Claims Kit

Physician Selection 21 VSA 640, Rule 12.0000

The employer has the right to designate the treating health care provider who will initially treat an injured worker. If the worker is dissatisfied with the employers choice, he or she may choose another provider, but must notify the employer in writing of the change, the reason the employee was dissatisfied, and the name of the medical provider the worker has selected. The employee need only file a Form 8 once, upon changing from the employer selected physician to their own choice. The employee may subsequently change physicians and without further approval.

Notice of Intent to Change Health Care Provider

Penalties for Late Reporting Vt. Stat. Ann. Title 21, 702

An employer who refuses or neglects to make a report may be assessed an administrative penalty of not more than $100.00 per violation.

Posting Requirements 21 VSA 691

The employer must post and maintain, in a conspicuous place in and about each of his places of business, typewritten or printed notices in form prescribed by the commissioner.

Employers Liability and Workers Compensation Poster (Spanish)

WC-9 Employers Reinstatement Liability Poster

Reporting of Claim by Employer Vt. Stat. Ann. Title 21, 701

The employer must report an injury that results in medical care or an absence of work within 72 hours. (Sundays and legal holidays excluded)