Builders and Contractors Exchange
Weekly Bulletin: 26 Jul 2004
Terminating An Open Workers' Compensation Award
By: Brian Sykes
When an employee is disabled from work and his injury is accepted as compensable, the Virginia Workers' Compensation Commission ("VWCC") will generally enter an Award for the period of disability. Usually, the parties submit an Agreement to Pay Benefits which states the periods and type of disability and the average weekly wage ("AWW") of the employee. Based upon this agreement, the VWCC will enter an Award.
If the employee has returned to full duty work, and there is a closed period of disability, then the parties will also submit a Termination of Wage Loss Award form. Based on that document, the Commission is able to enter an Award for the actual periods of disability.
When an Open Award is entered (i.e.: when there is not a closed period of disability), the employer must file an application to terminate the open award if termination is warranted. Therefore, in most cases, the workers' compensation carrier cannot terminate benefits unless the parties agree or if it files an Employer's Application along with evidence supporting the reason for termination.
Rule 1.4 of the Virginia Code addresses the Employer's Application for Hearing. Rule 1.4 requests a workers' compensation carrier to pay benefits through the date that its Application is filed unless:
1) The application alleges that the employee returned to work, in which case payment shall be made to the date of the return;
2) The application alleges a refusal of offered light duty work (selective employment), in which case payments must continue until the date of refusal or 14 days prior to filing, whichever date is later.
3) The application alleges a refusal of required medical treatment or examination, in which case payments must continue until the date of refusal or 14 days prior to filing, whichever date is later.
Please note that in cases in which the employee refuses to fully cooperate with assigned vocational rehabilitation, payment must continue until the date that the application is filed.
Thus, in cases in which the injured employee has not returned to work, but his or her benefits pursuant to the open Award should be terminated for a valid reason as outlined above, it is imperative that the Employer's Application be timely filed. If not, the workers' compensation carrier may be required to pay benefits well after suspension of benefits is justified.
Finally, all Employer's Applications should be sent by certified mail, as the VWCC mandates that the application is filed as of the date of the certification. If the application is sent by regular mail, the date of filing is the date that the application is received by the VWCC.
Questions?
If you have any questions about this article or any other related matters, please contact:
This article is meant to bring awareness to this topic and is not intended to be used as legal advice.