Current through Register Vol. XLI, No. 50, December 13, 2024
Section 85-12-3 - DefinitionsAs used in this legislative rule, the following terms have the stated meanings unless the context of a specific use clearly indicates another meaning is intended.
3.1. "Insurance Commissioner" means the Insurance Commissioner of West Virginia as provided in section one, article two, chapter thirty-three of the West Virginia Code, or any designated third-party administrator of the Insurance Commissioner.3.2. "Industrial Council" means the industrial council created pursuant to the provisions of W. Va. Code § 23-2C-5.3.3. "Orthopedic occupational disease" means an occupational disease that involves the musculoskeletal system as it functions for the purpose of mobility. The musculoskeletal system includes the following component parts: (5) nerve(s). An orthopedic occupational disease may affect one or more component parts of the musculoskeletal system.3.4. "Nonorthopedic occupational disease" is an occupational disease that is not an orthopedic occupational disease. For the purposes of this rule, the term "nonorthopedic occupational disease claim" does not include an occupational hearing loss or hearing impairment claim.3.5. "Occupational exposure injury" means a one-time, limited-duration hazardous exposure that creates an immediate acute pathophysiologic change.3.6. "Occupational disease," as further defined in W. Va. Code § 23-4-1(f), is related to prolonged hazardous exposure and creates chronic pathophysiologic changes that develop over time and that are more likely to result in prolonged sequelae and/or permanent physical impairment.3.7. "Private carrier" means any insurer authorized by the insurance commissioner to provide workers' compensation insurance pursuant to chapters twenty-three and thirty-three of the West Virginia Code.3.8. "Self-insurer" or "self-insured employer" mean an employer who is eligible and has been granted self-insured status under the provisions of W. Va. Code § 23-2-9.3.9. "Review process" refers to the period between the identification of a potential claim and the final closure of the claim pursuant to the statute. 3.10. "An employer that 'is not active in the claim'", as described in W. Va. Code § 23-5-7, means all employers other than those employers that have been granted self-insured status pursuant to W. Va. Code § 23-2-9: Provided, That the role of an insured employer to participate in the settlement of a workers' compensation claim shall be controlled by the terms of the workers' compensation insurance policy.