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Medical Fee Schedules Virginia Inaction Cost Employers 13%


Medical Fee Schedules – Virginia Legislature Moves On To Other Things

Virginia’s decision on medical fee schedules will cost the state’s employers dearly.  The Virginia State Legislature decided to not act on fixing their Worker Comp medical fees.  As I pointed out in previous posts, Virginia is one of the few states without a true pure medical fee schedule.

The state is one of the better ones for Workers Compensation rates.  However, there is still room for improvement.  As with all states that do not have fee schedules, the majority of the Workers Comp claims value is higher than states with fee schedules.

Graphic of form pill up by man hand Medical Fee Schedules Health Insurance Claim Form
(c) 123rf.com

The % is surprising for Virginia – one of my favorite states.  According to the venerable NCCI,  64% of Virginia’s Workers Comp claims cost is due to medical treatment.

 In VA’s neighboring states, the % of medical vs. indemnity is 51% of claims costs.   That 13% extra has an element of very bad timing as employers are wrangling with the Obamacare mandates.

A great example of what happens when fee schedules are initiated is the state of Tennessee.  Their Workers Compensation costs dropped dramatically after a fee schedule was legislated into existence.

How does a state legislate in a fee schedule?  They can take a copy of North Carolina’s or Tennessee’s and it is a done deal.

Virginia has always been on the cutting edge in technology, colleges, wineries, and of course, has a large amount of influence from DC in the northern part of the state.  They dropped the ball on this one.

One of the reasons/excuses you will hear is that medical practitioners will not see Workers Comp patients.  To that, I say BULL.

I have advised on Workers Comp policies in every state in the Union and have never seen this happen.  Workers Comp pays well for medical treatment.

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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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