W. Va. Code R. § 85-20-66

Current through Register Vol. XLI, No. 50, December 13, 2024

Section 85-20-66 - Evidentiary Requirements

66.1. The evidentiary weight to be given to a report will be determined by how well it demonstrates that the evaluation and examination that it memorializes were conducted in accordance with the applicable Guides and that the opinion with regard to the degree of permanent whole body medical impairment suffered by an injured worker was arrived at and composed in accordance with the requirements of the applicable Guides.

66.2. The report must state the factual findings of all tests, evaluations, and examinations that were conducted and must state the manner in which they were conducted so as to clearly indicate their performance in keeping with the requirements of the Guides. For any evaluation and examination of a compensable back injury, the back examination form previously adopted by the Workers' Compensation Commission must be completed and submitted with the narrative report. A copy of the current edition of the back examination form can be obtained from the Commission, Insurance Commissioner, private carrier or self-insured employer, whichever is applicable. A report and opinion submitted regarding the degree of permanent whole body medical impairment as a result of a back injury without a completed back examination form shall be disregarded.

66.3. The opinion stated in the report as to the degree of permanent whole body medical impairment must reflect the process of calculation as stated in the applicable Guides so as to demonstrate how the degree of permanent whole body medical impairment was arrived at and calculated.

66.4. To the extent that factors other than the compensable injury may be affecting the injured worker's whole body medical impairment, the opinion stated in the report must, to the extent medically possible, determine the contribution of those other impairments whether resulting from an occupational or a nonoccupational injury, disease, or any other cause.

66.5. In any claim for occupational pneumoconiosis benefits, for noise induced hearing loss, or for mental and emotional loss, the application of these evidentiary requirements of this section shall be based upon the guidelines referred to below in lieu of the Guides. All of the other requirements of this section shall be accordingly applied.

W. Va. Code R. § 85-20-66