Current through Register Vol. 41, No. 3, September 23, 2024
A. At the request
of either party, or at the commission's direction, contested issues not
resolved informally through prehearing procedures or alternative dispute
resolution will be referred for decision on the record or evidentiary
hearing.
B. Decision on the record.
When it appears that there is no material fact in dispute as to any contested
issue, determination will proceed on the record. After each party has been
given the opportunity to file a written statement of the evidence supporting a
claim or defense, the commission shall enter a decision on the record.
1. Written statements. When the commission
determines that decision on the record is appropriate, the applicant parties
shall be given 15 days from the date of the order to submit written statements
and evidence. The responding party shall be given an additional 15 days (30
days from the date of the order) to respond with a written statement and
evidence in reply. For good cause shown additional time may be allowed. Copies
of all written statements and evidence shall be filed to the commission and
served on all parties.
2. Review.
Request for review of decision on the record shall proceed under §
65.2-705 of the Code of Virginia
and 16VAC30-50-40.
C. Evidentiary hearing. An evidentiary
hearing by the commission shall be conducted as a judicial proceeding. All
witnesses shall testify under oath, and a record of the proceeding shall be
made. Except for rules that the commission promulgates, the commission is
neither bound by statutory or common law rules of pleading or evidence nor by
technical rules of practice.
The commission will take evidence at hearing and make inquiry
into the questions at issue to determine the substantial rights of the parties,
and to this end hearsay evidence may be received.
1. Continuances. The parties should be
prepared to present evidence at the time and place scheduled for hearing. A
motion to continue will be granted at the discretion of the commission on a
showing of good cause.
2. Evidence.
a. Stipulations to agreed facts shall be
included in the record. Each exhibit offered shall be marked and identified,
and the record shall show whether it was admitted in evidence.
b. Reports and records, depositions of health
care providers, and reports of medical care directed by physicians shall be
admitted in evidence. Upon timely motion, any party has the right to
cross-examine the source of a medical document offered for admission in
evidence.
c. The parties, by the
beginning of the hearing, shall specifically designate, with a chronological
table of contents, by author, deponent, and date, medical reports or records to
be received in evidence. Depositions will only be made part of the record
pursuant to
16VAC30-50-20 H 7 The requirements
of this provision may be modified or waived for pro se
litigants.
D.
Expedited hearing.
1. An employee may request
an expedited hearing before the commission when the employer has submitted an
application for hearing pursuant to
16VAC30-50-20 D and probable cause
has been found to suspend benefits pending a hearing on the matter. An employee
may also seek expedited determination of any disputed claim arising after the
initial compensability of the accident has been determined by the
commission.
2. Written request. An
employee seeking an expedited hearing must file a written request with the
clerk's office, and a copy of the request shall be sent to the employer. The
request must include, by way of description, attachment or enclosure, evidence
sufficient to find that, without an expedited proceeding to determine the
merits of the dispute, the employee will be caused to suffer severe economic
hardship. What constitutes severe economic hardship will be determined by the
commission on a case-by-case basis. A copy of the employee's accepted request
will be sent to the employer's counsel of record, the designated third-party
administrator, and the carrier, along with a Notice of Request for Expedited
Hearing.
3. Loss of income. When
the employee alleges that the employee is not receiving compensation benefits
and is unemployed, unable to work, or only partially employed because of an
injury compensable under the Act, the employee must establish that failure to
grant an expedited hearing will result in severe, immediate economic hardship.
In this regard, the commission will consider, but is not limited in
considering, the following evidence:
a.
Whether, and to what extent, the employee is presently employed, and what other
sources of income are available to support the employee;
b. Whether the employee has dependents for
whom the employee's wages, salary, or other income were the sole or primary
source of financial support;
c.
Whether the employee has received notices of imminent or threatened foreclosure
or eviction actions, or the employee is in a state of homelessness;
d. Whether the employee has received notices
of imminent repossession of personal vehicles necessary for employment or
medical treatment visits;
e.
Whether the employee's financial difficulties were caused by the termination of
workers' compensation benefits by prior adjudication, caused by other
circumstances, or both; and
f. Any
other evidence demonstrating that the employee's immediate ability to provide
food, clothing and shelter will be threatened by failure to grant an expedited
hearing.
Notwithstanding subdivisions 3 a through 3 f of this
subsection, upon the employee's return to work with the employer at a wage less
than the preinjury wage while on a current award for temporary total benefits
if, within 20 days after said return, the employer has not either presented
agreed forms for entry of an award for temporary partial benefits for same or
paid an agreed amount voluntarily pending entry of an award, the employee may
request an expedited hearing. Upon such request, there will be a presumption of
entitlement to such a hearing when in fairness to both the employer and
employee the hearing can be limited to that issue and the commission shall also
promptly schedule a conference to discuss both a hearing date for same or
whether the matter can be resolved without a hearing.
4. Medical expenses. When the
employee seeks an expedited hearing, asserting that authorization of or payment
for recommended medical treatment has been denied by the employer or insurer,
the employee must establish that failure to grant an expedited hearing will
result in severe economic hardship. In this regard, the commission will
consider, but is not limited in considering the following evidence:
a. The general nature of the employee's
injuries;
b. Whether, if
authorization is being sought for recommended treatment not already obtained,
the employee's physician has stated that the procedure must be performed on an
emergent basis and failure to do so will threaten the employee's life or result
in immediate and severe deterioration of the employee's physical or mental
condition;
c. Whether, if payment
or reimbursement for medical expenses already incurred is being sought,
reasonable and necessary ongoing medical treatment will be withheld for failure
to pay for prior medical treatment and that the withholding of such treatment
will threaten the employee's life or result in immediate and severe
deterioration of the employee's physical or mental condition;
d. The cost of the medical treatment in
dispute and the employee's ability to pay for it; and
e. Any other evidence demonstrating that
failure to grant an expedited hearing on this issue will result in severe
economic hardship.
5.
Employer response. Upon receipt of the commission's Notice of Request for
Expedited Hearing, the employer shall have 14 days to investigate the basis for
the employee's expedited hearing request. Prior to, or at the expiration of the
14th day, the employer shall file with the commission, by hand-delivery,
electronic filing, or certified mail, a written statement indicating whether
the employer will or will not agree to the employee's request for expedited
hearing. If the employer will not agree to proceed on an expedited basis, it
must state, with specificity, the basis for its inability to proceed pursuant
to an expedited hearing schedule. Filing shall be effective upon receipt by the
commission or its agent, or by placing the statement in certified
mail.
6. Informal conference. Once
the commission has received the employer's response statement, or 14 days pass
without a filed response from the employer, the commission shall schedule, as
expeditiously as possible, an informal conference with the parties, whether in
person, by teleconference, or by other electronic transmission. With regard to
expedited claims for payment of medical expenses pursuant to subdivision D 4 of
this section, no informal conference will be scheduled until the employee
submits medical evidence to the employer and the commission supporting both the
underlying claim and the necessity of expedited proceedings. During the
informal conference, the commission will discuss issues relevant to the
granting or denial of an expedited hearing including discovery between the
parties, the timing and scheduling of depositions, and the parties' ability to
secure other relevant evidence in an expedited manner. The commission will
discuss the issues raised by the claim and try to limit the scope of any matter
ultimately referred to the expedited hearing docket by facilitating agreements
between the parties. The commission will confer with the parties about
scheduling a hearing date at the informal conference or by teleconference after
the informal conference.
7.
Granting or denial of expedited hearing. During the informal conference, or
within seven days of its completion, the commission will determine whether the
claim underlying the request for expedited hearing is appropriate for the
expedited hearing docket. If the request for an expedited hearing is granted,
the commission will advise the parties of this decision during the informal
conference, or in writing within seven days. If the commission determines that
the matter is not appropriate for the expedited docket, the parties will be
advised of the commission's determination, and the matter will be referred for
regular processing.
8. Scheduling
and continuances. The matter will be set for a hearing no less than 10 days and
no more than 28 days after the expedited hearing was granted. Ordinarily, once
the matter is set down for an expedited hearing, neither party will be granted
a continuance. A continuance will be granted only for good cause shown,
involving exceptional circumstances beyond the control of the party or the
party's attorney. Any claim pending on the expedited docket that is continued
or nonsuited at the request of the employee will be removed from the expedited
docket and shall not be reinstated for expedited proceedings.
9. Closing the record. The record shall close
at the end of the expedited hearing unless, for good cause shown, one or both
parties are unable to present necessary medical or factual evidence.
10. Decision. The deputy commissioner hearing
the case will issue an opinion within 14 days after the record closes in an
expedited hearing proceeding.
11.
Expedited review. Either party may seek an expedited review of the decision to
grant or deny an expedited hearing. Parties seeking expedited review must file
a written request within seven days of the date of the decision to grant or
deny an expedited hearing. The written request must include a statement
explaining the grounds for review and must enclose all information the party
believes is necessary for consideration of the request. A copy of the Request
for Expedited Review shall be furnished to the opposing party. The commission
shall provide notice of the request for expedited review within three days of
its receipt. The opposing party shall have seven days from the date of the
commission's notice to file a written statement addressing the merits of the
review request and enclosing all information it believes is necessary for
consideration on review. The commission shall review the decision to grant or
deny an expedited hearing and will issue a decision by order within seven
days.
12. Review after expedited
hearing. Review of a deputy commissioner's decision following an expedited
hearing shall proceed according to the provisions of
16VAC30-50-40 A. and §
65.2-705 of the Code of
Virginia.
E. Video
hearings.
1. Prefiling of exhibits and
medical records designations mandatory.
a.
Filing deadline. A copy of each party's medical designation, as well as all
proposed exhibits, must be filed no later than seven days before the scheduled
hearing. The medical records designation must be filed in accordance with the
commission's July 1, 2013, Order Clarifying Commission Rules 2.2 B.3 and 4.2. A
copy of this order may be found at
http://www.workcomp.virginia.gov/documents/order-regarding-medical-records-and-designations.
Any other proposed exhibits must be filed with a numerical table of contents,
which must include title, author, and date. All proposed exhibits must be
preceded by a separator page and numbered to identify the document following in
accordance with the table of contents.
b. Objections. Objections to any item in the
medical designation or to a proposed exhibit must be filed with the commission
by any opposing party no later than four days prior to the scheduled
hearing.
c. Late filings. Any
medical record or exhibit submitted less than seven days before the hearing,
other than a response to a record timely submitted under this order for which
leave is granted to file a response, will be excluded from evidence or may
serve as a basis for the continuance of the hearing, in the sole discretion of
the deputy commissioner.
d. Copies
required for witnesses. If a party anticipates questioning an adverse party or
witness about a particular exhibit or medical record, identical electronic and
paper copies of the exhibit must be sent by the questioning party to the
adverse party or the witness so the party or witness may view the documents
while testifying. No other written explanatory or instructive materials may
accompany the documents. Failure to provide the witness with such copies will
be grounds for excluding the anticipated testimony from the record. It is not
considered an improper ex parte contact for a party to provide to the adverse
party or witness a particular exhibit or medical record with an accompanying
cover letter as long as no additional instructive or explanatory materials are
provided. A copy of the cover letter must be filed with the commission.
Alternatively, parties may agree which party will produce exhibits and medical
records to an adverse party or witness. Under this provision, it is expected
that parties will send exhibits and medical records to their own
witnesses.
2. Oaths
required. Witnesses will be sworn remotely and all witnesses must aver prior to
their testimony that they shall not receive any undisclosed or other assistance
from any source while testifying.
3. Witnesses. Parties must provide the
commission with the name, telephone number, and, if possible, email address of
all witnesses they expect to call to testify no less than seven days prior to
the scheduled hearing. Further, parties who receive a Webex meeting invitation
to the hearing from the commission must forward that invitation to any
witnesses the parties expect to call to testify to allow for ease of connecting
to the video hearing. Failure to do so may result in exclusion of witness
testimony, at the discretion of the deputy commissioner. Continuances will not
be granted solely because a witness fails to appear because the calling party
failed to provide this information, subject to the discretion of the deputy
commissioner. Nothing in this order shall preclude the parties from obtaining
evidence by de bene esse deposition or as otherwise permitted by the
commission.
4. Minimum technical
requirements. Parties and witnesses attending the video hearing must
participate remotely using a PC, laptop, tablet, or smartphone equipped with a
video camera and microphone. All parties and witnesses should use up-to-date
browsers and operating systems with a reliable high-speed internet connection,
and participation in the hearing will be subject to such other technical
requirements as are published from time to time. Parties and witnesses are
strongly encouraged to test their systems as instructed in advance of the
hearing date. Parties must notify the commission as soon as possible, and not
less than 14 days prior to the hearing without good cause being shown, if they
or any of their witnesses cannot meet the minimum requirements for
participation in the video hearing, so that alternate arrangements for the
participation of such attendees may be arranged. Deputy commissioners have
broad discretion to continue or cancel the hearing if attendees cannot meet the
minimum technical requirements for participants.
5. Recording prohibited. Parties and
witnesses attending the video hearing may not record the hearing by any means
except upon advance leave granted by the deputy commissioner. The commission's
recording of the hearing will be the sole official record of the
proceedings.
6. Proper decorum
required. Parties and witnesses attending a video hearing are attending a
formal judicial proceeding and must dress appropriately just as if personally
appearing in court. All attendees must participate from a quiet location free
of distractions. Deputy commissioners have broad discretion to continue or
cancel hearings or exclude witnesses if noise or extraneous activity disrupts
the proceedings and to impose contempt sanctions for inappropriate conduct
where necessary.
Statutory Authority: §
65.2-201 of the Code of
Virginia.