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Virginia Has Most Expensive Workers Comp Medical Costs


Workers Comp Medical Costs In Virginia

The Virginia WC medical costs are the most expensive in The Old Dominion State.

Map Of Virginia Graphic

I have posted often on fee schedules and their effect on Workers Compensation claims. In my original post (see link) on fee schedules, I did not include Virginia. The Dominion State was and is still without a Workers Compensation claims fee schedule.

Fee schedules are very important in controlling Workers Compensation costs. The state with the highest medical cost has always been a non-fee schedule state. Virginia was 30% more expensive than the median state for medical charges (non-hospital). That is a stark number when looking at the effect on a company’s Workers Comp E-Mod.

A recent article on Virginia having the highest medical costs is not surprising overall. Tennessee was in the same position a few years ago. Initiating a fee schedule reduced their Workers Comp medical costs dramatically. The original study was performed by WCRI.

Virginia’s lack of a fee schedule will continue to make it one of the most medically expensive states for Workers Compensation without a doubt. Unless I am mistaken, VA  uses the old Usual and Customary model or the average of what other medical providers charge for the same service in the same geographical area – better known as U&C. U&C is usually the most expensive way to pay Workers Compensation medical charges.

Dollars Virginia Cash

The 25 states included in the study, which represent more than three quarters of the workers’ compensation benefits paid in the United States, are: Arizona, Arkansas, California, Connecticut, Florida, Georgia, Illinois, Indiana, Iowa, Louisiana, Maryland, Massachusetts, Michigan, Minnesota, Missouri, New Jersey, New York, North Carolina, Oklahoma, Pennsylvania, South Carolina, Tennessee, Texas, Virginia, and Wisconsin.

In my next post, I will see if NCCI confirms this fact.

Update – Effective January 1, 2018, the state will have a full fee schedule.

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James J Moore - Workers Comp Expert

Raleigh, NC, United States

About The Author...

James founded a Workers’ Compensation consulting firm, J&L Risk Management Consultants, Inc. in 1996. J&L’s mission is to reduce our clients’ Workers Compensation premiums by using time-tested techniques. J&L’s claims, premium, reserve and Experience Mod reviews have saved employers over $9.8 million in earned premiums over the last three years. J&L has saved numerous companies from bankruptcy proceedings as a result of insurance overpayments.

James has over 27 years of experience in insurance claims, audit, and underwriting, specializing in Workers’ Compensation. He has supervised, and managed the administration of Workers’ Compensation claims, and underwriting in over 45 states. His professional experience includes being the Director of Risk Management for the North Carolina School Boards Association. He created a very successful Workers’ Compensation Injury Rehabilitation Unit for school personnel.

James’s educational background, which centered on computer technology, culminated in earning a Masters of Business Administration (MBA); an Associate in Claims designation (AIC); and an Associate in Risk Management designation (ARM). He is a Chartered Financial Consultant (ChFC) and a licensed financial advisor. The NC Department of Insurance has certified him as an insurance instructor. He also possesses a Bachelors’ Degree in Actuarial Science.

LexisNexis has twice recognized his blog as one of the Top 25 Blogs on Workers’ Compensation. J&L has been listed in AM Best’s Preferred Providers Directory for Insurance Experts – Workers Compensation for over eight years. He recently won the prestigious Baucom Shine Lifetime Achievement Award for his volunteer contributions to the area of risk management and safety. James was recently named as an instructor for the prestigious Insurance Academy.

James is on the Board of Directors and Treasurer of the North Carolina Mid-State Safety Council. He has published two manuals on Workers’ Compensation and three different claims processing manuals. He has also written and has been quoted in numerous articles on reducing Workers’ Compensation costs for public and private employers. James publishes a weekly newsletter with 7,000 readers.

He currently possess press credentials and am invited to various national Workers Compensation conferences as a reporter.

James’s articles or interviews on Workers’ Compensation have appeared in the following publications or websites:

  • Risk and Insurance Management Society (RIMS)
  • Entrepreneur Magazine
  • Bloomberg Business News
  • WorkCompCentral.com
  • Claims Magazine
  • Risk & Insurance Magazine
  • Insurance Journal
  • Workers Compensation.com
  • LinkedIn, Twitter, Facebook and other social media sites
  • Various trade publications


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