
COMMITTEE SUBSTITUTE
for
Senate Bill No. 123
(By Senators Tomblin, Mr. President, and Sprouse,
By Request of the Executive)
____________
[Originating in the Committee on Economic Development;
reported January 20, 2003.]
____________
A BILL to
repeal section seven-b, article four, chapter twenty-three of the code
of West Virginia, one thousand nine hundred thirty-one, as amended; to
repeal section fourteen, article
five of said chapter; to amend and
reenact section seventeen, article ten, chapter five of said code; 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 sections one and five,
article two, chapter five-f
of said code;
to amend and reenact
section
two-a, article seven, chapter six 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
sections one through
seven, inclusive, article three 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, one-g and four-a;
to amend and reenact
sections one, one-c, one-d, two, three, four, five, 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 one-b; to
amend and reenact sections one, one-a, one-b, one-c, one-d, one-e, two,
three, three-b, three-c, four, six, six-a, six-b, six-d, seven, seven-a,
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-g;
to amend and reenact
sections one, three, five, six, seven and eight, article four-a of said
chapter; to amend and reenact sections two, five, six, seven, eight and
eight-a, article four-b of said chapter; 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 sections one and two, article five-a 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
section twenty-four-g, article three,
chapter sixty-one of said code, all relating to workers' compensation
generally;
repealing provisions relating to trial return to work;
repealing provisions relating to disqualification of workers' compensation
appeal board members; removing workers' compensation from the bureau of
employment programs; creating workers' compensation commission as an
independent agency assuming all duties of division; transferring workers'
compensation office of judges and the appeal board to department of
administration; establishing salaries for members and the chief judge of
the workers' compensation appeal board; changing the name of the
compensation programs performance council to the state advisory council
for the bureau of employment programs; transferring certain powers of the
compensation programs performance council to the bureau of employment
programs and the state advisory council; requiring rules to be filed as
legislative rules; clarifying terms of state advisory council members;
precluding political candidates, political party officer or office-holders
from sitting on the state advisory council; establishing compensation for
advisory council members and limiting number of days per year for which an
advisory council member may be compensated; reporting requirements for
employers; creating the board of managers; establishing composition of
board; establishing qualifications for membership; establishing
appointment procedures for members; setting forth the powers and duties of
board; providing for payment withholding and interception of moneys of
certain employers to ensure compliance with unemployment and workers'
compensation laws; providing penalties for failure to withhold or
intercept payments; authorizing interagency agreements between bureau of
employment programs and workers' compensation commission; creating the
board of managers nominating committee and setting forth its composition and responsibilities; adopting workers' compensation rules by commission;
continuing workers' compensation division until the first day of July, two
thousand three; requiring commission to report to the commission on
economic development; providing for salaries and expenses; requiring
performance bonds under certain circumstances; providing for associate
director to assume authority in absence of executive director; authorizing
the executive director to hire certain administrative, managerial and
supervisory employees; authorizing certain commission employees to
administer oaths; providing for issuance and enforcement of agency
subpoenas; establishing fees; defining employer; allowing specified groups
of employers to self insure their obligations to the commission;
authorizing self-insured employers to administer claims; requiring self-
insured employers to comply with the law and commission rules; authorizing
the commission to determine the full accrued value of a defaulting self-
insured employer based on generally accepted actuarial and accounting
principles; setting forth powers and duties of the executive director to
regulate self-insured employers; establishing penalties for self-insured
employers and third-party administrators for violations of this chapter;
prohibiting self-insured employers from contracting with third-party
administrators who have not been approved by the commission; allowing for
subrogation and making it effective for claims arising from a cause of
action which arose or accrued after the effective date of this
legislation; eliminating the second injury fund; creating deficit
elimination fund; granting custody of fund to the state treasurer;
requiring investment of deficit reduction fund; providing funding for
deficit elimination through joint employer and employee payroll tax;
requiring the commission to promulgate rules for operation of the fund;
authorizing investment management board to invest surplus moneys to fund;
reporting requirements of self-insurers; requiring commission to make a
decision on compensability of a claim within fifteen days; prohibiting a
claimant from receiving both temporary total disability benefits and certain other employer-provided short-term disability benefits; requiring
award of permanent partial disability benefits be made as expeditiously as
possible; providing for weighing of evidence and application of rule of
liberality; providing that vendors must submit bills for services within
one year of provision of the service; authorizing employers to create
physician panels; requiring injured employees to chose a physician from
the panel; creating an exception for emergency treatment; allowing injured
employees to choose physician if employer protest compensability of claim;
reducing maximum weekly benefit for temporary total disability to sixty-
six and two-thirds percent of the average weekly wage of the employee;
increasing to fifty percent the percentage of whole body impairment which
establishes a rebuttable presumption of permanent total disability;
providing that permanent total disability benefits are subject to old age
social security offsets for claimants injured on or after the first day of
July, two thousand three; reducing permanent partial disability benefits
to seventy percent of the average weekly wage of the claimant not to
exceed sixty-six and two-thirds percent of the average weekly wage in West
Virginia; providing that reductions in benefit rates affect claimants
injured on or after the first day of July, two thousand three; requiring
the executive director to promulgate a rule to establish requirements for
an application for permanent total disability benefits; providing that
upon adoption of the rule on application requirements no claim for
permanent total disability benefits may be sent to the interdisciplinary
examining board without an application; providing for the establishment of
an onset date for permanent total disability benefits as of the date of
application; providing that a claimant must have been awarded fifty
percent permanent partial disability prior to applying for permanent total
disability; creating a definition of permanent total disability;
eliminating the five-percent presumptive award of occupational
pneumoconiosis without measurable impairment; increasing vocational
rehabilitation services; providing that the commission may suspend benefits to a claimant for refusing, without good cause, to be examined by
a physician; removing certain office-set provisions; removing mediation
provisions; authorizing appointment of chief administrative law judge by
secretary of department of administration; continuing the incumbent;
providing for removal only for specified misconduct; providing that the
commission must fund the office of judges and the appeals board; allowing
office of judges to promulgate procedural rules; providing for appeal of
office of judges' decision to the appeals board; providing for appeals of
compensability as matter of right, all other appeals within discretion of
board; establishing time frames for appeals; establishing standards for
appeal; creating full-time three judge appeal board; providing for
appointment by the governor for staggered six-year terms; authorizing
board to develop rules of procedure; establishing qualifications of
judges; requiring monthly reports to the board of managers; providing for
remand of cases; providing for appeals from the board to the West Virginia
supreme court of appeals; continuing the board; and making technical
corrections and removing archaic language throughout.
Be it enacted by the Legislature of West Virginia:

That
section seven-b, article four, chapter twenty-three of the code of
West Virginia, one thousand nine hundred thirty-one, as amended, be repealed;
that section fourteen, article
five of said chapter be repealed; that section
seventeen, article ten, chapter five of said code be amended and reenacted; 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 sections one and five, article two, chapter
five-f
of said code be amended and reenacted; that
section two-a, article seven,
chapter six 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 sections one through
seven, inclusive, article three 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, one-g and four-a; that
sections one, one-c, one-d, two, three, four, five, 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 one-b; that
sections one, one-a, one-b, one-c, one-d, one-e, two, three, three-b, three-c,
four, six, six-a, six-b, six-d, seven, seven-a, 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-g; that sections one, three, five, six, seven and eight,
article four-a of said chapter be amended and reenacted; that sections two, five,
six, seven, eight and eight-a, article four-b of said chapter be amended and
reenacted; 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 sections one and two, article
five-a 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 section twenty-four-g,
article three, chapter sixty-one of said code be amended and reenacted, all to
read as follows:
CHAPTER 5. GENERAL POWERS AND AUTHORITY OF THE GOVERNOR,
SECRETARY OF STATE AND ATTORNEY GENERAL; BOARD
OF PUBLIC WORKS; MISCELLANEOUS AGENCIES, COMMISSIONS,
OFFICES, PROGRAMS, ETC.
ARTICLE 10. WEST VIRGINIA PUBLIC EMPLOYEES RETIREMENT ACT.
§5-10-17. Retirement system membership.

The membership of the retirement system consists of the following persons:

(a) All employees, as defined in section two of this article, who are in
the employ of a political subdivision the day preceding the date it becomes a
participating public employer and who continue in the employ of the participating
public employer on and after that date shall become members of the retirement
system; and all persons who become employees of a participating public employer
on or after that date shall thereupon become members of the system; except as
provided in subdivisions (b) and (c) of this section.

(b) The membership of the retirement system shall not include any person
who is a member of, or who has been retired by, any of the state teachers
retirement systems, the judges retirement system, the retirement system of the
division of public safety, the deputy sheriff retirement system or any municipal retirement system for either, or both, policemen or firemen; and the bureau of
employment programs, by the commissioner of the bureau, and the workers'
compensation commission, by the executive director, may elect whether its
employees will accept coverage under this article or be covered under the
authorization of a separate enactment: Provided, That the exclusions of
membership shall not apply to any member of the state Legislature, the clerk of
the House of Delegates, the clerk of the state Senate or to any member of the
legislative body of any political subdivision provided he or she once becomes a
contributing member of the retirement system: Provided, however, That any
retired member of the retirement system of the division of public safety, the
deputy sheriff retirement system and any retired member of any municipal
retirement system for either, or both, policemen or firemen may on and after the
effective date of this section become a member of the retirement system as
provided in this article, without receiving credit for prior service as a
municipal policeman or fireman or as a member of the division of public safety
or of the deputy sheriff retirement system: Provided further, That the
membership of the retirement system does not include any person who becomes
employed by the Prestera center for mental health services, valley comprehensive
mental health center, Westbrook health services or eastern panhandle mental
health center on or after the first day of July, one thousand nine hundred
ninety-seven: And provided further, That membership of the retirement system
does not include any person who becomes a member of the federal railroad
retirement act on or after the first day of July, two thousand.

(c) Any member of the state Legislature, the clerk of the House of
Delegates, the clerk of the state Senate and any employee of the state
Legislature whose employment is otherwise classified as temporary and who is
employed to perform services required by the Legislature for its regular sessions
or during the interim between regular sessions and who has been or is so employed
during regular sessions or during the interim between sessions in seven
consecutive calendar years, as certified by the clerk of the house in which the
employee served, or any member of the legislative body of any other political subdivision shall become a member of the retirement system provided he or she
notifies the retirement system in writing of his or her intention to be a member
of the system and files a membership enrollment form as prescribed by the board
of trustees, and each person, upon filing his or her written notice to
participate in the retirement system, shall by that act authorize the clerk of
the House of Delegates or the clerk of the state Senate or such person or
legislative agency as the legislative body of any other political subdivision
shall designate to deduct the member's contribution, as provided in subsection
(b), section twenty-nine of this article, and after the deductions have been made
from the member's compensation, the deductions shall be forwarded to the
retirement system.

(d) If question arises regarding the membership status of any employee, the
board of trustees has the final power to decide the question.

(e) Any individual who is a leased employee is not eligible to participate
in the system. For the purposes of this article, the term "leased employee"
means any individual who performs services as an independent contractor or
pursuant to an agreement with an employee leasing organization or other similar
organization. If a question arises regarding the status of an individual as a
leased employee, the board has final authority to decide the question.
CHAPTER 5A. DEPARTMENT OF ADMINISTRATION.
ARTICLE 3. PURCHASING DIVISION.
§5A-3-33d. Grounds for debarment.

Grounds for debarment are:

(a) Conviction of an offense involving fraud or a felony offense in
connection with obtaining or attempting to obtain a public contract or
subcontract.

(b) Conviction of any federal or state antitrust statute relating to the
submission of offers.

(c) 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.

(d) Conviction of a felony offense demonstrating a lack of business
integrity or business honesty that affects the present responsibility of the
vendor or subcontractor.

(e) 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.

(f) 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.

(g) Violation of the terms of a public contract or subcontract for:

(1) Willful failure to substantially perform in accordance with the terms
of one or more public contracts;

(2) 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;

(3) 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;

(4) A repeated pattern or practice of failure to perform so serious and
compelling as to justify debarment; or

(5) 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
rules rule, interpretive rules rule or existing legislative rules ruleand make
recommendations concerning such rules to the Legislature.

(b) The development office and the tourism commission established pursuant
to article two, chapter five-b of this code, 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, chapter five-b, 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 herein. 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 chapter twenty-nine-a of
this code.
§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 such local areas are consistent with labor market
areas;

(D) The distance that individuals will need to travel to receive services
provided in such local areas; and

(E) The resources of such 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, chapter
five-b of this code, 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, the workforce investment commission established pursuant to article
two-c, chapter five-b, 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 it 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.

(12) Workers compensation appeals board and office of judges provided for
in article five, chapter twenty-three 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.;

(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 cost review 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 such 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 decision makers 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.
§5F-2-5. Independent appeal boards.

(a) The Legislature finds and declares that it may be desirable and
appropriate for certain boards and commissions created by the Legislature which
may be called upon to review, adjudicate or reverse administrative actions and
decisions of agencies of the state to be fiscally and functionally independent
of the agency or agencies reviewed, to issue rules and manage day-to-day
operations independently, and to function as independent and autonomous
instrumentalities of the state.

(b) To achieve this purpose, the governor may by executive order provide
for the transfer from the departments and agencies of the state of any or all of
the following boards or commissions which are appellate bodies or were otherwise
established to be independent decisionmakers:

(1) Human rights commission provided for in article eleven, chapter five
of this code;


(2) Workers compensation appeals board and office of judges provided for
in article five, chapter twenty-three of this code;


(3) (2) Air quality board provided for in article two, chapter twenty-two-b
of this code;


(4) (3) Environmental quality board provided for in article three, chapter
twenty-two-b of this code;


(5) (4) Surface mine board provided for in article four, chapter
twenty-two-b of this code;


(6) (5) Board of appeals provided for in article five, chapter twenty-two-a
of this code; and


(7) Shallow gas well review board provided for in article eight, chapter
twenty-two-c of this code.

(c) Upon any transfer by executive action authorized in subsection (b) of
this section, the governor may provide for administrative support by a department or agency of the state to the board or commission transferred in the same manner
as is provided by a department secretary and for liaison with the office of the
governor with respect to budgetary and administrative matters through a
department or agency of the state:
Provided,
That nothing in this section shall
be construed to affect the existence, powers, authority and duties of independent
boards and commissions or the membership, terms and qualifications of members of
such the boards and commissions.

(d) The authority to make transfers as provided in subsection (a) of this
section shall expire on the first day of January, one thousand nine hundred
ninety-five. Upon the exercise of the powers granted in subsection (b) of this
section, the governor shall submit to the Legislature a report setting forth the
reorganization implemented by executive action pursuant to this section, any
recommendations for further reorganization requiring legislative action and
drafts of any recommended legislation for consideration by the Legislature during
the regular session in the year one thousand nine hundred ninety-five to conform
this code to the reorganization implemented by executive action.

(e) Upon transfers as authorized in subsection (a) of this section, the
governor may transfer the funds appropriated to the department or agency of the
state attributable to the functions of the board or commission transferred in
order to implement the transfer:
Provided,
That the authority to transfer funds
under this section shall expire on the thirtieth day of June, one thousand nine
hundred ninety-five:
Provided, however,
That no funds may be transferred from
a special revenue account, dedicated account, capital expenditure account or any
other dedicated account or fund for any use or purpose other than the purpose for
which the account or fund is dedicated.

(f) Nothing in this section shall be construed to affect the consolidation
of legal, technical and support personnel and of procedures of the air quality
board, environmental quality board and surface mining board provided for in
article one, chapter twenty-two-b of this code.
CHAPTER 6. GENERAL PROVISIONS RESPECTING OFFICERS
ARTICLE 7. COMPENSATION AND ALLOWANCES.
§6-7-2a. Terms of certain appointive state officers; appointment;
qualifications; powers and salaries of officers.

(a) Each of the following appointive state officers named in this
subsection shall be appointed by the governor, by and with the advice and consent
of the Senate. Each of the appointive state officers serves at the will and
pleasure of the governor for the term for which the governor was elected and
until the respective state officers' successors have been appointed and
qualified. Each of the appointive state officers are subject to the existing
qualifications for holding each respective office and each has and is hereby
granted all of the powers and authority and shall perform all of the functions
and services heretofore vested in and performed by virtue of existing law
respecting each office.

Prior to the first day of July, two thousand three, each named appointive
state officer shall continue to receive the annual salaries they were receiving
as of the effective date of the enactment of this section in two thousand one,
and thereafter, notwithstanding any other provision of this code to the contrary,
the annual salary of each named appointive state officer shall be as follows:

Administrator, division of highways, ninety thousand dollars;
administrator, state tax division, sixty-five thousand dollars; administrator,
division of corrections, seventy-five thousand dollars; administrator, division
of natural resources, seventy thousand dollars; superintendent, state police,
seventy-five thousand dollars; administrator, lottery division, seventy-five
thousand dollars; director, public employees insurance agency, seventy-five
thousand dollars; administrator, division of banking, sixty thousand dollars;
administrator, division of insurance, sixty thousand dollars; administrator,
division of culture and history, fifty-five thousand dollars; administrator,
alcohol beverage control commission, seventy thousand dollars; administrator,
division of motor vehicles, seventy thousand dollars; director, division of
personnel, fifty-five thousand dollars; adjutant general, seventy-five thousand
dollars; chairman, health care authority, seventy thousand dollars; members,
health care authority, sixty thousand dollars; director, human rights commission, forty-five thousand dollars; administrator, division of labor, sixty thousand
dollars; administrator, division of veterans' affairs, forty-five thousand
dollars; administrator, division of emergency services, forty-five thousand
dollars; members, board of parole, forty-five thousand dollars; members,
employment security review board, seventeen thousand dollars; chief judge,
workers' compensation appeal board, seventy thousand dollars; members, workers'
compensation appeal board, seventeen thousand eight hundred dollars sixty
thousand dollars; administrator, bureau of employment programs, seventy thousand
dollars; administrator, bureau of commerce, seventy thousand dollars;
administrator, bureau of environment, seventy thousand dollars; and director,
office of miner's health, safety and training, sixty-five thousand dollars.
Secretaries of the departments shall be paid an annual salary as follows: Health
and human resources, ninety thousand dollars; transportation, seventy-five
thousand dollars; tax and revenue, seventy-five thousand dollars; military
affairs and public safety, seventy-five thousand dollars; administration,
seventy-five thousand dollars; education and the arts, seventy-five thousand
dollars; and environmental protection, seventy-five thousand dollars.

(b) Each of the state officers named in this subsection shall continue to
be appointed in the manner prescribed in this code and, prior to the first day
of July, two thousand two, each of the state officers named in this subsection
shall continue to receive the annual salaries he or she was receiving as of the
effective date of the enactment of this section in two thousand two, and shall
thereafter, notwithstanding any other provision of this code to the contrary, be
paid an annual salary as follows:

Administrator, division of risk and insurance management, fifty-five
thousand dollars; director, division of rehabilitation services, sixty thousand
dollars; executive director, educational broadcasting authority, sixty thousand
dollars; secretary, library commission, sixty-seven thousand dollars; director,
geological and economic survey, fifty-two thousand five hundred dollars;
executive director, prosecuting attorneys institute, sixty thousand dollars;
executive director, public defender services, sixty thousand dollars; commissioner, bureau of senior services, seventy thousand dollars; director,
state rail authority, fifty-five thousand dollars; executive secretary, women's
commission, thirty-one thousand dollars; director, hospital finance authority,
twenty-six thousand dollars; member, racing commission, twelve thousand dollars;
chairman, public service commission, seventy thousand dollars; and members,
public service commission, seventy thousand dollars.

(c) No increase in the salary of any appointive state officer pursuant to
this section shall be paid until and unless the appointive state officer has
first filed with the state auditor and the legislative auditor a sworn statement,
on a form to be prescribed by the attorney general, certifying that his or her
spending unit is in compliance with any general law providing for a salary
increase for his or her employees. The attorney general shall prepare and
distribute the form to the affected spending units.
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 shall be issued under the
provisions of section four of this article shall keep such certificate posted in
a conspicuous position in the place where the privilege of such business is
exercised. Such 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 wherein 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 herein; and any
person claiming that any business certificate is not due, for any reason, shall
pay the same 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 any such business certificate, the
circuit court or the judge thereof in vacation, of the county in which such
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 such person from continuing such business, activity or trade until
he has fully complied with the provisions of this article. The remedy provided
in this section shall be 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, pursuant to subsection (b), section
six-b, article two, chapter twenty-one-a 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 registration program for persons engaging in business
in this state. Such other departments and agencies shall have authority to 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 and the bureau of employment programs 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 commissioner of the bureau of employment programs executive director of
the workers' compensation commission as administrator of the workers'
compensation fund and coal-workers' pneumoconiosis fund as established in section
one 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 shall be authorized for use by members of the state police, and
shall provide for periodic inspection of such weapons and equipment. He 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 deems 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 shall also provide
the standard uniforms for all members of the state police, for officers,
noncommissioned officers and troopers herein provided for. All uniforms and all
arms, weapons and other property furnished the members of the state police by the
state of West Virginia shall be and remain the property of the state.

(d) The superintendent is authorized to 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 is authorized to 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 such member while engaged in the performance of duty and from causes beyond
control of such members. Notwithstanding any other provision of this code, the
superintendent shall have 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 is hereby authorized to initiate such 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 is further empowered to consult with the commissioner
of the bureau of employment programs 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
bureau of employment programs, workers' compensation division 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
such places in West Virginia as are in his 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 shall have the power to 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 commissioner
of the bureau of employment programs executive director of the workers'
compensation commission for the sole purpose of adjusting claims presented to the
commissioner 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 such 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 such the departments and divisions and to ensure the containment
of costs in the payment for such 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) Such 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. Such a 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 such 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
such 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 entities for the purpose of determining the
cost of providing coverage under the program, including administrative cost, to
each such 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 division of
workers' compensation 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 such 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, which the interest shall
be calculated from the sixty-sixth day after such the invoice was actually
received by the division, 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 commissioner of the bureau of employment programs executive
director of the workers' compensation commission, or his or her designee from the
division of workers' compensation;

(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 division 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 division 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, beginning the first day of December, one thousand nine hundred ninety-nine.

(c) The base premium tax rate reported to the state department of education
shall be that which was published by the workers' compensation division
commission prior to the first day of the immediately preceding July. That
premium tax rate, however, shall not be implemented by the workers' compensation
division commission until the first day of January and shall remain in effect
through the last day of the next December. The workers' compensation division
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 purposes of this section, the workers' compensation
division 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 division 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 division 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 division
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 division 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 division
commission. Such 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 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 commissioner of the bureau of employment programs 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 commissioner.

(a) There is hereby created in the labor department a division of
occupational safety and health, comprised of a subdivision for safety, a
subdivision for health and such other subdivisions as 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
commissioner 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 created 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, a division of workers'
compensation, and such other divisions or units as the commissioner determines
to be necessary.

Wherever, within this chapter, or in chapter twenty-three of this code, the
term "department", "bureau" or "fund" or "workers' compensation fund" is used,
it shall be taken to mean bureau of employment programs unless otherwise
indicated.

Notwithstanding the provisions of subsection (d) (11) and subsection (d)
(12), section one, article two, chapter five-f of this code, the division of
employment security and the division of workers' compensation programs are hereby
consolidated in an agency shall hereby be designated as the bureau of employment
programs, which the bureau shall be administered as part of the department of
commerce, labor and environmental resources created pursuant to subsection (b),
section one two, 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 of for the governance of the bureau and
make propose rules for the government of the bureau 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 promulgate rules;

(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 chapter twenty-three of this code and to satisfy
any conditions established in applicable federal legislation law or regulation;

(6) Make reports in such the form and containing such information as the
United States department of labor may from time to time require, and comply with
such provisions as any requirements that the United States department of labor
may from time to time find necessary to assure the correctness and verification
of such 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 and chapter twenty-three of this code;

(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, which 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) In addition to the authority granted to the commissioner by section
eighteen of this article and notwithstanding anything to the contrary elsewhere
in this code, utilize any attorney regularly employed by the bureau or the office
of the attorney general to represent the commissioner, the bureau or any of its
divisions in any matter. In addition, the commissioner, with the approval of the
compensation programs performance state advisory council, is authorized to retain
counsel for any purpose in the administration of this chapter or in the
administration of chapter twenty-three of this code relating to the collection
of any amounts due from employers to the bureau or any of its divisions. The
compensation programs performance state advisory council shall solicit proposals
from counsel who are interested in representing the commissioner, the bureau or
any of its divisions under the terms of this subdivision. Thereafter, the
compensation programs performance state advisory council shall select such
attorneys as it determines necessary to pursue the collection objectives of this
subdivision.

(A) Payment to any such retained counsel may either be by hourly or other
fixed fee, or as determined by the court or administrative law judge as provided
for below. A contingency fee payable from the amount recovered by judgment or
settlement for the commissioner, the bureau or any of its divisions 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.

(B) 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 commissioner, the bureau or any of its divisions results in a
judgment or settlement in favor of the commissioner, the bureau or any of its
divisions, then 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 commissioner, the bureau or any of its divisions. 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
commissioner, the bureau or its divisions 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 bureau or is an employee of the office of the attorney general, such the
hourly rate as the court or the administrative law judge shall determine 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 commissioner, the bureau
or any of its divisions.

(C) Notwithstanding the provisions of paragraph (B) of this subdivision,
if the commissioner, bureau or any of its divisions and the defendants or
respondents to any administrative or judicial action settle the action, then 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
commissioner, the bureau or any its divisions. In the event that such a
settlement of attorneys' fees is made, it must be submitted to the court or
administrative law judge for approval.

(D) Any attorney regularly employed by the bureau or by the office of the
attorney general may not receive any remuneration for his or her services other
than such the attorney's regular salary. Any attorneys' fees awarded for such
an employed attorney shall be payable to the commissioner;

(18) With the approval of the compensation programs performance state
advisory council created pursuant to section one, article three of this chapter,
to promulgate 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 and with regard to the administration of chapter twenty-three of
this code. 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 agreements agreement with the appropriate divisions unemployment
compensation division of the bureau and remains in compliance with its
obligations under the repayment agreements agreement.

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 appropriate divisions of 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 a division of the bureau may grant, issue or renew the contract,
license, permit, certificate, 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 such the
refusal to issue or renew shall be reviewed under the appropriate provisions of
this chapter or of chapter twenty-three of this code, or both, whichever is
applicable. The rules provided for by this subdivision shall be promulgated
pursuant to the provisions of subdivisions (b) and (c), section seven, article
three of this chapter as if they were rules being promulgated for the purposes
of chapter twenty-three of this code 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 are not
operative shall continue in full force and effect until the revised rules are
promulgated and are in effect, except as provided in subdivision (6), section
eight, article three, chapter twenty-two or otherwise by law.


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 council bureau of unemployment 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 shall be that
were promulgated no later than prior to the first day of January July, two
thousand three, shall be revised and submitted for legislative review no later
than the first day of January, two thousand four to reflect the elimination of
the workers' compensation division from the bureau of employment programs and its
replacement by the workers' compensation commission; and

(19) 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 and chapter twenty-three of this code. The amounts collected
shall not be treated by the auditor or treasurer as part of the general revenue
of the state; and

(20) Enter into interagency agency agreements to assist in exchanging
information and fulfilling the default provisions of this section.
§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 such 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 and under chapter twenty-three of this code 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 county imprisoned
confined in a county or regional jail for not more than one year in the jail, or
both fined and imprisoned 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, of 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 inter-agency agreement to effectuate 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 and chapter
twenty-three of this code, the commissioner shall appoint a necessary number of
deputies as his or her representatives.
ARTICLE 3. ADVISORY COUNCIL.
§21A-3-1. Creation of advisory council; purpose.

There is hereby created within the bureau of employment programs a
"compensation programs performance council" "state advisory council". The
purpose of said the council shall be is to ensure the effective, efficient and
financially stable operation of the unemployment compensation system and the
workers' compensation system of the state of West Virginia.
§21A-3-2. Appointment of members.

The members of the council shall be appointed by the governor by and with
the advice and consent of the Senate.
§21A-3-3. Membership; terms; chair.

The compensation programs performance state advisory council shall consist
of nine members: Four representing the interests of employees; four representing
the interests of employers; and the commissioner of the bureau of employment
programs. The term of each member except the commissioner shall be for six
years. The term of the commissioner shall continue for that period in which he
or she holds that office. The terms of all the initially appointed members of
the council shall begin on the first day of July, one thousand nine hundred
ninety-three two thousand three. The initially appointed members shall serve
until confirmed or rejected by the Senate. Of the persons initially appointed,
four members, including two members of each of the two representative groups,
shall be designated to serve for terms of two years each, two members, including
one member of each of the two representative groups, shall be designated to serve
for terms of four years each, and two members, including one member of each of the two representative groups shall be designated to serve for terms of six years
each. As these appointments expire, subsequent appointments shall be for six-
year terms. The commissioner shall serve as chair of the council and shall be
entitled to vote on all matters. The council shall elect from its members a vice
chair.
§21A-3-4. Qualifications; selection by governor; disqualification.

(a)
Members of the council shall be selected with special reference to
their ability and fitness to effectuate the purposes of this chapter and chapter
twenty-three of this code. In appointing members of this council to represent
the interests of employees, the governor shall select members as follows: One
member shall be appointed from a list of at least three names submitted to the
governor by the united mine workers of America; Two members shall be appointed
from a list of at least six names submitted to the governor by the West Virginia
labor federation, with one representing construction trades and one representing
industrial workers; and One one member selected by the governor to represent the
general interests of employees covered under the provisions of this chapter and
chapter twenty-three of this code. In appointing members of this council to
represent the interests of employers, the governor shall select members as
follows: One one member shall be appointed from a list of at least three names
submitted to the governor by the West Virginia coal industry; One one member
shall be appointed from a list of at least three names submitted to the governor
by the West Virginia manufacturers association; One one member shall be appointed
from a list of at least three names submitted to the governor by the West
Virginia chamber of commerce; and One one member selected by the governor to
represent the general interests of employers covered under the provisions of this
chapter and chapter twenty-three of this code. The governor shall ensure that
employer representation includes a representative of small businesses employing
fifty or less employees on a regular basis.

(b)
A member shall not be a candidate for, or hold, any other public
office or trust, nor shall he or she be a member of any political committee. If
a member becomes a candidate for, or is appointed to, any other public office or
political committee, his or her office as a member of the council shall automatically be vacated.
§21A-3-5. Compensation and travel expenses; insurance.

Members of the council shall receive reasonable compensation of two hundred
dollars for each day actually served in attendance at meetings of the council and
such traveling travel expenses as are incurred in the performance of his or her
duties in accordance with appropriate state travel guidelines promulgated by the
department of administration. Members shall not be compensated for more than
thirty days' service in any year. Payment for traveling travel expenses shall
be made consistent with state law department of administration travel guidelines.
Each member of this the council shall be provided appropriate liability
insurance, without additional premium, by the state board of risk and insurance
management established pursuant to article twelve, chapter twenty-nine of this
code.
§21A-3-6. Meetings; quorum.

The council shall hold meetings at any time at the call of the
commissioner. The commissioner shall call a meeting whenever three of the other
members of the council request the commissioner to do so. The exact date and
time of each meeting shall be determined by the commissioner. A majority of the
members of the council shall constitute a quorum for the conduct of council
business and, except as stated in subdivision (m), section seven of this article,
all issues shall be resolved by a majority vote of the total membership.
§21A-3-7. Powers and duties.

The council shall have the following powers and duties:

(a) Assist the governor and the commissioner in the development of overall
administrative policy for the unemployment compensation and workers' compensation
systems of the state bureau of employment programs.

(b) Recommend legislation and establish regulations rules designed to
ensure the effective administration and financial viability of the unemployment
compensation system and the workers' compensation system of West Virginia.


(c) Review and approve, reject or modify rules and regulations that are
proposed or promulgated by the commissioner for operation of the workers'
compensation system before the filing of the rules and regulations with the secretary of state. This provision is applicable to any instance under chapter
twenty-three of this code which authorizes the commissioner to promulgate rules
and regulations. Notwithstanding any provision in this code to the contrary,
including sections one and two, article three, and section three, article seven,
both of chapter twenty-nine of said code, any rules and regulations adopted
pursuant to this section which are applicable to the provisions of chapter
twenty-three of this code shall not be subject to sections nine through sixteen,
all of article three, chapter twenty-nine-a of this code. The commissioner and
the compensation programs performance council shall follow the remaining
provisions of said article for giving notice to the public of their actions and
the holding of hearings or receiving of comments on the rules. No later amendment
to this code shall have precedence over this section unless such later amendment
specifically provides to the contrary.


(d) (c) In accordance with the laws, rules and regulations of West
Virginia and the United States government, establish and monitor performance
measurements to ensure the timeliness and accuracy of activities performed under
the unemployment compensation laws and the workers' compensation laws.


(e) Have the final right of approval of all base rates for employers
covered by the workers' compensation law as recommended by the commissioner.


(f) (d) Advocate sufficient administrative resources to effectively operate
the unemployment compensation system and the workers' compensation system of West
Virginia.


(g) Approve the designation of health care providers to make decisions
regarding appropriateness of medical services pursuant to subsection (d), section
one, article five, chapter twenty-three of this code.


(h) (e) Ensure that the unemployment compensation system and the workers'
compensation system bureau of employment programs of West Virginia develop
develops and pursue pursues an effective program of outreach and communication
to employers, workers and others involved in these its programs.


(i) (f) Analyze opportunities to affect efficiencies and improvements for
employers and workers by developing common definitions, interrelated systems and
other internal operational improvements, including long-range planning for improvements.


(j) (g) Develop programs, linkages in the public sector and the private
sector, and information materials designed to promote the early return to work
of individuals receiving unemployment compensation benefits or workers'
compensation benefits.


(k) Examine the current design and report recommendations to the governor
and the Legislature regarding the second injury reserve of the surplus fund and
the financial viability of the state's workers' compensation system.


(l) (h) Consider such other matters regarding the unemployment compensation
system or the workers' compensation system as the commissioner or any appointed
member of the council may desire.


(m) On or before the first day of September, one thousand nine hundred
ninety- three, establish vocational standards to be considered in making
decisions on permanent total disability awards under subdivision (n), section
six, article four, chapter twenty-three of this code: Provided, That the
compensation programs performance council is expressly authorized to establish
this standard irrespective of court decisions interpreting any previous enactment
of said subdivision: Provided, however, That adoption of said vocational standard
shall require an affirmative vote of two thirds of the members of said
compensation programs performance council.


(n) Adopt criteria for the determination and standards for the payment of
attorneys' fees pursuant to subdivision (2), subsection (c), section sixteen,
article four, chapter twenty-three of this code.
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 such 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 such amount, notwithstanding subdivision (1), subsection
(b), section twenty-eight, article one-a of this chapter; and

(4) Other information as is reasonably connected with the administration
of this chapter.

(b) Information thus obtained may not be published or be open to public
inspection so as 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 thus 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 division of workers' compensation commission for purposes of
collection and enforcement: Provided, That the division of workers' compensation
commission shall provide similar information to the other divisions of 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 so 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 therewith.

(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 imprisoned 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 such person 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 such specified longer
term, the director may extend a permit for such a longer term: Provided,
however, That subject to the prior approval of the director, with such 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 such
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 such 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 such 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 such the extensions are necessary by reason of litigation precluding such 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 deemed to have commenced
surface-mining operations at such time as 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 such 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 unemployment compensation fund or the
to the workers' compensation fund, the payment of premiums to the fund, the
timely filing of payroll reports and the maintenance of an adequate premium
deposit. If the applicant is delinquent or defaulted, or has been terminated by
the bureau or the commission, then the permit shall not be issued until the
applicant returns to compliance or is restored by the workers' compensation
division bureau or the commission under a reinstatement agreement: Provided,
That in all such 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 shall be considered to indicate the
applicant is in compliance and such 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 of this code and provide proof of compliance to the director on an
annual basis.
CHAPTER 23. WORKERS' COMPENSATION.
ARTICLE 1. GENERAL ADMINISTRATIVE PROVISIONS.
§23-1-1. Workers' compensation commission created.












(a) The commissioner of the bureau of employment programs appointed under
the provisions of section one, article two, chapter twenty-one-a of this code,
has the sole responsibility for the administration of this chapter except for
such matters as are entrusted to the compensation programs performance council
created pursuant to section one, article three, chapter twenty-one-a of this
code. In the administration of this chapter, the commissioner shall exercise all
the powers and duties described in this chapter and in article two, chapter
twenty-one-a of this code.











(b) The commissioner is authorized to promulgate rules and regulations to
implement the provisions of this chapter.











(c) The commissioner shall have an official seal for the authentication of
orders and proceedings, upon which seal shall be engraved the words "West
Virginia Commissioner of Employment Programs" and such other design as the
commissioner may prescribe. The courts in this state shall take judicial notice
of the seal of the commissioner and in all cases copies of orders, proceedings
or records in the office of the West Virginia commissioner of employment programs
shall be equal to the original in evidence.











(d) Pursuant to the provisions of article ten, chapter four of this code,
the commissioner of the bureau of employment programs shall continue to
administer this chapter until the first day of July, two thousand four.











(e) The attorney general shall perform all legal services required by the commissioner under the provisions of this chapter: Provided, That in any case in
which an application for review is prosecuted from any final decision of the
workers' compensation appeal board to the supreme court of appeals, as provided
by section four, article five of this chapter, or in any court proceeding before
the workers' compensation appeal board, or in any proceedings before the office
of judges, or in any case in which a petition for an extraordinary writ is filed
in the supreme court of appeals or in any circuit court, in which such
representation shall appear to the commissioner to be desirable, the commissioner
may designate a regular employee of this office, qualified to practice before
such court to represent the commissioner upon such appeal or proceeding, and in
no case shall the person so appearing for the commissioner before the court
receive remuneration therefor other than such person's regular salary.












The "Workers' Compensation Division of the Bureau of Employment Programs"
is, on or after the first day of July, two thousand three, reestablished,
reconstituted and continued as the workers' compensation commission. It shall
be composed of a board of managers, an executive director who serves as the
chairperson of the board of managers, an associate director, the office of
judges, and other sections as the executive director and board of managers
determine to be necessary. 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 imposed
upon the workers' compensation commission and its executive directorin the manner
prescribed by this chapter.
§23-1-1a. Board of managers; appointment; composition; qualifications; terms;
meetings and quorum; compensation and travel expenses; powers and duties.











(a) The members of the board of managers shall be appointed by the
governor, with the advice and consent of the Senate, from a list of three
candidates submitted by the nominating committee for each of the eight board
positions: Provided, That no appointed member shall be a candidate for or hold
elected office. The initial appointees shall serve in their capacity as members of the board pending Senate action. If a candidate for board member is not
confirmed by the Senate, a new candidate shall be selected in accordance with the
provisions of section one-a and one-d of this article.











(b) The board of managers will be composed of the following members, each
of whom will be nominated with special reference to his or her demonstrated
knowledge and experience to effectively accomplish the purposes of this chapter:











(1) One who, on account of his or her vocation, employment, or
affiliations, can be classed as representative of the interests of employees;











(2) One who, on account of his or her vocation, employment, or
affiliations, can be classed as representative of the interests of employers;











(3) One who, on account of his or her vocation, employment, or
affiliations, can be classed as representative of the interests of vocational
rehabilitation with demonstrated experience within the West Virginia workers'
compensation system;











(4) A medical doctor, licensed in West Virginia, who by experience, board
certification, or university affiliation, has demonstrated expertise in
occupational medicine within the context of the West Virginia workers'
compensation system;











(5) Four members with demonstrated knowledge and experience in the area of
workers' compensation, claims administration, public administration,
administrative law, accounting, investments, finance, work place safety or
insurance administration.











(c) Of the initial appointments made to the board of managers, the employee
and employer representatives will serve one year each, the vocational and medical
representatives will serve two years each, two members of the remaining four will
serve three years each, and two will serve four years each. Thereafter, as each
term expires, the vacancy so created shall be filled by an appointee for a term
of four years. Members may be reappointed for no more than two consecutive
terms. Appointments to fill the unexpired term of a member shall be for the
remainder of the term.











(d) Members of the board of managers may only be removed by the governor
for good cause shown.











(e) The board of managers shall hold meetings at the request of the
executive director or at the request of at least three of the members of the
board of managers, but no less frequently than once every three months. The
executive director shall determine the date and time of each meeting. A majority
of the board of managers shall constitute a quorum for the conduct of the
business of the board of managers, and all issues shall be resolved by a majority
vote of the total membership of the board. The executive director shall call an
organizational meeting within thirty days of the initial appointment of the full
board of managers at which time the board shall adopt bylaws governing its
operation.











(f) Notwithstanding the provisions of article seven, chapter six of this
code, the board of managers shall establish the salary of the executive director,
at a minimum of one hundred twenty thousand dollars, not to exceed one hundred
eighty thousand dollars. The maximum salary may be adjusted by the board in
accordance with generally accepted annual inflation indices. 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.











(g) In addition to actual travel expenses incurred in the performance of
his or her duties, each member of the board of managers shall receive annual
compensation that is calculated by multiplying the percentage of total board
meetings attended by the member in the calendar year by twelve thousand dollars.











(h) Each member of the board shall be provided appropriate liability
insurance, without additional premium, by the state board of risk and insurance
management established pursuant to article twelve, chapter twenty-nine of this
code.











(i) The board of managers shall have the following powers and duties:











(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) Upon recommendation of 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
filing of the rules with the secretary of state. This provision is applicable
to any instance under this chapter which authorizes the executive director to
propose rules. Notwithstanding any provision in this code to the contrary,
including sections one and two, article three, and section three, article seven,
chapter twenty-nine-a of this code, any rules adopted pursuant to this section
which are applicable to the provisions of this chapter shall not be subject to
sections nine through sixteen, article three, chapter twenty-nine-a of this code.
The executive director and board of managers shall follow the remaining
provisions of chapter twenty-nine-a of this code for giving notice to the public
of their actions and the holding of hearings or receiving of comments on the
rules. No later amendment to this code shall have precedence over this section
unless the later amendment specifically provides to the contrary.











(4) In accordance with the laws, rules and regulations of West Virginia and
the United States government, establish and monitor performance 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, rate revisions, 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 audits and actuarial reviews of the commission. The
executive director shall provide access to records of the commission to
facilitate the review required under this section.











(7) Approve the allocation of sufficient administrative resources and funding to efficiently operate the workers' compensation system of West Virginia.
(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) Approve the designation of health care providers to make decisions
regarding appropriateness of medical services pursuant to subsection (d), section
one, article five of this chapter.











(10) Ensure that the workers' compensation commission develops and pursues
an effective program of outreach and communication to employers, workers, and
others participating in this system.
(11) Develop programs, linkages in the public sector and the private
sector, and information materials designed to promote the early return to work
of individuals receiving workers' compensation benefits.
(12) Consider other matters regarding the workers' compensation system as
the governor, executive director or any other appointed member of the board of
managers 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
permanent total disability awards. The standards should be established as an
effective means to accomplish the intent of subdivision (n), section six, article
four of this chapter.
(14) Adopt criteria for the determination of and standards for the payment
of attorneys' fees pursuant to any provision of this chapter authorizing payment
of attorneys' fees.
(15) Appoint a temporary executive director for a period not greater than
six months.
(16) 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 shall be exempt from the salary schedule or
pay plan adopted by the division of personnel.
§23-1-1b. Executive director; chairperson of the board of managers;
qualifications; oath; seal; removal; powers and duties.











(a) The executive director shall serve as the chairperson of the board of
managers and shall be appointed by the board of managers from a list of three
candidates submitted by the nominating committee. The position of executive
director shall be full-time employment. Candidates for the position of executive
director shall be considered based on their demonstrated experience and knowledge
in the areas of workers' compensation management, insurance management,
administrative experience within an organization comparable in size to the
workers' compensation commission, or other such 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 article four, section
five 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 such other design as
the board of managers may prescribe. 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 shall be equal to the original in evidence.











(e) The executive director shall not be a voting member of the board of
managers except in the event that the vote of the board of managers has resulted
in a tie: Provided, That under no circumstances shall the executive director vote on his or her compensation, removal, or any other matter affecting the terms
and conditions of his or her employment.











(f) The executive director will serve until removed by a three-fourths vote
of the full board of managers, and only for good cause shown.











(g) The executive director shall have overall management responsibility and
administrative control and supervision within the workers' compensation
commission and shall have 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 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;











(3) Reorganize the work of the commission, its sections, departments, and
offices to the extent necessary to achieve the most efficient performance of its
functions, and to that end may establish, change or abolish positions and assign
and reassign duties and responsibilities of every employee of the commission. 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 transferred to the
workers' compensation commission in their respective classifications but subject
to reassignment and reclassification of position and compensation as the
executive director determines to be in the interest of efficient administration;











(4) Provide offices, equipment, supplies, and other facilities for the
commission, including suitable office space for commission employees;











(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, for premium rates and
taxes, for administrative charges, for rules and systems of rating, rate revisions, and merit rating for employers covered by this chapter. 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 shall be responsible
for their acts;











(14) Provide at commission expense a program of continuing professional,
technical and specialized instruction for the personnel of the commission.











(15) (A) Employ in-house 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 in any state
or federal court. Additionally, commission may call upon the attorney general
for legal assistance and representation as provided by law.











(B) In addition to the authority granted herein to the executive director
and notwithstanding any provision to the contrary elsewhere in this code, utilize 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, is authorized to retain counsel for
any purpose in the administration of this relating to the collection of any
amounts due from employers to the commission. 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 such attorneys as 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 below.
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, then 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:











(a) 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 shall determine to be customary
based upon the attorney's experience and skill level;











(b) The number of hours actually expended on the action;
(c) The complexity of the issues involved in the action;











(d) The degree of risk involved in the case with regard to the probability
of success or failure;











(e) The overhead costs incurred by counsel with regard to the use of
paralegals and other office staff, experts, and investigators; and











(f) 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 such
an employed attorney shall be payable to the commission;











(16) With the approval of the board of managers to promulgate 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
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 repayment agreement with
the commission and remains in compliance with its obligations under the repayment
agreements.
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,
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 by the bureau of employment programs until the rules required by
this subsection are promulgated and in effect.
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) Shall recommend for approval of the board, rules to regulate and
sanction self-insured employers and third party administrators for excessive
rejection of claims. The rejection rate of self-insured employers shall be
measured against the rejection rate of the commission as a whole. Any rejection
rate of five percent or more is excessive;
(19) Shall 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; and
(20) Enter into interagency agreements to assist in exchanging information
and fulfilling the default provisions of this section.
(21) With the approval of the board of managers to promulgate rules for the
administration of claims management by self-insured employers and third party
administrators.
§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
and 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, 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, 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 inter-agency agreement to
effectuate 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. Workers' compensation nominating committee; composition;
responsibilities.
(a) There is hereby created the workers' compensation nominating committee
which shall consist of the following members:
(1) Chair of the West Virginia state bar workers' compensation committee,
who shall serve as the chair of the nominating committee;
(2) Executive director of the West Virginia development office;
(3) Chair of the West Virginia investment management board;
(4) Chair of the West Virginia state board of risk and insurance
management;
(5) President of the West Virginia AFL-CIO or his or her designee;
(6)
President of the West Virginia chamber of commerce or his or her
designee;
(7) President of the West Virginia medical association or his or her
designee;
(8) President of the West Virginia safety council or his or her designee;



(b) The nominating committee shall be responsible for reviewing and
evaluating candidates for possible appointment to the board of managers of the
workers' compensation commission as provided in subsection a, section one-a and
subsection a, section one-b, of article one of this chapter. In reviewing
candidates, the nominating committee may accept comments from and request
information from any person or source.







(c) For each position for the board of managers, the nominating committee
shall present a list of three candidates from which the governor will select one:
Provided, That for the initial board only, for the four members of the board
described in subdivision five, subsection (b), section one-a of this article, the
nominating committee shall provide a list of eight candidates from which the
governor shall select four. Each appointment to the board shall be with the
advise and consent of the Senate:







(d) No later than the first day of May, two thousand three, the nominating
committee shall present to the governor its list of candidates for the initial
board of managers. The governor shall appoint the initial full board no later
than the first day of July, two thousand three. Thereafter, the nominating
committee shall meet at the request of the governor or as the nominating committee determines necessary in order to make timely recommendations to the
governor for new appointees as the initial and subsequent terms expire; the
commendations to be submitted no later than thirty days prior to the expiration
of any term.
§23-1-1e. 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, operating guidelines, and policies no
later than the first day of July, two thousand six.
§23-1-1f. 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.
§23-1-1g. Continuation.



The workers' compensation division shall continue to exist pursuant to
article ten, chapter four of this code, until the first day of July, 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 article ten, chapter four of this code until the first day
of July, two thousand five unless sooner terminated, continued or reestablished
pursuant to the provisions of that article.
§23-1-2.
Oversight of the workers' compensation commission.




All expenses peculiar to the administration of this chapter, and, when on
official business, the traveling and incidental expenses of the commissioner and
salaries or other compensation, traveling and other expenses of all officers or
employees of the commissioner, and all expenses for furniture, books, maps,
stationery, appliances, property of all kinds and dues for membership in all organizations pertaining to workers' compensation or safety in which the
commissioner considers it advisable to maintain membership, shall be paid out of
the workers' compensation fund.




In addition to any other oversight of the commission exercised by the
Legislature, the commission shall report at least quarterly to the joint
commission on economic development. The commission shall provide to the joint
commission on economic development an action plan. This plan shall include
detail on any administrative changes undertaken by the commission, a report on
the anticipated outcome of these changes, a cost benefit analysis of these
changes and time frames for commencement and completion of these changes.
Subsequent reports to the joint commission on economic development shall report
on the progress of these changes. These administrative changes will include, but
are not limited to claims processing and organization, reorganization and
staffing.



The commission shall further provide detailed analysis in each quarterly
report to the joint commission on economic development of the current status of
the deficit elimination fund. This analysis shall include the current balance
in the fund, revenue generated and expended in relationship to the deficit
elimination fund and estimates of debt reduction relative to the deficit
elimination fund over the next quarter.



The commission shall also report on the current status of the workers'
compensation fund and the occupational pneumoconiosis fund. This analysis shall
include the current balances in the fund, revenue generated and expended in
relationship to the liabilities and assets of the funds.



The commission should further report to the joint commission on economic
development of legislative action that may be required to further improve the
operation of the commission.
§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 traveling and incidental expenses of the commissioner
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 or safety in which the
commissioner 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 any such payment shall be charged to the workers'
compensation fund: Provided, That the total charges against such fund under this
section for any one fiscal year shall not exceed the amount appropriated
therefor.
§23-1-4. Office hours; records; confidentiality; exceptions; associate
director
.



(a) The offices of the workers' compensation division 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 such additional days and at such additional
times as the division executive director may elect. As the chief executive
officer of the bureau of employment programs workers' compensation commission,
the commissioner executive director shall designate an executive associate
director to serve as the chief operating officer for the daily operations of the
workers' compensation division commission: Provided, That in any instance in this
chapter which refers to the commissioner's secretary, such reference shall be
taken to mean the executive director. The associate director shall serve at the
will and pleasure of the executive director.



(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 shall not be subject to the provisions of chapter
twenty-nine-b of this code unless such provisions are hereafter specifically made
applicable in whole or in part. Such information as may be 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 any such tribunal or court. Similarly,
claimants or other interested parties to an issue arising under this chapter may,
upon request, obtain information from the division's 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 any
such agency shall guarantee the confidentiality of the information so provided
to the fullest extent possible in keeping with its own statutory and regulatory
mandates. Nothing in this section shall prevent the division commission
complying with any subpoena duces tecum: Provided, however, That the issuing
tribunal or court shall take such actions as may be proper to maintain the
confidentiality of the information.



The division 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 division's commission's records and the time
periods thereof; and



(4) If a specific employer is delinquent or in default, what the payments
due the division 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.



The executive director and associate director of the workers' compensation
commission shall give bond in the penalty of twenty-five thousand dollars
conditioned for the faithful performance of the duties of the office, which bond
shall be approved by the attorney general as to form and by the board of managers
as to sufficiency. The surety of such bond may be a bonding or surety company, in which case the premium shall be paid out of the workers' compensation fund.
§23-1-5. Office of executive director; hearings.



The commissioner 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 commissioner
executive director may hold hearings anywhere within the state, or elsewhere by
agreement of claimant and employer, with the approval of the commissioner
executive director.
§23-1-6. Employment of associate director and other assistants; compensation
and travel expenses.



(a) The commissioner executive director may employ a secretary an
associate director, actuary, accountants, inspectors, examiners, experts, clerks,
stenographers and other assistants, and fix their compensation, which shall be
paid as provided in sections two and three of this article.



(b) The executive director shall appoint a competent and qualified person
to be chief of each operating division and shall fix his or her compensation,
which shall be paid as provided in sections two and three of this article. The
chief is the principal administrative officer of that division and is accountable
and responsible for the orderly and efficient performance of the duties,
functions and services or his or her office.



(c) There shall be in the commission other supervisory officers as the
executive director determines is necessary to administer the functions of the
commission. The supervisory officers are "administrators" as defined in section
two, article six, chapter twenty-nine of this code, notwithstanding the fact that
the positions filled by such persons are not statutorily created. Any
supervisory officer may be designated by the executive director as a deputy
director, assistant director, chief, administrator, or other administrative title
or designation. Each of the supervisory officers shall be appointed by the
executive director and serve at the will and pleasure of the executive director.
The compensation of such supervisory officers shall be fixed by the executive
director with the approval of the board of managers. A single individual may be appointed to serve simultaneously in two distinct supervisory positions, but in
a case where a dual appointment is made, the supervisory officer shall not
receive additional compensation above that which would be paid for serving in one
supervisory position.



(d) The commissioner executive director, secretary associate director,
chief, supervisory officers, actuaries, accountants, inspectors, examiners,
experts, clerks, stenographers and other assistants who may be employed shall be
are entitled to receive from the workers' compensation fund their actual and
necessary expense while traveling on business of the commissioner commission.
Such expenses shall be itemized and sworn to by the person who incurred the
expense, and shall be subject to the approval of the commissioner 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 shall appear appears that the commissioner executive director
will be absent or unable to act for one week or more, the secretary associate
director of the commissioner commission may be designated by the commissioner
executive director to act during his or her absence or inability to act, and
during such period he or she shall have all the duties and powers of the
commissioner executive director. The secretary shall give bond in the penalty
of twenty-five thousand dollars conditioned for the faithful performance of the
duties of his office, which bond shall be approved by the attorney general as to
form and by the governor as to sufficiency. The surety of such bond may be a
bonding or surety company, in which case the premium shall be paid out of the
appropriation made for the administration of this chapter. In the event a
vacancy occurs in the office of commissioner executive director, the secretary
of the commissioner associate director shall have all the duties and powers of
the commissioner executive director until a commissioner new executive director
is appointed by the governor in accordance with section one one-b of this
article. The board of managers shall 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 commissioner executive director, secretary associate director and every
inspector or examiner other employees appointed by the commissioner executive
director shall, for the purpose contemplated by this chapter, have power to
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
commissioner executive director, or subpoena issued by him or her, his secretary
the associate director, or one of his inspectors or examiners 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 commissioner executive director, associate director or any
inspector or examiner duly appointed by him employee, shall compel obedience by
attachment proceedings as for contempt, as in the case of disobedience of the
requirements of a subpoena issued from such court on a refusal to testify
therein.
§23-1-10. Fee of officer serving subpoena; fees and mileage of witnesses.



Each officer who serves such 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 commissioner executive director, associate director or an
inspector, or an examiner duly appointed employer, 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 such the
witness was subpoenaed without the request of either claimant or employer at the
instance of the commissioner executive director, associate director or an
inspector or an examiner 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 such the witness.
§23-1-11. Depositions; investigations.



(a) In an investigation into any matter arising under articles one through
five of this chapter, the division 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 such depositions shall be upon
reasonable notice to claimant and employer or other affected persons or their
respective attorneys. The division commission shall designate the person to
represent it for the taking of any such deposition.



(b) The division commission shall also have 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 such the depositions was given to the other parties or their attorneys,
if any: Provided, That the division commission, upon due notice to the parties,
shall have authority to refuse or permit the taking of such depositions or to
reject such the depositions after the taking thereof, if they were taken at such
a place or under such circumstances as which imposed an undue burden or hardship
upon the other parties., and the division's The commission's discretion to
accept, refuse to approve, or reject such depositions shall be binding in the
absence of abuse of such 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 commissioner executive director and certified and sworn to by such 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 such the
investigation or hearing so purporting to be taken and subscribed, may be
received in evidence by the commissioner executive director with the same effect
as if such stenographer were present and testified to the facts certified. A
copy of such the transcript shall be furnished on demand to any party upon
payment of the fee prescribed therefor in the rules and regulations policies of the commissioner commission, such the fee shall not to 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 division commission shall adopt reasonable
and proper rules of procedure, regulate and provide for the kind and character
of notices, and the service thereof, in cases of accident and injury to
employees, the nature and extent of the proofs and evidence, the method of taking
and furnishing the same 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 division commission or
before the duly authorized representative of the division 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 division commission as being qualified to represent a claimant or who is
an individual otherwise found to be qualified by the division commission to act
as a representative. Such representative shall participate in the presentation
of facts, figures and factual conclusions as distinguished from the presentation
of legal conclusions in respect to such facts and figures; or



(4) Pro se.



(c) At hearings and other proceedings before the division commission or before the duly authorized representative of the division 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 such facts and figures;
or



(4) By a representative from an employer service company who has been
recognized by the division commission as being qualified to represent an employer
or who is an individual otherwise found to be qualified by the division
commission to act as a representative. Such representative shall participate in
the presentation of facts, figures and factual conclusions as distinguished from
the presentation of legal conclusions in respect to such facts and figures.



(d) The division 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 so 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 which summary shall be provided to the claimant upon
his or her request. Any representative or attorney of the claimant must agree
to provide such a claimant with only the summary before the full report shall be
provided to the representative or attorney for his or her use in preparing the
claimant's case. Such a 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 of this chapter
in which the division 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 shall be is sufficient notice to the party so
represented.
§23-1-14. Forms.



The commissioner commission shall prepare and furnish free of cost blank
forms (and provide in his or her rules for their distribution so that the same
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 such other blanks forms as may be deemed proper
and advisable. and it shall be It is the duty of employers to constantly keep
on hand a sufficient supply of such blanks the forms.
§23-1-15. Procedure before commission.



The commissioner commission shall not be 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 such a manner as 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
commissioner 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 such 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 thereof, which the commissioner executive director may
consider 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 division 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.
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
hereby required to subscribe to and pay premium taxes into the workers' compensation fund for the protection of their employees and shall be subject to
all requirements of this chapter and all rules and regulations policies
prescribed by the workers' compensation division commission with reference to
rate, classification and premium payment: Provided, That such rates will be
adjusted by the division commission pursuant to subdivision five, subsection (i),
section one-a, article one of this chapter to reflect the demand on the
compensation fund by the covered employer. For purposes of this chapter
"employer" means an individual employer as well as an employer group as provided
for herein.



(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; or



(2) Employers of five or fewer full-time employees in agricultural service;
or



(3) Employers of employees while said the employees are employed without
the state except in cases of temporary employment without the state; or



(4) Casual employers. An employer is deemed to be 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; or



(5) Churches; or



(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 should any of the employers described in this subdivision have
paid employees, then to the extent of those paid employees the employer must 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, such
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 such clergyman from such 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 such case shall be subject
to all requirements of this chapter and all rules and regulations prescribed by
the division 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 such employers to choose to
subscribe to and to pay premiums into the fund shall not impose any liability
upon them other than such any liability as 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 herein provided for, and at the time of making
application to the workers' compensation division commission, such any 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
division commission. At the time of making application such the employer shall
deposit with the division commission to the credit of the workers' compensation
fund the amount required by section five of this article, which amount shall be
returned to the employer if the employer's application be is rejected by the
division commission. Upon notice to such the employer of the acceptance of his
or her application by the division commission, he or she shall be 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 hereunder shall, at the time of
making application to the division commission in addition to other requirements
of this chapter, furnish the division commission with a certificate from the
secretary of state, where such 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 such a foreign corporation employer shall be
accepted by the division commission until such 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) Employers of employees who are officers of and stockholders in a
corporation qualifying for special tax treatment under subchapter S of the
Internal Revenue Code of the United States may elect not to provide coverage to
such employees; or



(2) If an employer is a partnership, sole proprietorship, association or
corporation, such the employer may elect not to include as an "employee" within
this chapter, any member of such 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 consists of a president, a vice-president, a secretary and a
treasurer, each of whom shall be elected by the board of directors at such the
time and in such the manner as may be prescribed by the bylaws. Such other Other
officers and assistant officer as may be deemed necessary may be elected or
appointed by the board of directors or chosen in such any other manner as may be
prescribed by the bylaws and, if so elected, appointed or chosen, such the
employer may elect not to include any such 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 aforementioned 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 such 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 such 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 therefor
in the capacity of an employee; or



(C) If 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.



(h) In the event of election under subsection (g) of this section, the
employer shall serve upon the division commission written notice naming the
positions not to be covered and shall not include such the "employee's"
remuneration for premium purposes in all future payroll reports, and such the
partner, proprietor or corporate or executive officer shall not be deemed an
employee within the meaning of this chapter after such the notice has been
served. Notwithstanding the provisions of subsection (g), section five of this
article, if an employer has not subscribed to the fund even though it is
obligated to do so under the provisions of this article, then any such 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" shall mean 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 such any other state in which all or
some portion of the work of the employee is to be performed: Provided, That the
commissioner executive director shall have the authority to review and accept or
reject any such agreement. Any such The review shall be conducted in keeping
with the commissioner's 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 so as to require such 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.
Such agreement shall All agreements must be in writing and filed with the
commissioner executive director within ten days after execution thereof but shall
not become effective until approved by the commissioner executive director and
shall, thereafter, remain in effect until terminated or modified by agreement of
the parties similarly filed or by order of the commissioner 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 shall be 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, such the employee and his or her
dependents shall not be 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 such the employee
and his or her dependents under the laws of such the other state shall be the
exclusive remedy against the employer on account of such any injury, disease or
death.



(d) If any employee or his or her dependents be 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 so 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 shall include 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 shall does not include one providing goods rather than
services. In the event that such a subcontracting employer defaults on its
obligations to make payments to the commissioner commission, then such the
primary contractor shall be is liable for such payments. Notwithstanding the
foregoing, nothing contained in this section shall extend or except to such a
primary contractor or subcontractors the provisions of sections 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 shall also be 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.



(b) A primary contractor may avoid initial liability under subsection (a)
of this section if it obtains from the commissioner 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 shall result 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 division commission shall be is entitled to collect
only once for the amount of premiums, premium deposits and interest due to the
default, but the division 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 commissioner of the bureau of employment
programs commission inform the primary contractor of any subsequent default by
the subcontractor. In the event that the subcontractor does default, the
commissioner commission shall then 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 commissioner
commission by the primary contractor. Such mailing shall be is good and
sufficient notice to the primary contractor of the subcontractor's default.
However, the primary contractor shall not become liable under this section until
the first day of the calendar quarter following the calendar quarter in which the
notice is given and then such the liability shall only be for that following
calendar quarter and thereafter and only if the subcontract has not been terminated: Provided, That the commissioner commission shall be is entitled to
collect only once for the amount of premiums, premium deposits and interest due
to the default, but the commissioner 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, such the default or failure shall be
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 division 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 commissioner executive director, upon
request, all information required by him or her to carry out the purposes of this
chapter. The commissioner executive director, or any person employed by the
commissioner commission for that purpose, shall have the right to examine under
oath any employer or officer, agent or employee of any employer.



(b) Notwithstanding the provisions of any other statute, 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
commissioner of the bureau of employment programs 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 such 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 division of 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 division of workers' compensation
commission pursuant to subsection (b) of this section shall be used only for
auditing premium payments, 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 division
of 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 aforementioned information in any manner other than the one stated
herein or elsewhere authorized in this code, or who divulges or makes known in
any manner any of the aforementioned information shall be is guilty of a
misdemeanor and, upon conviction thereof, shall be fined not more than one
thousand dollars or imprisoned 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
division of workers' compensation commission.



(e) Information acquired by the commissioner commission pursuant to
subsection (b) of this section shall is not be 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 division commission shall prepare and furnish report forms for the use
of employers subject to this chapter. Every employer receiving from the division
commission any form or forms with direction for completion and returning to the
division commission shall return the same, within the period fixed by the
division commission, completed so as to answer fully and correctly all pertinent
questions therein propounded, and if unable to do so, shall give good and
sufficient reasons for such failure. Every employer subject to the provisions
of this chapter, shall make application to the division commission on the forms
prescribed by the division commission for such that purpose; and any employer who
shall terminate terminates his or her business or for any other reason is no
longer subject to this chapter shall so notify the division commission on forms
to be furnished by the division commission for that purpose.
§23-2-4. Classification of industries; rate of premiums; authority to adopt
various systems; accounts.











(a) The commissioner in conjunction with the compensation programs
performance council, executive director in conjunction with 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
thereto, 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) Such further matters that are necessary and consistent with the goals
of this chapter;











(2) The rule shall be consistent with the duty of the commissioner and the
compensation programs performance council 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 such the fund and in keeping with
their fiduciary obligations to the fund;











(3) The rule shall be consistent with generally accepted accounting
principles;











(4) The rule shall be consistent with classification and rate-making
methodologies found in the insurance industry; and











(5) 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) Notwithstanding any other provision of this chapter to the contrary,
the compensation programs performance council board of managers may elect to
premise its premium tax determination methodology on the aggregate number of
hours worked by employees of the employer rather than upon the gross wages of the
employer. Such an election may apply to all industrial classifications or to
less than all. If this election is made, then in all instances in which this
chapter refers to gross wage reports for the purpose of premium tax determination
such references shall be taken to mean a report of the number of hours so worked.











(c) The rule authorized by subsection (a) of this section shall be
promulgated on or before the first day of July, one thousand nine hundred ninety-
six. Until the rule is finally promulgated the prior provisions of this section
as found in chapter one hundred seventy-one of the acts of the Legislature, one
thousand nine hundred ninety-three, shall remain in effect.











(d) In accordance with generally accepted accounting principles, the
workers' compensation division 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 same 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.
§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 at the rate determined by the workers' compensation division commission
and then in effect. At the time each employer subscribes to the fund, the
application required by the division 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 shall be is
twenty-five dollars.











(1) Thereafter, 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 division commission may
permit employers who qualify under the provisions of rules promulgated by the
compensation programs performance council board of managers to report gross wages
and pay premium taxes at other intervals.











(2) Every subscribing employer shall make a gross wages payroll report to
the division commission for the preceding reporting period. The report shall be
on the form or forms prescribed by the division commission, and shall contain all
information required by the division 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
division 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
division 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 division 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 division commission, which shall
maintain a record of all sums so received. Any such sum mailed to the division
commission shall be deemed to be received on the date the envelope transmitting
it is postmarked by the United States postal service. All sums received by the
division commission shall be deposited in the state treasury to the credit of the
workers' compensation division commission in the manner now prescribed by law.











(5) The division commission may 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 commissioner and the compensation programs performance council executive
director and the board of managers.











(b) Failure of an employer to timely pay premium taxes, 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 therefor if the division commission determines that
such the delinquency has been caused by delays in the administration of the fund.
The division 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 shall fail fails to timely file any quarterly payroll report or timely pay the premium tax due with such 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 such the
report by the penalty rate applicable to that quarter. The penalty rate to be
used in a workers' compensation division's commission's fiscal year shall be
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 shall be is
the rate published in the Wall Street Journal on the last business day of the
division's 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. Such 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 such
the late penalty is not paid when due, the same it may be charged to and
collected by the division 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 division 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 such the default employer of the
benefits and protection afforded by this chapter, including section six of this article, and the employer shall be liable as provided in section eight of this
article. The default employer's liability under said these sections shall be
retroactive to midnight of the last day of the month following the end of the
quarter for which the delinquency occurs. The division commission shall notify
the default employer of the method by which the employer may be reinstated with
the fund. The division commission shall also notify the employees of such
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 such employer to pay
into the workers' compensation fund and shall deprive such 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 such
employer shall be liable as provided in section eight of this article. The
default employer's liability under said section shall be 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 such 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 division 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 shall be calculated as provided
for by section thirteen of this article.











The division 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 division commission under this section.











(2) The division commission shall have the authority to restore a defaulted
or terminated employer through a reinstatement agreement. Such 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 division 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 division commission. Such discretion shall be exercised in keeping with the
fiduciary obligations owed to the workers' compensation fund. Should the
division commission decline to enter into a reinstatement agreement and should
the employer not comply with the provisions of subdivision (1) of this
subsection, then the division 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 division commission; (B) include a report of the gross wages
payroll of the employer which had not been reported to the division commission
during the entire period of delinquency and default, which 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 as may be determined from time to time 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 shall be
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 division commission: Provided, That if the division
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 quarterly reports and to pay current quarterly premiums
within the month following the end of the quarter 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 shall be denied the
benefits and protection of this chapter effective from the date that such
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 such employer's account originally became delinquent.











(4) Following any failure of an employer to comply with the provisions of
a reinstatement agreement, the division 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 division commission
shall notify the employees of such the employer of said the termination in such
the manner as the division commission may deem best and sufficient.











(3) Notice to employees in this section provided for 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 herein provided, that neither the employer nor the employees
of such employer are protected by said laws the law as to any injury or death
sustained after the date specified in said the notice. Such The notice shall be
in the form prescribed by the division commission and shall be posted in a
conspicuous place at the chief works of the employer, as the same appear in
records of the division commission. If said the chief works of the employer
cannot be found or identified, then said the notices shall be posted at the front
door of the courthouse of the county in which said the chief works are located,
according to the division's commission's records. Any person who shall, prior
to the reinstatement of said the employer, as hereinbefore provided for, or prior
to sixty days after the posting of said the notice, whichever shall first occur,
remove, deface or render illegible said the notice, shall be guilty of a
misdemeanor and, upon conviction thereof, shall be fined one thousand dollars.
, and said The notice shall state this provision upon its face. The division
commission may require any sheriff, deputy sheriff, constable or other official
of the state of West Virginia, who may be authorized to serve civil process, to
post such the notice and to make return thereof of the fact of such the posting
to the division commission., and any Any failure of such the officer to post any
notice within ten days after he or she shall have received the same from the
division commission, without just cause or excuse, shall constitute 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 such failure shall have an action
against said the official, and upon any official bond he or she may have given,
for such the damages as such the person may actually have incurred, but not to
exceed, in the case of any surety upon said the bond, the amount of the penalty
of said the bond. Any official posting said the notice as herein required shall
be 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., which The fee shall be paid by the division commission out of any
funds at its disposal, but shall be charged by the division commission against
the account of the employer to whose delinquency such 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 division 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,
such the employer shall pay the costs of the action. Civil action under this
section shall be given preference on the calendar of the court over all other
civil actions. Upon prevailing in any such civil action, the division commission
shall be entitled to recover its attorneys' fees and costs of action from the
employer.











(b) In addition to the foregoing provisions of this section, any payment,
interest and penalty thereon due and unpaid under this chapter shall be a
personal obligation of the employer immediately due and owing to the division
commission and shall, in addition thereto, be a lien enforceable against all the
property of the employer: Provided, That no such lien shall 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 such the lien may be enforced as other judgment liens are enforced
through the provisions of chapter thirty-eight of this code and the same shall
be deemed by the circuit court to be a judgment lien for this purpose.











(c) In addition to all other civil remedies prescribed herein, the division
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 division commission has good reason to believe that such
property or a substantial portion thereof 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 division commission may
likewise distrain in the name of the state before such delinquency occurs. For
such purpose, the division commission may require the services of a sheriff of
any county in the state in levying such distress in the county in which the
sheriff is an officer and in which such personal property is situated. A sheriff
so collecting any payment, interest and penalty thereon shall be entitled to such
compensation as is provided by law for his or her services in the levy and
enforcement of executions. Upon prevailing in any distraint action, the division
commission shall be 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 shall be operated in connection with a
receivership or insolvency proceeding in any state court in this state, the court
under whose direction such 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 such payments, interest
and penalties as the same 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 division commission
that all payments, interest and penalties thereon against any such corporation
which is an employer under this chapter have been paid or that provision
satisfactory to the division 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 division commission may bring action in
the circuit court of Kanawha county to enjoin such employer from continuing to
carry on the business in which such liability was incurred: Provided, That the
division commission may as an alternative to this action require such delinquent
employer to file a bond in the form prescribed by the commissioner commission
with satisfactory surety in an amount not less than fifty percent more than the
payments, interest and penalties due.
§23-2-5b. Premium tax default settlements; relief from liability for accrued
interest and penalties; repayment terms and conditions; reinstatement to
good standing; voided reinstatement agreements.











The Legislature hereby declares that it is the purpose of this section to
provide any employer who is in default as of the effective date of this section
in any payment due pursuant to the provisions of this article an opportunity to
settle the amount of the default in accordance with the provisions hereinafter
set forth. For the purposes of this section, the term "default" applies to any
failure by an employer to subscribe to or pay premium taxes that are attributable
to the quarter ended on the thirty-first day of December, one thousand nine
hundred ninety-eight or quarters ended before that date. In addition, for the
purposes of this section, "employer" means any corporation, partnership, limited
liability company, sole proprietor, person or other legal entity which is liable
or which directly or indirectly may be held liable as a responsible party for the
nonpayment of premium taxes.











(a) An employer who qualifies under this section will have six months from
the first day of July, one thousand nine hundred ninety-nine, to apply to the
commissioner executive director for a settlement of the amount of premium taxes, accrued interest and penalties and any award of attorney's fees made pursuant to
subdivision (17), section six one-b, article two one of this chapter, twenty-one-
a of this code, owed to the workers' compensation fund as a result of the
employer's default on premium tax payments to the division commission. Such The
application shall be made on a form prescribed by the commissioner executive
director and may impose on the employer such obligations and constraints
concerning the time and manner of payment as the commissioner executive director
deems necessary to effectuate the purpose of this section.











(b) Notwithstanding provisions in this article to the contrary, the
employer shall be relieved of liability for the payment of the interest and
penalties which have accrued by operation of other provisions in this article and
shall further be relieved of liability for payment of any award of attorney's
fees made pursuant to subdivision (17), section six one-b, article two, one of
this chapter twenty-one-a of this code, by tendering payment in full of all past-
due premium taxes within thirty days from the date that the commissioner
executive director notifies the employer in writing that the application has been
approved: Provided, That in the alternative, an employer shall be relieved of
liability for the payment of the interest and penalties which have accrued by
operation of other provisions in this article by fulfilling the terms of a
written agreement with the division to pay, within three hundred sixty-five days
from the date upon which the agreement is executed, all past-due premium taxes
in monthly installments which shall include interest on such past-due premium
taxes calculated at the annual percentage rate of nine percent.











(c) Notwithstanding any provisions in this article to the contrary, an
employer which is remitting payments to the division commission pursuant to the
terms of an agreement entered into prior to the effective date of this section
may apply to the commissioner executive director in accordance with subsection
(a) of this section to discharge the remaining balance of its indebtedness to the
division commission by tendering, within thirty days from the date upon which the
commissioner executive director notifies the employer in writing that the
application has been approved, payment in full for that portion of the balance
which consists of unpaid premium taxes that are attributable to the quarter ended on the thirty-first day of December, one thousand nine hundred ninety-eight, or
quarters ended before that date: Provided, That in the alternative, an employer
which is remitting payments to the division commission pursuant to the terms of
an agreement entered into prior to the effective date of this section may apply
to the commissioner executive director in accordance with subsection (a) of this
section to discharge the balance of its indebtedness to the division commission
by fulfilling the terms of a written agreement with the division commission to
pay, within three hundred sixty-five days from the date upon which the agreement
is executed, all past-due premium taxes in monthly installments which shall
include interest on such the past-due premium taxes calculated at an annual
percentage rate of nine percent.











(d) An employer with which the commissioner executive director is, as of
the effective date of this section, engaged in litigation concerning the extent
to which that employer is liable to the division commission for past-due premium
taxes, accrued interest and penalties may in settlement: (1) Tender payment in
full for the past-due premium taxes; or (2) fulfill the terms of a written
agreement with the division commission to pay, within three hundred sixty-five
days from the date that the agreement is executed, all past-due premium taxes in
monthly installments which shall include interest on such past-due premium taxes
calculated at an annual percentage rate of nine percent.











(e) An employer shall be reinstated to good standing as of the date that
the employer tenders payment in full for all past-due premium taxes. An employer
who enters into a written agreement with the division commission to pay past-due
premium taxes in monthly installments shall be reinstated to good standing as of
the date on which the agreement is executed: Provided, That the failure of the
employer to make scheduled payments in accordance with a repayment agreement
entered into under this section may at the discretion of the commissioner
executive director cause the repayment agreement to be voided and the employer
shall be denied the benefits and protections of this chapter effective from the
date of the employer's initial default. In addition, the employer shall be
subject to all remedies available to the division commission pursuant to the
provisions of this chapter.
§23-2-5c. Statute of limitations; effective date for new payments; previous
payments due not affected.











For payments due after the effective date of this section, every action or
process to collect any premium, premium deposit, interest or penalty due from an
employer pursuant to this article by the commissioner 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 likewise apply to enforcement of the lien, if any,
securing the payment of such the premium, premium deposit, interest or penalty,
but shall not apply in event of fraud or in 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 shall continue to be no limitation on when actions or
processes may be brought or issued.
§23-2-5d. Uncollectible receivables; write-offs











Notwithstanding any other provision to the contrary, the division, with the
approval of the compensation programs performance council, the executive
director, with the approval of the board of managers may write-off any
uncollected receivable due under the provisions of this article which the
division and the compensation programs performance council deem to be the
executive director and the board of managers determine is uncollectible.
§23-2-6. Exemption of contributing employers from liability.
Any employer subject to this chapter who shall subscribe and pay into the
workers' compensation fund the premiums provided by this chapter or who shall
elect to make direct payments of compensation as herein provided 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 so subscribing or electing, and during
any period in which such employer shall not be in default in the payment of such
premiums or direct payments and shall have complied fully with all other
provisions of this chapter. The continuation Continuation in the service of such 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 such 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.
(a) Notwithstanding any provisions of this chapter to the contrary, the
following types of employers or employers' group may apply for permission to
self-insure their workers' compensation risk including their risk of catastrophic
injuries. Except as provided for in subsection (e) of this section, no employer
may self-insure its second injury risk.
(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; or
(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.
(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 must individually and collectively meet the conditions set forth in
subdivision (A) or (B) above.
(2) In order to be approved for self-insurance status, the employer must:
(A) Have an effective health and safety program at its workplaces; and
(B) Provide security or bond in an amount and form to be determined by the
compensation programs performance council 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 future claim liability based upon generally accepted actuarial and
accounting principles of the employer's existing and expected liability; and
(C) Security or bond which may be in such form as the commissioner and the
compensation programs performance council created pursuant to section one,
article three, chapter twenty-one-a of this code permits.











(3) Any employer whose record upon the books of the division 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 such the employer, shall not
be granted the right, individually and directly or from such the benefit funds
or system of compensation, to be self-insured until the employer has paid into
the workers' compensation fund the amount of such 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 that 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 division
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, in the division's discretion, 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 shall furnish security or bond,
including replacement and amended bonds and other securities, as security surety
to ensure the employer's or guarantor's payment of all obligations under this
chapter for which the security or bond was furnished, such security or bond shall
be in the most current form or forms approved and authorized by the division
commission for use by the employer or its guarantors, surety companies, banks,
financial institutions or others in its behalf for such purpose.











(b) 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 to enter orders and provide notices of action
taken in effectuating the purposes of this chapter to provide benefits to persons
who have suffered injuries or diseases covered by this chapter. An employer
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 shall
be binding on and shall be strictly to by the self-insured employer in its
administration of claims presented by employees of the self-insured employer.












(b) (c) Each self-insured employer shall, on or before the last day of the
first month of each quarter, file with the division 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; and











(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.












(c) (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.











(1) If an employer defaults in the payment of any portion of its self-
insured premium taxes, the division commission may, 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 so
determined may, in an appropriate case, be assessed against the employer. and the
division The commission may demand and collect the present value of such 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 division commission and to the
employer's employees is a sufficient basis for reinstating the employer to good
standing with the fund.











(2) Such premium Premium tax assessments are special revenue taxes under
and according to the provisions of state workers' compensation law and are deemed
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 division commission.












(d) (e) 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 may insure its
catastrophic risk through a policy of excess insurance obtained through a private
insurance carrier.











(1) If the employer does not elect to self-insure its catastrophic risk, then 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 said section. Until such the rules are adopted, the employer's premium
taxes shall be determined in accordance with the provisions of chapter one
hundred seventy-four, acts of the Legislature, one thousand nine hundred ninety-
one. If the employees of such an employer suffer injury or death from a
catastrophe, then 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. Such an An employer's catastrophic liability
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 not to self-insure its
catastrophic risk, then the security or bond required in subsection (a) of this
section shall include the liability for the catastrophic risk.












(e) (1) Any self-insured employer who was, prior to the second day of
February, one thousand nine hundred ninety-five, permitted to self-insure its
second injury risk as defined in subsection (d), section one, article three of
this chapter, may elect to continue to self-insure its second injury risk for so
long as it meets the requirements of this chapter. Any employer which was
previously permitted to self-insure its second injury risk who then elects to
terminate that self-insurance status shall not thereafter be permitted to self-
insure its second injury risk.











(2) 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 then be paid by the employer and not the
division.











(3) (A) For those employers which do not self-insure their second injury
risk, the premium tax for second injury coverage shall be determined by the rules
which implement section four of this article. Such rules may provide for merit
rate adjustments of the amount of premium tax to be paid based upon the accrued costs to be determined under generally accepted accounting principles of second
injury benefits paid and to be paid to the employer's employees. Until such rules
are adopted, the employer's premium taxes shall be determined in accordance with
the provisions of chapter one hundred seventy-four, acts of the Legislature, one
thousand nine hundred ninety-one.











(B) In case there is a second injury to an employee of any employer making
such second injury premium tax payments, the employer shall be liable to pay
compensation or expenses arising from or necessitated by the second injury and
such compensation and expenses shall be charged against the employer. After the
completion of these payments, the employee shall be paid the remainder of the
compensation and expenses that would be due for permanent total disability from
the second injury reserve of the surplus fund. Such additional compensation and
expenses shall not be charged against such employer.











(f) The compensation programs performance council 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
such a pool is created, the compensation programs performance council commission
shall adopt rules for the organizational plan, participation, contributions and
other payments which may be required of self-insured employers under this
section. The council executive director, with approval of the board of managers,
in order to create and fund such a risk pool, may adopt a rule authorizing the
division 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 such the risk pool to serve the needs of employees, employers and the
workers' compensation fund by providing adequate security. The council
commission, in funding establishing such security risk pool, may authorize the
division commission to use any assessments, premium tax assessments and revenues
and appropriations as may be made available to the division commission.











(g) 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
quarterly reports to the division commission for a period of four or more
consecutive quarters shall have its status at the division commission inactivated
and shall be required to apply for reactivation to status as a self-insured
employer prior to its reemployment of employees. Despite such 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 must 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.











(h) In any case under the provisions of this section that shall 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, then the division 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, such the employer shall be
discharged from any further portion of premium tax liability upon such the award
or awards and payment of the award or awards shall be assumed by the division
commission.











(i) Any employer subject to this chapter, who shall elect 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 such election's approval and during the period
that the employer is allowed to carry the employer's own risk.











(j) The executive director shall submit for approval of the board rules setting forth procedures for auditing and investigating the program of self-
insured employers and third-party administrators wherever a formal substantive
complaint has been filed. Audits and investigations shall be conducted whenever
the commission has grounds for believing that a self-insured employer is not in
full compliance with the commission's rules or this chapter. In addition, the
executive director shall monitor programs established by self-insured or third-
party administrators under this chapter to ensure compliance with the
commission's rules and the law.











(k) The executive director shall submit for approval of the board rules for
the approval, renewal, suspension, revocation or termination of an employer's
status as a self-insured. Violations for which negative action may be taken by
the commission includes, but is not limited to, failure to comply with this
chapter, rules or orders of the commission, failure to pay any premium, tax or
assessment levied under this chapter, failure to provide medical care or pay
benefits as required by this chapter or other misconduct effecting the rights of
employers or employees under this chapter.











(l) The executive director may order corrective action rather than taking
negative action against a self-insured employer after conducting an investigation
into allegations of violations or misconduct by a self-insured employer. If the
self-insured employer fails to comply with the order for corrective action or is
otherwise in violation of this chapter, the executive director shall recommend
to the board revocation, suspension or termination of the employer's self-insured
status, probation, a civil penalty not to exceed ten thousand dollars for each
failure to comply or each violation or a combination thereof. Any negative
action taken or penalty assessed against a self-insured employer may be appealed
to as provided in article five of this chapter.











(m) No employer may hire any person or group to administer claims under
this chapter as third-party administrators unless the person or group has been
approved by the commission.
§23-2-10. Application of chapter to interstate commerce.
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 shall apply 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 such work in this state is
clearly separable and distinguishable from his or her interstate work, such
employer shall be subject to the terms and provisions of this chapter in like
manner as all other employers hereunder. Payments of premiums shall be on the
basis of the payroll of those employees who perform work in this state only.











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 1, section 8), section one of
this article shall apply 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 shall be 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 shall be 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, any such adjudication shall not impair the validity of this chapter in
other respects, and in every such 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, shall be held invalid, the entire
chapter shall be thereby 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 thereof.
§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, workmen workers shall be repealed or adjudged invalid or
unconstitutional, the period intervening between the occurrence of any injury or
death and such 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 such injuries or death, but the
amount of any compensation which may have been paid on account of such injury or
death shall be deducted from any judgment for damages recovered on account of
such 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 hereinafter. The interest rate per annum for each
fiscal year shall be calculated as the greater of the division's 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 compensation
programs performance council 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 division's 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 commissioner 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 commissioner 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 commissioner commission shall provide for a simple rate of
interest, determined in accordance with the provisions of this section which
shall not be subject to change during the life of the reinstatement agreement for such 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 shall sell or otherwise transfer 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, then:











(1) Such employer's premium taxes, premium deposits, interest and other
payments owed to the division commission shall be due and owing to the division
commission upon the execution of the agreement of sale or other transfer;











(2) Any repayment agreement entered into by the employer with the division
commission pursuant to section five of this article shall terminate upon the
execution of the aforesaid agreement of sale or other transfer and all amounts
owed to the division commission but not yet paid shall become due; and











(3) Upon execution of an agreement of sale or other transfer, as aforesaid,
the division 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, which lien shall constitute 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, then:











(1) Any liens for payments owed to the division commission for premium
taxes, premium deposits, interest or other payments owed to the division
commission by the predecessor employer shall be extended to the successor
employer;











(2) Any liens held by the division 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 shall be enforceable by the division 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 shall
sell or otherwise transfer a portion of the employer's assets so as to affect the
employer's capacity to do business, then:











(1) Such employer's premium taxes, premium deposits, interest, and other
payments owed to the division commission shall be due and owing to the division
commission upon the execution of the agreement of sale or other transfer;











(2) Any repayment agreement entered into by the employer with the division
commission pursuant to section five of the article shall terminate upon the
execution of the aforesaid agreement of sale or other transfer and all amounts
owed to the division commission but not yet paid shall become due; and











(3) Upon execution of an agreement of sale or other transfer, as aforesaid,
the division 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, which lien shall constitute a
personal obligation of the employer.











(d) If an employer subject to subsection (a), (b) or (c) of this section
pays to the division 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, then the division commission
shall issue a certificate to the employer stating that the employer's account is
in good standing with the division commission and that the assets may be sold or
otherwise transferred without the attachment of the division's 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 division
commission. The subsequent timely payment of that full amount to the division commission shall operate to place both employers in good standing with the
division 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 division commission on the aforesaid date of
execution, then 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 division commission and that the assets may be sold or otherwise transferred
without the attachment of the division's 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, good will, 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 shall be 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
fifteen of this article and in consideration of the factors thereunder.











(g) The foregoing provisions are expressly intended to impose upon such
successor employers the duty of obtaining from the division commission or
predecessor employer, prior to the date of such acquisition, a valid "certificate
of good standing to transfer a business or business assets" to verify that the
predecessor employer's account with the division 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 division commission requesting
that the division 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 division commission shall review the petition by
considering the seven factors set forth below:



(1) The exact nature of the default;



(2) The amount owed to the division 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 division commission, no hearing need
be held on the petition. However, any decision made by the division commission
on the petition shall be in writing and shall include appropriate findings of
fact and conclusions of law. Such decision shall be effective ten days following
notice to the public of the decision unless an objection is filed in the manner
herein provided. Such notice shall be given by the division's 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
division 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 division commission setting forth the
objection and the basis therefor. If any such objection is filed, the division
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 said
section, for other employers in the same class or group, then, 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 are: (1) Managed by the same, or substantially
the same, management personnel; and (2) have a common ownership by at least forty
percent of each corporation's shareholders; and (3) is in the same class or group
as determined by the commissioner 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 commissioner commission, then, at the time
the new corporate employer registers with the commissioner commission, the new
corporate employer may request that the commissioner commission assign to it the
same rate of payment of premiums as that assigned to the preexisting corporate
employer. If the commissioner executive director decides that the granting of
such a request is in keeping with his or her fiduciary obligations to the
workers' compensation fund, then the commissioner 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 are: (1) Managed by the same, or substantially
the same, management personnel; and (2) have a common ownership by at least forty percent of each corporation's shareholders; and (3) is in the same class or group
as determined by the commissioner executive director under the provisions of
section four of this article, then, at any time within one year of the new
corporate employer's registration with the commissioner commission, the
commissioner 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
commissioner commission on the forms provided by the commissioner commission that
its situation meets the factual requirements of this section, then the
commissioner 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 commissioner
commission may utilize use the its powers given to the commissioner in 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 commissioner executive director made under the
provisions of this article, then such employer shall be entitled to file a
petition demanding a hearing upon such decision or action which petition must be
filed within thirty days of the employer's receipt of notice of the disputed
commissioner's executive director's decision or action or, in the absence of such
receipt, within sixty days of the date of the commissioner's executive director's
making such disputed decision or taking such disputed action, such time
limitations being hereby declared to be a condition of the right to litigate such
decision or action and hence 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 such a petition, the commissioner 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 commissioner executive director shall be taken in accord with the
provisions of articles five and six of said chapter: Provided, That all such
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 shall be entitled to compensation under the provisions of this
chapter and shall not by having received same be precluded from making claim
against said 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 said third party and recovers any sum thereby, the
commissioner commission or a self-insured employer shall be allowed statutory
subrogation with regard to all indemnity benefits, medical benefits, and any and
all other workers' compensation benefits paid as of the date of the recovery:
Provided, That under no circumstances shall any moneys received by the
commissioner or self-insured employer as subrogation to medical benefits expended
on behalf of the injured or deceased worker exceed fifty percent of the amount
received from the third party as a result of the claim made by the injured
worker, his or her dependents or personal representative, after payment of
attorney's fees and costs, if such exist. The commission or self-insured
employer shall permit the deduction from the amount received of a reasonable
attorney's fee, not to exceed the attorney's fees permitted in this chapter, and
reasonable costs. It shall be 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:
Provided, That in no event shall subrogation of workers' compensation claims cause the injured worker or dependents to receive less than what he or she
received or may receive from workers' compensation.



(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 such moneys received which
shall exist in favor of the commissioner 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 shall remain
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 this article. The
provisions of this article remain in effect for claims arising from a right of
action which arose or accrued, in whole or in part, after the effective date of
the amendments to this article enacted during the regular session of the
Legislature in 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 commissioner executive director acting in conjunction with the performance
council board of managers created pursuant to section one, article three, chapter
twenty-one-a of this code, 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 compensation programs performance council 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
compensation programs performance council executive director, the commissioner
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 commissioner 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 commissioner
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 compensation programs performance council board of
managers, the commissioner 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 commissioner and
the compensation programs performance council executive director shall promulgate
rules which shall include, but are not limited to, the following provisions:



(1) Prescribing the membership of the committees, training, frequency of
meetings, record keeping 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 multi-employer 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 shall be 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 this program these programs.
§23-2B-3. Premium rate credits; qualified loss management program; loss
management firms; penalties; rules.



(a) The commissioner, in conjunction with the compensation programs
performance council, executive director in consultation with the board of
managers is authorized to establish by rule a premium credit program for certain
employers. The program shall be applicable solely to regular subscribers to the
workers' compensation fund and not to self-insurers. Participation in any
premium credit program shall be voluntary and no employer shall be required to
participate.



(b) The program shall apply a prospective credit to the premium rate of a
subscribing employer who participates in a qualified loss management program.
The prospective credit shall be 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 commissioner
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
commissioner executive director.



(d) A credit shall be 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 shall be 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 commissioner, in
conjunction with the compensation programs performance council, executive
director, in consultation with the board of managers promulgates an appropriate
rule to implement the section's provisions.
ARTICLE 3. WORKERS' COMPENSATION FUND.
§23-3-1. Compensation fund; surplus fund; catastrophe and catastrophe payment
defined; compensation by employers.



(a) The commissioner commission shall establish a workers' compensation
fund from the premiums and other funds paid thereto by employers, as herein
provided, for the benefit of employees of employers who have paid the premiums
applicable to such 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 surplus fund hereinafter provided for, and for the benefit of the dependents
of all such employees, and for the payment of the administration expenses of this
chapter.



(b) A portion of all premiums that shall be paid into the workers'
compensation fund by subscribers not electing to carry their own risk under
section nine, article two of this chapter, shall be set aside to create and
maintain a surplus fund to cover the catastrophe hazard, the second injury
hazard, and all losses not otherwise specifically provided for in this chapter.
The percentage to be set aside shall be 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 surplus fund. All interest earned on investments
by the workers' compensation fund, which is attributable to the surplus fund,
shall be credited to the surplus 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; or loss of both hands or the
use thereof; or 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 hereby
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 heretofore elected, or may hereafter elect, to pay into the catastrophe reserve of the surplus fund under
the provisions of that section, then the catastrophe payment arising from such
catastrophe shall not be charged against, or paid by, such employer but shall be
paid from the catastrophe reserve of the surplus fund.




(d) (1) 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 such 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 such
second injury: Provided, That in addition to such 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 a
special reserve of the surplus fund known as the second injury reserve, created
in the manner hereinbefore set forth. 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 shall be 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.




(2) If an employee of an employer, where the employer has elected to carry
his or her own risk under section nine, article two of this chapter, and is
permitted not to make payments into the second injury reserve of surplus fund
under the provisions of said section, has a definitely ascertainable physical
impairment caused by a previous occupational injury, occupational pneumoconiosis
or occupational disease, irrespective of its compensability, and becomes
permanently and totally disabled from the combined effect of such previous injury
and a second injury received in the course of and as a result of his or her
employment, the employee shall be granted an award of total permanent disability
and his or her employer shall, upon order of the division commission, compensate the said employee in the same manner as if the total permanent disability of the
employee had resulted from a single injury while in the employ of such employer.




(e) (d) Employers electing, as herein provided, to compensate individually
and directly their injured employees and their fatally injured employees'
dependents shall do so in the manner prescribed by the division commission, and
shall make all reports and execute all blanks, forms and papers as directed by
the division 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, which
article is by this act repealed, shall be transferred to and made a part of the
workers' compensation fund provided for in the preceding section, and the balance
thereof shall be refunded to the subscribers thereto in proportion to their
contributions to the same under the provisions of said former article six; and
all awards heretofore made under the provisions of article six shall be paid from
the workers' compensation fund, or directly by the employer, under order of the
commissioner 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 said article six, the provisions
thereof shall be 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 said date, and whose employer, at the time of such exposure,
was subject to the provisions of said article six.
§23-3-1b. Deficit elimination fund.



(a) The Legislature hereby finds and declares that the there is a
substantial actuarial deficit in the workers' compensation fund in the excess of
six billion dollars on a full accrued value basis. The Legislature further finds
and declares that this deficit represents clear and present danger to the current
financial viability of the workers' compensation system and the ability of the system to deliver benefits and services in the future.



The Legislature hereby declares that it is the purpose of this section to
identify the deficit existing in the workers' compensation fund on the effective
date of this section and provide for a separate funding mechanism not otherwise
provided for in this chapter, to extinguish the claim liability associated with
the deficit. For purposes of this section, "deficit" means an obligation to make
future benefit payments as a result of prior awards for which insufficient
invested reserves currently exist to ensure the payment of such future
obligations.



(b) There is hereby created in the state treasury a special revenue fund
known as the "Deficit Elimination Fund." The fund shall operate as a special
fund whereby all deposits and payments thereto do not expire to the general
revenue fund, but shall remain in the fund and be available for expenditure in
succeeding fiscal years. This fund shall consist of payroll taxes paid by
employers and employees, as herein provided, to pay all benefits which shall be
due on or after the first day of July two thousand three, in those certain claims
which are transferred to the deficit fund for the payment of benefits, as well
as interest earned on investments made from moneys deposited in the fund.



(c) On or before the first day of June, two thousand three, and each year
thereafter, the commission shall cause to be completed an independent actuarial
review of the workers' compensation fund to determine those claims for which
future benefit obligations exist as a result of awards previously made, but for
which insufficient invested reserves currently exist to ensure the payment of
such future obligations. All claims so identified shall be transferred to the
deficit fund for payment of benefits due on and after the first day of July, two
thousand three, and each year thereafter, and all such future benefit obligations
and liability shall cease to be an obligation and liability of the workers'
compensation fund and shall become the obligation and liability of the deficit
fund.



(d) For the purpose of creating and maintaining the deficit fund, each
employer and employee shall pay taxes calculated as a percentage of the
employee's gross wages payroll in an amount to be determined by the commission as shall be necessary to meet the annual benefit payment obligations of the
deficit fund. The percentage shall be shared equally by the employer and
employee and shall be reported to the commission on a quarterly basis along with
the employer's quarterly premium taxes. It shall be the obligation of the
employer to report, collect through payroll deduction and remit both the employer
and employee portion of said tax on forms to be provided by the commission. The
deficit fund payroll tax shall be remitted to and collected by the West Virginia
department of tax and revenue and any collection enforcement shall be executed
pursuant to the provisions of chapter eleven of this code. Copies of such
reports shall also be filed with the commission for informational purposes.



(e) All deficit fund payroll taxes remitted to the West Virginia
department of tax and revenue shall be delivered to the state treasurer who shall
be the custodian of the deficit fund. All deficit fund payroll taxes, deposits
or other moneys paid thereto shall be deposited in the state treasury to the
credit of the deficit fund. The deficit fund shall be a separate and distinct
fund and shall be so kept on the books of the auditor and treasurer in the same
manner as provided for in section two, article three of this chapter with respect
to the workers' compensation fund. The West Virginia investment management board
shall have authority to invest any surplus, reserve or other moneys belonging to
the deficit fund on the same basis and in the same manner as is provided for in
section two, article three of this chapter with respect to the workers'
compensation fund.



(f) The commission shall administer the deficit fund and is authorized to
establish rules for the operation of the fund to ensure proper and timely
delivery of payments in claims transferred to the fund for payment. The rule
shall be promulgated on or before the first day of July, two thousand four.
§23-3-2. Custody, investment and disbursement of fund.



The state treasurer shall be the custodian of the workers' compensation
fund and all premiums, deposits or other moneys paid thereto shall be deposited
in the state treasury to the credit of the workers' compensation fund in the
manner prescribed in section five, article two of this chapter. The workers'
compensation fund shall consist of the premiums and deposits provided by this chapter and all interest accruing thereto upon investments and deposits in the
state depositories, and any other moneys or funds which may be given,
appropriated or otherwise designated or accruing thereto. Said The fund shall be
a separate and distinct fund and shall be so kept upon the books and records of
the auditor and treasurer and the state depositories in which any part is
deposited. Disbursements therefrom shall be made upon requisitions signed by the
secretary executive director and approved by the commissioner of the bureau of
employment programs.



The board of investments investment management board created pursuant to
the provisions of article six, chapter twelve of this code shall have authority
to invest the surplus, reserve or other moneys belonging to the fund in the bonds
of the United States, notes or bonds of this state, bridge revenue bonds of this
state issued prior to the first day of January, one thousand nine hundred thirty-
nine, or any bonds issued to refund the same, bonds of any county, city, town,
village or school district of the state. No such investment shall be made, nor
any investment sold or otherwise disposed of without the concurrence of a
majority of all members of the board of investments investment management board.
It shall be the duty of every county, school district or municipality issuing any
bonds, to offer the same in writing to the board of investments investment
management board, prior to advertising the same for sale, and the board of
investments investment management board shall, within fifteen days after receipt
of such an offer, accept the same and purchase such the bonds, or any portion
thereof at par and accrued interest, or reject such the offer. All securities
purchased by the board of investments investment management board for investment
for the workers' compensation fund shall be placed in the hands of the state
treasurer as the custodian thereof, and it shall be his or her duty to keep and
account for the same as he or she keeps and accounts for other securities of the
state, and to collect the interest thereon as the same becomes due and payable
and the principal when the same is due. No notes, bonds or other securities
shall be purchased by the board of investments investment management board until
and unless the attorney general shall investigate the issuance of such the notes,
bonds or securities and shall give a written opinion to the board that the same have been regularly issued according to the constitution and the laws of this
state, which opinion, if such the notes, bonds or securities be purchased, shall
be filed with the treasurer with such the bonds or securities.
§23-3-3. Investment of surplus funds required.



Whenever there shall be in the state treasury any funds belonging to the
workers' compensation fund not likely, in the opinion of the commissioner
executive director in consultation with the board of managers, to be required for
immediate use, it shall be the duty of the board of investments investment
management board to invest the same as prescribed in the preceding section.
Whenever it may become necessary or expedient to use any of the funds so
invested, the board of investments investment management board, at the direction
of the commissioner board of managers, 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 division commission is authorized to
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 claimants may
not be required to accept such transfers but may elect to do so.



(b) The division commission is further authorized to establish a program
to require payments of deposits, premiums and other funds into the workers'
compensation fund by electronic transfer of funds.



(c) The division commission is further authorized to establish a program
that invoices and other charges against the workers' compensation fund may be
submitted to the division commission by electronic means.



(d) Any program authorized by this section must be implemented through the
issuance of a rule pursuant to subdivisions (b) and (c) subdivision (i), section
seven one-a, article three one, chapter twenty-one-a of this code of this
chapter.
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 set
forth, the commissioner commission shall disburse the workers' compensation fund
to the employees of employers subject to this chapter, which employees have
received personal injuries in the course of and resulting from their covered
employment or to the dependents, if any, of such 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, such employees are ineligible to receive
compensation while such employees are at the same time and for the same reason
drawing sick leave benefits. Such state employees may only use sick leave for
non-job related absences consistent with sick leave utilization, 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 such
employees may collect sick leave benefits until receiving temporary total
disability benefits. The division of personnel shall promulgate rules pursuant
to 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 such injury results in lost time from work, and such employee for whatever reason uses or obtains sick leave
benefits and subsequently receives temporary total disability benefits for the
same time period, such 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. Such 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 paragraph 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 herein may be construed to
prevent 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" shall include occupational pneumoconiosis and any other occupational
disease, as hereinafter defined, and the commissioner commission shall likewise
disburse the workers' compensation fund to the employees of such the employers
in whose employment such 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 such 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 therefrom, 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 such 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, and the commissioner. 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 the immediately succeeding sentence,
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" shall include, but shall not be 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 herein meeting
the definition of occupational pneumoconiosis set forth in the immediately
preceding sentence.



(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 shall be
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 deemed 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 must appear 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.



(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 deemed to have contracted an
occupational disease within the meaning of this paragraph 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 hereinbefore defined, except
occupational pneumoconiosis, shall be processed in like manner as claims for all
other personal injuries.
§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 such 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 such injury, with like
notice or a copy thereof to the workers' compensation division 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 therefrom. Such 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. Such notice may be given to the workers' compensation
division commission by mail.
§23-4-1b. Report of injuries by employers.



(a) It shall be the duty of every employer to report to the commissioner
commission every injury sustained by any person in his employ employee. Such
report shall be on forms prescribed by the commissioner 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 commissioner 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, such five-
day period may not be extended by the commissioner commission, but the employer
shall have 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 then available, the employer disputes the
compensability of the injury or objects to the payment of temporary total
disability benefits in connection therewith. Such 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 herein, or statements in such 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 such injury,
shall be deemed to be a waiver of the employer's right to object to any interim
payment of temporary total disability benefits paid by the commissioner
commission with respect to any period from the date of injury to the date of the
commissioner's commission receipt of any objection made thereto by the employer.



(b) Employers authorized to self-insure their obligations under this
chapter, or their duly authorized representatives shall report to the division
and the claimant on forms prescribed by the division every injury sustained by
any person in his or her employ that results in lost time from the employees
workplace in excess of three days. The self-insured employers report shall
include a statement as to whether or not, on the basis of the information then
available, the self-insured employer has accepted or denied the compensability
of the injury or has accepted or denied the payment of temporary disability benefits in connection therewith.
§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 instance when the employer, including self-insured employers,
has denied compensability, the commission shall conduct an investigation of the
facts and circumstances surrounding the injury. No later than fifteen days from
submission of the report of injury, the commission shall make a decision on the
compensability of the injury. Should the investigation not be completed within
the fifteen day period, the commission shall make a determination on the
compensability of the claim based on the information available. In any claim for
benefits under this chapter, the workers' compensation division commission shall
determine whether the claimant has sustained a compensable injury within the
meaning of section one of this article and the division shall enter an order
giving all parties immediate notice of such the decision.



(1) The division commission may enter an order conditionally approving the
claimant's application if the division commission finds that obtaining additional
medical evidence or evaluations or other evidence related to the issue of
compensability would aid the division 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, then any such
payments shall be considered an overpayment. The division commission may only
recover the amount of such the an overpayment as provided for in subsection (i)
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 division commission shall consider the date of
the filing of the claim for benefits for a determination of the following:



(A) Whether the claimant had scheduled shutdown beginning within one week of the date of the filing; or



(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; or



(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, then
such 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 shall have the right to object to the order of the division
commission and obtain an evidentiary hearing as provided in section one, article
five of this chapter.



(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 division
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 said injury,
without waiting for the expiration of the thirty-day period during which
objections may be filed to such findings as provided in section one, article five
of this chapter. The division 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 division commission
shall give to the parties immediate notice of any order granting temporary total
disability or medical benefits.



(c) The division commission may enter orders granting temporary total disability benefits upon receipt of medical evidence justifying the payment of
such benefits. In no claim shall the division commission enter an order granting
prospective temporary total disability benefits for a period of more than ninety
days: Provided, That when the division commission determines that the claimant
remains disabled beyond the period specified in the prior order granting
temporary total disability benefits, the division 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 such decision.



(d) Upon receipt of the first report of injury in claim, the division
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 division commission with this information
within fifteen days from the date the division 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 division commission obtains
from reports made pursuant to section eleven, article ten, chapter twenty-one-a
of this code subsection (b), section two, article two of this chapter. If no
such wages have been reported, then the division commission shall make such
payments at the rate the division commission finds would be justified by the
usual rate of pay for the occupation of the injured employee. The division
commission shall adjust the rate of benefits both retroactively and prospectively
upon receipt of proper wage information. The division 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 division commission that a claimant who has
sustained a previous compensable injury which has been closed by any order of the
division commission, 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 division commission shall immediately
enter an order commencing 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 said the disability, without waiting for the expiration of
the thirty-day period during which objections may be filed to such findings as
provided in section one, article five of this chapter. The division commission
shall give immediate notice to the parties of its order.



(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 division 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 division
commission shall immediately issue a pay order directing the employer to pay such
amounts as are due the claimant for temporary total disability benefits. A copy
of the order shall be sent to the claimant. The self-insured employer shall
commence such payments by mailing or delivering the payments directly to the
employee within ten days of the date of the receipt of the pay order by the
employer. If the self-insured employer believes that its employee is entitled
to benefits, the employer may start payments before receiving a pay order from
the division commission.



(h) In the event that an employer files a timely objection to any order of
the division commission with respect to compensability, or any order denying an
application for modification with respect to temporary total disability benefits,
or with respect to those expenses outlined in subsection (a), section three of
this article, the division commission shall continue to pay to the claimant such
the benefits and expenses during the period of such the disability. Where it is
subsequently found by the division commission that the claimant was not entitled
to receive such temporary total disability benefits or expenses, or any part
thereof, so paid, the division commission shall, when the employer is a
subscriber to the fund, credit said employer's account with the amount of the
overpayment; and, when the employer has elected to carry its own risk, the
division commission shall refund to such the employer the amount of the overpayment. The amounts so credited to a subscriber or repaid to a self-insurer
shall be charged by the division commission to the surplus fund created in
section one, article three of this chapter.



(i) 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 such case determines that the claimant was not entitled to such
the benefits or expenses, the amount of such benefits or expenses shall be
considered overpaid. The division commission may only recover the amount of such
overpaid benefits or expenses by withholding, in whole or in part, as determined
by the division commission, future permanent partial disability benefits payable
to the individual in the same or other claims and credit such the amount against
the overpayment until it is repaid in full.



(j) In the event that the division commission finds that based upon the
employer's report of injury, the claim is not compensable, the division
commission shall provide a copy of such employer's report to the claimant in
addition to the order denying the claim.



(k) No claimant may receive both temporary total disability 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 in excess of
the amount of temporary total disability benefits for which the claimant would
otherwise be eligible. The employer shall notify the commission of any benefit
paid to a claimant and the commission shall reduce the temporary total disability
benefits accordingly.
§23-4-1d. Method and time of payments for permanent disability.
(a) If the division commission makes an award for permanent partial or
permanent total disability, the division 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 division commission may withhold payment of the portion of the award that is
the subject of the following subsection until seventy-seven days have expired
without an objection being filed.







(b) On and after the first day of July, one thousand nine hundred ninety-five, whenever the division commission or the office of judges or the workers'
compensation appeal board enters an order granting the claimant a permanent total
disability award and an objection or petition for appeal is then filed by the
employer or the division commission, the division commission 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, the award of permanent total
disability benefits is upheld, then the claimant shall receive the remainder of
benefits due to him or her based upon the onset date of total permanent
disability that was finally determined.







(c) If the claimant is then owed any additional payment of back permanent
total disability benefits, then the division commission 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 division commission or self-insured
employer shall continue to pay to the claimant such benefits during the period
of such disability unless it is subsequently found that the claimant was not
entitled to receive the benefits, or any part thereof, so paid, in which event
the division commission shall, where the employer is a subscriber to the fund,
credit said employer's account with the amount of the overpayment; and, where the
employer has elected to carry the employer's own risk, the division commission
shall refund to such employer the amount of the overpayment. The amounts so
credited to a subscriber or repaid to a self-insurer shall be charged by the division commission to the surplus fund created by section one, article three of
this chapter. 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, such amount of benefits so paid shall be deemed overpaid. The division
commission may only recover such amount by withholding, in whole or in part, as
determined by the division commission, future permanent partial disability
benefits payable to the individual in the same or other claims and credit such
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.
§23-4-1e. Temporary total disability benefits not to be paid for periods of
penitentiary 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 such person is
incarcerated confined in a penitentiary or state correctional center, county or
regional jail: Provided, That incarceration confined 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 incarceration 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 commissioner
commission.



(b) Notwithstanding any provision of this code to the contrary, no person
incarcerated confined in a penitentiary or state correctional center, county or
regional jail who suffers injury or a disease in the course of and resulting from
his or her work during such period of incarceration confinement which work is
imposed by the administration of the penitentiary or state correctional center,
county or regional jail and is not suffered during such person's usual employment
with his or her usual employer when not incarcerated confined shall receive benefits under the provisions of this chapter for such injury or disease.
§23-4-1g. Weighing of evidence; rule of liberality; failure to cooperate.



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 each piece of
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.
There shall be a rule of liberality requiring that 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
manners of resolution, the resolution that is most consistent with the claimant's
position will be adopted.
§23-4-2. Disbursement where injury is self-inflicted or intentionally caused by
employer; legislative declarations and findings; "deliberate intention"
defined.



(a) Notwithstanding anything hereinbefore or hereinafter contained, no
employee or dependent of any employee is entitled to receive any sum from the
workers' compensation fund, or to direct compensation from any employer making
the election and receiving the permission mentioned in section nine, article two
of this chapter, 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 such employee.



(b) For the purpose of this chapter, the commissioner 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.




(b) (c) If injury or death result to any employee from the deliberate
intention of his or her employer to produce such 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.




(c) (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 herein expressly provided, 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 co-employee; 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 law suit was and is to protect
those so immunized from litigation outside the workers' compensation system
except as herein expressly provided; 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 such 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 such the specific unsafe working condition and of the high
degree of risk and the strong probability of serious injury or death presented
by such specific unsafe working condition;



(C) That such 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 such 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) hereof, such the employer nevertheless thereafter
exposed an employee to such the specific unsafe working condition intentionally;
and



(E) That such employee so exposed suffered serious injury or death as a
direct and proximate result of such specific unsafe working condition.



(iii) In cases alleging liability under the provisions of the preceding
paragraph (ii):



(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) of the preceding
paragraph (ii) 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) of the preceding paragraph (ii); 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.




(d) (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 such
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; employer physician panels; denial of benefits; payments to
certain providers prohibited; medical cost and care programs; payments;
interlocutory orders.



(a) The workers' compensation division commission shall establish and alter
from time to time as the division commission may determine to be 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 division commission also, on the first
day of each regular session and also from time to time, as the division
commission may consider appropriate, shall submit the schedule, with any changes
thereto, to the Legislature. The promulgation of the schedule is not subject to
the legislative rule-making review procedures established in sections nine
through sixteen, article three, chapter twenty-nine-a of this code.



The division commission shall disburse and pay from the fund for such
personal injuries to such employees as may be entitled thereto hereunder as
follows:



(1) Such sums 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 division 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 herein 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 said section may be utilized by the division
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 such guideline shall submit to the
division commission specific justification for the need for such additional
services in the particular case and the division commission shall have the
justification reviewed by a health care professional before authorizing any such
additional services. The division commission is authorized to 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 such treatment or furnished health care
services, rehabilitation services, durable medical or other goods or other
supplies and items, or who has advanced payment for same, as the division
commission may deem proper, but no such payments or disbursements shall be made
or awarded by the division commission unless duly verified statements on forms
prescribed by the division commission shall be have been filed with the division
commission within two years one year after the rendering of such treatment or the
delivery of such goods, supplies or items: Provided, That no payment hereunder
shall be made unless such a verified statement shows no charge for or with
respect to such the treatment or for or with respect to any of the items
specified above has been or will be made against the injured employee or any
other person, firm or corporation., and when 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 such treatment is hereby
prohibited from making any charge or charges therefor or with respect thereto
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 division's commission 's schedule established
as aforesaid.



(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 exits. If a generic brand does not exist, then the pharmacist
may dispense the name brand. In the event that a physician wishes to prescribe
the use of the name brand of a given prescription medication, then he or she must
indicate in his or her own handwriting on the prescription order form that the
brand name medication is to be issued. In the event that a claimant wishes to
receive the name brand medication in lieu of the generic brand and if the
physician has not indicated that the brand name is required, then the claimant may receive the name brand medication but, in that event, the claimant will be
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 division commission pursuant to
the schedule of maximum reasonable amounts of fees authorized by subsection (a)
of this section, then, with the exceptions noted below, the claimant will be
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, then that the claimant will not be
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 such claimant refuses
to seek the specified alternative health care providers, then he or she will be
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 and 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, then the
division commission upon application by the claimant may authorize the claimant
to receive medical services from another health care provider. and such The
claimant shall not be personally liable for the difference in costs between the scheduled amount and the amount demanded by the health care provider.



(b) 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 therein 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 such compensable injury. Any employer violating this section shall
be 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 shall be 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
confinement in a county or regional jail not exceeding one year, or both:
Provided, That the foregoing provisions of this subsection shall not be deemed
to prohibit an employer from participating in 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: Provided, however, That nothing in this section
shall be deemed to restrict the right of a claimant to select his or her initial
health care provider for treatment of a compensable injury or disease an employer
to create or participate in an organization that provides a physician panel of
at least three physicians per medical specialty. An injured employee shall
choose a physician from the physician panel for treatment of the employee's
compensable conditions within the provisions of this chapter. This shall not
preclude an injured employee seeking emergency treatment from a physician,
hospital, clinic or health care provider which is not on the physician panel.
Whenever an employer protests the compensability of an injury, the claimant shall
have no restriction on the right to select his or her treating physician. The
refusal, without good cause, of an injured employee to select a physician from
the physician panel shall bar the employee from further compensation until the
refusal ceases. The physician selected by the claimant shall be subject to the payment provisions of this section. Should such a claimant obtain his or her
initial health care from a provider other than one on his or her employer's
physician panel and thereafter wish wishes to change his or her health care
provider and if his or her employer has established and maintains a managed
health care program consisting of a preferred provider organization or program,
a health maintenance organization, then the claimant shall select a new health
care provider through such the managed care program. Moreover, if the division
commission enters into an agreement which has been approved by the compensation
programs performance council board of managers with a preferred provider
organization or program, a health maintenance organization or other health care
delivery organization or organizations, then if a claimant seeks to change his
or her initial choice of health care provider and if the claimant's employer does
not provide access to such an organization as part of the employer's general
health insurance benefit, then the claimant shall be provided with a new health
care provider from the division's commission 's preferred provider organization
or program, health maintenance organization or other health care delivery
organization or organizations available to him or her.



(c) When an injury has been reported to the division commission by the
employer without protest, the division commission may pay, or order an employer
who or which made the election and who or which received the permission mentioned
in section nine, article two of this chapter a self-insured employer to pay,
within the maximum amount provided by schedule established by the division
commission as aforesaid, bills for health care services without requiring the
injured employee to file an application for benefits.



(d) The division 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 same to be originally furnished, or which are broken in the
course of and as a result of the employee's employment. The fund 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 that section.



(f) The division commission is authorized to engage in and contract for
medical cost containment programs, medical case management programs and
utilization review programs. Payments for these programs shall be made from the
supersedeas reserve of the surplus fund. Any order issued pursuant to any such
program shall be interlocutory in nature until an objecting party has exhausted
all review processes provided for by the division commission.



(g) Notwithstanding the foregoing, the division 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.



The commissioner 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:



(a) 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.



(b) 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.



(c) Assist the commissioner 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.



(d) Assist the commissioner commission in establishing guidelines as to the anticipated period of disability for the various types of injuries pursuant to
subsection (b), section seven-a of this article.



(e) Assist the commissioner 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
subsection (a) of this section.
§23-4-3c. Suspension or termination of providers of health care.



(a) The commissioner commission may suspend for up to one year or 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 commissioner commission finds that the health care provider is
regularly providing excessive, medically unreasonable or unethical care to
injured employees;



(2) If the commissioner 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 commissioner
commission, in violation of section three of this article;



(3) If the commissioner 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; or



(4) If the commissioner commission determines that the health care provider
has been convicted of any crime in relation to his or her practice.



The commissioner commission 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 commissioner commission determining that there is probable
cause to believe that a health care provider should be suspended or terminated
pursuant to this section, the commissioner commission shall provide such the
health care provider with written notice which shall state the nature of the charges against the health care provider and the time and place of a hearing at
which such 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 which time and place such At the hearing the health
care provider shall be afforded an opportunity to review the commissioner's
commission's evidence and to cross-examine the commissioner's commission's
witnesses and also afforded the opportunity to 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 commissioner executive director or a hearing
officer appointed by the commissioner executive director. The commissioner
executive director or hearing officer shall have the power to subpoena witnesses,
papers, records, documents and other data and things in connection with the
proceeding hereunder and to administer oaths or affirmations in any such hearing.
If, after reviewing the record of such the hearing, the commissioner commission
determines that the right of such the health care provider to obtain payment
under this article should be suspended for a specified period of time or should
be terminated, the commissioner commission shall issue a final order suspending
or terminating the right of such the health care provider to obtain payment for
services under this article. Any health care provider so suspended or terminated
shall be notified in writing and the notice shall specify the reasons for the
action so taken. 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 such
an the appeal shall be as provided in section four, of said article article five,
chapter twenty nine (a) of this code. The provider may be suspended or
terminated, based upon the final order of the commissioner commission, pending
final disposition of any appeal. Such 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 of
the commissioner commission within thirty days, it shall be 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 commissioner's commission's final order terminating or suspending the health
care provider: Provided, That nothing herein shall prohibit payment by the
commissioner commission 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 is prohibited from making any charge or charges for any
services so 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 commissioner commission or the self-insured employer. The written
consent and waiver signed by the injured employee shall be filed by the provider
with the commissioner commission and shall be made a part of the claim file.



(d) The commissioner commission 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
commissioner commission, of the suspension or termination of the provider's
rights to obtain payment under this chapter.



(f) A suspended or terminated provider may apply for reinstatement at the
end of the term of suspension or, if terminated, after one year from the
effective date of termination.



(g) The commissioner executive director 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 expense,
in an amount to be fixed from time to time by the division 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 same, as
the division commission may deem proper, in addition to such award as may be made
to the employee's dependents.



(b) A funeral director, or any person who furnished the services and
supplies associated with the funeral expenses, or a person who has advanced
payment for same, 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 division 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 division 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 division commission.



(c) Any person who knowingly and willfully seeks or receives payment of
funeral expenses in excess of the amount fixed by the division 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.
§23-4-6. 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 expressions "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, shall 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) If the injury causes temporary total disability, the employee shall
receive during the continuance thereof a maximum weekly benefit to be computed
on the basis of seventy 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 the case of a claimant whose injury occurred prior to the
second day of February, one thousand nine hundred ninety-five, the first day of
July, 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, and the rate shall not be affected by the amendment and
reenactment of this section during the regular session of the Legislature in the
year one thousand nine hundred ninety-five. The minimum weekly benefits paid
hereunder shall not be less than thirty-three and one-third percent of the
average weekly wage in West Virginia, except as provided in section six-d and
section nine of this article. In no event, however, shall such minimum weekly
benefits exceed the level of benefits determined by use of the then applicable
federal minimum hourly wage: Provided, however, 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 herein that the minimum weekly benefit shall not exceed the
applicable federal minimum hourly wage.



(c) Subdivision (b) of this section shall be limited as follows: Aggregate
award for a single injury causing temporary disability shall be for a period not
exceeding two hundred eight weeks.



(d) For all awards of permanent total disability benefits that are made
where the date of injury is on or after the second first day of February July,
one thousand nine hundred ninety-five two thousand three, 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. Such a 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
hereunder 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 first day of February July, one thousand nine hundred ninety-five
two thousand three, such awards shall continue to be paid at the rate in effect
prior to the said date, subject to annual adjustments for changes in the average
weekly wage in West Virginia: Provided, That the provisions of sections one
through eight, article four-a of this chapter shall be applied thereafter to all
such prior awards that were previously subject to its provisions. A single or
aggregate permanent disability of eighty-five percent or more shall entitle the
employee to a rebuttable presumption of a permanent total disability for the
purpose of paragraph (2) two, subdivision (n) of this section: Provided,
however, That the claimant must also be at least forty 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 shall the division 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 therefrom, the
total permanent disability award benefit rate shall be computed at the highest
benefit rate justified by any of the compensable injuries, and the cost of any
increase in the permanent total disability benefit rate shall be paid from the second injury reserve created by section one, article three of this chapter.



(e)(1) For all awards made where the date of injury is on or after the
second day of February, one thousand nine hundred ninety-five first day of July,
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
provided for in subdivision (d) of this section: as follows: seventy percent of
the average weekly wage earnings, wherever earned, of the injured employee at the
date of injury, not to exceed sixty-six and two-thirds percent of the average
weekly wage in West Virginia: Provided, That in the case of a claimant whose
injury occurred prior to the second day of February, one thousand nine hundred
ninety-five first day of July, 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, and the rate shall not be affected by the
amendment and reenactment of this section during the regular session of the
Legislature in the year one thousand nine hundred ninety-five.



(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 such a position is available to be offered,
then 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 finger shall be considered a thirty-two percent
disability.



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



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



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



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



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



The loss of middle, ring and little finger 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
division 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 division commission, using as a basis the
total loss of hearing in both ears.



Should a claimant sustain a compensable injury which results in the total
loss by severance of any of the bodily members named in this subdivision, die
from sickness or noncompensable injury before the division commission makes the
proper award for such injury, the division commission shall make such award to
claimant's dependents as defined in this chapter, if any; such 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 such claimant
after his or her remarriage, and that this liability shall not accrue to the
estate of such claimant and shall not be subject to any debts of, or charges
against, such estate.



(g) Should a claimant to whom has been made a permanent partial award die
from sickness or noncompensable injury, the unpaid balance of such award shall
be paid to claimant's dependents as defined in this chapter, if any; such 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 such
claimant after his or her remarriage, and that this liability shall not accrue
to the estate of such claimant and shall not be subject to any debts of, or
charges against, such estate.



(h) For the purposes of this chapter, a finding of the occupational
pneumoconiosis board shall have 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 division 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 shall be
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
such date, and to all applications for an award of permanent partial disability
that were pending before the division commission or pending in litigation but not
yet submitted for decision on and after such date. The prior provisions of this
subdivision shall remain in effect for all other claims.



(j) From a list of names of seven persons submitted to the commissioner
executive director by the health care advisory panel, the commissioner executive
director shall appoint an interdisciplinary examining board consisting of five
members to evaluate claimants, including by examination if the board so 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 commissioner
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:
Provided, That two of the persons initially appointed shall serve a term of six
years, two of the remaining persons shall serve a term of four years and the
remaining member shall serve a term of two years. 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 commissioner executive director, from time to time,
shall fix the compensation to be paid to each member of the board, and the
members shall also be 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 as assigned by the provisions
of this chapter, consistent with the administrative policies developed by the
commissioner executive director with the assistance approval of the compensation
programs performance council board of managers.



(1) The executive director shall establish requirements for the proper
completion and support for an application for permanent total disability 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 no issue of permanent total
disability shall be referred to the interdisciplinary examining board unless a
properly completed and supported application for permanent total disability has
been first filed with the commission. Prior to the referral of any issue to the
interdisciplinary examining board, the division commission shall conduct such
examinations of the claimant as 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 division 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 shall be entitled to have the claimant examined
by medical specialists and vocational rehabilitation specialists: Provided, That
the employer is entitled to only one such examination on each issue present in
a given claim. Any additional examinations must be approved by the division
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 such additional
information as the board may deem necessary. Both the claimant and the employer,
as well as the division commission, may submit reports from experts challenging
or supporting the other reports in the record regardless of whether or not such
an the expert examined the claimant or relied solely upon the evidence of record.



(2) If the board or a quorum thereof elects to examine a claimant, the
individual members shall conduct such examinations as 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 compensation programs performance council 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, then the council board of managers may
authorize the commissioner executive director to appoint such additional members
to the board as may be necessary to reduce the backlog of applications. Such The
additional members shall be recommended by the health care advisory panel. and
the commissioner The executive director may make such any appointments as he or
she chooses from the recommendations. The additional board members shall not
serve a set term but shall serve until the council 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 therefor. Copies of the reports of all such examinations made by the
board shall be served upon the parties and the division commission. and each 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 division
commission in writing with an explanation for each such recommendation setting
forth the reasons for each. The recommendations shall be served upon the parties
and the division 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 then review any such responses and issue its final recommendations.
The final recommendations shall then be effectuated by the entry of an
appropriate order by the division commission. For all awards for permanent
partial disability where the injury occurred on or after the first day of July,
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 that results in a
finding of permanent total disability was filed with the commission pursuant to
subdivision (1), subsection (j), section six of this section



(6) Except as noted below, objections pursuant to section one, article five
of this chapter to any such order shall be limited in scope to matters within the
record developed before the workers' compensation division 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. Should either party
contend 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 such
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
such comments as if the board chooses within sixty days of the board's receipt
of the report. The board may then either supply such comments or, at the board's
discretion, request that the claim be remanded to the board for further review
by the board. If remanded, the claimant is not required to submit to further
examination by the employer's medical specialists or vocational rehabilitation
specialists. Following any such 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, such 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 comment comments, the administrative law judge
shall then 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 division 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 then 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 thereto 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
such the injured employee if there be such 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, with a date of last exposure on and after the second
first day of February July, one thousand nine hundred ninety-five two thousand
three, and for all requests for such an award pending before the division
commission on and after the second day of February July, one thousand nine
hundred ninety-five, a claimant must have been awarded the sum of forty fifty
percent in prior permanent partial disability awards, have suffered an
occupational injury or disease which results in a finding that the claimant has
suffered a medical impairment of forty fifty percent or has sustained a thirty-five percent statutory disability pursuant to the provisions of subdivision (f)
of this section. Upon filing such an application, the claim will be reevaluated
by the examining board pursuant to subdivision (i) of this section to determine
if he or she has suffered a whole body medical impairment of forty 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 forty 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 forty fifty percent or has sustained a thirty-five
percent statutory disability pursuant to the provisions of subdivision (f) of
this section, then the request shall be denied. Upon a finding that the claimant
does have a forty 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, then the review of the application shall
continue 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 forty fifty percent or have sustained a thirty-five percent statutory
disability pursuant to the provisions of subdivision (f) of this section shall
then be entitled to the rebuttable presumption created pursuant to subdivision
(d) for the remaining issues in the request. For the purposes of determining
whether the claimant should be awarded permanent total disability benefits under
the second injury provisions of subsection (d), section one, article three of
this chapter, only a combination of occupational injuries and occupational
diseases, including occupational pneumoconiosis, shall be considered.



(2) A disability which renders the injured employee unable to engage in
substantial gainful activity requiring skills or abilities 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. For all awards for permanent total
disability where the date of injury or last exposure to an occupational disease
was on or after the first day of July, two thousand three, a person will be
considered to be permanently and totally disabled within the context of this
chapter if that person has not voluntarily retired from the work force, and after
achieving maximum medical improvement from an injury or disease covered by this
chapter is incapable of returning to gainful employment due to the residuals of
that injury or disease, or due to the combined effects of that injury or disease
and prior injuries or diseases that are also covered by this chapter. Gainful
employment is work for which a person has or can acquire the skills or abilities
necessary for its performance and which will result in the payment of a wage or
salary that is equal to or greater than the claimant's earnings prior to the
injury. In addition, the vocational standards adopted pursuant to subsection
(m), section seven, article three, chapter twenty-one-a of this code shall be
considered once they are effective.



(3) In the event that a claimant, who has been found to have at least a
forty 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 then accepts and continues to work at a lesser paying job
than he or she previously held, then such a the claimant shall be eligible,
notwithstanding the provisions of section nine of this article, to receive
temporary partial rehabilitation benefits for a period of four years. Such 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
such the benefits exceed one hundred percent of the average weekly wage in West
Virginia. In no event shall such the benefits be subject to the minimum benefit
amounts required by the provisions of subdivision (b) of this section.




(4) It is the intent of the Legislature that the amendments to this section
enacted during the regular session of the Legislature in the year one thousand
nine hundred ninety-nine which change criteria for an award of permanent total
disability benefits be applied retroactively to all injuries incurred and all
occupational diseases, including occupational pneumoconiosis, with a date of last
exposure on and after the second day of February, one thousand nine hundred
ninety-five, and for all requests for such an award pending before the division
on and after the second day of February, one thousand nine hundred ninety-five:
Provided, That any claimant whose application for permanent total disability
benefits was rejected on or after the second day of February, one thousand nine
hundred ninety-five, based on a finding that the claimant: (1) Was not awarded
the sum of fifty percent in prior permanent partial disability awards; or (2) did
not suffer an occupational injury or occupational disease which resulted in a
finding that the claimant has suffered a medical impairment of fifty percent; or
(3) did not suffer whole body medical impairment of at least fifty percent, then
such claimant may, during the period beginning on the first day of July, one
thousand nine hundred ninety-nine, and ending on the thirtieth day of September,
one thousand nine hundred ninety-nine, file with the division a petition for
reconsideration of the denial of permanent total disability benefits. After
review of the petition by the division and the examining board, the division
shall enter an appropriate order on the claimant's petition for reconsideration.
§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 shall be determined by the degree of medical impairment that
is found by the occupational pneumoconiosis board. The division 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 shall be
the final decision of the division commission for purposes of section one,
article five of this chapter. If such 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 shall be
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 if it
shall be determined by the division in accordance with the facts in the case and
with the advice and recommendation of the occupational pneumoconiosis board that
an employee has occupational pneumoconiosis, but without measurable pulmonary
impairment therefrom, such employee shall be awarded and paid twenty weeks of
benefits at the same benefit rate as hereinabove provided. for any employee who
applies for occupational pneumoconiosis benefits, whose last exposure to the
hazards of occupational pneumoconiosis was on or after the first day of July, 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 such benefits sections
eleven to fourteen, inclusive, of this article shall 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 and sections two, three,
four and five, article five of this chapter providing for the further adjustment
of claims shall be 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 so obtained shall then 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
shall be 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 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;



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



(d) No permanent partial disability benefits shall be granted for
impairment of speech discrimination other than that compensated for by
application of the formulas specified in subdivisions (b) and (c) of this
section, or 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 so 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



















Partial





% of Speech Discrimination 



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, and
the commissioner The commission shall allocate to and divide any charges
resulting from such the claim among such 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
shall be based upon the time of exposure with each employer. In determining the
allocation, the commissioner commission shall consider all the time of employment
by each employer during which the claimant was so exposed and not just the time
within such the three-year period, under the same allocation as is applied in
occupational pneumoconiosis cases.



(h) The commissioner commission shall provide, consistent with current
practice, for prompt referral of such 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 the
article insofar as applicable to permanent partial disabilities for hearing loss
shall be 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 all
such 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:







(1) Until the first day of July, one thousand nine hundred ninety-four,
based upon the average gross pay, wherever earned, which is received by the
employee during the two months, six months or twelve months immediately preceding
the date of the injury, whichever is most favorable to the injured employee; or



(2) On and after the first day of July, one thousand nine hundred ninety-
four, 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 commissioner commission pursuant to
section eleven, article ten, chapter twenty-one-a of this code 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
commissioner 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 such a part-time employee, the average weekly wage shall be computed by
multiplying such 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 division 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 division commission and their employers; that the division 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 division 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 division 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 division commission, the employer or to the employer's
representative. Whenever a copy of any such medical report is obtained by the
employer or its representative and the physician has not also forwarded a copy
of the same to the division commission, the employer shall forward a copy of such
the medical report to the division commission within ten days from the date such
the employer received the same from such 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 temporary total disability 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 division 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 division 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 so established for the injury involved shall be reviewed by
the division commission. If satisfied, after reviewing the medical evidence,
that the claimant would not benefit by an independent medical evaluation, the
division commission shall mark the claim file accordingly and shall diary such
the claim file as to the next date for required review which shall not exceed
sixty days. If the division commission concludes that the claimant might benefit
by an independent medical evaluation, the division 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, such 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 shall govern and control:



(1) If the authorized treating physician recommends a permanent partial
disability award of fifteen percent or less, the division commission shall enter
an award of permanent partial disability benefits based upon such the
recommendation and all other available information., and the The claimant's
entitlement to temporary total disability benefits shall cease upon the entry of
such 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 shall cease upon the receipt by the division commission of such the
report. and the division The commission shall refer the claimant to a physician
or physicians of the division's 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 then 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, and which The amount of
such benefits paid prior to the receipt of such the independent evaluation report
shall be considered and deemed to be payment of the permanent disability award
then granted, if any. In the event that benefits actually paid exceed the amount
granted by the permanent partial disability award, the claimant shall be entitled
to no further benefits by such the award but shall not be liable by offset or
otherwise for the excess paid.



(d) When the division 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 division
commission shall refer the claimant to a physician or physicians of the
division's commission 's selection for examination and evaluation. If the
physician or physicians so selected recommend continued, additional or different
treatment, the recommendation shall be relayed to the claimant and the claimant's
then treating physician and the recommended treatment may be authorized by the
division commission.



(e) Notwithstanding any provision in subsection (c) of this section, the
division 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 division commission
conclude that the claimant has reached his or her maximum degree of improvement;
or



(2) When the authorized treating physician shall advise the division
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; or



(3) When other evidence submitted to the division commission justifies a
finding that the claimant has reached his or her maximum degree of improvement:
Provided, That in all cases a finding by the division commission that the
claimant has reached his or her maximum degree of improvement shall terminate the
claimant's entitlement to temporary total disability benefits regardless of
whether the claimant has been released to return to work: Provided, however,
That 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 then 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 division commission, or until the claimant returns
to work. and which The amount of benefits shall be considered and deemed to be
payment of the permanent disability award then granted, if any. In the event
that benefits actually paid exceed the amount granted under the permanent
disability award, the claimant shall be entitled to no further benefits by such
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 shall continue 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 division commission under other provisions of this chapter),
the division commission shall refer the claimant to a physician or physicians of
the division 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 shall be 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 division 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 should the
claimant refuse without good cause, to undergo the examinations provided for in
this section until the claimant submits to the examination.
§23-4-8. Physical examination of claimant.
The commissioner commission shall have authority, after due notice to the
employer and claimant, whenever in the commissioner's commission's opinion it
shall be necessary, to 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 commissioner commission; and the claimant
and employer, respectively, shall 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 such the examination. All such
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 commissioner commission. The
respective physicians selected by the claimant and employer shall have the right
to concur in any report made by the medical examiner or examiners selected by the
commissioner commission, or each may file with the commissioner commission a
separate report, which separate report shall be considered by the commissioner
commission in passing upon the claim. If the compensation claimed is for
occupational pneumoconiosis, the commissioner commission shall have the power,
after due notice to the employer, and whenever in the commissioner's commission's
opinion it shall be necessary, to order a claimant to appear for examination
before the occupational pneumoconiosis board hereinafter provided. In any case
the claimant shall be entitled to reimbursement for loss of wages, and to
reasonable traveling and other expenses necessarily incurred by him or her in
obeying such 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 such the examination or examinations, not to exceed
the expenses paid when a claimant is examined by a physician or physicians
selected by the commissioner 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 commissioner 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., and two Two of them shall be roentgenologists. One
of the board shall be designated annually as chairman by the commissioner
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 commissioner 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 commissioner executive director shall from time to time fix the compensation
to be paid each member of the board., and members 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 commissioner 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
compensation programs performance council 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
commissioner 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 such board at a time and place stated in the notice. If the
employee be living, he or she shall appear before the board at the time and place
specified and submit to such examination, including clinical and X-ray
examinations, as the board may require. If a physician licensed to practice
medicine in the state shall make affidavit that the employee is physically unable
to appear at the time and place designated by the board, such 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 be 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 shall so
direct. When in the opinion of the board an autopsy is deemed necessary
accurately and scientifically to ascertain and determine the cause of death, such autopsy examination shall be ordered by the board, which shall designate a duly
licensed physician, a pathologist, or such other specialists as may be deemed
necessary by the board, to make such examination and tests to determine the cause
of death and certify his or her or their written findings, in triplicate, to the
board, which findings shall be public records. In the event that a claimant for
compensation for such death refuses to consent and permit such autopsy to be
made, all rights for compensation shall thereupon be 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
commissioner commission, of its findings and conclusions on every medical
question in controversy and the commissioner commission shall send one copy
thereof to the employee or claimant and one copy to the employer., and the The
board shall also return to and file with the commissioner commission all the
evidence as well as all statements under oath, if any, of the persons who appear
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 such the claimant or deceased employee has sustained a chronic respiratory disability, then it shall be presumed that such the claimant is
suffering or such 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 shall not be 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.



(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 such findings and
conclusions of the board, such the party shall file with the commissioner
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 such
copy to such party, unless for good cause shown, the commissioner commission or
chief administrative law judge extends such time, such party's objections thereto
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 hereby declared to be a condition of the right to litigate such
findings and hence jurisdictional. After the time has expired for the filing of
objections to the findings and conclusions of the board, the commissioner
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 therein stated. If objection has been filed to the findings and
conclusions of the board, notice thereof shall be given to the board, and the
members thereof joining in such findings and conclusions shall appear at the time
fixed by the commissioner commission or office of judges for the hearing to
submit to examination and cross-examination in respect to such findings and
conclusions. At such 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, then such 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 deemed 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 workers 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 shall be a priority of the commissioner commission to
achieve early identification of individuals likely to need rehabilitation
services and to assess the rehabilitation needs of these injured employees. It
shall be the goal of rehabilitation to return injured workers employees to
employment which shall be 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 shall be 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 commissioner 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 in excess of one
hundred twenty days, and such fact has been determined by the commissioner
commission, the commissioner 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 commissioner
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 will assist the
employee return to remunerative employment, the commissioner commission shall
forthwith develop a rehabilitation plan for the employee and, after due notice
to the employer, expend such an amount as may be necessary for the aforesaid
purposes: Provided, That such expenditure for vocational rehabilitation shall
not exceed ten 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 commissioner commission prior
to the rendering of such 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 such treatment: Provided further, That payment for
physical rehabilitation, including the purchase of prosthetic devices and other
equipment and training in use of such devices and equipment, shall be considered
expenses within the meaning of section three of this article and shall be subject
to the provisions of sections three, three-a, three-b and three-c of this
article. The provision of any rehabilitation services shall be pursuant to a
rehabilitation plan to be developed and monitored by a rehabilitation
professional for each injured employee.



(c) In every case in which the commissioner commission shall order orders
physical or vocational rehabilitation of a claimant as provided herein, 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 thereof, be compensated on a temporary total
disability basis for such 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 such the calculation is performed for
temporary total disability benefits, subject to the following limitations: In
no event shall such benefits be subject to the minimum benefit amounts required
by the provisions of subdivision (b), section six of this article, nor shall such
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.
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 such
change has occurred, the amount of benefits payable hereunder 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.



(e) The commissioner executive director in conjunction with the board of
managers shall promulgate 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. Such rules shall provide definitions for
rehabilitation facilities and rehabilitation services pursuant to this section.




(f) The reenactment of the provisions of this section during the regular
session of the Legislature in the year one thousand nine hundred ninety-nine is
for the purpose of reestablishing the rehabilitation program heretofore created
by virtue of the provisions of this section and the rules promulgated pursuant
thereto for all injured employees who sustained injuries on or after the first
day of July, one thousand nine hundred ninety-eight. To this end, the performance
council is directed to reenact the rules promulgated under the prior enactment
of this section within fifteen days of the effective date hereof and the
commissioner shall promulgate any revisions to the rules for review by the
performance council on or before the first day of July, one thousand nine hundred
ninety-nine.
§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 such the employee shall thereafter receive an injury in the
course of and resulting from his or her employment, unless such the subsequent
injury results in total permanent disability within the meaning of section one,
article three of this chapter, such impairment the prior injury, and the effect
thereof, and an aggravation thereof, shall not be taken into consideration in
fixing the amount of compensation allowed by reason of such the subsequent
injury. , and such compensation Compensation shall be awarded only in the amount
that would have been allowable had such the employee not had such the preexisting
impairment. Nothing in this section shall be construed to require that the degree of such preexisting impairment be definitely ascertained or rated prior
to the injury received in the course of and resulting from such the employee's
employment or that benefits must have been granted or paid for such the
preexisting impairment. The degree of such the preexisting impairment may be
established at any time by competent medical or other evidence. Notwithstanding
the foregoing provisions of this section, if such the definitely ascertainable
preexisting impairment resulted from an injury or disease previously held
compensable and such the impairment had not been rated, benefits for such 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
from the second injury reserve created by section one, article three of this
chapter 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 date of
such injury until 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 be no dependents, the disbursements shall be limited to the
expense provided for in sections three and four of this article.







(b) If there be dependents as defined in subdivision (d) of this section,
such the dependents shall be paid for as long as their dependency shall continue
in the same amount as 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 such the widow or widower, and any child or children dependent upon the decedent until
each such child shall reach reaches eighteen years of age or where such 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 such
the child reaches the age of twenty-five years or if an invalid child to continue
as long as such the child remains an invalid. All such persons shall be jointly
entitled to the amount of benefits payable as a result of employee's death.



(2) A wholly dependent father or mother until death.



(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 such the portion of the period of six years
after the death, as the division commission may determine, but no such partially
dependent person shall receive compensation payments as a result of the death of
more than one employee.



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



(d) "Dependent", as used in this chapter, shall mean a widow, widower,
child under eighteen years of age, or under twenty-five years of age when a full-
time student as provided herein, invalid child or posthumous child, who, at the
time of the injury causing death, is dependent, in whole or 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 herein,
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
herein, 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.



(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 such 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. Direct premium
rating experience charges for the payment of such benefits granted as a result
of a second injury award of permanent total disability shall not be made to the
employee's employer. It is the intent of the Legislature that the amendments to
this subsection enacted during the regular session of the Legislature in the year
one thousand nine hundred ninety-nine be construed so as to make dependents
eligible for benefits under this subsection retroactive to the second day of
February, one thousand nine hundred ninety-five.
§23-4-11. To whom death benefits paid.



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



The dependent or person to whom benefits are paid shall apply the same to
the use of the several beneficiaries thereof according to their respective claims
upon the decedent for support, in compliance with the finding and direction of
the commissioner 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 commissioner 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" shall be 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 commissioner 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 commissioner commission pursuant to
section eleven, article ten, chapter twenty-one-a of this code 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, shall be the average weekly wage in West Virginia as
determined by the commissioner commission in accordance with the provisions of
sections ten and eleven, article six, chapter twenty-one-a of this code
subsection (b), section two, article two of this chapter, 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 therein in effect on the date of such injury.
If during the life of such award for temporary total, permanent partial or
permanent total disability benefits or for dependent benefits, the weekly rates
or the monthly amount in the case of dependent benefits are increased or
decreased, the claimant shall receive such increased or decreased benefits
beginning as of the effective date of said increase or decrease.
§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 therefor must be made on the form or
forms prescribed by the division commission and filed with the division
commission within six months from and after the injury or death, as the case may
be, and unless so filed within such the six month 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 hence jurisdictional,
and all proofs of dependency in fatal cases must likewise be filed with the
division commission within six months from and after the death. In case the
employee is mentally or physically incapable of filing such 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 hereof, the application therefor must be made on the form
or forms prescribed by the division commission and filed with the division
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 the
employee's occupational pneumoconiosis was made known to him or her by a
physician or which he or she should reasonably have known, whichever shall last
occur, and unless so filed within such 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 hence jurisdictional,
or, in the case of death, the application shall be filed as aforesaid by the
dependent of such employee within one year from and after such 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 hereof, the application therefor must be made on the form or forms prescribed by the division commission
and filed with the division 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 shall last occur, and unless so filed within such 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 hence jurisdictional, or, in case of death, the application shall be filed
as aforesaid by the dependent of such employee within one year from and after
such 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 shall be entitled to the same benefits as citizens of the United
States: Provided, however, That the commissioner commission in his its
discretion may make, and such beneficiary shall be required to accept,
commutation of such benefits into a lump sum settlement and payment. Nonresident
alien beneficiaries within the meaning hereof shall mean 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 be 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 division
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 thereto and
whether the claimant was exposed to such hazard over a period of not less than
ten years during the fifteen years immediately preceding the date of his or her
last exposure thereto. If a claim for occupational pneumoconiosis benefits be
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 or
otherwise should have reasonably been known to the employee, the division
commission shall determine whether the claimant filed his or her application
within said that period and 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 last exposure thereto and
whether the claimant was exposed to such hazard over a period of not less than
ten years during the fifteen years immediately preceding the date of last
exposure thereto. If a claim for occupational pneumoconiosis benefits be filed
by a dependent of a deceased employee, the division 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 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 thereto and whether
the claimant was exposed to such hazard over a period of not less than ten years
during the fifteen years immediately preceding the date of his or her last
exposure thereto. The division commission shall also determine such other
nonmedical facts as may in the division's commission 's opinion be pertinent to a decision on the validity of the claim.



The division commission shall enter an order with respect to such
nonmedical findings within ninety days following receipt by the division
commission of both the claimant's application for occupational pneumoconiosis
benefits and the physician's report filed in connection therewith, and shall give
each interested party notice in writing of these findings with respect to all
such nonmedical facts. and such The findings and such actions of the division
commission shall be final unless the employer, employee, claimant or dependent
shall, within thirty days after receipt of such the notice, object to such
findings, and unless an objection is filed within such the thirty-day period,
such the findings shall be forever final, such the time limitation being hereby
declared to be a condition of the right to litigate such findings and hence
jurisdictional. Upon receipt of such 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 such the findings by the employer, the
claim shall, notwithstanding the fact that one or more hearings may be held with
respect to such 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. , which
The final order shall be 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 such 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 division commission over each case
shall be continuing and the division commission may, in accordance with the
following provisions and after due notice to the employer, make such
modifications or changes with respect to former findings or orders as may be
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 such date
shall be determined by the following paragraphs of this subsection. Any such
request that is made beyond such 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 such request must be made within five years of the
closure. During that time period, only two such requests may be filed.



(2) Except as stated below, in any claim in which an award of permanent
disability was made, any such request must be made within five years of the date
of the initial award. During that time period, only two such 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 division commission, then a new five-year period
shall begin upon the date of the subsequent award. With the advice of the health
care advisory panel, the commissioner and the compensation programs performance
council 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 wherein 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, then no request for additional medical
or any type of rehabilitation benefits shall be granted nor shall any such
medical or any type of rehabilitation benefits or any type of goods or supplies
be paid for by the division commission if such were provided without a prior
request. For the exclusive purposes of this paragraph, 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 shall make application for
a further period of temporary total disability, if such the application be is in
writing and filed within the applicable time limit stated above, then the
division commission shall pass upon the request within thirty days of the receipt
of the request. If the decision is to grant the request, then the order shall
provide for the receipt of temporary total disability benefits. In any case in
which an injured employee shall make makes application for a further award of
permanent partial disability benefits or for an award of permanent total
disability benefits, if such the application be is in writing and filed within
the applicable time limit as stated above, the division commission shall pass
upon the request within thirty days of its receipt and, if the division
commission determines that the claimant may be entitled to an award, the division
commission will then refer the claimant for such further examinations as may be
necessary.



(c) If such the application is based on a report of any medical examination
made of the claimant and submitted by the claimant to the division 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 such the examination. Such The reimbursement
shall be made by the division commission to the claimant, in addition to all
other benefits awarded, upon due proof of the amount thereof being furnished the
division commission by the claimant, but shall in no case exceed the sum fixed
pursuant to the division's commission 's schedule of maximum reasonable fees
established under the provisions of section three of this article.



(d) The division commission shall have 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 division 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: Provided, That such reopenings shall not be
done sooner than every two years: Provided, however, That any individual
claimant shall only be reevaluated a total of two times after which he or she may
not be again reevaluated under the provisions of this subsection. The division
commission may reopen a claim for reevaluation when, in the division's 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: Provided further, That if a permanent total
disability award was made on or after the eighth day of April, one thousand nine
hundred ninety-three, and on or before the second day of February, one thousand
nine hundred ninety-five, the eligibility requirements for the claimant upon a
reopening shall be the eligibility requirements which applied to his or her claim
at the time the award was made. This section shall not be applicable to any claim in which the final decision on the eligibility of the claimant to a
permanent total disability award was made more than ten years prior to the date
of proposed reevaluation.



(2) Upon reopening a claim under this subsection, the division 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 such any information to the division commission as
the employer may elect. In the event the claimant retains his or her award
following the reevaluation, then the claimant's reasonable attorneys' fees
incurred in defending the award shall be paid by the workers' compensation
division commission from the supersedeas reserve of the surplus fund. In
addition, the workers' compensation division 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 such the reimbursement being
made from the supersedeas reserve of the surplus fund. The compensation programs
performance council 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 division's commission 's final order as otherwise provided for
in article five of this chapter for review of orders granting or denying
permanent disability awards.



(e) A claimant may have only one active request for a permanent disability
award pending in a claim at any one time. Any new such 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 July one, one
thousand nine hundred seventy-one, and a protest is filed thereto or an appeal
is taken therefrom by an employer only and not by the claimant or dependent and
the award is not ultimately denied or reduced following such protest or appeal,
the commissioner commission shall add thereto interest at the simple rate of six
percent per annum from the date the award would have been payable had such
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 such the employer.
§23-4-17. Commutation of periodical benefits.



The commissioner commission, under special circumstances and when the same
it is deemed 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, such dependent residing in
the territorial limits of the United States at the time of the decedent's death,
and desiring to reside permanently beyond such the territorial limits of the
United States, the commissioner commission may commute into one lump-sum payment
the periodical payments to which such 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., and such The lump-sum
payment at the rate aforesaid shall discharge all liability with respect of said
to the award, but in no event shall such the award be paid until such the claimant or dependent shall have actually arrived and domiciled himself or
herself outside the territorial limits of the United States, except a sufficient
portion of said 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 such
employees or their dependents, and shall be 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
such periodic installments as determined by the division 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 thereof shall be calculated and
paid from the date of disability.
§23-4-20. Postmortem examinations.



The commissioner commission shall have authority, after due notice to the
employer and claimant, whenever he shall deem it deems it necessary, to order an
autopsy, and may designate a duly licensed physician to make such postmortem
examination or examinations as may be necessary to determine the cause of the
deceased employee's death., and such The physician shall file with the
commissioner commission a written report of his or her findings.; the The
claimant and the employer respectively, shall have the right to select a
physician of his, her or its own choosing and at his or her or its own expense,
to participate in the postmortem examination., and the The respective physicians selected by the claimant and the employer shall have the right to concur in any
report made by the physician selected by the commissioner commission, or each may
file with the commissioner commission a separate report. In any case, including
silicosis cases, in which either the employer or a claimant requests that an
autopsy be performed, then such the autopsy shall be directed as hereinbefore
provided., and in In the event that a claimant for compensation for such death
refuses to consent and permit such 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 closure 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 such an evaluation has not heretofore been conducted and a
decision on permanent disability has not been made: Provided, That if a request
for an evaluation was made in such a claim prior to the twenty-ninth day of
March, one thousand nine hundred ninety-three, the commissioner commission shall
have such the evaluation performed. In every such instance, such 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
commissioner 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 therefor.



(b) Whenever applicable benefits are paid to a beneficiary with respect to
the same time period for which old-age insurance benefit payments under the
Social Security Act, 42 U.S.C. 401 and 402, or 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, then such
applicable benefits shall be reduced by these amounts:




(1) Fifty percent of the amount of full old-age insurance benefits received
or being received under the Social Security Act: Provided, That if the claimant
is receiving reduced old-age retirement benefits, then ten percent of the amount
of old-age social security insurance benefits, had such benefits not been
reduced, shall be deducted from the applicable benefits: Provided, however, That
social security disability benefits shall not be deducted from the applicable
benefits when such disability benefits are later changed to old-age insurance
benefits upon the claimant's attaining the age specified for such conversion by
the social security administration;




(2) (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




(3) (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) The commissioner shall notify a claimant or self-insured employer of
possible eligibility for social security benefits and the requirements for
establishing proof of application for those benefits. Notification shall be
promptly mailed by the commissioner or self-insured employer to the claimant
after the date on which by reason of age the claimant may be entitled to social
security benefits. A self-insured employer shall file a copy of any such notice
of possible eligibility with the commissioner within ten days of its mailing to
the claimant.



(1) Within thirty days after the receipt of the notification of possible
eligibility, the claimant shall:



(A) Make application for social security benefits;



(B) Provide the commissioner or a self-insured employer with proof of that
application; and



(C) Provide the commissioner or self-insured employer with an authorization
for release of information which shall be utilized by the commissioner or self-
insured employer to obtain necessary benefit entitlement and amount information
from the social security administration. The authorization for release of
information shall be effective for one year.



(2) Failure of the claimant to provide the proof of application or
authorization for release of information shall allow the commissioner or self-
insured employer with the approval of the commissioner to discontinue the payment
of applicable benefits until the proof of application and the authorization for
release of information is provided. Compensation benefits withheld shall be reimbursed to the claimant upon the providing of the required proof of
application or the authorization for release of information, or both.



(d) If the commissioner or the self-insured employer is required to submit
a new authorization for release of information to the social security
administration in order to receive information necessary to comply with this
section, the claimant shall provide the new authorization for release of
information within thirty days of a request by the commissioner or self-insured
employer. Failure of the claimant to provide the new authorization for release
of information shall allow the commissioner or self-insured employer with the
approval of the commissioner to discontinue the payment of applicable benefits
until the authorization for release of information is provided. Compensation
benefits withheld shall be reimbursed to the claimant upon the providing of the
authorization for release of information.



(e) Within thirty days after either the date of first payment of benefits
or after the date of application for any benefit under subsection (b) of this
section, whichever is later, the claimant shall provide the commissioner or self-
insured employer with a properly executed authorization for release of
information which shall be utilized by the commissioner or self-insured employer
to obtain necessary benefit entitlement and amount information from the
appropriate source. The authorization for release of information shall be
effective for one year. Failure of the claimant to provide a properly executed
authorization for release of information shall allow the commissioner or self-
insured employer with the approval of the commissioner to discontinue the payment
of applicable benefits until the authorization for release of information is
provided. Compensation benefits withheld shall be reimbursed to the claimant
upon the providing of the authorization for release of information. If the
commissioner or the self-insured employer is required to submit a new
authorization for release of information to the appropriate source in order to receive information necessary to comply with this section, the claimant shall
provide the new authorization for release of information within thirty days of
a request by the commissioner or self-insured employer. Failure of the claimant
to provide the new authorization for release of information shall allow the
commissioner or self-insured employer with the approval of the commissioner to
discontinue the payment of applicable benefits until the authorization for
release of information is provided. Compensation benefits withheld shall be
reimbursed to the claimant upon the providing of the authorization for release
of information.



(f) Any benefit payments under the Social Security Act, or any fund, policy
or program as specified under subsection (b) of this section which the claimant
receives after the effective date of this section and during a period in which
the claimant also receives unreduced workers' compensation benefits shall be
considered to create an overpayment of benefits for that period. The commissioner
or self-insured employer shall calculate the amount of the overpayment and send
a notice of overpayment and a request for reimbursement to the claimant. Failure
by the claimant to reimburse the commissioner or self-insured employer within
thirty days after the mailing date of the notice of request for reimbursement
shall allow the commissioner or the self-insured employer, with the approval of
the commissioner, to discontinue fifty percent of future benefits payments. The
benefit payments withheld shall be credited against the amount of the
overpayment. Payment of the appropriate benefit shall resume when the total
amount of the overpayment has been withheld. Any self-insured employer taking
a credit or making a reduction as provided for in this subsection shall
immediately report to the commissioner the amount of the credit or reduction and,
as requested by the commissioner, furnish to the commissioner satisfactory proof
of the basis for a credit or reduction.



(g) Nothing in this section shall be considered to compel a claimant to apply for early federal social security old-age benefits or to apply for other
early or reduced benefits.




(k)




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




(i) (d) The commissioner and the compensation programs performance council
executive directors shall promulgate the appropriate rules for the
interpretation, processing and enforcement of this section.




(j) (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 such
applications of the section as are not unconstitutional or in such 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 or of 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 such claimant
shall be evaluated only for the purposes of receiving a permanent partial
disability award premised solely upon the claimant's impairments. This subsection
shall not be 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 shall not be permitted to produce additional evidence of permanent total disability before the
division commission or the office of judges nor shall such a claim be remanded
for the production of such evidence.




(b) For the purposes of subdivisions (d) and (n), section six of this
article, the award of permanent partial disability benefits under the provisions
of section six-b of this article or under that portion of section six-a of this
article which awards twenty weeks of benefits to a claimant who has occupational
pneumoconiosis but without measurable pulmonary impairment therefrom shall not
be counted towards the eighty-five percent needed to gain the rebuttable
presumption of permanent total disability or towards the fifty percent threshold
of paragraph (1), subdivision (n), section six of this article when such claimant
has terminated active employment and is receiving federal nondisability pension
or retirement benefits, including old-age benefits under the Social Security Act.
This subsection shall not affect any other awards of permanent partial disability
benefits and their use in achieving the rebuttable eighty-five percent
presumption or the fifty percent threshold.




(c) (b) The workers' compensation division commission shall have 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 division 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 such a claim only after the division 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 such benefits were awarded. This section is
not applicable to the receipt of medical benefits or the payment therefor, 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 division commission shall give
the claimant notice of the effect of this section upon a claimant's award if and
when such 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 such 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, then such 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 WORKMEN'S RELIEF FUND.
§23-4A-1. Disabled workmen's 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 July one, one
thousand nine hundred seventy-three, there is hereby created a separate fund to
be known as the "Disabled Workmen's Relief Fund," which fund shall consist of
such sums as are from time to time made available to carry out the objects and
purposes of this article. Said fund shall be in the custody of the state
treasurer and disbursements therefrom shall be made upon requisition signed by
the commissioner executive director to those persons entitled to participate
therein and in such amounts to each participant as is provided in section three
of this article.
§23-4A-3. Computation of benefits.



Each individual entitled to participate in the disabled workers' relief
fund shall be entitled to receive payments without application (except that an
application shall be required under section five of this article) from said the
fund of an amount equal to the difference between the amounts set forth in
section one of this article, and the amount said the individual is in fact
receiving by virtue of and under the laws of this state. The first such 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 such
participant shall be 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 commissioner executive director shall promptly require of each employer
who has elected to pay direct compensation direct under the provisions of section
nine, article two of this chapter a verified list of the names and addresses of
all persons to whom such the employer is paying workers' compensation on account
of permanent total disability or because of the death of an employee and such any
evidence respecting such persons as the commissioner executive director may
reasonably consider necessary to determine the eligibility of any such person to
participate in the disabled workers' relief fund. Any person claiming the right
to participate in said fund under the provisions of this section may file his or
her application therefor with the commissioner executive director and shall be
accorded a hearing thereon.
§23-4A-6. Powers of commission over disabled workmen's relief fund.
In the investigation and determination of the right of persons to
participate in the disabled workmen's relief fund, the commissioner executive
director shall have and 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 shall be continuing, but there shall be no appeal from his the commission's
decisions to any other body or tribunal. No attorney, representative or agent of
any claimant or participant shall be 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 said the disabled
workmen's relief fund.
§23-4A-7. Employees to administer disabled workmen's relief fund; payment of
salaries.



The commissioner executive director shall employ such employees as may be
necessary to discharge his or her duties and responsibilities under this article.
The salaries and expenses of such the employees shall be paid by the treasurer
of the state from the disabled workmen's relief fund upon vouchers authorized and signed as provided in section two, article one of this chapter.
§23-4A-8. Disabled workers' relief fund; how funded.



For the purpose of carrying out the provisions of this article, the
commissioner 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 article two, section nine, an amount estimated by the
commissioner executive directors to be necessary to carry out the provisions of
this article for one year.



Such money shall be deposited by the commissioner 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 hereby established 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 thereto 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 such the fund to ensure the payment of benefits required by such the
act.



The state treasurer shall be the custodian of the coal-workers'
pneumoconiosis fund, and all premiums, deposits or other moneys paid thereto
shall be deposited in the state treasury to the credit of the coal-workers'
pneumoconiosis fund. Disbursements from such the fund shall be made upon
requisition signed by the commissioner executive director of the workers'
compensation commission to those persons entitled to participate therein. The West Virginia state board of investments shall have authority to 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 commissioner executive director shall
disburse the coal-workers' pneumoconiosis fund in such the amounts and to such
the persons as said the order shall direct.
§23-4B-6. Coal-workers' pneumoconiosis fund; how funded.



For the purpose of creating the coal-workers' pneumoconiosis fund, each
employer, who shall elect elects to subscribe to such the fund, shall pay
premiums based upon and being such a percentage of the payroll of such the
employer as the commissioner board of managers may determine. It shall be the
duty of the commissioner 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. Such the person rates shall be
adjusted annually, or more often as may in the opinion of the commissioner board
of managers be necessary.



The commissioner commission may by rule and regulation classify subscribers
into groups or classes according to the nature of the hazards incident to the
business thereof, and assign premium rates thereto. In addition, the
commissioner commission may by rule and regulation prescribe procedures for
subscription, payroll reporting, premium payment, termination of subscription,
reinstatement and other matters pertinent to such the subscribers' continuing
participation in the coal-workers' pneumoconiosis fund.
§23-4B-7. Administration.
The coal-workers' pneumoconiosis fund shall be administered by the
commissioner of the bureau of employment programs executive director of the
workers' compensation commission, who shall employ such any employees as may be
necessary to discharge his or her duties and responsibilities under this article.
All payments of salaries and expenses of such 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 commissioner executive director.
§23-4B-8. Separable from workers' compensation fund.
(a) No disbursements shall be made from the workers' compensation fund on
account of any provision of this article: Provided, That the Legislature may at
any time merge, consolidate, alter or liquidate this fund as it may determine and
in no instance shall the operation of this article be construed as creating any
contract which would deprive any injured employee of future benefits or increases
awarded by an act of Congress, nor shall this section operate to create any
liability upon the state of West Virginia.



(b) The Legislature hereby finds and declares that there is a substantial
actuarial surplus in the coal-workers' pneumoconiosis fund in excess of two
hundred million dollars. The Legislature further finds and declares that there
is a substantial actuarial deficit in the workers' compensation fund in excess
of four hundred million dollars, and that this deficit is in large part
attributable to claims arising out of the coal industry. The commissioner
executive director in conjunction with the board of managers is hereby directed
to conduct an actuarial audit to determine the amount, computed at book value,
of the actuarial surplus in the coal-workers' pneumoconiosis fund as of the
thirtieth day of June, one thousand nine hundred ninety, and to certify such
amount, as of that date, in a written order which together with the results of
said the audit shall be a public record. Notwithstanding the provisions of
subsection (a) of this section or any other provision of this article to the
contrary, the commissioner executive director in conjunction with the board of
managers shall, by written order, transfer the assets underlying said the surplus
to the workers' compensation fund, which assets shall thereupon become merged
into and consolidated with the workers' compensation fund: Provided, That the
value of the assets so transferred, when computed according to the book value of
said the assets on the date of transfer, shall not exceed two hundred fifty
million dollars: Provided, however, That such the assets so transferred shall be held in a separate account and shall not be used for the satisfaction of
obligations of the workers' compensation fund until all other assets of the
workers' compensation fund have been expended: Provided further, That the income
earned, from time to time, on the assets so transferred may be used to satisfy
obligations of the workers' compensation fund: And provided further, That a
sufficient reserve shall be retained in the coal-workers' pneumoconiosis fund to
guarantee the payment of all claims incurred, including claims which were
incurred but not reported, on or before the thirtieth day of June, one thousand
nine hundred ninety: And provided further, That any moneys due and owing to the
coal-workers' pneumoconiosis fund as a result of any transfer of moneys pursuant
to section eight-a of this article shall be construed as an asset of the coal-
workers' pneumoconiosis fund and shall be included as an asset transferred to the
workers' compensation fund under the provisions of this section. If at any time
subsequent to the transfer of the aforesaid assets to the workers' compensation
fund, the standards for obtaining benefits under Title IV of the Federal Coal
Mine Health and Safety Act of 1969, as amended and as subsequently amended, are
changed such that the actuarial audit performed hereunder may no longer
accurately reflect the liabilities of the coal-workers' pneumoconiosis fund for
claims arising prior to the first day of July, one thousand nine hundred ninety,
the commissioner board of managers in conjunction with the executive director
shall promptly conduct a new audit to determine whether any portion of the
foregoing separate account should be returned to the coal-workers' pneumoconiosis
fund in order to provide adequate reserves for claims arising prior to the first
day of July, one thousand nine hundred ninety, and, if the results of such the
new audit determine that said the reserves are inadequate, the commissioner board
of managers in conjunction with the executive director shall transfer back to the
coal-workers' pneumoconiosis fund that portion of the assets in the separate
account necessary to provide adequate reserves for such claims.
§23-4B-8a. Legislative findings; transfers to the state; maximum transfer
authorization; purpose for which moneys transferred may be disbursed and
expended; maximum amount of transfer authorization; terms and conditions
for repayment; premiums to be set without regard to transfers; creation of
special account in state treasury.



(a) The Legislature hereby finds and declares that there is a casual
deficit in the general revenue fund of this state because of the failure of the
state's taxation program to produce the estimated revenues, such deficit
condition having come into existence from ordinary expenses of the state without
design and unexpectedly; that there is a large surplus of moneys in the coal-
workers' pneumoconiosis fund; that transfers not to exceed thirty million dollars
from the coal-workers' pneumoconiosis fund will assist in financing government
operations, without in any way affecting the solvency of the coal-workers'
pneumoconiosis fund; and that the interest being earned on the coal-workers'
pneumoconiosis fund each year has for some time exceeded thirty million dollars.
This section is enacted in view of these findings.



(b) Whenever the governor determines that the general revenue fund
available for expenditure is insufficient for the timely payment for government
operations, the treasurer, state board of investments and the commissioner
executive director shall transfer moneys from the coal-workers' pneumoconiosis
fund to the special account created in the state treasury by subsection (f) of
this section, in the amounts determined by the governor to be sufficient and
necessary to meet such payments. The total of the amounts transferred may not
exceed thirty million dollars, and the transfers shall be subject to the payment
of interest equal to the actual interest rate earned by the coal-workers'
pneumoconiosis fund on the day of each transfer for the period of each transfer
until repayment.



(c) Any such transfer may be used only for payments for medicaid reimbursement.



(d) Full repayment of all transfers, with interest, shall be made to the
coal-workers' pneumoconiosis fund by budget action as first priority from the
moneys available for each fiscal year as follows: At least one fifth of the
outstanding amount with interest shall be repaid no later than the thirtieth day
of June, one thousand nine hundred eighty-nine; at least one fourth of the
outstanding amount with interest shall be repaid no later than the thirtieth day
of June, one thousand nine hundred ninety; at least one third of the outstanding
amount with interest shall be repaid no later than the thirtieth day of June, one
thousand nine hundred ninety-one; at least one half of the outstanding amount
with interest shall be repaid no later than the thirtieth day of June, one
thousand nine hundred ninety-two; and the balance of the remaining amount
transferred shall be repaid with interest no later than the thirtieth day of
June, one thousand nine hundred ninety-three. Repayment transfers, shall be made
by budget action as first priority from the moneys available for each fiscal year
and as made, shall not be deemed to renew, restore or increase in any way the
maximum amount of thirty million dollars herein authorized.



(e) The rates of premiums to be paid for coverage by the coal-workers'
pneumoconiosis fund shall be determined by the commissioner board of managers
with like effect as if all such transfers had not been made but had, together
with the interest earned thereon, been available for use by the coal-workers'
pneumoconiosis fund.



(f) There is hereby created in the state treasury a special account for the
deposit, withdrawal and repayment of moneys transferred pursuant to this section
and to invoke the applicability of the special fund doctrine with respect to
budgetary transfer activities involving more than one fiscal year.
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 division 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 thereto 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 commissioner and the compensation programs performance council are
board of managers is authorized to provide for, by the promulgation of a rule
pursuant to subdivisions (b) and (c), section seven, article three, chapter
twenty-one-a of this code 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 fund is to be
sold, the sale shall be conducted through the solicitation of competitive bids.
Any funds that may 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, such
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 commissioner executive director shall make disbursements from the employers' excess liability fund in such the amounts and to such the persons as
such the final order may direct. In the event of a proposed settlement of a
disputed claim against a subscribing employer, the commissioner executive
director, upon approving the settlement upon petition by the subscribing
employer, shall make disbursements from the employers' excess liability fund in
such the amounts and to such the persons as the approved settlement may specify.
In the event of the settlement of any disputed claim wherein one or more of the
persons entitled to the proceeds to be paid pursuant to such settlement is under
a legal disability by reason of age, mental incapacity or other reason, such 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 wherein such the
person under disability is a resident or wherein a civil action could be brought
and maintained upon such claim, in addition to being approved by the commissioner
commission as required by this section. The commissioner executive director
shall by legislative rule establish criteria and procedures for the settlement
of all disputed claims. In order to expeditiously establish such criteria and
procedures, the commissioner is hereby given authority to promulgate such
emergency rule or rules as may be necessary in accordance with the provisions of
section fifteen, article three, chapter twenty-nine-a of this code. The
provisions of said section fifteen, article three, chapter twenty-nine-a
notwithstanding such emergency rule, whether procedural, interpretive or
legislative, shall be effective upon the filing thereof in the state register and
shall have an effective period of not to exceed eighteen months, unless any such
rule or rules be altered or amended or such period of time shortened or
lengthened by subsequent act of the Legislature. No action shall lie for de novo
or other review of such rule to contest or question the existence of
circumstances justifying the promulgation of an emergency rule nor to challenge
the validity of such rule because of its classification as an emergency rule.
§23-4C-4. Employers' excess liability fund; how funded.



For the purpose of creating the employers' excess liability fund, each
employer who shall elect elects to subscribe to the fund shall pay premiums based
upon and being such a percentage of the payroll of the employer as the
commissioner board of managers may determine. It shall be the duty of the
commissioner 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
commissioner board of managers be necessary.







The commissioner board of managers shall initially classify subscribers
into groups or classes according to the nature of the unusual hazards incident
to the business thereof as contemplated by section four, article two of this
chapter, and assign premium rates thereto. The fixing, maintaining and adjusting
of premium rates and the initial classification of subscribers into groups or
classes pursuant to this section shall be deemed to be findings or determinations
of fact and not a legislative rule. In addition, the commissioner board of
managers shall by legislative 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
commissioner of employment programs executive director, who shall employ such
employees as may be 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 commissioner executive director.
ARTICLE 5. REVIEW.
§23-5-1. Notice by commission of decision; procedures on claims; objections and
hearing; mediation.



(a) The workers' compensation division commission shall have full power and
authority to hear and determine all questions within its jurisdiction. In matters
arising under articles three and four of this chapter, the division commission
shall promptly review and investigate all claims. The parties to a claim shall
file such the information in support of their respective positions as they deem
proper. In addition, the division commission
is authorized to develop such
additional information as it deems 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 division commission
shall explain the basis of its decisions.



(b) Except with regard to interlocutory matters, upon making any decision,
upon the making or refusing to make any award, or upon the making of any
modification or change with respect to former findings or orders, as provided by
section sixteen, article four of this chapter, the division commission
shall give
notice, in writing, to the employer, employee, claimant, as the case may be, of
its action, which. The notice shall state the time allowed for filing an
objection to such the finding and such. The action of the division commission
shall be final unless the employer, employee, claimant or dependant shall, within
thirty days after the receipt of such notice, object in writing, to such the
finding, and unless. Unless an objection is filed within such the
thirty-day
period, such the
finding or action shall be forever final, such. This time
limitation being hereby declared to be is a condition of the right to litigate
such the
finding or action and hence jurisdictional. Any such objection shall be filed with the office of judges with a copy served upon the division
commission
and other parties in accordance with the procedures set forth in
sections eight and nine of this article.



(c) Where a finding or determination of the division 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 division commission
or
office of judges, then such the
claimant in addition to reasonable traveling and
other expenses shall be reimbursed for loss of wages incurred by the claimant in
attending such the
hearing.



(d) Once an objection has been filed with the office of judges, the parties
to the objection shall be offered an opportunity for mediation of the disputed
issue by the division
. If all of the parties to the objection agree to
mediation, the division
shall designate a deputy who was not involved in the
original decision to act as mediator: Provided, That on issues related solely
to the medical necessity of proposed medical treatment or diagnostic services,
the division
shall offer the parties to the objection a selection of names of
medical providers in the appropriate specialty. The parties shall then either
agree upon a medical provider who shall act as mediator or, in the absence of an
agreement, the division
shall select a medical provider who shall act as
mediator. In cases where issues of medical necessity are intertwined with
nonmedical treatment or nondiagnostic issues, both a medical provider and a
designated deputy shall act as comediators and shall consider their respective
issues. Neither shall be empowered to overturn the decision of the other.




Upon entering into mediation, the parties shall inform the office of judges
of that action and the office of judges shall stay further action on the
objection.




The mediator shall solicit the positions of the parties and shall review such additional information as the parties or the division
shall furnish. The
mediator shall then issue a decision in writing with the necessary findings of
fact and conclusions of law to support that decision. If any party disagrees
with the decision, that party may note its objection to the office of judges, the
division
and the other parties, and the office of judges shall lift the stay on
the original protest. The decision and any information introduced during the
attempted mediation shall be subject to consideration by the office of judges in
making its decision on the objection. Upon acceptance by the parties of the
result of the mediation, the office of judges shall dismiss the objection with
prejudice.




The mediator shall conduct the mediation in an informal manner and without
regard to the formal rules of evidence and procedure. Once the parties agree to
mediation, then the agreement cannot be withdrawn.




(e) The panel of medical providers who shall serve as mediators shall be
selected and approved by the compensation programs performance council. A
medical provider serving as a mediator shall have the same protections from
liability as does the division's
's employees with regard to their decisions
including coverage by the board of risk management which shall be provided by the
workers' compensation division
.




(f) (e) The division commission
is expressly authorized to amend, correct,
or set aside any order on any issue entered by it which is on its face defective
or clearly erroneous or the result of mistake, clerical error or fraud.
Jurisdiction to take this action shall continue until the expiration of one
hundred eighty days 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.




(g) (f) All objections to orders of the division commission
shall be styled
in the name of the workers' compensation division commission
. All appeals prosecuted from the office of judges or from the appeal board shall either be in
the name of the workers' compensation division commission
or shall be against the
workers' compensation division commission
. In all such matters actions under
this article, the workers' compensation division commission
shall be the party
in interest.
§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 such the
application discloses cause for a
further adjustment thereof, the division commission
shall, after due notice to
the employer, make such the modifications, or changes with respect to former
findings or orders in such claim as may be justified, and any. Any party
dissatisfied with any such modification or change so made by the division
commission
shall, upon proper and timely objection, be entitled to a hearing, as
provided in section nine of this article.
§23-5-3. Refusal to reopen claim; notice; objection.




If, however, in In any case in which application for further adjustment of
a claim is filed under the preceding section, it shall appear appears to the
division commission
that such the
application fails to disclose a progression or
aggravation in the claimant's condition, or some other fact or facts which were
not theretofore considered by the division commission
in its former findings, and
which would entitle such the
claimant to greater benefits than the claimant has
already received, the division commission
shall, within a reasonable time, notify
the claimant and the employer that such the
application fails to establish a
prima facie cause for reopening the claim such. The
notice shall be in writing
stating the reasons for denial and the time allowed for objection to such the
decision of the division commission
. The claimant may, within thirty days after receipt of such the
notice, object in writing to such the
finding and unless.
Unless the objection is filed within such the
thirty-day period, no such
objection shall be allowed, such. This time limitation being hereby declared to
be is a condition of the right to such 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 wherein an employer makes application in writing for a
modification of any award previously made to an employee of said the employer,
and such the
application discloses cause for a further adjustment thereof, the
division commission
shall, after due notice to the employee, make such the
modifications or changes with respect to former findings or orders in such form
as may be justified, and any. Any party dissatisfied with any such modification
or change so made by the division commission
, shall upon proper and timely
objection, be entitled to a hearing as provided in section nine of this article.
§23-5-5. Refusal of modification; notice; objection.



If in any such case it shall appear to the division commission
that the
application filed pursuant to section four of this article fails to disclose some
fact or facts which were not theretofore considered by the division commission
in its former findings, and which would entitle such the
employer to any
modification of said the previous award, the division commission
shall, within
sixty days from the receipt of such the
application, notify the claimant and
employer that such the
application fails to establish a just cause for
modification of said the award. Such The
notice shall be in writing stating the
reasons for denial and the time allowed for objection to such the
decision of the
division commission
. The employer may, within thirty days after receipt of said
the notice, object in writing to such the
decision, and unless. Unless the objection is filed within such the
thirty-day period, no such objection shall be
allowed, such. This time limitation being hereby declared to be is a condition
of the right to such objection and hence jurisdictional. Upon receipt of such
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 appeal board, are
jurisdictional, such 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 such the
time period showing good cause or excusable neglect,
accompanied by the objection or appeal petition. In exercising such 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, the The claimant, the employer and
the workers' compensation division commission
, may negotiate a final settlement
of any and all issues in a claim wherever the claim may then be in the review
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 are
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, then the agreement will not be approved, which. The decision on this question shall may not be reviewable reviewed. If the employer is not
active in the claim, then the division commission
may negotiate a final
settlement of any and all issues in a claim except for medical benefits with the
claimant. Upon approval of the settlement, it shall be made a part of the claim
record and the. 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
division commission
. Any settlement agreement may provide for a lump sum payment
or a structured payment plan, or any combination thereof, or such any other basis
as the parties may agree. If such a self-insured employer later fails to make
the agreed upon payment, the division commission
shall assume the obligation to
make the payments and shall be entitled to 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 and two thousand
three shall apply to all settlement agreements executed after such the
effective
date of the legislation.
§23-5-8. Designation of office of administrative law judges; powers of chief
administrative law judge and said office.



(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 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 secretary of the department of administration
from a list prepared by the board of managers. The previously appointed incumbent of that position who was serving on the second day of February, one
thousand nine hundred ninety-five, shall continue to serve in that capacity
unless subsequently removed as provided for in subsection (b) of this section.



(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 compensation programs performance council created in
section one, article three, chapter twenty-one-a of this code secretary of
administration. Said 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 said this code. The
chief administrative law judge may only be removed by a vote of two thirds of the
members of the compensation programs performance council the secretary of
administration
and shall not be removed except for official misconduct,
incompetence, neglect of duty, gross immorality or malfeasance 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 shall be applicable to the chief administrative law judge.



(c) By and with the consent of the commissioner the The chief
administrative law judge shall employ administrative law judges and other
personnel as are necessary for the proper conduct of a system of administrative
review of orders issued by the workers' compensation division commission which
orders have been objected to by a party and all
such 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 the statutes, rules and regulations of the classified service pursuant to article six, chapter
twenty-nine of this code. All such 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 division department of
administration. The workers' compensation commission shall pay the budget as
approved by the secretary of administration.



(e) Subject to the approval of the compensation programs performance
council pursuant to subdivisions (b) and (c), section seven, article three,
chapter twenty-one-a of this code, the 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 division
pursuant to section one of this article. 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 said code commission. Notwithstanding
any provision in this code to the contrary, including sections one and two,
article three, and section three, article seven, chapter twenty-nine-a of this
code, any rules adopted pursuant to this section which are applicable to the
provisions of this chapter shall not be subject to sections nine through sixteen,
article three, chapter twenty-nine-a of this code. The office of judges shall
follow the remaining provisions of chapter twenty-nine-a of this code for giving
notice to the public of their actions and the holding of hearings or receiving
of comments on the rules. No later amendment to this code shall have precedence
over this section unless the later amendment specifically provides to the contrary.



(f) The chief administrative law judge shall continue to have 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
such records and make such reports as are necessary for disputed claims and
exercise such any additional powers, including the delegation of such powers to
administrative law judges or hearing examiners as may be necessary for the proper
conduct of a system of administrative review of disputed claims. The chief
administrative law judge shall make such reports as may be requested of him or
her by the compensation programs performance council board of managers.
§23-5-9. Hearings on objections to commission decisions.
(a) Objections to a workers' compensation division commission decision 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 division 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 division commission
shall be notified of any
hearing at least ten days in advance.
(b) 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 division's commission
's claim files which relate to the subject matter objected to 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 referred to herein. The
office of judges shall not be bound by the usual common law or statutory rules
of evidence.
(c) 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
entire record, the chief administrative law judge or other authorized adjudicator
within the office of judges shall render a decision affirming, reversing or
modifying the division's commission's
action. Said The decision shall contain
findings of fact and conclusions of law and shall be mailed to all parties.
(d) The rule authorized by subsection (a) of this section shall be
promulgated on or before the first day of July, two thousand four. Until the
rule is finally promulgated, the prior provisions of this section as found in
chapter two hundred fifty-three of the acts of the Legislature, one thousand nine
hundred ninety-five, shall remain in effect any rules previously promulgated
shall remain in full force and effect.
§23-5-10. Appeal from administrative law judge decision to appeal board.

The employer, claimant or workers' compensation division 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.

The decision of the workers' compensation office of judges regarding any
protest shall be final and benefits shall be paid or denied in accordance
therewith, subject to the following provisions:
(a) A claimant, employer, or the workers' compensation commission may
appeal, as a matter of right, subject to the notice and procedure requirements
in this section, a decision by the workers' compensation office of judges
regarding compensability of a workers' compensation claim and/or a particular
alleged injury or disease to the workers' compensation appeal board within thirty
days of receipt of notice of the office of judges' decision, or in any event,
within sixty days of the date of final action, regardless of notice and, unless
the petition for appeal is filed within the time specified, no review or appeal
shall be allowed. This time limitation is a condition of the right of appeal or
review and hence jurisdictional;
(b) A claimant, employer, or the workers' compensation commission may file
a petition for discretionary appeal from a decision of the workers' compensation
office of judges regarding the extent of impairment or disability or any other
issue decided by the workers' compensation office of judges, subject to the
timeliness requirement in subsection (1) above. The notice and procedure
requirements in this section shall apply with equal force to petitions for
discretionary appeal. Other interested parties may file a response opposing the
petition within thirty days of receipt of the petition for discretionary appeal,
but no response is required. The board may hear the appeal only if it appears
on the face of the petition that the administrative law judge's findings were:
(1) In clear violation of unambiguous statutory provisions or the result
of erroneous conclusions of law; or
(2) Beyond the statutory authority or jurisdiction of the
administrative
law judge or based upon unlawful procedures; or
(3) Based upon findings of fact that were clearly wrong in view of the reliable , probative and substantial evidence on the whole record; or
(4) Arbitrary or capricious or characterized by abuse of discretion or
clearly unwarranted exercise of discretion.
(c) If the appeals board receives a notice of an appeal by right or accepts
a petition for appeal, the appellant shall be allowed sixty days notice from
receipt of the board's acknowledgment of receipt of notice or the board's
acceptance of a discretionary appeal to submit additional argument in support of
the appeal. All responding parties shall be afforded thirty days from receipt
of the appellant's brief to submit additional response. The board may grant
extension of an appellant's deadline to file an appeal brief. If desired, the
appellant may notify the board in writing that it wishes the board to consider
the petition for appeal as its appeal brief. Receipt of notice shall trigger the
responding parties' thirty-day period within which to file additional responses,
as desired. If no appearance is made by the respondent and/or appellee, the
board may not enter default judgment against the party, but rather shall decide
the appeal based upon applicable standards of review contained in this section.
(d) If the board declines to hear a discretionary appeal, no appeal shall
lie to the supreme court of appeals, as provided in section sixteen of this
article.
§23-5-11. Workers' compensation appeal board -- Generally.
(a) There shall be is hereby created a board to be known as the "Workers'
Compensation Appeal Board", which shall be referred to in this article as the
"board", to be composed of three members.
(b) The board shall be comprised of three, full-time members and perform
the duties and responsibilities assigned to it by this code consistent with the
administrative policies developed by the governor and the commissioner with the
assistance of the compensation programs performance council. The governor shall
appoint three individual pursuant to the qualifications in this subsections (d) and (f) of this section to serve as members of the board and designate the chief
judge. The chief judge shall serve a term of six years. One member shall be
appointed for four years and one member shall be appointed for two years. Upon
vacancy, the governor shall, within thirty days of vacation of the position,
appoint a new member.

Two members of such board shall be of opposite politics to the third, and
all three shall be citizens of this state who have resided therein for a period
of at least five years. All members of the board shall be appointed by the
governor and shall receive an annual salary in accordance with the provisions
of section two-a, article seven, chapter six of this code. The salaries shall
be payable in monthly installments, and the members shall also be entitled to all
reasonable and necessary traveling and other expenses actually incurred while
engaged in the performance of their duties. The governor shall designate one of
the members of the board as chairman thereof, and the board shall meet at the
capitol or at such other places throughout the state as it may consider proper
at regular sessions designated as "Appeal Board Hearing Days" commencing on the
first Tuesday of every month or the next regular business day, for a period of
at least three days, for the purpose of conducting hearings on appeals, and
continuing as long as may be necessary for the proper and expeditious transaction
of the hearings, decisions and other business before it. All clerical services
required by the board shall be paid for by the commissioner from any funds at his
or her disposal.

(c) (1) The board shall, from time to time, compile and promulgate such
rules of practice and procedure as to it shall may appear proper for the prompt
and efficient discharge of its business and such rules shall be submitted first
to the compensation programs performance council for its approval pursuant to
subdivisions (b) and (c), section seven, article three, chapter twenty-one-a of
this code and, if so approved, then to the supreme court of appeals for approval, and if approved by such court shall have the same force and effect as the
approved rules of procedure of circuit courts. Notwithstanding any provision in
this code to the contrary, including sections one and two, article three, and
section three, article seven, chapter twenty-nine-a of this code, any rules
adopted pursuant to this section which are applicable to the provisions of this
chapter shall not be subject to sections nine through sixteen, article three,
chapter twenty-nine-a of this code. The board shall follow the remaining
provisions of chapter twenty-nine-a of this code for giving notice to the public
of their actions and the holding of hearings or receiving of comments on the
rules. No later amendment to this code shall have precedence over this section
unless the later amendment specifically provides to the contrary.
(2) It shall report monthly to the board of managers on the status of all
claims on appeal.
(3) No member of the board may engage in the private practice of law.
(d) To qualify as chief judge, an appointee must possess the following
qualifications:
(1) A minimum of five years experience as a practicing attorney at law;
(2) Current active membership in the West Virginia State Bar; and
(3) A minimum of two years experience in the preparation, presentation or
hearing of actions, or in making decisions on the basis of the record of those
hearings, origination before administrative agencies or regulatory bodies at the
federal, state or local level.
(e) By and with the consent of the commissioner, the board The chief judge
shall employ such clerical staff as may be necessary for the efficient conduct
of its business. Salaries of the board, and its employees, and all of its
necessary operating expenses shall be paid from the workers' compensation fund.
The board He or she shall also submit its an annual budget on behalf of the board
to the commissioner secretary of administration for inclusion as a separate item in the budget estimates prepared by him or her annually and within the limits of
such budget, all expenses of the board shall be by the requisition of the
commissioner. Salaries of the employees of the board shall be governed by the
provisions of article six, chapter twenty-nine of this code. The board shall
report monthly to the compensation programs performance council on the status of
all claims on appeal. The workers' compensation shall pay the budget as approved
by the secretary of administration.
(f) The governor shall appoint the chief judge and two members. The chief
judge shall be appointed for a six year term
(g) Salaries of the board, and its employees, and all of its necessary
operating expenses shall be paid from the workers' compensation fund upon the
budget approved by the secretary of administration.
§23-5-12. Appeal to board; procedure; remand and supplemental hearing.
(a) Any employer, employee, claimant or dependent, who shall feel aggrieved
at of 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 may appeal to the board created in section eleven of this article for
a review of
such the
action. The workers' compensation division shall likewise
have the right to commission may also appeal to the appeal 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 such the board, within
thirty days after receipt of notice of the final action complained of, or in any
event, regardless of notice, within sixty days after the date of the action
complained of, and unless. Any notice of appeal shall be filed within sixty days
of the final action, regardless of notice. Unless the notice of appeal is filed
within the time specified, no such appeal shall be allowed, such. This time
limitation being hereby declared to be is a condition of the right to such
objection and hence jurisdictional; and the. The office of judges shall notify the other parties immediately upon the filing of a notice of appeal. The office
of judges shall forthwith promptly make up a transcript of the proceedings before
the office of judges and certify and transmit the same it to the board. Such The
certificate shall incorporate a brief recital of the proceedings therein had and
recite, each order entered and the date thereof dates of the proceedings and
orders.
(b) The After thirty days of the filing of a notice, the board shall may,
in accordance with section ten of this article, review the action of the
administrative law judge complained of at its next meeting after the filing of
notice of appeal, provided such notice of appeal shall have been filed thirty
days before such meeting of the board. All appeals shall be reviewed within
sixty days of the filing of the notice, unless such the review be is postponed
by agreement of parties or by the board for good cause. The board shall set a
time and place for the hearing of arguments on each claim and shall notify the
interested parties thereof and briefs of the date and time for the hearing.
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, within thirty days of the
hearing:
(1) sustain Sustain the finding of the administrative law judge, in which
case it need not make findings of fact or conclusions of law,; or
(2) enter such Enter an order or make such award as the administrative law
judge should have made, stating in writing its reasons therefor, reasoning; or
(3) Remand the case to the chief administrative law judge for the taking
of 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; or
(4) Remand the case to the workers' compensation division commission
for
further development
upon a finding of good cause.
and The board shall thereupon certify the same its order to the workers'
compensation division commission
and chief administrative law judge, who shall
proceed in accordance therewith.
(d) The board may remand any case as often as in its opinion is necessary
for a full development and just decision of the case.

(d) Instead of affirming, reversing or modifying the decision of the
administrative law judge as aforesaid, 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.
(e) 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 any new, additional or
further evidence in accordance with any instruction given ordered by the board, and shall take the same. The evidence shall be taken within thirty days after
receipt of the order remanding the case, giving to the interested parties at
least ten days' written notice of such the 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 the
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 appeal board 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 division
for further development. Any
The decision of the
administrative law judge may by appealed according to subsection (a) of this
section.
(f) In the event the board remand the decision to the workers' compensation
commission, any decision made by the division commission
following such a remand
shall be subject to objection to the office of judges, pursuant to section five
of this article 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.
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. In all proceedings before the
board, any party may be represented by counsel.
§23-5-14. Disqualification of board members.
Repealed.
§23-5-15. Appeals from final decisions of board to supreme court of appeals;
procedure; costs.
(a) From any final decision of the board, including any order of remand,
an application for review may be prosecuted by either party or by the workers' compensation division commission
to the supreme court of appeals within thirty
days from the date thereof by the filing of a petition therefor to such the court
against the board and the adverse party or parties as respondents, and unless.
Unless the petition for review is filed within such the thirty-day period, no
such appeal or review shall be allowed, such.
This time limitation being hereby
declared to be is a condition of the right to such appeal or review and hence
jurisdictional;
and the. The clerk of such the court shall notify each of the
respondents and the workers' compensation division commission
of the filing of
such the 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 If review
is granted to a nonresident of this state, he or she shall be required to execute
and file with the clerk before such the 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.
(b) 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 is 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
division commission
, of that fact by mail. If a review be is 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 the term. The attorney general shall, without extra compensation, represent the board in such the cases. The court shall determine the matter so brought
before it and certify its decision to the board and to the division commission
.
The cost of such the
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 division commission
(in case the latter be the applicant for
review) be unsuccessful, such the
costs, not including attorney's fees, shall be
taxed against the division 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 No costs may be taxed upon a certified question.
§23-5-17. Termination of office of judges.
The office of judges shall terminate on the first day of July, two thousand
three five, pursuant to the provisions of article ten, chapter four of this code
unless sooner terminated, continued or reestablished pursuant to the provisions
of that article.
§23-5-18. Workers' compensation appeal board termination.
Pursuant to the provisions of article ten, chapter four of this code, the
workers' compensation appeal board shall continue to exist until the first day
of July, two thousand three five, unless sooner terminated, continued or
reestablished by act of the Legislature.
ARTICLE 5A. DISCRIMINATORY PRACTICES.
§23-5A-1. Discriminatory practices prohibited.
No employer shall discriminate in any manner against any of his or her
present or former employees because of such the present or former employee's
receipt of or attempt to receive benefits under this chapter.
§23-5A-2. Discriminatory practices prohibited -- Medical insurance.
Any employer who has provided any type of medical insurance for an employee
or his
or her
dependents by paying premiums, in whole or in part, on an individual or group policy shall not cancel, decrease his
or her
participation
on behalf of the employee or his
or her
dependents, or cause coverage provided
to be decreased during the entire period for which that employee during the
continuance of the employer- employee relationship is claiming or is receiving
benefits under this chapter for a temporary disability. If the medical insurance
policy requires a contribution by the employee, that employee must continue to
make the contribution required, to the extent the insurance contract does not
provide for a waiver of the premium.
Nothing in this section shall prevent an employer from changing insurance
carriers or cancelling or reducing medical coverage if the temporarily disabled
employee and his
or her
dependents are treated with respect to insurance in the
same manner as other similarly classified employees and their dependents who are
also covered by the medical insurance policy.
This section provides a private remedy for the employee which shall be
enforceable in an action by the employee in a circuit court having jurisdiction
over the employer.
CHAPTER 26. STATE BENEVOLENT INSTITUTIONS.
ARTICLE 8. EMERGENCY HOSPITALS.
§26-8-2. Patients; expenses; disposition of receipts.
The state commissioner of public institutions shall admit to said
hospitals, under its rules and regulations, 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 commissioner of the bureau of
employment programs executive director of the workers' compensation commission
shall pay to said hospitals for the treatment of anyone entitled to benefits or
aid out of the workers' compensation fund the same fee or expenses as 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 such 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 such 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
such 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 so 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 such information to any agent of the agency that is under
contract with the bureau to carry out such 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, shall be kept confidential and shall not be released except as provided
below:
(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 such 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 is necessary or 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 division
commission, state tax department and the internal revenue service, or other state
or federal agencies or departments as may be 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 shall be guilty of a
misdemeanor and, upon conviction thereof, shall be fined not less than one
hundred nor more than one thousand dollars, or confined in the county or regional
jail not more than six months, or both fined and imprisoned.
CHAPTER 61. CRIMES AND THEIR PUNISHMENT.
ARTICLE 3. CRIMES AGAINST PROPERTY.
§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; or
(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 therefore
in the workers' compensation division's commission's schedule of maximum
reasonable amounts to be paid for such treatment or services issued pursuant to
subsection (a), section three, article four, chapter twenty-three of this code
shall be guilty of a felony and, upon conviction thereof, shall be imprisoned in
the penitentiary not less than one nor more than ten years or, in the discretion
of the court, be confined in 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, shall be guilty of a felony and, upon conviction thereof, shall be
confined in the penitentiary 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,
shall be guilty of a felony and, upon conviction thereof, shall be imprisoned in
the penitentiary for not less than one 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
division, 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
such patient consents, in writing, prior to the provision of such treatment or
other services or supplies, to make payment for that treatment or other services
or supplies himself or herself, shall be 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, from
and 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 such services or supplies.
(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 paragraph (6) (A), 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 such property, including payment for:
(a) Contract services;
(b) 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
(c) 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 for prosecution of any violation of this subsection 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.
__________
(NOTE: The purpose of this bill is to remove the division of Workers
Compensation from the Bureau of Employment Programs; create an independent
Workers Compensation Commission which will provide a more efficient and effective
operation; bring the deficit under control before the agency is forced into
bankruptcy by increasing employer premiums to fully fund new claims thereby
reducing or stopping future unfunded claims and levying and employer and employee
tax to pay off the deficit; establish an independent appeals system; and reduce
the number of appeals to the Supreme Court.
Strike-throughs indicate language that would be stricken from the present
law, and underscoring indicates new language that would be added.
§§23-1-1a, 23-1-1b, 23-1-1c, 23-1-1c, 23-1-1d, 23-1-1e, 23-1-1f, 23-1-1g,
23-1-4a, 23-3-1b, 23-4-1g are new; therefore, strike-throughs and underscoring
have been omitted.