1. Employer’s Applications for Hearing
The Commission closely examines these items to determine if the Application is technically correct:
a. Claimant’s address
b. Grounds for the Application
c. Relief requested
d. Compensation rate
e. Date compensation was paid through
f. Presence of supporting documentation
g. Application signed
h. Application dated
i. Whether the claimant and the attorney, if represented, were sent a copy of the Application.
2. Unauthorized Practice of Law
The Commission provided these tips for adjusters about the unauthorized practice of law:
a. An adjuster cannot appear at an evidentiary hearing to advocate for an insurer or employer by offering evidence, argument, or examining witnesses.
b. An adjuster cannot file a position statement for an on-the-record hearing;
c. Adjusters can file Applications on behalf of the insurer and employer, investigate a claim, obtain medical documentation, and respond to orders directed toward the insurer and employer regarding claims for benefits and change-in-condition applications filed.
3. Amended Statute of Limitations
The Commission stressed that adjusters should investigate claims within six months after the accident for accidents occurring on or after July 1, 2019 . This is because recent amendments to §65.2-602 extend the statute of limitations when voluntary wage loss or indemnity benefits are paid more than six months after the date of injury.
The amendment gives the adjuster a six month grace period after the accident to investigate the claim. During that time, the adjuster can voluntarily pay indemnity or wage loss benefits with no adverse effect on the statute of limitations. After the grace period ends, the adjuster is effectively penalized for paying wage loss or indemnity benefits because paying those benefits extends the amount of time the claimant has to file a claim. The Commission stressed the importance of investigating claims before the grace period ends so that this does not occur.
Joe McNally is an Associate in the Workers' Compensation Practice Group. His practice is focused on representing employers and carriers defending workers’ compensation claims in Virginia. Previously, Joe represented Plaintiffs before the Workers' Compensation Commission, informing his experience with all sides of matters.