Overview of the 2019 Virginia Workers' Compensation Fee Schedule
The 2019 fee schedule sets the maximum reimbursable amounts for medical services, legal fees, and administrative costs under Virginia workers' compensation law. Rates are published by the Virginia Workers' Compensation Commission (VWCC) and apply to all employers and insurers filing claims for injuries occurring on or after January 1, 2019. Understanding these specific caps helps providers bill correctly and claimants gauge potential benefits.
More from this site
Keep reading the latest coverage
Medical Service Rates
Medical fees are the largest component of the schedule. VWCC categorizes services into evaluation, treatment, and ancillary procedures, each with a defined maximum. For example, a standard physician evaluation is capped at $115, while a physical therapy session ranges from $70 to $95 depending on duration. Imaging follows a tiered structure: a basic X‑ray costs up to $45, whereas a CT scan may be reimbursed up to $225. All rates are subject to annual adjustments for inflation, but the 2019 schedule remains the baseline for claims filed that year.
Attorney and Legal Fees
Attorney fees are limited to a percentage of the total benefits awarded. In 2019 the cap is 15 % of the total compensation, not exceeding $2,500 per claim unless the case proceeds to trial, at which point the limit can rise to 20 % of the award. This structure aims to keep legal costs predictable while ensuring representation for injured workers.
Filing and Administrative Charges
Employers and insurers must pay filing fees when submitting a claim. The standard filing fee in 2019 is $50 per claim, with an additional $25 for each amendment. The VWCC also imposes a $10 per‑day surcharge for claims that remain unresolved beyond 180 days, encouraging timely resolution.
Comparison Table of Core Fee Categories
| Category | Maximum Rate (2019) | Notes |
|---|---|---|
| Physician Evaluation | $115 | Includes history and exam |
| Physical Therapy (30‑min) | $70 | Short session |
| Physical Therapy (60‑min) | $95 | Long session |
| Standard X‑ray | $45 | Single view |
| CT Scan | $225 | Up to 3 slices |
| Attorney Fee (settlement) | 15 % of award, max $2,500 | Non‑trial cases |
| Attorney Fee (trial) | 20 % of award | Applicable if case goes to court |
| Initial Filing Fee | $50 | Per claim |
| Amendment Fee | $25 | Per amendment |
Practical Implications for Claimants and Providers
Providers must verify that billed services align with the schedule to avoid claim denials. Using the 2019 rates as a reference, a typical outpatient injury might generate $115 for the initial exam, $95 for a follow‑up therapy session, and $45 for an X‑ray, totaling $255 before any ancillary costs. Claimants should be aware that attorney fees will be deducted from the total award, potentially reducing net compensation.
How to Access Updates and Verify Current Rates
Although the 2019 schedule remains relevant for claims filed that year, the VWCC releases annual updates. Stakeholders can download the latest fee schedule from the VWCC website or consult a certified workers' compensation attorney for guidance on any retroactive adjustments.