Located at the Greater Richmond Convention Center Awards Processing Tips and Tools Claims Services Department Award Agreement Establishes Nature of InjuryBody ID: 644138
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Slide1
October
2
4 - 25 2017
Located at the Greater Richmond Convention CenterSlide2
Awards
Processing:
Tips
and Tools Claims
Services DepartmentSlide3
Award
Agreement
Establishes:
Nature of Injury/Body PartsAverage Weekly Wage
Compensation RatePeriods of Disability
Percentage of Loss, Loss of
Use or Disfigurement
Agreement of lifetime
causally
related
medical
benefits
*Parties
must sign and initial all
changes*Slide4
Award Agreement -
Permanent Partial Disability §65.2-503
Requirements:
Loss of Use: Medical Report indicating maximum medical
improvement (MMI) along with the impairment ratingAmputation: Completed
Amputation Chart (VWC Form
#7) with a clear line at the
exact point of amputation
Disfigurement
:
Clear
color photographs,
or
a
personal
viewing,
once
maximum
medical
improvement
(MMI)
is
reached,
is necessary
for
the
Commission
to
determine
the
ratingSlide5
Award Agreement -
Permanent Partial Disability Pitfalls
Pitfalls:
Medical Documentation not providedWeeks owed not properly
calculatedMember/Digit does not specify Right/Left or refers to
the wrong
member/digitImpairment
rating does not coincide with medical
documentation
Beginning
date
is
incorrectSlide6
Award Agreement -
Common Pitfalls
Incomplete
Forms: form does not include established average weekly wage, compensation rate, beginning date of the period of disability and signatures of both
the injured worker and the AdjustorALL
the items listed are necessary
to enter the
award order even if
full
wages
are
paid
in
lieu
of
compensation
First
Week
(First
seven
days
of
incapacity):
while no longer
required
on
the
forms,
should
still
be
established
to
determine
if the
injured
worker
has
lost
enough
time
to
be
eligible
for
benefits.
Per
Rule 9 of the Act
any
portion
of a
day
where
there is
any wage
loss counts
as
one
daySlide7
Award Agreement -
Pitfalls, Cont’d
–
Compensation Rate is not calculated correctly or maximum andminimum compensation rate is not appliedSlide8
Termination of Wage Loss
Award
Establishes the
terms of an agreement between the parties to:Date the injured worker returned to work
at a pre- injury average weekly wage
Date that the injured worker
was able to return
to work at a
pre-injury
average
weekly
wage
*Parties
must sign and initial all
changes*Slide9
Termination
of Wage Loss Award
-
Common PitfallsIncomplete Forms: form does not include the date returned/able to return to work
and signatureChanges to Forms: changes not
initialed by all
partiesSlide10
Changes
to Forms
If the
forms reflect changes have been made to the compensationinformation and the changes have not been initialed by both parties, this
will require contact by Commission staff to request written approval by fax, mail or
WebFile
Changes requiring both parties’ initials
:
Date
of
Injury
Nature
of
Injury/Body
Parts
accepted
Pre-Injury
Average
Weekly
Wage
Compensation
Rate
Compensation Beginning
Date
Return
or
Was
Able
to
Return
to
Work
DateSlide11
Rejection of Agreements
The Commission
will
REJECT, in writing, any Award Agreement form that is missing the following information:
Beginning date of compensation
Compensation Rate
Pre-Injury Average Weekly
Wage
Date
of
Injury
Note:
If
no
nature
of
injury
(body parts)
are listed
on
the
form,
the
Award
Order will
reflect
“All
causally
related
body
parts”Slide12
Temporary Partial section of
Award Agreement
2 options
are listed (#1 or #2)B Temporary Partial: Please select option 1 or 2 below
and complete.1 – Will be paid at the compensation rate
of $
per week. This period of
disability began on
(m/d/yyyy)
2 –
Was
paid an
averaged
weekly compensation
rate
of
$
per
week
from
through
and
will continue
to
be paid
at
a
compensation
rate
of
$
per week beginning on (m/d/yyyy)
Award
Agreement:
Temporary
PartialSlide13
Temporary Partial section
of Award Agreement
2
options are listed (#1 or #2)B Temporary Partial: Please select option 1 or 2
below and complete.1 – Will be paid at the compensation
rate of $
per week. This period
of disability began
on
(m/d/yyyy)
2 –
Was
paid an
averaged
weekly compensation
rate
of
$
156.55
per
week
from
5/2/12
through
6/13/12
and
will continue to
be paid
at
a
compensation
rate
of
$
156.55
per
week beginning on
5/2/12
(m/d/yyyy)
Temporary Partial Agreement Rejection –Example
#1
Do
NOT
duplicate
the periods
by
adding the
compensation
beginning
date
of
5/2/2012
again.
If
there
is
no
consecutive
period
,
then
leave
the
last two
blanks
empty.
You
will
also
need
to
submit
a
Termination
of
Wage
Loss
Award
form to
end the period
effective
6/13/2012.Slide14
Temporary Partial section
of Award Agreement
2
options are listed (#1 or #2)B Temporary Partial: Please select option 1 or 2
below and complete.1 – Will be paid at the compensation
rate of $
per week. This period
of disability began
on
(m/d/yyyy)
2 –
Was
paid an
averaged
weekly compensation
rate
of
$
39.81
per
week
from
3/23/2013
through
3/23/2013
and
will continue to
be paid
at
a
compensation
rate
of
$
32.43
per
week beginning on
4/21/2013
(m/d/yyyy)
Temporary Partial Agreement Rejection –Example
#2
Since periods
are
NOT
CONSECUTIVE
, a
Termination
of
Wage
Loss
Award
for
the period
ending on 03/23/2013
would
be
required.Slide15
Deborah RhodesClaims Services Department
804-205-3577
[debbie
.rhodes@workcomp.virginia.gov]Virginia Workers’ Compensation Commission877-664-2566
│ questions@workcomp.virginia.gov │ workcomp.virginia.gov
Questions & Comments