The national Workers Compensation guide covers how the coverage works: the no-fault bargain, the standard policy's Part One (statutory benefits) and Part Two (employers liability), and premium rating. This guide covers the Vermont rules: who must be covered, the ways to secure coverage, the benefit rules, cancellation notice and the penalties for going uninsured.

Who runs it

• Vermont's workers compensation law is 21 V.S.A. chapter 9. It is administered by the Commissioner of Labor (Department of Labor).
• The Department of Financial Regulation regulates the insurers that write the coverage.
• Vermont is not a monopolistic state. Employers buy from private insurers or self-insure.
• Benefits are paid for personal injury arising out of and in the course of employment, without regard to fault (21 V.S.A. § 618). Workers compensation is the employee's exclusive remedy against the employer (§ 622).

Securing coverage (21 V.S.A. § 687)

An employer may secure compensation by:

• insurance with an authorized carrier
• guarantee insurance
• approved self-insurance
• a nonprofit self-insurance corporation

Other rules:

• An employer may not make employees pay any part of the cost. Such an agreement is void, and an employer who deducts it may be fined up to $500 (§ 699).
• On written request, a carrier must offer a deductible of at least $500, which the employer repays. The insurer still adjusts and pays the claims (§ 687(e)).
• If a corporation is uninsured, its officers and majority stockholders are personally liable for the benefits. Partners are liable for an uninsured partnership (§ 687(b)).

Who is covered (21 V.S.A. § 601)

• Part-time and seasonal workers are covered.
• Excluded:
  • casual work not done for the employer's trade or business
  • farm work for an employer with an aggregate payroll under $10,000 a year, unless the employer elects coverage. Buying insurance counts as electing.
  • a family member living in the employer's home, unless their wages are in the payroll used to figure the premium
• A corporation or LLC may, with approval, exclude up to four executive officers, managers or members (§ 601(14)(H)).
• Injury includes occupational disease and damage to prosthetics, hearing aids and eyeglasses (§ 601(7)).
• A mental injury from work stress is covered only if the stress was extraordinary and unusual compared with all occupations and was the predominant cause. Good-faith discipline, demotion or firing doesn't qualify (§ 601(11)(J)).

Benefits

• Temporary total disability pays two-thirds of the average weekly wage, within the state maximum and minimum (§ 642(a)).
• Waiting period: the first three days aren't paid. If disability lasts seven consecutive days or more after the third day, those days are paid back (§ 642).
• Total weekly wage replacement, including payments for dependent children, can't exceed 90% of the average weekly wage before cost-of-living adjustments (§ 642(c)).
• Temporary partial disability begins on the eighth day of disability (§ 646(a)).

Claims

• The worker gives notice to the employer as soon as practicable. A claim is made within six months of the injury unless compensation was paid voluntarily (§ 656(a)).
• Workers compensation claims are handled by a licensed workers compensation adjuster (8 V.S.A. § 4793(c)).

Cancellation and nonrenewal

• A carrier cancels by filing a notice with the Commissioner of Labor and sending it to the employer by certified mail. The cancellation takes effect at least 45 days later (21 V.S.A. § 696).
• Nonrenewal also needs 45 days' notice to the Commissioner and the employer. A carrier that fails to give it must continue the policy for 45 days from when notice is received (§ 697).
• The general P&C cancellation statute in Title 8 doesn't apply to workers compensation policies (8 V.S.A. § 3880(a)).

Enforcement

• An uninsured employer gets an emergency stop-work order until coverage is in place (§ 692(b)).
• The administrative penalty is up to $100 per day for the first seven days and up to $150 per day after that (§ 692(a)).
• Each insurer's anti-fraud plan covers misclassification, which is treating employees as independent contractors, and miscoding, which is using the wrong NCCI class codes (8 V.S.A. § 4750(b)).
• The Workers' Compensation Administration Fund, financed by employer contributions on premiums and self-insured losses, pays for running the program (§ 711).

Guaranty association

The Vermont Property and Casualty Insurance Guaranty Association has a separate workers compensation account. The $500,000 per-claim cap doesn't apply to workers compensation claims (8 V.S.A. §§ 3613, 3615).

Common exam traps

• Coverage is administered by the Commissioner of Labor, not DFR.
• The waiting period is 3 days, paid back if disability lasts 7 days or more after the third day.
• TTD is two-thirds of the average weekly wage, with a 90% total cap including dependents.
• Cancellation and nonrenewal take 45 days' notice.
• A corporation or LLC may exclude up to four officers or members.
• The farm exemption is a payroll under $10,000.
• The claim deadline is six months.