State Employee Workers' Compensation and Injury Prevention (WCP) -- Frequently Asked Questions
Frequently Asked Questions
Workers’ Compensation is “no-fault” insurance that provides medical and disability benefits for injury/illness, disability, or death that happens in the course of employment.
The State of Vermont, BGS Office of State Employee Workers’ Compensation and Injury Prevention (WCP) runs the State of Vermont Workers’ Compensation Program. WCP acts as the insurance carrier for covered employees. WCP assigns a claims adjuster and a medical case manager to each claim.
After the injured worker files a claim, the adjuster has twenty-one (21) calendar days to decide if the injured worker is entitled to benefits. To make this decision, the adjuster needs information about the injured worker’s injury from the injured worker’s medical provider. The quicker that this information is received, the sooner a decision regarding the injured worker’s claim will be made.
The injured worker will receive a Claim Questionnaire Form and a Medical Authorization (DOL Form 7). The injured worker must complete both of these forms and return them to WCP as soon as possible. Failure to sign and return the Medical Authorization (DOL Form 7) will result in a denial of the injured worker’s claim. If the injured worker’s injury places him/her out of work, (s)he may also be required to complete a Certificate of Dependency and Concurrent Employment (DOL Form 10), and an Agreement for Temporary Compensation (DOL Form 32).
Workers’ compensation provides coverage for all reasonable and necessary medical treatment that is related to the injured worker's work injury/illness. WCP will pay for this treatment once the injured worker’s claim is approved. Other expenses may also include prescriptions and mileage allowed to and from a medical appointment. WCP may pay for meals and lodging in cases where distant travel is unavoidable. Expense reimbursements are subject to the rules stated in the collective bargaining agreements and State regulations. The injured worker should submit any expense reimbursement requests to WCP.
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The injured worker may be paid for lost time if it is related to his/her work injury/illness. It will only be covered if the injured worker has a current disability note or a Work Capabilities Form (DOL Form 20) from a medical provider. Compensation is available if the injured worker is out of work more than three (3) full calendar days or if the injured worker were restricted to part time work for more than seven (7) calendar days.
Medical End Result (MER) is when the injured worker has recovered from hsi/her injury/illness to a point where the injured worker will not have any significant further improvement, regardless of treatment. The injured worker may still have pain and still need occasional treatment even if (s)he has reached MER. The terms Medical End, Medical End Result, and Maximum Medical Improvement all mean the same thing.
An Independent Medical Evaluation (IME) is an examination conducted by a physician selected by WCP. This physician cannot have treated the injured worker for his/her workers’ compensation injury/illness.
A permanent disability occurs when the injured worker has reached MER and (s)he has a permanent impairment of function.
A Permanent Impairment Rating (PIR) is a medical evaluation to assess permanent loss of function. A physician rates the injured worker’s impairment. The most current edition of the AMA Guide to the Evaluation of Permanent Impairment is used. Not all injuries/illnesses will result in a permanent impairment.
Vocational Rehabilitation is a service to help the injured worker return to suitable employment as quickly as possible. The injured worker may be eligible for vocational rehabilitation benefits if (s)he is unable to return to his/her previous job. Not everyone is eligible for these services. A vocational rehabilitation counselor determines eligibility on a case by case basis. The injured worker’s skills, education, and work history will affect eligibility.
Department of Labor, Workers’ Compensation Division oversees all requests for appeal of decisions made by workers’ compensation insurers in Vermont. They may be contacted at: The Vermont Department of Labor, 5 Green Mountain Drive, PO Box 488, Montpelier, VT 05601-0488. Tel: (802) 828-2286 Fax: (802) 828-2195 Website: http://labor.vermont.gov/
Click on the link to view claims team by department assignments.
Use Code 24 to report the number of hours an injured employee is absent from work each day. To be eligible to use Code 24 the injured employee must present an out-of-work note from his/her treatment provider outlining what, if any, work-related duties may be performed by the employee.
Use Code 27 to report the number of hours an injured employee is absent from work for medical appointments. The use of Code 27 should also include the amount of time for a normal commute from the workplace to the treatment provider’s location.
Wage Replacement Benefits are included in the employee’s regular State of Vermont paycheck.
Invoices for medical services provided must be submitted via standard Form UB-92 or standard HCFA Invoice and be accompanied by treatment notes for dates of service invoiced. The mailing address is:
BGS Office of State Employee Workers' Compensation and Injury Prevention
6 Baldwin Street
Montpelier, VT 05633-3801
Please note the change in name of our office and please be sure to use the complete nine digit zip code (Zip + 4) when mailing to insure delivery to the proper area.
The Agency of Administration, Department of Buildings and General Services underwent a reorganization in an effort to better serve our customers. Previously, the Risk Management Division was comprised of three sections—Workers’ Compensation, Property and Casualty Insurance, and Workplace Safety. Workplace Safety is now part of the Office of State Employee Workers' Compensation and Injury Prevention (WCP). WCP is now a part of the Financial Operations Division. The Office of Risk Management is the new title of the section formerly known as the Property and Casualty Insurance Section. Please address all future correspondence regarding your Workers’ Compensation insured Vermont State employees to the BGS-Office State Employee Workers’ Compensation and Injury Prevention (WCP). WCP provides workers' compensation benefits to injured State of Vermont Employees. It should not be confused with the Vermont Department of Labor, Workers’ Compensation Division, which regulates actions of all workers’ compensation insurers doing business in Vermont.
A Work Capabilities Form is used to indicate what, if any, work-related activities may be performed (and to what degree) by an injured worker if he/she is unable to return to regular full-time, full-duty work. Follow this link to the Work Capabilities Form (Vermont Department of Labor Form 20):
All medical invoicing is subject to reductions as dictated by the Vermont Department of Labor Workers’ Compensation Rule 40.000, Workers’ Compensation Medical Fee Schedule. This rule is promulgated by the Department of Labor under the authority of 21 V.S.A. 640(d). It establishes that the liability of an employer to pay for medical, surgical, hospital and nursing services provided to an injured employee shall not exceed the maximum fee for a particular service as provided for in this rule. Follow this link to the Workers’ Compensation Medical Fee Schedule: Link to http://labor.vermont.gov/?TabId=311.
For information about equipment on contract please contact:
Or visit http://bgs.vermont.gov/purchasing.
You may also refer to our Erogonomic Equipment Guide. It is a summary of all Ergo equipment under contract.
There are a couple of ways to learn how to set up your workstation. One of the best ways would be to participate in an Ergo 101 class held at your worksite. Please contact WCP at email@example.com for an in-house class. In the meantime, OSHA has some interesting information and self help tools you are welcome to visit at http://www.OSHA.gov/SLTC/etools/computerworkstations/index.html.
Complete the Ergonomic Assessment Request form entirely and forward to WCP as instructed.
WCP does not recommend the use of an exercise ball as a replacement for ergonomic office chairs. See the following flyer for more information:
You can find some sample checklists at http://www.osha.gov/.
Compliance with VOSHA rules is essential. Compliance along with an effective voluntary safety and health program can help reduce your costs, injuries and illnesses. An organized, carefully crafted plan that systematically focuses on workplace hazards and employee training is critical. Buy-in from every manager, supervisor and employee is necessary. Everyone has to work at safety and health.
Each safety and health program should be tailored to fit the agency: to blend with its unique operations and culture and to help employers maintain a system that continually addresses workplace hazards. There are five elements that every effective program should have:
- management leadership and employee participation;
- job hazard analysis;
- hazard prevention and control;
- safety and health training and education;
- and program evaluation.
A great resource for safety program development is: Developing An Effective Safety & Health Program available from the VT Dept. of Labor.
The vital part of a good safety and health program is continual review of work environment and work practices to control or prevent workplace hazards.
This can be done when you:
- Regularly and thoroughly maintain equipment
- Establish a work order system to ensure hazards are corrected
- Ensure that hazard correction procedures are in place
- Ensure that employees know how to use and maintain personal protective equipment
- Ensure that all employees understand and follow safe work procedures
Any building-related issues or concerns can be reported by completing the on-line form on our Safe and Healthy Buildings section of our website entitled: "Building-Related Issues Notification Form".
Only the products designated on state contracts are authorized for use unless a waiver is on file. Unless otherwise stated, waivers will only be approved for products with existing EPP contract vendors. When utilizing products, custodians and contract janitorial staff will follow manufacturer's instructions for use. For a complete list of current contracts visit our Current Contracts section of the Office of Purchasing and Contracting on our website and click on Custodial Supplies.