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Criteria for filing an Employer’s Accident Report

 

1.      Why must an employer/carrier file an Employer’s Accident Report?

Ø                 It is required by statute pursuant to Virginia Code § 65.2-900, which

states in part, “Every employer shall keep a record of all injuries or deaths of its employees which occur in the course of employment.  Within ten days after the occurrence of such injury or death, and knowledge of injury as provided in § 65.2-600, a report of the injury or death shall be made and transmitted to the Commission by the employer, its representative or, in the case of an insured employer, its insurance carrier, in accordance with regulations adopted by the Commission…” 

Ø                 Failure to file the accident report may toll the statute of limitations.  Where an employer has received notice of an accident or the occurrence of an occupational disease, as required by Virginia Code § 65.2-600, the employer must file the report of the accident or occupational disease with the Virginia Workers' Compensation Commission as required by Virginia Code § 65.2-900.  If the employer fails to do so, and such conduct operates to prejudice the rights of the employee with respect to the filing of a claim prior to expiration of a statute of limitations otherwise applicable, the statute may be tolled until the employer files the Employer’s Accident Report.

Ø                 It allows the employer/carrier to provide appropriate medical care and potentially minimize the incapacity and reduce the seriousness of the injury through reporting the injury and providing the panel of three physicians as required by Virginia Code § 65.2-603.   

Ø                 It allows the employer’s insurance carrier or claims administrator time to investigate the claim to determine compensability as well as provide an appropriate defense should the claim be denied and proceed to the Commission’s hearing docket. 

2.      What happens if an employer/carrier fails to file the Employer’s Accident Report?

Ø                 The employer/carrier will receive notice of a Show Cause hearing to appear before the Commission to show cause why they failed to respond to the Commission’s Order. 

Ø                 The Commission may assess a civil penalty up to $ 5,000.00.

§ 65.2-902. Failure to make required reports; civil penalty.

A.  Any employer who fails to make any report required by the Commission pursuant to this title shall be assessed a civil penalty of not more than $500 for each failure. If the Commission determines that any such failure is willful, it shall assess a civil penalty of not less than $500 and not more than $5,000. The civil penalty herein provided may be assessed by the Commission in an open hearing with the right of review and appeal as in other cases. In the event the employer has transmitted the report to the insurance carrier or third party administrator for transmission to the Commission, the insurance carrier or third party administrator failing to transmit the report shall be liable for the civil penalty.

3.      When must an employer or insurance carrier file an Employer’s Accident Report with the Commission and not a Report of Minor Injuries (VWC form 45A)?

Ø                 When accidents meet one of the following seven criteria for establishing a

Commission file, the employer or their insurance carrier must submit the original and one copy of a completed Employer’s Accident Report (VWC form 3) to the Virginia Workers’ Compensation Commission:

                        1)  Lost time exceeds 7 days

            2)  Medical expenses exceed $1,000

            3)  Compensability is denied

4)  Issues are disputed

            5)  Accident resulted in death

            6)  Permanent disability or disfigurement may be involved

7)  A specific request is made by the Virginia Workers’   

     Compensation Commission

4.      How should I file? 

Ø                 You should immediately file an Employer’s Accident Report with your workers’ compensation insurance carrier or directly with the Commission if your organization is self-insured.   You can request forms by calling the Commission’s toll-free number 1-877-664-2566 or download forms from our website.  You can also file electronically on the Commission’s website.  Click here to file electronically or download the form from our Forms page.

Ø                 The completed Employer’s Accident Report should be signed, dated and mailed to the Commission on the required tan paper with the reason for filing listed in the upper right hand corner.   See the back of the form for instructions and reasons for filing.  

5.      If I suspect fraud is involved, do I still have to file an Employer’s Accident Report?

Ø                 Yes, you must still file an Employer’s Accident Report even if you suspect the claim is fraudulent.   You may want to consult with your legal representative regarding completion of the Employer’s Accident Report.  

Ø                 You can report suspected fraudulent claims directly to the Virginia State

Police at http://www.vsp.state.va.us/bciifd.htm or by calling their toll-free Fraud hot line 1-877-623-7283.