The Award Agreement Form in Virginia Workers’ Compensation: What to Check Before You Sign

Corey R. PollardWorkers’ compensation attorney · Former insurance defense · $100M+ recovered

The insurance carrier will send you an Award Agreement form if it accepts that you have a compensable claim and are entitled to benefits. Once both sides sign and file it, a Deputy Commissioner with the Workers’ Compensation Commission reviews the form and, if it conforms to the Workers’ Compensation Act, enters an Award Order adopting its terms. That order becomes the basis for every dollar of wage loss and every medical bill the insurer must pay.

After the order goes final, you are bound by what the form says, with limited exceptions. So the form has to be right before you sign it. This page tells you what to check.

Why Virginia uses a form at all

There are two ways a workers’ compensation system handles the first payment of benefits.

Under a direct payment system, the employer must start paying as soon as it accepts liability for the injury or fails to respond to a claim.

Under an agreement system, the employer does not have to pay anything, even on an accepted claim, until the parties agree in writing on which benefits are owed and in what amount and duration.

Virginia is an agreement state. Virginia Code Section 65.2-701 directs employers and injured employees to file a memorandum of agreement with the Commission when they agree on entitlement to benefits. The Virginia Workers’ Compensation Commission has read this statute as a policy preference for resolving claims without litigation. Gutierrez v. Sensata Technologies, JCN VA00001336817 (May 3, 2018).

In practice, this means an accepted claim looks like this: you report the injury, the adjuster investigates, you receive a claim acceptance letter stating which benefits the insurer agrees to pay and attached to that letter is an Award Agreement form for you to sign. You cannot force the insurer to pay until you sign the form, file it, and the Commission approves it.

Some insurers will pay wage loss benefits or cover medical treatment voluntarily, before circulating an Award Agreement or the entry of an award. The law allows this; however, it does not mean that you have the protection of an award. You must still file a claim for benefits to protect your legal rights.

Is there a standard Award Agreement form?

Yes. The Commission publishes one on its website, and Code Section 65.2-701 requires the parties to use the form the Commission prescribes.

Do not let the carrier substitute its own document. If the adjuster sends you something that is not the Commission’s form, ask why. You don’t want to risk the Commission rejecting the proposed agreement because you used the wrong paperwork.

You can download a copy here. 

What to check before you sign

Receiving the form is a good sign. It means the insurer accepts you meet the threshold requirements for a compensable accident and does not plan on challenging compensability at a hearing. But an accepted claim does not mean the insurer agrees to pay every benefit owed.  

I have prepared and reviewed thousands of these forms. The two places where the form is most likely to be wrong in the carrier’s favor are the following:

Your pre-injury average weekly wage

Your average weekly wage (AWW) sets the value of the claim. The amount you receive in temporary total disability, temporary partial disability, and permanent partial disability benefits depends on it.

Don’t rely on the employer’s wage chart or the adjuster’s calculation. Always check the numbers yourself, and include overtime, bonuses, and stipends paid before the injury. Also, those of you who worked two or more jobs at the time of the accident should combine wages from those other jobs if they were similar to the one where you were hurt.

Do not sign the Award Agreement if the AWW is wrong. Instead, send your wage documentation to the adjuster. If they won’t correct it, ask for a hearing before the Commission.

The problem is that once the Commission enters an award using the AWW on the form, amending it later is difficult. The Commission may reopen an award for a mistake of fact; however, it generally will not reopen it if you forgot to combine wages from other employment or failed to include earnings not shown in the original paperwork.

The body parts and injuries accepted as compensable.

Carriers often accept some injuries and leave others off the form. In a recent case I handled, the adjuster sent an Award Agreement listing the knee and hand injuries but omitting the back, because the worker had mentioned a back surgery ten years earlier during the recorded statement. The carrier will presumably argue that any back treatment or disability flows from the pre-existing condition.

I usually recommend signing, as long as everything else on the form is correct. You do not give up the right to litigate the omitted body part; you file a claim for it – generally after the award goes final on the Award Agreement – and take it to hearing.

I recommend letting the award go final so that the insurer does not back out of the agreement once you seek coverage of additional body parts.

It’s easier to add an injury when you already have an award confirming the accident itself was compensable. The compensability fight is done. Now the issue is causation for the omitted body part.

If you sign a form with omitted injuries, you must file a claim for those injuries within the statute of limitations (usually two years from the accident date). An award covering the knee does not preserve a claim for the back.

A related worry: the form understates how bad the injury is

I hear this from injured workers frequently: the Award Agreement downplays the severity of their injury. For example, the urgent care doctor diagnoses a “right shoulder strain” at your first visit, so that is what the adjuster writes on the form. Three weeks later, an orthopedic surgeon orders an MRI and finds a full-thickness rotator cuff tear. The worker is afraid that by agreeing to “strain,” they have given up the right to benefits for the tear.

They have not. The Court of Appeals of Virginia has held that the description of the injury on an Award Agreement does not limit you to treatment or disability benefits for that description only. In Corporate Resource Management Inc. v. Southers, 51 Va. App. 118, 655 S.E.2d 34 (2008), the Court held that an agreement to pay benefits that listed a shoulder “contusion” did not limit the claimant to treatment for only the “contusion.” Instead, identifying the body part was broad enough to cover all of the symptoms related to it.

Because of this case, I often advise clients to sign a form with a specific, milder description of the injury rather than hold out for better language. It’s unnecessary. Sign the form so that your benefits start, the Commission enters the award, and you get the leverage that comes with it. The diagnosis can catch up.

Other items to check:

• The types of benefits the insurer will pay: The form should clarify whether the insurer only agrees to a medical award or whether it will also pay wage loss or permanency benefits.
• The start date for wage loss benefits: Adjusters may shave a few days or weeks off the front end – intentionally or unintentionally. Unless the medical records support a later start, push back.
• The lump-sum election on permanent partial disability: If the form covers PPD, you can elect to receive the payment in a lump sum with a four percent discount instead of weekly payments over the assigned number of weeks. It’s your choice, not the insurer’s.
• Any Termination of Wage Loss form attached to the agreement. Carriers sometimes ask you to sign an Award Agreement and Termination of Wage Loss form at once. Signing it means you agree to a closed period of wage loss payments, not ongoing benefits. Do not sign it just because the insurer asks you to.

What happens after both sides sign?

An Award Agreement is not binding on anyone until the Commission approves it. Damewood v. Lanford Bros. Co., 29 Va. App. 43, 45, 509 S.E.2d 530, 531 (1999). Either you or the claim administrator must submit the signed form to the Commission for its review. A Deputy Commissioner reviews it to confirm the terms comply with the Act and, if they do, enters an Award Order adopting them.

The Award Order is the document that gives you power. Once it is entered, the carrier cannot simply stop paying because it feels like it. It has to file an Employer’s Application for Hearing and show the Commission there is probable cause to suspend or terminate benefits. Otherwise, if payment stops without an application, and your check is more than two weeks late, you are entitled to a 20 percent penalty under Virginia Code Section 65.2-524. My penalty page covers that situation. This page explains what you can do to get the agreement right so you have maximum leverage in future disputes.

How long does approval take?

The Commission does not have a set timeline for entering an award after the parties file a signed Award Agreement. In my experience, a Deputy Commissioner will review the form and enter an award within seven to ten business days. However, the process can take longer if the Commission has concerns with the agreement and needs you to clarify something.

What if the adjuster will not file the signed form?

This happens more than it should. And I think many adjusters do it on purpose.

Some adjusters sit on the signed form for a month to see if a doctor releases you to light duty or the employer creates a modified-duty job for you. If this happens, the carrier’s position changes. It may now refuse to agree to an award unless you show evidence of marketing, or it could force you to meet your burden of proving ongoing disability at a hearing.

The Commission can sanction this behavior. An employer or carrier that fails to file a fully executed Award Agreement form with the Commission within 14 days may be fined up to $1,000 and subjected to other sanctions. Virginia Code Section 65.2-701(B). Rule 4.1 of the Workers’ Compensation Commission’s Rules also requires the employer to file all agreements promptly.

If you are in this position, do two things. File a motion for sanctions under this statute and rule and ask the Commission to refer your Claim for Benefits to the hearing docket. The motion brings your case to the adjuster’s attention and, hopefully, prompts filing of the executed form.

Does signing the form close my case?

No. The Award Agreement resolves the dispute before the Commission. It does not close the claim, and it is not a settlement.

You can still file a change in condition application if your disability status changes, file for permanent partial disability when you reach maximum medical improvement (MMI), seek treatment for compensable consequences of the original injury, and negotiate a full and final settlement later if that is in your best interest. A severe injury claim can generate several award orders over its life.

What if I change my mind after signing?

You can back out of an Award Agreement if you have second thoughts or discover an incorrect term and the Commission has not entered an Award Order. But only if the timing is right.

Before entry of the Award Order, you can withdraw consent at any time.

Within 30 days after the Commission enters the Award Order, you can file a request for review to vacate the order. The Commission routinely grants these requests, even if you do not provide a reason for it. This policy comes from Virginia Code Section 65.2-705(A) and Commission case law. See Sovran Fin. Corp. v. Nanney, 12 Va. App. 1156, 408 S.E.2d 266 (1991) (either side may petition the Commission within the review period).

If more than 30 days have passed, the award is final. The Commission can only vacate the award in limited circumstances, such as fraud or mutual mistake of fact. Otherwise, you must live with the form’s terms.

Ask a workers’ compensation attorney to review your Award Agreement before you sign it

The entry of an award comes near the beginning of the case, not the end.

What follows an accepted claim may include a functional capacity evaluation, an independent medical examination, interrogatories, a light-duty job offer, and vocational rehabilitation, each of which is a lever the carrier can pull to end or reduce benefits.

If the insurer has sent you an Award Agreement form, take the time to confirm that each part is correct. You can also call (804) 251-1620 to see if we can help.

About the authorCorey Pollard is a Virginia workers’ compensation and Social Security Disability attorney in Richmond. Best Lawyers in America® (2020–2026), $100M+ recovered, and a former insurance defense lawyer — which is the part that matters.