Forms

The workplace workers’ compensation notices (posters) required by statute are NOT subject to OIC review or approval West Virginia Code § 23-2C-15(c) requires, in part, that:
			“Every employer shall post a notice upon its premises in a conspicuous place identifying its workers' compensation insurer. The notice must include the name, business address and telephone number of the insurer and of the person to contact with questions about a claim. The employer shall at all times maintain the notice provided for the information of his or her employees.”
There is currently no legislative rule addressing this requirement, and the workplace notices required by § 23-2C-15(c) are not subject to review or approval by the OIC. However, OIC interprets this statute as requiring two basic pieces of information to be set forth in the notice. First, the statute simply requires that the notice include the name, business address and telephone number of the employer’s workers’ compensation insurer. This requirement is straightforward and self-explanatory. Second, the statute requires that the notice should contain information regarding the “person” an injured worker may contact with any questions he or she may have regarding a claim. OIC interprets this requirement broadly. The “person” identified in the notice may be 1) an employee of the injured worker’s employer – for example, a manager, human resources director or employee benefits coordinator; 2) an adjuster for the insurer; or 3) the insurer’s third-party claims administrator. However, the “person” identified: 1) should be readily available to the injured worker to personally assist the injured worker with the injured worker’s claim; and 2) should possess sufficient knowledge about the workers’ compensation claims process to adequately do so. With regard to the physical composition of the notice, the statute provides no requirements with regard to the composition or size of the notice, or typeface used in the notice, and these determinations are left to the discretion of the insurer. It should be noted that the statute requires the notice to be posted in a conspicuous place upon the employer’s premises. Consistent with spirit of this directive, notices should be composed in a fashion that will provide workers with the required information in a legible format that can be easily seen and understood.
BROCHURES
The following brochures have been prepared by the OIC for use in claims made against State-administered workers’ compensation claims. The purpose of these brochures is to outline the claims process and the benefits available to injured workers. Brochures that are based on the form used in these OIC brochures are deemed to be approved; private carriers may prepare brochures utilizing their own trade dress, and should modify their brochures as necessary to provide the claimant with accurate contact information and other carrier-specific information. For example, claimants in OIC-administered claims may choose any physician so long as that physician accepts payment from the OIC-administered funds, whereas there may be limitations regarding the choice of a physician under the managed care organization of a private carrier. Under these circumstances, the brochure used by the private carrier should be modified to reflect information regarding the private carrier’s managed care organization, how a physician is to be selected under that organization, and specific contact information where a claimant may obtain answers to any questions they may have.