COLA Request Form (CA51)

Download COLA Request Form (CA51)

The injured worker must file a COLA Request Form every year in order to apply for the applicable cost of living adjustments.

To apply for a Cost-of-Living Adjustment (COLA), the injured worker or beneficiary should complete the required information (upper portion of the eligibility form) and choose either Option 1 or Option 2 and return this form to the Virginia Workers' Compensation Commission.

This form may be filed with the Commission in the following ways:

  • ONLINE: WebFile users may upload this form through their account. Click here to learn more about WebFile.
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  • FAX: Fax the complete form to 804-823-6956.
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  • MAIL: Mail the completed form to 333 E. Franklin St., Richmond, VA 23219.
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  • IN PERSON: Bring the completed form to any of our VWC Office Locations.

For questions, please contact the Commission toll-free at 1-877-664-2566 or by email at Questions@workcomp.virginia.gov.