By Patty McEnteer, Esq.
Throughout the years West Virginia has been the butt of many jokes. However, from an employer’s standpoint, West Virginia is far from a joke when it comes to workers’ compensation. Indeed, in many respects, West Virginia is ahead of many states with respect to its workers’ compensation system. The following are a few reasons as to why West Virginia’s workers’ compensation system is better than other states, namely Pennsylvania.
First, a claimant’s receipt of temporary total disability benefits is capped at 104 weeks of benefits. Unlike Pennsylvania where a claimant could receive temporary total disability benefits for an inordinate amount of time for a simple lumbar strain, in West Virginia a claimant could not receive more than 104 weeks of temporary total benefits. Even for more serious injuries, such as when a claimant undergoes a fusion, a claimant is only entitled to 104 weeks of temporary total disability benefits.
Second, temporary total disability benefits can be suspended immediately upon receipt of evidence of maximum medical improvement, claimant abuse, or job availability or return to work. It is not necessary to file a petition and go through the litigation process that could last more than year to have benefits suspended. Nor is it necessary to have the claimant sign a document agreeing to have his/her benefits suspended. Rather, an order just needs to be issued suspending benefits and it is up to the claimant to protest the decision.
Likewise, if a claimant is not compliant with medical treatment benefits can be suspended until the claimant becomes compliant with treatment. A claimant cannot extend his receipt of temporary total disability benefits by failing to undergo treatment. It is ironic how fast a claimant will become compliant with medical treatment once his indemnity benefits are suspended.
Third, and most importantly, there is much more control over the medical treatment a claimant undergoes as result of a work injury. Medical treatment is governed by Rule 20 which sets forth treatment recommendations for common work injuries. If treatment deviates from the guidelines, authorization must be obtained. Likewise, authorization is required for numerous forms of treatment. If authorization is required and is not obtained, payment can be denied.
Most notably is the limitation in the use of narcotic medication. In most cases, narcotic medication is only permissible for a short period of time following the injury or surgery. Unlike in Pennsylvania, a claimant will not receive narcotic medical for years for a simple lumbar strain.
These are just a few of the reasons as to why West Virginia workers‘ compensation system is better than Pennsylvania‘s system.