West VirginiaHB 55152026 Regular SessionHouseWALLET

Relating to modernizing and updating workers’ compensation statutes.

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Bill Overview

Analyzed Economic Effects

19 provisions identified: 2 benefits, 6 costs, 11 mixed.

Rehab help and partial wage support

The insurer must quickly decide if rehabilitation will help you return to paid work and create a plan. Vocational rehab funding is available up to $20,000 per injured worker with prior approval. If ordered rehab makes you totally disabled for a time, you get TTD during that period. If you return to lower‑paid work under an approved rehab plan, you get 70% of the weekly wage gap, reviewed every 90 days, for up to 52 weeks (up to 104 weeks with approved retraining), capped at your TTD amount. If you are denied PTD but have the required impairment and keep a lower‑paying job, you can get temporary rehab pay for four years at 80%, 70%, 60%, then 50% of your average weekly wage.

Strict deadlines to file work claims

For most injuries or deaths, you must file within six months or you lose the right to benefits. For occupational pneumoconiosis, you must file within three years of the last day of your last continuous 60‑day exposure, or within three years of when a diagnosed impairment was made known; dependents have two years after death. For other occupational diseases, file within three years of last exposure or when you knew (or should have known) of the disease; dependents have one year after death. Missing these deadlines permanently bars compensation.

Autopsy may be required for benefits

The insurer or Insurance Commissioner can order an autopsy or other post‑mortem exam and choose the doctor. You may have your own doctor attend at your expense. If you refuse to permit the autopsy, you forfeit compensation tied to the death claim.

Permanent total disability: thresholds and offsets

You can apply for permanent total disability only if one of these is true: prior partial awards total at least 50%, your current injury is 50% whole‑body impairment, or you meet a 35% schedule. If prior awards total 85% or more, you must also have at least 50% whole‑body impairment. If an appeal is filed, monthly payments start, but back pay is capped at 12 months until the case is final. Your benefit is reduced when you also get employer self‑insurance, wage‑continuation, or disability insurance (after‑tax amounts; never below the legal minimum). If your monthly benefit plus current net wages is over 120% of your prior net wages, the excess is cut $1 for every $2 over. If you stop working and get full Social Security retirement, you cannot get permanent total disability (unless you finished submitting proof before you left work or started those benefits).

Limits on reopening claims and care

The insurer, Commissioner, or employer can change past decisions after notice, but only within set time limits; late requests must be refused. You can file only two reopening requests within five years of closure or of the initial permanent award; a later award for a progressive disease restarts the five‑year clock. If no medical, rehab service, or medical goods were provided on the claim for five years, new medical or rehab requests are not allowed, with narrow exceptions.

Half lump-sum for noncitizens abroad

If you are not a U.S. citizen and plan to live outside the U.S. permanently, you may convert periodic payments into one lump sum equal to one‑half of what a U.S. citizen would get. The lump sum is paid after you actually move, except an amount can be paid earlier for travel and needed expenses.

Tighter rules for pneumoconiosis claims

For occupational pneumoconiosis, you get a disability percentage only if the Pneumoconiosis Board finds a measurable impairment. A diagnosis alone is not enough for awards after the 2003 amendment. In death cases, the Pneumoconiosis Board can order an autopsy to determine the cause of death, and refusing a Board‑ordered autopsy forfeits compensation rights.

Death benefits: who gets paid and limits

Death benefits may be split among dependents in a fair way, and anyone paid for others must use the money for those beneficiaries. Reasonable funeral or cemetery costs set by the Insurance Commissioner are paid to the person who advanced them. Funeral homes cannot charge more without written notice and written consent; knowing violations can bring up to a $3,000 fine or 12 months in jail. No further award is allowed unless requested within two years after death. Nonresident alien beneficiaries get the same benefits, but the payer may convert them to a lump sum that must be accepted.

Pneumoconiosis claims: help and new limits

A five-doctor Occupational Pneumoconiosis Board now handles medical questions and must share its report and evidence with both sides. You must object to the Board’s findings within 60 days or they become final. After your application and doctor report arrive, nonmedical issues must be decided within 90 days; timely objections trigger a hearing. If you had at least 10 years of exposure in the 15 years before last exposure and have a chronic breathing disability, the law presumes it is work-related. Your injury date is your last day of exposure. If the Board finds no evidence, you are barred from refiling for three years, unless you ended work with that employer (no work for more than 90 days). Any past silicosis payments are deducted from new pneumoconiosis awards.

Caps on medical bills and drugs

The state sets a fee schedule that caps what providers are paid for approved workers’ comp care. Providers must file a verified bill within six months of treatment, or within 90 days after a later compensability ruling, or they cannot be paid. Pharmacies must dispense generics when they exist; if you choose the brand name, you pay the price difference. If you choose out‑of‑state care and the provider rejects the state fee, you pay the difference unless it was an emergency or officials authorize it because no nearby qualified provider accepts the fee.

Faster claim decisions and new checks

You must give your employer written injury notice right away or as soon as you can. Your employer must report the injury to its insurer within five days or it can lose some rights to object to interim TTD. If a carrier misses a ruling deadline or you file a timely protest, you get an expedited hearing. If a denial relies on the employer’s report, you must receive that report. The insurer must rule on your written request for more TTD or a new award within 30 days and send you for needed exams if you may be owed money. If your exam led to reopening and you win more benefits, your exam cost is repaid up to the fee cap. When deciding compensability or a reopening, shutdowns, layoff notices, and recent unemployment benefits must be weighed and can count against compensability.

Faster TTD checks, payback risk

If medical evidence shows your injury will disable you for more than three days, the insurer must start TTD and medical payments within 15 working days. TTD payments go directly to you. If your employer does not send wage data within 15 days, you get an interim TTD rate based on state wage reports or usual pay, and it is corrected later. Benefits continue during a timely employer protest and during conditional approvals. But if the claim is finally denied, those payments become overpayments and are taken from future workers’ comp checks.

More claim checks, medical record sharing

The state monitors long TTD cases using expected recovery times. The payer can order exams and, after notice, pause TTD if you reach maximum medical improvement, refuse exams or treatment without good cause, or there is suspected abuse. Severe paralysis or amputation cases are exempt from mandatory exams. When you file for benefits, you waive doctor‑patient privilege for injury‑related records, and doctors may share reports with your employer and the payer. If your employer gets a report the doctor didn’t send to the payer, it must forward a copy within 10 days.

Payment deadlines, interest, protections

When you get a permanent disability award, the payer must send the first payment within 15 working days. If extra permanent total back pay is owed after a final order, you also get 6% simple interest from the initial award date. Most workers’ comp checks are protected from creditors; temporary checks pay at least twice a month and permanent checks monthly by the third day. Your weekly rate is set by your injury date, and permanent total benefits do not rise each year with statewide wages.

Stricter PTD rules and reviews

PTD decisions look at jobs within 75 miles of your home (or your former commute if longer). PTD benefits stop at age 70 for post‑2003 awards. A reviewing body processes PTD applications, orders exams, and lets you submit only one report per issue. For claims filed on or after the 2003 amendment, your PTD onset is the date you filed a complete application, but not before you met the law’s medical percentage thresholds. You can have only one active request at a time; new requests are consolidated. The insurer or Commissioner has the first review, and the Board of Review steps in only after an order. PTD awards after April 8, 1993 can be reopened and reviewed; you must cooperate or payments can be suspended. If you keep your award after a reopening, the insurer pays your reasonable lawyer fees and one expert evaluation per issue.

Your weekly benefit and short-term pay limits

For injuries on or after July 1, 1994, your average weekly wage is the higher of: your daily rate times seven, or the weekly average from your best quarter of the last four. If your disability lasts three days or less, the first three days are not paid. If it lasts more than seven days, those first three days are paid. Any single temporary total disability order cannot run for more than 90 days; continuing pay needs a new order for up to another 90 days.

No employer contracts that bill injured workers

Employers cannot make deals with hospitals or doctors for work injuries that require employees to help pay those bills. Violations can lead to damages and misdemeanor penalties. This protects you from surprise medical charges for compensable injuries.

New rules for workers’ rehab services

The Insurance Commissioner sets rules for a full rehabilitation program, including what services and facilities count. Employers may choose preferred vocational rehab providers, and rules may require injured workers to use them.

How wages and hours set benefits

If you get employer‑paid wage replacement you did not fund and it has no workers’ comp offset, your TTD is reduced so your total monthly pay is not more than the employer plan or TTD amount, whichever is higher. This does not apply to union‑negotiated plans. Part‑time workers (25 hours a week or less) get TTD based on the best average weekly gross pay from the best quarter in the last year, and TTD cannot exceed that average weekly wage. Permanent benefits use the same basis as full‑time.

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Sponsors & Cosponsors

Sponsor

Walter Hall
Republican • House

Cosponsors

John Paul Hott
Republican • House
Dean Jeffries
Republican • House
Matthew Rohrbach
Republican • House

Roll Call Votes

All Roll Calls

Yes: 216 • No: 1

House vote • 3/14/2026

House concurred in Senate amendment and and title amendmentpassed bill (Roll No. 647)

Yes: 94 • No: 1

Senate vote • 3/13/2026

Passed Senate with amended title (Roll No. 571)

Yes: 34 • No: 0

House vote • 3/4/2026

Passed House (Roll No. 327)

Yes: 88 • No: 0

Actions Timeline

Approved by Governor 4/1/2026
4/1/2026House
To Governor 3/25/26
3/25/2026House
House received Senate message
3/14/2026House
House concurred in Senate amendment and and title amendmentpassed bill (Roll No. 647)
3/14/2026House
Communicated to Senate
3/14/2026House
Completed legislative action
3/14/2026House
House Message received
3/14/2026Senate
To Governor 3/25/2026 - Senate Journal
3/14/2026Senate
Approved by Governor 4/1/2026 - Senate Journal
3/14/2026Senate
Approved by Governor 4/1/2026 - House Journal
3/14/2026House
On 3rd reading
3/13/2026Senate
Read 3rd time
3/13/2026Senate
Passed Senate with amended title (Roll No. 571)
3/13/2026Senate
Senate requests House to concur
3/13/2026Senate
On 2nd reading
3/12/2026Senate
Read 2nd time
3/12/2026Senate
Committee amendment adopted (Voice vote)
3/12/2026Senate
Reported do pass, with amendment and title amendment
3/11/2026Senate
Immediate consideration
3/11/2026Senate
Read 1st time
3/11/2026Senate
Introduced in Senate
3/5/2026Senate
To Banking and Insurance
3/5/2026Senate
To Banking and Insurance
3/5/2026Senate
On 3rd reading, Special Calendar
3/4/2026House
Read 3rd time
3/4/2026House

Bill Text

Committee Substitute
HTML PDF
Engrossed
HTML PDF
Enrolled
HTML PDF
Introduced Version
HTML PDF

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