This form assures that the compensation committee considers all relevant information when deciding the allocation of compensation. It provides an opportunity for each lawyer to list unique accomplishements, involvement with associates and management committees, national practice groups participation, recruiting, and an area for comments.
Virginia Compensation Committee Information Form
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Multi-State
Control #:
US-L05041B
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How to fill out Compensation Committee Information Form?
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FAQ
The funds you receive for your Workers' Comp settlement depends on your original wages and the severity of your injuries. For example, if you're unable to work in any capacity, you may be eligible for total disability benefits. These benefits cover two-thirds of your lost wages while you're unable to work.
2023 Rates: Effective July 1, 2023 the maximum compensation rate will be $1343.00. Effective July 1, 2023 the minimum compensation rate will be $335.75.
Instructions ONLINE: WebFile users may upload this form through their account. Click here to learn more about WebFile. FAX: Fax the complete form to 804-823-6956. MAIL: Mail the completed form to 333 E. Franklin St., Richmond, VA 23219. IN PERSON: Bring the completed form to any of our VWC Office Locations.
Workers' Comp Exemptions in Virginia. Sole-Proprietors and Partners who include themselves on workers' compensation coverage must use a minimum annual payroll amount of $67,100 for rating their overall workers' compensation premium cost in 2023.
If your doctor says you cannot work because of your work-related injury or illness, you may be entitled to compensation equaling 66 2/3% of your regular wages based upon earnings for the 52 weeks prior to your injury. This amount is subject to a statewide maximum reimbursement amount.
1 Q: Am I required to obtain workers' compensation insurance? A: Virginia law requires that an employer who regularly employs more than two part-time or full-time employees carry workers' compensation.
Contact Us by Phone For general questions, please contact the Customer Contact Center toll free at 1-877-664-2566 from a.m. - p.m., Monday - Friday. Language translation available, TTY users dial 7-1-1.
The formula for PPD wage benefits is: your permanent impairment rating multiplied by two-thirds (66.66 percent) of your average weekly wage, and the product multiplied by the number of weeks specified in the Virginia Workers' Compensation Act (§ 65.2-503).