reglab/statecodes huggingface dataset:
West Virginia Code of State Rules › Agency 85 - Workers' Compensation › Title 85 - PROCEDURAL RULE WORKERS' COMPENSATION RULES OF THE WEST VIRGINIA INSURANCE COMMISSIONER › Series 85-11 - Employer Default, Enforcement, Collections and Related Matters › Section 85-11-6 - Methods of Collection of Payments and Enforcement

Current through Register Vol. XLI, No. 28, July 12, 2024
6.1. Following the default of an employer, in
				addition to the remedies described in previous sections of this rule, the
				Commissioner shall have available to him or her the following remedies which
				shall each be described more fully below:
6.1.a. Initiation of a civil action against
				the employer.
6.1.b. Filing of a
				lien or liens enforceable against all the property of the employer.
6.1.c. Initiation of an action in the Circuit
				Court of Kanawha County to enjoin the employer from continuing to carry on the
				business in which its liability was incurred or, in the alternative, to accept
				a bond from the employer.
6.1.d.
				Filing a claim in any bankruptcy proceeding or in a receivership or insolvency
				proceeding which involves the employer.
6.1.e. Informing the Secretary of
				environmental protection when an employer is in default prior to the director's
				issuance of a coal mining permit so that the permit may not be issued until the
				applicant is in compliance with chapter twenty-three of the West Virginia Code
				or the Rules promulgated thereunder, as provided in W. Va. Code §
										22-3-8.
6.1.f. Pursuant to W. Va. Code §§
										23-1-1b(g)(16),
				23-2C-15(d),
				and
				23-2C-19(e)
				and 85CSR32 §1 et seq., informing the director, commissioner or head of
				any state agency when an employer is in default, so that the director may take
				appropriate remedial action against the employer in regard to a contract,
				license, permit, certificate or other authority to conduct a trade, profession
				or business.
6.1.g. Requesting a
				criminal prosecution of any person, firm, corporation or other employer whose
				non-compliance with chapter twenty-three of the West Virginia Code or the rules
				promulgated thereunder is believed to be in violation of W. Va. Code §
										61-3-24e
				and section 15 of this rule.
West Virginia Code of State Rules › Agency 85 - Workers' Compensation › Title 85 - PROCEDURAL RULE WORKERS' COMPENSATION RULES OF THE WEST VIRGINIA INSURANCE COMMISSIONER › Series 85-11 - Employer Default, Enforcement, Collections and Related Matters › Section 85-11-8 - Civil Actions

Current through Register Vol. XLI, No. 28, July 12, 2024
8.1. The
				Commissioner in the name of the State may commence a civil action against a
				default employer to recover any payment and interest thereon due and unpaid
				under chapter twenty-three of the West Virginia Code and the rules promulgated
				thereunder, including, but not limited to, money owed to the Old Fund, money
				owed to the Uninsured Employers' Fund and money owed pursuant to liabilities
				accrued by the employer while the employer was self-insured.
8.2. Pursuant to W. Va. Code §
									23-2-5a,
				if the judgment entered in a civil action as described in this section is
				against the defendant employer, the defendant shall pay the costs of the
				action. In addition, a civil action as described in this section shall be given
				preference on the calendar of the court over all other civil actions.
8.3. Consistent with the provisions of W. Va.
				Code §
									33-2-22(e),
				the Commissioner may compromise and settle amounts due to the Old Fund or
				Uninsured Employer Fund if it is found to be in the best interests of the
				State. Any such compromise or settlement is public information.
West Virginia Code of State Rules › Agency 85 - Workers' Compensation › Title 85 - PROCEDURAL RULE WORKERS' COMPENSATION RULES OF THE WEST VIRGINIA INSURANCE COMMISSIONER › Series 85-11 - Employer Default, Enforcement, Collections and Related Matters › Section 85-11-9 - Injunctions From Carrying On Business

Current through Register Vol. XLI, No. 28, July 12, 2024
9.1. Pursuant to the provisions of W. Va.
				Code §
									33-2-22(b),
				the Commissioner may bring an action against a default employer in the Circuit
				Court of Kanawha County to enjoin such default employer from continuing to
				carry on business.
9.2. Pursuant to
				the provisions of W. Va. Code §
									33-2-22(c),
				the Circuit Court of Kanawha County shall issue an injunction prohibiting the
				default employer from operating its business if the Commissioner proves by a
				preponderance of the evidence that the employer is in default status.
9.3. The Commissioner may, in the
				Commissioner's sole discretion, as an alternative to pursuing such an
				injunction as described in this section, require a default employer to file a
				bond in the form prescribed by the Commissioner with satisfactory surety in an
				amount not less than fifty percent more than the payments and interest due. The
				bond must be issued by a corporate surety satisfactory to the
				Commissioner.
West Virginia Code of State Rules › Agency 85 - Workers' Compensation › Title 85 - PROCEDURAL RULE WORKERS' COMPENSATION RULES OF THE WEST VIRGINIA INSURANCE COMMISSIONER › Series 85-11 - Employer Default, Enforcement, Collections and Related Matters › Section 85-11-12 - Administrative Hearings

Current through Register Vol. XLI, No. 28, July 12, 2024
All administrative hearings conducted pursuant to this rule
				  will be held in accordance with the provisions of W. Va. Code §
									29A-5-1,
				  et seq., and with the provisions of Sections 4 through 10 of 85CSR7, "Rules for
				  Selected Hearings."
West Virginia Code of State Rules › Agency 85 - Workers' Compensation › Title 85 - PROCEDURAL RULE WORKERS' COMPENSATION RULES OF THE WEST VIRGINIA INSURANCE COMMISSIONER › Series 85-11 - Employer Default, Enforcement, Collections and Related Matters › Section 85-11-13 - Interest

Current through Register Vol. XLI, No. 28, July 12, 2024
13.1. Pursuant to
				W. Va. Code §
									23-2-13,
				all payments unpaid on the date on which due and payable, as prescribed by the
				Commissioner, shall immediately begin bearing interest. Interest shall be
				compounded quarterly until payment plus accrued interest is received by the
				Commissioner; except that future interest for payment agreements shall be
				calculated and provided at a simple rate of interest. Interest collected
				pursuant to this subsection shall be paid into the Old Fund, Uninsured
				Employers' Fund or Self-Insured Guaranty Risk Pool or Security Risk Pool (as
				established in 85CSR19 §1, et seq.), whichever is applicable.
13.2. Notwithstanding the provisions of
				subsection 13.1 of this section, in no event shall the rate of interest charged
				a political subdivision of the State or a volunteer fire department exceed ten
				percent per annum.
West Virginia Code of State Rules › Agency 85 - Workers' Compensation › Title 85 - PROCEDURAL RULE WORKERS' COMPENSATION RULES OF THE WEST VIRGINIA INSURANCE COMMISSIONER › Series 85-11 - Employer Default, Enforcement, Collections and Related Matters › Section 85-11-15 - Criminal Penalties

Current through Register Vol. XLI, No. 28, July 12, 2024
In addition to all other remedies available to the
				  Commissioner, in accordance with W. Va. Code §
									61-3-24e,
				  the Commissioner may elect to request prosecution of any person, firm,
				  partnership, association, corporation or other entity who violates certain
				  provisions of Chapter twenty-three of the West Virginia Code or the rules
				  promulgated thereunder.
West Virginia Code of State Rules › Agency 85 - Workers' Compensation › Title 85 - PROCEDURAL RULE WORKERS' COMPENSATION RULES OF THE WEST VIRGINIA INSURANCE COMMISSIONER › Series 85-11 - Employer Default, Enforcement, Collections and Related Matters › Section 85-11-16 - Freedom of Information Act

Current through Register Vol. XLI, No. 28, July 12, 2024
Pursuant to the Freedom of Information Act, W. Va. Code
				  §
									29B-1-1, et
				  seq. and W. Va. Code §
									23-1-4(b),
				  all of the evidence and records submitted during a hearing or proceeding under
				  this rule, or as part of a stipulation, except insofar as those records contain
				  confidential medical information or other information confidential to a
				  workers' compensation claimant, employer, or other person or entity shall be
				  subject to public inspection and copying; except that, if under the rules of
				  evidence certain testimony or documentary evidence may be deemed privileged or
				  confidential and placed under seal, then upon such a ruling by the hearing
				  officer, such testimony or documentary evidence shall not be disclosed. If the
				  privileged or confidential information cannot be excised from a record, then
				  the record as a whole will be deemed confidential and sealed; however, the
				  Commissioner shall release in its place a statement explaining in detail the
				  basis for the withholding of the record.
West Virginia Code of State Rules › Agency 85 - Workers' Compensation › Title 85 - PROCEDURAL RULE WORKERS' COMPENSATION RULES OF THE WEST VIRGINIA INSURANCE COMMISSIONER › Series 85-11 - Employer Default, Enforcement, Collections and Related Matters › Section 85-11-17 - Placement on Workers' Compensation Default List; Due Process and Hearing

Current through Register Vol. XLI, No. 28, July 12, 2024
17.1. When the
				Commissioner is made aware that an employer is in default, the Commissioner
				shall send the alleged default employer a notice informing the employer of the
				circumstances causing the employer to be in default and that the employer will
				be placed on the Default List within fifteen (15) days of the date on the
				letter. The notice shall also inform the employer that the employer may request
				an expedited administrative hearing before the Commissioner if the employer
				believes that the impending action by the Commissioner is factually or legally
				erroneous.
17.2. A request for an
				expedited administrative hearing, as described in subsection 17.1 of this
				section, shall clearly identify why the employer believes the Commissioner's
				impending action of placing it on the Default List is legally or factually
				erroneous. Upon receiving the request, the Commissioner shall, within ten (10)
				business days, hold a hearing which shall be conducted in accordance with the
				provisions of W. Va. Code §
									29A-5-1,
				et seq., and 85CSR7 §§4 through 10. A continuance shall only be
				granted upon the showing of good cause. An appeal from a final decision of the
				Commissioner shall be taken in accordance with the provisions of articles five
				and six [§ 29A-6-1, et seq.] of said chapter:
Provided
,
				That all appeals shall be taken to the Circuit Court of Kanawha
				County.
17.3. If an employer files
				a request for an expedited hearing pursuant to subsections 17.1 and 17.2 of
				this section, the fifteen (15) day time frame for placing the employer on the
				Default List shall be stayed until the Commissioner's final order upon the
				expedited hearing is issued, the request is withdrawn or the matter is
				otherwise resolved.
17.4. If the
				final decision of the Commissioner following the hearing upholds the original
				decision to place the employer on the Default List, the employer shall
				immediately be placed on the Default List.
17.5. The administrative appeal process
				described in this section does not interfere with or toll a workers'
				compensation carrier's right to terminate the employer's West Virginia workers'
				compensation coverage. The workers' compensation carrier's right to terminate
				an employer's West Virginia workers' compensation coverage is based upon the
				provisions of the insurance policy and the applicable law in chapters
				twenty-three and thirty-three of the West Virginia Code and the rules
				promulgated thereunder.
West Virginia Code of State Rules › Agency 85 - Workers' Compensation › Title 85 - PROCEDURAL RULE WORKERS' COMPENSATION RULES OF THE WEST VIRGINIA INSURANCE COMMISSIONER › Series 85-11 - Employer Default, Enforcement, Collections and Related Matters › Section 85-11-18 - Removal From the Default List

Current through Register Vol. XLI, No. 28, July 12, 2024
18.1. The Commissioner shall remove the
				employer from the Default List if an employer has met all of its legal, fiscal
				or other obligations pursuant to chapter twenty-three of the West Virginia Code
				and the rules promulgated thereunder, including, but not limited to, providing
				proof of current West Virginia workers' compensation coverage and paying all
				amounts owed under c hapter twenty-three of the West Virginia Code.
18.2. An employer on the Default List shall
				be permitted at any time to make a written request to the Commissioner for
				removal from the Default List:
Provided
, That such request is
				accompanied by evidence not previously submitted to the Commissioner which
				indicates that the employer making the request has met its obligations
				described in subsection 18.1 of this section and therefore is entitled to be
				removed from the Default List.
18.3. Employers may file a petition with the
				Commissioner requesting an administrative hearing before the Commissioner if
				they believe they should be removed from the Default List:
Provided
, That the Commissioner reserves the right to
				summarily deny an employer's petition for a hearing if the Commissioner
				determines that the employer presented no new evidence to the Commissioner in
				support of its written request for removal, is presenting evidence of no
				probative value or is otherwise making a frivolous request.
West Virginia Code of State Rules › Agency 85 - Workers' Compensation › Title 85 - PROCEDURAL RULE WORKERS' COMPENSATION RULES OF THE WEST VIRGINIA INSURANCE COMMISSIONER › Series 85-11 - Employer Default, Enforcement, Collections and Related Matters › Section 85-11-19 - Uninsured Fines

Current through Register Vol. XLI, No. 28, July 12, 2024
19.1. Any
				employer that fails to maintain West Virginia workers' compensation coverage
				for any period, regardless of whether the employer has such coverage at the
				time the uninsured period is discovered, shall, subject to the limitations of
				subsection 19.2 of this section, be fined by the Commissioner an amount equal
				to twice the amount of monthly base premium as calculated at the beginning of
				the uninsured period for each month, or portion of each month, the employer is
				or was without West Virginia workers' compensation coverage.
19.2. Pursuant to W. Va. Code §
									23-2C-8(d)(3),
				no fine imposed in this section for a single continuous period of failing to
				maintain West Virginia workers' compensation coverage shall exceed ten thousand
				dollars ($10,000). However, if an employer procures West Virginia workers'
				compensation coverage following a period of failing to maintain such coverage
				and then thereafter again fails to maintain such coverage, they will again be
				subject to a fine pursuant to subsection 19.1 of this section of up to ten
				thousand dollars ($10,000).
West Virginia Code of State Rules › Agency 85 - Workers' Compensation › Title 85 - PROCEDURAL RULE WORKERS' COMPENSATION RULES OF THE WEST VIRGINIA INSURANCE COMMISSIONER › Series 85-11 - Employer Default, Enforcement, Collections and Related Matters › Section 85-11-20 - Employer Violator System

Current through Register Vol. XLI, No. 28, July 12, 2024
20.1.
				Every employer subject to placement on the Default List shall also be placed in
				the Employer Violator System {W. Va. Code §
									23-1-1b(g)(25)},
				and shall remain in the Employer Violator System until such time as the
				employer is removed from the Default List.
20.2. All individuals who own, are officers,
				members or partners of, control, have a 10% ownership interest in, or are
				otherwise deemed to have a substantive or active ownership interest in an
				employer company which is on the Default List shall be placed in the Employer
				Violator System, and shall remain in the Employer Violator System until such
				time as the employer is removed from the Default List.
West Virginia Code of State Rules › Agency 85 - Workers' Compensation › Title 85 - PROCEDURAL RULE WORKERS' COMPENSATION RULES OF THE WEST VIRGINIA INSURANCE COMMISSIONER › Series 85-12 - Compromise and Settlement of Workers' Compensation Issues › Section 85-12-1 - General

Current through Register Vol. XLI, No. 28, July 12, 2024
1.1. Scope. --
				These rules shall govern the compromise and settlement of workers' compensation
				issues pursuant to W. Va. Code §
									23-5-7.
1.2. Authority. -- W. Va. Code §§
									23-2C-5(c)(2);
				23-2C-22;
				33-2-10(b);
				33-2-20(a);
				23-4-1
				et seq.;
				23-5-1;
				23-5-7.
				Pursuant to W. Va. Code §§
									23-2C-5(c)(2)
				and
				33-2-10(b),
				rules adopted by the industrial council and the Insurance Commissioner are not
				subject to legislative approval as would otherwise be required under W. Va.
				Code, §
									29A-3-1
				et seq. Public notice requirements of that chapter and article, however, must
				be followed.
1.3. Filing Date. --
				October 16, 2019.
1.4. Effective
				Date. -- November 15, 2019.
West Virginia Code of State Rules › Agency 85 - Workers' Compensation › Title 85 - PROCEDURAL RULE WORKERS' COMPENSATION RULES OF THE WEST VIRGINIA INSURANCE COMMISSIONER › Series 85-12 - Compromise and Settlement of Workers' Compensation Issues › Section 85-12-2 - Purpose

Current through Register Vol. XLI, No. 28, July 12, 2024
The purpose of this rule is to establish a consistent process
				  to govern the settlement of workers' compensation issues.
West Virginia Code of State Rules › Agency 85 - Workers' Compensation › Title 85 - PROCEDURAL RULE WORKERS' COMPENSATION RULES OF THE WEST VIRGINIA INSURANCE COMMISSIONER › Series 85-12 - Compromise and Settlement of Workers' Compensation Issues › Section 85-12-3 - Definitions

Current through Register Vol. XLI, No. 28, July 12, 2024
As used in this legislative rule, the following terms have
				  the stated meanings unless the context of a specific use clearly indicates
				  another meaning is intended.
3.1.
				"Insurance Commissioner" means the Insurance Commissioner of West Virginia as
				provided in section one, article two, chapter thirty-three of the West Virginia
				Code, or any designated third-party administrator of the Insurance
				Commissioner.
3.2. "Industrial
				Council" means the industrial council created pursuant to the provisions of W.
				Va. Code §
									23-2C-5.
3.3. "Orthopedic occupational disease" means
				an occupational disease that involves the musculoskeletal system as it
				functions for the purpose of mobility. The musculoskeletal system includes the
				following component parts:
(1)
				bone(s);
(2) muscle(s);
(3) tendon(s);
(4) ligament(s); and
(5) nerve(s). An orthopedic occupational
				disease may affect one or more component parts of the musculoskeletal
				system.
West Virginia Code of State Rules › Agency 85 - Workers' Compensation › Title 85 - PROCEDURAL RULE WORKERS' COMPENSATION RULES OF THE WEST VIRGINIA INSURANCE COMMISSIONER › Series 85-12 - Compromise and Settlement of Workers' Compensation Issues › Section 85-12-4 - Parties

Current through Register Vol. XLI, No. 28, July 12, 2024
Pursuant to the requirements of W. Va. Code §
									23-5-7
				  and the regulations herein set forth, the claimant and the Insurance
				  Commissioner, other private insurance carriers, or self-insured employer,
				  whichever is applicable, may negotiate a settlement of any and all issues in a
				  claim or claims, provided that in the settlement of medical benefits for
				  nonorthopedic occupational disease claims, the claimant shall be represented by
				  legal counsel. An insured employer is permitted to participate in the
				  settlement of a claim only to the extent that the employer is permitted to do
				  so under the terms of the applicable workers' compensation insurance
				  policy.
West Virginia Code of State Rules › Agency 85 - Workers' Compensation › Title 85 - PROCEDURAL RULE WORKERS' COMPENSATION RULES OF THE WEST VIRGINIA INSURANCE COMMISSIONER › Series 85-12 - Compromise and Settlement of Workers' Compensation Issues › Section 85-12-5 - Issues Subject to Settlement

Current through Register Vol. XLI, No. 28, July 12, 2024
If the claim is in the review or appellate process, all claim
				  issues may be settled even though the issues may not be currently contested.
				  These issues include, but are not limited to, medical benefits, temporary total
				  disability, temporary partial disability, permanent partial disability,
				  permanent total disability, vocational rehabilitation and any other issues
				  within the settlement provisions of W. Va. Code §
									23-5-7.
West Virginia Code of State Rules › Agency 85 - Workers' Compensation › Title 85 - PROCEDURAL RULE WORKERS' COMPENSATION RULES OF THE WEST VIRGINIA INSURANCE COMMISSIONER › Series 85-12 - Compromise and Settlement of Workers' Compensation Issues › Section 85-12-6 - Manner of Payment

Current through Register Vol. XLI, No. 28, July 12, 2024
The parties to any settlement may arrange for any amount to
				  be paid to the claimant or for the benefit of the claimant in a lump sum or in
				  incremental payments or in any manner as agreed upon by the parties. If no
				  mention is made in the settlement agreement regarding a permanent disability
				  percentage, the claim record will not reflect a percentage for the settlement
				  award.
West Virginia Code of State Rules › Agency 85 - Workers' Compensation › Title 85 - PROCEDURAL RULE WORKERS' COMPENSATION RULES OF THE WEST VIRGINIA INSURANCE COMMISSIONER › Series 85-12 - Compromise and Settlement of Workers' Compensation Issues › Section 85-12-7 - Dependent's Benefits

Current through Register Vol. XLI, No. 28, July 12, 2024
Except in cases where the claimant has previously been
				  granted a permanent total disability award, dependents are not entitled to one
				  hundred four (104) weeks of benefits as set forth in W. Va. Code §
									23-4-10
				  if the agreement is silent as to the claimant's entitlement to a permanent
				  total disability award.
West Virginia Code of State Rules › Agency 85 - Workers' Compensation › Title 85 - PROCEDURAL RULE WORKERS' COMPENSATION RULES OF THE WEST VIRGINIA INSURANCE COMMISSIONER › Series 85-12 - Compromise and Settlement of Workers' Compensation Issues › Section 85-12-8 - Settlement Not to be Considered an Admission Against Interest

Current through Register Vol. XLI, No. 28, July 12, 2024
The terms of a settlement agreement shall not constitute an
				  admission against interest by any party. All communications and correspondence
				  between the parties during settlement negotiations are confidential and may not
				  be used against a party if a settlement is not reached.
West Virginia Code of State Rules › Agency 85 - Workers' Compensation › Title 85 - PROCEDURAL RULE WORKERS' COMPENSATION RULES OF THE WEST VIRGINIA INSURANCE COMMISSIONER › Series 85-12 - Compromise and Settlement of Workers' Compensation Issues › Section 85-12-9 - Effective Date of Settlement

Current through Register Vol. XLI, No. 28, July 12, 2024
Unless otherwise agreed upon by the parties, the effective
				  date of a settlement shall be the date the agreement is executed by the
				  claimant and the Insurance Commissioner, private insurance carrier, or
				  self-insured employer, whichever is applicable.
West Virginia Code of State Rules › Agency 85 - Workers' Compensation › Title 85 - PROCEDURAL RULE WORKERS' COMPENSATION RULES OF THE WEST VIRGINIA INSURANCE COMMISSIONER › Series 85-12 - Compromise and Settlement of Workers' Compensation Issues › Section 85-12-10 - Minor Dependents and Claimants

Current through Register Vol. XLI, No. 28, July 12, 2024
In any case in which a surviving dependent infant may be
				  entitled to receive the balance of a permanent partial disability award due to
				  the death of a claimant before such award was paid in full or in any case in
				  which the claimant is an infant, the legal guardian of such infant may
				  negotiate a settlement of such claim with the Insurance Commissioner, private
				  insurance carriers, and self-insured employers, whichever is applicable. The
				  legal guardian shall proceed as set forth in W. Va. Code §
									44-10-14.
				  The appointment of said guardian shall be done as set forth in W. Va. Code
				  §
									44-10-1 et
				  seq. No bond shall be required of said guardian by the Insurance Commissioner
				  in addition to that required by the appointment of said guardian or approval by
				  the circuit court of any settlement pursuant to the provisions of W. Va. Code
				  §
									44-10-1 et
				  seq.
West Virginia Code of State Rules › Agency 85 - Workers' Compensation › Title 85 - PROCEDURAL RULE WORKERS' COMPENSATION RULES OF THE WEST VIRGINIA INSURANCE COMMISSIONER › Series 85-12 - Compromise and Settlement of Workers' Compensation Issues › Section 85-12-11 - Death of Claimant

Current through Register Vol. XLI, No. 28, July 12, 2024
Unless otherwise agreed upon by the parties, should a
				  claimant to whom an award has been made pursuant to a settlement die, the
				  unpaid balance of the award shall be paid to the claimant's dependents as
				  defined in W. Va. Code §
									23-4-10,
				  if any. The payment shall be made in the same installments which would have
				  been made to the claimant if living, but, unless otherwise specified in the
				  settlement agreement, no payment shall be made to a surviving spouse of the
				  claimant after his or her remarriage and such liability shall not accrue to the
				  estate of such claimant and shall not be subject to any debts or charges
				  against the estate.
If the claimant dies while the settlement is pending and the
				  claimant is survived by dependents, the settlement may continue as if the death
				  had not occurred. The payment shall be made to the
				  dependents.
West Virginia Code of State Rules › Agency 85 - Workers' Compensation › Title 85 - PROCEDURAL RULE WORKERS' COMPENSATION RULES OF THE WEST VIRGINIA INSURANCE COMMISSIONER › Series 85-12 - Compromise and Settlement of Workers' Compensation Issues › Section 85-12-12 - Deductions From Settlement Awards

Current through Register Vol. XLI, No. 28, July 12, 2024
12.1. Pursuant to W. Va. Code §
									23-4-18,
				any amounts owed for child or spousal support will be withheld from settlement
				payments.
12.2. Overpayments will
				be deducted pursuant to W. Va. Code §§
									23-4-1c
				and
				23-4-1d,
				unless otherwise agreed upon by the parties in the agreement.
12.3. Any award of monetary benefits entered
				by the office of judges, the Appeal Board or the Supreme Court of Appeals of
				West Virginia after the date the settlement agreement was signed by the
				necessary parties shall be deducted from the agreed upon settlement amount:
				Provided, That the deduction in this subsection can only be applied for amounts
				of award(s) of monetary benefits which involve the same issue(s) that the
				settlement involved, or if the settlement was a full and final settlement of
				all issues involved in the claim. If the amount of any such award is greater
				than the agreed upon settlement amount, the claimant's recovery shall be
				limited to the amount specified in the settlement agreement.
West Virginia Code of State Rules › Agency 85 - Workers' Compensation › Title 85 - PROCEDURAL RULE WORKERS' COMPENSATION RULES OF THE WEST VIRGINIA INSURANCE COMMISSIONER › Series 85-12 - Compromise and Settlement of Workers' Compensation Issues › Section 85-12-13 - Settlement Terms

Current through Register Vol. XLI, No. 28, July 12, 2024
Under the terms of the agreement, the claimant shall be
				  provided five (5) business days to revoke the executed settlement agreement. In
				  addition and in accordance with the provisions of W. Va. Code §
									23-5-7,
				  each settlement agreement shall provide the toll free number of the West
				  Virginia State Bar.
West Virginia Code of State Rules › Agency 85 - Workers' Compensation › Title 85 - PROCEDURAL RULE WORKERS' COMPENSATION RULES OF THE WEST VIRGINIA INSURANCE COMMISSIONER › Series 85-12 - Compromise and Settlement of Workers' Compensation Issues › Section 85-12-14 - Insurance Commissioner Review

Current through Register Vol. XLI, No. 28, July 12, 2024
14.1. In accordance with the provisions of W.
				Va. Code §
									23-5-7,
				the Insurance Commissioner may review any workers' compensation settlement
				entered into between an unrepresented claimant and the Insurance Commissioner,
				private insurance carriers, or self-insured employer, and may declare any such
				settlement void if the Insurance Commissioner determines the settlement to be
				unconscionable pursuant to the criteria set forth in subsection 14.2 of this
				section.
14.2. A workers'
				compensation settlement shall be considered unconscionable, and therefore be
				declared void as against public policy, if it is found to constitute a gross
				miscarriage of justice or if the terms of the settlement shock the conscience.
Criteria to be considered by the Insurance Commissioner in
				  determining whether a settlement is unconscionable include, but are not limited
				  to:
14.2.a. The relative position of
				the parties involved in the settlement at the time the settlement was entered
				into;
14.2.b. The adequacy of the
				bargaining position of the parties at the time the settlement was entered
				into;
14.2.c. The meaningful
				alternatives available to the claimant at the time the settlement was entered
				into;
14.2.d. The existence of
				specific unfair terms in the settlement agreement;
14.2.e. The nature of the entire
				agreement;
14.2.f. Whether the
				claimant was provided ample opportunity to read and review the settlement
				agreement and/or whether the settlement agreement was read to the
				claimant;
14.2.g. Whether the
				claimant was not informed of his ability to obtain a lawyer to assist in the
				review of the agreement;
14.2.h.
				Whether any of the material terms of the settlement agreement were not
				conspicuous;
14.2.i. The percentage
				of total benefits provided for under the settlement terms which have actually
				been received by the claimant when the claimant requested the settlement be
				reviewed; and
14.2.j. The time that
				has elapsed between the time the settlement was entered into and the time the
				claimant requested the settlement be reviewed.
West Virginia Code of State Rules › Agency 85 - Workers' Compensation › Title 85 - PROCEDURAL RULE WORKERS' COMPENSATION RULES OF THE WEST VIRGINIA INSURANCE COMMISSIONER › Series 85-12 - Compromise and Settlement of Workers' Compensation Issues › Section 85-12-15 - Severability

Current through Register Vol. XLI, No. 28, July 12, 2024
If any provision of these rules or the application thereof to
				  any person, party, or circumstances is held unconstitutional or invalid, such
				  unconstitutionality or invalidity shall not affect the other provisions or
				  application of these rules, and to this end the provisions of these rules are
				  declared to be severable.
West Virginia Code of State Rules › Agency 85 - Workers' Compensation › Title 85 - PROCEDURAL RULE WORKERS' COMPENSATION RULES OF THE WEST VIRGINIA INSURANCE COMMISSIONER › Series 85-13 - Procedural Rules for the Industrial Council › Section 85-13-1 - General

Current through Register Vol. XLI, No. 28, July 12, 2024
1.1. Scope. -- The
				West Virginia Open Governmental Proceedings Law, notably at W. Va. Code §
									6-9A-3,
				requires that governing bodies of state public bodies shall promulgate rules by
				which the time, the place, and the purpose of all regularly scheduled meetings
				and the time, place, and purpose of all emergency meetings are made available,
				in advance, to the public and the news media to the extent possible. Similarly,
				W. Va. Code §
									29A-3-3
				requires that agencies adopt procedural rules. The purpose of this rule is to
				comply with these requirements.
1.2. Authority. -- W. Va. Code §§
									6-9A-3,
				23-2C-5
				and
				29A-3-3.
1.3. Filing Date. -- March 10,
				2022.
1.4. Effective Date. -- March
				10, 2022.
West Virginia Code of State Rules › Agency 85 - Workers' Compensation › Title 85 - PROCEDURAL RULE WORKERS' COMPENSATION RULES OF THE WEST VIRGINIA INSURANCE COMMISSIONER › Series 85-13 - Procedural Rules for the Industrial Council › Section 85-13-2 - Application and Enforcement

Current through Register Vol. XLI, No. 28, July 12, 2024
2.1.
				Application. This procedural rule applies to the Workers' Compensation
				Industrial Council created pursuant to W. Va. Code §
									23-2C-5.
				The enforcement of this rule is vested with the Chairperson of the
				Council.
2.2. Except as
				specifically required by this rule, the Council shall not use any formal points
				of parliamentary order, personal privilege, parliamentary inquiry or other
				technical forms.
2.3. Any matter,
				procedure or order not covered by these rules shall be referred to the
				presiding officer who shall decide the matter in conformity with the purpose of
				these rules in a fair and expeditious manner. The decision of the presiding
				officer may be reversed by an affirmative vote of three (3) Members of the
				Council.
West Virginia Code of State Rules › Agency 85 - Workers' Compensation › Title 85 - PROCEDURAL RULE WORKERS' COMPENSATION RULES OF THE WEST VIRGINIA INSURANCE COMMISSIONER › Series 85-13 - Procedural Rules for the Industrial Council › Section 85-13-3 - Definitions

Current through Register Vol. XLI, No. 28, July 12, 2024
3.1. "Advisory
				Member" means a non-voting member as more fully set forth in W. Va. Code §
									23-2C-5(b).
3.2. "Chairperson" means the member elected
				as provided for by W. Va. Code §
									23-2C-5(b)(2)(D).
3.3. "Commissioner" means the West Virginia
				Insurance Commissioner.
3.4. "The
				Council" means the Workers' Compensation Industrial Council created under W.
				Va. Code §
									23-2C-5.
3.5. "Decision" means any determination,
				action, vote or final disposition of a motion, proposal, resolution, order or
				measure on which a vote of the Council is required at any meeting at which a
				quorum is present.
3.6. "Meeting"
				means the convening of the Council for which a quorum is required in order to
				make a decision or to deliberate toward a decision on any matter. For the
				purposes of W. Va. Code §
									23-2C-5(b)(3)(A),
				subcommittee meetings shall meet the definition of "Meeting" for those Members
				required to attend the subcommittee meeting: Provided, That when subcommittee
				meetings are held on the same day as a full Council meeting, Members may only
				receive compensation for the attendance of one meeting.
3.7. "Member" means a voting member of the
				Council as more fully set forth in W. Va. Code §
									23-2C-5(b).
3.8. "Presiding Officer" means the
				Chairperson or, in the absence of the Chairperson, the Vice-Chairperson. If
				both the Chairperson and Vice-Chairperson are absent, the presiding officer is
				the person elected pursuant to sections 6.1 and 6.2 of this rule.
3.9. "Quorum" means the presence of three (3)
				Members of the Council as provided for in W. Va. Code §
									23-2C-5(b)(2)(D).
West Virginia Code of State Rules › Agency 85 - Workers' Compensation › Title 85 - PROCEDURAL RULE WORKERS' COMPENSATION RULES OF THE WEST VIRGINIA INSURANCE COMMISSIONER › Series 85-13 - Procedural Rules for the Industrial Council › Section 85-13-5 - Agenda

Current through Register Vol. XLI, No. 28, July 12, 2024
5.1. Prior to each
				regular meeting, the Commissioner, or his or her designee, shall publish an
				agenda that contains all items the Council anticipates acting upon at the
				meeting. The Council may adopt the agenda as presented or may amend the
				agenda.
5.2. The Commissioner may
				utilize, for purposes of accomplishing his or her secretarial duties under this
				rule, clerical staff designated by the Offices of the Insurance Commissioner.
				This utilization may include, but is not limited to, the designation of staff
				to receive proposed agenda items, preparation of the agenda, recording and
				preparation of minutes, and all necessary public filing duties.
5.3. Agenda deadline. Any Member or Advisory
				Member may have an item included on the agenda by requesting the Commissioner,
				or his or her designee, to include the item by 5:00 p.m. on the Tuesday
				preceding the Wednesday by which the agenda must be filed with the Secretary of
				State's Office for publication on the Secretary of State's website in order to
				comply with the open meetings laws of this State.
5.4. Notice of Meeting. The Commissioner, or
				his or her designee, shall electronically file a notice of each Council meeting
				with the Secretary of State for publication on the Secretary of State's
				website. Each notice shall be filed in a manner to allow it to appear on the
				Secretary of State's website at least five (5) business days prior to the date
				of the meeting. When calculating the days, the day of the meeting is not to be
				counted. If a meeting notice is filed anytime other than during the Secretary
				of State's regular business hours, the date of filing will be considered the
				next business day.
5.5. Items
				requested or filed after the deadline for electronically filing the agenda with
				the Secretary of State's Office shall not be included on the agenda unless a
				Member or Advisory Member deems the item of sufficient urgency to warrant
				immediate Council action. These items shall be designated as "Extra" items and
				will be considered at the end of the regular agenda. The Commissioner, or his
				or her designee, shall record on the Extra item the name of the sponsoring
				Member or Advisory Member.
5.6.
				Withdrawal of items. Only the Member or Advisory Member requesting the
				placement of an item on the Agenda may withdraw the item prior to the
				electronic filing of the agenda with the Secretary of State's Office
				.
5.7. A Member or Advisory Member
				wishing the Council to continue, defer, or not act on an agenda item has a
				right to make and have his or her motion to continue, defer, or not act on any
				agenda item considered before any other act that the Council may consider on
				the agenda item.
West Virginia Code of State Rules › Agency 85 - Workers' Compensation › Title 85 - PROCEDURAL RULE WORKERS' COMPENSATION RULES OF THE WEST VIRGINIA INSURANCE COMMISSIONER › Series 85-13 - Procedural Rules for the Industrial Council › Section 85-13-6 - Opening the Meeting

Current through Register Vol. XLI, No. 28, July 12, 2024
6.1. Call to
				order. The Chairperson or Vice-Chairperson of the Council shall call the
				meeting to order at the appointed hour. In the absence of the Chairperson or
				Vice-Chairperson, the Commissioner shall call the meeting to order and a
				temporary presiding officer shall then be selected as set forth under section
				6.2 of this rule.
6.2. Presiding
				officer. The Chairperson, or in the Chairperson's absence or incapacity, the
				Vice-Chairperson, shall be the presiding officer at the meeting of the Council.
				If both the Chairperson and the Vice-Chairperson are absent, the Commissioner,
				or his or her designee, shall call the meeting to order and the Members present
				shall select a presiding officer by a majority vote of present Members. In the
				absence of such vote, the Commissioner, or his or her designee, shall remain
				and continue to be the presiding officer of the meeting.
6.3. Roll call. Before proceeding with the
				business of the Council, the Chairperson shall call the roll of Members and
				Advisory Members present, and ensure that the names are recorded in the minutes
				of the meeting. The Chairperson or presiding officer shall determine the
				presence of a quorum as required by these rules.
6.4. Order of consideration of agenda items.
				Except as otherwise provided in these rules, each agenda item shall be
				considered in numerical order. Each agenda item shall be separately announced
				for purposes of discussion and consideration.
West Virginia Code of State Rules › Agency 85 - Workers' Compensation › Title 85 - PROCEDURAL RULE WORKERS' COMPENSATION RULES OF THE WEST VIRGINIA INSURANCE COMMISSIONER › Series 85-13 - Procedural Rules for the Industrial Council › Section 85-13-7 - Discussion

Current through Register Vol. XLI, No. 28, July 12, 2024
7.1. The presiding
				officer shall control the discussion of the Council on each agenda item to
				assure full participation in accordance with these rules.
7.1.1. A Member or Advisory Member shall
				speak only after being recognized by the presiding officer. A Member or
				Advisory Member recognized for a specific purpose shall limit his or her
				remarks to that purpose. A Member or Advisory Member, after being recognized,
				shall not be interrupted except by the presiding officer to enforce these
				rules.
7.1.2. Each Member and
				Advisory Member shall limit his or her remarks to a reasonable
				length.
7.1.3. The presiding
				officer may enter into any discussion. The presiding officer has the right to
				close debate and speak last on any item.
West Virginia Code of State Rules › Agency 85 - Workers' Compensation › Title 85 - PROCEDURAL RULE WORKERS' COMPENSATION RULES OF THE WEST VIRGINIA INSURANCE COMMISSIONER › Series 85-13 - Procedural Rules for the Industrial Council › Section 85-13-8 - Motions; Voting

Current through Register Vol. XLI, No. 28, July 12, 2024
8.1. Motion to
				act on matters. At any appropriate place on the agenda, any Member may make a
				motion for the Council to act upon any matter if the motion is germane to the
				matter then under consideration.
8.2. Motion required. All action requiring a
				vote shall be moved by a Member and seconded by a different Member of the
				Council.
8.3. Recording names of
				moving Members. The Commissioner, or his or her designee, shall record for the
				official minutes the name of the Council Member moving and seconding each
				motion.
8.4. Call for vote. At the
				conclusion of debate, the presiding officer shall call for a vote: Provided,
				That an affirmative vote of three (3) Members may require a vote at any
				time.
8.5. Prevailing vote
				required; Vote by Proxy Prohibited. The vote of three (3) Members shall be
				necessary to take any action.
8.6.
				Motion to reconsider. A motion to reconsider must be made by a Member who was
				on the prevailing side in the original action.
West Virginia Code of State Rules › Agency 85 - Workers' Compensation › Title 85 - PROCEDURAL RULE WORKERS' COMPENSATION RULES OF THE WEST VIRGINIA INSURANCE COMMISSIONER › Series 85-13 - Procedural Rules for the Industrial Council › Section 85-13-10 - Citizen's Right to Address Council

Current through Register Vol. XLI, No. 28, July 12, 2024
10.1. Persons other than Members and Advisory
				Members shall be permitted to address the Council only upon specific agenda
				items, which may include an agenda item called "General Public Comment
				Period."
10.2. Persons desiring to
				address the Council shall register to speak prior to the start of the Council
				meeting. The form for registration shall require the following information:
(1) name of the person,
(2) mailing address,
(3) telephone number where the person may be
				reached during the day,
(4) the
				person's group affiliation, if any, and
(5) the agenda item to which the person
				desires to speak. If the person does not desire to speak to a particular agenda
				item, the person shall identify the subject matter about which he or she wishes
				to speak. If a member of the public is attending a meeting virtually, the
				person should register by providing the information required herein through
				electronic mail, fax, through a chat or message function if participating
				through videoconferencing, or by any other means acceptable to the
				Council.
West Virginia Code of State Rules › Agency 85 - Workers' Compensation › Title 85 - PROCEDURAL RULE WORKERS' COMPENSATION RULES OF THE WEST VIRGINIA INSURANCE COMMISSIONER › Series 85-13 - Procedural Rules for the Industrial Council › Section 85-13-11 - Subcommittees

Current through Register Vol. XLI, No. 28, July 12, 2024
11.1. The Council
				shall establish such subcommittees as it may from time to time determine are
				needed. Each subcommittee shall consist of at least two (2) Members. The
				Chairperson shall designate each subcommittee's membership and chairperson. In
				addition, the Chairperson may designate the subject matter to be considered by
				each such subcommittee. Only those Members assigned to the subcommittee shall
				be required to attend a meeting of the subcommittee.
11.2. The Chairperson, in his or her
				discretion, may appoint Advisory Members as non-voting members of
				subcommittees.
West Virginia Code of State Rules › Agency 85 - Workers' Compensation › Title 85 - PROCEDURAL RULE WORKERS' COMPENSATION RULES OF THE WEST VIRGINIA INSURANCE COMMISSIONER › Series 85-13 - Procedural Rules for the Industrial Council › Section 85-13-12 - Minutes

Current through Register Vol. XLI, No. 28, July 12, 2024
12.1. The Council
				shall provide for the preparation of written minutes of all its meetings. All
				such minutes shall be available to the public within a reasonable time after
				their approval by the Council and shall include the following information:
12.1.1. The date, time and place of the
				meeting;
12.1.2. The name of each
				Member and Advisory Member present or absent;
12.1.3. All motions, proposals, resolutions,
				orders, ordinances and measures proposed, the name of the person proposing the
				same and their disposition; and
12.1.4. The results of all votes and, upon
				request of a Member, the vote of each Member, by name.
West Virginia Code of State Rules › Agency 85 - Workers' Compensation › Title 85 - PROCEDURAL RULE WORKERS' COMPENSATION RULES OF THE WEST VIRGINIA INSURANCE COMMISSIONER › Series 85-13 - Procedural Rules for the Industrial Council › Section 85-13-13 - Records of the Council - Public

Current through Register Vol. XLI, No. 28, July 12, 2024
Records of the Council are public records consistent with W.
				  Va. Code §
									29B-1-3
				  and may be inspected and copied at a charge reasonably calculated by the
				  Council or Commissioner to recover its reasonable costs associated with the
				  production of documents.
West Virginia Code of State Rules › Agency 85 - Workers' Compensation › Title 85 - PROCEDURAL RULE WORKERS' COMPENSATION RULES OF THE WEST VIRGINIA INSURANCE COMMISSIONER › Series 85-14 - Procedural Rules For The Workers' Compensation Board Of Managers › Section 85-14-1 - General

Current through Register Vol. XLI, No. 28, July 12, 2024
1.1. Scope. -- The
				West Virginia Open Governmental Proceedings Law, W. Va. Code §
									6-9A-1,
				of 1931, as amended, requires in section three that governing bodies of state
				public bodies shall promulgate rules by which the time, the place, and the
				purpose of all regularly scheduled meetings and the time, place, and purpose of
				all emergency meetings are made available, in advance, to the public and the
				news media to the extent possible. Similarly, W. Va. Code §
									29A-3-3,
				requires that agencies adopt procedural rules. The purpose of this rule is to
				comply with these requirements.
1.2. Authority. -- W. Va. Code §§
									6-9A-3,
				23-1-1a(j)(3)
				and
				29A-3-3.
1.3. Filing date. -- May 27, 2005.
1.4. Effective date. -- July 1,
				2005.