West Virginia Carrier/Self-Insured/TPA Request for Permanent Total Disability Review is a process for those injured in the workplace who are unable to return to work due to their injury. The review is conducted by a panel of experts from the West Virginia Workers' Compensation Commission. The panel reviews the medical records, medical evidence, and other relevant information to determine if the individual is eligible for permanent total disability benefits. The panel can also consider other factors such as age, occupation, education, and prior work experience when making a decision. There are two types of West Virginia Carrier/Self-Insured/TPA Request for Permanent Total Disability Review: a "Formal Review" and an "Informal Review". The Formal Review is a detailed review of the individual's medical evidence by the panel of experts. The Informal Review is an administrative review by the West Virginia Workers' Compensation Commission staff.
West Virginia Carrier/Self-Insured/TPA Request for Permanent Total Disability Review
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FAQ
West Virginia Code § 23-4-1(f) (2021)1 provides that no ordinary disease of life to which the general public is exposed outside of employment is compensable under workers' compensation unless the disease was incurred in the course of and resulted from employment.
You cannot do work and engage in substantial gainful activity (SGA) because of your medical condition. You cannot do work you did previously or adjust to other work because of your medical condition. Your condition has lasted or is expected to last for at least 1 year or to result in death.
What are Common and different types of Permanent Disabilities? Sensory Disability. Head injury, stroke or acquired brain injury Disability. Psychosocial Disability. Physical Disability. Intellectual Disability.
Permanent disability (PD) is any lasting disability from your work injury or illness that affects your ability to earn a living. If your injury or illness results in PD you are entitled to PD benefits, even if you are able to go back to work.
Permanent Partial Disability (PPD) Benefits: 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 $350.67, 70% of the West Virginia state average weekly wage.
A person is permanently and totally disabled when he or she is unable to engage in any substantial gainful activity because of a mental or physical condition and that disability has lasted or can be expected to last continuously for at least a year or can be expected to lead to death.
Your physician must certify that you are unable to engage in any substantial gainful activity by reason of a medically determinable physical or mental impairment that: Can be expected to result in death, Has lasted for a continuous period of not less than 60 months, or.
Many permanent total disabilities include physical injuries like spinal cord injuries or brain injuries, but others include illness or other conditions. For example, cancer, multiple sclerosis, or chronic heart disease are often listed as disabilities, as are conditions that last from birth, such as cerebral palsy.