West Virginia Code of State Rules › Agency 102 - Workers' Compensation Board Of Review › Title 102 - PROCEDURAL RULE WORKERS' COMPENSATION BOARD OF REVIEW › Series 102-01 - Rules of Practice and Procedure and Litigation of Protests › Section 102-1-3 - Definitions

Current through Register Vol. XLI, No. 28, July 12, 2024
3.1. "Board of Review" shall include Board of
				Review Members, Clerk, Deputy Clerks, Office of Counsel, Hearing Examiners,
				other staff, and any authorized representatives and designees of the Board of
				Review.
3.2. "Board of Review's
				Clerk and Office of Counsel" serve as staff counsel to the Board of Review. The
				Clerk and Office of Counsel provide procedural assistance and information to
				pro se litigants. Various motions and other matters requiring rulings in claims
				pending before the Board of Review are presented to the Board of Review through
				the Clerk/Office of Counsel. Other duties of the Clerk/Office of Counsel
				include, but are not limited to, reviewing protests; holding status conferences
				in protests; providing memoranda on legal issues; making recommendations
				regarding claim processing, such as the expedited hearings process, mediation,
				settlements, adding or dismissing chargeable employers and carriers,
				unreasonable denials, stays, attorney fees, failure of claim administrator to
				timely rule, and denial of a claim based upon W. Va. Code § 21-5I-4
				(classification of independent contractors and employees); and other duties as
				assigned by the Board of Review.
3.3. "Claim administrator" shall mean the
				entity with legal authority to administer workers' compensation claims, make
				awards, and take any other administrative actions as authorized in Chapter 23
				of the W. Va. Code. In some places in the code, the term "issuing entity" is
				used. For purposes of this Rule, "claim administrator" and "issuing entity"
				mean the same thing. "Claim administrator" includes the Offices of the
				Insurance Commissioner, any self-administering employer who has been granted
				self-insured status, any authorized third-party administrator, or any private
				insurance carrier authorized to issue workers' compensation coverage in West
				Virginia.
3.4. "Closing argument"
				shall mean a written discussion of the facts and controlling law of the case.
				Such written summary may be submitted at any time up to ten days after the
				expiration of the time frame. An argument that is filed later than ten days
				after the expiration of the time frame may be considered at the discretion of
				the Board of Review.
3.5. "Argument
				in lieu of evidence" shall mean a written statement explaining why the claim
				administrator's ruling is incorrect on its face. Such statement may be
				submitted instead of submitting evidence when the party believes that evidence
				is not necessary. Such statement avoids having the claim administrator's ruling
				automatically affirmed for failure to prosecute. Such statement must be filed
				during the protesting party's time frame.
3.6. "Electronic filing" includes
				transmitting information and documents over the internet in accordance with
				security guidelines. Electronic filing includes a computer-based system for the
				storage, retrieval, and management of documents. Instructions for electronic
				filing will be provided when electronic filing becomes available.
3.7. "Expedited hearing," as contemplated by
				W. Va. Code §
									23-4-1c(a)(3), shall mean the final resolution of the issue.
				The term "hearing" is used in the sense of an opportunity for a party to
				request that a hearing be scheduled, an opportunity for a party to offer
				written evidence or argument, or both, and to have his or her cause considered
				by the Board of Review.
3.8. "Mail
				sent to the parties by the Board of Review" means documents sent by United
				States Postal Service or by electronic means or by other methods.
3.9. "Hearing Examiner" shall include the
				Board of Review's Clerk, Deputy Clerks, Hearing Examiners, and other Board of
				Review attorneys.
3.10. "Party"
				shall mean the injured worker (claimant), claimant's dependents, the employer,
				and, with respect to some claims, the Offices of the Insurance Commissioner.
				Private carriers, insurance agents, and third-party administrators are not
				parties to the litigation.
3.11.
				"Presiding Board Member" shall mean the Board Member authorized to make the
				final decision in the protest. In addition to having a Presiding Board Member,
				each protest may, in the Board's discretion, be assigned to a Mediator. The
				Mediator may be an attorney on the Board of Review's staff or a Board of Review
				Member, who is not the Presiding Board Member.
3.12. "Protest" shall mean an objection to a
				ruling of the claim administrator. A protest shall be filed with the Board of
				Review in writing and a copy served on the claim administrator and all parties.
				The protest shall include a copy of the claim administrator's ruling to which
				the protest has been made. The protest shall include the claimant's mailing
				address and phone number. In some sections of Chapter 23 of the W. Va. Code,
				the term "objection" is used. For purposes of this Rule, "protest" and
				"objection" mean the same thing. For purposes of this Rule and the expedited
				hearing process set forth herein, the term "protest" also includes the filing
				of a written petition, motion, or statement alleging that a private carrier or
				self-insured employer, whichever is applicable, has failed to timely issue a
				ruling upon any application or motion as provided by law and as set forth in W.
				Va. Code §
									23-4-1c(a)(3).
3.13.
				"Record" shall mean evidence timely submitted by a party to the Board of
				Review, evidence taken at hearings conducted by the Board of Review, and prior
				rulings upon which the Board of Review took judicial
				notice.