Workers’ Compensation Claim Kit – West Virginia

Who will handle your claims?

The Orlando Claim Office will handle your West Virginia claims:

PO Box 14139
Lexington, KY 40512

Phone: 800-423-3060
Rose Powell, Manager

How to Report Workers’ Compensation Claims?

To report via the Internet: Log on to the Crum & Forster website at https://cfconnect.cfins.com. Use your assigned User ID and Password. If you do not have a current User ID, please contact your local Crum & Forster Claims or Marketing resource.

To report e-mail: crumandforsternol@cfins.com

To report via fax: 1-877-622-6218

To report claims via telephone: 1-800-690-5520

(7 day/24 hour toll free reporting line for all states)

  • In the event of a serious or fatal injury, notify the local claim office immediately by telephone.

What forms and pamphlets does the employer need to be aware of?

The claim initiation process involves the filing of both the OIC – WC1 and the OIC- WC2

Employer’s First Report of Injury (OIC WC-2):
If you report the claim via the Internet or by telephone, you do not need to fill out this form. If you report the claim via fax, complete this form, and fax it to Crum & Forster at the fax number provided above.

WV-First Report of Injury

 

Employees’ and Physicians’ Report of Occupational Injury or Disease

WV-Employees’ and Physicians Report of Injury

This form should be given to the employee at the time of injury, completed by the employee and treating physician and returned to Crum and Forster.

 

Statement of Wages:
File this form with the carrier, claimant, and claimant’s representative when the claimant is losing time from work.

WV-Statement of Wages

What is the Waiting Period for Lost Wages in West Virginia?
The waiting period is 3 days. If the employee is off for more than 7 days, the first 3 days are paid retroactively.

What is the Choice of Physician Rule in West Virginia?

Provider Selection
The employee chooses the initial treating provider without restriction; however, to change a treating physician, you must obtain prior authorization from your claims adjuster.

Provider Lists
There is no state-mandated posting. Postings may be informational but cannot direct employees to providers.

Preferred Provider Organization Network (PPO):

Crum & Forster has a PPO network available. Follow the instructions below to access the PPO Network:

Logon to the website at: https://www-sf.talispoint.com/conduent/cfi/

  • Search by Provider Address, Name or Region
  • Select the Distance, Provider Type and Specialty
  • Results can then be exported to a directory or excel.
  • You can obtain a Map List or text message by selecting a specific provider

Where should all medical bills be sent?

Crum & Forster
PO Box 14801
Lexington, KY 40512

Important Websites:

West Virginia Offices of the Insurance Commissioner:

http://www.wvinsurance.gov/

Multi-State Information: http://www.workerscompensation.com/