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Workers Compensation Claim Customer Workers Compensation Jurisdictional Resource – West Virginia Issue Timely Reporting of Claims Mandatory What & How Yes, for both Employers and Employees. Impact State Forms Loss of potential defenses such as statutes of limitation. West Virginia Form WC-1 Employees' First Report of Injury (FROI) West Virginia Form WC-2 Employers' Report of Injury Timely Reporting of Employee Returning to Work No, employer is not required to provide a notice to their Injured workers. Managed Care Law No, but optional. Drug Free Work Place Yes, at employer’s discretion. Early return to work and reduced claim cost. N/A Managed Law Care of West Virginia Potential to increases ability to direct medical and decrease litigation. N/A Industry and Occupation Specific. Section 22A (Drug Free Coal Mine Act) of the West Virginia Code Potential to decrease cost of claim. West Virginia Form Controlled Substance Section 17E (Drivers' Requiring CDL Licensure) of the West Virginia Code Directing Medical Treatment No N/A © 2009 The Travelers Companies, Inc. All rights reserved Page 1 of 2 N/A N/A C E - 1 0 1 6 4 Rev. 11/09 Customer Workers Compensation Jurisdictional Resource – West Virginia Issue Safety Mandatory Yes, depending on industry. Reporting First Aide Claims Yes Posting Notices Yes What & How OSHA Compliance MSHA Compliance Impact State Forms Potential to decrease cost of claim and comply with federal and state laws and regulations. N/A Assists in Investigation of Claims. 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. N/A West Virginia Form WC-1 Employees' First Report of Injury (FROI) N/A Section 23-2C-15(c) of the West Virginia Code The Travelers Indemnity Company and its property casualty affiliates One Tower Square Hartford, CT 06183 This material does not amend, or otherwise affect, the provisions or coverages of any insurance policy or bond issued by Travelers. It is not a representation that coverage does or does not exist for any particular claim or loss under any such policy or bond. Coverage depends on the facts and circumstances involved in the claim or loss, all applicable policy or bond provisions, and any applicable law. Availability of coverage referenced in this document can depend on underwriting qualifications and state regulations. travelers.com © 2009 The Travelers Companies, Inc. All rights reserved Page 2 of 2 C E - 1 0 1 6 4 Rev. 11/09