Claim Administrators, or those organizations managing claims activity on behalf of employers and insurance carriers, play a vital role in Virginia's workers' compensation program. Under Va. Code §65.2-900, all workplace accidents that occur in the course of employment must be reported to the Commission and can be reported by a representative of the employer which would be the Claim Administrator.
A Claim Administrator can be any of the following but there is only one per JCN (claim):
- Third Party Administrator (TPA)
- Self-insured/self-administered employer
- Self-administered Insurance Carrier
Certain events and transactions that occur in the course of handling claims relating to workplace accidents must be reported in addition to the initial report of the injury. The Commission uses Electronic Data Interchange (EDI) and expects the Claim Administrator to report these events and transactions in this manner. For additional information regarding the Commission’s EDI Program, please visit the Commission’s Electronic Data Interchange - Quality Assurance page.
In addition to EDI requirements, Claim Administrators are also required to complete and submit Agreement Forms for the entry of an Award when the parties agree to such. They are also responsible for responding to any orders or requests for information generated by the Commission.
Subscribe to the EDI E-mail Distribution List for Claim Administrators
If the Claim Administrator assigned to a particular JCN wants to view the Commission’s Claim File, they may access these files through WebFile, the Commission's web-based tool. They can also use this tool to upload forms and documents directly into the JCN.