Self-Insured Employer Survey

Pursuant to W.Va. Code §23-2C-5(c)(6), this form will serve as a mandatory survey to provide an overview of the safety initiatives currently being utilized by self-insured employers.  All self-insured employers are required to respond. 

Please contact Juanita Wimmer at Juanita.D.Wimmer@wv.gov or via telephone at 304-414-8491 with questions or concerns regarding the survey questions or the online survey form.