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West Virginia Employees' Report of Occupational Pneumoconiosis

State:
West Virginia
Control #:
WV-SKU-0511
Format:
PDF
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Description

Employees' Report of Occupational Pneumoconiosis

West Virginia Employees’ Report of Occupational Pneumoconiosis is a medical form filled out by workers who have been exposed to silica, silicates, coal dust, and other hazardous substances in the workplace. The form is designed to document the individual’s work history, medical diagnosis, and the associated risk of developing occupational pneumoconiosis. It is used to help employers identify and address potential issues related to the health and safety of their employees. There are three types of West Virginia Employees’ Report of Occupational Pneumoconiosis: Initial Report, Update Report, and Final Report. The Initial Report must be completed and submitted within 30 days of the initial diagnosis of occupational pneumoconiosis, and is used to document the initial diagnosis of the disease. The Update Report must be completed and submitted every three years, and is used to document any changes in the diagnosis or the individual’s work history that could affect the risk of developing occupational pneumoconiosis. The Final Report must be completed and submitted when the individual leaves the workplace, and is used to document any changes to the diagnosis or the individual’s work history that could affect the risk of developing occupational pneumoconiosis.

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FAQ

All West Virginia employers are statutorily required to maintain workers' compensation insurance coverage. Visit the West Virginia Offices of the Insurance Commissioner Employer Coverage Unit online to file workers' compensation.

Claims Must Be Filed Within Six Months West Virginia requires injured workers to file an application for benefits within six months of the date of injury. Do not allow yourself or your loved one to miss out on valuable financial help to replace lost wages, cover medical expenses, and more.

What Is a Monopolistic State? Every state can have different workers' compensation (WC) requirements. Monopolistic states require employers to purchase state fund workers' comp coverage. In these states, buying workers' compensation from private insurers is not allowed.

What's covered? Workers' compensation insurance in WV helps pay medical costs for employees that become hurt or sick as a result of their job. It can also help replace some of your employee's missed wages or provide disability payments if they're unable to return to work.

An injured worker's wage paid is 66 2/3%. The weekly payment minimum is $175.33, 33 1/3% of the West Virginia state average weekly wage and may not exceed the Federal minimum hourly wage. The weekly maximum is $526, 100% of the West Virginia state average weekly wage. Maximum period of payments is 104 weeks.

To make up for missed wages, an employee with a work-related injury or illness is eligible to receive up to two-thirds of their pre-injury average weekly earnings. Temporary total disability benefits begin after they can't work for more than three consecutive calendar days.

In these states, employers must buy workers comp insurance from an insurance fund operated by the state. Nevada and West Virginia were monopolistic states in the past but now have a competitive market system.

The term monopolistic state refers to any state that has special legislation in place that requires workers' compensation coverage be provided exclusively by the state's workers' compensation program.

More info

Chicago, IL 60666-0941. Return completed form to your workers' compensation carrier.Employees Report Of Occupational Pneumoconiosis {OICWC1OP}. Manner in which the report shall be completed. 1. The manner in which the report shall be completed. 5. 1. For coal-related occupational pneumoconiosis claims, each clinical. Occupational Health Indicator 10: Mortality from or with Pneumoconiosis . There are over 3 million workers in Washington State. 1 Annual Number of Total Pneumoconiosis Deaths. Health of full-time workers engaged in any dusty work.

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West Virginia Employees' Report of Occupational Pneumoconiosis