Workers' Compensation Notice for the Commonwealth of Virginia Poster Required

Form VWC1 	
WORKERS'
 COMPENSATION NOTICE	
                                                                        \
     
The employees of this business are covered by the Virginia Workers' Compensation Act.  In case of injury by accident or 
notice of an occupational disease: 
   THE EMPLOYEE SHOULD:	 	
1. Im	mediately give notice to the employer, in writing,  of the injury	 or occupational disease and the date of
accident or notice of the occupational disease.	
2. Prom	ptly give to the employer and to the  Virginia Workers'	  Compensation Commission notice of any
claim for compensation for the period of disability beyond  the seventh day after the accident.  In case of 	
fatal	
injuries, notice m	

ust be given by one or more depende nts of the deceased or by	
 a person in their behalf.	
3. In case of failure to reach an agreem	ent with the em	 ployer in regard to comp	ensation under the act, file	
application 	

with the Commission for a hearing within tw o years of the date of accidental injury	
 or first	
com	

m	
unication of the diagnosis of an occupational disease.	
4. If m	edical treatment is anticipated for more than two years from	 the date of the accident and no award has	
been entered, the em	
 ployee should file a claim with  the Commission within two years from	
 the date of the
accident.	
NOTE:	  The employer's report of accident is not the filing of a claim for the employee.  The voluntary 
payment of wages or compensation during disability, or  of medical expenses, does not affect the running of 
the time limitation for filing claims.  An award based on a voluntary agreement must be entered or a claim 
filed within two years; one year in death cases. 	
   THE EMPLOYER SHOULD:	 	
1. At the tim	e of the accident, give the employee  the nam	 es of at least three physicians from which 	the	
em	

ployee may select the treating phy	
sician.	
2. Report the injury	 to the Commission through your carrier or directly to the Comm	ission.	
3. Accurately	 determine the employee's average w eekly	  wage, including overtime, meals, uniform	s, etc. Questions may be answered by con	
tacting th	e Comm
ission.	  A boo	klet explaining the Workers' Com pensation 	Act is 
available 	
without cost from: 
THE VIRGINIA WORKERS' COMPENSATION COMMISSION  333 E. Fran	
klin St 
Richmond, Virginia 23219
1-877-664-2566
www.work	
comp.virginia.gov
Every em ployer within the operation of the Virginia Work	
ers' 	Compensation Act MUST POST THIS NOTICE 	IN A 
CONSPICUOUS PLACE in his place 	
of busin	ess.