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