October 06, 2021

WV Insurance Commissioner Limits Access to the Permanent Total Disability Review Board

On September 1, 2021, West Virginia Insurance Commissioner Jim Doddrill issued Insurance Bulletin No. 21-06 titled “Permanent Total Disability Review Board”.  The Bulletin provides that as of January 1, 2022, the Offices of the Insurance Commissioner’s Permanent Total Disability Review Board (“PTDRB”) will no longer accept applications from self-insured employers or private carriers to evaluate claimants for permanent total disability benefits.  The Commissioner noted that the PTDRB could have been phased out with the termination of the Workers’ Compensation Commission, but the Insurance Commissioner chose to maintain the PTDRB.  However, the “dwindling number of applications” made the Insurance Commissioner decide to “discontinue the practice of accepting applications from outside parties to the PTDRB.”

The Insurance Commissioner made it clear that self-insured employers and/or private carriers must continue to abide by the provisions of W.Va. Code §23-4-6(j) in reviewing permanent total disability applications.  These provisions include the use of adequate resources in evaluating the application for permanent total disability benefits.  In addition, the employers and/or private carriers, and their representatives, “shall properly apply all standards for determining medical impairment and for determining whether a claimant is eligible for an award of permanent total disability benefits”.

In practical terms, this means that it will be the responsibility of the employers and/or private carriers and their representatives to schedule all evaluations regarding a permanent total disability application, including but not limited to, medical and vocational evaluations, and then make a determination based on those evaluations if the claimant is entitled to an award for permanent, total disability.  As always, we can assist in developing a list of providers that perform these evaluations.  We will keep you apprised of any vendors that may develop their own review boards.

If you have any questions about how this Bulletin may affect you, please feel free to contact one of the Workers’ Compensation attorneys in our Charleston office at (304) 341-0500.

A copy of Insurance Bulletin No. 21-06 (PTDRB) is attached.