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Important News from the Virginia Workers’ Compensation Commission

A number of recent changes have occurred and continue to occur with the Virginia Workers’ Compensation Commission (“VWC”). There has been a recent push to expand Alternative Dispute Resolution (“ADR”) and in August the Commission relocated and expanded the Virginia Beach Regional office at 281 Independence Boulevard, Suite 310, Virginia Beach, Virginia. In November the VWC began moving the main, or Richmond, office from the outskirts of the City of Richmond to the downtown area, at 333 East Franklin Street, Richmond, VA 23219. Though the Commission insists that there will be sufficient parking at the corner of 3rd and Main Streets, Richmond is a city that was built, destroyed, and rebuilt before the existence of cars. Those with business at the Commission should plan accordingly. Hearings downtown start after January 1, 2018, and hearing notices should reflect the correct location – if a hearing notice after January 1, 2018 does not reflect the downtown location, it would be best to confirm the correct location with the Commission.

For over a year the Commission has been working on implementation of the “Medical Fee Services Department” (“MFS”) project, which goes into effect January 1, 2018. The Commission’s website (http://www.vwc.state.va.us/ content/medical-fee-services-mfs) has more information on the MFS, and the approved fee schedule using Current Procedural Terminology (“CPT®“), 4th Edition codes is now available (http://www.vwc.state.va.us/content/virginia- medical-fee-schedules). In essence, the MFS is intended to largely remove lawyers from the initial process of medical billing disputes in WC matters by providing for administrative review prior to the docketing of any claim addressing such a billing dispute. Because of the new fee schedules, the amount to be paid for any given CPT code (medical service) cannot be disputed, but we expect reasonableness, necessity, causal connection to a WC injury (which are not appropriate grounds for an MFS dispute and may cause some confusion), and the appropriateness of CPT coding for services (entirely appropriate under the MFS system) will be the bulk of the early matters for this new department. The MFS process is outlined in a document on the VWC website (http:// www.vwc.state.va.us/content/medical-fee-schedule-dispute-resolution-process).

If you have any questions about the coming changes, or any questions about preventing or defending workers’ compensation claims in Virginia, please call Setliff & Holland at 804.377.1261.