How to Apply for West Virginia Workers’ Compensation Benefits

Important: We updated this article in November 2024 after fact checking against current West Virginia workers’ compensation laws. Hurt on the job in the Mountain State? State law outlines who gets workers’ compensation benefits and how the process works unless you’re a federal employee. If you have a job-related injury or occupational disease in the Mountain State, we’ll explain how to get West Virginia workers’ compensation benefits.

However, who can treat you after a job accident may be up to your employer. And if you think you’re owed benefits that your employer refuses to pay, we can get you a free, no-obligation case review. Keep reading to learn what types of benefits may be available to you, how to file a claim, and more helpful info below.

West Virginia Workers’ Comp Benefits: Key Takeaways

• Most West Virginia employers must have workers’ compensation insurance coverage. However, like every other U.S. state, some types of employees have an automatic coverage exemption under state law.
• Workers’ compensation insurance generally does not cover self-inflicted injuries or those that result from fighting, drug or alcohol use, or refusal to use required safety gear on the job.
• At just 6 months, WV has the shortest deadline for filing workers’ compensation claims in the entire nation.

Do You Have West Virginia Workers’ Compensation Insurance Coverage?

State law requires nearly all employers with at least one employee to carry West Virginia workers’ compensation insurance. However, the law also provides an exemption from workers’ compensation insurance coverage for the following:

• Agricultural employers who hire no more than 5 total workers
• Casual employers (i.e., families hiring babysitters, West Virginia employers with temporary or seasonal workers hired 10 days or less at a time)
• Churches
• Domestic servants
• Emergency service volunteers
• Federal employees, including longshoremen and harbor workers
• Independent contractors
• Professional athletes
• Sole proprietors

Any WV employer who fits one of the above descriptions may apply to submit a letter of exemption to the Insurance Commissioner.

How to File Your West Virginia Workers’ Compensation Benefits Claim

Important: Seek treatment immediately if you require emergency or urgent care. Every workers’ comp case is different, so your experience may vary. Most West Virginia workers’ compensation applications work like this:

1. If you need urgent medical care for a life-threatening injury or illness, go to the nearest hospital or clinic immediately.

Be sure to tell the doctor who initially treats you that your injury or illness is work-related. Ask the provider to help you fill out Form OIC-WC-1. You can download a copy of OIC-WC-1, Employees’ and Physicians’ Report of Occupational Injury or Disease form here. However, the healthcare facility that treats you will likely have a copy for you to complete on-site. Once you fill out the top portion of that form, the doctor can fill out the rest for you.

2. Notify your supervisor that you have a job-related injury, preferably in writing, as soon as is reasonably possible.

You can of course complete this step before you seek medical attention if your situation isn’t dire or life-threatening. When you notify your employer, you should also receive the form you’ll need to complete with the doctor who initially treats you.

We recommend you provide a written account of exactly what happened during your accident that led to your injury, including:

• Time
• Location
• Any witnesses who saw the incident happen, including their names and contact information
• Other relevant details, such as photographs, video footage, whether a piece of equipment you normally use at work broke, etc.

If you cannot provide a written statement, have a coworker record video of you describing the incident using your mobile phone’s camera.

The statute of limitations in West Virginia says that you must start the workers’ compensation claims process within 6 months. Failure to file before that deadline passes may make you unable to claim any workers’ compensation benefits.

3. Your employer must notify their insurance company within 5 days after they receive notice your injury occurred.

If your employer refuses to take this step, you might want to verify your employer has West Virginia workers’ compensation insurance coverage. You can use the online lookup tool at the Insurance Commissioner’s website here.

4. A claims administrator for your employer’s insurance company must either approve or deny your claim within 15 working days.

Expect a letter in the mail explaining the decision to approve or deny your claim, reasons why and how to appeal, if necessary.

5. If approved, you must miss 3 days of work before you’re eligible for workers’ comp payments that cover lost wages.

West Virginia workers’ compensation insurance typically covers all medical expenses related to your claim. However, not every injury requires time off to recover, and many workers can return to work right away. If your treating physician determined that you cannot work because of your injury, your first 3 days off work are always unpaid.

After that initial time period passes, you become eligible for lost-wage benefits. And if you must miss more than one week of work, workers’ compensation also covers your first 3 unpaid days off.

These are the types of disability benefits available through workers’ compensation insurance in WV:

• Temporary total disability benefits. These cover two-thirds of your average weekly wages, subject to the state’s minimum and maximum benefit amounts. Eligible injured workers can receive temporary total disability payments for no more than 104 weeks total.
• Temporary partial disability benefits. These payments cover 70% of the difference between your pre-injury and post-injury earnings for up to 104 weeks.
• Permanent partial disability benefits. The insurance company calculates these monthly payments using your percentage of established medical disability. Then, they multiply that percentage times 4 weeks of your TTD payments to determine the final amount.
• Permanent total disability benefits. Eligible workers can receive these monthly TTD payments until reaching full retirement age. Once you start drawing your full pension or Social Security retirement benefit, these PTD payments will end.

In addition, families of workers with fatal injuries can also receive death benefits from workers’ compensation. West Virginia pays up to $7,000 for funeral and burial expenses, plus TTD payments until the surviving spouse remarries or dies. If there are dependent children beneficiaries, those minors can receive benefits until their 18th birthday passes.

6. To protest a West Virginia workers’ compensation benefits denial, you must appeal in writing within 60 days.

Currently, the West Virginia Workers’ Compensation Board of Review hears all disputes for initial claim denials.

To contact the Board, you can call 1-304-558-5230 or send written correspondence to the following address:

WC Board of Review
P.O. Box 2628
Charleston, West Virginia 25329-2628

You can also file your dispute electronically through the Board’s online portal.

If the Board denies your claim a second time, you have another 30 days from the date you receive notice to appeal that decision. At this time, the West Virginia Intermediate Court of Appeals handles all disputed decisions by the Board of Review.

Workers’ Compensation: West Virginia Statistics from 2017 to 2022

Every year, the Bureau of Labor Statistics publishes reports covering workers’ compensation claim statistics for most U.S. states. As you can see from the chart below, total claims rose 14% in 2022 from their all-time low in 2020 during the pandemic:

Much like that trend, we similar recoveries in the number of employees who missed work, changed jobs, or received transfers.

Learn more about workers’ compensation benefits.

Talk to a West Virginia Workers’ Comp Attorney for Free

When you’re dealing with a work-related illness or injury, navigating the workers’ compensation system can make you feel even worse.

Consider requesting a free, confidential claim evaluation from an experienced workers’ comp attorney near you. They all work on contingency, which means you don’t pay a fee unless your case wins. You only pay one reasonable fee for legal services if your case is successful.

To see if you may qualify for a free workers’ comp claim evaluation, click the button below and start your free online benefits quiz now:

Get Your Free Benefits Evaluation