Referral for Lack of Coverage
VWC Form
Description
Virginia employers lacking coverage may now be reported online via the Virginia Employer Non-Compliance Alerts (VENCA) website operated by the Commission. Click here file a report online.
The Referral for Lack of Coverage Form is offered by the Commission for the public to report an employer suspected of operating in Virginia without workers’ compensation insurance when it is believed the employer is required to carry coverage under the Act.
An employer is required to carry coverage in Virginia when they have more than two part-time or full-time employees. For a contractor that hires subcontractors to assist them in their work, the contractor must count subcontractors’ employees as well as their own.
The form is a one page form and requests limited information but the information requested must be provided, including employer name, address, phone number and information as to why the submitter thinks the employer is operating without workers’ compensation insurance and has more than two employees. The form provides information fields for the submitter to provide their name and contact information, however, the Commission will accept anonymous submissions.
Instructions
The employer information section of the form must be filled out completely. Please list all possible names you believe the employer may be operating under. The more information that can be provided as to why the submitter believes the employer is operating without coverage and with more than two employees, the better. The submitter may provide their name and contact information, however, the Commission will also accept submissions anonymously.
The form may be submitted to the Commission by mail or fax. The mailing address and fax number are listed on the form. Once the form is received in the Insurance Department of the Commission the employer will be investigated.