State News : West Virginia

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West Virginia



Lawyers Representing Injured Workers in West Virginia Oppose Proposed Rule Changes


The work of the Workers’ Compensation Subcommittee of the West Virginia Supreme Court’s Access to Justice Commission resulted in a proposed change to Rule 1 (85 W. Va. CSR 1) dealing with claim administration practices by carriers and third party administrators.  The West Virginia Insurance Commissioner issued a proposed revision to Rule 1 regarding a claim administrator’s acknowledgment of counsel and providing access to claim file materials.  On September 4, there was a public hearing on the proposed rule at the scheduled Workers’ Compensation Industrial Council meeting.  The filed and proposed Rule 1 can be found at the Insurance Commissioner’s website.


Union and claimant representatives challenged the Rule because it would allow the carrier to charge for copies of the claim file making it more difficult for injured workers to get copies, and would allow carriers to send checks to claimants and not the lawyers that represent them. 


At the Public Hearing, the Insurance Commissioner’s proposed Rule 1 amendment was challenged.  Opposition was expressed to a portion of 19.2.a. related to acknowledgment of counsel, and it was expressed that one section should be removed allowing the carrier to reserve the right to make determinations about where to send checks.  The opposition expressed that proper receipt of indemnity checks by the claimant’s attorney can help claimants report to Social Security on indemnity payments and so that offsets can be properly administered. With respect to the proposed subdivision 19.2.b., there was opposition to the rule that places the burden of the cost of producing a copy of a claim file on injured workers and their attorneys.  The Access to Justice Workers’ Compensation Committee proposed a revision to Rule 1 where the claim administrator would provide the claim file at no cost.  Additional comments expressed no opposition to the language in the proposed amendment whereby the claim administrator can resist overly burdensome, repetitive or abusive claim file requests.


The next meeting of the Industrial Council is November 6, where it may make a determination on the proposed changes to Rule 1.           


Dill Battle

Spilman Thomas & Battle, PLLC