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	Government of the United States Virgin Islands
	Department of Labor
	Workers Compensation
	Worker's Compensation Benefits under VI law ...

WORKERS’ COMPENSATION BENEFITS UNDER VIRGIN ISLANDS LAW

The following summary of the basic provisions governing Workers’ Compensation benefits as provided by Title 24, Section 250 et. seq., of the Virgin Islands Code has been prepared by the Workers’ Compensation Administration of the Government of the Virgin Islands Department of Labor. The information contained in this brochure is general in nature and not intended as a substitute for legal advice. Changes in the law or the specific facts of a case may result in legal interpretations that are different from those presented here. Anyone having questions or clarification of issues may contact the Administration at the address or phone number listed at the end of this brochure for an Advisory Meeting with the Employee Assistance Unit.

WHAT IS WORKERS’ COMPENSATION?

Workers’ Compensation is an Insurance Program that provides medical and disability benefits for work-related injuries and diseases. If injured on the job, a worker’s medical treatment costs will be paid by the policy. If the worker is disabled following the job injury, he will also receive weekly income benefits through the policy until able to return to work. Workers’ Compensation protects both employee and employers. Each worker covered under the policy is entitled to benefits if injured on the job. In return, the worker forfeits the right to sue the employer for job related injuries. All employers must obtain coverage by purchasing an insurance policy through the Government Insurance Fund of the Virgin Islands.

II. BENEFITS

Benefits are not allowed when an injury is due to willful misconduct, intoxication, willful intention of the employees to injure or kill him or her-self, illegal use of drugs, or willful failure to use a furnished safety appliance. A false representation of a claimant’s health at the time of obtaining employment may also preclude the awarding of benefits.

MEDICAL BENEFITS

For any injury covered by the Workers’ Compensation Statue, the worker is entitled to all medical services, including chiropractic and dental services, appliances, supplies and transportation which are required by the nature of the injury and which will relieve pain and promote and hasten restoration to health and employment. This includes such services, appliances and supplies, and necessary replacements or repairs of such appliances unless the need for such replacements or repair is due to lack of proper care by the worker.

The injured worker has the right to make the initial selection of the health care provider of his choice. However, the agency has the authority to determine the necessity, character, and sufficiency of any medical services furnished and shall have the authority to order a change of health care provider, hospital, or rehabilitation facility when deemed necessary.

Whenever necessary to resolve any issue of medical fact of opinion, the administration may order an Independent Medical Examination by a health care provider selected by the administration and obtain from such provider a report upon the condition or matter which is the subject of the injury. The employee has the right to, and may obtain a second opinion of any finding, at his own expense.

The costs of travel, lodging and meals incurred as a result of securing specialized treatment are also compensable in certain instances. Generally, such expenses will be only allowed if the worker is required to seek medical treatment out of the territory. The maximum of $75,000.00 is the statutory limitation for medical benefits. The maximum for specialized medical attendance in institutions out of the Virgin Islands is $200,000.00.

If a claimant unreasonably refuses to submit to medical examination or treatment, all payments of further compensation and the right to further proceedings shall be suspended during such time as such refusal continues.
B. DISABILITY BENEFITS

The Workers’ Compensation Law provides a series of benefits during the period of disability. These benefits are not to be considered as a replacement of lost wages or income redistribution, but more as an insurance against interruption of income. The disability benefits are as follows:

Temporary Total Disability

An employee who cannot work because of the work-related injury or disease is eligible for temporary total disability benefits. Generally, this inability to work must be confirmed by a qualified health care provider. Lost wage benefits begin on the second day after the injury is determined. Benefits continue until a physician releases the employee for return to work or determines that the employee’s condition has reached a point of maximum improvement. The weekly rate for temporary disability is explained in Paragraph D following.

2. Temporary Partial Disability

If a physician allows an employee who is still recovering from a work related injury or disease to return to a part-time or modified work, the employee receives a bona fide job offer, and the employee is receiving less that his or her usual earnings, the worker may be entitled to temporary partial disability benefits. These benefits are computed on the basis of one-half the difference between the average amount earned before the injury and the average amount the worker is earning or able to earn some suitable employment after the injury. The amount of compensation allowed for temporary partial disability shall not exceed the maximum set forth in Paragraph D. The total compensation for earnings and workers’ compensation may not be less than the amount received for temporary total disability. These benefits are payable until the worker is returned to full employment or until maximum improvement is reached.

3. Permanent Partial Disability

If an injury or illness results in loss of use of certain members of the body, the injured worker may be entitled to permanent partial disability benefits. Benefits are computed by applying a determination of the worker’s percentage of loss to the number of weeks designated in the schedule provided by law (Title 24, Section 254c[b]) for full disability of that part of the body. This number of weeks is then multiplied by the compensation rate as set forth in Paragraph D, at the initial rate at time of injury. Permanent disability from internal injuries, back injury or others not specifically listed, is represented by the percentage that such permanent partial disability bears to the body as a whole. Payments are made in monthly installments. Lump sum payments are not allowed by law.

Permanent Total Disability

A worker who is totally and permanently disabled in terms of occupational capacity, provided that such disability is a consequence of the injury and ensues within four years thereof, is entitled to compensation, known as continuous income benefits. These benefits shall be equal to sixty-six and two-thirds percent of the worker’s weekly wage rate at the time of injury. The rate of compensation shall not exceed 90% of the average weekly wage rate, and shall be paid during the continuance of such disability lapsing upon the death of the recipient. Permanent total disability shall be considered to be total and permanent loss of vision in both eyes, the loss of both feet at or above the ankle, the loss of both hands at or above the wrists, the loss of one hand and one foot or one arm and one leg, or both arms and both legs. Permanent total disability shall also include such other injuries as result in the total and permanent disability of the person to perform any kind of labor in remunerative occupations as determined by the administration. The benefits may be subject to review at any time by the administration.

C. DEATH BENEFITS

If an injury causes death, at the time of injury or within four years as a consequence thereof, compensation is awarded to the surviving spouse, parents, or any heirs, including illegitimate children, who were dependent upon the deceased for support, partially or totally at the time of death. They are entitled to compensation payable in an amount not less than $25,000.oo nor more than $50,000.00. Survivors of a worker who dies as a result of a work-related incident should contact the Workers Compensation Administration for further information.

D. RATE OF COMPENSATION

Income disability benefits shall be sixty-six and two thirds percent of the worker’s weekly wage rate at the time of injury, not to exceed sixty-six and two-thirds percent of the average weekly wage of the Virgin Islands nor be less than $60.00 a week, except that if the wages earned were less than $60.00 a week, the benefits shall be awarded in a sum equal to said wages. Income benefits shall be paid for the total period of temporary total or partial disability as supported by medical evidence including unemployed periods spent waiting for prostheses in case of bodily losses. Income benefits shall be paid for temporary partial disability equal to sixty-six and two-thirds percent of the difference between weekly wage rate at the time of injury and the wages, if any, earned by the injured worker during the period of partial disability. A worker shall not be entitled to lost wage benefits for any period during which he received from his employer full wages or wages not less than the compensation rate provided above. An insured employer shall be entitled to reimbursement for wages paid the worker not to exceed the compensable rate as determined above.

Mission Statement

The Mission of the Virgin Islands Workers’ Compensation Administration is to provide a fair, efficient and professional public agency to serve the people of the Virgin Islands by administering actions required or authorized by the workers’ compensation laws of the Virgin Islands. The main purposes of the WCA is to minimize the adverse impact of work-related injuries on the employees and employers of the territory by providing greater access to the WCA program in a manner that is sensitive, responsive, and effective…to ensure efficient processing and resolution of claims and disputes…and to ensure proper payment of compensation benefits along with necessary medical coverage and rehabilitation assistance to employees injured on the job, or to their dependents in case of death.