NOTICE OF A RIGHT TO DISPUTE A DENIAL AND CONTACT INFORMATION FOR THE VIRGINIA WORKERS’ COMPENSATION COMMISSION MUST BE INCLUDED IN ANY WRITTEN DENIAL NOTICE TO THE CLAIMANT BEGINNING JULY 1, 2024.
The Virginia legislature recently enacted Senate Bill 241. The Bill was signed by the Governor and is set to go into effect on July 1, 2024. The Bill amends the Workers’ Compensation Act to include a section numbered 65.2-601.3. The relevant text of the new legislation is:
§ 65.2-601.3. Notice of right to dispute claim.
A. If an employer subject to this title, or an employer’s insurer, denies a covered employee’s request for workers’ compensation benefits, the employer or the insurer, as applicable, shall include in its letter denying benefits a notice that the employee has a right to dispute the claim denial through the Virginia Workers’ Compensation Commission. Such notice shall include the following text:
EMPLOYEE RIGHT TO DISPUTE DENIAL OF WORKERS’ COMPENSATION BENEFITS.
IF YOU DISAGREE WITH THIS DENIAL, YOU HAVE THE RIGHT TO DISPUTE THE DECISION BY FILING A REQUEST FOR A HEARING WITH THE VIRGINIA WORKERS’ COMPENSATION COMMISSION. IT IS YOUR RESPONSIBILITY TO DISPUTE THE DECISION AS SOON AS PRACTICABLE. THE WORKERS’ COMPENSATION COMMISSION IS A STATE AGENCY RESPONSIBLE FOR MAKING FINAL DECISIONS ON DISPUTED WORKERS’ COMPENSATION CLAIMS. HOWEVER, SUCH CLAIM MAY BE LOST IF YOU DO NOT FILE IT WITHIN THE TIME LIMIT PROVIDED BY LAW, WHICH IS TYPICALLY TWO YEARS AFTER THE INJURY.
Such notice shall also include the address, telephone number, and website through which the employee may contact the Virginia Workers’ Compensation Commission.
B. Failure to comply with the provisions of this section shall not be considered a failure to make a required report for the purposes of § 65.2-902.
The new law requires that employers and insurers, subject to the Virginia Workers’ Compensation Act, include in any written denial letter to the claimant the above capitalized language completely unaltered. The law also requires that the denial letter include the address, telephone number, and website whereby the claimant may contact the Virginia Workers’ Compensation Commission.
We recommend including the following language in any denial letter that is issued to the claimant:
You may contact the Virginia Workers’ Compensation Commission by mail, telephone, or via the internet using the information provided below.
Virginia Workers’ Compensation Commission
333 E. Franklin St.
Richmond, VA 23219
877-664-2566
https://workcomp.virginia.gov/content/contact-commission
It is important to note that the provisions of § 65.2-601.3 will only apply to written denials sent to the claimant. The provisions of the new law do not apply to any verbal statement to a claimant denying a claim. Additionally, the Workers’ Compensation Act does not require that a written denial letter or notice be issued to the claimant. However, if a written denial notice is issued to the claimant on or after July 1, 2024, it must comply with the new law.
Subsection B of the new law explicitly states that failure to comply with the notice provisions will not be considered a failure to make a required report for the purposes of § 65.2-902, which allows for a civil fine of up to $5,000 for willful failure to make a required report. It is unclear at this time how the Commission will enforce the provisions of § 65.2-601.3, given the limitations found in subsection B. We will likely know more about any potential enforcement mechanisms after the law goes into effect on July 1st.
