Appeals
Process
Appealing a Decision
If you disagree with a decision made by the Program regarding coverage for a specific service or piece of equipment, you have the right to appeal.
This information can also be found in the program handbook, page 10.
Steps
1: Contact the Executive Director
Your first level of appeal is to the Program’s Executive Director. They will review your concerns and attempt to resolve the matter directly with you.
2: Appeal to the Board of Directors
If the Executive Director is unable to resolve the issue, you may escalate the appeal to the Program’s Board of Directors. You may submit a written explanation of your dispute along with any supporting documentation, such as:
- Letters of medical necessity
- Relevant correspondence or documentation
- A statement of the resolution you are seeking
You are also welcome to attend the Board’s next regularly scheduled meeting to present your appeal in person.
3: File a Petition with the WCC
If the Board of Directors cannot resolve the matter to your satisfaction, you may file a formal petition of appeal with the Virginia Workers’ Compensation Commission (WCC). Appeals must be filed within 30 days of receiving the Board’s decision.
Virginia Workers’ Compensation Commission
Clerk of the Commission
333 East Franklin Street
Richmond, VA 23219
Information
Disclaimer: All information on this website is intended for general informational purposes only and should not be considered legally binding, legal advice, nor substitute for obtaining legal advice from competent legal counsel. Although reasonable efforts are made to keep information on this site accurate, no guarantee is made as to its accuracy.