article, but
the failure of the employers to choose to subscribe to and to pay
premiums into the fund shall not impose any liability upon them other
than any liability that would exist notwithstanding the provisions of
this chapter.
(e) Any foreign corporation employer whose employment in this
state is to be for a definite or limited period which could not be
considered "regularly employing" within the meaning of this section may choose to pay into the workers' compensation fund the premiums provided
for in this section, and at the time of making application to the
workers' compensation commission, the employer shall furnish a
statement under oath showing the probable length of time the employment
will continue in this state, the character of the work, an estimate of
the monthly payroll and any other information which may be required by
the commission. At the time of making application the employer shall
deposit with the commission to the credit of the workers' compensation
fund the amount required by section five of this article. That amount
shall be returned to the employer if the employer's application is
rejected by the commission. Upon notice to the employer of the
acceptance of his or her application by the commission, he or she is
an employer within the meaning of this chapter and subject to all of
its provisions.
(f) Any foreign corporation employer choosing to comply with the
provisions of this chapter and to receive the benefits under this
chapter shall, at the time of making application to the commission in
addition to other requirements of this chapter, furnish the commission
with a certificate from the secretary of state, where the certificate
is necessary, showing that it has complied with all the requirements
necessary to enable it legally to do business in this state and no
application of a foreign corporation employer shall be accepted by the
commission until the certificate is filed.
(g) The following employers may elect not to provide coverage to
certain of their employees under the provisions of this chapter:
(1) Any political subdivision of the state including county
commissions and municipalities, boards of education, or emergency services organizations organized under the auspices of a county
commission may elect not to provide coverage to any elected official.
The election not to provide coverage does not apply to individuals in
appointed positions or to any other employees of the political
subdivision;
(2) If an employer is a partnership, sole proprietorship,
association or corporation, the employer may elect not to include as
an "employee" within this chapter, any member of the partnership, the
owner of the sole proprietorship or any corporate officer or member of
the board of directors of the association or corporation. The officers
of a corporation or an association shall consist of a president, a vice
president, a secretary and a treasurer, each of whom is elected by the
board of directors at the time and in the manner prescribed by the
bylaws. Other officers and assistant officers that are considered
necessary may be elected or appointed by the board of directors or
chosen in any other manner prescribed by the bylaws and, if elected,
appointed or chosen, the employer may elect not to include the officer
or assistant officer as an "employee" within the meaning of this
chapter: Provided, That except for those persons who are members of the
board of directors or who are the corporation's or association's
president, vice president, secretary and treasurer and who may be
excluded by reason of their positions from the benefits of this chapter
even though their duties, responsibilities, activities or actions may
have a dual capacity of work which is ordinarily performed by an
officer and also of work which is ordinarily performed by a worker, an
administrator or an employee who is not an officer, no other officer
or assistant officer who is elected or appointed shall be excluded by election from coverage or be denied the benefits of this chapter merely
because he or she is an officer or assistant officer if, as a matter
of fact:
(A) He or she is engaged in a dual capacity of having the duties
and responsibilities for work ordinarily performed by an officer and
also having duties and work ordinarily performed by a worker,
administrator or employee who is not an officer;
(B) He or she is engaged ordinarily in performing the duties of
a worker, an administrator or an employee who is not an officer and
receives pay for performing the duties in the capacity of an employee;
or
(C) He or she is engaged in an employment palpably separate and
distinct from his or her official duties as an officer of the
association or corporation;
(3) If an employer is a limited liability company, the employer
may elect not to include as an "employee" within this chapter a total
of no more than four persons, each of whom are acting in the capacity
of manager, officer or member of the company.
(h) In the event of election under subsection (g) of this
section, the employer shall serve upon the commission written notice
naming the positions not to be covered and shall not include the
"employee's" remuneration for premium purposes in all future payroll
reports, and the partner, proprietor or corporate or executive officer
is not considered an employee within the meaning of this chapter after
the notice has been served. Notwithstanding the provisions of
subsection (g), section five of this article, if an employer is
delinquent or in default or has not subscribed to the fund even though it is obligated to do so under the provisions of this article, any
partner, proprietor or corporate or executive officer shall not be
covered and shall not receive the benefits of this chapter.
(i) "Regularly employing" or "regular employment" means
employment by an employer which is not a casual employer under this
section.
§23-2-1c. Extraterritorial coverage; approval and change of
agreements.
(a) Whenever, with respect to an employee of an employer who is
a subscriber in good standing to the workers' compensation fund or an
employer who has elected to pay compensation directly, as provided in
section nine of this article, there is a possibility of conflict with
respect to the application of workers' compensation laws because the
contract of employment is entered into and all or some portion of the
work is performed or is to be performed in a state or states other than
this state, the employer and the employee may agree to be bound by the
laws of this state or by the laws of any other state in which all or
some portion of the work of the employee is to be performed: Provided,
That the executive director may review and accept or reject the
agreement. The review shall be conducted in keeping with the executive
director's fiduciary obligations to the workers' compensation fund
which may include, among other things, the nexus of the employer and
the employee to the state: Provided, however, That nothing in this
section shall be construed as to require an agreement in those
instances where subdivision (3), subsection (b), section one of this
article or subdivision (1), subsection (a), section one-a of this
article are applicable. All agreements shall be in writing and filed with the executive director within ten days after execution of the
agreement but shall not become effective until approved by the
executive director and shall, thereafter, remain in effect until
terminated or modified by agreement of the parties similarly filed or
by order of the executive director. If the parties agree to be bound
by the laws of this state, an employee injured within the terms and
provisions of this chapter is entitled to benefits under this chapter
regardless of the situs of the injury or exposure to occupational
pneumoconiosis or other occupational disease, and the rights of the
employee and his or her dependents under the laws of this state shall
be the exclusive remedy against the employer on account of injury,
disease or death in the course of and as a result of the employment.
(b) If the parties agree to be bound by the laws of another state
and the employer has complied with the laws of that state, the rights
of the employee and his or her dependents under the laws of that state
shall be the exclusive remedy against the employer on account of
injury, disease or death in the course of and as a result of the
employment without regard to the situs of the injury or exposure to
occupational pneumoconiosis or other occupational disease.
(c) If the employee is a resident of a state other than this
state and is subject to the terms and provisions of the workers'
compensation law or similar laws of a state other than this state, the
employee and his or her dependents are not entitled to the benefits
payable under this chapter on account of injury, disease or death in
the course of and as a result of employment temporarily within this
state, and the rights of the employee and his or her dependents under
the laws of the other state shall be the exclusive remedy against the employer on account of any injury, disease or death.
(d) If any employee or his or her dependents are awarded workers'
compensation benefits or recover damages from the employer under the
laws of another state for an injury received in the course of and
resulting from the employment, the amount awarded or recovered, whether
paid or to be paid in future installments, shall be credited against
the amount of any benefits payable under this chapter for the same
injury.
§23-2-1d. Primary contractor liability; definitions; applications and
exceptions; certificates of good standing; reimbursement and
indemnification; termination of contracts; effective date;
collections efforts.
(a) For the exclusive purposes of this section, the term
"employer" as defined in section one of this article includes any
primary contractor who regularly subcontracts with other employers for
the performance of any work arising from or as a result of the primary
contractor's own contract: Provided, That a subcontractor does not
include one providing goods rather than services. For purposes of this
subsection, extraction of natural resources is a provision of services.
In the event that a subcontracting employer defaults on its obligations
to make payments to the commission, then the primary contractor is
liable for the payments. However, nothing contained in this section
shall extend or except to a primary contractor or subcontractors the
provisions of section six, six-a or eight of this article. This
section is applicable only with regard to subcontractors with whom the
primary contractor has a contract for any work or services for a period
longer than thirty days: Provided, however, That this section is also applicable to contracts for consecutive periods of work that total more
than thirty days. It is not applicable to the primary contractor with
regard to sub-subcontractors. However, a subcontractor for the
purposes of a contract with the primary contractor can itself become
a primary contractor with regard to other employers with whom it
subcontracts. It is the intent of the Legislature that no contractor,
whether a primary contractor, subcontractor or sub-subcontractor,
escape or avoid liability for any workers' compensation premium,
assessment or tax. The executive director shall propose for
promulgation a rule to effect this purpose on or before the thirty-
first day of December, two thousand three.
(b) A primary contractor may avoid initial liability under
subsection (a) of this section if it obtains from the executive
director, prior to the initial performance of any work by the
subcontractor's employees, a certificate that the subcontractor is in
good standing with the workers' compensation fund.
(1) Failure to obtain the certificate of good standing prior to
the initial performance of any work by the subcontractor results in the
primary contractor being equally liable with the subcontractor for all
delinquent and defaulted premium taxes, premium deposits, interest and
other penalties arising during the life of the contract or due to work
performed in furtherance of the contract: Provided, That the commission
is entitled to collect only once for the amount of premiums, premium
deposits and interest due to the default, but the commission may impose
other penalties on the primary contractor or on the subcontractor, or
both.
(2) In order to continue avoiding liability under this section, the primary contractor shall request that the commission inform the
primary contractor of any subsequent default by the subcontractor. In
the event that the subcontractor does default, the commission shall
notify the primary contractor of the default by placing a notice in the
first-class United States mail, postage prepaid, and addressed to the
primary contractor at the address furnished to the commission by the
primary contractor. The mailing is good and sufficient notice to the
primary contractor of the subcontractor's default. However, the
primary contractor is not liable under this section until the first day
of the calendar quarter following the calendar quarter in which the
notice is given and then the liability is only for that following
calendar quarter and thereafter and only if the subcontract has not
been terminated: Provided, That the commission is entitled to collect
only once for the amount of premiums, premium deposits and interest due
to the default, but the commission may impose other penalties on the
primary contractor or on the subcontractor, or both.
(c) In any situation where a subcontractor defaults with regard
to its payment obligations under this chapter or fails to provide a
certificate of good standing as provided for in this section, the
default or failure is good and sufficient cause for a primary
contractor to hold the subcontractor responsible and to seek
reimbursement or indemnification for any amounts paid on behalf of the
subcontractor to avoid or cure a workers' compensation default, plus
related costs including reasonable attorneys' fees, and to terminate
its subcontract with the subcontractor notwithstanding any provision
to the contrary in the contract.
(d) The provisions of this section are applicable only to those contracts entered into or extended on or after the first day of
January, one thousand nine hundred ninety-four.
(e) The commission may take any action authorized by section
five-a of this article in furtherance of its efforts to collect amounts
due from the primary contractor under this section.
§23-2-2. Commission to be furnished information by employers, state
tax commissioner and division of unemployment compensation;
secrecy of information; examination of employers, etc.; violation
a misdemeanor.
(a) Every employer shall furnish the executive director, upon
request, all information required by him or her to carry out the
purposes of this chapter. Every employer shall have a continuous and
ongoing duty to maintain current information about its activities,
risks and rates on the books of the commission. The executive
director, or any person employed by the commission for that purpose,
may examine under oath any employer or officer, agent or employee of
any employer.
(b) Notwithstanding the provisions of any other statute to the
contrary, specifically, but not exclusively, sections five and five-b,
article ten, chapter eleven of this code and section eleven, article
ten, chapter twenty-one-a of this code, the executive director of the
workers' compensation commission may receive the following information:
(1) Upon written request to the state tax commissioner: The
names, addresses, places of business and other identifying information
of all businesses receiving a business franchise registration
certificate and the dates thereof; and the names and social security
numbers or other tax identification numbers of the businesses and of the businesses' workers and employees, if otherwise collected, and the
quarterly and annual gross wages or other compensation paid to the
workers and employees of businesses reported pursuant to the
requirement of withholding of tax on income.
(2) Upon written application to the division of unemployment
compensation: In addition to the information that may be released to
the workers' compensation commission for the purposes of this chapter
under the provisions of chapter twenty-one-a of this code, the names,
addresses and other identifying information of all employing units
filing reports and information pursuant to section eleven, article ten,
chapter twenty-one-a of this code as well as information contained in
those reports regarding the number and names, addresses and social
security numbers of employees employed and the gross quarterly wages
paid by each employing unit to each identified employee.
(c) All information acquired by the workers' compensation
commission pursuant to subsection (b) of this section shall be used
only for auditing premium payments, assisting in a wage determination,
assisting in the determination of employment status and registering
businesses under the single point of registration program as defined
in section two, article one, chapter eleven of this code. The workers'
compensation commission, upon receiving the business franchise
registration certificate information made available pursuant to
subsection (b) of this section, shall contact all businesses receiving
a business franchise registration certificate and provide all necessary
forms to register the business under the provisions of this article.
Any officer or employee of this state who uses the information obtained
under this section in any manner other than the one stated in this section or elsewhere authorized in this code, or who divulges or makes
known in any manner any of the information obtained under this section,
is guilty of a misdemeanor and, upon conviction thereof, shall be fined
not more than one thousand dollars or incarcerated in the county or
regional jail for not more than one year, or both, together with cost
of prosecution.
(d) Reasonable costs of compilation and production of any
information made available pursuant to subsection (b) of this section
shall be charged to the workers' compensation commission.
(e) Information acquired by the commission pursuant to subsection
(b) of this section is not subject to disclosure under the provisions
of chapter twenty-nine-b of this code.
§23-2-3. Report forms and other forms for use of employers.
The commission shall prepare and furnish report forms for the use
of employers subject to this chapter. Every employer receiving from
the commission any form or forms with direction for completion and
returning to the commission shall return the form, within the period
fixed by the commission, completed as to answer fully and correctly all
pertinent questions in the form, and if unable to do so, shall give
good and sufficient reasons for the failure. Every employer subject
to the provisions of this chapter shall make application to the
commission on the forms prescribed by the commission for that purpose;
and any employer who terminates his or her business or for any other
reason is no longer subject to this chapter shall immediately notify
the commission on forms to be furnished by the commission for that
purpose.
§23-2-4. Classification of industries; rate of premiums; authority to adopt various systems; accounts.
(a) The executive director with approval of the board of managers
is authorized to establish by rule a system for determining the
classification and distribution into classes of employers subject to
this chapter, a system for determining rates of premium taxes
applicable to employers subject to this chapter, a system of multiple
policy options with criteria for subscription and criteria for an
annual employer's statement providing both benefits liability
information and rate determination information.
(1) In addition, the rule shall provide for, but not be limited
to:
(A) Rate adjustments by industry or individual employer,
including merit rate adjustments;
(B) Notification regarding rate adjustments prior to the quarter
in which the rate adjustments will be in effect;
(C) Chargeability of claims; and
(D) Any further matters that are necessary and consistent with
the goals of this chapter;
(2) The rule shall require the establishment of a program under
which the commissioner may grant discounts on premium rates for
employers who meet either of the following requirements:
(A) Have not incurred a compensable injury for one year or more
and who maintain an employee safety committee or similar organization
and make periodic safety inspections of the workplace;
(B) Successfully complete a loss prevention program, including
establishment of a drug-free workplace, prescribed by the commission's
safety and loss control office and conducted by the commission or by any other person approved by the commission;
(3) The rule shall be consistent with the duty of the executive
director and the board of managers to fix and maintain the lowest
possible rates of premium taxes consistent with the maintenance of a
solvent workers' compensation fund and the reduction of any deficit
that may exist in the fund and in keeping with their fiduciary
obligations to the fund;
(4) The rule shall be consistent with generally accepted
accounting principles;
(5) The rule shall be consistent with classification and rate-
making methodologies found in the insurance industry; and
(6) The rule shall be consistent with the principles of promoting
more effective workplace health and safety programs as contained in
article two-b of this chapter.
(b) In accordance with generally accepted accounting principles,
the workers' compensation commission shall keep an accurate accounting
of all money or moneys earned, due and received by the workers'
compensation fund and of the liability incurred and disbursements made
against the fund; and an accurate account of all money or moneys
earned, due and received from each individual subscriber and of the
liability incurred and disbursements made against the same.
(c) Prospective rates set in accordance with the provisions of
this article shall at all times be financially sound in accordance with
generally accepted accounting principles and fully fund the prospective
claim obligations for the year in which the rates were made. Rates,
surcharges or assessments for deficit management and deficit reduction
purposes shall be fair and equitable, financially sound in accordance with generally accepted accounting principles and sufficient to meet
the payment obligations of the fund.
(d) Notwithstanding any provision of subsection (c) of this
section to the contrary, except for those increases made effective for
fiscal year two thousand four by action of the compensation programs
performance council heretofore established in article three, chapter
twenty-one-a of this code taken prior to the effective date of the
amendment and reenactment of this section, base rates, assessments and
surcharges shall not be increased during fiscal years two thousand
four, two thousand five and two thousand six:
Provided, That the
portion of the rate increase attributable to claims management
incentive adjustments, as determined by the compensation programs
performance council for fiscal year two thousand four prior to the
effective date of the amendment and reenactment of this section by the
Legislature in the year two thousand three, shall not be considered a
part of the employer's premium taxes and shall not be subject to
collection by the commission.
(e) Claims management incentive adjustments, whether imposed in
a manner that would result in either a debit or a credit to any
employer's account, shall not be considered by the board of managers
in its future rate determinations.
§23-2-5. Application; payment of premium taxes; gross wages; payroll
report; deposits; delinquency; default; reinstatement; payment of
benefits; notice to employees; criminal provisions; penalties.
(a) For the purpose of creating a workers' compensation fund,
each employer who is required to subscribe to the fund or who elects
to subscribe to the fund shall pay premium taxes calculated as a percentage of the employer's gross wages payroll as defined by the
commission at the rate determined by the commission and then in effect
plus any additional premium taxes developed from rates, surcharges or
assessments as determined by the commission. At the time each employer
subscribes to the fund, the application required by the commission
shall be filed and a premium deposit equal to the first quarter's
estimated premium tax payment shall be remitted. The minimum quarterly
premium to be paid by any employer is twenty-five dollars.
(1) Thereafter, the premium taxes shall be paid quarterly on or
before the last day of the month following the end of the quarter, and
shall be the prescribed percentage of the entire gross wages of all
employees, from which net payroll is calculated and paid, during the
preceding quarter. The commission may require employers, in accordance
with the provisions of rules proposed by the executive director and
promulgated by the board of managers, to report gross wages and pay
premium taxes monthly or at other intervals.
(2) Every subscribing employer shall make a gross wages payroll
report to the commission for the preceding reporting period. The
report shall be on the form or forms prescribed by the commission and
shall contain all information required by the commission.
(3) After subscribing to the fund, each employer shall remit with
each premium tax payment an amount calculated to be sufficient to
maintain a premium deposit equal to the premium payment for the
previous reporting period. The commission may reduce the amount of the
premium deposit required from seasonal employers for those quarters
during which employment is significantly reduced. If the employer pays
premium tax on a basis other than quarterly, the commission may require the deposit to be based upon some other time period. The premium
deposit shall be credited to the employer's account on the books of the
commission and used to pay premium taxes and any other sums due the
fund when an employer becomes delinquent or in default as provided in
this article.
(4) All premium taxes and premium deposits required by this
article to be paid shall be paid by the employers to the commission,
which shall maintain a record of all sums so received. Any sum mailed
to the commission is considered to be received on the date the envelope
transmitting it is postmarked by the United States postal service. All
sums received by the commission shall be deposited in the state
treasury to the credit of the workers' compensation commission in the
manner now prescribed by law.
(5) The commission shall encourage employer efforts to create and
maintain safe workplaces, to encourage loss prevention programs and to
encourage employer-provided wellness programs, through the normal
operation of the experience rating formula, seminars and other public
presentations, the development of model safety programs and other
initiatives as may be determined by the executive director and the
board of managers.
(b) Failure of an employer to timely pay premium taxes as
provided for in subsection (a) of this section, to timely file a
payroll report or to maintain an adequate premium deposit shall cause
the employer's account to become delinquent. No employer will be
declared delinquent or be assessed any penalty for the delinquency if
the commission determines that the delinquency has been caused by
delays in the administration of the fund. The commission shall, in writing, within sixty days of the end of each quarter notify all
delinquent employers of their failure to timely pay premium taxes, to
timely file a payroll report or to maintain an adequate premium
deposit. Each employer who fails to timely file any payroll report or
timely pay the premium tax due with the report, or both, for any
quarter commencing on and after the first day of July, one thousand
nine hundred ninety-five, shall pay a late reporting or payment penalty
of the greater of fifty dollars or a sum obtained by multiplying the
premium tax due with the report by the penalty rate applicable to that
quarter. The penalty rate to be used in a workers' compensation
commission's fiscal year is calculated annually on the first day of
each fiscal year. The penalty rate used to calculate the penalty for
each quarter in a fiscal year is the quotient, rounded to the nearest
higher whole number percentage rate, obtained by dividing the sum of
the prime rate plus four percent by four. The prime rate is the rate
published in the Wall Street Journal on the last business day of the
commission's prior fiscal year reflecting the base rate on corporate
loans posted by at least seventy-five percent of the nation's thirty
largest banks. The late penalty shall be paid with the most recent
quarter's report and payment and is due when that quarter's report and
payment are filed. If the late penalty is not paid when due, it may
be charged to and collected by the commission from the employer's
premium deposit account or otherwise as provided for by law. The
notification shall demand the filing of the delinquent payroll report
and payment of delinquent premium taxes, the penalty for late reporting
or payment of premium taxes or premium deposit, the interest penalty
and an amount sufficient to maintain the premium deposit before the end of the third month following the end of the preceding quarter.
Interest shall accrue and be charged on the delinquent premium payment
and premium deposit pursuant to section thirteen of this article.
(c) Whenever the commission notifies an employer of the
delinquent status of its account, the notification shall explain the
legal consequence of subsequent default by an employer required to
subscribe to the fund and the legal consequences of termination of an
electing employer's account.
(d) Failure by the employer, who is required to subscribe to the
fund and who fails to resolve the delinquency within the prescribed
period, shall place the account in default and shall deprive the
default employer of the benefits and protection afforded by this
chapter, including section six of this article, and the employer is
liable as provided in section eight of this article. The default
employer's liability under these sections is retroactive to midnight
of the last day of the month following the end of the quarter for which
the delinquency occurs. The commission shall notify the default
employer of the method by which the employer may be reinstated with the
fund. The commission shall also notify the employees of the employer
by written notice as hereinafter provided for in this section.
(e) Failure by any employer, who voluntarily elects to subscribe,
to resolve the delinquency within the prescribed period shall place the
account in default and shall automatically terminate the election of
the employer to pay into the workers' compensation fund and shall
deprive the employer and the employees of the default elective employer
of the benefits and protection afforded by this chapter, including
section six of this article, and the employer is liable as provided in section eight of this article. The default employer's liability under
that section is retroactive to midnight of the last day of the month
following the end of the quarter for which the delinquency occurs.
Employees who were the subject of the default employer's voluntary
election to provide them the benefits afforded by this chapter shall
have the protection terminated at the time of their employer's default.
(f)(1) Except as provided for in subdivision (3) of this
subsection, any employer who is required to subscribe to the fund and
who is in default on the effective date of this section or who
subsequently defaults, and any employer who has elected to subscribe
to the fund and who defaults and whose account is terminated prior to
the effective date of this section or whose account is subsequently
terminated, shall be restored immediately to the benefits and
protection of this chapter only upon the filing of all delinquent
payroll and other reports required by the commission and payment into
the fund of all unpaid premiums, an adequate premium deposit, accrued
interest and the penalty for late reporting and payment. Interest is
calculated as provided for by section thirteen of this article.
The commission shall not have the authority to waive either
premium or accrued interest. The provisions of section seventeen of
this article apply to any action or decision of the commission under
this section.
(2) The commission may restore a defaulted or terminated employer
through a reinstatement agreement. The reinstatement agreement shall
require the payment in full of all premium taxes, premium deposits, the
penalty for late reporting and payment, past accrued interest and
future interest calculated pursuant to the provisions of section thirteen of this article. Notwithstanding the filing of a
reinstatement application or the entering into of a reinstatement
agreement, the commission is authorized to file a lien against the
employer as provided by section five-a of this article. In addition,
entry into a reinstatement agreement is discretionary with the
commission. Its discretion shall be exercised in keeping with the
fiduciary obligations owed to the workers' compensation fund. If the
commission declines to enter into a reinstatement agreement and if the
employer does not comply with the provisions of subdivision (1) of this
subsection, the commission may proceed with any of the collection
efforts provided for by section five-a of this article or as otherwise
provided for by this code. Applications for reinstatement shall: (A)
Be made upon forms prescribed by the commission; (B) include a report
of the gross wages payroll of the employer which had not been reported
to the commission during the entire period of delinquency and default.
The gross wages information shall be certified by the employer or its
authorized agent; and (C) include a payment of a portion of the
liability equal to one half of one percent of the gross payroll during
the period of delinquency and default or equal to another portion of
the liability determined by rule but not to exceed the amount of the
entire liability due and owing for the period of delinquency and
default. An employer who applies for reinstatement is entitled to the
benefits and protection of this chapter on the day a properly completed
and acceptable application which is accompanied by the application
payment is received by the commission: Provided, That if the commission
reinstates an employer subject to the terms of a reinstatement
agreement, the subsequent failure of the employer to make scheduled payments or to pay accrued or future interest in accordance with the
reinstatement agreement or to timely file current reports and to pay
current premiums within the month following the end of the period for
which the report and payment are due, or to otherwise maintain its
account in good standing or, if the reinstatement agreement does not
require earlier restoration of the premium deposit, to restore the
premium deposit to the required amount by the end of the repayment
period shall cause the reinstatement application and the reinstatement
agreement to be null, void and of no effect, and the employer is denied
the benefits and protection of this chapter effective from the date
that the employer's account originally became delinquent.
(3) Any employer who fails to maintain its account in good
standing with regard to subsequent premium taxes and premium deposits
after filing an application for reinstatement and prior to the final
resolution of an application for reinstatement by entering into a
reinstatement agreement or by payment of the liability in full as
provided for in subdivision (1) of this subsection shall cause the
reinstatement application to be null, void and of no effect, and the
employer shall be denied the benefits and protection of this chapter
effective from the date that the employer's account originally became
delinquent.
(4) Following any failure of an employer to comply with the
provisions of a reinstatement agreement, the commission may make and
continue with any of the collection efforts provided for by this
chapter or elsewhere in this code even if the employer files another
reinstatement application.
(g) With the exception noted in subsection (h), section one of this article, no employee of an employer required by this chapter to
subscribe to the workers' compensation fund shall be denied benefits
provided by this chapter because the employer failed to subscribe or
because the employer's account is either delinquent or in default.
(h)(1) The provisions of this section shall not deprive any
individual of any cause of action which has accrued as a result of an
injury or death which occurred during any period of delinquency not
resolved in accordance with the provisions of this article, or
subsequent failure to comply with the terms of the repayment agreement.
(2) Upon withdrawal from the fund or termination of election of
any employer, the employer shall be refunded the balance due the
employer of its deposit, after deducting all amounts owed by the
employer to the workers' compensation fund and other agencies of this
state, and the commission shall notify the employees of the employer
of the termination in the manner as the commission may consider best
and sufficient.
(3) Notice to employees provided for in this section shall be
given by posting written notice that the employer is defaulted under
the compensation law of West Virginia, and in the case of employers
required by this chapter to subscribe and pay premiums to the fund,
that the defaulted employer is liable to its employees for injury or
death, both in workers' compensation benefits and in damages at common
law or by statute; and in the case of employers not required by this
chapter to subscribe and pay premiums to the fund, but voluntarily
electing to do so as provided in this article, that neither the
employer nor the employees are protected by the law as to any injury
or death sustained after the date specified in the notice. The notice shall be in the form prescribed by the commission and shall be posted
in a conspicuous place at the chief works of the employer, as it
appears in records of the commission. If the chief works of the
employer cannot be found or identified, the notices shall be posted at
the front door of the courthouse of the county in which the chief works
are located, according to the commission's records. Any person who
shall, prior to the reinstatement of the employer, as provided for in
this section, or prior to sixty days after the posting of the notice,
whichever shall first occur, remove, deface or render illegible the
notice, shall be guilty of a misdemeanor and, upon conviction thereof,
shall be fined one thousand dollars. The notice shall state this
provision upon its face. The commission may require any sheriff,
deputy sheriff, constable or other official of the state of West
Virginia, authorized to serve civil process, to post the notice and to
make return thereof of the fact of the posting to the commission. Any
failure of the officer to post any notice within ten days after he or
she has received the notice from the commission, without just cause or
excuse, constitutes a willful failure or refusal to perform a duty
required of him or her by law within the meaning of section twenty-
eight, article five, chapter sixty-one of this code. Any person
actually injured by reason of the failure has an action against the
official, and upon any official bond he or she may have given, for the
damages as the person may actually have incurred, but not to exceed,
in the case of any surety upon the bond, the amount of the penalty of
the bond. Any official posting the notice as required in this
subdivision is entitled to the same fee as is now or may hereafter be
provided for the service of process in suits instituted in courts of record in the state of West Virginia. The fee shall be paid by the
commission out of any funds at its disposal, but shall be charged by
the commission against the account of the employer to whose delinquency
the notice relates.
§23-2-5a. Collection of premiums from defaulting employers; interest
and penalties; civil remedies; creation and enforcement of lien
against employer and purchaser; duty of secretary of state to
register liens; distraint powers; insolvency proceedings;
secretary of state to withhold certificates of dissolution;
injunctive relief; bond; attorney fees and costs.
(a) The workers' compensation commission in the name of the state
may commence a civil action against an employer who, after due notice,
defaults in any payment required by this chapter. If judgment is
against the employer, the employer shall pay the costs of the action.
A civil action under this section shall be given preference on the
calendar of the court over all other civil actions. Upon prevailing
in a civil action, the commission is entitled to recover its attorneys'
fees and costs of action from the employer.
(b) In addition to the provisions of subsection (a) of this
section, any payment, interest and penalty due and unpaid under this
chapter is a personal obligation of the employer immediately due and
owing to the commission and shall, in addition, be a lien enforceable
against all the property of the employer: Provided, That the lien shall
not be enforceable as against a purchaser (including a lien creditor)
of real estate or personal property for a valuable consideration
without notice, unless docketed as provided in section one, article
ten-c, chapter thirty-eight of this code: Provided, however, That the lien may be enforced as other judgment liens are enforced through the
provisions of said chapter and the same is considered deemed by the
circuit court to be a judgment lien for this purpose.
(c) In addition to all other civil remedies prescribed, the
commission may in the name of the state, after giving appropriate
notice as required by due process, distrain upon any personal property,
including intangible property, of any employer delinquent for any
payment, interest and penalty thereon. If the commission has good
reason to believe that the property or a substantial portion of the
property is about to be removed from the county in which it is
situated, upon giving appropriate notice, either before or after the
seizure, as is proper in the circumstances, the commission may likewise
distrain in the name of the state before the delinquency occurs. For
that purpose, the commission may require the services of a sheriff of
any county in the state in levying the distress in the county in which
the sheriff is an officer and in which the personal property is
situated. A sheriff collecting any payment, interest and penalty
thereon is entitled to the compensation as provided by law for his or
her services in the levy and enforcement of executions. Upon
prevailing in any distraint action, the commission is entitled to
recover its attorneys' fees and costs of action from the employer.
(d) In case a business subject to the payments, interest and
penalties thereon imposed under this chapter is operated in connection
with a receivership or insolvency proceeding in any state court in this
state, the court under whose direction the business is operated shall,
by the entry of a proper order or decree in the cause, make provisions,
so far as the assets in administration will permit, for the regular payment of the payments, interest and penalties as they become due.
(e) The secretary of state of this state shall withhold the
issuance of any certificate of dissolution or withdrawal in the case
of any corporation organized under the laws of this state or organized
under the laws of any other state and admitted to do business in this
state, until notified by the commission that all payments, interest and
penalties thereon against the corporation which is an employer under
this chapter have been paid or that provision satisfactory to the
commission has been made for payment.
(f) In any case when an employer required to subscribe to the
fund defaults in payments of premium, premium deposits, penalty or
interest thereon, for as many as two calendar quarters, which quarters
need not be consecutive, and remains in default after due notice, the
commission may bring action in the circuit court of Kanawha County to
enjoin the employer from continuing to carry on the business in which
the liability was incurred: Provided, That the commission may as an
alternative to this action require the delinquent employer to file a
bond in the form prescribed by the commission with satisfactory surety
in an amount not less than fifty percent more than the payments,
interest and penalties due.
§23-2-5c. Statute of limitations; effective date for new payments;
previous payments due not affected.
For payments due after the effective date of the amendment and
reenactment of this section during the year one thousand nine hundred
ninety-three, every action or process to collect any premium, premium
deposit, interest or penalty due from an employer pursuant to this
article by the executive director shall be brought or issued within five years next after the date on which the employer is required by the
section imposing the premium, premium deposit, interest or penalty to
file a report and pay the amount due thereunder. The limitation
provided by this section shall also apply to enforcement of the lien,
if any, securing the payment of the premium, premium deposit, interest
or penalty, but shall not apply in the event of fraud or in the event
the employer wholly fails to file the report required by the section
imposing the premium, premium deposit, interest or penalty. For
payments that were due prior to the effective date of this section,
there continues to be no limitation on when actions or processes may
be brought or issued. For every debt collectible under this section
which first becomes due and owing after the effective date of the
amendment and reenactment of this section during the year two thousand
three, every action or process to collect the debt shall be brought or
issued within ten years after the date on which the employer is
required to file a report and pay the amount assessed or owed to the
commission.
§23-2-5d. Uncollectible receivables; write-offs.
Notwithstanding any other provision to the contrary, the
executive director, with the approval of the board of managers, may
write-off any uncollected receivable due under the provisions of this
article or article four of this chapter which the executive director
and the board of managers determine uncollectible.
§23-2-6. Exemption of contributing employers from liability.
Any employer subject to this chapter who subscribes and pays into
the workers' compensation fund the premiums provided by this chapter
or who elects to make direct payments of compensation as provided in this section is not liable to respond in damages at common law or by
statute for the injury or death of any employee, however occurring,
after so subscribing or electing, and during any period in which the
employer is not in default in the payment of the premiums or direct
payments and has complied fully with all other provisions of this
chapter. Continuation in the service of the employer shall be
considered a waiver by the employee and by the parents of any minor
employee of the right of action as aforesaid, which the employee or his
or her parents would otherwise have: Provided, That in case of
employers not required by this chapter to subscribe and pay premiums
into the workers' compensation fund, the injured employee has remained
in the employer's service with notice that his or her employer has
elected to pay into the workers' compensation fund the premiums
provided by this chapter, or has elected to make direct payments as
aforesaid.
§23-2-9. Election of employer or employers' group to be self-insured
and to provide own system of compensation; exceptions;
catastrophe coverage; self administration; rules; penalties;
regulation of self-insurers.
(a) Notwithstanding any provisions of this chapter to the
contrary, the following types of employers or employers' groups may
apply for permission to self-insure their workers' compensation risk
including their risk of catastrophic injuries.
(1) The types of employers are:
(A) Any employer who is of sufficient capability and financial
responsibility to ensure the payment to injured employees and the
dependents of fatally injured employees of benefits provided for in this chapter at least equal in value to the compensation provided for
in this chapter;
(B) Any employer of such capability and financial responsibility
who maintains its own benefit fund or system of compensation to which
its employees are not required or permitted to contribute and whose
benefits are at least equal in value to those provided for in this
chapter; or
(C) Any group of employers who are subject to the same collective
bargaining agreement or who are in a collective bargaining group may
apply to the commission to collectively self-insure their obligations
under this chapter. The employers' group must individually and
collectively meet the conditions set forth in paragraph (A) or (B) of
this subdivision. There shall be joint and several liability for all
groups of employers who choose to self-insure under the provisions of
this article.
(2) In order to be approved for self-insurance status, the
employer shall:
(A) Have an effective health and safety program at its
workplaces; and
(B) Provide security or bond in an amount and form determined by
the executive director with the approval of the board of managers which
shall balance the employer's financial condition based upon an analysis
of its audited financial statements and the full accrued value of
current liability for future claim payments based upon generally
accepted actuarial and accounting principles of the employer's existing
and expected liability.
.
(3) Any employer whose record upon the books of the commission
shows a liability, as determined on an accrued basis against the
workers' compensation fund incurred on account of injury to or death
of any of the employer's employees, in excess of premiums paid by the
employer, shall not be granted the right, individually and directly or
from the benefit funds or system of compensation, to be self-insured
until the employer has paid into the workers' compensation fund the
amount of the excess of liability over premiums paid, including the
employer's proper proportion of the liability incurred on account of
catastrophes or second injuries as defined in section one, article
three of this chapter and charged against such fund.
(4) Upon a finding that the employer has met all of the
requirements of this section, the employer may be permitted self-
insurance status. An annual review of each self-insurer's continuing
ability to meet its obligations and the requirements of this section
shall be made by the workers' compensation commission. This review
shall include a redetermination of the amount of security or bond which
shall be provided by the employer. Failure to provide any new amount
or form of security or bond may cause the employer's self-insurance
status to be terminated by the workers' compensation commission. The
security or bond provided by employers prior to the second day of
February, one thousand nine hundred ninety-five, shall continue in full
force and effect until the performance of the employer's annual review
and the entry of any appropriate decision on the amount or form of the
employer's security or bond.
(5) Whenever a self-insured employer furnishes security or bond,
including replacement and amended bonds and other securities, as surety to ensure the employer's or guarantor's payment of all obligations
under this chapter for which the security or bond was furnished, the
security or bond shall be in the most current form or forms approved
and authorized by the commission for use by the employer or its
guarantors, surety companies, banks, financial institutions or others
in its behalf for that purpose.
(b)(1) Notwithstanding any provision in this chapter to the
contrary, self-insured employers shall, effective the first day of
July, two thousand four, administer their own claims. The executive
director shall, pursuant to rules promulgated by the board of managers,
regulate the administration of claims by employers granted permission
to self-insure their obligations under this chapter. Such rules shall
be promulgated at least thirty days prior to the first day of July, two
thousand four. A self-insured employer shall comply with rules
promulgated by the board of managers governing the self-administration
of its claims.
(2) An employer or employers' group who self-insures its risk and
self-administers its claims shall exercise all authority and
responsibility granted to the commission in this chapter and provide
notices of action taken to effect the purposes of this chapter to
provide benefits to persons who have suffered injuries or diseases
covered by this chapter. An employer or employers' group granted
permission to self-insure and self-administer its obligations under
this chapter shall at all times be bound and shall comply fully with
all of the provisions of this chapter. Furthermore, all of the
provisions contained in article four of this chapter pertaining to
disability and death benefits are binding on and shall be strictly adhered to by the self-insured employer in its administration of claims
presented by employees of the self-insured employer. Violations of the
provisions of this chapter and such rules relating to this chapter as
may be approved by the board of managers may constitute sufficient
grounds for the termination of the authority for any employer to self-
insure its obligations under this chapter. Claim notices currently
generated by the commission on behalf of self-insured employers must
be generated and sent by the self-insured employer or its third-party
administrator.
(c) Each self-insured employer shall, on or before the last day
of the first month of each quarter, file with the commission a
certified statement of the total gross wages and earnings of all of the
employer's employees subject to this chapter for the preceding quarter.
Each self-insured employer shall pay into the workers' compensation
fund as portions of its self-insured premium tax:
(1) A sum sufficient to pay the employer's proper portion of the
expense of the administration of this chapter;
(2) A sum sufficient to pay the employer's proper portion of the
expense of claims for those employers who are in default in the payment
of premium taxes or other obligations;
(3) A sum sufficient to pay the employer's fair portion of the
expenses of the disabled workers' relief fund;
(4) A sum sufficient to maintain as an advance deposit an amount
equal to the previous quarter's payment of each of the foregoing three
sums;
(5) A sum as determined by the commission to be sufficient to pay
the employer's portion of rates, surcharges or deficit management and deficit reduction assessments; and
(6) A sum as determined by the commission to pay the employer's
portion of self-insured catastrophic injury benefits, and second injury
payments on all self-insured second injury claims other than second
injury claims for those employers self-insured for second injury. Any
employer previously self-insured for second injury benefits shall
continue to be responsible for payment of those benefits.
(d) The required payments to the employer's injured employees or
dependents of fatally injured employees as benefits provided for by
this chapter including second injury benefits and catastrophic injury
benefits, if applicable, shall constitute the remaining portion of the
self-insurer's premium tax.
(e) Notwithstanding any provision of subsection (d) of this
section to the contrary, except for those increases made effective for
fiscal year two thousand four by action of the compensation programs
performance council heretofore established in article three, chapter
twenty-one-a of this code taken prior to the effective date of the
amendment and reenactment of this section, the portion of the premium
taxes for each self-insured employer as determined under subdivisions
(1) through (6), inclusive, subsection (c) of this section shall not
be increased during fiscal years two thousand four, two thousand five
and two thousand six.
(f)(1) If an employer defaults in the payment of any portion of
its self-insured premium taxes, surcharges or assessments, the
commission shall, in an appropriate case, determine the full accrued
value based upon generally accepted actuarial and accounting principles
of the employer's liability including the costs of all awarded claims and of all incurred but not reported claims. The amount determined
may, in an appropriate case, be assessed against the employer. The
commission may demand and collect the present value of the defaulted
tax liability. Interest shall accrue upon the demanded amount as
provided for in section thirteen of this article until the premium tax
is fully paid. Payment of all amounts then due to the commission and
to the employer's employees is a sufficient basis for reinstating the
employer to good standing with the fund. In addition, any self-insured
employer who, without good cause, ceases to make required payments to
the employer's injured employees or dependents of fatally injured
employees as benefits provided for by this chapter including second
injury benefits and catastrophic injury benefits, if applicable, is in
default. The board of managers shall establish by rule the procedures
by which the existence or nonexistence of good cause is to be
determined by the commission.
(2) Premium tax assessments are special revenue taxes under and
according to the provisions of state workers' compensation law and are
considered to be tax claims, as priority claims or administrative
expense claims according to those provisions under the law provided in
the United States bankruptcy code, Title 11 of the United States Code.
In addition, as the same was previously intended by the prior
provisions of this section, this amendment and reenactment is for the
purpose of clarification of the taxing authority of the workers'
compensation commission.
(g) Each self-insured employer shall elect whether or not to
self-insure its catastrophic injury risk as defined in subsection (c),
section one, article three of this chapter. A self-insured employer who elects to insure its catastrophic risk through a policy of excess
insurance obtained through a private insurance carrier approved by the
commission shall provide a copy of the policy to the commission.
(1) If the employer does not elect to self-insure its
catastrophic risk, the employer shall pay premium taxes for this
coverage in the same manner as is provided for in section four of this
article and in rules adopted to implement that section. If the
employees of that employer suffer injury or death from a catastrophe,
the payment of the resulting benefits shall be made from the
catastrophe reserve of the surplus fund provided for in subsection (b),
section one, article three of this chapter. Any portion of an
employer's catastrophic liability insured and paid under a policy of
insurance purchased by the employer shall not be included in the
liabilities upon which the employer's security or bond is determined
in subsection (a) of this section.
(2) If an otherwise self-insured employer elects to self-insure
its catastrophic risk, the security or bond required in subsection (a)
of this section shall include the liability for the catastrophic risk.

(h) For those employers previously permitted to self-insure
their second injury risks, the amount of the security or bond required
in subsection (a) of this section shall include the liability for that
risk. All benefits provided for by this chapter which are awarded to
the employer's employees which constitute second injury life awards
shall be paid by the employer and not the commission.


(i) The commission may create, implement, establish and
administer a perpetual self-insurance security risk pool of funds,
sureties, securities, insurance provided by private insurance carriers or other states' programs, and other property, of both real and
personal properties, to secure the payment of obligations of self-
insured employers. If a pool is created, the board of managers shall
adopt rules for the organizational plan, participation, contributions
and other payments which may be required of self-insured employers
under this section. The board of managers may adopt a rule authorizing
the commission to assess each self-insured employer in proportion
according to each employer's portion of the unsecured obligation and
liability or to assess according to some other method provided for by
rule which shall properly create and fund the risk pool to serve the
needs of employees, employers and the workers' compensation fund by
providing adequate security. The board of managers, in establishing
a security risk pool, may authorize the executive director to use any
assessments, premium taxes and revenues and appropriations as may be
made available to the commission.
(j) Any self-insured employer which has had a period of
inactivity due to the nonemployment of employees which results in its
reporting of no wages on reports to the commission for a period of four
or more consecutive quarters shall have its status at the commission
inactivated and shall apply for reactivation to status as a self-
insured employer prior to its reemployment of employees. Despite the
inactivation, the self-insured employer shall continue to make payments
on all awards for which it is responsible. Upon application for
reactivation of its status as an operating self-insured employer, the
employer shall document that it meets the eligibility requirements
needed to maintain self-insured status under this section and any rules
adopted to implement it. If the employer is unable to requalify and obtain approval for reactivation, the employer shall, effective with
the date of employment of any employee, become a subscriber to the
workers' compensation fund, but shall continue to be a self-insurer as
to the prior period of active status and to furnish security or bond
and meet its prior self-insurance obligations.
(k) In any case under the provisions of this section that require
the payment of compensation or benefits by an employer in periodical
payments and the nature of the case makes it possible to compute the
present value of all future payments, the commission may, in its
discretion, at any time compute and permit to be paid into the workers'
compensation fund an amount equal to the present value of all unpaid
future payments on the award or awards for which liability exists in
trust. Thereafter, the employer shall be discharged from any further
portion of premium tax liability upon the award or awards and payment
of the award or awards shall be assumed by the commission.
(l) Any employer subject to this chapter, who elects to carry the
employer's own risk by being self-insured and who has complied with the
requirements of this section and of any applicable rules, shall not be
liable to respond in damages at common law or by statute for the injury
or death of any employee, however occurring, after the election's
approval and during the period that the employer is allowed to carry
the employer's own risk.
(m) An employer may not hire any person or group to self-
administer claims under this chapter as a third-party administrator
unless the person or group has been determined to be qualified to be
a third-party administrator by the commission pursuant to rules adopted
by the board of managers. Any person or group whose status as a third-party administrator has been revoked, suspended or terminated by the
commission shall immediately cease administration of claims and shall
not administer claims unless subsequently authorized by the commission.
§23-2-10. Application of chapter to interstate commerce.
(a) In case any employer within the meaning of this chapter is
also engaged in interstate or foreign commerce, and for whom a rule of
liability or method of compensation has been established by the
Congress of the United States, this chapter applies to him or her only
to the extent that his or her mutual connection with work in this state
is clearly separable and distinguishable from his or her interstate
work, and to the extent that the work in this state is clearly
separable and distinguishable from his or her interstate work, the
employer is subject to the terms and provisions of this chapter in like
manner as all other employers under this chapter. Payments of premiums
shall be on the basis of the payroll of those employees who perform
work in this state only.
(b) Unless and until the Congress of the United States has by
appropriate legislation established a rule of liability or method of
compensation governing employers and employees engaged in commerce
within the purview of the commerce clause of the United States
Constitution (article I, section 8), section one of this article
applies without regard to the interstate or intrastate character or
nature of the work or business engaged in.
§23-2-11. Partial invalidity of chapter.
If any employer is adjudicated to be outside the lawful scope of
this chapter, the chapter shall not apply to him or her or his or her
employee; or if any employee is adjudicated to be outside the lawful scope of this chapter, because of remoteness of his or her work from
the hazard of his or her employer's work, the adjudication shall not
impair the validity of this chapter in other respects and in every case
an accounting in accordance with the justice of the case shall be had
of moneys received. If the provisions of this chapter for the creation
of the workers' compensation fund, or the provisions of this chapter
making the compensation to the employee provided in it exclusive of any
other remedy on the part of the employee, is held invalid, the entire
chapter shall be invalidated and an accounting according to the justice
of the case shall be had of money received. In other respects an
adjudication of invalidity of any part of this chapter shall not affect
the validity of the chapter as a whole or any part of this chapter.
§23-2-12. Effect of repeal or invalidity of chapter on action for
damages.
If the provisions of this chapter relating to compensation for
injuries to, or death of, workers are repealed or adjudged invalid or
unconstitutional, the period intervening between the occurrence of any
injury or death and the repeal, or the final adjudication of invalidity
or unconstitutionality, shall not be computed as a part of the time
limited by law for the commencement of any action relating to the
injuries or death, but the amount of any compensation which may have
been paid on account of injury or death shall be deducted from any
judgment for damages recovered on account of the injury or death.
§23-2-13. Interest on past-due payments; reinstatement agreements.
Effective the first day of July, one thousand nine hundred
ninety-nine, payments unpaid on the date on which due and payable shall
immediately begin bearing interest as specified in this section. The interest rate per annum for each fiscal year shall be calculated as the
greater of the commission's current discount rate or the prime rate
plus four percent, each rounded to the nearest whole percent. The
discount rate shall be determined by the board of managers on an annual
basis. The prime rate shall be the rate published in the Wall Street
Journal on the last business day of the commission's prior fiscal year
reflecting the base rate on corporate loans posted by at least seventy-
five percent of the nation's thirty largest banks. This same rate of
interest shall be applicable to all reinstatement agreements entered
into by the commission pursuant to section five of this article on and
after the effective date of this section: Provided, That if an employer
enters into a subsequent reinstatement agreement within seven years of
the date of the first agreement, the interest rate shall be eighteen
percent per annum. Interest shall be compounded quarterly until
payment plus accrued interest is received by the commission: Provided,
however, That on and after the date of execution of a reinstatement
agreement, for determining future interest on any past-due premium,
premium deposit, and past compounded interest thereon, any
reinstatement agreement entered into by the commission shall provide
for a simple rate of interest, determined in accordance with the
provisions of this section which is not subject to change during the
life of the reinstatement agreement for the future interest. Interest
collected pursuant to this section shall be paid into the workers'
compensation fund: Provided further, That in no event shall the rate
of interest charged a political subdivision of the state or a volunteer
fire department pursuant to this section exceed ten percent per annum.
§23-2-14. Sale or transfer of business; attachment of lien for premium, etc., payments due; criminal penalties for failure to
pay; creation and avoidance or elimination of lien; enforcement
of lien; successor liability.
(a) If any employer sells or otherwise transfers substantially
all of the employer's assets, so as to give up substantially all of the
employer's capacity and ability to continue in the business in which
the employer has previously engaged:
(1) The employer's premium taxes, premium deposits, interest and
other payments owed to the commission are due and owing to the
commission upon the execution of the agreement of sale or other
transfer;
(2) Any repayment agreement entered into by the employer with the
commission pursuant to section five of this article terminates upon the
execution of the agreement of sale or other transfer and all amounts
owed to the commission but not yet paid become due; and
(3) Upon execution of an agreement of sale or other transfer, as
aforesaid, the commission shall continue to have a lien, as provided
for in section five-a of this article, against all of the remaining
property of the employer as well as all of the sold or transferred
assets. The lien constitutes a personal obligation of the employer.
(b) Notwithstanding any provisions of section five-a of this
article to the contrary, in the event that a new employer acquires by
sale or other transfer or assumes all or substantially all of a
predecessor employer's assets:
(1) Any liens for payments owed to the commission for premium
taxes, premium deposits, interest or other payments owed to the
commission by the predecessor employer shall be extended to the successor employer;
(2) Any liens held by the commission against the predecessor
employer's property shall be extended to all of the assets of the
successor employer; and
(3) Liens acquired in the manner described in subdivisions (1)
and (2) of this subsection are enforceable by the commission to the
same extent as provided for the enforcement of liens against the
predecessor employer in section five-a of this article.
(c) Notwithstanding the provisions of section five-a of this
article to the contrary, if any employer as described in subsection (a)
of this section sells or otherwise transfers a portion of the
employer's assets so as to affect the employer's capacity to do
business:
(1) The employer's premium taxes, premium deposits, interest and
other payments owed to the commission are due and owing to the
commission upon the execution of the agreement of sale or other
transfer;
(2) Any repayment agreement entered into by the employer with the
commission pursuant to section five of this article terminates upon the
execution of the aforesaid agreement of sale or other transfer and all
amounts owed to the commission but not yet paid shall become due; and
(3) Upon execution of an agreement of sale or other transfer, as
aforesaid, the commission shall continue to have a lien, as provided
for in section five-a of this article, against all of the remaining
property of the employer as well as all the sold or transferred assets.
The lien constitutes a personal obligation of the employer.
(d) If an employer subject to subsection (a), (b) or (c) of this section pays to the commission, prior to the execution of an agreement
of sale or other transfer, a sum sufficient to retire all of the
indebtedness that the employer would owe at the time of the execution,
the commission shall issue a certificate to the employer stating that
the employer's account is in good standing with the commission and that
the assets may be sold or otherwise transferred without the attachment
of the commission's lien. An agreement of sale or other transfer may
provide for the creation of an escrow account into which the employers
shall pay the full amount owed to the commission. The subsequent
timely payment of that full amount to the commission operates to place
both employers in good standing with the commission to the extent of
the predecessor employer's liabilities retroactive to the date of sale
or other transfer. In the event that the employer would not owe any
sum to the commission on the aforesaid date of execution, a certificate
shall also be issued to the employer upon the employer's request
stating that the employer's account is in good standing with the
commission and that the assets may be sold or otherwise transferred
without the attachment of the commission's lien.
(e) As used in this article, the term "assets" means all property
of whatever type in which the employer has an interest including, but
not limited to, goodwill, business assets, customers, clients,
contracts, access to leases such as the right to sublease, assignment
of contracts for the sale of products, operations, stock of goods or
inventory, accounts receivable, equipment or transfer of substantially
all of its employees.
(f) The transfer of any assets of the employer is presumed to be
a transfer of all or substantially all of the assets if the transfer affects the employer's capacity to do business. The presumption can
be overcome upon petition presented and an administrative hearing in
accordance with section seventeen of this article.
(g) The provisions of this section are expressly intended to
impose upon successor employers the duty of obtaining from the
commission or predecessor employer, prior to the date of the
acquisition, a valid "certificate of good standing to transfer a
business or business assets" to verify that the predecessor employer's
account with the commission is in good standing.
§23-2-15. Liabilities of successor employer; waiver of payment by
commission; assignment of predecessor employer's premium rate to
successor.
(a) At any time prior to or following the acquisition described
in subsection (a), (b) or (c), section fourteen of this article, the
buyer or other recipient may file a certified petition with the
commission requesting that the commission waive the payment by the
buyer or other recipient of premiums, premium deposits, interest and
imposition of the modified rate of premiums attributable to the
predecessor employer or other penalty, or any combination thereof. The
commission shall review the petition by considering the following seven
factors:
(1) The exact nature of the default;
(2) The amount owed to the commission;
(3) The solvency of the fund;
(4) The financial condition of the buyer or other recipient;
(5) The equities exhibited towards the fund by the buyer or other
recipient during the acquisition process;
(6) The potential economic impact upon the state and the specific
geographic area in which the buyer or other recipient is to be or is
located, if the acquisition were not to occur; and
(7) Whether the assets are purchased in an arms-length
transaction.
Unless requested by a party or by the commission, no hearing need
be held on the petition. However, any decision made by the commission
on the petition shall be in writing and shall include appropriate
findings of fact and conclusions of law. The decision shall be
effective ten days following notice to the public of the decision
unless an objection is filed in the manner provided in this section.
Notice shall be given by the commission's filing with the secretary of
state, for publication in the state register, of a notice of the
decision. At the time of filing the notice of its decision, the
commission shall also file with the secretary of state a true copy of
the decision. The publication shall include a statement advising that
any person objecting to the decision must file, within ten days after
publication of the notice, a verified response with the commission
setting forth the objection and the basis for the objection. If any
objection is filed, the commission shall hold an administrative
hearing, conducted pursuant to article five, chapter twenty-nine-a of
this code, within fifteen days of receiving the response unless the
buyer or other recipient consents to a later hearing. Nothing in this
subsection shall be construed to be applicable to the seller or other
transferor or to affect in any way a proceeding under sections five and
five-a of this article.
(b) In the factual situations set forth in subsection (a), (b) or (c), section fourteen of this article, if the predecessor's modified
rate of premium tax, as calculated in accordance with section four of
this article, is greater than the manual rate of premium tax, as
calculated in accordance with that section, for other employers in the
same class or group, and if the new employer does not already have a
modified rate of premium, it shall also assume the predecessor
employer's modified rates for the payment of premiums as determined
under sections four and five of this article until sufficient time has
elapsed for the new employer's experience record to be combined with
the experience record of the predecessor employer so as to calculate
the new employer's own modified rate of premium tax.
§23-2-16. Acceptance or assignment of premium rate.
(a) If a new corporate employer which is not subject to the
provisions of section fifteen of this article is created by the
officers or shareholders of a preexisting corporate employer and if the
new corporate employer and the preexisting corporate employer: (1) Are
managed by the same, or substantially the same, management personnel;
(2) have a common ownership by at least forty percent of each
corporation's shareholders; (3) are in the same class or group as
determined by the executive director under the provisions of section
four of this article; and (4) if the preexisting corporate employer's
account is in good standing with the commission, at the time the new
corporate employer registers with the commission, the new corporate
employer may request that the commission assign to it the same rate of
payment of premiums as that assigned to the preexisting corporate
employer. If the executive director decides that the granting of the
request is in keeping with his or her fiduciary obligations to the workers' compensation fund, the executive director may grant the
request of the employer.
(b) If a new corporate employer which is not subject to the
provisions of section fifteen of this article is created by the
officers or shareholders of a preexisting corporate employer and if the
new corporate employer and the preexisting corporate employer: (1) Are
managed by the same, or substantially the same, management personnel;
(2) have a common ownership by at least forty percent of each
corporation's shareholders; and (3) are in the same class or group as
determined by the executive director under the provisions of section
four of this article, at any time within one year of the new corporate
employer's registration with the commission, the executive director may
decide that, in keeping with his or her fiduciary obligations to the
workers' compensation fund, the new corporate employer shall be
assigned the same rate of payment of premiums as that assigned to the
preexisting corporate employer at any time within the aforesaid one-
year period: Provided, That if the new corporate employer fails to
reveal to the commission on the forms provided by the commission that
its situation meets the factual requirements of this section, the
commission may demand payment from the new corporate employer in an
amount sufficient to eliminate the deficiency in payments by the new
corporate employer from the date of registration to the date of
discovery plus interest thereon as provided for by section thirteen of
this article. The commission may use its powers pursuant to section
five-a of this article to collect the amount due.
§23-2-17. Employer right to hearing; content of petition; appeal.
Notwithstanding any provision in this chapter to the contrary and notwithstanding any provision in section five, article five, chapter
twenty-nine-a of this code to the contrary, in any situation where an
employer objects to a decision or action of the executive director made
under the provisions of this article, the employer is entitled to file
a petition demanding a hearing upon the decision or action. The
petition must be filed within thirty days of the employer's receipt of
notice of the disputed executive director's decision or action or, in
the absence of such receipt, within sixty days of the date of the
executive director's making the disputed decision or taking the
disputed action, the time limitations being hereby declared to be a
condition of the right to litigate the decision or action and therefore
jurisdictional.
The employer's petition shall clearly identify the decision or
action disputed and the bases upon which the employer disputes the
decision or action. Upon receipt of a petition, the executive director
shall schedule a hearing which shall be conducted in accordance with
the provisions of article five, chapter twenty-nine-a of this code.
An appeal from a final decision of the executive director shall be
taken in accord with the provisions of articles five and six of said
chapter: Provided, That all appeals shall be taken to the circuit court
of Kanawha County.
ARTICLE 2A. SUBROGATION.
§23-2A-1. Subrogation; limitations; effective date.
(a) Where a compensable injury or death is caused, in whole or in
part, by the act or omission of a third party, the injured worker or,
if he or she is deceased or physically or mentally incompetent, his or
her dependents or personal representative are entitled to compensation under the provisions of this chapter and shall not by having received
compensation be precluded from making claim against the third party.
(b) Notwithstanding the provisions of subsection (a) of this
section, if an injured worker, his or her dependents or his or her
personal representative makes a claim against the third party and
recovers any sum for the claim, the commission or a self-insured
employer shall be allowed statutory subrogation with regard to medical
benefits paid as of the date of the recovery. The commission or self-
insured employer shall permit the deduction from the amount received
a reasonable attorney's fee and a reasonable portion of costs. It is
the duty of the injured worker, his or her dependents, his or her
personal representative, or his or her attorney to notify the
commission and the employer when the claim is filed against the third
party.
(c) In the event that an injured worker, his or her dependents or
personal representative makes a claim against a third party, there
shall be, and there is hereby created, a statutory subrogation lien
upon the moneys received which shall exist in favor of the commission
or self-insured employer. Any injured worker, his or her dependents
or personal representative who receives moneys in settlement in any
manner of a claim against a third party remains subject to the
subrogation lien until payment in full of the amount permitted to be
subrogated under subsection (b) of this section is paid.
(d) The right of subrogation granted by the provisions of this
section shall not attach to any claim arising from a right of action
which arose or accrued, in whole or in part, prior to the effective
date of the amendment and reenactment of this section during the year two thousand three.
ARTICLE 2B. OCCUPATIONAL SAFETY AND HEALTH PROGRAMS.
§23-2B-1. Occupational safety and health activities; voluntary
compliance; consultative services.
In order to carry out the purposes of this chapter and to
encourage voluntary compliance with occupational safety and health
laws, regulations, rules and standards and to promote more effective
workplace health and safety programs, the executive director acting in
conjunction with the board of managers shall:
(a) Develop greater knowledge and interest in the causes and
prevention of industrial accidents, occupational diseases and related
subjects through:
(1) Research, conferences, lectures and the use of public
communications media;
(2) The collection and dissemination of accident and disease
statistics; and
(3) The publication and distribution of training and accident
prevention materials, including audio and visual aids;
(b) Provide consultative services for employers on safety and
health matters and prescribe procedures which will permit any employer
to request a special inspection or investigation, focused on specific
problems or hazards in the place of employment of the employer or to
request assistance in developing a plan to correct such problems or
hazards, which will not directly result in a citation and civil
penalty; and
(c) Place emphasis, in the research, education and consultation
program, on development of a model for providing services to groups of small employers in particular industries and their employees and for
all employers whose experience modification factor for rate-setting
purposes is in excess of the criteria established by the board of
managers.
§23-2B-2. Mandatory programs; safety committees; requirements; rules;
exceptions.
(a) Based upon and to the extent authorized by criteria
established by the executive director, the commission is authorized to
conduct special inspections or investigations focused on specific
problems or hazards in the workplace with or without the agreement of
the employer. The executive director shall issue a report on his or
her findings and shall furnish a copy of the report to the employer and
to any bargaining unit representing the employees of the employer. The
executive director may share information obtained or developed pursuant
to this article with other governmental agencies.
(b) For any employer whose experience modification factor exceeds
the criteria established by the board of managers, the executive
director may require the employer to establish a safety committee
composed of representatives of the employer and the employees of the
employer.
(c) In carrying out the provisions of this article, the executive
director shall propose rules for promulgation which shall include, but
are not limited to, the following provisions:
(1) Prescribing the membership of the committees, training,
frequency of meetings, recordkeeping and compensation of employee
representatives on safety committees; and
(2) Prescribing the duties and functions of safety committees which include, but are not limited to:
(A) Establishing procedures for workplace safety inspections and
for investigating job-related accidents, illnesses and deaths; and
(B) Evaluating accident and illness prevention programs.
(d) An employer that is a member of a multiemployer group
operating under a collective bargaining agreement that contains
provisions regulating the formation and operation of a safety committee
that meets or exceeds the minimum requirements of this section is
considered to have met the requirements of this section.
(e) It is not the purpose of this article to either supercede the
federal Occupational Health and Safety Act program, federal Mine Safety
and Health Act program or to create a state counterpart to these
programs.
§23-2B-3. Premium rate credits; qualified loss management program;
loss management firms; penalties; rules.
(a) The executive director may establish by rule a premium credit
program for certain employers. The program is applicable solely to
regular subscribers to the workers' compensation fund and not to self-
insurers. Participation in any premium credit program is voluntary and
no employer is required to participate.
(b) The program applies a prospective credit to the premium rate
of a subscribing employer who participates in a qualified loss
management program. The prospective credit is given for a period of
up to three years: Provided, That the employer remains in the program
for a corresponding period of time.
(c) The rule shall specify the requirements of a qualified loss
management program and shall include a requirement that a recognized loss management firm participate in the program. A loss management
firm shall be recognized if it has demonstrated an ability to
significantly reduce workers' compensation losses for its client
employers by implementing a loss control management program. The
amount of credit against premium rates that may be allowed by the
executive director shall vary from firm to firm and shall be primarily
determined by the loss reduction success experienced by all of the
subscribing employers of the sponsoring loss management firm over a
period of time to be determined by the executive director.
(d) A credit is applied to the employer's premium rate for up to
three years. The amount of the credit applied to the first year is
based on the credit factor assigned to the loss management firm on the
date the employer subscribes to the program. The amount of the credit
applied to the second and third years shall be based on the credit
factor assigned to the loss management firm and in effect on each first
day of July of the pertinent year: Provided, That the applicable credit
is halved in the third year.
(e) The employer may terminate participation in the program upon
three years of continuous participation in the program without penalty.
Sooner termination may result in a penalty being applied to the
employer's premium rate.
(f) An employer who has subscribed to an existing program of a
qualified loss management firm prior to the effective date of this
section is subject to a reduction in credit as follows:
(1) Participation for one year or less shall result in credit for
the full three years;
(2) Participation for more than one year but less than two years shall result in a credit for two years;
(3) Participation for two years or more but less than three years
shall result in a credit for one year; and
(4) Participation for three years or more shall result in no
credit.
(g) This section shall not become effective until the board of
managers promulgates an appropriate rule to implement this section's
provisions.
ARTICLE 3. WORKERS' COMPENSATION FUND.
§23-3-1. Compensation fund; catastrophe and catastrophe payment
defined; compensation by employers.
(a) The commission shall establish a workers' compensation fund
from the premiums and other funds paid thereto by employers, as
provided in this section, for the benefit of employees of employers who
have paid the premiums applicable to the employers and have otherwise
complied fully with the provisions of section five, article two of this
chapter, and for the benefit, to the extent elsewhere in this chapter
set out, of employees of employers who have elected, under section
nine, article two of this chapter, to make payments into the workers'
compensation fund as provided for in this section, and for the benefit
of the dependents of all the employees, and for the payment of the
administration expenses of this chapter.
(b) A portion of all premiums that are paid into the workers'
compensation fund by subscribers not electing to carry their own risk
under section nine, article two of this chapter that is set aside to
create and maintain a reserve of the fund to cover the catastrophe
hazard and all losses not otherwise specifically provided for in this chapter. The percentage to be set aside is determined pursuant to the
rules adopted to implement section four, article two of this chapter
and shall be in an amount sufficient to maintain a solvent fund. All
interest earned on investments by the workers' compensation fund, which
is attributable to the reserve, shall be credited to the fund.
(c) A catastrophe is hereby defined as an accident in which three
or more employees are killed or receive injuries, which, in the case
of each individual, consist of: Loss of both eyes or the sight thereof;
loss of both hands or the use thereof; loss of both feet or the use
thereof; or loss of one hand and one foot or the use thereof. The
aggregate of all medical and hospital bills and other costs and all
benefits payable on account of a catastrophe is defined as "catastrophe
payment". In case of a catastrophe to the employees of an employer who
is an ordinary premium-paying subscriber to the fund, or to the
employees of an employer who, having elected to carry the employer's
own risk under section nine, article two of this chapter, has
previously elected, or may later elect, to pay into the catastrophe
reserve of the fund under the provisions of said section, the
catastrophe payment arising from the catastrophe shall not be charged
against, or paid by, the employer but shall be paid from the
catastrophe reserve of the fund.
(d) For all awards made on or after the effective date of the
amendments to this section enacted during the year two thousand three,
the following provisions relating to second injury are not applicable.
For awards made before the date specified in this subsection, if an
employee who has a definitely ascertainable physical impairment, caused
by a previous occupational injury, occupational pneumoconiosis or occupational disease, irrespective of its compensability, becomes
permanently and totally disabled through the combined effect of the
previous injury and a second injury received in the course of and as
a result of his or her employment, the employer shall be chargeable
only for the compensation payable for the second injury: Provided, That
in addition to the compensation, and after the completion of the
payments therefor, the employee shall be paid the remainder of the
compensation that would be due for permanent total disability out of
the workers' compensation fund. The procedure by which the claimant's
request for a permanent total disability award under this section is
ruled upon shall require that the issue of the claimant's degree of
permanent disability first be determined. Thereafter, by means of a
separate order, a decision shall be made as to whether the award is a
second injury award under this subsection or a permanent total
disability award to be charged to the employer's account or to be paid
directly by the employer if the employer has elected to be self-insured
under the provisions of section nine, article two of this chapter.

(e) Employers electing, as provided in this chapter, to
compensate individually and directly their injured employees and their
fatally injured employees' dependents shall do so in the manner
prescribed by the commission and shall make all reports and execute all
blanks, forms and papers as directed by the commission, and as provided
in this chapter.
§23-3-1a. Transfer of silicosis fund to workers' compensation fund;
claims under former article six.
Ten percent of the funds collected and held as the workers' compensation silicosis fund under the provisions of former article six
of this chapter shall be transferred to and made a part of the workers'
compensation fund provided for in the preceding section, and the
balance of the silicosis fund shall be refunded to the subscribers to
the fund in proportion to their contributions to the fund under the
provisions of former article six; and all awards previously made under
the provisions of article six shall be paid from the workers'
compensation fund, or directly by the employer, under order of the
executive director, if the employer has elected to carry his or her own
risk under the provisions of section nine, article two of this chapter:
Provided, That notwithstanding the repeal of article six, the
provisions of the article are applicable in all cases of the disease
or death, because of silicosis, or an employee whose last exposure to
silicon dioxide dust has occurred prior to the effective date of this
section, whose claim or application for compensation benefits for
silicosis, or that of his or her dependent, has not been filed prior
to that date, and whose employer, at the time of the exposure, was
subject to the provisions of article six of this chapter.
§23-3-2. Custody, investment and disbursement of funds.
The state treasurer is the custodian of the workers' compensation
fund and all premiums, deposits or other moneys payable to each fund
shall be deposited in the state treasury to the credit of the fund for
which it was assessed, transferred or collected in the manner
prescribed in this chapter. The workers' compensation fund shall
consist of the premiums and deposits provided by this chapter and any
other moneys or funds given, appropriated or otherwise designated or
accruing to it and all earnings. The fund shall be a separate and distinct fund upon the books and records of the auditor and treasurer.
Disbursements therefrom shall be made upon requisitions signed by the
executive director.
The workers' compensation fund is a participant plan as defined
in section two, article six, chapter twelve of this code and is subject
to the provisions of section nine-a of said article. The fund shall
be invested by the investment management board in accordance with said
article.
§23-3-3. Investment of surplus funds required.
Whenever there is in the state treasury any funds belonging to
the workers' compensation fund not likely, in the opinion of the
commission, to be required for immediate use, it is the duty of the
investment management board to invest the funds as prescribed in
section two of this article. Whenever it becomes necessary or
expedient to use any of the invested funds, the investment management
board, at the direction of the commission, shall collect, sell or
otherwise realize upon any investment to the amount considered
necessary or expedient to use.
§23-3-5. Authorization to require the electronic invoices and
transfers.
(a) The workers' compensation commission shall on or before the
thirty-first day of December, two thousand five, establish a program
to require the acceptance of disbursements by electronic transfer from
the workers' compensation fund to employers, vendors and all others
lawfully entitled to receive such disbursements: Provided, That until
the thirty-first day of December, two thousand five, claimants may not
be required to accept the transfers but may elect to do so.
(b) The commission may establish a program to require payments of
deposits, premiums and other funds into the workers' compensation fund
by electronic transfer of funds.
(c) The commission may establish a program that invoices and
other charges against the workers' compensation fund may be submitted
to the commission by electronic means.
(d) Any program authorized by this section must be implemented
through a rule promulgated by the board of managers.
§23-3-6. Emergency fiscal measures.
(a) In addition to other measures intended by the Legislature to
address the imminent threat to the fiscal solvency of the workers'
compensation fund, the Legislature finds that the prudent use of
available moneys may be necessary to supplement ongoing efforts to
reduce and eliminate that threat. The provisions of this section are
enacted for those purposes.
(b) The following measures are authorized for the purposes
described in subsection (a) of this section:
(1) Upon meeting the conditions and requirements of subsection
(a), section eight-b, article four-b of this chapter, the commission
may expend the assets described in said subsection and any income
earned thereon to satisfy the obligations of the workers' compensation
fund.
(2) Upon meeting the conditions and requirements of subsection
(b), section eight-b, article four-b of this chapter, the commission
may expend the assets described in said subsection and any income
earned thereon to satisfy the obligations of the workers' compensation
fund.
(3) In each fiscal year beginning after the thirtieth day of
June, two thousand three, it is the intent of the Legislature that,
pursuant to appropriation in the budget bill for each respective fiscal
year, five million dollars of general revenue funds be transferred to
the workers' compensation fund and that the amounts transferred be
expended to satisfy the obligations of the workers' compensation fund.
(4) (A) If in any year expenditures from the workers'
compensation fund are expected to exceed assets in that fund, the
executive director may under the following conditions request a
transfer of moneys from the principal of the West Virginia tobacco
settlement medical trust fund created in section two, article eleven-a,
chapter four of this code. Prior to requesting the transfer the
executive director shall obtain an opinion from the commission's
actuary as to the amount of the deficit in the workers' compensation
fund. Upon meeting the requirements of this subdivision, the executive
director shall, upon approval of the board of managers, submit a
written request to the joint committee on government and finance that
an amount determined by the Legislature be transferred by appropriation
from the principal of the West Virginia tobacco settlement medical
trust fund to the workers' compensation fund. Upon appropriation of
the Legislature, the commission may expend the assets transferred and
any income earned thereon to satisfy the obligations of the workers'
compensation fund.
(B) Upon any exercise of the authority granted by this
subdivision, the executive director shall not increase benefit rates
during the year as provided in section fourteen, article four of this
chapter and shall conduct an investigation into the causes of the deficit and determine the best course of action to alleviate the
shortfall.
(5) It is the intent of the Legislature that, pursuant to
legislative appropriation, fourteen million dollars of funds made
available to the state pursuant to the federal Jobs and Growth Tax
Relief Reconciliation Act of 2003, PL 108-27, be transferred to the
workers' compensation fund and that the amounts transferred be expended
to satisfy the obligations of the workers' compensation fund.
(6) It is the intent of the Legislature that, pursuant to
legislative appropriation, one million dollars will be expired from the
alcohol beverage control administration's general administrative fund
and transferred to the workers' compensation fund and that the amounts
transferred be expended to satisfy the obligations of the workers'
compensation fund.
(7) It is the intent of the Legislature that, pursuant to
legislative appropriation, four million dollars will be transferred
from the unappropriated balance of the state excess lottery reserve
fund to the workers' compensation fund and that the amounts transferred
be expended to satisfy the obligations of the workers' compensation
fund.
(8) Funds transferred to the workers' compensation fund pursuant
to the provisions of this subsection are anticipated to generate income
of at least six million dollars over the course of the three-year
period following the enactment of this section in the year two thousand
three. The commission may expend any income earned on these
transferred funds to satisfy the obligations of the workers'
compensation fund.
ARTICLE 4. DISABILITY AND DEATH BENEFITS.
§23-4-1. To whom compensation fund disbursed; occupational
pneumoconiosis and other occupational diseases included in
"injury" and "personal injury"; definition of occupational
pneumoconiosis and other occupational diseases.
(a) Subject to the provisions and limitations elsewhere in this
chapter, the commission shall disburse the workers' compensation fund
to the employees of employers subject to this chapter who have received
personal injuries in the course of and resulting from their covered
employment or to the dependents, if any, of the employees in case death
has ensued, according to the provisions hereinafter made; and also for
the expenses of the administration of this chapter, as provided in
section two, article one of this chapter: Provided, That in the case
of any employees of the state and its political subdivisions,
including: Counties; municipalities; cities; towns; any separate
corporation or instrumentality established by one or more counties,
cities or towns as permitted by law; any corporation or instrumentality
supported in most part by counties, cities or towns; any public
corporation charged by law with the performance of a governmental
function and whose jurisdiction is coextensive with one or more
counties, cities or towns; any agency or organization established by
the department of mental health for the provision of community health
or mental retardation services and which is supported, in whole or in
part, by state, county or municipal funds; board, agency, commission,
department or spending unit, including any agency created by rule of
the supreme court of appeals, who have received personal injuries in
the course of and resulting from their covered employment, the employees are ineligible to receive compensation while the employees
are at the same time and for the same reason drawing sick leave
benefits. The state employees may only use sick leave for nonjob-
related absences consistent with sick leave use and may draw workers'
compensation benefits only where there is a job-related injury. This
proviso shall not apply to permanent benefits: Provided, however, That
the employees may collect sick leave benefits until receiving temporary
total disability benefits. The division of personnel shall promulgate
rules pursuant to article three, chapter twenty-nine-a of this code
relating to use of sick leave benefits by employees receiving personal
injuries in the course of and resulting from covered employment:
Provided further, That in the event an employee is injured in the
course of and resulting from covered employment and the injury results
in lost time from work, and the employee for whatever reason uses or
obtains sick leave benefits and subsequently receives temporary total
disability benefits for the same time period, the employee may be
restored sick leave time taken by him or her as a result of the
compensable injury by paying to his or her employer the temporary total
disability benefits received or an amount equal to the temporary total
disability benefits received. The employee shall be restored sick
leave time on a day-for-day basis which corresponds to temporary total
disability benefits paid to the employer: And provided further, That
since the intent of this subsection is to prevent an employee of the
state or any of its political subdivisions from collecting both
temporary total disability benefits and sick leave benefits for the
same time period, nothing in this subsection prevents an employee of
the state or any of its political subdivisions from electing to receive either sick leave benefits or temporary total disability benefits but
not both.
(b) For the purposes of this chapter, the terms "injury" and
"personal injury" includes occupational pneumoconiosis and any other
occupational disease, as hereinafter defined, and the commission shall
also disburse the workers' compensation fund to the employees of the
employers in whose employment the employees have been exposed to the
hazards of occupational pneumoconiosis or other occupational disease
and in this state have contracted occupational pneumoconiosis or other
occupational disease, or have suffered a perceptible aggravation of an
existing pneumoconiosis or other occupational disease, or to the
dependents, if any, of the employees, in case death has ensued,
according to the provisions hereinafter made: Provided, That
compensation shall not be payable for the disease of occupational
pneumoconiosis, or death resulting from the disease, unless the
employee has been exposed to the hazards of occupational pneumoconiosis
in the state of West Virginia over a continuous period of not less than
two years during the ten years immediately preceding the date of his
or her last exposure to such hazards, or for any five of the fifteen
years immediately preceding the date of his or her last exposure. An
application for benefits on account of occupational pneumoconiosis
shall set forth the name of the employer or employers and the time
worked for each. The commission may allocate to and divide any charges
resulting from such claim among the employers by whom the claimant was
employed for as much as sixty days during the period of three years
immediately preceding the date of last exposure to the hazards of
occupational pneumoconiosis. The allocation shall be based upon the time and degree of exposure with each employer.
(c) For the purposes of this chapter, disability or death
resulting from occupational pneumoconiosis, as defined in subsection
(d) of this section shall be treated and compensated as an injury by
accident.
(d) Occupational pneumoconiosis is a disease of the lungs caused
by the inhalation of minute particles of dust over a period of time due
to causes and conditions arising out of and in the course of the
employment. The term "occupational pneumoconiosis" includes, but is
not limited to, such diseases as silicosis, anthracosilicosis, coal
worker's pneumoconiosis, commonly known as black lung or miner's
asthma, silico-tuberculosis (silicosis accompanied by active
tuberculosis of the lungs), coal worker's pneumoconiosis accompanied
by active tuberculosis of the lungs, asbestosis, siderosis, anthrax and
any and all other dust diseases of the lungs and conditions and
diseases caused by occupational pneumoconiosis which are not
specifically designated in this section meeting the definition of
occupational pneumoconiosis set forth in this subsection.
(e) In determining the presence of occupational pneumoconiosis,
X-ray evidence may be considered but shall not be accorded greater
weight than any other type of evidence demonstrating occupational
pneumoconiosis.
(f) For the purposes of this chapter, occupational disease means
a disease incurred in the course of and resulting from employment. No
ordinary disease of life to which the general public is exposed outside
of the employment is compensable except when it follows as an incident
of occupational disease as defined in this chapter. Except in the case of occupational pneumoconiosis, a disease shall be considered to have
been incurred in the course of or to have resulted from the employment
only if it is apparent to the rational mind, upon consideration of all
the circumstances: (1) That there is a direct causal connection between
the conditions under which work is performed and the occupational
disease; (2) that it can be seen to have followed as a natural incident
of the work as a result of the exposure occasioned by the nature of the
employment; (3) that it can be fairly traced to the employment as the
proximate cause; (4) that it does not come from a hazard to which
workmen would have been equally exposed outside of the employment; (5)
that it is incidental to the character of the business and not
independent of the relation of employer and employee; and (6) that it
appears to have had its origin in a risk connected with the employment
and to have flowed from that source as a natural consequence, though
it need not have been foreseen or expected before its contraction:
Provided, That compensation shall not be payable for an occupational
disease or death resulting from the disease unless the employee has
been exposed to the hazards of the disease in the state of West
Virginia over a continuous period that is determined to be sufficient,
by rule of the board of managers, for the disease to have occurred in
the course of and resulting from the employee's employment. An
application for benefits on account of an occupational disease shall
set forth the name of the employer or employers and the time worked for
each. The commission may allocate to and divide any charges resulting
from such claim among the employers by whom the claimant was employed.
The allocation shall be based upon the time and degree of exposure with
each employer.
(g) No award shall be made under the provisions of this chapter
for any occupational disease contracted prior to the first day of July,
one thousand nine hundred forty-nine. An employee shall be considered
to have contracted an occupational disease within the meaning of this
subsection if the disease or condition has developed to such an extent
that it can be diagnosed as an occupational disease.
(h) Claims for occupational disease as defined in subsection (f)
of this section, except occupational pneumoconiosis, shall be processed
in like manner as claims for all other personal injuries.
(i) On or before the first day of January, two thousand four,
workers' compensation commission shall adopt standards for the
evaluation of claimants and the determination of a claimant's degree
of whole body medical impairment in claims of carpal tunnel syndrome.
§23-4-1a. Report of injuries by employee.
Every employee who sustains an injury subject to this chapter, or
his or her representative, shall immediately on the occurrence of the
injury or as soon thereafter as practicable give or cause to be given
to the employer or any of the employer's agents a written notice of the
occurrence of the injury, with like notice or a copy of the notice to
the workers' compensation commission stating in ordinary language the
name and address of the employer, the name and address of the employee,
the time, place, nature and cause of the injury, and whether temporary
total disability has resulted from the injury. The notice shall be
given personally to the employer or any of the employer's agents, or
may be sent by certified mail addressed to the employer at the
employer's last known residence or place of business. The notice may
be given to the workers' compensation commission by mail.
§23-4-1b. Report of injuries by employers.
It is the duty of every employer to report to the commission
every injury sustained by any person in his or her employ. The report
shall be on forms prescribed by the commission and shall be made within
five days of the employer's receipt of the employee's notice of injury,
required by section one-a of this article, or within five days after
the employer has been notified by the commission that a claim for
benefits has been filed on account of such injury, whichever is sooner,
and, notwithstanding any other provision of this chapter to the
contrary, the five-day period may not be extended by the commission,
but the employer has the right to file a supplemental report at a later
date. The employer's report of injury shall include a statement as to
whether or not, on the basis of the information available, the employer
disputes the compensability of the injury or objects to the payment of
temporary total disability benefits in connection with the injury. The
statements by the employer shall not prejudice the employer's right
thereafter to contest the compensability of the injury, or to object
to any subsequent finding or award, in accordance with article five of
this chapter; but an employer's failure to make timely report of an
injury as required in this section, or statements in the report to the
effect that the employer does not dispute the compensability of the
injury or object to the payment of temporary total disability benefits
for the injury, shall be considered to be a waiver of the employer's
right to object to any interim payment of temporary total disability
benefits paid by the commission with respect to any period from the
date of injury to the date of the commission's receipt of any objection
made to the interim payments by the employer.
§23-4-1c. Payment of temporary total disability benefits directly to
claimant; payment of medical benefits; payments of benefits
during protest; right of commission to collect payments
improperly made.
(a) In any claim for benefits under this chapter, the workers'
compensation commission shall determine whether the claimant has
sustained a compensable injury within the meaning of section one of
this article and enter an order giving all parties immediate notice of
the decision.
(1) The commission may enter an order conditionally approving the
claimant's application if the commission finds that obtaining
additional medical evidence or evaluations or other evidence related
to the issue of compensability would aid the commission in making a
correct final decision. Benefits shall be paid during the period of
conditional approval; however, if the final decision is one that
rejects the claim, the payments shall be considered an overpayment.
The commission or self-insured employer may only recover the amount of
the overpayment as provided for in subsection (h) of this section.
(2) In making a determination regarding the compensability of a
newly filed claim or upon a filing for the reopening of a prior claim
pursuant to the provisions of section sixteen of this article based
upon an allegation of recurrence, reinjury, aggravation or progression
of the previous compensable injury or in the case of a filing of a
request for any other benefits under the provisions of this chapter,
the commission shall consider the date of the filing of the claim for
benefits for a determination of the following:
(A) Whether the claimant had a scheduled shutdown beginning within one week of the date of the filing;
(B) Whether the claimant received notice within sixty days of the
filing that his or her employment position was to be eliminated,
including, but not limited to, the claimant's worksite, a layoff or the
elimination of the claimant's employment position;
(C) Whether the claimant is receiving unemployment compensation
benefits at the time of the filing; or
(D) Whether the claimant has received unemployment compensation
benefits within sixty days of the filing.
In the event of an affirmative finding upon any of these four
factors, the finding shall be given probative weight in the overall
determination of the compensability of the claim or of the merits of
the reopening request.
(3) Any party may object to the order of the commission and
obtain an evidentiary hearing as provided in section one, article five
of this chapter: Provided, That if the claimant files a timely protest
to the ruling of a self-insured employer denying the compensability of
the claim, the office of judges shall provide a hearing on the protest
on an expedited basis as determined by rule of the office of judges.
(b) Where it appears from the employer's report, or from proper
medical evidence, that a compensable injury will result in a disability
which will last longer than three days as provided in section five of
this article, the commission may immediately enter an order commencing
the payment of temporary total disability benefits to the claimant in
the amounts provided for in sections six and fourteen of this article,
and the payment of the expenses provided for in subsection (a), section
three of this article, relating to the injury, without waiting for the expiration of the thirty-day period during which objections may be
filed to the findings as provided in section one, article five of this
chapter. The commission shall enter an order commencing the payment
of temporary total disability or medical benefits within fifteen days
of receipt of either the employee's or employer's report of injury,
whichever is received sooner, and also upon receipt of either a proper
physician's report or any other information necessary for a
determination. The commission shall give to the parties immediate
notice of any order granting temporary total disability or medical
benefits. When an order granting temporary total disability benefits
is made, the claimant's return-to-work potential shall be assessed.
The commission may schedule medical and vocational evaluation of the
claimant and assign appropriate personnel to expedite the claimant's
return to work as soon as reasonably possible.
(c) The commission may enter orders granting temporary total
disability benefits upon receipt of medical evidence justifying the
payment of the benefits. The commission may not enter an order
granting prospective temporary total disability benefits for a period
of more than ninety days: Provided, That when the commission determines
that the claimant remains disabled beyond the period specified in the
prior order granting temporary total disability benefits, the
commission shall enter an order continuing the payment of temporary
total disability benefits for an additional period not to exceed ninety
days and shall give immediate notice to all parties of the decision.
(d) Upon receipt of the first report of injury in claim, the
commission shall request from the employer or employers any wage
information necessary for determining the rate of benefits to which the employee is entitled. If an employer does not furnish the commission
with this information within fifteen days from the date the commission
received the first report of injury in the case, the employee shall be
paid temporary total disability benefits for lost time at the rate the
commission obtains from reports made pursuant to subsection (b),
section two, article two of this chapter. If no wages have been
reported, the commission shall make the payments at the rate the
commission finds would be justified by the usual rate of pay for the
occupation of the injured employee. The commission shall adjust the
rate of benefits both retroactively and prospectively upon receipt of
proper wage information. The commission shall have access to all wage
information in the possession of any state agency.
(e) Subject to the limitations set forth in section sixteen of
this article, upon a finding of the commission or a self-insured
employer that a claimant who has sustained a previous compensable
injury which has been closed by order, or by the claimant's return to
work, suffers further temporary total disability or requires further
medical or hospital treatment resulting from the compensable injury,
the commission or the self-insured employer shall immediately commence
the payment of temporary total disability benefits to the claimant in
the amount provided for in sections six and fourteen of this article,
and the expenses provided for in subsection (a), section three of this
article, relating to the disability, without waiting for the expiration
of the thirty-day period during which objections may be filed. The
commission or self-insured employer shall give immediate notice to the
parties of its decision.
(f) Where the employer is a subscriber to the workers' compensation fund under the provisions of article three of this
chapter, and upon the findings aforesaid, the commission shall mail all
workers' compensation checks paying temporary total disability benefits
directly to the claimant and not to the employer for delivery to the
claimant.
(g) Where the employer has elected to carry its own risk under
section nine, article two of this chapter, and upon the findings
aforesaid, the self-insured employer shall immediately pay the amounts
due the claimant for temporary total disability benefits. A copy of
the notice shall be sent to the claimant.

(h) When the employer has protested the compensability or
applied for modification of a temporary total disability benefit award
or expenses and the final decision in that case determines that the
claimant was not entitled to the benefits or expenses, the amount of
benefits or expenses is considered overpaid.
For all awards made or
nonawarded partial benefits paid the commission or self-insured
employer may only recover the amount of overpaid benefits or expenses
by withholding, in whole or in part, future disability benefits payable
to the individual in the same or other claims and credit the amount
against the overpayment until it is repaid in full.
(i) In the event that the commission finds that, based upon the
employer's report of injury, the claim is not compensable, the
commission shall provide a copy of the employer's report to the
claimant in addition to the order denying the claim.
(j) If a claimant is receiving benefits paid through a wage
replacement plan, salary continuation plan or other benefit plan
provided by the employer to which the employee has not contributed, and that plan does not provide an offset for temporary total disability
benefits to which the claimant is also entitled under this chapter as
a result of the same injury or disease, the employer shall notify the
commission of the duplication of the benefits paid to the claimant.
Upon receipt of the notice, the commission shall reduce the temporary
total disability benefits provided under this chapter by an amount
sufficient to ensure that the claimant does not receive monthly
benefits in excess of the amount provided by the employer's plan or the
temporary total disability benefit, whichever is greater: Provided,
That this subsection does not apply to benefits being paid under the
terms and conditions of a collective bargaining agreement.
§23-4-1d. Method and time of payments for permanent disability.
(a) If the commission makes an award for permanent partial or
permanent total disability, the commission or self-insured employer
shall start payment of benefits by mailing or delivering the amount due
directly to the employee within fifteen days from the date of the
award: Provided, That the commission may withhold payment of the
portion of the award that is the subject of subsection (b) of this
section until seventy-seven days have expired without an objection
being filed.
(b) When the commission, self-insured employer, the office of
judges or the intermediate court of appeals enters an order or provides
notice granting the claimant a permanent total disability award and an
objection or petition for appeal is filed by the employer or the
commission, the commission or self-insured employer shall begin the
payment of monthly permanent total disability benefits. However, any
payment for a back period of benefits from the onset date of total permanent disability to the date of the award shall be limited to a
period of twelve months of benefits. If, after all litigation is
completed and the time for the filing of any further objections or
appeals to the award has expired and the award of permanent total
disability benefits is upheld, the claimant shall receive the remainder
of benefits due to him or her based upon the onset date of permanent
total disability that was finally determined.
(c) If the claimant is owed any additional payment of back
permanent total disability benefits, the commission or self-insured
employer shall not only pay the claimant the sum owed but shall also
add thereto interest at the simple rate of six percent per annum from
the date of the initial award granting the total permanent disability
to the date of the final order upholding the award. In the event that
an intermediate order directed an earlier onset date of permanent total
disability than was found in the initial award, the interest-earning
period for that additional period shall begin upon the date of the
intermediate award. Any interest payable shall be charged to the
account of the employer or shall be paid by the employer if it has
elected to carry its own risk.
(d) If a timely protest to the award is filed, as provided in
section one or nine, article five of this chapter, the commission or
self-insured employer shall continue to pay to the claimant benefits
during the period of the disability unless it is subsequently found
that the claimant was not entitled to receive the benefits, or any part
thereof, in which event the commission shall, where the employer is a
subscriber to the fund, credit the employer's account with the amount
of the overpayment. If the final decision in any case determines that a claimant was not lawfully entitled to benefits paid to him or her
pursuant to a prior decision, the amount of benefit paid shall be
considered overpaid.
For all awards made or nonawarded partial
benefits paid the commission or self-insured employer may only recover
that amount by withholding, in whole or in part, as determined by the
commission, future disability benefits payable to the individual in the
same or other claims and credit the amount against the overpayment
until it is repaid in full.
(e) An award for permanent partial disability shall be made as
expeditiously as possible and in accordance with the time frame
requirements promulgated by the board of managers.
(f) If a claimant is receiving benefits paid through a retirement
plan, wage replacement plan, salary continuation plan or other benefit
plan provided by the employer to which the employee has not
contributed, and that plan does not provide an offset for permanent
total disability benefits to which the claimant is also entitled under
this chapter as a result of the same injury or disease, the employer
shall notify the commission of the duplication of the benefits paid to
the claimant. Upon receipt of the notice, the commission shall reduce
the permanent total disability benefits provided under this chapter by
an amount sufficient to ensure that the claimant does not receive
monthly benefits in excess of the amount provided by the employer's
plan or the permanent total disability benefit, whichever is greater:
Provided, That this subsection does not apply to benefits being paid
under the terms and conditions of a collective bargaining agreement.
§23-4-1e. Temporary total disability benefits not to be paid for
periods of correctional center or jail confinement; denial of workers' compensation benefits for injuries or disease incurred
while confined.
(a) Notwithstanding any provision of this code to the contrary,
no person shall be jurisdictionally entitled to temporary total
disability benefits for that period of time in excess of three days
during which that person is confined in a state correctional facility
or a county or regional jail: Provided, That confinement shall not
affect the claimant's eligibility for payment of expenses: Provided,
however, That this subsection is applicable only to injuries and
diseases incurred prior to any period of confinement. Upon release
from confinement, the payment of benefits for the remaining period of
temporary total disability shall be made if justified by the evidence
and authorized by order of the commission.
(b) Notwithstanding any provision of this code to the contrary,
no person confined in a state correctional facility or a county or
regional jail who suffers injury or a disease in the course of and
resulting from his or her work during the period of confinement which
work is imposed by the administration of the state correctional
facility or the county or regional jail and is not suffered during the
person's usual employment with his or her usual employer when not
confined shall receive benefits under the provisions of this chapter
for the injury or disease.
§23-4-1f. Weighing of evidence.
(a) For all awards made on or after the effective date of the
amendment and reenactment of this section during the year two thousand
three, resolution of any issue raised in administering this chapter
shall be based on a weighing of all evidence pertaining to the issue and a finding that a preponderance of the evidence supports the chosen
manner of resolution. The process of weighing evidence shall include,
but not be limited to, an assessment of the relevance, credibility,
materiality and reliability that the evidence possesses in the context
of the issue presented. Under no circumstances will an issue be
resolved by allowing certain evidence to be dispositive simply because
it is reliable and is most favorable to a party's interests or
position. If, after weighing all of the evidence regarding an issue
in which a claimant has an interest, there is a finding that an equal
amount of evidentiary weight exists favoring conflicting matters for
resolution, the resolution that is most consistent with the claimant's
position will be adopted.
(b) Except as provided in subsection (a) of this section, a claim
for compensation filed pursuant to this chapter must be decided on its
merit and not according to any principle that requires statutes
governing workers' compensation to be liberally construed because they
are remedial in nature. No such principle may be used in the
application of law to the facts of a case arising out of this chapter
or in determining the constitutionality of this chapter.
§23-4-2. Disbursement where injury is self-inflicted or intentionally
caused by employer; legislative declarations and findings;
"deliberate intention" defined.
(a) Notwithstanding anything contained in this chapter, no
employee or dependent of any employee is entitled to receive any sum
from the workers' compensation fund, from a self-insured employer, or
otherwise under the provisions of this chapter, on account of any
personal injury to or death to any employee caused by a self-inflicted injury or the intoxication of the employee. Upon the occurrence of an
injury which the employee asserts, or which reasonably appears to have,
occurred in the course of and resulting from the employee's employment,
the employer may require the employee to undergo a blood test for the
purpose of determining the existence or nonexistence of evidence of
intoxication pursuant to rules for the administration of the test
promulgated by the board of managers: Provided, That the employer must
have a reasonable and good faith objective suspicion of the employee's
intoxication and may only test for the purpose of determinating whether
the person is intoxicated.
(b) For the purpose of this chapter, the commission may cooperate
with the office of miners' health, safety and training and the state
division of labor in promoting general safety programs and in
formulating rules to govern hazardous employments.
(c) If injury or death result to any employee from the deliberate
intention of his or her employer to produce the injury or death, the
employee, the widow, widower, child or dependent of the employee has
the privilege to take under this chapter and has a cause of action
against the employer, as if this chapter had not been enacted, for any
excess of damages over the amount received or receivable under this
chapter.
(d) (1) It is declared that enactment of this chapter and the
establishment of the workers' compensation system in this chapter was
and is intended to remove from the common law tort system all disputes
between or among employers and employees regarding the compensation to
be received for injury or death to an employee except as expressly
provided in this chapter and to establish a system which compensates even though the injury or death of an employee may be caused by his or
her own fault or the fault of a coemployee; that the immunity
established in sections six and six-a, article two of this chapter is
an essential aspect of this workers' compensation system; that the
intent of the Legislature in providing immunity from common lawsuit was
and is to protect those immunized from litigation outside the workers'
compensation system except as expressly provided in this chapter; that,
in enacting the immunity provisions of this chapter, the Legislature
intended to create a legislative standard for loss of that immunity of
more narrow application and containing more specific mandatory elements
than the common law tort system concept and standard of willful, wanton
and reckless misconduct; and that it was and is the legislative intent
to promote prompt judicial resolution of the question of whether a suit
prosecuted under the asserted authority of this section is or is not
prohibited by the immunity granted under this chapter.
(2) The immunity from suit provided under this section and under
section six-a, article two of this chapter may be lost only if the
employer or person against whom liability is asserted acted with
"deliberate intention". This requirement may be satisfied only if:
(i) It is proved that the employer or person against whom
liability is asserted acted with a consciously, subjectively and
deliberately formed intention to produce the specific result of injury
or death to an employee. This standard requires a showing of an
actual, specific intent and may not be satisfied by allegation or proof
of: (A) Conduct which produces a result that was not specifically
intended; (B) conduct which constitutes negligence, no matter how gross
or aggravated; or (C) willful, wanton or reckless misconduct; or
(ii) The trier of fact determines, either through specific
findings of fact made by the court in a trial without a jury, or
through special interrogatories to the jury in a jury trial, that all
of the following facts are proven:
(A) That a specific unsafe working condition existed in the
workplace which presented a high degree of risk and a strong
probability of serious injury or death;
(B) That the employer had a subjective realization and an
appreciation of the existence of the specific unsafe working condition
and of the high degree of risk and the strong probability of serious
injury or death presented by the specific unsafe working condition;
(C) That the specific unsafe working condition was a violation of
a state or federal safety statute, rule or regulation, whether cited
or not, or of a commonly accepted and well-known safety standard within
the industry or business of the employer, which statute, rule,
regulation or standard was specifically applicable to the particular
work and working condition involved, as contrasted with a statute,
rule, regulation or standard generally requiring safe workplaces,
equipment or working conditions;
(D) That notwithstanding the existence of the facts set forth in
subparagraphs (A) through (C), inclusive, of this paragraph, the
employer nevertheless thereafter exposed an employee to the specific
unsafe working condition intentionally; and
(E) That the employee exposed suffered serious injury or death as
a direct and proximate result of the specific unsafe working condition.
(iii) In cases alleging liability under the provisions of
paragraph (ii) of this subdivision:
(A) No punitive or exemplary damages shall be awarded to the
employee or other plaintiff;
(B) Notwithstanding any other provision of law or rule to the
contrary, and consistent with the legislative findings of intent to
promote prompt judicial resolution of issues of immunity from
litigation under this chapter, the court shall dismiss the action upon
motion for summary judgment if it finds, pursuant to rule 56 of the
rules of civil procedure that one or more of the facts required to be
proved by the provisions of subparagraphs (A) through (E), inclusive,
paragraph (ii) of this subdivision do not exist, and the court shall
dismiss the action upon a timely motion for a directed verdict against
the plaintiff if after considering all the evidence and every inference
legitimately and reasonably raised thereby most favorably to the
plaintiff, the court determines that there is not sufficient evidence
to find each and every one of the facts required to be proven by the
provisions of subparagraphs (A) through (E), inclusive, paragraph (ii)
of this subdivision; and
(C) The provisions of this paragraph and of each subparagraph
thereof are severable from the provisions of each other subparagraph,
subsection, section, article or chapter of this code so that if any
provision of a subparagraph of this paragraph is held void, the
remaining provisions of this act and this code remain valid.
(e) The reenactment of this section in the regular session of the
Legislature during the year one thousand nine hundred eighty-three does
not in any way affect the right of any person to bring an action with
respect to or upon any cause of action which arose or accrued prior to
the effective date of the reenactment.
§23-4-3. Schedule of maximum disbursements for medical, surgical,
dental and hospital treatment; legislative approval; guidelines;
preferred provider agreements; charges in excess of scheduled
amounts not to be made; required disclosure of financial interest
in sale or rental of medically related mechanical appliances or
devices; promulgation of rules to enforce requirement;
consequences of failure to disclose; contract by employer with
hospital, physician, etc., prohibited; criminal penalties for
violation; payments to certain providers prohibited; medical cost
and care programs; payments; interlocutory orders.
(a) The workers' compensation commission shall establish and
alter from time to time, as the commission determines appropriate, a
schedule of the maximum reasonable amounts to be paid to health care
providers, providers of rehabilitation services, providers of durable
medical and other goods and providers of other supplies and medically
related items or other persons, firms or corporations for the rendering
of treatment or services to injured employees under this chapter. The
commission also, on the first day of each regular session and also from
time to time, as the commission may consider appropriate, shall submit
the schedule, with any changes thereto, to the Legislature.
The commission shall disburse and pay from the fund for personal
injuries to the employees who are entitled to the benefits under this
chapter as follows:
(1) Sums for health care services, rehabilitation services,
durable medical and other goods and other supplies and medically
related items as may be reasonably required. The commission shall
determine that which is reasonably required within the meaning of this section in accordance with the guidelines developed by the health care
advisory panel pursuant to section three-b of this article: Provided,
That nothing in this section shall prevent the implementation of
guidelines applicable to a particular type of treatment or service or
to a particular type of injury before guidelines have been developed
for other types of treatment or services or injuries: Provided,
however, That any guidelines for utilization review which are developed
in addition to the guidelines provided for in section three-b of this
article may be used by the commission until superseded by guidelines
developed by the health care advisory panel pursuant to said section.
Each health care provider who seeks to provide services or treatment
which are not within any guideline shall submit to the commission
specific justification for the need for the additional services in the
particular case and the commission shall have the justification
reviewed by a health care professional before authorizing the
additional services. The commission may enter into preferred provider
and managed care agreements.
(2) Payment for health care services, rehabilitation services,
durable medical and other goods and other supplies and medically
related items authorized under this subsection may be made to the
injured employee or to the person, firm or corporation who or which has
rendered the treatment or furnished health care services,
rehabilitation services, durable medical or other goods or other
supplies and items, or who has advanced payment for them, as the
commission considers proper, but no payments or disbursements shall be
made or awarded by the commission unless duly verified statements on
forms prescribed by the commission have been filed with the commission within six months after the rendering of the treatment or the delivery
of such goods, supplies or items or within ninety days of a subsequent
compensability ruling if a claim is initially rejected: Provided, That
no payment under this section shall be made unless a verified statement
shows no charge for or with respect to the treatment or for or with
respect to any of the items specified in this subdivision has been or
will be made against the injured employee or any other person, firm or
corporation. When an employee covered under the provisions of this
chapter is injured in the course of and as a result of his or her
employment and is accepted for health care services, rehabilitation
services, or the provision of durable medical or other goods or other
supplies or medically related items, the person, firm or corporation
rendering the treatment may not make any charge or charges for the
treatment or with respect to the treatment against the injured employee
or any other person, firm or corporation which would result in a total
charge for the treatment rendered in excess of the maximum amount set
forth therefor in the commission's schedule.
(3) Any pharmacist filling a prescription for medication for a
workers' compensation claimant shall dispense a generic brand of the
prescribed medication if a generic brand exists. If a generic brand
does not exist, the pharmacist may dispense the name brand. In the
event that a claimant wishes to receive the name brand medication in
lieu of the generic brand, the claimant may receive the name brand
medication but, in that event, the claimant is personally liable for
the difference in costs between the generic brand medication and the
brand name medication.
(4) In the event that a claimant elects to receive health care services from a health care provider from outside of the state of West
Virginia and if that health care provider refuses to abide by and
accept as full payment the reimbursement made by the workers'
compensation commission pursuant to the schedule of maximum reasonable
amounts of fees authorized by subsection (a) of this section, with the
exceptions noted below, the claimant is personably liable for the
difference between the scheduled fee and the amount demanded by the
out-of-state health care provider.
(A) In the event of an emergency where there is an urgent need
for immediate medical attention in order to prevent the death of a
claimant or to prevent serious and permanent harm to the claimant, if
the claimant receives the emergency care from an out-of-state health
care provider who refuses to accept as full payment the scheduled
amount, the claimant is not personally liable for the difference
between the amount scheduled and the amount demanded by the health care
provider. Upon the claimant's attaining a stable medical condition and
being able to be transferred to either a West Virginia health care
provider or an out-of-state health care provider who has agreed to
accept the scheduled amount of fees as payment in full, if the claimant
refuses to seek the specified alternative health care providers, he or
she is personally liable for the difference in costs between the
scheduled amount and the amount demanded by the health care provider
for services provided after attaining stability and being able to be
transferred.
(B) In the event that there is no health care provider reasonably
near to the claimant's home who is qualified to provide the claimant's
needed medical services who is either located in the state of West Virginia or who has agreed to accept as payment in full the scheduled
amounts of fees, the commission, upon application by the claimant, may
authorize the claimant to receive medical services from another health
care provider. The claimant is not personally liable for the
difference in costs between the scheduled amount and the amount
demanded by the health care provider.
(b) (1) No employer shall enter into any contracts with any
hospital, its physicians, officers, agents or employees to render
medical, dental or hospital service or to give medical or surgical
attention to any employee for injury compensable within the purview of
this chapter, and no employer shall permit or require any employee to
contribute, directly or indirectly, to any fund for the payment of such
medical, surgical, dental or hospital service within such hospital for
the compensable injury. Any employer violating this subsection is
liable in damages to the employer's employees as provided in section
eight, article two of this chapter, and any employer or hospital or
agent or employee thereof violating the provisions of this section is
guilty of a misdemeanor and, upon conviction thereof, shall be punished
by a fine not less than one hundred dollars nor more than one thousand
dollars or by imprisonment not exceeding one year, or both.
(2) The provisions of this subsection shall not prohibit an
employer from participating in a managed health care plan, including,
but not limited to, a preferred provider organization or program or a
health maintenance organization or managed care organization or other
medical cost containment relationship with the providers of medical,
hospital or other health care. An employer that provides a managed
health care plan approved by the commission for its employees may require an injured employee to use health care providers authorized by
the managed health care plan for care and treatment of his or her
compensable injuries. If the employer does not provide a managed
health care plan or program, the claimant may select his or her initial
health care provider for treatment of a compensable injury or disease,
except as provided under subdivision (3) of this subsection. If a
claimant wishes to change his or her health care provider and if his
or her employer has established and maintains a managed health care
plan, the claimant shall select a new health care provider through the
managed health care plan. A claimant who has used the providers under
the employer's managed health care plan may select a health care
provider outside the employer's plan for treatment of the compensable
injury or disease if the employee receives written approval from the
commission to do so and the approval is given pursuant to criteria
established by rule of the commission.
(3) If the commission enters into an agreement which has been
approved by the board of managers with a managed health care plan,
including, but not limited to, a preferred provider organization or
program, a health maintenance organization or managed care organization
or other health care delivery organization or organizations or other
medical cost containment relationship with the providers of medical,
hospital or other health care, then:
(A) If an injured employee's employer does not provide a managed
health care plan approved by the commission for its employees as
described in subdivision (2) of this subsection, the commission may
require the employee to use health care providers authorized by the
commission's managed health care plan for care and treatment of his or her compensable injuries; and
(B) If a claimant seeks to change his or her initial choice of
health care provider where neither the employer or the commission had
an approved health care management plan at the time the initial choice
was made, and if the claimant's employer does not provide access to
such a plan as part of the employer's general health insurance benefit,
then the claimant shall be provided with a new health care provider
from the commission's managed health care plan available to him or her.
(c) When an injury has been reported to the commission by the
employer without protest, the commission or self-insured employer may
pay, within the maximum amount provided by schedule established under
this section, bills for health care services without requiring the
injured employee to file an application for benefits.
(d) The commission or self-insured employer shall provide for the
replacement of artificial limbs, crutches, hearing aids, eyeglasses and
all other mechanical appliances provided in accordance with this
section which later wear out, or which later need to be refitted
because of the progression of the injury which caused the devices to
be originally furnished, or which are broken in the course of and as
a result of the employee's employment. The commission or self-insured
employer shall pay for these devices, when needed, notwithstanding any
time limits provided by law.
(e) No payment shall be made to a health care provider who is
suspended or terminated under the terms of section three-c of this
article except as provided in subsection (c) of said section.
(f) The commission may engage in and contract for medical cost
containment programs, pharmacy benefits management programs, medical case management programs and utilization review programs. Payments for
these programs shall be made from the workers' compensation fund. Any
order issued pursuant to the program shall be interlocutory in nature
until an objecting party has exhausted all review processes provided
for by the commission.
(g) Notwithstanding the provisions of this section, the
commission may establish fee schedules, make payments and take other
actions required or allowed pursuant to article twenty-nine-d, chapter
sixteen of this code.
§23-4-3b. Creation of health care advisory panel.
(a) The commission shall establish a health care advisory panel
consisting of representatives of the various branches and specialties
among health care providers in this state. There shall be a minimum
of five members of the health care advisory panel who shall receive
reasonable compensation for their services and reimbursement for
reasonable actual expenses. Each member of this panel shall be
provided appropriate professional or other liability insurance, without
additional premium, by the state board of risk and insurance management
created pursuant to article twelve, chapter twenty-nine of this code.
The panel shall:
(1) Establish guidelines for the health care which is reasonably
required for the treatment of the various types of injuries and
occupational diseases within the meaning of section three of this
article;
(2) Establish protocols and procedures for the performance of
examinations or evaluations performed by physicians or medical
examiners pursuant to sections seven-a and eight of this article;
(3) Assist the commission in establishing guidelines for the
evaluation of the care provided by health care providers to injured
employees for purposes of section three-c of this article;
(4) Assist the commission in establishing guidelines regarding
the anticipated period of disability for the various types of injuries
pursuant to subsection (b), section seven-a of this article; and
(5) Assist the commission in establishing appropriate
professional review of requests by health care providers to exceed the
guidelines for treatment of injuries and occupational diseases
established pursuant to subdivision (1) of this section.
(b) In addition to the requirements of subsection (a) of this
section, on or before the thirty-first day of December, two thousand
three, the board of managers shall promulgate a rule establishing the
process for the medical management of claims and awards of disability
which includes, but is not limited to, reasonable and standardized
guidelines and parameters for appropriate treatment, expected period
of time to reach maximum medical improvement and range of permanent
partial disability awards for common injuries and diseases or, in the
alternative, which incorporates by reference the medical and disability
management guidelines, plan or program being utilized by the commission
for the medical and disability management of claims, with the
requirements, standards, parameters and limitations of such guidelines,
plan or program having the same force and effect as the rule
promulgated in compliance herewith.
§23-4-3c. Suspension or termination of providers of health care.
(a) The commission may suspend for up to three years or
permanently terminate the right of any health care provider, including a provider of rehabilitation services within the meaning of section
nine of this article, to obtain payment for services rendered to
injured employees:
(1) If the commission finds that the health care provider is
regularly providing to injured employees health care that is excessive,
medically unreasonable or unethical, which shall include abusing the
workers' compensation system in the treatment provided to injured
employees or in its billing practices;
(2) If the commission finds that a health care provider is
attempting to make any charge or charges against the injured employee
or any other person, firm or corporation which would result in a total
charge for any treatment rendered in excess of the maximum amount set
by the commission, in violation of section three of this article;
(3) If the commission determines that the health care provider
has had his or her license to practice suspended or terminated by the
appropriate authority in this state or in another state;
(4) If the commission determines that the health care provider
has been convicted of any crime in relation to his or her practice, or
any felony; or
(5) If the commission determines that the health care provider
has made medically unsupported recommendations regarding a percentage
of disability or has prescribed medically unsupported treatment
including medication. The rules promulgated under this section shall
establish criteria for determining whether recommendations or treatment
are medically unsupported.
The executive director shall consult with medical experts,
including the health care advisory panel established pursuant to section three-b of this article, for purposes of determining whether
a health care provider should be suspended or terminated pursuant to
this section.
(b) Upon the determination by the executive director that there
is probable cause to believe that a health care provider should be
suspended or terminated pursuant to this section, the executive
director shall provide the health care provider with written notice
stating the nature of the charges against the health care provider and
the time and place of a hearing. Upon issuance of the notice and due
consideration of the executive director's fiduciary duties, the
executive director may immediately suspend payment to the health care
provider pending the final order of suspension or termination. The
health care provider shall appear to show cause why the health care
provider's right to receive payment under this chapter should not be
suspended or terminated. At the hearing the health care provider shall
be afforded an opportunity to review the evidence, to cross-examine the
witnesses, and present testimony and enter evidence in support of its
position. The hearing shall be conducted in accordance with the
provisions of article five, chapter twenty-nine-a of this code. The
hearing may be conducted by the executive director or a hearing officer
appointed by the executive director. The executive director or hearing
officer has the power to subpoena witnesses, papers, records, documents
and other data and things in connection with the proceeding under this
subsection and to administer oaths or affirmations in the hearing. If,
after reviewing the record of the hearing, the executive director
determines that the right of the health care provider to obtain payment
under this article should be suspended for a specified period of time or should be permanently terminated, the executive director shall issue
a final order suspending or terminating the right of the health care
provider to obtain payment for services under this article. The order
shall set forth findings of fact and conclusions of law in support of
the decision. The order shall be mailed to the health care provider
by certified mail, return receipt requested. Any appeal by the health
care provider shall be brought in the circuit court of Kanawha County
or in the county in which the provider's principal place of business
is located. The scope of the court's review of the final order shall
be as provided in section four, article five, chapter twenty-nine-a of
this code. The provider may be suspended or terminated, based upon the
final order of the executive director or hearing officer, pending final
disposition of any appeal. The final order may be stayed by the
circuit court after hearing, but shall not be stayed in or as a result
of any ex parte proceeding. If the health care provider does not
appeal the final order within thirty days, it is final.
(c) No payment shall be made to a health care provider or to an
injured employee for services provided by a health care provider after
the effective date of a final order terminating or suspending the
health care provider: Provided, That nothing in this subsection shall
prohibit payment by the executive director or self-insured employer to
a suspended or terminated health care provider for medical services
rendered where the medical services were rendered to an injured
employee in an emergency situation. The suspended or terminated
provider may not make any charge or charges for any services provided
against the injured employee unless the injured employee, before any
services are rendered, is given notice by the provider in writing that the provider does not participate in the workers' compensation program
and that the injured employee will be solely responsible for all
payments to the provider and unless the injured employee also signs a
written consent, before any services are rendered, to make payment
directly and to waive any right to reimbursement from the executive
director or the self-insured employer. The written consent and waiver
signed by the injured employee shall be filed by the provider with the
executive director and shall be made a part of the claim file.
(d) The executive director shall notify each claimant, whose duly
authorized treating physician or other health care provider has been
suspended or terminated pursuant to this section, of the suspension or
termination of the provider's rights to obtain payment under this
chapter and shall assist the claimant in arranging for transfer of his
or her care to another physician or provider.
(e) Each suspended or terminated provider shall post in the
provider's public waiting area or areas a written notice, in the form
required by the executive director, of the suspension or termination
of the provider's rights to obtain payment under this chapter.
(f) A suspended provider may apply for reinstatement at the end
of the term of suspension.
(g) The board of managers shall promulgate rules for the purpose
of implementing this section.
§23-4-4. Funeral expenses; wrongfully seeking payment; criminal
penalties.

(a) In case the personal injury causes death, reasonable funeral
or cemetery expense, in an amount to be fixed, from time to time, by
the commission shall be paid from the fund, payment to be made to the persons who have furnished the services and supplies, or to the persons
who have advanced payment for the services and supplies, as the
commission may determine proper, in addition to any award made to the
employee's dependents.
(b) A funeral director or cemeterian, or any person who furnished
the services and supplies associated with the funeral or cemetery
expenses, or a person who has advanced payment for the services and
supplies, is prohibited from making any charge or charges against the
employee's dependents for funeral expenses which would result in a
total charge for funeral expenses in excess of the amount fixed by the
commission unless:
(1) The person seeking funeral expenses notifies, in writing and
prior to the rendering of any service, the employee's dependent as to
the exact cost of the service and the exact amount the employee's
dependent would be responsible for paying in excess of the amount fixed
by the commission; and
(2) The person seeking funeral expenses secures, in writing and
prior to the rendering of any service, consent from the employee's
dependent that he or she will be responsible to make payment for the
amount in excess of the amount fixed by the commission.
(c) Any person who knowingly and willfully seeks or receives
payment of funeral expenses in excess of the amount fixed by the
commission without satisfying both of the requirements of subsection
(b) of this section is guilty of a misdemeanor and, upon conviction
thereof, shall be fined three thousand dollars or confined in a county
or regional jail for a definite term of confinement of twelve months,
or both.
§23-4-5. Benefits for first three days after injury.




If the period of disability does not last longer than three days
from the day the employee leaves work as the result of the injury, no
award shall be allowed, except the disbursements provided for in the
two next preceding sections, but if the period of disability lasts
longer than seven days from the day the employee leaves work as a
result of the injury, an award shall be allowed for the first three
days of such disability.
§23-4-6. Classification of and criteria for disability benefits.




Where compensation is due an employee under the provisions of
this chapter for personal injury, the compensation shall be as provided
in the following schedule:




(a) The terms "average weekly wage earnings, wherever earned, of
the injured employee, at the date of injury" and "average weekly wage
in West Virginia", as used in this chapter, have the meaning and shall
be computed as set forth in section fourteen of this article except for
the purpose of computing temporary total disability benefits for part-
time employees pursuant to the provisions of section six-d of this
article.




(b) For all awards made on and after the effective date of the
amendment and reenactment of this section during the year two thousand
three, if the injury causes temporary total disability, the employee
shall receive during the continuance of the disability a maximum weekly
benefit to be computed on the basis of sixty-six and two-thirds percent
of the average weekly wage earnings, wherever earned, of the injured
employee, at the date of injury, not to exceed one hundred percent of
the average weekly wage in West Virginia: Provided, That in no event shall an award for temporary total disability be subject to annual
adjustments resulting from changes in the average weekly wage in West
Virginia: Provided, however, in the case of a claimant whose award was
granted prior to the effective date of the amendment and reenactment
of this section during the year two thousand three, the maximum benefit
rate shall be the rate applied under the prior enactment of this
subsection which was in effect at the time the injury occurred. The
minimum weekly benefits paid under this subdivision shall not be less
than thirty-three and one-third percent of the average weekly wage in
West Virginia, except as provided in sections six-d and nine of this
article. In no event, however, shall the minimum weekly benefits
exceed the level of benefits determined by use of the applicable
federal minimum hourly wage: Provided further, That any claimant
receiving permanent total disability benefits, permanent partial
disability benefits or dependents' benefits prior to the first day of
July, one thousand nine hundred ninety-four, shall not have his or her
benefits reduced based upon the requirement in this subdivision that
the minimum weekly benefit shall not exceed the applicable federal
minimum hourly wage.




(c) Subdivision (b) of this section is limited as follows:
Aggregate award for a single injury causing temporary disability shall
be for a period not exceeding two hundred eight weeks; aggregate award
for a single injury for which an award of temporary total disability
benefits is made on or after the effective date of the amendment and
reenactment of this section in the year two thousand three shall be for
a period not exceeding one hundred four weeks. Notwithstanding any
other provision of this subdivision to the contrary, no person may receive temporary total disability benefits under an award for a single
injury for a period exceeding one hundred four weeks from the effective
date of the amendment and reenactment of this section in the year two
thousand three.




(d) For all awards of permanent total disability benefits that
are made on or after the second day of February, one thousand nine
hundred ninety-five, including those claims in which a request for an
award was pending before the division or which were in litigation but
not yet submitted for a decision, then benefits shall be payable until
the claimant attains the age necessary to receive federal old age
retirement benefits under the provisions of the Social Security Act,
42 U. S. C. §401 and 402, in effect on the effective date of this
section. The claimant shall be paid benefits so as not to exceed a
maximum benefit of sixty-six and two-thirds percent of the claimant's
average weekly wage earnings, wherever earned, at the time of the date
of injury not to exceed one hundred percent of the average weekly wage
in West Virginia. The minimum weekly benefits paid under this section
shall be as is provided for in subdivision (b) of this section. In all
claims in which an award for permanent total disability benefits was
made prior to the second day of February, one thousand nine hundred
ninety-five, the awards shall continue to be paid at the rate in effect
prior to
the effective date of the amendment and reenactment of this
section in the year two thousand three
: Provided, That the provisions
of sections one through eight, inclusive, article four-a of this
chapter shall be applied thereafter to all prior awards that were
previously subject to its provisions. A single or aggregate permanent
disability of eighty-five percent or more entitles the employee to a rebuttable presumption of a permanent total disability for the purpose
of paragraph (2), subdivision (n) of this section: Provided, however,
That the claimant must also be at least fifty percent medically
impaired upon a whole body basis or has sustained a thirty-five percent
statutory disability pursuant to the provisions of subdivision (f) of
this section. The presumption may be rebutted if the evidence
establishes that the claimant is not permanently and totally disabled
pursuant to subdivision (n) of this section. Under no circumstances
may the commission grant an additional permanent disability award to
a claimant receiving a permanent total disability award: Provided
further, That if any claimant thereafter sustains another compensable
injury and has permanent partial disability resulting from the injury,
the total permanent disability award benefit rate shall be computed at
the highest benefit rate justified by any of the compensable injuries.




(e) (1) For all awards made on or after the effective date of the
amendment and reenactment of this section during the year two thousand
three, if the injury causes permanent disability less than permanent
total disability, the percentage of disability to total disability
shall be determined and the award computed on the basis of four weeks'
compensation for each percent of disability determined at the maximum
or minimum benefit rates as follows: Sixty-six and two-thirds percent
of the average weekly wage earnings, wherever earned, of the injured
employee at the date of injury, not to exceed seventy percent of the
average weekly wage in West Virginia: Provided, That in no event shall
an award for permanent partial disability be subject to annual
adjustments resulting from changes in the average weekly wage in West
Virginia: Provided, however, That in the case of a claimant whose award was granted prior to the effective date of the amendment and
reenactment of this section during the year two thousand three the
maximum benefit rate shall be the rate applied under the prior
enactment of this section which was in effect at the time the injury
occurred.




(2) If a claimant is released by his or her treating physician to
return to work at the job he or she held before the occupational injury
occurred and if the claimant's preinjury employer does not offer the
preinjury job or a comparable job to the employee when a position is
available to be offered, the award for the percentage of partial
disability shall be computed on the basis of six weeks of compensation
for each percent of disability.




(3) The minimum weekly benefit under this subdivision shall be as
provided in subdivision (b) of this section for temporary total
disability.




(f) If the injury results in the total loss by severance of any
of the members named in this subdivision, the percentage of disability
shall be determined by the percentage of disability, specified in the
following table:




The loss of a great toe shall be considered a ten percent
disability.




The loss of a great toe (one phalanx) shall be considered a five
percent disability.




The loss of other toes shall be considered a four percent
disability.




The loss of other toes (one phalanx) shall be considered a two
percent disability.




The loss of all toes shall be considered a twenty-five percent
disability.




The loss of forepart of foot shall be considered a thirty percent
disability.




The loss of a foot shall be considered a thirty-five percent
disability.




The loss of a leg shall be considered a forty-five percent
disability.




The loss of thigh shall be considered a fifty percent disability.




The loss of thigh at hip joint shall be considered a sixty
percent disability.




The loss of a little or fourth finger (one phalanx) shall be
considered a three percent disability.




The loss of a little or fourth finger shall be considered a five
percent disability.




The loss of ring or third finger (one phalanx) shall be
considered a three percent disability.




The loss of ring or third finger shall be considered a five
percent disability.




The loss of middle or second finger (one phalanx) shall be
considered a three percent disability.




The loss of middle or second finger shall be considered a seven
percent disability.




The loss of index or first finger (one phalanx) shall be
considered a six percent disability.




The loss of index or first finger shall be considered a ten
percent disability.




The loss of thumb (one phalanx) shall be considered a twelve
percent disability.




The loss of thumb shall be considered a twenty percent
disability.




The loss of thumb and index fingers shall be considered a thirty-
two percent disability.




The loss of index and middle fingers shall be considered a twenty
percent disability.




The loss of middle and ring fingers shall be considered a fifteen
percent disability.




The loss of ring and little fingers shall be considered a ten
percent disability.




The loss of thumb, index and middle fingers shall be considered
a forty percent disability.




The loss of index, middle and ring fingers shall be considered a
thirty percent disability.




The loss of middle, ring and little fingers shall be considered
a twenty percent disability.




The loss of four fingers shall be considered a thirty-two percent
disability.




The loss of hand shall be considered a fifty percent disability.




The loss of forearm shall be considered a fifty-five percent
disability.




The loss of arm shall be considered a sixty percent disability.




The total and irrecoverable loss of the sight of one eye shall be
considered a thirty-three percent disability. For the partial loss of
vision in one or both eyes, the percentages of disability shall be determined by the commission, using as a basis the total loss of one
eye.




The total and irrecoverable loss of the hearing of one ear shall
be considered a twenty-two and one-half percent disability. The total
and irrecoverable loss of hearing of both ears shall be considered a
fifty-five percent disability.




For the partial loss of hearing in one or both ears, the
percentage of disability shall be determined by the commission, using
as a basis the total loss of hearing in both ears.




If a claimant sustains a compensable injury which results in the
total loss by severance of any of the bodily members named in this
subdivision or dies from sickness or noncompensable injury before the
commission makes the proper award for the injury, the commission shall
make the award to the claimant's dependents as defined in this chapter,
if any; the payment to be made in the same installments that would have
been paid to claimant if living: Provided, That no payment shall be
made to any surviving spouse of the claimant after his or her
remarriage and that this liability shall not accrue to the estate of
the claimant and is not subject to any debts of, or charges against,
the estate.




(g) If a claimant to whom has been made a permanent partial award
dies from sickness or noncompensable injury, the unpaid balance of the
award shall be paid to claimant's dependents as defined in this
chapter, if any; the payment to be made in the same installments that
would have been paid to claimant if living: Provided, That no payment
shall be made to any surviving spouse of the claimant after his or her
remarriage, and that this liability shall not accrue to the estate of the claimant and is not subject to any debts of, or charges against,
such estate.




(h) For the purposes of this chapter, a finding of the
occupational pneumoconiosis board has the force and effect of an award.




(i) For the purposes of this chapter, with the exception of those
injuries provided for in subdivision (f) of this section and in section
six-b of this article, the degree of permanent disability other than
permanent total disability shall be determined exclusively by the
degree of whole body medical impairment that a claimant has suffered.
For those injuries provided for in subdivision (f) of this section and
section six-b of this article, the degree of disability shall be
determined exclusively by the provisions of said subdivision and said
section. The occupational pneumoconiosis board created pursuant to
section eight-a of this article shall premise its decisions on the
degree of pulmonary function impairment that claimants suffer solely
upon whole body medical impairment. The workers' compensation
commission shall adopt standards for the evaluation of claimants and
the determination of a claimant's degree of whole body medical
impairment. Once the degree of medical impairment has been determined,
that degree of impairment shall be the degree of permanent partial
disability that shall be awarded to the claimant. This subdivision is
applicable to all injuries incurred and diseases with a date of last
exposure on or after the second day of February, one thousand nine
hundred ninety-five, to all applications for an award of permanent
partial disability made on and after that date and to all applications
for an award of permanent partial disability that were pending before
the commission or pending in litigation but not yet submitted for decision on and after that date. The prior provisions of this
subdivision remain in effect for all other claims.




(j) From a list of names of seven persons submitted to the
executive director by the health care advisory panel, the executive
director shall appoint an interdisciplinary examining board consisting
of five members to evaluate claimants, including by examination if the
board elects. The board shall be composed of three qualified
physicians with specialties and expertise qualifying them to evaluate
medical impairment and two vocational rehabilitation specialists who
are qualified to evaluate the ability of a claimant to perform gainful
employment with or without retraining. One member of the board shall
be designated annually as chairperson by the executive director. The
term of office of each member of the board shall be six years and until
his or her successor has been appointed and has qualified. Any member
of the board may be appointed to any number of terms. Any two
physician members and one vocational rehabilitation specialist member
shall constitute a quorum for the transaction of business. The
executive director, from time to time, shall fix the compensation to
be paid to each member of the board, and the members are also entitled
to reasonable and necessary traveling and other expenses incurred while
actually engaged in the performance of their duties. The board shall
perform the duties and responsibilities assigned by the provisions of
this chapter, consistent with the administrative policies developed by
the executive director with the approval of the board of managers.




(1) The executive director shall establish requirements for the
proper completion and support for an application for permanent total
disability benefits within an existing or a new rule no later than the first day of January, two thousand four. Upon adoption of the rule by
the board of managers, no issue of permanent total disability may be
referred to the interdisciplinary examining board unless a properly
completed and supported application for permanent total disability
benefits has been first filed with the commission. Prior to the
referral of any issue to the interdisciplinary examining board, the
commission shall conduct examinations of the claimant that it finds
necessary and obtain all pertinent records concerning the claimant's
medical history and reports of examinations and forward them to the
board at the time of the referral. The commission shall provide
adequate notice to the employer of the filing of the request for a
permanent total disability award and the employer shall be granted an
appropriate period in which to respond to the request. The claimant
and the employer may furnish all pertinent information to the board and
shall furnish to the board any information requested by the board. The
claimant and the employer may each submit no more than one report and
opinion regarding each issue present in a given claim. The employer
may have the claimant examined by medical specialists and vocational
rehabilitation specialists: Provided, That the employer is entitled to
only one examination on each issue present in a given claim. Any
additional examinations must be approved by the commission and shall
be granted only upon a showing of good cause. The reports from all
employer-conducted examinations must be filed with the board and served
upon the claimant. The board may request that those persons who have
furnished reports and opinions regarding a claimant provide it with
additional information considered necessary by the board. Both the
claimant and the employer, as well as the commission, may submit reports from experts challenging or supporting the other reports in the
record regardless of whether or not the expert examined the claimant
or relied solely upon the evidence of record.




(2) If the board or a quorum of the board elects to examine a
claimant, the individual members shall conduct any examinations that
are pertinent to each of their specialties. If a claim presents an
issue beyond the expertise of the board, the board may obtain advice
or evaluations by other specialists. In addition, if the board of
managers determines that the number of applications pending before the
interdisciplinary examining board has exceeded the level at which the
board can review and make recommendations within a reasonable time, the
board of managers may authorize the executive director to appoint any
additional members to the board that are necessary to reduce the
backlog of applications. The additional members shall be recommended
by the health care advisory panel. The executive director may make any
appointments he or she chooses from the recommendations. The
additional board members shall not serve a set term but shall serve
until the board of managers determines that the number of pending
applications has been reduced to an acceptable level.




(3) Referrals to the board shall be limited to matters related to
the determination of permanent total disability under the provisions
of subdivision (n) of this section and to questions related to medical
cost containment, utilization review decisions and managed care
decisions arising under section three of this article.




(4) In the event the board members elect to examine a claimant,
the board shall prepare a report stating the tests, examinations,
procedures and other observations that were made, the manner in which each was conducted and the results of each. The report shall state the
findings made by the board and the reasons for the findings. Copies
of the reports of all examinations made by the board shall be served
upon the parties and the commission. Each shall be given an
opportunity to respond in writing to the findings and conclusions
stated in the reports.




(5) The board shall state its initial recommendations to the
commission in writing with an explanation for each recommendation
setting forth the reasons for each. The recommendations shall be
served upon the parties and the commission and each shall be afforded
a thirty-day opportunity to respond in writing to the board regarding
the board's recommendations. The board shall review any responses and
issue its final recommendations. The final recommendations shall be
effectuated by the entry of an appropriate order by the commission.
For all awards for permanent total disability where the claim was filed
on or after the effective date of the amendment and reenactment of this
section in the year two thousand three, the commission shall establish
the date of onset of the claimant's permanent total disability as the
date when a properly completed and supported application for permanent
total disability benefits as prescribed in subdivision (1) of this
subsection that results in a finding of permanent total disability was
filed with the commission: Provided, That upon notification of the
commission by a claimant or his or her representative that the claimant
seeks to be evaluated for permanent total disability, the commission
shall send the claimant or his or her representative the proper
application form. The commission shall set time limits for the return
of the application. A properly completed and supported application returned within the time limits set by the commission shall be treated
as if received on the date the commission was notified the claimant was
seeking evaluation for permanent total disability: Provided, however,
That notwithstanding any other provision of this section to the
contrary, the onset date may not be sooner than the date upon which the
claimant meets the percentage thresholds of prior permanent partial
disability that are established by subsection (n) of this section as
a prerequisite to the claimant's qualification for consideration for
a permanent total disability award.




(6) Except as noted below, objections pursuant to section one,
article five of this chapter to any order shall be limited in scope to
matters within the record developed before the workers' compensation
commission and the board and shall further be limited to the issue of
whether the board properly applied the standards for determining
medical impairment, if applicable, and the issue of whether the board's
findings are clearly wrong in view of the reliable, probative and
substantial evidence on the whole record. If either party contends
that the claimant's condition has changed significantly since the
review conducted by the board, the party may file a motion with the
administrative law judge, together with a report supporting that
assertion. Upon the filing of the motion, the administrative law judge
shall cause a copy of the report to be sent to the examining board
asking the board to review the report and provide comments if the board
chooses within sixty days of the board's receipt of the report. The
board may either supply comments or, at the board's discretion, request
that the claim be remanded to the board for further review. If
remanded, the claimant is not required to submit to further examination by the employer's medical specialists or vocational rehabilitation
specialists. Following the remand, the board shall file its
recommendations with the administrative law judge for his or her
review. If the board elects to respond with comments, the comments
shall be filed with the administrative law judge for his or her review.
Following the receipt of either the board's recommendations or
comments, the administrative law judge shall issue a written decision
ruling upon the asserted change in the claimant's condition. No
additional evidence may be introduced during the review of the
objection before the office of judges or elsewhere on appeal: Provided,
That each party and the commission may submit one written opinion on
each issue pertinent to a given claim based upon a review of the
evidence of record either challenging or defending the board's findings
and conclusions. Thereafter, based upon the evidence of record, the
administrative law judge shall issue a written decision containing his
or her findings of fact and conclusions of law regarding each issue
involved in the objection.




(k) Compensation payable under any subdivision of this section
shall not exceed the maximum nor be less than the weekly benefits
specified in subdivision (b) of this section.




(l) Except as otherwise specifically provided in this chapter,
temporary total disability benefits payable under subdivision (b) of
this section shall not be deductible from permanent partial disability
awards payable under subdivision (e) or (f) of this section.
Compensation, either temporary total or permanent partial, under this
section shall be payable only to the injured employee and the right to
the compensation shall not vest in his or her estate, except that any unpaid compensation which would have been paid or payable to the
employee up to the time of his or her death, if he or she had lived,
shall be paid to the dependents of the injured employee if there are
any dependents at the time of death.




(m) The following permanent disabilities shall be conclusively
presumed to be total in character:




Loss of both eyes or the sight thereof.




Loss of both hands or the use thereof.




Loss of both feet or the use thereof.




Loss of one hand and one foot or the use thereof.




(n) (1) Other than for those injuries specified in subdivision
(m) of this section, in order to be eligible to apply for an award of
permanent total disability benefits for all injuries incurred and all
diseases, including occupational pneumoconiosis, regardless of the date
of last exposure, on and after the effective date of the amendment and
reenactment of this section during the year two thousand three a
claimant: (A) Must have been awarded the sum of fifty percent in prior
permanent partial disability awards; (B) must have suffered a single
occupational injury or disease which results in a finding by the
commission that the claimant has suffered a medical impairment of fifty
percent; or (C) has sustained a thirty-five percent statutory
disability pursuant to the provisions of subdivision (f) of this
section. Upon filing an application, the claim will be reevaluated by
the examining board pursuant to subdivision (i) of this section to
determine if the claimant has suffered a whole body medical impairment
of fifty percent or more resulting from either a single occupational
injury or occupational disease or a combination of occupational injuries and occupational diseases or has sustained a thirty-five
percent statutory disability pursuant to the provisions of subdivision
(f) of this section. A claimant whose prior permanent partial
disability awards total eighty-five percent or more shall also be
examined by the board and must be found to have suffered a whole body
medical impairment of fifty percent in order for his or her request to
be eligible for further review. The examining board shall review the
claim as provided for in subdivision (j) of this section. If the
claimant has not suffered whole body medical impairment of at least
fifty percent or has sustained a thirty-five percent statutory
disability pursuant to the provisions of subdivision (f) of this
section, the request shall be denied. Upon a finding that the claimant
has a fifty percent whole body medical impairment or has sustained a
thirty-five percent statutory disability pursuant to the provisions of
subdivision (f) of this section, the review of the application
continues as provided for in the following paragraph of this
subdivision. Those claimants whose prior permanent partial disability
awards total eighty-five percent or more and who have been found to
have a whole body medical impairment of at least fifty percent or have
sustained a thirty-five percent statutory disability pursuant to the
provisions of subdivision (f) of this section are entitled to the
rebuttable presumption created pursuant to subdivision (d) of this
section for the remaining issues in the request.




(2) For all awards made on or after the effective date of the
amendment and reenactment of this section during the year two thousand
three, disability which renders the injured employee unable to engage
in substantial gainful activity requiring skills or abilities which can be acquired or which are comparable to those of any gainful activity
in which he or she has previously engaged with some regularity and over
a substantial period of time shall be considered in determining the
issue of total disability. The comparability of preinjury income to
post-disability income will not be a factor in determining permanent
total disability. Geographic availability of gainful employment within
a driving distance of seventy-five miles from the residence of the
employee or within the distance from the residence of the employee to
his or her preinjury employment, whichever is greater, will be a factor
in determining permanent total disability. For any permanent total
disability award made after the amendment and reenactment of this
section in the year two thousand three, permanent total disability
benefits shall cease at age seventy years. In addition, the vocational
standards adopted pursuant to subsection (m), section seven, article
three of this chapter shall be considered once they are effective.




(3) In the event that a claimant, who has been found to have at
least a fifty percent whole body medical impairment or has sustained
a thirty-five percent statutory disability pursuant to the provisions
of subdivision (f) of this section, is denied an award of permanent
total disability benefits pursuant to this subdivision and accepts and
continues to work at a lesser paying job than he or she previously
held, the claimant is eligible, notwithstanding the provisions of
section nine of this article, to receive temporary partial
rehabilitation benefits for a period of four years. The benefits shall
be paid at the level necessary to ensure the claimant's receipt of the
following percentages of the average weekly wage earnings of the
claimant at the time of injury calculated as provided in this section and sections six-d and fourteen of this article:




(A) Eighty percent for the first year;




(B) Seventy percent for the second year;




(C) Sixty percent for the third year; and




(D) Fifty percent for the fourth year: Provided, That in no event
shall the benefits exceed one hundred percent of the average weekly
wage in West Virginia. In no event shall the benefits be subject to
the minimum benefit amounts required by the provisions of subdivision
(b) of this section.




(4) Notwithstanding any provision of this subsection, subsection
(d) of this section or any other provision of this code to the
contrary, on any claim filed on or after the effective date of the
amendment and reenactment of this section in the year two thousand
three:




(A) No percent of whole body medical impairment existing as the
result of carpal tunnel syndrome for which a claim has been made under
this chapter may be included in the aggregation of permanent disability
under the provisions of this subsection or subsection (d) of this
section; and




(B) No percent of whole body medical impairment existing as the
result of any occupational disease, the diagnosis of which is based
solely upon symptoms rather than specific, objective and measurable
medical findings, and for which a claim has been made under this
chapter may be included in the aggregation of permanent disability
under the provisions of this subsection or subsection (d) of this
section.




(o) The commission may elect to have any recipient of a permanent total disability award undergo one independent medical examination
during each of the first five years that the permanent total disability
award is paid and one independent medical examination during each
three-year period thereafter until the claimant reaches the age of
seventy: Provided, That the commission may elect to have any recipient
of a permanent total disability award under the age of fifty years
undergo one independent medical examination during each year that the
permanent total disability award is paid and one independent medical
examination during each three-year period thereafter until the claimant
reaches the age of seventy. The purpose of any such independent
medical examination will be to confirm the ongoing permanent total
disability status of the claimant.
§23-4-6a. Benefits and mode of payment to employees and dependents for
occupational pneumoconiosis; further adjustment of claim for
occupational pneumoconiosis.




If an employee is found to be permanently disabled due to
occupational pneumoconiosis, as defined in section one of this article,
the percentage of permanent disability is determined by the degree of
medical impairment that is found by the occupational pneumoconiosis
board. The commission shall enter an order setting forth the findings
of the occupational pneumoconiosis board with regard to whether the
claimant has occupational pneumoconiosis and the degree of medical
impairment, if any, resulting therefrom. That order is the final
decision of the commission for purposes of section one, article five
of this chapter. If a decision is objected to, the office of judges
shall affirm the decision of the occupational pneumoconiosis board made
following hearing unless the decision is clearly wrong in view of the reliable, probative and substantial evidence on the whole record.
Compensation is paid therefor in the same manner and at the same rate
as is provided for permanent disability under the provisions of
subdivisions (d), (e), (g), (h), (i), (j), (k), (m) and (n), section
six of this article: Provided, That for any employee who applies for
occupational pneumoconiosis benefits whose award was granted on or
after the effective date of the amendment and reenactment of this
section during the year two thousand three, there shall be no permanent
partial disability awarded based solely upon a diagnosis of
occupational pneumoconiosis, it being the intent of the Legislature to
eliminate any permanent partial disability awards for occupational
pneumoconiosis without a specific finding of measurable impairment.




If the employee dies from occupational pneumoconiosis, the
benefits shall be as provided for in section ten of this article; as
to the benefits sections eleven to fourteen, inclusive, of this article
apply.




In cases of permanent disability or death due to occupational
pneumoconiosis, as defined in section one of this article, accompanied
by active tuberculosis of the lungs, compensation shall be payable as
for disability or death due to occupational pneumoconiosis alone.




The provisions of section sixteen, article four of this chapter
and sections two, three, four and five, article five of this chapter
providing for the further adjustment of claims are applicable to the
claim of any claimant who receives a permanent partial disability award
for occupational pneumoconiosis.
§23-4-6b. Occupational hearing loss claims.




(a) In all claims for occupational hearing loss caused by either a single incident of trauma or by exposure to hazardous noise in the
course of and resulting from employment, the degree of permanent
partial disability, if any, shall be determined in accordance with the
provisions of this section and awards made in accordance with the
provisions of section six of this article.




(b) The percent of permanent partial disability for a monaural
hearing loss shall be computed in the following manner:




(1) The measured decibel loss of hearing due to injury at the
sound frequencies of five hundred, one thousand, two thousand and three
thousand hertz shall be determined for the injured ear and the total
shall be divided by four to ascertain the average decibel loss;




(2) The percent of monaural hearing impairment for the injured
ear shall be calculated by multiplying by one and six-tenths percent
the difference by which the aforementioned average decibel loss exceeds
twenty-seven and one-half decibels, up to a maximum of one hundred
percent hearing impairment, which maximum is reached at ninety
decibels; and




(3) The percent of monaural hearing impairment obtained shall be
multiplied by twenty-two and one-half to ascertain the degree of
permanent partial disability.




(c) The percent of permanent partial disability for a binaural
hearing loss shall be computed in the following manner:




(1) The measured decibel loss of hearing due to injury at the
sound frequencies of five hundred, one thousand, two thousand and three
thousand hertz is determined for each ear and the total for each ear
shall be divided by four to ascertain the average decibel loss for each
ear;




(2) The percent of hearing impairment for each ear is calculated
by multiplying by one and six-tenths percent the difference by which
the aforementioned average decibel loss exceeds twenty-seven and one-
half decibels, up to a maximum of one hundred percent hearing
impairment, which maximum is reached at ninety decibels;




(3) The percent of binaural hearing impairment shall be
calculated by multiplying the smaller percentage (better ear) by five,
adding this figure to the larger percentage (poorer ear) and dividing
the sum by six; and




(4) The percent of binaural hearing impairment obtained shall be
multiplied by fifty-five to ascertain the degree of permanent partial
disability.




(d) No permanent partial disability benefits shall be granted for
tinnitus, psychogenic hearing loss, recruitment or hearing loss above
three thousand hertz.




(e) An additional amount of permanent partial disability shall be
granted for impairment of speech discrimination, if any, to determine
the additional amount for binaural impairment, the percentage of speech
discrimination in each ear shall be added together and the result
divided by two to calculate the average percentage of speech
discrimination, and the permanent partial disability shall be
ascertained by reference to the percentage of permanent partial
disability in the table below on the line with the percentage of speech
discrimination obtained. To determine the additional amount for
monaural impairment, the permanent partial disability shall be
ascertained by reference to the percentage of permanent partial
disability in the table below on the line with the percentage of speech discrimination in the injured ear.
TABLE





% of Permanent



% of Speech Discrimination



Partial Disability
90% and up to and including 100% 







0%
80% and up to but not including 90%






1%
70% and up to but not including 80%






3%
60% and up to but not including 70%






4%
0% and up to but not including 60%







5%



(f) No temporary total disability benefits shall be granted for
noise-induced hearing loss.



(g) An application for benefits alleging a noise-induced hearing
loss shall set forth the name of the employer or employers and the time
worked for each. The commission shall allocate to and divide any
charges resulting from the claim among the employers with whom the
claimant sustained exposure to hazardous noise for as much as sixty
days during the period of three years immediately preceding the date
of last exposure. The allocation is based upon the time of exposure
with each employer. In determining the allocation, the commission
shall consider all the time of employment by each employer during which
the claimant was exposed and not just the time within the three-year
period, under the same allocation as is applied in occupational
pneumoconiosis cases.



(h) The commission shall provide, consistent with current
practice, for prompt referral the claims for evaluation, for all
medical reimbursement and for prompt authorization of hearing
enhancement devices.



(i) The provisions of this section and the amendments to section
six of this article insofar as applicable to permanent partial
disabilities for hearing loss are operative as to any claim filed after
thirty days from the effective date of this section.
§23-4-6d. Benefits payable to part-time employees.



(a) For purposes of this section, a part-time employee means an
employee who, at the date of injury, is customarily employed twenty-
five hours per week or less on a regular basis and is classified by the
employer as a part-time employee: Provided, That the term "part-time
employee" shall not include an employee who regularly works more than
twenty-five hours per week for the employer, nor shall it include an
employee who regularly works for more than one employer and whose
regular combined working hours total more than twenty-five hours per
week when that employee is rendered unable to perform the duties of his
or her employment as a result of the injury, nor shall it include any
employee in the construction industry who works less than twenty-five
hours per week.



(b) For purposes of establishing temporary total disability
weekly benefits pursuant to subdivision (b), section six of this
article for part-time employees, the "average weekly wage earnings,
wherever earned, of the injured person at the date of injury" shall be
computed based upon the best average weekly gross pay, wherever earned,
which is received by the employee during the best quarter of wages out
of the preceding four quarters of wages as reported to the commission
pursuant to subsection (b), section two, article two of this chapter:
Provided, That for part-time employees who have been employed less than
two months but more than one week prior to the date of injury or any employee whose wages have not yet been reported to the commission, the
average weekly wage earnings shall be calculated based upon the average
gross earnings in the weeks actually worked: Provided, however, That
for part-time employees who have been employed one week or less, the
average weekly wage earnings shall be calculated based upon the average
weekly wage prevailing for the same or similar part-time employment at
the time of injury except that when an employer has agreed to pay a
certain hourly wage to a part-time employee, the average weekly wage
shall be computed by multiplying the hourly wage by the regular numbers
of hours contracted to be worked each week: Provided further, That
notwithstanding any provision of this article to the contrary, no part-
time employee shall receive temporary total disability benefits greater
than his or her average weekly wage earnings as so calculated.



(c) Notwithstanding any other provisions of this article to the
contrary, benefits payable to a part-time injured employee for any
permanent disability shall be computed and paid on the same basis as
if the injured employee is not a part-time employee within the meaning
of this section.
§23-4-7. Release of medical information to employer; legislative
findings; effect of application for benefits; duty of employer.



(a) The Legislature hereby finds and declares that two of the
primary objectives of the workers' compensation system established by
this chapter are to provide benefits to an injured claimant promptly
and to effectuate his or her return to work at the earliest possible
time; that the prompt dissemination of medical information to the
commission and employer as to diagnosis, treatment and recovery is
essential if these two objectives are to be achieved; that claimants are increasingly burdened with the task of contacting their treating
physicians to request the furnishing of detailed medical information
to the commission and their employers; that the commission is
increasingly burdened with the administrative responsibility of
providing copies of medical reports to the employer involved, whereas
in other states the employer can obtain the necessary medical
information direct from the treating physician; that much litigation
is occasioned in this state because of a lack of medical information
having been received by the employer as to the continuing disability
of a claimant; and that detailed narrative reports from the treating
physician are often necessary in order for the commission, the
claimant's representatives and the employer to evaluate a claim and
determine whether additional or different treatment is indicated.



(b) In view of the foregoing findings, a claimant irrevocably
agrees by the filing of his or her application for benefits that any
physician may release to and orally discuss with the claimant's
employer, or its representative, or with a representative of the
commission, from time to time, the claimant's medical history and any
medical reports pertaining to the occupational injury or disease and
to any prior injury or disease of the portion of the claimant's body
to which a medical impairment is alleged containing detailed
information as to the claimant's condition, treatment, prognosis and
anticipated period of disability and dates as to when the claimant will
reach or has reached his or her maximum degree of improvement or will
be or was released to return to work. For the exclusive purposes of
this chapter, the patient-physician privilege of confidentiality is
waived with regard to the physician's providing this medical information to the commission, the employer or to the employer's
representative. Whenever a copy of any medical report is obtained by
the employer or its representative and the physician has not also
forwarded a copy of the medical report to the commission, the employer
shall forward a copy of the medical report to the commission within ten
days from the date the employer received the medical report from the
physician.
§23-4-7a. Monitoring of injury claims; legislative findings; review
of medical evidence; recommendation of authorized treating
physician; independent medical evaluations; temporary total
disability benefits and the termination thereof; mandatory
action; additional authority; suspension of benefits.



(a) The Legislature hereby finds and declares that injured
claimants should receive the type of treatment needed as promptly as
possible; that overpayments of benefits with the resultant hardship
created by the requirement of repayment should be minimized; and that
to achieve these two objectives it is essential that the commission
establish and operate a systematic program for the monitoring of injury
claims where the disability continues longer than might ordinarily be
expected.



(b) In view of the foregoing findings, the commission, in
consultation with the health care advisory panel, shall establish
guidelines as to the anticipated period of disability for the various
types of injuries. Each injury claim in which temporary total
disability continues beyond the anticipated period of disability
established for the injury involved shall be reviewed by the
commission. If satisfied, after reviewing the medical evidence, that the claimant would not benefit by an independent medical evaluation,
the commission shall mark the claim file accordingly and shall diary
the claim file as to the next date for required review which shall not
exceed sixty days. If the commission concludes that the claimant might
benefit by an independent medical evaluation, the commission shall
proceed as specified in subsections (d) and (e) of this section.



(c) When the authorized treating physician concludes that the
claimant has either reached his or her maximum degree of improvement
or is ready for disability evaluation, or when the claimant has
returned to work, the authorized treating physician may recommend a
permanent partial disability award for residual impairment relating to
and resulting from the compensable injury, and the following provisions
govern and control:



(1) If the authorized treating physician recommends a permanent
partial disability award of fifteen percent or less, the commission
shall enter an award of permanent partial disability benefits based
upon the recommendation and all other available information. The
claimant's entitlement to temporary total disability benefits ceases
upon the entry of the award unless previously terminated under the
provisions of subsection (e) of this section.



(2) If, however, the authorized treating physician recommends a
permanent partial disability award in excess of fifteen percent, or
recommends a permanent total disability award, the claimant's
entitlement to temporary total disability benefits ceases upon the
receipt by the commission of the medical report. The commission shall
refer the claimant to a physician or physicians of the commission's
selection for independent evaluation prior to the entry of a permanent disability award: Provided, That unless the claimant has returned to
work, the claimant shall thereupon receive benefits which shall be at
the permanent partial disability rate as provided in subdivision (e),
section six of this article until the entry of a permanent disability
award or until the claimant returns to work. The amount of benefits
paid prior to the receipt of the independent evaluation report shall
be considered and determined to be payment of the permanent disability
award granted, if any. In the event that benefits actually paid exceed
the amount granted by the permanent partial disability award, the
claimant is entitled to no further benefits by the award and the excess
paid shall be an overpayment
. For all awards made or nonawarded
partial benefits paid the commission or self-insured employer may only
recover the amount of overpaid benefits or expenses by withholding, in
whole or in part, future disability benefits payable to the individual
in the same or other claims and credit the amount against the
overpayment until it is repaid in full.



(d) When the commission concludes that an independent medical
evaluation is indicated, or that a claimant may be ready for disability
evaluation in accordance with other provisions of this chapter, the
commission shall refer the claimant to a physician or physicians of the
commission's selection for examination and evaluation. If the
physician or physicians selected recommend continued, additional or
different treatment, the recommendation shall be relayed to the
claimant and the claimant's treating physician and the recommended
treatment may be authorized by the commission.



(e) Notwithstanding any provision in subsection (c) of this
section, the commission shall enter a notice suspending the payment of temporary total disability benefits but providing a reasonable period
of time during which the claimant may submit evidence justifying the
continued payment of temporary total disability benefits when:



(1) The physician or physicians selected by the commission
conclude that the claimant has reached his or her maximum degree of
improvement;



(2) When the authorized treating physician advises the commission
that the claimant has reached his or her maximum degree of improvement
or that he or she is ready for disability evaluation and when the
authorized treating physician has not made any recommendation with
respect to a permanent disability award as provided in subsection (c)
of this section;



(3) When other evidence submitted to the commission justifies a
finding that the claimant has reached his or her maximum degree of
improvement; or



(4) When other evidence submitted or otherwise obtained justifies
a finding that the claimant has engaged or is engaging in abuse,
including, but not limited to, physical activities inconsistent with
his or her compensable workers' compensation injury.



In all cases, a finding by the commission that the claimant has
reached his or her maximum degree of improvement terminates the
claimant's entitlement to temporary total disability benefits
regardless of whether the claimant has been released to return to work.
Under no circumstances shall a claimant be entitled to receive
temporary total disability benefits either beyond the date the claimant
is released to return to work or beyond the date he or she actually
returns to work.



In the event that the medical or other evidence indicates that
claimant has a permanent disability, unless he or she has returned to
work, the claimant shall thereupon receive benefits which shall be at
the permanent partial disability rate as provided in subdivision (e),
section six of this article until entry of a permanent disability
award, pursuant to an evaluation by a physician or physicians selected
by the commission, or until the claimant returns to work. The amount
of benefits shall be considered and determined to be payment of the
permanent disability award granted, if any. In the event that benefits
actually paid exceed the amount granted under the permanent disability
award, the claimant is entitled to no further benefits by the order but
shall not be liable by offset or otherwise for the excess paid.



(f) Notwithstanding the anticipated period of disability
established pursuant to the provisions of subsection (b) of this
section, whenever in any claim temporary total disability continues
longer than one hundred twenty days from the date of injury (or from
the date of the last preceding examination and evaluation pursuant to
the provisions of this subsection or pursuant to the directions of the
commission under other provisions of this chapter), the commission
shall refer the claimant to a physician or physicians of the
commission's selection for examination and evaluation in accordance
with the provisions of subsection (d) of this section and the
provisions of subsection (e) of this section are fully applicable:
Provided, That the requirement of mandatory examinations and
evaluations pursuant to the provisions of this subsection shall not
apply to any claimant who sustained a brain stem or spinal cord injury
with resultant paralysis or an injury which resulted in an amputation necessitating a prosthetic appliance.



(g) The provisions of this section are in addition to and in no
way in derogation of the power and authority vested in the commission
by other provisions of this chapter or vested in the employer to have
a claimant examined by a physician or physicians of the employer's
selection and at the employer's expense, or vested in the claimant or
employer to file a protest, under other provisions of this chapter.



(h) All evaluations and examinations performed by physicians
shall be performed in accordance with the protocols and procedures
established by the health care advisory panel pursuant to section
three-b of this article: Provided, That the physician may exceed these
protocols when additional evaluation is medically necessary.



(i) The commission may suspend benefits being paid to a claimant
if the claimant refuses, without good cause, to undergo the
examinations or needed treatments provided for in this section until
the claimant submits to the examination or needed treatments. The
executive director shall propose rules for approval by the commission
to implement the provisions of this subsection.
§23-4-7b. Trial return to work.



(a) The Legislature hereby finds and declares that it is in the
interest of employees, employers and the commission that injured
employees be encouraged to return to work as quickly as possible after
an injury and that appropriate protections be afforded to injured
employees who return to work on a trial basis.



(b) Notwithstanding any other provisions of this chapter to the
contrary, the injured employee shall not have his or her eligibility
to receive temporary total disability benefits terminated when he or she returns to work on a trial basis as set forth in this section. An
employee is eligible to return to work on a trial basis when he or she
is released to work on a trial basis by the treating physician.



(c) When an injured employee returns to work on a trial basis,
the employer shall provide a trial return-to-work notification to the
commission. Upon receipt of the notification, the commission shall
note the date of the first day of work pursuant to the trial return and
shall continue the claimant's eligibility for temporary total
disability benefits, but shall temporarily suspend the payment of
temporary total disability benefits during the period actually worked
by the injured employee. The claim shall be closed on a temporary
total disability basis either when the injured employee or the
authorized treating physician notifies the commission that the injured
employee is able to perform his or her job or automatically at the end
of a period of three months from the date of the first day of work
unless the employee notifies the commission that he or she is unable
to perform the duties of the job, whichever occurs first. If the
injured employee is unable to continue working due to the compensable
injury for a three-month period, the injured employee shall notify the
commission and temporary total disability benefits shall be reinstated
immediately and he or she shall be referred for a rehabilitation
evaluation as provided in section nine of this article. No provision
of this section shall be construed to prohibit the commission from
referring the injured employee for any permanent disability evaluation
required or permitted by any other provision of this article.



(d) Nothing in this section shall prevent the employee from
returning to work without a trial return-to-work period.



(e) Nothing in this section shall be construed to require an
injured employee to return to work on a trial basis.



(f) The provisions of this section shall be terminated and be of
no further force and effect on the first day of July, two thousand
seven.
§23-4-8. Physical examination of claimant.



The commission may, after due notice to the employer and
claimant, whenever in the commission's opinion it is necessary, order
a claimant of compensation for a personal injury other than
occupational pneumoconiosis to appear for examination before a medical
examiner or examiners selected by the commission; and the claimant and
employer, respectively, each have the right to select a physician of
the claimant's or the employer's own choosing and at the claimant's or
the employer's own expense to participate in the examination. All
examinations shall be performed in accordance with the protocols and
procedures established by the health care advisory panel pursuant to
section three-b of this article: Provided, That the physician may
exceed these protocols when additional evaluation is medically
necessary. The claimant and employer shall, respectively, be furnished
with a copy of the report of examination made by the medical examiner
or examiners selected by the commission. The respective physicians
selected by the claimant and employer have the right to concur in any
report made by the medical examiner or examiners selected by the
commission, or each may file with the commission a separate report,
which separate report shall be considered by the commission in passing
upon the claim. If the compensation claimed is for occupational
pneumoconiosis, the commission may, after due notice to the employer, and whenever in the commission's opinion it is necessary, order a
claimant to appear for examination before the occupational
pneumoconiosis board provided for in section eight-a of this article.
In any case the claimant is entitled to reimbursement for loss of
wages, and to reasonable traveling and other expenses necessarily
incurred by him or her in obeying the order.



Where the claimant is required to undergo a medical examination
or examinations by a physician or physicians selected by the employer,
as aforesaid or in connection with any claim which is in litigation,
the employer shall reimburse the claimant for loss of wages, and
reasonable traveling and other expenses in connection with the
examination or examinations, not to exceed the expenses paid when a
claimant is examined by a physician or physicians selected by the
commission.
§23-4-8a. Occupational pneumoconiosis board; composition; term of
office; duties; quorum; remuneration.



The occupational pneumoconiosis board shall consist of five
licensed physicians who shall be appointed by the executive director.
No person shall be appointed as a member of the board, or as a
consultant thereto, who has not by special study or experience, or
both, acquired special knowledge of pulmonary diseases. All members
of the occupational pneumoconiosis board shall be physicians of good
professional standing admitted to practice medicine and surgery in this
state. Two members shall be roentgenologists. One member of the board
shall be designated annually as chairman by the executive director.
The term of office of each member of the board shall be six years. The
five members of the existing board in office on the effective date of this section shall continue to serve until their terms expire and until
their successors have been appointed and have qualified. Any member
of the board may be appointed to any number of terms. The function of
the board is to determine all medical questions relating to cases of
compensation for occupational pneumoconiosis under the direction and
supervision of the executive director. Any three members of the board
constitute a quorum for the transaction of its business if at least one
of the members present is a roentgenologist. The executive director
shall, from time to time, fix the compensation to be paid each member
of the board. Members are also entitled to reasonable and necessary
traveling and other expenses incurred while actually engaged in the
performance of their duties. In fixing the compensation of board
members, the executive director shall take into consideration the
number of claimants a member of the board actually examines, the actual
time spent by members in discharging their duties and the
recommendation of the board of managers as to reasonable reimbursement
per unit of time expended based on comparative data for physicians
within the state in the same medical specialties.
§23-4-8b. Occupational pneumoconiosis board; procedure; autopsy.



The occupational pneumoconiosis board, upon reference to it by
the commission of a case of occupational pneumoconiosis, shall notify
the employee, or in case he or she is dead, the claimant, and the
employer to appear before the board at a time and place stated in the
notice. If the employee is living, he or she shall appear before the
board at the time and place specified and submit to the examination,
including clinical and X-ray examinations, required by the board. If
a physician licensed to practice medicine in the state makes an affidavit that the employee is physically unable to appear at the time
and place designated by the board, the board shall, on notice to the
proper parties, change the place and time as may reasonably facilitate
the hearing or examination of the employee or may appoint a qualified
specialist in the field of respiratory disease to examine the claimant
on behalf of the board. The employee, or in case he or she is dead,
the claimant, and employer shall also produce as evidence to the board
all reports of medical and X-ray examinations which may be in their
respective possession or control, showing the past or present condition
of the employee. If the employee is dead, the notice of the board
shall further require that the claimant produce necessary consents and
permits so that an autopsy may be performed, if the board so directs.
When in the opinion of the board an autopsy is considered necessary
accurately and scientifically to ascertain and determine the cause of
death, the autopsy examination shall be ordered by the board, which
shall designate a duly licensed physician, a pathologist or any other
specialists determined necessary by the board, to make the examination
and tests to determine the cause of death and certify his or her or
their written findings, in triplicate, to the board. The findings
shall be public records. In the event that a claimant for compensation
for the death refuses to consent and permit the autopsy to be made, all
rights for compensation are forfeited.



The employee, or if he or she be dead, the claimant, and the
employer, shall be entitled to be present at all examinations conducted
by the board and to be represented by attorneys and physicians.
§23-4-8c. Occupational pneumoconiosis board; reports and distribution
thereof; presumption; findings required of board; objection to findings; procedure thereon; limitations on refilings;
consolidation of claims.



(a) The occupational pneumoconiosis board, as soon as
practicable, after it has completed its investigation, shall make its
written report, to the commission of its findings and conclusions on
every medical question in controversy and the commission shall send one
copy of the report to the employee or claimant and one copy to the
employer. The board shall also return to and file with the commission
all the evidence as well as all statements under oath, if any, of the
persons who appeared before it on behalf of the employee or claimant,
or employer, and also all medical reports and X-ray examinations
produced by or on behalf of the employee or claimant, or employer.



(b) If it can be shown that the claimant or deceased employee has
been exposed to the hazard of inhaling minute particles of dust in the
course of and resulting from his or her employment for a period of ten
years during the fifteen years immediately preceding the date of his
or her last exposure to such hazard and that the claimant or deceased
employee has sustained a chronic respiratory disability, it shall be
presumed that the claimant is suffering or the deceased employee was
suffering at the time of his or her death from occupational
pneumoconiosis which arose out of and in the course of his or her
employment. This presumption is not conclusive.



(c) The findings and conclusions of the board shall set forth,
among other things, the following:



(1) Whether or not the claimant or the deceased employee has
contracted occupational pneumoconiosis and, if so, the percentage of
permanent disability resulting therefrom;



(2) Whether or not the exposure in the employment was sufficient
to have caused the claimant's or deceased employee's occupational
pneumoconiosis or to have perceptibly aggravated an existing
occupational pneumoconiosis or other occupational disease; and



(3) What, if any, physician appeared before the board on behalf
of the claimant or employer and what, if any, medical evidence was
produced by or on behalf of the claimant or employer.



(d) If either party objects to the whole or any part of the
findings and conclusions of the board, the party shall file with the
commission or, on or after the first day of July, one thousand nine
hundred ninety-one, with the office of judges, within thirty days from
receipt of the copy to that party, unless for good cause shown the
commission or chief administrative law judge extends the time, the
party's objections to the findings and conclusions of the board in
writing, specifying the particular statements of the board's findings
and conclusions to which such party objects. The filing of an
objection within the time specified is a condition of the right to
litigate the findings and therefore jurisdictional. After the time has
expired for the filing of objections to the findings and conclusions
of the board, the commission or administrative law judge shall proceed
to act as provided in this chapter. If after the time has expired for
the filing of objections to the findings and conclusions of the board
no objections have been filed, the report of a majority of the board
of its findings and conclusions on any medical question shall be taken
to be plenary and conclusive evidence of the findings and conclusions
stated in the report. If objection has been filed to the findings and
conclusions of the board, notice of the objection shall be given to the board, and the members of the board joining in the findings and
conclusions shall appear at the time fixed by the commission or office
of judges for the hearing to submit to examination and cross-
examination in respect to the findings and conclusions. At the
hearing, evidence to support or controvert the findings and conclusions
of the board shall be limited to examination and cross-examination of
the members of the board and to the taking of testimony of other
qualified physicians and roentgenologists.



(e) In the event that a claimant receives a final decision that
he or she has no evidence of occupational pneumoconiosis, the claimant
is barred for a period of three years from the date of the occupational
pneumoconiosis board's decision or until his or her employment with the
employer who employed the claimant at the time designated as the
claimant's last date of exposure in the denied claim has terminated,
whichever is sooner, from filing a new claim or pursuing a previously
filed, but unruled upon, claim for occupational pneumoconiosis or
requesting a modification of any prior ruling finding him or her not
to be suffering from occupational pneumoconiosis. For the purposes of
this subsection, a claimant's employment shall be considered to be
terminated if, for any reason, he or she has not worked for that
employer for a period in excess of ninety days. Any previously filed,
but unruled upon, claim shall be consolidated with the claim in which
the board's decision is made and shall be denied together with the
decided claim. The provisions of this subsection shall not be applied
in any claim where doing so would, in and of itself, later cause a
claimant's claim to be forever barred by the provisions of section
fifteen of this article.
§23-4-9. Physical and vocational rehabilitation.



(a) The Legislature hereby finds that it is a goal of the
workers' compensation program to assist employees to return to suitable
gainful employment after an injury. In order to encourage workers to
return to employment and to encourage and assist employers in providing
suitable employment to injured employees, it is a priority of the
commission to achieve early identification of individuals likely to
need rehabilitation services and to assess the rehabilitation needs of
these injured employees. It is the goal of rehabilitation to return
injured employees to employment which is comparable in work and pay to
that which the individual performed prior to the injury. If a return
to comparable work is not possible, the goal of rehabilitation is to
return the individual to alternative suitable employment, using all
possible alternatives of job modification, restructuring, reassignment
and training, so that the individual will return to productivity with
his or her employer or, if necessary, with another employer. The
Legislature further finds that it is the shared responsibility of the
employer, the employee, the physician and the commission to cooperate
in the development of a rehabilitation process designed to promote
reemployment for the injured employee.



(b) In cases where an employee has sustained a permanent
disability, or has sustained an injury likely to result in temporary
disability as determined by the commission, the commission shall at the
earliest possible time determine whether the employee would be assisted
in returning to remunerative employment with the provision of
rehabilitation services and if the commission determines that the
employee can be physically and vocationally rehabilitated and returned to remunerative employment by the provision of rehabilitation services
including, but not limited to, vocational or on-the-job training,
counseling, assistance in obtaining appropriate temporary or permanent
work site, work duties or work hours modification, by the provision of
crutches, artificial limbs or other approved mechanical appliances, or
medicines, medical, surgical, dental or hospital treatment or other
services which the commission in its sole discretion determines will
directly assist the employee's return to employment, the commission
shall immediately develop a rehabilitation plan for the employee and,
after due notice to the employer, expend an amount necessary for that
purpose: Provided, That the expenditure for vocational rehabilitation
shall not exceed twenty thousand dollars for any one injured employee:
Provided, however, That no payment shall be made for such vocational
rehabilitation purposes as provided in this section unless authorized
by the commission prior to the rendering of the physical or vocational
rehabilitation, except that payments shall be made for reasonable
medical expenses without prior authorization if sufficient evidence
exists which would relate the treatment to the injury and the attending
physician or physicians have requested authorization prior to the
rendering of the treatment: Provided further, That payment for physical
rehabilitation, including the purchase of prosthetic devices and other
equipment and training in use of the devices and equipment, are
considered expenses within the meaning of section three of this article
and are subject to the provisions of sections three, three-b and three-
c of this article. The provision of any rehabilitation services may
be pursuant to a rehabilitation plan to be developed and monitored by
a rehabilitation professional for each injured employee or by such other provider as determined by the commission. Notwithstanding any
other provision of this section to the contrary, the commission may
determine under rules promulgated by the board of managers that a
rehabilitation plan or any component thereof is not appropriate for an
injured employee.



(c) In every case in which the commission orders physical or
vocational rehabilitation of a claimant as provided in this section,
the claimant shall, during the time he or she is receiving any
vocational rehabilitation or rehabilitative treatment that renders him
or her totally disabled during the period of rehabilitation, be
compensated on a temporary total disability basis for that period.



(d) In every case in which the claimant returns to gainful
employment as part of a rehabilitation plan, and the employee's average
weekly wage earnings are less than the average weekly wage earnings
earned by the injured employee at the time of the injury, he or she
shall receive temporary partial rehabilitation benefits calculated as
follows: The temporary partial rehabilitation benefit shall be seventy
percent of the difference between the average weekly wage earnings
earned at the time of the injury and the average weekly wage earnings
earned at the new employment, both to be calculated as provided in
sections six, six-d and fourteen of this article as the calculation is
performed for temporary total disability benefits, subject to the
following limitations: In no event are the benefits subject to the
minimum benefit amounts required by the provisions of subdivision (b),
section six of this article, nor may the benefits exceed the temporary
total disability benefits to which the injured employee would be
entitled pursuant to sections six, six-d and fourteen of this article during any period of temporary total disability resulting from the
injury in the claim: Provided, That no temporary total disability
benefits shall be paid for any period for which temporary partial
rehabilitation benefits are paid: Provided, however, That the aggregate
award of temporary total rehabilitation or temporary partial
rehabilitation benefits for a single injury for which an award of
temporary total rehabilitation or temporary partial rehabilitation
benefits is made on or after the effective date of the amendment and
reenactment of this section in the year two thousand three shall be for
a period not exceeding fifty-two weeks unless the payment of temporary
total rehabilitation disability benefits is in conjunction with an
approved vocational rehabilitation plan for retraining, in which event
the payment period of temporary total rehabilitation disability
benefits may be extended for a period not to exceed a total of one
hundred four weeks. The amount of temporary partial rehabilitation
benefits payable under this subsection shall be reviewed every ninety
days to determine whether the injured employee's average weekly wage
in the new employment has changed and, if the change has occurred, the
amount of benefits payable under this subsection shall be adjusted
prospectively. Temporary partial rehabilitation benefits shall only
be payable when the injured employee is receiving vocational
rehabilitation services in accordance with a rehabilitation plan
developed under this section and no payment of temporary partial
rehabilitation benefits shall be made after the claimant has received
the vocational training provided under the rehabilitation plan.



(e) The executive director, in consultation with the board of
managers, shall propose for promulgation rules for the purpose of developing a comprehensive rehabilitation program which will assist
injured workers to return to suitable gainful employment after an
injury in a manner consistent with the provisions and findings of this
section. The rules shall provide definitions for rehabilitation
facilities and rehabilitation services pursuant to this section.
Notwithstanding any other provision of this chapter to the contrary,
and in addition to the provisions of section three of this article
authorizing employers to participate in a managed health care plan,
including a managed health care plan that provide physical and
vocational rehabilitation services, an employer may contract directly
with one or more providers of vocational rehabilitation services to be
the employer's preferred provider of vocational rehabilitation services
for its employees who receive injuries compensable under the provisions
of this chapter and the rules promulgated under this section may
require those employees to use the preferred providers.




§23-4-9b. Preexisting impairments not considered in fixing amount of
compensation.



Where an employee has a definitely ascertainable impairment
resulting from an occupational or a nonoccupational injury, disease or
any other cause, whether or not disabling, and the employee thereafter
receives an injury in the course of and resulting from his or her
employment, unless the subsequent injury results in total permanent
disability within the meaning of section one, article three of this
chapter, the prior injury, and the effect of the prior injury, and an
aggravation, shall not be taken into consideration in fixing the amount
of compensation allowed by reason of the subsequent injury. Compensation shall be awarded only in the amount that would have been
allowable had the employee not had the preexisting impairment. Nothing
in this section requires that the degree of the preexisting impairment
be definitely ascertained or rated prior to the injury received in the
course of and resulting from the employee's employment or that benefits
must have been granted or paid for the preexisting impairment. The
degree of the preexisting impairment may be established at any time by
competent medical or other evidence. Notwithstanding the foregoing
provisions of this section, if the definitely ascertainable preexisting
impairment resulted from an injury or disease previously held
compensable and the impairment had not been rated, benefits for the
impairment shall be payable to the claimant by or charged to the
employer in whose employ the injury or disease occurred. The employee
shall also receive the difference, if any, in the benefit rate
applicable in the more recent claim and the prior claim.
§23-4-10. Classification of death benefits; "dependent" defined.



In case a personal injury, other than occupational pneumoconiosis
or other occupational disease, suffered by an employee in the course
of and resulting from his or her employment, causes death, and
disability is continuous from the date of the injury until the date of
death, or if death results from occupational pneumoconiosis or from any
other occupational disease, the benefits shall be in the amounts and
to the persons as follows:



(a) If there are no dependents, the disbursements shall be
limited to the expense provided for in sections three and four of this
article;



(b) If there are dependents as defined in subdivision (d) of this section, the dependents shall be paid for as long as their dependency
continues in the same amount that was paid or would have been paid the
deceased employee for total disability had he or she lived. The order
of preference of payment and length of dependence shall be as follows:



(1) A dependent widow or widower until death or remarriage of the
widow or widower, and any child or children dependent upon the decedent
until each child reaches eighteen years of age or where the child after
reaching eighteen years of age continues as a full-time student in an
accredited high school, college, university, business or trade school,
until the child reaches the age of twenty-five years, or if an invalid
child, to continue as long as the child remains an invalid. All
persons are jointly entitled to the amount of benefits payable as a
result of employee's death;



(2) A wholly dependent father or mother until death; and



(3) Any other wholly dependent person for a period of six years
after the death of the deceased employee;



(c) If the deceased employee leaves no wholly dependent person,
but there are partially dependent persons at the time of death, the
payment shall be fifty dollars a month to continue for the portion of
the period of six years after the death, determined by the commission,
but no partially dependent person shall receive compensation payments
as a result of the death of more than one employee.



Compensation under subdivisions (b) and (c) of this section
shall, except as may be specifically provided to the contrary in those
subdivisions, cease upon the death of the dependent, and the right to
the compensation shall not vest in his or her estate.



(d) "Dependent", as used in this chapter, means a widow, widower, child under eighteen years of age, or under twenty-five years of age
when a full-time student as provided in this section, invalid child or
posthumous child, who, at the time of the injury causing death, is
dependent, in whole or in part, for his or her support upon the
earnings of the employee, stepchild under eighteen years of age, or
under twenty-five years of age when a full-time student as provided in
this section, child under eighteen years of age legally adopted prior
to the injury causing death, or under twenty-five years of age when a
full-time student as provided in this section, father, mother,
grandfather or grandmother, who, at the time of the injury causing
death, is dependent, in whole or in part, for his or her support upon
the earnings of the employee; and invalid brother or sister wholly
dependent for his or her support upon the earnings of the employee at
the time of the injury causing death; and



(e) If a person receiving permanent total disability benefits
dies from a cause other than a disabling injury leaving any dependents
as defined in subdivision (d) of this section, an award shall be made
to the dependents in an amount equal to one hundred four times the
weekly benefit the worker was receiving at the time of his or her death
and be paid either as a lump sum or in periodic payments, at the option
of the dependent or dependents.
§23-4-11. To whom death benefits paid.



The benefits, in case of death, shall be paid to one or more
dependents of the decedent, or to any other persons, for the benefit
of all of the dependents, as may be determined by the commission, who
may apportion the benefits among the dependents in the manner as they
consider just and equitable. Payment to a dependent subsequent in right may be made if the commission considers proper and it operates
to discharge all other claims for the benefits.
§23-4-12. Application of benefits.



The dependent or person to whom benefits are paid shall apply the
benefits to the use of the several beneficiaries of the benefits
according to their respective claims upon the decedent for support, in
compliance with the finding and direction of the commission.
§23-4-14. Computation of benefits.



(a) The average weekly wage earnings, wherever earned, of the
injured person at the date of injury and the average weekly wage in
West Virginia as determined by the commission, in effect at the date
of injury, shall be taken as the basis upon which to compute the
benefits.



(1) In cases involving occupational pneumoconiosis or other
occupational diseases, the "date of injury" is the date of the last
exposure to the hazards of occupational pneumoconiosis or other
occupational diseases.



(2) In computing benefits payable on account of occupational
pneumoconiosis, the commission shall deduct the amount of all prior
workers' compensation benefits paid to the same claimant on account of
silicosis, but a prior silicosis award shall not, in any event,
preclude an award for occupational pneumoconiosis otherwise payable
under this article.



(b) (1) Until the first day of July, one thousand nine hundred
ninety-four, the expression "average weekly wage earnings, wherever
earned, of the injured person, at the date of injury", within the
meaning of this chapter, shall be computed based upon the daily rate of pay at the time of the injury or upon the average pay received
during the two months, six months or twelve months immediately
preceding the date of the injury, whichever is most favorable to the
injured employee, except for the purpose of computing temporary total
disability benefits for part-time employees pursuant to the provisions
of section six-d of this article.



(2) On and after the first day of July, one thousand nine hundred
ninety-four, the expression "average weekly wage earnings, wherever
earned, of the injured person, at the date of injury", within the
meaning of this chapter, shall be computed based upon the daily rate
of pay at the time of the injury or upon the weekly average derived
from the best quarter of wages out of the preceding four quarters of
wages as reported to the commission pursuant to subsection (b), section
two, article two of this chapter, whichever is most favorable to the
injured employee, except for the purpose of computing temporary total
disability benefits for part-time employees pursuant to the provisions
of section six-d of this article.



(c) The expression "average weekly wage in West Virginia", within
the meaning of this chapter, is the average weekly wage in West
Virginia as determined by the commissioner of the bureau of employment
programs in accordance with the provisions of sections ten and eleven,
article six, chapter twenty-one-a of this code and other applicable
provisions of said chapter.



(d) In any claim for injuries, including occupational
pneumoconiosis and other occupational diseases, occurring on or after
the first day of July, one thousand nine hundred seventy-one, any award
for temporary total, permanent partial or permanent total disability benefits or for dependent benefits shall be paid at the weekly rates
or in the monthly amount in the case of dependent benefits applicable
to the claimant in effect on the date of the injury. In no event shall
an award for permanent total disability be subject to annual
adjustments resulting from changes in the average weekly wage in West
Virginia.
§23-4-15. Application for benefits.



(a) To entitle any employee or dependent of a deceased employee
to compensation under this chapter, other than for occupational
pneumoconiosis or other occupational disease, the application for
compensation shall be made on the form or forms prescribed by the
commission and filed with the commission within six months from and
after the injury or death, as the case may be, and unless filed within
the six months period, the right to compensation under this chapter is
forever barred, such time limitation being hereby declared to be a
condition of the right and hence jurisdictional, and all proofs of
dependency in fatal cases must also be filed with the commission within
six months from and after the death. In case the employee is mentally
or physically incapable of filing the application, it may be filed by
his or her attorney or by a member of his or her family.



(b) To entitle any employee to compensation for occupational
pneumoconiosis under the provisions of this subsection, the application
for compensation shall be made on the form or forms prescribed by the
commission and filed with the commission within three years from and
after the last day of the last continuous period of sixty days or more
during which the employee was exposed to the hazards of occupational
pneumoconiosis or within three years from and after a diagnosed impairment due to occupational pneumoconiosis was made known to the
employee by a physician and unless filed within the three-year period,
the right to compensation under this chapter is forever barred, such
time limitation being hereby declared to be a condition of the right
and hence jurisdictional, or, in the case of death, the application
shall be filed by the dependent of the employee within one year from
and after the employee's death, and such time limitation is a condition
of the right and hence jurisdictional.



(c) To entitle any employee to compensation for occupational
disease other than occupational pneumoconiosis under the provisions of
this section, the application for compensation shall be made on the
form or forms prescribed by the commission and filed with the
commission within three years from and after the day on which the
employee was last exposed to the particular occupational hazard
involved or within three years from and after the employee's
occupational disease was made known to him or her by a physician or
which he or she should reasonably have known, whichever last occurs,
and unless filed within the three-year period, the right to
compensation under this chapter shall be forever barred, such time
limitation being hereby declared to be a condition of the right and
therefore jurisdictional, or, in case of death, the application shall
be filed as aforesaid by the dependent of the employee within one year
from and after the employee's death, and such time limitation is a
condition of the right and hence jurisdictional.
§23-4-15a. Nonresident alien beneficiaries.



Notwithstanding any other provisions of this chapter, nonresident
alien beneficiaries are entitled to the same benefits as citizens of the United States: Provided, That the commission in its discretion may
make, and the beneficiary shall accept, commutation of the benefits
into a lump sum settlement and payment. Nonresident alien
beneficiaries within the meaning of this section means persons not
citizens of the United States residing outside of the territorial
limits of the United States at the time of the injury with respect to
which benefits are awarded.
§23-4-15b. Determination of nonmedical questions by commission; claims
for occupational pneumoconiosis; hearing.



If a claim for occupational pneumoconiosis benefits is filed by
an employee within three years from and after the last day of the last
continuous period of sixty days' exposure to the hazards of
occupational pneumoconiosis, the commission shall determine whether the
claimant was exposed to the hazards of occupational pneumoconiosis for
a continuous period of not less than sixty days while in the employ of
the employer within three years prior to the filing of his or her
claim, whether in the state of West Virginia the claimant was exposed
to such hazard over a continuous period of not less than two years
during the ten years immediately preceding the date of his or her last
exposure to the hazard and whether the claimant was exposed to the
hazard over a period of not less than ten years during the fifteen
years immediately preceding the date of his or her last exposure to the
hazard. If a claim for occupational pneumoconiosis benefits is filed
by an employee within three years from and after the employee's
occupational pneumoconiosis was made known to the employee by a
physician, the commission shall determine whether the claimant filed
his or her application within that period and whether in the state of West Virginia the claimant was exposed to the hazard over a continuous
period of not less than two years during the ten years immediately
preceding the date of last exposure to the hazard and whether the
claimant was exposed to the hazard over a period of not less than ten
years during the fifteen years immediately preceding the date of last
exposure to the hazard. If a claim for occupational pneumoconiosis
benefits is filed by a dependent of a deceased employee, the commission
shall determine whether the deceased employee was exposed to the
hazards of occupational pneumoconiosis for a continuous period of not
less than sixty days while in the employ of the employer within ten
years prior to the filing of the claim, whether in the state of West
Virginia the deceased employee was exposed to the hazard over a
continuous period of not less than two years during the ten years
immediately preceding the date of his or her last exposure to the
hazard and whether the claimant was exposed to the hazard over a period
of not less than ten years during the fifteen years immediately
preceding the date of his or her last exposure to the hazard. The
commission shall also determine other nonmedical facts that, in the
commission's opinion, are pertinent to a decision on the validity of
the claim.



The commission shall enter an order with respect to nonmedical
findings within ninety days following receipt by the commission of both
the claimant's application for occupational pneumoconiosis benefits and
the physician's report filed in connection with the claimant's
application and shall give each interested party notice in writing of
these findings with respect to all the nonmedical facts. The findings
and actions of the commission are final unless the employer, employee, claimant or dependent, within thirty days after receipt of the notice,
objects to the findings, and unless an objection is filed within the
thirty-day period, the findings are forever final, the time limitation
is a condition of the right to litigate the findings and therefor
jurisdictional. Upon receipt of an objection, the chief administrative
law judge shall set a hearing as provided in section nine, article five
of this chapter. In the event of an objection to the findings by the
employer, the claim shall, notwithstanding the fact that one or more
hearings may be held with respect to the objection, mature for
reference to the occupational pneumoconiosis board with like effect as
if the objection had not been filed. If the administrative law judge
concludes after the protest hearings that the claim should be
dismissed, a final order of dismissal shall be entered. The final
order is subject to appeal in accordance with the provisions of
sections ten and twelve, article five of this chapter. If the
administrative law judge concludes after the protest hearings that the
claim should be referred to the occupational pneumoconiosis board for
its review, the order entered shall be interlocutory only and may be
appealed only in conjunction with an appeal from a final order with
respect to the findings of the occupational pneumoconiosis board.
§23-4-16. Commission's jurisdiction over case continuous; modification
of finding or order; time limitation on awards; reimbursement of
claimant for expenses; reopening cases involving permanent total
disability; promulgation of rules.



(a) The power and jurisdiction of the commission over each case
is continuing and the commission may, in accordance with the provisions
of this section and after due notice to the employer, make modifications or changes with respect to former findings or orders that
are justified. Upon and after the second day of February, one thousand
nine hundred ninety-five, the period in which a claimant may request
a modification, change or reopening of a prior award that was entered
either prior to or after that date shall be determined by the following
subdivisions of this subsection. Any request that is made beyond that
period shall be refused.



(1) Except as provided in section twenty-two of this article, in
any claim which was closed without the entry of an order regarding the
degree, if any, of permanent disability that a claimant has suffered,
or in any case in which no award has been made, any request must be
made within five years of the closure. During that time period, only
two requests may be filed.



(2) Except as stated below, in any claim in which an award of
permanent disability was made, any request must be made within five
years of the date of the initial award. During that time period, only
two requests may be filed. With regard to those occupational diseases,
including occupational pneumoconiosis, which are medically recognized
as progressive in nature, if any such request is granted by the
commission, a new five-year period begins upon the date of the
subsequent award. With the advice of the health care advisory panel,
the executive director and the board of managers shall by rule
designate those progressive diseases which are customarily the subject
of claims.



(3) No further award may be made in fatal cases except within two
years after the death of the employee.



(4) With the exception of the items set forth in subsection (d), section three of this article, in any claim in which medical or any
type of rehabilitation service has not been rendered or durable medical
goods or other supplies have not been received for a period of five
years, no request for additional medical or any type of rehabilitation
benefits shall be granted nor shall any medical or any type of
rehabilitation benefits or any type of goods or supplies be paid for
by the commission if they were provided without a prior request. For
the exclusive purposes of this subdivision, medical services and
rehabilitation services shall not include any encounter in which
significant treatment was not performed.



(b) In any claim in which an injured employee makes application
for a further period of temporary total disability, if the application
is in writing and filed within the applicable time limit stated above,
the commission shall pass upon the request within thirty days of the
receipt of the request. If the decision is to grant the request, the
order shall provide for the receipt of temporary total disability
benefits. In any case in which an injured employee makes application
for a further award of permanent partial disability benefits or for an
award of permanent total disability benefits, if the application is in
writing and filed within the applicable time limit as stated above, the
commission shall pass upon the request within thirty days of its
receipt and, if the commission determines that the claimant may be
entitled to an award, the commission shall refer the claimant for
further examinations that are necessary.



(c) If the application is based on a report of any medical
examination made of the claimant and submitted by the claimant to the
commission in support of his or her application and the claim is opened for further consideration and additional award is later made, the
claimant shall be reimbursed for the expenses of the examination. The
reimbursement shall be made by the commission to the claimant, in
addition to all other benefits awarded, upon due proof of the amount
thereof being furnished the commission by the claimant, but shall in
no case exceed the sum fixed pursuant to the commission's schedule of
maximum reasonable fees established under the provisions of section
three of this article.



(d) The commission has continuing power and jurisdiction over
claims in which permanent total disability awards have been made after
the eighth day of April, one thousand nine hundred ninety-three.



(1) The commission shall continuously monitor permanent total
disability awards and may, from time to time, after due notice to the
claimant, reopen a claim for reevaluation of the continuing nature of
the disability and possible modification of the award. At such times
as the commission may determine, the commission may require the
claimant to provide documents and other information to the commission,
including, but not limited to, tax returns, financial records and
affidavits demonstrating level of income, recreational activities, work
activities, medications used and physicians or other medical or
rehabilitation providers treating or prescribing medication or other
services for the claimant; require the claimant to appear under oath
before the commission or its duly authorized representative and answer
questions; and suspend or terminate any benefits of a claimant who
willfully fails to provide the information or appear as required:
Provided, That the commission shall develop, implement and complete a
program as soon as reasonably possible that requires each person receiving permanent total disability benefits on the effective date of
the amendment and reenactment of this section in the year two thousand
three, and each person who is awarded those benefits thereafter, to
submit the tax returns and the affidavit described herein at least
once: Provided, however, That this requirement does not restrict the
commission's authority to require the information that may be required
herein at such other times as the commission may determine. The
commission may reopen a claim for reevaluation when, in the
commission's sole discretion, it concludes that there exists good cause
to believe that the claimant no longer meets the eligibility
requirements under subdivision (n), section six of this article. The
eligibility requirements, including any vocational standards, shall be
applied as those requirements are stated at the time of a claim's
reopening.



(2) Upon reopening a claim under this subsection, the commission
may take evidence, have the claimant evaluated, make findings of fact
and conclusions of law and shall vacate, modify or affirm the original
permanent total disability award as the record requires. The
claimant's former employer shall not be a party to the reevaluation,
but shall be notified of the reevaluation and may submit any
information to the commission as the employer may elect. In the event
the claimant retains his or her award following the reevaluation, the
claimant's reasonable attorneys' fees incurred in defending the award
shall be paid by the workers' compensation commission from the workers'
compensation fund. In addition, the workers' compensation commission
shall reimburse a prevailing claimant for his or her costs in obtaining
one evaluation on each issue during the course of the reevaluation with the reimbursement being made from the fund. The board of managers
shall adopt criteria for the determination of reasonable attorneys'
fees.



(3) This subsection shall not be applied to awards made under the
provisions of subdivision (m), section six of this article. The
claimant may seek review of the commission's final order as otherwise
provided for in article five of this chapter for review of orders
granting or denying permanent disability awards.



(4) The commission shall establish by rule criteria for review,
reopening and reevaluating a claim under this subsection. The
commission shall at least quarterly provide a report of the exercise
of its authority to continuously monitor permanent total disability
awards under this section to the joint committee on government and
finance and the joint commission on economic development.



(e) A claimant may have only one active request for a permanent
disability award pending in a claim at any one time. Any new request
that is made while another is pending shall be consolidated into the
former request.
§23-4-16a. Interest on benefits.



Whenever any award of temporary total, permanent partial or
permanent total disability benefits or dependent benefits is made on
or after the first day of July, one thousand nine hundred seventy-one,
and a protest is filed to the award or an appeal is taken from the
award by an employer only and not by the claimant or dependent and the
award is not ultimately denied or reduced following the protest or
appeal, the commission shall add interest to the award at the simple
rate of six percent per annum from the date the award would have been payable had the protest or appeal not been filed or taken, exclusive
of any period for which a continuance was granted upon motion of any
party other than the protesting or appealing employer. Any interest
payable shall be charged to the account of the protesting or appealing
employer to the extent that the benefits upon which such interest is
computed are charged to the account of the employer.
§23-4-17. Commutation of periodical benefits.



The commission, under special circumstances and when it is
considered advisable, may commute periodical benefits to one or more
lump-sum payments. Upon the application of any claimant who has
received an award of partial or total disability, who is not a citizen
of the United States and desires to reside permanently beyond the
territorial limits of the United States, or upon the application of an
alien dependent of a deceased employee with respect of whose death
award of compensation has been made, the dependent residing in the
territorial limits of the United States at the time of the decedent's
death, and desiring to reside permanently beyond the territorial limits
of the United States, the commission may commute into one lump-sum
payment the periodical payments to which the claimant or dependent
would be entitled, but at the rate of one-half the amount that would
be payable to a citizen of the United States under like circumstances.
The lump-sum payment at the rate specified in this section discharges
all liability with respect to the award, but in no event shall the
award be paid until the claimant or dependent has actually arrived and
domiciled himself or herself outside the territorial limits of the
United States, except a sufficient portion of the award to pay
transportation and other necessary expenses.
§23-4-18. Mode of paying benefits generally; exemptions of
compensation from legal process.



Except as provided by this section, compensation shall be paid
only to the employees or their dependents and is exempt from all claims
of creditors and from any attachment, execution or assignment other
than compensation to counsel for legal services, under the provisions
of, and subject to the limitations contained in section sixteen,
article five of this chapter, and other than for the enforcement of
orders for child or spousal support entered pursuant to the provisions
of chapter forty-eight of this code. Payments may be made in the
periodic installments determined by the commission in each case, but
in no event less frequently than semimonthly for any temporary award
and monthly for any permanent award. Payments for permanent disability
shall be paid on or before the third day of the month in which they are
due. In all cases where compensation is awarded or increased, the
amount of compensation shall be calculated and paid from the date of
disability.
§23-4-20. Postmortem examinations.



The commission may, after due notice to the employer and
claimant, whenever it considers it necessary, order an autopsy and may
designate a duly licensed physician to make the postmortem examination
or examinations that are necessary to determine the cause of the
deceased employee's death. The physician shall file with the
commission a written report of his or her findings. The claimant and
the employer, respectively, have the right to select a physician of
his, her or its own choosing and, at his, her or its own expense, to
participate in the postmortem examination. The respective physicians selected by the claimant and the employer have the right to concur in
any report made by the physician selected by the commission, or each
may file with the commission a separate report. In any case, including
silicosis cases, in which either the employer or a claimant requests
that an autopsy be performed, the autopsy shall be directed as provided
in this section. In the event that a claimant for compensation for the
death refuses to consent and permit the autopsy to be made all rights
to compensation shall be forfeited.
§23-4-22. Permanent disability evaluations; limitations; notice.



Notwithstanding any provision in this chapter to the contrary,
any claim which was closed for the receipt of temporary total
disability benefits or which was closed on a no-lost-time basis and
which was more than five years prior to the effective date of this
section shall not be considered to still be open or the subject for an
evaluation of the claimant for permanent disability merely because an
evaluation has not previously been conducted and a decision on
permanent disability has not been made: Provided, That if a request for
an evaluation was made in a claim prior to the twenty-ninth day of
March, one thousand nine hundred ninety-three, the commission shall
have the evaluation performed. In every instance, a claim shall be a
case in which no award has been made for the purposes of section
sixteen of this article. In every claim closed after the effective
date of this section, the commission shall give notice to the parties
of the claimant's right to a permanent disability evaluation.
§23-4-23. Permanent total disability benefits; reduction of disability
benefits; reduction of benefits; application of section;
severability.



(a) This section is applicable whenever benefits are being paid
for permanent total disability benefits arising under subdivision (d),
(m) or (n), section six of this article or under section eight-c of
this article. This section is not applicable to the receipt of
temporary total disability benefits, the receipt of permanent partial
disability benefits, the receipt of benefits by partially or wholly
dependent persons or to the receipt of benefits pursuant to the
provisions of subsection (e), section ten of this article. This
section is not applicable to the receipt of medical benefits or the
payment for medical benefits.



(b) Whenever applicable benefits are paid to a beneficiary with
respect to the same time period for which payments under a self-
insurance plan, a wage continuation plan or a disability insurance
policy provided by an employer are also received or being received by
the beneficiary, the applicable benefits shall be reduced by these
amounts:







(1) The after-tax amount of the payments received or being
received under a self-insurance plan, a wage continuation plan or under
a disability insurance policy provided by an employer if the employee
did not contribute directly to the plan or to the payment of premiums
regarding the disability insurance policy; or



(2) The proportional amount, based on the ratio of the employer's
contributions to the total insurance premiums for the policy period
involved, of the after-tax amount of the payments received or being
received by the employee pursuant to a disability insurance policy
provided by an employer if the employee did contribute directly to the payment of premiums regarding the disability insurance policy:
Provided, That in no event shall applicable benefits be reduced below
the minimum weekly benefits as provided for in subdivisions (b) and
(d), section six of this article.












(c) This
section applies to awards of permanent total disability made after the
effective date of this section.



(d) The board of managers shall promulgate the appropriate rules
for the interpretation, processing and enforcement of this section.



(e) If any portion of this section or any application of this
section is subsequently found to be unconstitutional or in violation
of applicable law, it shall not affect the validity of the remainder
of this section or the applications of the section that are not
unconstitutional or in violation.
§23-4-24. Permanent total disability awards; retirement age;
limitations on eligibility and the introduction of evidence;
effects of other types of awards; procedures; requests for
awards; jurisdiction.



(a) Notwithstanding any provision of this chapter to the
contrary, except as stated below, no claimant shall be awarded
permanent total disability benefits arising under subdivision (d) or
(n), section six of this article or section eight-c of this article who
terminates active employment and is receiving full old-age retirement
benefits under the Social Security Act, 42 U. S. C. §401 and 402. Any
claimant shall be evaluated only for the purposes of receiving a permanent partial disability award premised solely upon the claimant's
impairments. This subsection is not applicable in any claim in which
the claimant has completed the submission of his or her evidence on the
issue of permanent total disability prior to the later of the
following: Termination of active employment or the initial receipt of
full old-age retirement benefits under the Social Security Act. Once
the claimant has terminated active employment and has begun to receive
full old-age social security retirement benefits, the claimant may not
produce additional evidence of permanent total disability before the
commission or the office of judges nor shall the claim be remanded for
the production of the evidence.







(b) The workers' compensation commission has the sole and
exclusive jurisdiction to initially hear and decide any claim or
request pertaining, in whole or in part, to subdivision (d) or (n),
section six of this article. Any claim or request for permanent total
disability benefits arising under said subdivisions shall first be
presented to the commission as part of the initial claim filing or by
way of an application for modification or adjustment pursuant to
section sixteen of this article. The office of judges may consider a
claim only after the commission has entered an appropriate order.
§23-4-25. Permanent total disability benefits; reduction of disability
benefits for wages earned by claimant.



(a) After the eighth day of April, one thousand nine hundred
ninety-three, a reduction in the amount of benefits as specified in
subsection (b) of this section shall be made whenever benefits are
being paid for a permanent total disability award regardless of when the benefits were awarded. This section is not applicable to the
receipt of medical benefits or the payment for medical benefits, the
receipt of permanent partial disability benefits, the receipt of
benefits by partially or wholly dependent persons, or to the receipt
of benefits pursuant to the provisions of subsection (e), section ten
of this article. Prior to the application of this section to any
claimant, the commission shall give the claimant notice of the effect
of this section upon a claimant's award if and when the claimant later
earns wages.



(b) Whenever applicable benefits are paid to a claimant with
respect to the same time period in which the claimant has earned wages
as a result of his or her employment, the following reduction in
applicable benefits shall be made. The claimant's applicable monthly
benefits and monthly net wages received from the current employment
shall be added together. If the total exceeds by more than one hundred
twenty percent of the amount of the claimant's monthly net wages earned
during his or her last employment prior to the award of permanent total
disability benefits, the excess shall be reduced by one dollar for each
two dollars that the claimant's monthly benefits and monthly net wages
exceed the one hundred twenty percent level: Provided, That in no event
shall applicable benefits be reduced below the minimum weekly benefits
as provided for in subdivisions (b) and (d), section six of this
article.
ARTICLE 4A. DISABLED WORKERS' RELIEF FUND.
§23-4A-1. Disabled workers' relief fund created.



For the relief of persons who are receiving benefits pursuant to
a permanent total disability award in amounts less than thirty-three and one-third percent of the average weekly wage for the state of West
Virginia per month, and for the relief of widows who are receiving
benefits on account of the death of an employee in amounts less than
thirty-three and one-third percent of the average weekly wage in the
state of West Virginia per month, and for the relief of children of
employees deceased before one thousand nine hundred sixty-seven, who
are under the age of twenty-three and who are full-time students, and
for the relief of other persons who are receiving dependents' benefits
on account of the death of an employee in amounts less than the
specific monetary amounts set forth in section ten, article four of
this chapter and in effect as of the first day of July, one thousand
nine hundred seventy-three, there is continued a separate fund,
heretofore known as the "Disabled Workmen's Relief Fund", and which
shall hereafter be known as the "Disabled Workers' Relief Fund", which
shall consist of any sums that are, from time to time, made available
to carry out the objects and purposes of this article. The fund shall
be in the custody of the state treasurer and disbursements from the
fund shall be made upon requisition signed by the executive director
to those persons entitled to participate in the fund and in such
amounts to each participant that are provided in section three of this
article.
§23-4A-3. Computation of benefits.



Each individual entitled to participate in the disabled workers'
relief fund is entitled to receive payments without application (except
that an application shall be required under section five of this
article) from the fund of an amount equal to the difference between the
amounts set forth in section one of this article and the amount the individual is in fact receiving by virtue of and under the laws of this
state. The first payment shall be made concurrently with the payment
to him or her of workers' compensation on the first day of August, one
thousand nine hundred seventy-six, and subsequent payments shall be
made during the period thereafter in which the participant is entitled
to workers' compensation benefits by virtue of and under the laws of
this state.
§23-4A-5. Employers providing own system of compensation.



The executive director shall promptly require of each employer
who has elected to pay direct compensation under the provisions of
section nine, article two of this chapter a verified list of the names
and addresses of all persons to whom the employer is paying workers'
compensation on account of permanent total disability or because of the
death of an employee and any evidence respecting those persons as the
executive director may reasonably consider necessary to determine the
eligibility of any person to participate in the disabled workers'
relief fund. Any person claiming the right to participate in the fund
under the provisions of this section may file his or her application
for participation with the executive director and shall be accorded a
hearing on the application.
§23-4A-6. Powers of commission over disabled workers' relief fund.



In the investigation and determination of the right of persons to
participate in the disabled workers' relief fund, the executive
director has and may exercise all the powers which he or she possesses
under the other articles of this chapter. His or her powers and
jurisdiction over each case is continuing, but there shall be no appeal
from the commission's decisions to any other body or tribunal. No attorney, representative or agent of any claimant or participant is
entitled to charge or receive a fee or compensation or gratuity in any
form for representing or assisting or pretending to represent or assist
any person to become a participant in the disabled workers' relief
fund.
§23-4A-8. Disabled workers' relief fund; how funded.



For the purpose of carrying out the provisions of this article,
the board of managers shall transfer annually, out of the interest
earned during the previous year on investments held by the workers'
compensation fund, and out of the amount assessed against self-insured
employers pursuant to the provisions of section nine, article two of
this chapter an amount estimated by the executive director to be
necessary to carry out the provisions of this article for one year.



The money shall be deposited by the board of managers in the
disabled workers' relief fund, as required by this article.
ARTICLE 4B. COAL-WORKERS' PNEUMOCONIOSIS FUND.
§23-4B-2. Coal-workers' pneumoconiosis fund established.



For the relief of persons who are entitled to receive benefits by
virtue of Title IV of the federal Coal Mine Health and Safety Act of
1969, as amended, there is continued a fund to be known as the coal-
workers' pneumoconiosis fund, which fund shall be separate from the
workers' compensation fund. The coal-workers' pneumoconiosis fund
shall consist of premiums and other funds paid to the fund by
employers, subject to the provisions of Title IV of the federal Coal
Mine Health and Safety Act of 1969, as amended, who shall elect to
subscribe to the fund to ensure the payment of benefits required by the
act.



The state treasurer shall be the custodian of the coal-workers'
pneumoconiosis fund, and all premiums, deposits or other moneys paid
to the fund shall be deposited in the state treasury to the credit of
the coal-workers' pneumoconiosis fund. Disbursements from the fund
shall be made upon requisition signed by the executive director of the
workers' compensation commission to those persons entitled to
participate in the fund. The West Virginia state board of investments
may invest any surplus, reserve or other moneys belonging to the coal-
workers' pneumoconiosis fund in accordance with article six, chapter
twelve of this code.
§23-4B-5. Payment of benefits.



Upon receipt of an order of compensation issued pursuant to a
claim for benefits filed under the provisions of Title IV of the
federal Coal Mine Health and Safety Act of 1969, as amended, the
executive director shall disburse the coal-workers' pneumoconiosis fund
in the amounts and to the persons as directed by the order.
§23-4B-6. Coal-workers' pneumoconiosis fund; how funded.



For the purpose of creating the coal-workers' pneumoconiosis
fund, each employer, who elects to subscribe to the fund, shall pay
premiums based upon and being a percentage of the payroll of the
employer determined by the board of managers. It is the duty of the
board of managers to fix and maintain the lowest possible rates of
premiums consistent with the maintenance of a solvent fund and the
creation and maintenance of a reasonable surplus after providing for
payment to maturity of all liability insured pursuant to Title IV of
the federal Coal Mine Health and Safety Act of 1969, as amended. The
rates shall be adjusted annually or more often as may, in the opinion of the board of managers, be necessary.



The board of managers may by rule classify subscribers into
groups or classes according to the nature of the hazards incident to
the business of the subscribers and assign premium rates to the
subscribers. In addition, the board of managers may by rule prescribe
procedures for subscription, payroll reporting, premium payment,
termination of subscription, reinstatement and other matters pertinent
to the subscribers' continuing participation in the coal-workers'
pneumoconiosis fund.
§23-4B-7. Administration.



The coal-workers' pneumoconiosis fund shall be administered by
the executive director of the workers' compensation commission, who
shall employ any employees necessary to discharge his or her duties and
responsibilities under this article. All payments of salaries and
expenses of the employees and all expenses peculiar to the
administration of this article shall be made by the state treasurer
from the coal-workers' pneumoconiosis fund upon requisitions signed by
the executive director.
§23-4B-8b. Transfer of funds to workers' compensation fund.



(a) Notwithstanding any provision of section eight of this
article to the contrary, the assets which were previously transferred
from the coal-workers' pneumoconiosis fund and held in a separate
account may, on or after the first day of July, two thousand three, be
expended for workers' compensation fund liabilities.



(b) The Legislature hereby finds and declares that there is a
substantial actuarial surplus in the coal-workers' pneumoconiosis fund
in excess of one hundred seventy million dollars. The Legislature further finds and declares that there is a substantial actuarial
deficit in the workers' compensation fund. The executive director
shall conduct an actuarial audit to determine the amount of the
actuarial surplus in the coal-workers' pneumoconiosis fund as of the
thirtieth day of June, two thousand three, and certify the amount, as
of that date, in a written order which together with the results of the
audit shall be a public record. The executive director shall also
obtain a statement from the commission's actuary that a distributable
surplus exists in the coal-workers' pneumoconiosis fund. When the
actuary provides the statement, and notwithstanding any provision of
this article to the contrary, the executive director shall, by written
order, transfer an amount not to exceed one hundred seventy million
dollars from the coal-workers' pneumoconiosis fund to the workers'
compensation fund, which assets shall thereupon become merged into and
consolidated with the workers' compensation fund and expended for
workers' compensation fund liabilities: Provided, That a level of
reserve shall be retained in the coal-workers' pneumoconiosis fund
sufficient within a seventy percent confidence level, on an actuarial
basis, to satisfy the payment of all claims incurred, including claims
which were incurred but not reported, on or before the thirtieth day
of June, two thousand three. In the event the commission's actuary or
an actuary employed by the board of managers determines prior to the
thirtieth day of June, two thousand six, that the assets of the coal-
workers' pneumoconiosis fund are not adequate to enable the coal-
workers' pneumoconiosis fund to meet its claim obligations under Title
IV of the federal Coal Mine Health and Safety Act of 1996, as amended,
the executive director
shall, upon appropriation of the Legislature, transfer an amount not to exceed fifty
million dollars from the
workers' compensation fund to the coal-workers' pneumoconiosis fund for
expenditure to meet those obligations.
ARTICLE 4C. EMPLOYERS' EXCESS LIABILITY FUND.
§23-4C-2. Employers' excess liability fund established.



(a) To provide insurance coverage for employers subject to this
chapter who may be subjected to liability for any excess of damages
over the amount received or receivable under this chapter, the
commission may continue the fund known as the employers' excess
liability fund, which fund shall be separate from the workers'
compensation fund. The employers' excess liability fund shall consist
of premiums paid to it by employers who may voluntarily elect to
subscribe to the fund for coverage of potential liability to any person
who may be entitled to any excess of damages over the amount received
or receivable under this chapter.



(b) The board of managers may provide for, by the promulgation of
a rule pursuant to section one-a, article one of this chapter, the
continuance, abolition or sale of the employers' excess liability fund
established by section one of this article. In the event that the fund
is to be sold, the sale shall be conducted through the solicitation of
competitive bids. Any funds that remain after the sale or abolition
of the employers' excess liability fund shall be paid into and become
a part of the workers' compensation fund to be used for the purposes
of that fund. In the event that the employers' excess liability fund
program is abolished and the remaining liabilities of that program
exceed the amount retained in the employers' excess liability fund, the
excess liability including the costs of administration shall be paid for from the workers' compensation fund.
§23-4C-3. Payment of excess damages from fund.



Upon receipt of a final order of a court determining the
liability under section two, article four of this chapter of a
subscribing employer and the amount of the excess of damages over the
amount received or receivable under this chapter, the executive
director shall make disbursements from the employers' excess liability
fund in the amounts and to the persons as directed by the final order.
In the event of a proposed settlement of a disputed claim against a
subscribing employer, the executive director, upon approving the
settlement upon petition by the subscribing employer, shall make
disbursements from the employers' excess liability fund in the amounts
and to the persons specified in the approved settlement. In the event
of the settlement of any disputed claim in which one or more of the
persons entitled to the proceeds to be paid pursuant to the settlement
is under a legal disability by reason of age, mental incapacity or
other reason, the settlement, if required by other provisions of law
to be approved by a circuit court, shall be approved by the circuit
court of the county in which the person under disability is a resident
or in which a civil action could be brought and maintained upon the
claim, in addition to being approved by the commission as required by
this section. The executive director shall by rule establish criteria
and procedures for the settlement of all disputed claims.
§23-4C-4. Employers' excess liability fund; how funded.



For the purpose of creating the employers' excess liability fund,
each employer who elects to subscribe to the fund shall pay premiums
based upon and being a percentage of the payroll of the employer determined by the board of managers. It is the duty of the board of
managers to fix and maintain the lowest possible rates or premiums
consistent with the maintenance of a solvent fund. The premium rates
shall be adjusted annually or more often as may, in the opinion of the
board of managers, be necessary.



The board of managers shall initially classify subscribers into
groups or classes according to the nature of the unusual hazards
incident to the business of the subscribers as contemplated by section
four, article two of this chapter and assign premium rates to the
subscribers. The fixing, maintaining and adjusting of premium rates
and the initial classification of subscribers into groups or classes
pursuant to this section are findings or determinations of fact and not
a legislative rule. In addition, the board of managers shall by rule
prescribe procedures for subscription, payroll reporting, premium
payment, termination of subscription, reinstatement, reclassification
of groups, classes or subscribers, the increase or decrease of premiums
based upon incidence of liability and amounts awarded, and other
matters pertinent to the subscribers' continuing participation in the
employers' excess liability fund.
§23-4C-5. Administration.



The employers' excess liability fund shall be administered by the
executive director, who shall employ any employees that are necessary
to discharge his or her duties and responsibilities under this article.
All payments of salaries and expenses of the employees and all expenses
peculiar to the administration of this article shall be made by the
state treasurer from the employers' excess liability fund upon
requisitions signed by the executive director.
ARTICLE 5. REVIEW.
§23-5-1. Notice by commission or self-insured of decision; procedures
on claims; objections and hearing.



(a) The workers' compensation commission may hear and determine
all questions within its jurisdiction. In matters arising under
articles three and four of this chapter, the commission shall promptly
review and investigate all claims. The parties to a claim shall file
the information in support of their respective positions as they
consider proper. In addition, the commission may develop additional
information that it considers to be necessary in the interests of
fairness to the parties and in keeping with the fiduciary obligations
owed to the fund. With regard to any issue which is ready for a
decision, the commission shall explain the basis of its decisions.



(b) Except with regard to interlocutory matters and those matters
set forth in subsection (d) of this section, upon making any decision,
upon making or refusing to make any award or upon making any
modification or change with respect to former findings or orders, as
provided by section sixteen, article four of this chapter, the
commission shall give notice, in writing, to the employer, employee,
claimant or dependant as the case may be, of its action. The notice
shall state the time allowed for filing an objection to the finding.
The action of the commission is final unless the employer, employee,
claimant or dependant shall, within thirty days after the receipt of
the notice, object in writing, to the finding. Unless an objection is
filed within the thirty-day period, the finding or action is final.
This time limitation is a condition of the right to litigate the
finding or action and hence jurisdictional. Any objection shall be filed with the office of judges with a copy served upon the commission
and other parties in accordance with the procedures set forth in
sections eight and nine of this article. In all instances where a
self-insured employer or a third-party administrator has made claims
decisions as authorized in this chapter, they shall provide claimants
and the commission notice of all claims decisions as provided for by
rules for self-administration promulgated by the board of managers and
shall be bound by each requirement imposed upon the commission by this
article.



(c) Where a finding or determination of the commission is
protested only by the employer, and the employer does not prevail in
its protest, and in the event the claimant is required to attend a
hearing by subpoena or agreement of counsel or at the express direction
of the commission or office of judges, then the claimant in addition
to reasonable traveling and other expenses shall be reimbursed for loss
of wages incurred by the claimant in attending the hearing.



















(d) The commission or self-insured employer may amend, correct or
set aside any order or decision on any issue entered by it which, at
the time of issuance or any time thereafter, is discovered to be
defective or clearly erroneous or the result of mistake, clerical error
or fraud, or otherwise not supported by the evidence. Jurisdiction to
take this action continues until the expiration of two years from the
date of entry of an order unless the order is sooner affected by
appellate action: Provided, That corrective actions in the case of fraud may be taken at any time.



(e) All objections to orders of the commission or self-insured
employers shall be styled in the name of the workers' compensation
commission. All appeals prosecuted from the office of judges shall
either be in the name of the workers' compensation commission or shall
be against the workers' compensation commission unless the parties to
the appeal are limited to a claimant and a self-insured employer. In
all actions under this article, the workers' compensation commission
shall be the party in interest unless the parties to the appeal are
limited to a claimant and a self-insured employer.
§23-5-2. Application by employee for further adjustment of claim;
objection to modification; hearing.



In any case where an injured employee makes application in
writing for a further adjustment of his or her claim under the
provisions of section sixteen, article four of this chapter and the
application discloses cause for a further adjustment, the commission
shall, after due notice to the employer, make the modifications, or
changes with respect to former findings or orders in the claim that are
justified. Any party dissatisfied with any modification or change made
by the commission is, upon proper and timely objection, entitled to a
hearing, as provided in section nine of this article.
§23-5-3. Refusal to reopen claim; notice; objection.



If it appears to the commission that an application filed under
section two of this article fails to disclose a progression or
aggravation in the claimant's condition, or some other fact or facts
which were not previously considered by the commission in its former
findings and which would entitle the claimant to greater benefits than the claimant has already received, the commission shall, within a
reasonable time, notify the claimant and the employer that the
application fails to establish a prima facie cause for reopening the
claim. The notice shall be in writing stating the reasons for denial
and the time allowed for objection to the decision of the commission.
The claimant may, within thirty days after receipt of the notice,
object in writing to the finding. Unless the objection is filed within
the thirty-day period, no objection shall be allowed. This time
limitation is a condition of the right to objection and hence
jurisdictional. Upon receipt of an objection, the office of judges
shall afford the claimant an evidentiary hearing as provided in section
nine of this article.
§23-5-4. Application by employer for modification of award; objection
to modification; hearing.



In any case in which an employer makes application in writing for
a modification of any award previously made to an employee of the
employer, the commission shall make a decision upon the application.
If the application discloses cause for a further adjustment, the
commission shall, after due notice to the employee, make the
modifications or changes with respect to former findings or orders that
are justified. Any party dissatisfied with any modification or change
made by the commission or by the denial of an application for
modification is, upon proper and timely objection, entitled to a
hearing as provided in section nine of this article.
§23-5-5. Refusal of modification; notice; objection.



If in any case it appears to the commission that the application
filed pursuant to section four of this article fails to disclose some fact or facts which were not previously considered by the commission
in its former findings, and which would entitle the employer to any
modification of the previous award, the commission shall, within sixty
days from the receipt of the application, notify the claimant and
employer that the application fails to establish a just cause for
modification of the award. The notice shall be in writing stating the
reasons for denial and the time allowed for objection to the decision
of the commission. The employer may, within thirty days after receipt
of the notice, object in writing to the decision. Unless the objection
is filed within the thirty-day period, no objection shall be allowed.
This time limitation is a condition of the right to objection and hence
jurisdictional. Upon receipt of the objection, the office of judges
shall afford the employer an evidentiary hearing as provided in section
nine of this article.
§23-5-6. Time periods for objections and appeals; extensions.



Notwithstanding the fact that the time periods set forth for
objections, protests and appeals to or from the workers' compensation
office of judges are jurisdictional, the periods may be extended or
excused upon application of either party within a period of time equal
to the applicable period by requesting an extension of the time period
showing good cause or excusable neglect, accompanied by the objection
or appeal petition. In exercising discretion the administrative law
judge, appeal board or court, as the case may be, shall consider
whether the applicant was represented by counsel and whether timely and
proper notice was actually received by the applicant or the applicant's
representative.
§23-5-7. Compromise and settlement.



With the exception of medical benefits for nonorthopedic
occupational disease claims, the claimant, the employer and the
workers' compensation commission may negotiate a final settlement of
any and all issues in a claim wherever the claim is in the
administrative or appellate processes. Upon entering into an
agreement, the parties shall file the written and executed agreement
with the office of judges. The office of judges shall review the
proposed agreement to determine if it is fair and reasonable to the
parties and shall ensure that each of the parties is fully aware of the
effects of the agreement including what each party is conceding in
exchange for the agreement. If the office of judges concludes that the
agreement is not fair or is not reasonable or that one of the parties
is not fully informed, the agreement will not be approved. The
decision on this question is not reviewable. If the employer is not
active in the claim, the commission may negotiate a final settlement
of any and all issues in a claim except for medical benefits for
nonorthopedic occupational disease claims with the claimant. Upon
approval of the settlement, it shall be made a part of the claim
record. The office of judges shall send written notice of the
settlement to all parties and, where appropriate, to the appeal board
or the supreme court of appeals. Except in cases of fraud, no issue
that is the subject of an approved settlement agreement may be reopened
by any party, including the commission. Any settlement agreement may
provide for a lump-sum payment or a structured payment plan, or any
combination thereof, or any other basis as the parties may agree. If
a self-insured employer later fails to make the agreed-upon payment,
the commission shall assume the obligation to make the payments and shall recover the amounts paid or to be paid from the self-insured
employer and its sureties or guarantors or both as provided for in
sections five and five-a, article two of this chapter.



The amendments to this section enacted during the regular session
of the Legislature in the year one thousand nine hundred ninety-nine
shall apply to all settlement agreements executed after the effective
date.
§23-5-8. Designation of office of administrative law judges; powers
of chief administrative law judge.



(a) The workers' compensation office of administrative law judges
previously created pursuant to chapter twelve, acts of the Legislature,
one thousand nine hundred ninety, second extraordinary session, is
hereby continued and designated to be an integral part of the workers'
compensation system of this state. The office of judges shall be under
the supervision of a chief administrative law judge who shall be
appointed by the governor, with the advice and consent of the Senate.



(b) The chief administrative law judge shall be a person who has
been admitted to the practice of law in this state and shall also have
had at least four years of experience as an attorney. The chief
administrative law judge's salary shall be set by the workers'
compensation board of managers. The salary shall be within the salary
range for comparable chief administrative law judges as determined by
the state personnel board created by section six, article six, chapter
twenty-nine of this code. The chief administrative law judge may only
be removed by a vote of two thirds of the members of the workers'
compensation board of managers and shall not be removed except for
cause and then only after he or she has been presented in writing with the reasons for his or her removal and is given opportunity to respond
and to present evidence. No other provision of this code purporting
to limit the term of office of any appointed official or employee or
affecting the removal of any appointed official or employee is
applicable to the chief administrative law judge.



(c) The chief administrative law judge shall employ
administrative law judges and other personnel that are necessary for
the proper conduct of a system of administrative review of orders
issued by the workers' compensation commission which orders have been
objected to by a party. The employees shall be in the classified
service of the state. Qualifications, compensation and personnel
practice relating to the employees of the office of judges, other than
the chief administrative law judge, shall be governed by the provisions
of this code and rules of the classified service pursuant to article
six, chapter twenty-nine of this code. All additional administrative
law judges shall be persons who have been admitted to the practice of
law in this state and shall also have had at least two years of
experience as an attorney. The chief administrative law judge shall
supervise the other administrative law judges and other personnel which
collectively shall be referred to in this chapter as the office of
judges.



(d) The administrative expense of the office of judges shall be
included within the annual budget of the workers' compensation
commission.



(e) The office of judges shall, from time to time, promulgate
rules of practice and procedure for the hearing and determination of
all objections to findings or orders of the workers' compensation commission. The office of judges shall not have the power to initiate
or to promulgate legislative rules as that phrase is defined in article
three, chapter twenty-nine-a of this code. Any rules adopted pursuant
to this section which are applicable to the provisions of this article
are not subject to sections nine through sixteen, inclusive, article
three, chapter twenty-nine-a of this code. The office of judges shall
follow the remaining provisions of said chapter for giving notice to
the public of its actions and the holding of hearings or receiving of
comments on the rules.



(f) The chief administrative law judge has the power to hear and
determine all disputed claims in accordance with the provisions of this
article, establish a procedure for the hearing of disputed claims, take
oaths, examine witnesses, issue subpoenas, establish the amount of
witness fees, keep records and make reports that are necessary for
disputed claims and exercise any additional powers, including the
delegation of powers to administrative law judges or hearing examiners
that are necessary for the proper conduct of a system of administrative
review of disputed claims. The chief administrative law judge shall
make reports that are requested of him or her by the workers'
compensation board of managers.
§23-5-9. Hearings on objections to commission or self-insured employer
decisions; mediation; remand.



(a) Objections to a decision of the workers' compensation
commission or of a self-insured employer made pursuant to the
provisions of section one of this article shall be filed with the
office of judges. Upon receipt of an objection, the office of judges
shall notify the commission and all other parties of the filing of the objection. The office of judges shall establish by rule promulgated
in accordance with the provisions of subsection (e), section eight of
this article an adjudicatory process that enables parties to present
evidence in support of their positions and provides an expeditious
resolution of the objection. The employer, the claimant and the
commission shall be notified of any hearing at least ten days in
advance.



(b) The office of judges shall establish a program for mediation
to be conducted in accordance with the requirements of rule twenty-five
of the West Virginia trial court rules. The parties may agree that the
result of the mediation is binding. A case may be referred to
mediation by the administrative law judge on his or her own motion, on
motion of a party or by agreement of the parties. Upon issuance of an
order for mediation, the office of judges shall assign a mediator from
a list of qualified mediators maintained by the West Virginia state
bar.



(c) The office of judges shall keep full and complete records of
all proceedings concerning a disputed claim. Subject to the rules of
practice and procedure promulgated pursuant to section eight of this
article, the record upon which the matter shall be decided shall
include any evidence submitted by a party to the office of judges,
evidence taken at hearings conducted by the office of judges and any
documents in the commission's claim files which relate to the subject
matter of the objection. The record may include evidence or documents
submitted in electronic form or other appropriate medium in accordance
with the rules of practice and procedure. The office of judges is not
bound by the usual common law or statutory rules of evidence.



(d) All hearings shall be conducted as determined by the chief
administrative law judge pursuant to the rules of practice and
procedure promulgated pursuant to section eight of this article. Upon
consideration of the designated record, the chief administrative law
judge or other authorized adjudicator within the office of judges
shall, based on the determination of the facts of the case and
applicable law, render a decision affirming, reversing or modifying the
commission's action. The decision shall contain findings of fact and
conclusions of law and shall be mailed to all parties.



(e) The rule authorized by subsection (a) of this section shall
be promulgated on or before the first day of September, two thousand
three. Until the rule is promulgated, any rules previously promulgated
shall remain in full force and effect.



(f) The office of judges may remand a claim to the commission for
further development of the facts or administrative matters as, in the
opinion of the administrative law judge, may be necessary for a full
and complete disposition of the case. The administrative law judge
shall establish a time within which the commission must report back to
the administrative law judge.



(g) The decision of the workers' compensation office of judges
regarding any objections to a decision of the workers' compensation
commission or a self-insured employer is final and benefits shall be
paid or denied in accordance with the decision unless the decision is
subsequently appealed and reversed in accordance with the procedures
set forth in this article and in article one-b, chapter fifty-one of
this code.
§23-5-10. Appeal from administrative law judge decision to appeal board.



The employer, claimant or workers' compensation commission may
appeal to the appeal board created in section eleven of this article
for a review of a decision by an administrative law judge. No appeal
or review shall lie unless application therefor be made within thirty
days of receipt of notice of the administrative law judge's final
action or in any event within sixty days of the date of such final
action, regardless of notice and, unless the application for appeal or
review is filed within the time specified, no such appeal or review
shall be allowed, such time limitation being hereby declared to be a
condition of the right of such appeal or review and hence
jurisdictional.
§23-5-11. Workers' compensation board of review generally.





(a) On the thirty-first day of January, two thousand four, the
workers' compensation appeal board heretofore established in section
eleven, article five of this chapter is hereby abolished.



(b) There is hereby created the "workers' compensation board of
review", which may also be referred to as "the board of review" or "the
board". Effective the first day of February, two thousand four, the
board of review shall exercise exclusive jurisdiction over all appeals
from the workers' compensation office judges including any and all
appeals pending with the board of appeals on the thirty-first day of
January, two thousand four.



(c) The board shall consist of three judges.



(d) The governor shall appoint, from names submitted by the
"workers' compensation board of review nominating committee", with the
advice and consent of the Senate, three qualified attorneys to serve as judges of the board of review. If the governor does not select a
nominee for any vacant position from the names provided by the
nominating committee, he shall notify the nominating committee of that
circumstance and the committee shall provide additional names for
consideration by the governor
. A member of the board of review may be
removed by the governor for official misconduct, incompetence, neglect
of duty, gross immorality or malfeasance and then only after notice and
opportunity to respond and present evidence. No more than two of the
members of the board may be of the same political party.



(e) The nominating committee shall consist of the following
members: (1) The president of the West Virginia state bar who will
serve as the chairperson of the committee; (2) an active member of the
West Virginia state bar workers' compensation committee selected by the
major trade association representing employers in this state; (3) an
active member of the West Virginia state bar workers' compensation
committee selected by the highest ranking officer of the major employee
organization representing workers in this state; (4) the dean of the
West Virginia university school of law; and (5) the chairman of the
judicial investigation committee.



(f) The nominating committee is responsible for reviewing and
evaluating candidates for possible appointment to the board of review
by the governor. In reviewing candidates, the nominating committee may
accept comments from and request information from any person or source.



(g) Each member of the nominating committee may submit up to
three names of qualified candidates for each position on the board of
review
: Provided, That the member of the nominating committee selected
by the major trade organization representing employers of this state shall submit at least one name of a qualified candidate for each
position on the board who either are, or who represent, small business
employers of this state
. After careful review of the candidates, the
committee shall select a minimum of one candidate for each position on
the board.



(h) No later than the first day of November, two thousand three,
the nominating committee shall present to the governor its list of
candidates for the initial board of review. The governor shall appoint
the initial board no later than the thirty-first day of December, two
thousand three: Provided, That upon the thirty-first day of December,
two thousand three, the deadline for filling all positions of the board
of review will be extended, as necessary, if on or before that date the
governor has timely requested additional names from the nominating
committee
. Thereafter, the nominating committee shall meet at the
request of the governor in order to make timely recommendations to the
governor for appointees to the board as the initial and subsequent
terms expire or become vacant. The recommendations shall be submitted
no later than thirty days prior to the expiration of any term.



(i) Of the initial appointments, one judge shall be appointed for
a term ending the thirty-first day of December, two thousand six; one
judge shall be appointed for a term ending the thirty-first day of
December, two thousand eight; and one judge shall be appointed for a
term ending the thirty-first day of December, two thousand ten.
Thereafter, the appointments shall be for six-year terms.



(j) A judge of the board of review must, at the time he or she
takes office and thereafter during his or her continuance in office,
be a resident of this state, be a member in good standing of the West Virginia state bar, have a minimum of ten years' experience as an
attorney admitted to practice law in this state prior to appointment
and have a minimum of five years' experience in preparing and
presenting cases or hearing actions and making decisions on the basis
of the record of those hearings before administrative agencies,
regulatory bodies or courts of record at the federal, state or local
level.



(k) No judge of the board of review may hold any other office, or
accept any appointment or public trust, nor may he or she become a
candidate for any elective public office or nomination thereto.
Violation of this subsection requires the judge to vacate his or her
office. No judge of the board of review may engage in the practice of
law during his or her term of office.



(l) A vacancy occurring on the board other than by expiration of
a term shall be filled in the manner original appointments were made,
for the unexpired portion of the term.



(m) The board shall designate one of its judges in rotation to be
chief judge of the board for as long as the board may determine by
order made and entered of record. In the absence of the chief judge,
any other judge designated by the judges present shall act as chief
judge.



(n) The board of review shall meet as often as necessary to hold
review hearings, at such times and places as the chairman may
determine. Two members shall be present in order to conduct review
hearings or other business. All decisions of the board shall be
determined by a majority of the members of the board.



(o) The board of review shall make general rules regarding the pleading, including the form of the petition and any responsive
pleadings, practice and procedure to be used by the board.



(p) The board of review may hire a clerk and other professional
and clerical staff necessary to carry out the requirements of this
article. It is the duty of the clerk of the board of review to attend
in person, or by deputy, all the sessions of the board, to obey its
orders and directions during term and in vacation, to take care of and
preserve in an office, kept for the purpose, all records and papers of
the board and to perform other duties as prescribed by law or required
of him or her by the board. All employees of the board shall serve at
the will and pleasure of the board. The board's employees are exempt
from the salary schedule or pay plan adopted by the division of
personnel. All personnel of the board of review shall be under the
supervision of the chief judge of the board of review.



(q) If deemed necessary by the board, the board may, through
staffing or other resources, procure assistance in review of medical
portions of decisions.



(r) Upon the conclusion of any hearing, or prior thereto with
concurrence of the parties, the judge shall promptly determine the
matter and make an award in accordance with his or her determination.



(s) The award shall become a part of the commission file. A copy
of the award shall be sent forthwith by mail to all parties in
interest.



(t) The award is final when entered. The award shall contain a
statement explaining the rights of the parties to an appeal to the
board of review and the applicable time limitations involved.



(u) The board shall submit a budget to the executive director for inclusion in the budget for the workers' compensation commission
sufficient to adequately provide for the administrative and other
operating expenses of the board.



(v) The board shall report monthly to the board of managers on
the status of all claims on appeal.
§23-5-12. Appeal to board; procedure; remand and supplemental hearing.



(a) Any employer, employee, claimant or dependent, who shall feel
aggrieved at any final action of the administrative law judge taken
after a hearing held in accordance with the provisions of section nine
of this article, shall have the right to appeal to the board created
in section eleven of this article for a review of such action. The
workers' compensation commission shall likewise have the right to
appeal to the board any final action taken by the administrative law
judge. The aggrieved party shall file a written notice of appeal with
the office of judges directed to the board, within thirty days after
receipt of notice of the action complained of, or in any event,
regardless of notice, within sixty days after the date of the action
complained of, and unless the notice of appeal is filed within the time
specified, no such appeal shall be allowed, such time limitation being
hereby declared to be a condition of the right to such appeal and hence
jurisdictional; and the office of judges shall notify the other parties
immediately upon the filing of a notice of appeal. The notice of
appeal shall state the ground for review and whether oral argument is
requested. The office of judges shall forthwith make up a transcript
of the proceedings before the office of judges and certify and transmit
it to the board. The certificate shall incorporate a brief recital of
the proceedings in the case and recite each order entered and the date thereof.



(b) The board shall set a time and place for the hearing of
arguments on each claim and shall notify the interested parties
thereof. The review by the board shall be based upon the record
submitted to it and such oral argument as may be requested and
received. The board may affirm, reverse, modify or supplement the
decision of the administrative law judge and make such disposition of
the case as it determines to be appropriate. Briefs may be filed by
the interested parties in accordance with the rules of procedure
prescribed by the board. The board may affirm the order or decision
of the administrative law judge or remand the case for further
proceedings. It shall reverse, vacate or modify the order or decision
of the administrative law judge if the substantial rights of the
petitioner or petitioners have been prejudiced because the
administrative law judge's findings are:



(1) In violation of statutory provisions; or



(2) In excess of the statutory authority or jurisdiction of the
administrative law judge; or



(3) Made upon unlawful procedures; or



(4) Affected by other error of law; or



(5) Clearly wrong in view of the reliable, probative and
substantial evidence on the whole record; or



(6) Arbitrary or capricious or characterized by abuse of
discretion or clearly unwarranted exercise of discretion.



(c) After a review of the case, the board shall issue a written
decision to be filed with the commission and a copy thereof sent by
mail to the parties.



(1) All decisions, findings of fact and conclusions of law of the
board of review shall be in writing and state with specificity the laws
and facts relied upon to sustain, reverse or modify the administrative
law judge's decision.



(2) Decisions of the board of review shall be made by a majority
vote of the board of review.



(3) A decision of the board of review is binding upon the
executive director and the commission with respect to the parties
involved in the particular appeal. The executive director shall have
the right to seek judicial review of a board of review decision
irrespective of whether or not he appeared or participated in the
appeal to the board of review.



(d) Instead of affirming, reversing or modifying the decision of
the administrative law judge, the board may, upon motion of any party
or upon its own motion, for good cause shown, to be set forth in the
order of the board, remand the case to the chief administrative law
judge for the taking of such new, additional or further evidence as in
the opinion of the board may be necessary for a full and complete
development of the facts of the case. In the event the board shall
remand the case to the chief administrative law judge for the taking
of further evidence therein, the administrative law judge shall proceed
to take such new, additional or further evidence in accordance with any
instruction given by the board, and shall take the same within thirty
days after receipt of the order remanding the case, giving to the
interested parties at least ten days' written notice of such
supplemental hearing, unless the taking of evidence shall be postponed
by agreement of parties, or by the administrative law judge for good cause. After the completion of such supplemental hearing, the
administrative law judge shall, within sixty days, render his or her
decision affirming, reversing or modifying the former action of the
administrative law judge, which decision shall be appealable to, and
proceeded with by the board of review in like manner as in the first
instance. In addition, upon a finding of good cause, the board may
remand the case to the workers' compensation commission for further
development. Any decision made by the commission following such a
remand shall be subject to objection to the office of judges and not
to the board. The board may remand any case as often as in its opinion
is necessary for a full development and just decision of the case.



(e) All appeals from the action of the administrative law judge
shall be decided by the board at the same session at which they are
heard, unless good cause for delay thereof be shown and entered of
record.



(f) In all proceedings before the board, any party may be
represented by counsel.
§23-5-15. Appeals from final decisions of board to supreme court of
appeals; procedure; costs.



(a) Review of any final decision of the board, including any
order of remand, may be prosecuted by either party or by the workers'
compensation commission to the supreme court of appeals within thirty
days from the date of the final order by filing a petition therefor
with the court against the board and the adverse party or parties as
respondents. Unless the petition for review is filed within the
thirty-day period, no appeal or review shall be allowed, such time
limitation being hereby declared to be a condition of the right to such appeal or review and hence jurisdictional. The clerk of the supreme
court of appeals shall notify each of the respondents and the workers'
compensation commission of the filing of such petition. The board
shall, within ten days after receipt of such notice, file with the
clerk of the court the record of the proceedings had before it,
including all the evidence. The court or any judge thereof in vacation
may thereupon determine whether or not a review shall be granted. And
if granted to a nonresident of this state, he or she shall be required
to execute and file with the clerk before such order or review shall
become effective, a bond, with security to be approved by the clerk,
conditioned to perform any judgment which may be awarded against him
or her thereon. The board may certify to the court and request its
decision of any question of law arising upon the record, and withhold
its further proceeding in the case, pending the decision of court on
the certified question, or until notice that the court has declined to
docket the same. If a review be granted or the certified question be
docketed for hearing, the clerk shall notify the board and the parties
litigant or their attorneys and the workers' compensation commission
of that fact by mail. If a review be granted or the certified question
docketed, the case shall be heard by the court in the same manner as
in other cases, except that neither the record nor briefs need be
printed. Every such review granted or certified question docketed
prior to thirty days before the beginning of the term, shall be placed
upon the docket for such term. The attorney general shall, without
extra compensation, represent the board in such cases. The court shall
determine the matter so brought before it and certify its decision to
the board and to the division. The cost of such proceedings on petition, including a reasonable attorney's fee, not exceeding thirty
dollars to the claimant's attorney, shall be fixed by the court and
taxed against the employer if the latter be unsuccessful, and if the
claimant, or the commission (in case the latter be the applicant for
review) be unsuccessful, such costs, not including attorney's fees,
shall be taxed against the commission, payable out of the workers'
compensation fund, or shall be taxed against the claimant, in the
discretion of the court. But there shall be no cost taxed upon a
certified question.



(b) In reviewing a decision of the board of review, the supreme
court of appeals shall consider the record provided by the board. The
decision of the board may be reversed or modified by the supreme court
of appeals only if the board's findings of fact are not supported by
any evidence in the record or the decision is in clear violation of
constitutional or statutory provisions or clearly the result of
erroneous conclusions of law. The court may not re-weigh the evidence.
If the court reverses or modifies the board's decision on the basis
that its findings of fact are not supported by any evidence, the court
must state with specificity the reason or reasons the evidence relied
upon by the board does not satisfy this section.
§23-5-17. Termination of office of judges.



The office of judges terminates on the first day of July, two
thousand nine, pursuant to the provisions of article ten, chapter four
of this code unless sooner terminated, continued or reestablished
pursuant to the provisions of said article.
§23-5-18. Workers' compensation appeal board termination.



After the thirty-first day of December, two thousand three, the workers' compensation appeal board shall be terminated, the provisions
of sections ten, eleven, twelve, fourteen and fifteen of this article
shall be of no further force and effect and all matters pending before
the appeal board on the thirty-first day of December, two thousand
three, shall be transferred to the intermediate court of appeals
created in article one-b, chapter fifty-one of this code.
CHAPTER 26. STATE BENEVOLENT INSTITUTIONS.
ARTICLE 8. EMERGENCY HOSPITALS.
§26-8-2. Patients; expenses; disposition of receipts.



The department of health and human resources shall admit to the
hospitals, under its rules, persons requiring hospital care and shall
treat free of charge persons accidentally injured in this state while
engaged in their usual employment, but preference at all times shall
be given to persons accidentally injured: Provided, That the executive
director of the workers' compensation commission shall pay to the
hospitals for the treatment of anyone entitled to benefits or aid out
of the workers' compensation fund the same fee or expenses that would
be paid to a private hospital for similar treatment. All moneys
collected under this section shall be paid into the state treasury
through the state commissioner of public institutions as required in
section thirteen, article one, chapter twenty-five of this code.
CHAPTER 48. DOMESTIC RELATIONS.
ARTICLE 18. BUREAU FOR CHILD SUPPORT ENFORCEMENT.
§48-18-125. Employment and income reporting.



(a) For purposes of this section:



(1) "Employee" means an individual who is an "employee" for
purposes of federal income tax withholding, as defined in 26 U. S. C. §3401;



(2) "Employer" means the person or entity for whom an individual
performs or performed any service of whatever nature and who has
control of the payment of the individual's wages for performance of the
service or services, as defined in 26 U. S. C. §3401;



(3) An individual is considered a "new hire" on the first day in
which that individual performs services for remuneration and on which
an employer begins to withhold amounts for income tax purposes.



(b) Except as provided in subsections (c) and (d) of this
section, all employers doing business in the state shall report to the
bureau for child support enforcement:



(1) The hiring of any person who resides or works in this state
to whom the employer anticipates paying earnings; and



(2) The rehiring or return to work of any employee who resides or
works in this state.



(c) Employers are not required to report the hiring, rehiring or
return to work of any person who is an employee of a federal or state
agency performing intelligence or counterintelligence functions if the
head of the agency has determined that reporting could endanger the
safety of the employee or compromise an ongoing investigation or
intelligence mission.



(d) An employer that has employees in states other than this
state and that transmits reports magnetically or electronically is not
required to report to the bureau for child support enforcement the
hiring, rehiring or return to work of any employee if the employer has
filed with the secretary of the federal department of health and human
services, as required by 42 U. S. C. §653A, a written designation of another state in which it has employees as the reporting state.



(e) Employers shall report by mailing to the bureau for child
support enforcement a copy of the employee's W-4 form; however, an
employer may transmit the information through another means if approved
in writing by the bureau for child support enforcement prior to the
transmittal. The report shall include the employee's name, address and
social security number, the employer's name and address, any different
address of the payroll office and the employer's federal tax
identification number. The employer may report other information, such
as date of birth or income information, if desired.



(f) Employers shall submit a report within fourteen days of the
date of the hiring, rehiring or return to work of the employee.
However, if the employer transmits the reports magnetically or
electronically by two monthly submissions, the reports shall be
submitted not less than twelve days nor more than sixteen days apart.



(g) An employer shall provide to the bureau for child support
enforcement, upon its written request, information regarding an
obligor's employment, wages or salary, medical insurance, start date
and location of employment.



(h) Any employer who fails to report in accordance with the
provisions of this section shall be assessed a civil penalty of no more
than twenty-five dollars per failure. If the failure to report is the
result of a conspiracy between the employer and the employee not to
supply the required report or to supply a false or incomplete report,
the employer shall be assessed a civil penalty of no more than five
hundred dollars.



(i) Employers required to report under this section may assess each employee reported one dollar for the administrative costs of
reporting.



(j) Uses for the new hire information include, but are not
limited to, the following:



(1) The state directory of new hires shall furnish the
information to the national directory of new hires;



(2) The bureau for child support enforcement shall use
information received pursuant to this section to locate individuals for
purposes of establishing paternity and of establishing, modifying and
enforcing child support obligations and may disclose the information
to any agent of the agency that is under contract with the bureau to
carry out those purposes;



(3) State agencies responsible for administering a program
specified in 42 U. S. C. §1320b-7(b) shall have access to information
reported by employers for purposes of verifying eligibility for the
program; and



(4) The bureau of employment programs and the workers'
compensation commission shall have access to information reported by
employers for purposes of administering employment security and
workers' compensation programs.
§48-18-131. Access to records, confidentiality.



(a) All records in the possession of the bureau for child support
enforcement, including records concerning an individual case of child
or spousal support, are confidential and shall not be released except
as follows:



(1) Records shall be disclosed or withheld as required by federal
law or regulations promulgated thereunder notwithstanding other provisions of this section.



(2) Information as to the whereabouts of a party or the child
shall not be released to a person against whom a protective order has
been entered with respect to that party or child or where the state has
reason to believe that the release of the information to the person
making the request may result in physical or emotional harm to the
party or the child.



(3) The phone number, address, employer and other information
regarding the location of the obligor, the obligee and the child shall
only be disclosed: (A) Upon his or her written consent, to the person
whom the consent designates; or (B) notwithstanding subdivision (4) of
this subsection, to the obligee, the obligor, the child or the
caretaker or representative of the child, upon order of a court if the
court finds that the disclosure is for a bona fide purpose, is not
contrary to the best interest of a child and does not compromise the
safety of any party: Provided, That the identity and location of the
employer may be disclosed on the letters, notices and pleadings of the
bureau as necessary and convenient for the determination of support
amounts and the establishment, investigation, modification,
enforcement, collection and distribution of support.



(4) Information and records other than the phone number, address,
employer and information regarding the location of the obligor, the
obligee and the child shall be disclosed to the obligor, the obligee,
the child or the caretaker of the child or his or her duly authorized
representative, upon his or her written request: Provided, That when
the obligor requests records other than collection and distribution
records, financial records relevant to the determination of the amount of support pursuant to the guidelines, or records the obligor has
supplied, the bureau shall mail a notice by first-class mail to the
last known address of the obligee notifying him or her of the request.
The notice shall advise the obligee of his or her right to object to
the release of records on the grounds that the records are not relevant
to the determination of the amount of support or the establishment,
modification, enforcement, collection or distribution of support. The
notice shall also advise the obligee of his or her right to disclosure
of records provided in this section in order to determine what records
the bureau for child support enforcement may have. In the event of any
objection, the bureau shall determine whether or not the information
shall be released.



(5) Information in specific cases may be released as necessary to
determine the identity, location, employment, income and assets of an
obligor.



(6) Information and records may be disclosed to the bureau of
vital statistics, bureau of employment programs, the workers'
compensation commission, state tax department and the internal revenue
service, or other state or federal agencies or departments that are
necessary or desirable in obtaining any address, employment, wage or
benefit information for the purpose of determining the amount of
support or establishing, enforcing, collecting and distributing
support.



(b) Any person who willfully violates this section is guilty of
a misdemeanor and, upon conviction thereof, shall be fined not less
than one hundred dollars nor more than one thousand dollars, or
confined in the county or regional jail not more than six months, or both fined and confined.
CHAPTER 51. COURTS AND THEIR OFFICERS.
ARTICLE 1B. INTERMEDIATE COURT OF APPEALS.
§51-1B-1. Intermediate court of appeals; jurisdiction; initial
appointment; salary.



(a) There is hereby created the West Virginia intermediate court
of appeals which shall consist of three judges, any two of whom
constitute a quorum.



(b) The intermediate court of appeals shall exercise exclusive
jurisdiction over all appeals from the workers' compensation office of
judges filed after the thirty-first day of December, two thousand
three, and over all matters transferred to it pursuant to section
eighteen, article five, chapter twenty-three of this code. The supreme
court of appeals may, in its discretion, transfer to the intermediate
court of appeals for consideration and decision in accordance with the
provisions of this article, any appeals filed with the supreme court
of appeals prior to the thirty-first day of December, two thousand
three.



(c) The governor shall appoint, with the advice and consent of
the Senate, three qualified attorneys to serve five-year terms as
judges of the intermediate court of appeals. No more than two of the
judges may be from the same political party.



(d) The initial appointees shall serve until confirmed by the
Senate. If the Senate does not confirm an appointee the governor shall
forthwith submit the name of another qualified appointee for
consideration by the Senate. The initial appointments shall be made
no later than the thirty-first day of December, two thousand three. Should a vacancy occur, the governor shall, within thirty days of
vacation of the position, appoint a new judge to fill the unexpired
term.



(e) The salary of each of the judges of the intermediate court of
appeals is ninety-two thousand dollars per year.
§51-1B-2. Qualifications.



(a) A judge of the intermediate court of appeals must, at the
time he or she takes office, and thereafter during his or her
continuance in office, be a resident of this state, be a member in good
standing of the West Virginia state bar, have a minimum of ten years'
experience as an attorney admitted to practice law in this state prior
to appointment, and have a minimum of five years' experience in
preparing and presenting cases or hearing actions and making decisions
on the basis of the record of those hearings before administrative
agencies, regulatory bodies or courts of record at the federal, state
or local level.



(b) No judge of the intermediate court of appeals may hold any
other office, or accept any appointment or public trust, nor may he or
she become a candidate for any elective public office or nomination
thereto, except a judicial office. Violation of this subsection
requires the judge to vacate his or her office. No judge of an
intermediate court of appeals may engage in the practice of law during
his or her term of office.
§51-1B-3. Chief judge.



The court shall designate one of its judges in rotation to be
chief judge of the court for as long as the court may determine by
order made and entered of record. In the absence of the chief judge, any other judge designated by the judges present shall act as chief
judge.
§51-1B-4. Regular terms of court.



Two terms of the intermediate court of appeals shall be held
every year at Charleston, in Kanawha County, the first commencing on
the second Tuesday in January and ending on the thirty-first day of
July, the second on the first Wednesday in September and ending on the
fifteenth day of December. The intermediate court of appeals shall,
from time to time, hold hearings in other counties of the state as the
court finds appropriate.
§51-1B-5. Location.



The intermediate court of appeals shall be located in the same
facility as or in reasonable proximity, within the city of Charleston,
to the West Virginia supreme court of appeals.
§51-1B-6. Regulation of pleading, practice and procedure.



The supreme court of appeals shall make general rules regarding
the pleading, including the form of the petition and any responsive
pleadings, practice and procedure to be used by the intermediate court
of appeals.
§51-1B-7. Rejection, remand or allowance of appeal.



Upon its initial review of the petition, the intermediate court
of appeals may reject the appeal or allow the appeal to be heard. If
the petition is rejected by the intermediate court of appeals, no other
petition for appeal from the decision or order of the office of judges
shall be permitted. If the petition is granted, the court shall
immediately notify the petitioner, the respondents, the office of
judges and the workers' compensation commission of its decision and may schedule the filing of written briefs and a time for hearing oral
arguments, if necessary, by the parties in accordance with the rules
of the court.
§51-1B-8. Decisions.



(a) In all cases before it, the intermediate court of appeals
shall consider the record, the legal briefs of the parties and, when
the court considers it necessary, the oral arguments of the parties
prior to rendering a decision.



(b) The court may affirm or reverse the order or decision of the
office of judges or remand the case for further proceedings.



(c) Any decision reversing, remanding or affirming a decision of
the office of judges must set forth the reasons therefor, including the
court's findings of fact and the legal precedents and conclusions
supporting the decision.
§51-1B-9. Adjournment.



The court may, at any regular or special term, adjourn from day
to day or from time to time, as the court may order, until its close.
§51-1B-10. Clerk; deputy; other assistants and employees;
compensation; expenses.



The intermediate court of appeals, or the judges thereof in
vacation, may with the approval of the supreme court of appeals appoint
a clerk, who shall give bond as required by article two, chapter six
of this code. The intermediate court of appeals, or the judges thereof
in vacation, may with the approval of the supreme court of appeals
appoint one deputy clerk, and other full-time and part-time assistants
and clerical employees necessary to perform properly the functions and
duties of the office of the clerk. The annual compensation of the clerk shall be fixed by the supreme court of appeals. The clerk and
other employees shall serve at the will and pleasure of the court.
Vacancies in the office of the clerk which occur during vacation may
be filled by appointment, in writing, made by a majority of the judges
of the court. The administrative and other operating expenses of the
intermediate court of appeals shall be determined and provided by the
supreme court of appeals.
§51-1B-11. Duties of clerk.



It is the duty of the clerk of the intermediate court of appeals
to attend in person, or by deputy, all the sessions of the court, to
obey its orders and directions during term and in vacation, to take
care of and preserve in an office, kept for the purpose, all records
and papers of the court, and to perform other duties as prescribed by
law or required of him or her by the court.
§51-1B-12. Appeals to the supreme court of appeals.



(a) Either party or the workers' compensation commission may file
a petition for an appeal from a final order of the intermediate court
of appeals with the supreme court of appeals within thirty days of the
entry of the order. This time limitation is a condition of the right
to appeal and, hence, jurisdictional, and unless the petition for
review is filed within the thirty-day period, no appeal or review shall
be allowed. The clerk of the supreme court of appeals shall notify
each of the respondents, the workers' compensation commission, and the
clerk of the intermediate court of appeals of the filing of the
petition. The clerk of the intermediate court of appeals shall, within
ten days after receipt of the notice, file the record, including all
the evidence, with the clerk of the supreme court of appeals. If a review is granted to a nonresident of this state, he or she shall,
before the order or review becomes effective, execute and file with the
clerk of the supreme court of appeals a bond, with security to be
approved by the clerk, conditioned to perform any judgment which may
be awarded against him or her thereon. A petition for appeal shall be
filed in the office of the clerk of the supreme court of appeals in
accordance with the rules of appellate procedure.



(b) No petition for appeal to the supreme court of appeals shall
lie from a decision of the intermediate court of appeals rejecting the
petition pursuant to section seven of this article.



(c) In reviewing a decision of the intermediate court of appeals,
the supreme court of appeals shall consider the record provided by the
intermediate court of appeals. The decision of the intermediate court
of appeals may be reversed or modified by the supreme court of appeals
only if the lower court's findings of fact are not supported by any
evidence in the record or the decision is in clear violation of
constitutional or statutory provisions or clearly the result of
erroneous conclusions of law.
§51-1B-13. Termination of intermediate court of appeals.



(a) The intermediate court of appeals and the provisions of this
article shall be of no further force and effect after the thirty-first
day of December, two thousand eight.



(b) The termination of the provisions of this article as
specified in this section is intended to provide an opportunity to
evaluate the intermediate court of appeals, its structure and
operation, the advisability of requiring the election of its judges,
the desirability of expanding its jurisdiction, and other related matters. The Legislature finds that it would be most beneficial, for
purposes of accomplishing this evaluation, to consider any report or
recommendations of the supreme court of appeals if available on or
before the thirty-first day of December, two thousand six.
CHAPTER 61. CRIMES AND THEIR PUNISHMENT.
ARTICLE 3. CRIMES AGAINST PROPERTY.
§61-3-24e. Omission to subscribe to the workers' compensation fund;
failure to file a premium tax report or pay premium taxes; false
testimony or statements; failure to file reports; penalties;
asset forfeiture; venue.



(1) Failure to subscribe:



(A) Responsible person. Any person who individually or as owner,
partner, president, other officer, or manager of a sole proprietorship,
firm, partnership, company, corporation or association, who, as a
person who is responsible for and who is required by specific
assignment, duty or legal duty, which is either expressed or inherent
in laws which require the employer's principals to be informed and to
know the facts and laws affecting the business organization and to make
internal policy and decisions which ensure that the individual and
organization comply with the general laws and provisions of chapter
twenty-three of this code, knowingly and willfully fails to subscribe
to the workers' compensation fund shall be guilty of a felony and, upon
conviction, shall be imprisoned in a state correctional facility not
less than one nor more than ten years, or in the discretion of the
court, be confined in a county or regional jail not more than one year
and shall be fined not more than two thousand five hundred dollars.



(B) Any corporation, association or partnership who, as an employer as defined in chapter twenty-three of this code, knowingly and
willfully fails to subscribe to the workers' compensation fund shall
be guilty of a felony and, upon conviction, shall be fined not less
than two thousand five hundred dollars nor more than ten thousand
dollars.



(2) Failure to pay:



(A) Any person who individually or as owner, partner, president,
other officer or manager of a sole proprietorship, firm, partnership,
company, corporation or association, who, as a responsible person as
defined in section twenty-four-e of this article, knowingly and
willfully fails to make premium tax payments to the workers'
compensation fund as required by chapter twenty-three of this code,
shall be guilty of the larceny of the premium owed and, if the amount
is one thousand dollars or more, such person shall be guilty of a
felony and, upon conviction thereof, shall be imprisoned in a state
correctional facility not less than one nor more than ten years or, in
the discretion of the court, be confined in a county or regional jail
not more than one year and shall be fined not more than two thousand
five hundred dollars. If the amount is less than one thousand dollars,
such person shall be guilty of a misdemeanor and, upon conviction
thereof, shall be confined in a county or regional jail for a term not
to exceed one year or fined an amount not to exceed two thousand five
hundred dollars, or both, in the discretion of the court.



(B) Any corporation, association, company or partnership which,
as an employer as defined in chapter twenty-three of this code,
knowingly and willfully fails to make premium tax payments to the
workers' compensation fund as required by chapter twenty-three of this code shall be guilty of the larceny of the premium owed, and, if the
amount is one thousand dollars or more, such corporation, association,
company or partnership shall be guilty of a felony and, upon conviction
thereof, shall be fined not less than two thousand five hundred dollars
nor more than ten thousand dollars. If the amount is less than one
thousand dollars, such corporation, association, company or partnership
shall be guilty of a misdemeanor and, upon conviction thereof, shall
be fined an amount not to exceed two thousand five hundred dollars.



(C) Any person who individually or as owner, partner, president,
other officer, or manager of a sole proprietorship, firm, partnership,
company, corporation or association, who, as a responsible person, as
defined in section twenty-four-e of this article, knowingly and
willfully and with fraudulent intent sells, transfers or otherwise
disposes of substantially all of the employer's assets for the purpose
of evading the payment of workers' compensation premium taxes to the
workers' compensation fund as required by chapter twenty-three of this
code, shall be guilty of the larceny of the premium owed and, if the
amount is one thousand dollars or more, such person shall be guilty of
a felony and, upon conviction thereof, shall be imprisoned in a state
correctional facility not less than one nor more than ten years or, in
the discretion of the court, be confined in a county or regional jail
not more than one year and shall be fined not more than two thousand
five hundred dollars. If the amount is less than one thousand dollars,
such person shall be guilty of a misdemeanor and, upon conviction
thereof, shall be confined in a county or regional jail for a term not
to exceed one year or fined an amount not to exceed two thousand five
hundred dollars, or both, in the discretion of the court.



(D) Any corporation, association, company or partnership which,
as an employer as defined in chapter twenty-three of this code,
knowingly and willfully and with fraudulent intent sells, transfers or
otherwise disposes of substantially all of the employer's assets for
the purpose of evading the payment of workers' compensation premium
taxes to the workers' compensation fund as required by chapter twenty-
three of this code shall be guilty of the larceny of the premium owed,
and, if the amount is one thousand dollars or more, such corporation,
association, company or partnership shall be guilty of a felony and,
upon conviction thereof, shall be fined not less than two thousand five
hundred dollars nor more than ten thousand dollars. If the amount is
less than one thousand dollars, such corporation, association, company
or partnership shall be guilty of a misdemeanor and, upon conviction
thereof, shall be fined an amount not to exceed two thousand five
hundred dollars.



(3) Failure to file premium tax reports:



(A) Any person who individually or as owner, partner, president,
other officer, or manager of a sole proprietorship, firm, partnership,
company, corporation or association, who, as a responsible person as
defined in section twenty-four-e of this article, knowingly and
willfully fails to file a premium tax report with the workers'
compensation fund as required by chapter twenty-three of this code,
shall be guilty of a felony and, upon conviction thereof, shall be
imprisoned in a state correctional facility not less than one nor more
than ten years, or in the discretion of the court, be confined in a
county or regional jail for a term not to exceed one year and shall be
fined not more than two thousand five hundred dollars.



(B) Any corporation, association, company or partnership which,
as an employer as defined in chapter twenty-three of this code,
knowingly and willfully fails to file a premium tax report with the
workers' compensation fund as required by chapter twenty-three of this
code, shall be guilty of a felony and, upon conviction thereof, shall
be fined not less than two thousand five hundred dollars nor more than
ten thousand dollars.



(4) Failure to file other reports:



(A) Any person, individually or as owner, partner, president or
other officer, or manager of a sole proprietorship, firm, partnership,
company, corporation or association who, as a responsible person as
defined in section twenty-four-e of this article, knowingly and
willfully fails to file any report, other than a premium tax report,
required by such chapter shall be guilty of a misdemeanor and, upon
conviction thereof, shall be confined in a county or regional jail for
a term not to exceed one year or fined an amount not to exceed two
thousand five hundred dollars, or both, in the discretion of the court.



(B) Any corporation, association, company or partnership which,
as an employer as defined in chapter twenty-three of this code,
knowingly and willfully fails to file any report, other than a premium
tax report, with the workers' compensation fund as required by chapter
twenty-three of this code, shall be guilty of a misdemeanor and, upon
conviction thereof, shall be fined an amount not to exceed two thousand
five hundred dollars.



(5) False testimony or statements:



Any person, individually or as owner, partner, president, other
officer, or manager of a sole proprietorship, firm, partnership, company, corporation or association who, as a responsible person as
defined in section twenty-four-e of this article, knowingly and
willfully makes a false report or statement under oath, affidavit,
certification or by any other means respecting any information required
to be provided under chapter twenty-three of this code shall be guilty
of a felony and, upon conviction thereof, shall be confined in a state
correctional facility for a definite term of imprisonment which is not
less than one year nor more than three years or fined not less than one
thousand dollars nor more than ten thousand dollars, or both, in the
discretion of the court. In addition to any other penalty imposed, the
court shall order any defendant convicted under this section to make
full restitution of all moneys paid by or due to the workers'
compensation fund as the result of a violation of this section. The
restitution ordered shall constitute a judgment against the defendant
and in favor of the state of West Virginia workers' compensation
commission.



(6) Asset forfeiture:



(A) The court, in imposing sentence on a person or entity
convicted of an offense under this section, shall order the person or
entity to forfeit property, real or personal, that constitutes or is
derived, directly or indirectly, from gross proceeds traceable to the
commission of the offense. Any person or entity convicted under this
section shall pay the costs of asset forfeiture.



(B) For purposes of subdivision (A) of this subsection, the term
"payment of the costs of asset forfeiture" means:



(i) The payment of any expenses necessary to seize, detain,
inventory, safeguard, maintain, advertise, sell or dispose of property under seizure, detention, forfeiture or of any other necessary expenses
incident to the seizure, detention, forfeiture, or disposal of such
property, including payment for:



(I) Contract services;



(II) The employment of outside contractors to operate and manage
properties or provide other specialized services necessary to dispose
of such properties in an effort to maximize the return from such
properties; and



(III) Reimbursement of any state or local agency for any
expenditures made to perform the functions described in this
subparagraph;



(ii) The compromise and payment of valid liens and mortgages
against property that has been forfeited, subject to the discretion of
the workers' compensation fund to determine the validity of any such
lien or mortgage and the amount of payment to be made, and the
employment of attorneys and other personnel skilled in state real
estate law as necessary;



(iii) Payment authorized in connection with remission or
mitigation procedures relating to property forfeited; and



(iv) The payment of state and local property taxes on forfeited
real property that accrued between the date of the violation giving
rise to the forfeiture and the date of the forfeiture order.



(7) Venue:



Venue for prosecution of any violation of this section shall be
either the county in which the defendant's principal business
operations are located or in Kanawha County where the workers'
compensation fund is located.
§61-3-24f. Wrongfully seeking workers' compensation; false testimony
or statements; penalties; venue.
(1) Any person who shall knowingly and with fraudulent intent
secure or attempt to secure compensation from the workers' compensation
fund or from a self-insured employer:
(A) That is larger in amount than that to which he or she is
entitled; or
(B) That is longer in term than that to which he or she is
entitled; or
(C) To which he or she is not entitled, shall be guilty of a
larceny and, if the amount is one thousand dollars or more, such person
shall be guilty of a felony and, upon conviction thereof, shall be
imprisoned in a state correctional facility not less than one nor more
than ten years or, in the discretion of the court, be confined in a
county or regional jail not more than one year and shall be fined not
more than two thousand five hundred dollars. If the amount is less
than one thousand dollars, such person shall be guilty of a misdemeanor
and, upon conviction thereof, shall be confined in a county or regional
jail for a term not to exceed one year or fined an amount not to exceed
two thousand five hundred dollars, or both, in the discretion of the
court.
(2) Any person who shall knowingly and willfully make a false
report or statement under oath, affidavit, certification or by any
other means respecting any information required to be provided under
chapter twenty-three of this code shall be guilty of a felony and, upon
conviction thereof, shall be confined in a state correctional facility
for a definite term of imprisonment which is not less than one year nor more than three years or fined not less than one thousand dollars nor
more than ten thousand dollars, or both, in the discretion of the
court.
(3) In addition to any other penalty imposed, the court shall
order any person convicted under this section to make full restitution
of all moneys paid by the workers' compensation fund or self-insured
employer as the result of a violation of this section. The restitution
ordered shall constitute a judgment against the defendant and in favor
of the state of West Virginia workers' compensation commission or self-
insured employer.
(4) If the person so convicted is receiving compensation from
such fund or employer, he or she shall, from and after such conviction,
cease to receive such compensation as a result of any alleged injury
or disease.
(5) Venue for prosecution of any violation of this section shall
either be the county in which the claimant resides, the county in which
the claimant is employed or working, or in Kanawha County where the
workers' compensation fund is located.
§61-3-24g. Workers' compensation health care offenses; fraud; theft
or embezzlement; false statements; penalties; notice; prohibition
against providing future services; penalties; asset forfeiture;
venue.
(1) Any person who knowingly and willfully executes, or attempts
to execute, a scheme or artifice:
(A) To defraud the workers' compensation fund or a self-insured
employer in connection with the delivery of or payment for workers'
compensation health care benefits, items or services;
(B) To obtain, by means of false or fraudulent pretenses,
representations, or promises any of the money or property owned by or
under the custody or control of the workers' compensation fund or a
self-insured employer in connection with the delivery of or payment for
workers' compensation health care benefits, items or services; or
(C) To make any charge or charges against any injured employee or
any other person, firm or corporation which would result in a total
charge for the treatment or service rendered in excess of the maximum
amount set forth in the workers' compensation commission's schedule of
maximum reasonable amounts to be paid for the treatment or services
issued pursuant to subsection (a), section three, article four, chapter
twenty-three of this code is guilty of a felony and, upon conviction
thereof, shall be imprisoned in a state correctional facility not less
than one year nor more than ten years or, in the discretion of the
court, be confined in a county or regional jail not more than one year
and shall be fined not more than two thousand five hundred dollars.
(2) Any person who, in any matter involving a health care program
related to the workers' compensation fund, knowingly and willfully:
(A) Falsifies, conceals or covers up by any trick, scheme or
device a material fact; or
(B) Makes any materially false, fictitious or fraudulent
statement or representation, or makes or uses any materially false
writing or document knowing the same to contain any materially false,
fictitious or fraudulent statement or entry, is guilty of a felony and,
upon conviction thereof, shall be confined in a state correctional
facility for a definite term of imprisonment which is not less than one
year nor more than three years or fined not less than one thousand dollars nor more than ten thousand dollars, or both, in the discretion
of the court.
(3) Any person who willfully embezzles, steals or otherwise
unlawfully converts to the use of any person other than the rightful
owner, or intentionally misapplies any of the moneys, funds,
securities, premiums, credits, property or other assets of a health
care program related to the workers' compensation fund, is guilty of
a felony and, upon conviction thereof, shall be imprisoned in a state
correctional facility for not less than one year nor more than ten
years or fined not less than ten thousand dollars, or both, in the
discretion of the court.
(4) Any health care provider who fails, in violation of
subsection (5) of this section to post a notice, in the form required
by the workers' compensation commission, in the provider's public
waiting area that the provider cannot accept any patient whose
treatment or other services or supplies would ordinarily be paid for
from the workers' compensation fund or by a self-insured employer
unless the patient consents, in writing, prior to the provision of the
treatment or other services or supplies, to make payment for that
treatment or other services or supplies himself or herself, is guilty
of a misdemeanor and, upon conviction thereof, shall be fined one
thousand dollars.
(5) Any person convicted under the provisions of this section
shall, after such conviction, be barred from providing future services
or supplies to injured employees for the purposes of workers'
compensation and shall cease to receive payment for services or
supplies. In addition to any other penalty imposed, the court shall order any defendant convicted under this section to make full
restitution of all moneys paid by or due to the workers' compensation
fund as the result of a violation of this section. The restitution
ordered shall constitute a judgment against the defendant and in favor
of the state of West Virginia workers' compensation commission.
(6)(A) The court, in imposing sentence on a person convicted of
an offense under this section, shall order the person to forfeit
property, real or personal, that constitutes or is derived, directly
or indirectly, from gross proceeds traceable to the commission of the
offense. Any person convicted under this section shall pay the costs
of asset forfeiture.
(B) For purposes of subdivision (A) of this subsection, the term
"payment of the costs of asset forfeiture" means:
(i) The payment of any expenses necessary to seize, detain,
inventory, safeguard, maintain, advertise, sell or dispose of property
under seizure, detention or forfeiture, or of any other necessary
expenses incident to the seizure, detention, forfeiture or disposal of
the property, including payment for:
(I) Contract services;
(II) The employment of outside contractors to operate and manage
properties or provide other specialized services necessary to dispose
of the properties in an effort to maximize the return from the
properties; and
(III) Reimbursement of any state or local agency for any
expenditures made to perform the functions described in this
subparagraph;
(ii) The compromise and payment of valid liens and mortgages against property that has been forfeited, subject to the discretion of
the workers' compensation fund to determine the validity of the lien
or mortgage and the amount of payment to be made, and the employment
of attorneys and other personnel skilled in state real estate law as
necessary;
(iii) Payment authorized in connection with remission or
mitigation procedures relating to property forfeited; and
(iv) The payment of state and local property taxes on forfeited
real property that accrued between the date of the violation giving
rise to the forfeiture and the date of the forfeiture order.
(7) Venue for prosecution of any violation of this section shall
be either the county in which the defendant's principal business
operations are located or in Kanawha County where the workers'
compensation fund is located.