Virginia Workers’ Compensation Commission

Quick Reference Guide

workcomp.virginia.gov
Revised March 2023
Virginia Workers’ Compensation Commission Claims Services Reference Material

Table of Contents

Cover

Average Weekly Wage

Wage Chart

Calculating Cost of Living

Converting Partial Week of Temporary Partial Disability

Calculating Permanent Partial Disability

Amputation Chart
Calculating Vision Loss

Calculating Hearing Loss

Hearing Loss - Audiogram Example

Third Party Settlements and Request for Offset Toward Future

Benefits Subrogation Lien Recovery Checklist

VWC Calculator Application

Vocational Rehabilitation Guidelines

Marketing Guidelines

Marketing/Job Search Form

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Virginia Workers’ Compensation Commission Claims Services Reference Material

Average Weekly Wage

If an injured worker lost more than 7 consecutive calendar days, although not in the same week, these periods
should be noted on the Wage Chart using an asterisk (*) in the Week No. column and are not to be counted in
the calculations.
If an injured employee has worked less than 12 months, the earnings for the time worked should be used or
the earnings for a similar employee may be used if the employee has worked less than 60 days.
Quick Facts:
• “AWW” means Average Weekly Wage
• VWC Form #7A is the preferred method for submitting wage information to the
Commission
• Use the gross earnings for the 52 weeks preceding the date of injury
• List any perquisites (amounts paid to the employee for meals, lodging, uniforms,
etc.) in the spaces provided on the bottom section of the form and do not include
in the total gross earnings

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Virginia Workers’ Compensation Commission Claims Services Reference Material

Wage Chart The boxes

to the right
Reserved VWC File Number
000-00-00
Employer’s Statement of Wage Earnings are for the
use of the Insurer Code Insurer Location
Virginia Workers’ Compensation Commission insurer.
333 E. Franklin St., Richmond, Virginia 23219 Insurer Claim Number

Employee Address

Name of Employee Date of Accident Date of Hire

John P. Hurtworker 07/10/2004
Employer Address

Name of Employer Employee’s Social Security Number

Virginia Workers' Compensation Commission xxx-xx-xxxx

PLEASE REFER TO THE FILING INSTRUCTIONS PRINTED ON THE BACK OF THIS FORM

Week Week Days Gross amount Week Week Ending Days Gross amount Week Week Ending Days Gross amount
No. Ending Worked paid, including No. Date Worked paid, including No. Date Worked paid, including
Date overtime overtime overtime
07/18/03 5 200.00 11/21/03 6 240.00 03/26/04 6 240.00
1 19 37

2 07/25/03 6 240.00 20 11/28/03 5 200.00 38

04/02/04 5 200.00

3
08/01/03 5 200.00 21 12/05/03 5 200.00 39
04/09/04 5 200.00

4 08/08/03 5 200.00 22
12/12/03 5 200.00 40 04/16/04 5 200.00

5
08/15/03 5 200.00 23
12/19/03 5 200.00 41
04/23/04 5 200.00
EXAMPLE
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08/22/03 6 240.00 24 12/26/03 5 200.00 42
04/30/04 5 200.00

7
08/29/03 5 200.00 25
01/02/04 4 160.00 43 05/07/04 5 200.00
Date of injury: 7/10/04
8
09/05/03 5 200.00 26 01/09/04 5 200.00 44 05/14/04 5 200.00
09/12/03 5 200.00 01/16/04 5 200.00 05/21/04 4 160.00
9
09/19/03 5 200.00
27
01/23/04 5 200.00
45
05/28/04 6 280.00
Date range you can use:
10 28 46

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09/26/03 5 200.00 29 01/30/04 5 200.00 47
06/04/04 5 220.00 7/10/03 to 7/09/04
12 10/03/03 5 200.00 30 02/06/04 5 200.00 48
06/11/04 5 220.00

13 10/10/03 5 200.00 31
02/13/04 4 160.00 49 06/18/04 5 220.00 STEPS:
14
10/17/03 6 288.00 32
02/20/04 6 296.00 50 06/25/04 5 220.00 1. Add up all applicable
10/24/03 6 294.00 02/27/04 5 200.00 07/02/04 5 220.00
15 33
03/05/04
51
weeks
10/31/03 5 200.00 5 200.00 07/09/04 4 176.00
16
11/07/03 5 200.00
34
03/12/04 5 200.00
52
2. Add any perquisites to
17 35 Totals
18
11/14/03 5 200.00 36
03/19/04 5 200.00 $10,874.00 total (if any)
10,874.00 52
3. Divide by the number
Value of perquisites for entire year: Total gross earning $ ____________ Total weeks worked _______
of weeks used
Bonuses $ 500.00 Electricity $ _______
Meals/Lodging $ Water $ 500.00
Total value of perquisites $_____________
Meals Only $ Telephone $ _______ VWC use only:
Temporary Lodging $ Uniforms $ _______
House Rent $ Laundry $ 11,374.00
Total earnings & perquisites $ _____________ AWW: ________ This example:
Tip Income $ ________
CR: ________
$10,874.00 + $500 =
INSURER OR EMPLOYER (include name & signature) Date Telephone number
$11,374.00 ÷ 52 weeks=
$218.73 AWW
Wage Chart
VWC Form No. 7A (rev. 07-01-06)

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Virginia Workers’ Compensation Commission Claims Services Reference Material

Calculating Cost of Living (COLA)

A Quick How-To
Average Weekly Wage (AWW)
• *Net SS x 12 ÷ 52 = weekly SS Compensation Rate (CR)
• CR + weekly SS = total combined Social Security (SS)
• AWW x 80% = *after deduction for medicare premium

If the total combined exceeds 80% of the average weekly wage (AWW), COLA is not due.

EXAMPLE
$1,864 (Net SS) x 12 ÷ 52 = $430.15 weekly $734 (Net SS) x 12 ÷ 52 = $169.38 weekly
$841 (CR) + $430.15 (Weekly SS)= $1,271.15 total $189.16 (CR)+ $169.38 (Weekly SS) = $358.54 total
$2,232.23 (AWW) x 80% = $1,785.78 $283.75 (AWW) x 80% = $227.00

COLA ELIGIBLE NOT COLA ELIGIBLE

Min/Max Rate Chart

Virginia Workers’ Compensation Commission Chronological Compensation Benefits Chart
Weekly Weekly
% of Maximum COLA Limit of Mileage
Minimum Maximum Burial Transportation
Weekly Benefit (effective Medical Reimbursement
Year (effective (effective Expenses
Wage Weeks Oct. 1) Benefits Rate
July 1) July 1)
$0.655 Burial not exceeding $10,000
2023 $335.75 $1,343.00 66 2/3% 500 6.40% Life
(effective 1/1/23) Transportation not exceeding $1,000
$0.585
(effective 4/1/22) Burial not exceeding $10,000
2022 $322.50 $1,290.00 66 2/3% 500 7.40% Life
$0.625 Transportation not exceeding $1,000
(effective 7/1/22)
Burial not exceeding $10,000
2021 $298.75 $1,195.00 66 2/3% 500 1.40% Life $0.555
Transportation not exceeding $1,000
Burial not exceeding $10,000
2020 $284.25 $1,137.00 66 2/3% 500 2.30% Life $0.555
Transportation not exceeding $1,000
Burial not exceeding $10,000
2019 $275.50 $1,102.00 66 2/3% 500 1.85% Life $0.555
Transportation not exceeding $1,000
Burial not exceeding $10,000
2018 $270.50 $1,082.00 66 2/3% 500 2.15% Life $0.555
Transportation not exceeding $1,000
Burial not exceeding $10,000
2017 $260.75 $1,043.00 66 2/3% 500 2.05% Life $0.555
Transportation not exceeding $1,000
Burial not exceeding $10,000
2016 $249.00 $996.00 66 2/3% 500 0.55% Life $0.555
Transportation not exceeding $1,000
Burial not exceeding $10,000
2015 $243.75 $975.00 66 2/3% 500 0.55% Life $0.555
Transportation not exceeding $1,000
Burial not exceeding $10,000
2014 $241.75 $967.00 66 2/3% 500 1.50% Life $0.555
Transportation not exceeding $1,000

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Virginia Workers’ Compensation Commission Claims Services Reference Material

Converting Partial Week of Temporary Partial Disability (TPD)

A Quick How-To

• All figures are to be converted into weekly figures (7 days)

• Calculate the average earned by the injured worker for the specified time frame
• Determine the number of days the injured worker worked
• The average earned ÷ by the number of days worked = the daily rate
• Convert that amount into a weekly rate by multiplying by 7 (for 7 days/week). This is the
post-injury wage (PIW)
• AWW - PIW x .66667 = TPD rate

EXAMPLE

AWW = $652.56
Partial PIW earnings of the injured worker $238.55
Number of days worked 4
Convert to a daily PIW: $238.55 ÷ 4 = $59.64 daily PIW

Convert to a weekly PIW: $59.64 x 7 = $417.48 weekly PIW

AWW - PIW: $652.56 - $417.48= $235.08 $235.08 x .66667

and multiply by .66667 = TPD Compensation Rate $156.72 TPD rate

AWW- Average Weekly Wage

PIW- Post-Injury Wage
TPD- Temporary Partial Disability
CR- Compensation Rate

* For assistance with calculations, please contact the Commission at 877-664-2566.

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Virginia Workers’ Compensation Commission Claims Services Reference Material

Calculating Permanent Partial Disability (PPD) Virginia Code § 65.2-503

A Quick How-To
Multiply (rating) “x” number of weeks LOSS COMPENSATION PERIOD
for body part “x” compensation rate =
Thumb 60 weeks
total amount due claimant.
First finger (index finger) 35 weeks

Second finger 30 weeks

EXAMPLE
Third finger 20 weeks
20% loss of use of arm:
200 x 20% = 40 weeks due Fourth finger (little finger) 15 weeks
1st phalanx of the thumb or any finger is equal to half
compensation for loss of entire thumb or finger.
Loss of more than one phalanx of thumb or any finger is deemed
100% loss of entire thumb or finger.
Amounts received for loss of more than one finger shall not
exceed compensation for loss of hand.
Great toe 30 weeks

Any toe other than great toe 10 weeks

Loss of more than one phalanx of a toe is deemed loss of the
entire toe.
Hand 150 weeks
Arm 200 weeks
Foot 125 weeks
Leg 175 weeks
Permanent loss of vision of an eye 100 weeks

Permanent loss of hearing of an ear 50 weeks

Severely marked disfigurement Not exceeding 60 weeks

First stage of pneumoconiosis,
50 weeks
silicosis & asbestoses
Second stage of pneumoconiosis,
100 weeks
silicosis & asbestoses
Third stage of pneumoconiosis,
300 weeks
silicosis & asbestoses
Byssinosis 50 weeks

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 Virginia Workers’ Compensation Commission Amputation Chart
Virginia Workers’ Compensation Commission Claims Services
AccessReference Material
your claim online: webfile.workcomp.virginia.gov

Jurisdiction Claim Number (JCN) Claim Administrator Number

Injured Worker Information

Patient’s Name Date of Injury/Occupational Disease Date of Amputation

Name of Company/Employer

Amputation Chart - Hand/Foot

The physician should complete this form with a straight line drawn at the exact point of amputation. Circles are not acceptable.

Middle Great
Index (2nd) Ring Toe 2nd
(1st) (3rd) 3rd
4th
Distal Little
(4th) 5th
Phalanges

Middle
2 3
1 4
Proximal 5
Thumb
Metatarsals
Distal
2 3
4
Proximal 5

1
Metacarpals

Which hand? Which foot?

Attending Physician
Attending Physician’s Name

Address City State Zip Code

I certify that I personally examined and treated this patient.

SIGNATURE OF PHYSICIAN DATE

Toll-Free: 877-664-2566 | Online: workcomp.virginia.gov | Mail: 3336 E. Franklin St., Richmond, Virginia 23219 Rev. 11/21
Amputation Chart Process & Instructions

Amputation Chart

The treating physician completes this form to provide information to support an injured worker’s claim which
resulted in amputation to the hand, fingers, metacarpal bones; or, the foot, toes (phalanges) or metatarsals.

Instructions

The physician should complete this form with a straight line drawn at the exact point of amputation. Circles
are not acceptable. This will allow the Commission to determine an accurate entitlement of permanent partial
disability benefits.

This form may be filed electronically through the Commission’s WebFile system at:
webfile.workcomp
p.virgginia.g
gov.

To file electronically, the user must have a valid and active WebFile account. This form may also be filed by
mail or in-person at 333 E. Franklin St., Richmond, Virginia 23219.

For questions or assistance with completing this form, please contact the Virginia Workers’ Compensation
Commission toll-free at 877-664-2566.

Ombudsman Office
Have questions about the Virginia Workers’ Compensation Commission and no lawyer? Call the Ombuds Department
at 833-448-1681, or email [email protected]. We cannot give legal advice, but all conversations will be
kept confidential.

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Toll-Free: 877-664-2566 | Online: workcomp.virginia.gov | Mail: 333 E. Franklin St., Richmond, Virginia 23219
Virginia Workers’ Compensation Commission Claims Services Reference Material

Calculating Vision Loss

The percentage of visual acuity is based on the
Snellen’s Chart (Rule 13). If the injured worker
had pre-existing loss of vision, it is subtracted
from the post-injury reading prior to SNELLEN’S CHART PERCENTAGE OF LOSS
READINGS OF VISUAL ACUITY
determination of the percentage of loss.
20/20 0

20/25 5

20/30 10

20/40 20

20/50 25

20/60 33.5
20/70 40
20/80 50
20/90 62.5
20/100 75
20/110 80

20/120 85

20/130 87

20/140 89

20/150 91

20/160 93

20/170 95

20/180 97

20/190 99

20/200 100

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Virginia Workers’ Compensation Commission Claims Services Reference Material

Calculating Hearing Loss

• 100% loss of hearing to an ear is equal to 50 weeks of compensation benefits
• Hearing loss percentages are determined by the Hearing Loss Table - Rule 12 of the Rules of the
Virginia Workers’ Compensation Commission

Hearing Loss Table (Rule 12)

Average Decibel Percent of Compensable Average Decibel Percent of Compensable
Loss Hearing Loss Loss Hearing Loss
27 0.8 60 55.0
28 2.2 61 56.7
29 3.6 62 58.3
30 5.0 63 60.0
31 6.7 64 61.7
32 8.3 65 63.3
33 10.0 66 65.0
34 11.7 67 66.7
35 13.3 68 68.3
36 15.0 69 70.0
37 16.7 70 71.7
38 18.3 71 73.3
39 20.0 72 75.0
40 21.7 73 76.4
41 23.3 74 77.8
42 25 0 75 79.2
43 26.7 76 80.6
44 28.3 77 82.0
45 30 0 78 83.4
46 31.7 79 84.8
47 33.3 80 86.2
48 35 0 81 87.6
49 36.7 82 89.0
50 38.3 83 90.4
51 40 0 84 91.8
52 41.7 85 93.2
53 43.3 86 94.6
54 45 0 87 96.0
55 46.7 88 97.4
56 48.3 89 98.8
57 50 0
58 51.7 90 and over 100
59 53.3

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 Virginia Workers’ Compensation Commission Claims Services Reference Material

Hearing Loss- Audiogram Example

• An audiogram graph is used to measure hearing loss intensity and frequency

a. The symbol O represents the right ear
b. The symbol X represents the left ear
c. Hertz (Hz): The measurement standard for the frequency or frequency
of sound. On an audiogram, these typically range from 250 Hz to 8,000 Hz.
d. decibels (dB HL): The measurement standard for the amplitude or
loudness/intensity of sound. On an audiogram, these typically range
from 0 to 110 dB HL.

• Calculating hearing loss:

- Add the decibels on the audiogram for each ear at 500, 1,000, 2,000, and 3,000
- Divide the total by 4 = average decibel of hearing in that ear

• The average decibel of hearing is equal to the percentage of compensable hearing loss, if any.
Note: Hearing that is less than 27 average decibels is not at a compensable level pursuant to the Virginia
Workers’ Compensation Act

• Use rounding rule: .50 decibels round up, below .50 decibels round down

Audiogram Example

Frequency (Htz) Right Ear -

500 1000 2000 3000 4000
20 dB
25 dB
35 dB
+ 45 dB
10 125 dB ÷ 4 = 31.25
Average decibel loss = 6.7%
decibels

20

30 Left Ear -
35 dB
40 40 dB
35 dB
50
+ 30 dB

60 140 dB ÷ 4 = 35
Average decibel loss = 13.3%
70

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Virginia Workers’ Compensation Commission Claims Services Reference Material

Third Party Settlements and Request for Offset Toward Future Benefits

• Third party settlements and offset toward future benefits may apply when an injury occurs from a traffic
accident or from a faulty equipment incident, etc.

• Information for lien against settlement proceeds/third party recoveries can be found in Virginia Code
§§ 65.2-309 – 311.

• Virginia Code § 65.2-313 provides information on employer offset.

Information needed by the Virginia Workers’ Compensation Commission when submitting a request for an
offset award towards future benefits payable based on proceeds from the third party settlement.

• Date of the third party settlement

• Total amount of the third party settlement
• Total amount of the carrier’s original lien
• Amount the carrier recovered from the original lien
• Total amount of the third party settlement cost
• Total amount of the third party settlement attorney fees
• Settlement disbursement sheet

Determination of the offset amount

The total amount of the settlement minus the carrier/employer’s original lien.

Offset Amount:
Ex: $75,000.00 Full Settlement
- $18,565.00 Statutory Lien
$56,435.00 Employers Offset

Determination of percentage of pro rata share of fees and costs

The amount of the attorney fees and costs.

Offset Percentage:
Ex: $20,000.00 Attorney Fee
+ $565.00 Attorney Cost
$20,565.00 Total Attorney Fees and Costs
÷ 75,000.00 Full Settlement
.27

27% Offset for reduction of future benefits

Exception: Any portion of a third party recovery that was received based upon the claimant’s Underinsured
Motorist coverage does not apply to the workers’ compensation claim for an offset. Attorney fees should be
adjusted accordingly.

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Virginia Workers’ Compensation Commission Claims Services Reference Material

Subrogation Lien Recovery Checklist

Injured Worker: Claim Number:

JCN:

In order for the Commission to determine the effect of the third party settlement on the workers’
compensation case, it will be necessary to provide the following information:

Date of the third party settlement

$ Total amount of the third party settlement

$ Total amount of the carrier’s lien
$ Total amount that the carrier recovered from the lien
$ Total amount of the third party settlement attorney costs
$ Total amount of the third party settlement attorney fees

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Virginia Workers’ Compensation Commission Claims Services Reference Material

VWC Calculator Application

On the Commission’s website, workcomp.virginia.gov,

VWC Resources, Online Tools and Calculators

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Virginia Workers’ Compensation Commission Claims Services Reference Material

• TTD, TPD and PPD

• 500 weeks

• TTD, TPD and PPD for multiple periods

• 5+ benefit lines

• PPD (4% discount compounded annually)

• Lump sum request date = date award processed

• Interest due after Review Opinion

• Required:
• opinion appeal date
• compensation begin/end date
• issue payment date
• compensation rate

• COLA due
• Maximum CR exceeded > cell turns red

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Calculator Examples

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Virginia Workers’ Compensation Commission Claims Services Reference Material

Browser Requirements

To use this application, your browser must have JavaScript enabled.

We recognize that our users may have various internet browsers and operating systems or devices. We
like our visitors to have the best possible experience when using our applications. The Virginia Workers’
Compensation Commission recommends Google Chrome for best results or any other modern web browsers
with HTML5 and CSS3 compatibility.

NOTE: If you are using Microsoft Internet Explorer and still encounter problems, please verify that your
browser is not operating in Compatibility Mode.

Disclaimer

The VWC Calculator Application is a reference tool provided by the Virginia Workers’ Compensation
Commission. Ultimately, the amount of benefits due will be determined by the Commission on a case-by-case
basis, according to eligibility and corresponding statutes.

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Virginia Workers’ Compensation Commission Claims Services Reference Material

Vocational Rehabilitation Guidelines

(effective October 1, 2015)
The Virginia Workers’ Compensation Commission has issued these guidelines for vocational rehabilitation
with the hope that the guidelines will provide better understanding between the parties, facilitate
appropriate vocational rehabilitation, and eliminate needless conflict and litigation.

Neither the Virginia Workers’ Compensation Act nor the regulations of the Commission have any
provisions regarding the licensure or certification of rehabilitation counselors. Therefore, the Commission
does no regulation on this point. Reference should be made to the provisions of Title 54.1 referenced
in Virginia Code § 65.2-603(A)(3) of the Workers’ Compensation Act.

I. THE VOCATIONAL REHABILITATION PROCESS

Vocational rehabilitation services may only be provided by rehabilitation providers certified in accordance
with Virginia Code § 54.1-3510 et seq. Certified Rehabilitation Providers must comply with the Regulations
Governing the Certification of Rehabilitation Providers, 18 VAC 115-40-10 et seq., Part V Standards
of Practice, or by rehabilitation providers certified in accordance with the laws of the state where the
vocational rehabilitation services are provided.

A. Vocational rehabilitation services, including vocational evaluation, counseling, job coaching, job
development, job placement, on-the-job training, education, and retraining, shall take into account
the employee’s pre-injury job and wage classification; age, aptitude and level of education; the likelihood
of success in the new vocation; and the relative costs and benefits of such services. Retraining should
be considered if job placement efforts are not successful, or the employee’s transferable skills are not
readily marketable.

B. The provider should not ask the employee to engage in job development, job placement or on-the-
job training until he/she is medically released for work. However, the provider may require the employee
to meet in order to assess the employee’s potential for work, and to prepare résumés and to schedule
other appropriate actions, such as attending job preparation training, in anticipation of employment.

C. The two goals of vocational rehabilitation are to restore the employee to gainful employment, and to
relieve the employer’s burden of future compensation. Rehabilitation providers should attempt to find
employment within the employee’s medical restrictions consistent with the employee’s pre-injury position
and salary level, and the provider should take into account such factors as distance, transportation costs,
and actual anticipated earnings from the potential job, when considering such alternative employment.

D. It is the rehabilitation provider’s responsibility to assess employment opportunities by direct contact

with potential employers when possible or through research in the labor market as to how the job is
commonly performed in the local economy. The assessment should determine whether a suitable
position is presently available that is within the employee’s restrictions and for which the employee
is qualified. The provider shall not send the employee to apply or interview for positions not suitable
for the employee with or without reasonable accommodation, but the provider may ask the employee
to develop résumés and to attend job preparation training as well as job fairs. The provider may ask the
employee to attend interviews for present employment opportunities where the treating physician
anticipates that the employee will be released to such work within a reasonably brief period.
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Virginia Workers’ Compensation Commission Claims Services Reference Material

Vocational Rehabilitation Guidelines (continued)

(effective October 1, 2015)

E. Telemarketing and commission sales positions are only appropriate job placement when the employee
has demonstrated aptitude or ability in this line of work. Interviews with sheltered workshops and
selective employers who are subsidized by employers/carriers are inappropriate if they do not provide
the potential for legitimate rehabilitation, such as learning work skills or restoring the employee to a
productive place in the labor market.

F. It is the responsibility of the provider to assist the employee in all aspects of the vocational rehabilitation
process such as appropriate presentation, interviewing skills, discussion of limitations with employers, and
other employability factors. The employee will be counseled in accordance with the Standards of Practice
for Certified Rehabilitation Providers, 18 VAC 115-40-40. Requiring employees to look in newspapers,
contact a specific number of potential employers per week, check listings at the VEC, or register with
agencies for short-term jobs does not constitute appropriate “vocational rehabilitation.”

G. Rehabilitation providers may not advise the employee to withhold information about his/her injury or
job capabilities during job interviews or on applications. However the employee may not discuss them
in such a way as to sabotage the interview or application process. Any discussion should be limited to the
question of whether the employee can perform the job(s) at issue with or without reasonable
accommodation.

H. Employees are not required to give rehabilitation providers personal or financial information, such as
number of children, spouse’s employment, or credit history, unless such information relates to a bona fide
occupational qualification for employment. An employee is required to disclose whether he/she is legally
eligible for employment, including their Social Security number, has a valid driver’s license, or has
been convicted of a felony or a misdemeanor, and to provide his/her previous employment history.

II. MEETINGS BETWEEN EMPLOYEES AND PROVIDERS

A. Meetings should be held at reasonable times and places for both the employee and provider. Employees
are not required to invite rehabilitation providers onto their property or into their homes. Also, just as the
employee must cooperate with reasonable demands of the rehabilitation provider that are likely to
return him/her to gainful employment, the provider must make reasonable accommodation for the
employee’s personal life, such as medical conditions and transportation problems.

B. Routine telephone contact should be made between 9:00 a.m. and 6:00 p.m. No calls should be made
before 7:00 a.m. or after 10:00 p.m. except in cases of emergency.

C. The provider should give the employee advance notice, in writing or by phone, of meetings between
the rehabilitation provider and employee, and of employment interviews. A minimum of two calendar
days’ notice of any meeting or employment interview is suggested, except for exceptional situations.

D. Prior to being released to selective employment, the employee does not have to seek employment.
However, the employee must meet with the provider for the purpose of a vocational assessment.

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Vocational Rehabilitation Guidelines (continued)

(effective October 1, 2015)

III. ROLE OF EMPLOYEE’S ATTORNEY

A. Employees have the right to have their attorney present at the initial rehabilitation meeting. However,
an attorney may not delay such a meeting for more than 10 business days after initial contact by the
rehabilitation provider with the employee’s attorney.

B. An employee may consult with his/her attorney at any time. Actions of the attorney will be imputed
to the employee for the purposes of considering whether the employee is cooperating.

IV. MEDICAL ASPECTS OF VOCATIONAL REHABILITATION

A. As the vocational rehabilitation provider’s role is limited to providing vocational rehabilitation, the provider
is prohibited from medically managing the employee’s treatment in any way, even if requested by the
physician.

B. Monitoring treatment is not medical management. Determining return to work status is part of the
rehabilitation process intended to enhance communication between all parties involved in the
rehabilitation process. With the consent of the physician, the provider may meet with the doctor
outside of the employee’s presence. The employee is not required to sign a consent granting the
provider access to the physicians. If the physician does not wish to communicate with the provider,
information will have to be obtained by other means provided or permitted by law.

C. The employee has the right to a private examination by and consultation with the medical provider
without the presence of any certified rehabilitation provider and/or nurse or case manager.

D. In order to determine the work capacity of the employee, the provider may require the employee to
submit to a functional evaluation, if approved and authorized by the employee’s treating physician or
an independent medical examiner.

V. TRANSPORTATION AND OTHER COSTS

A. The employee is entitled to reimbursement for expenses incurred in rehabilitation efforts. This
includes mileage costs for trips to rehabilitation meetings, obtaining or returning applications,
attending interviews, and other travel at the direction of the provider. Costs incurred for telephone
calls, photocopying, postage, and obtaining DMV and other records are also reimbursable, if such
are requested by the rehabilitation provider or a potential employer.

B. If the claimant does not have access to transportation, it is the responsibility of the employee to notify
the vocational rehabilitation provider. The vocational rehabilitation provider should contact the carrier
regarding the issue and make appropriate arrangements as directed/approved by the carrier to
insure the employee’s attendance at meetings and interviews. This may include the carrier forwarding
mileage payments in advance or arranging appropriate alternative transportation. The employee must
provide information explaining why transportation is or is not available.

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Virginia Workers’ Compensation Commission Claims Services Reference Material

Marketing Guidelines

GUIDELINES ON LOOKING FOR LIGHT DUTY WORK

1. Good faith search for work - An employee who is partially disabled – i.e., unable to perform his or her
regular job, but able to perform light duty work – is required to seek light duty work in good faith in
order to receive disability benefits if he or she is not on an open award.

2. Factors the Commission considers - In deciding whether a partially disabled employee has made a
reasonable effort to find suitable light duty employment the Commission considers such factors as:
(1) the nature and extent of the disability; the employee’s training, age, experience and education;
(3) the nature and extent of the job search; (4) the availability of jobs in the area suitable for the
employee considering his or her disability; (5) any other matter affecting the employee’s capacity to
find suitable employment.

3. Evidence of reasonable effort - It is presumed that in most cases the claimant made a reasonable
effort to market residual work capacity when he or she (a) registered with the Virginia Employment
Commission within a reasonable time after being released to return to work and (b) directly contacted
at least five potential employers per week where the employee has a reasonable basis to believe that
there might be a job available that he or she might be able to *perform and (c) if appropriate, contacted
the pre-injury employer for light duty work.

4. Keep a job search record - Information provided by the injured worker about job contacts should
be supported by facts, preferably in writing, about the names of the employers contacted; where the
employers are located; the date(s) the contact was made; whether the contact was in person, by phone
or via internet; and the result of the contact.

5. Pre-injury skills or experience - Where an injured worker has particular job skills or training, he or she
may focus the search on jobs in that field if there are jobs in that field that the employee can reasonably
perform. However, if within a reasonable amount of time the search is not successful, the employee
must broaden the search beyond that field.

6. Method of Contacting Employers - Employer contacts should be conducted in a manner reasonably

suited to the position sought, which in some cases may be personal visits. In other cases, contacts may
be by phone, internet, mail, or through employment agents such as union hiring halls.

7. Attempt to maximize earnings - If the employee locates and takes a job that pays substantially less
than his or her pre-injury job, the employee should continue looking for a higher paying job.

It is not necessary to prescreen or know for certain of the availability of a suitable job.
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 Virginia Workers’ Compensation Commission Marketing/Job Search Form
Virginia Workers’ Compensation Commission Claims Services
Access Reference Material
your claim online: webfile.workcomp.virginia.gov

Jurisdiction Claim Number (JCN) Claim Administrator Number

Injured Worker Information

Name Date of Injury/Occupational Disease

Address City State Zip Code

Marketing/Job Search Log

Date Name of Company: Name of Contact:

Job Title: Were there any openings? Yes No

Address: Outcome:

Contact Method: In Person Internet Phone

Date Name of Company: Name of Contact:

Job Title: Were there any openings? Yes No

Address: Outcome:

Contact Method: In Person Internet Phone

Date Name of Company: Name of Contact:

Job Title: Were there any openings? Yes No

Address: Outcome:

Contact Method: In Person Internet Phone

Date Name of Company: Name of Contact:

Job Title: Were there any openings? Yes No

Address: Outcome:

Contact Method: In Person Internet Phone

Date Name of Company: Name of Contact:

Job Title: Were there any openings? Yes No

Address: Outcome:

Contact Method: In Person Internet Phone

Please attach copies reflecting the submission of any applications via online and any correspondence received in response to your
applications.

22E. Franklin St., Richmond, Virginia 23219

Toll-Free: 877-664-2566 | Online: workcomp.virginia.gov | Mail: 333 Rev. 11/21
Marketing Remaining Work Capacity: Light Duty Work Guidelines

Good Faith Search for Work

An injured worker who is partially disabled (unable to perform his or her or her regular job, but able to perform light
duty work) is required to seek light duty work in good faith in order to receive disability benefits if he or she is not on
an open award.

Factors the Commission Considers

In deciding whether a partially disabled injured worker has made a reasonable effort to find suitable light duty
employment, the Commission considers such factors as:
(1) the nature and extent of the disability;
(2) the injured worker’s training, age, experience and education;
(3) the nature and extent of the job search;
(4) the availability of jobs in the area suitable for the injured worker considering his or her disability;
(5) any other matter affecting the injured worker’s capacity to find suitable work.

Evidence of Reasonable Effort

It is presumed that in most cases the claimant made a reasonable effort to market residual work capacity when he or
she:
(1) registered with the Virginia Employment Commission within a reasonable time after being released to return to
work and;
(2) directly contacted at least five (5) potential employers per week where the injured worker has reasonable basis
to believe that there might be a job available that he or she might be able to perform* and;
(3) if appropriate, contacted the pre-injury employer for light duty work.

*It is not necessary to prescreen or know for certain of the availability of a suitable job.

Keep a Job Search Record

Information provided by the injured worker about job contacts should be supported by facts, preferably in writing,
about the names of the employers contacted; where the employers are located; the date(s) the contact was made;
whether the contact was in person, by phone or via internet; and the result of the contact. Please attach printouts
reflecting the submission of any applications via Internet and any correspondence received in response to your
application.

Pre-injury Skills or Experience

Where an injured worker has particular job skills or training, he or she may focus the search on jobs in that field if
there are jobs in that field that the injured worker can reasonably perform. However, if within a reasonable amount of
time the search is not successful, the injured worker must broaden the search beyond that field.

Method of Contacting Employers

Employer contacts should be conducted in a manner reasonably suited to the position sought, which in some cases
may be personal visits. In other cases, contacts may be by phone, internet, mail, or through employment agents such
as union hiring halls.

Attempt to Maximize Earnings

If the injured worker locates and accepts a job that pays substantially less than his or her or her pre-injury job, the
injured worker should continue looking for a higher paying job.

Ombudsman Office
Have questions about the Virginia Workers’ Compensation Commission and no lawyer? Call the Ombuds Department at 833-448-
1681, or email [email protected]. We cannot give legal advice, but all conversations will be kept confidential.

23 | Mail: 333 E. Franklin St., Richmond, Virginia 23219

Toll-Free: 877-664-2566 | Online: workcomp.virginia.gov
24
workcomp.virginia.gov
Revised March 2023