WV 150th
Claims Services Division


The SAWC program has a $250,000.00 deductible policy with Zurich, which was effective on October 1, 2011. The Claims Services Staff conducts ongoing quality assurance reviews, coordinates and participates with large loss claims staffing, and travels to Pittsburgh, PA and Philadelphia, PA when conducting on-site semi-annual claims best practices reviews that ensure compliance and claims handling efficiency.

The West Virginia state agencies, boards and commissions have been combined under one workers' compensation policy covering all state employees. Specific policy information is provided below:

  Enabling Statute - WV Code §33-2-21a 
  SAWC Member Listing
  Workplace Posting Notice
  SAWC Safety Policy Statement

 Additional Information:

     Claims Reporting - -

  Employer Manual    Agency and Location Site Codes 
  Employee Manual   Zurich FAQ
  Employee Brochure   Zurich - Important Information
  Customer Letter   TTD Wage Calculator
  HealthSmart Wallcard   Election of Option Form
  HealthSmart Employee ID                          

    Forms - -

  Employee’s and Physician’s Report of Occupational Injury or Disease [OIC-WC-1] 
  Employer’s Report of Occupational Injury or Disease [OIC –WC-2]
  Application for Fatal Dependent Benefits     Report of Hearing Loss
  Attending Physicians Report   Report of OP - Employee
  Change of Address Notification   Report of OP - Employer
  Change of Physician   Report of OP - Physician
  Claimant Travel Voucher   Report of OP - Physician Interpretation
  Claim Reopening Form   Service Invoice
  Diagnosis Update   Transitional Employment Agreement
  Functional Job Description   Wage Report
  Pharmacy Invoice  
  Physician Statement of Physical Capabilities                       

Contact Information:

P. O. Box 968044
Schaumburg, IL  60196-8044
Phone: 1-(800)-987-3373
Fax: 1-(973)-394-5262

Email Inquiry – OICSAWC@wv.gov
Tom Judy, Program Manager (policy & coverage inquiries)
Phone: (304)-558-6279, ext. 1127
Email: Thomas.G.Judy@wv.gov

Tonya Montez, WC Systems Specialist III (claims questions)
Phone: (304)-558-1966, ext. 3132
Email: Tonya.R.Montez@wv.gov


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