How to Fill Out the Virginia VWC Compromise Settlement Petition + FAQs

The Virginia VWC Compromise Settlement Petition is the document an injured worker and the employer’s insurer file with the Virginia Workers’ Compensation Commission to ask a Deputy Commissioner to approve a lump-sum settlement of a workers’ compensation claim. No Virginia work injury settlement is final until the Commission signs an Order approving it, no matter what the two sides agreed to between themselves.

This is one of the most carefully reviewed documents in Virginia workers’ comp because it ends or limits your right to future benefits. The Commission says in its Petition and Order Requirements that it “carefully scrutinizes settlements and is particularly reluctant to approve a settlement that ends lifetime medical benefits.” Most Virginia settlements take roughly 60 to 90 days to move from first filing to a signed Order, and a petition with one missing piece can be sent back and reset that clock.

Here is what you will learn in this guide:

  • 📄 What the Compromise Settlement Petition is and who must file it under § 65.2-701
  • ✍️ How to fill out every required part of the petition, section by section, in plain English
  • 📎 The exact supporting documents you must file at the same time, including the affidavit and confidential letter
  • 🏥 How to handle Medicare, a Medicare Set-Aside, child support, and attorney fees so the Commission does not reject your papers
  • 🚫 The most common mistakes that get settlements declined and how to avoid each one

What the Compromise Settlement Petition Is and Who Must File It

A Compromise Settlement is a deal where an injured worker gives up some or all future workers’ compensation rights in exchange for a lump sum of money. The Commission’s own glossary defines it as a settlement where the worker “receives a lump sum payment and may become responsible for paying for future medical” care. The petition is the formal written request that explains the deal and asks the Commission to approve it.

Virginia law, found at Virginia Code § 65.2-701, requires that a memorandum of the agreement “in the form prescribed by the Commission shall be filed with the Commission for approval.” The statute says the agreement may be prepared by the employee, the employer, or the carrier. In real practice, the Commission requires that a Virginia-licensed attorney prepare the papers, because Rule 1.7(B) of the Commission’s rules bars non-attorney insurance representatives from drafting the petition and order.

The plain-English point is that this is a court-style filing, even though the Commission is an agency and not a regular court. The consequence of ignoring the statute is severe: a settlement that is not approved by the Commission is not binding, so the worker could later reopen the claim or, in multi-state cases, the Commission “is not required to” honor an out-of-state settlement that it never approved, as one multi-state law guide explains. A common misconception is that a signed release alone ends the case; in Virginia, only the Deputy Commissioner’s signed Order does that.

The main parties are the claimant (the injured worker), the employer, the carrier or third-party administrator, and the Deputy Commissioner who reviews and signs the Order. Each party’s name and address must be correct so the Commission can mail the final Order to everyone, as the requirements stress.

Before You Start: Documents and Information You Need

Settlement papers in Virginia are filed as a package, and the Commission warns that “all documents must be sent together” and that it “will not hold the file for the missing documents.” Gathering everything first is the single best way to avoid a rejection that costs you weeks. Here is the pre-filing checklist.

  1. The signed settlement agreement terms. You need the final dollar amount and whether medical benefits stay open or close, because these are the heart of the petition and the Commission cannot review a blank deal.
  2. Date of accident and Jurisdiction Claim Number (VWC File Number). The petition must tie the release to specific accident dates and file numbers, and a missing date can make the release too broad and lead to rejection.
  3. Average weekly wage and compensation history. You must state the average weekly wage and the dates compensation was already paid, since the Commission checks these against its own records.
  4. Recent medical reports. Current records must be attached to support the petition, because the Commission will not weigh future medical needs without proof of your condition.
  5. Attorney fee agreement and itemized time. A signed fee agreement and time records are required so the Commission can set a reasonable fee; without them, the fee award can be delayed.
  6. Medicare status and any Medicare Set-Aside (MSA) approval. You need to know if you get Medicare now or expect it soon, because a missing MSA on a qualifying case will stop approval cold.
  7. Child or spousal support orders. Any legally enforceable Order to Withhold must be filed so the carrier can deduct the right amount, or the settlement can violate a support order.
  8. Personal and financial details for the confidential letter. Your age, dependents, income, and your plan for spending the money all go in the informational letter, and leaving them out invites a conference or a denial.
  9. Notary access. The affidavit must be notarized, so you need a notary public available before filing.
  10. A plan for how you will use the money. The Commission wants to see the funds serve your best interest, and a vague plan can trigger a required conference before approval.

Where to Get the Form and How to Access It

There is no single fill-in-the-blank PDF for this petition. Instead, the Commission publishes a Sample Petition “for guidance only,” a sample Order, a mandatory affidavit sample, and sample information letters that unrepresented claimants must use. These templates live on the Commission’s website alongside the full Petition and Order Requirements page that lists every part the petition must contain.

The plain-English point is that you draft the petition to match the sample’s format, not by typing into preset boxes. The consequence of treating it like a casual letter is rejection, because the Commission examines each filing “to determine if the papers are properly executed” and contain the required information. A real example: an attorney for claimant Maria Lopez opens the sample petition, then writes a fresh petition that mirrors each lettered section while inserting Maria’s facts.

The forms and links sit on the attorneys resource page and the requirements PDF. A common misconception is that you can download a “VWC settlement form” and check boxes; the truth is the petition is a custom legal document built from the Commission’s required parts.

Step-by-Step: How to Fill Out the Compromise Settlement Petition Line by Line

The petition follows a lettered structure set by the Commission, from the introductory paragraph through the Deputy Commissioner’s signature line. Build your petition in this exact order, and use the Commission’s own labels so reviewers can match each part to the requirements. Every section below explains what it asks, how to answer it, a sample entry, an edge case, a common mistake, and a misconception to drop.

1. The Caption and Parties

This is the heading block at the top of the petition that names the worker, the employer, the carrier, and the VWC File Number. You answer it by listing the claimant’s full legal name, the employer’s correct legal name and address, the carrier or third-party administrator’s name and address, and the jurisdiction claim number, each on its own line in the format the sample shows.

For example, the caption reads Maria Lopez, Claimant v. Riverside Logistics, Inc., Employer, and Old Dominion Insurance Co., Carrier, VWC File No. VA00001234567. An edge case comes up when there is more than one accident: you must list each accident date and each VWC File Number, because the release can only cover the accidents you identify.

The most common mistake is using the wrong or outdated employer or carrier address, and the direct consequence is that the Commission cannot mail the final Order to all parties, which delays everyone. A misconception is that a trade name is enough; the Commission wants the correct legal name so the Order binds the right company.

2. Introductory Paragraph

This paragraph tells the Commission in one breath what the deal is and what the employer gets in return. The Commission requires specific language, so you answer it by tracking its wording: that the case is before the Commission upon a Petition for Compromise Settlement seeking approval whereby the employee receives a stated sum and, upon payment, the employer and carrier are released from the stated liability.

A sample entry reads: This case is before the Commission upon Petition for Compromise Settlement seeking approval of a settlement whereby the employee receives $85,000.00 and upon payment the employer and carrier are released from all liability arising from the January 8, 2024 accident under VWC File No. VA00001234567. An edge case is a settlement that keeps medical open, where the release must be limited to indemnity (wage) benefits only.

The most common mistake is writing a vague release such as “all claims,” and the consequence is rejection, because the Commission says a “blanket release of all workers’ compensation claims is not acceptable and will be rejected.” A misconception is that broader language protects the employer better; in Virginia, an overbroad release gets the whole petition declined.

3. Statement of the Case

This section sets out the basic facts the Commission uses to confirm the claim is real and within its system. You answer it by stating four items in order: the date of the accident or alleged accident, the average weekly wage, the dates for which compensation has been paid, and the date of the most recent award, if any.

For example, Carlos Mendez writes that the accident occurred 03/15/2023, the average weekly wage was $960.00, temporary total disability was paid from 03/16/2023 through 11/30/2023, and the most recent award was entered 12/05/2023. An edge case is a “denied” or “alleged” claim with no award, where you state that the claim is contested and no award has entered.

The most common mistake is listing an average weekly wage that does not match the Commission’s records, and the consequence is a hold while the reviewer reconciles the numbers. A misconception is that these facts are just background; they actually let the Commission judge whether the settlement amount is fair against what benefits would be worth.

4. Payments Made to Date

This part shows everything already paid on the claim so the Commission sees the full financial picture. You answer it by listing four totals: amounts paid to the employee, amounts paid to medical providers, amounts paid for vocational rehabilitation and placement, and the total amount paid on the case to date.

A sample entry reads that $31,200.00 was paid to the employee in wage benefits, $48,500.00 to medical providers, $2,000.00 for vocational rehabilitation, for a total of $81,700.00 paid to date. An edge case is a denied claim where nothing has been paid, in which you state that no benefits have been paid because the claim is contested.

The most common mistake is leaving out medical payments, and the consequence is that the Commission cannot judge whether the lump sum reasonably reflects the claim’s value. A misconception is that only the new settlement money matters; the Commission wants the total history to protect the worker.

5. Statement of the Controversy

This section explains why the parties are settling instead of litigating. You answer it by describing the dispute in a few sentences, such as a fight over the cause of the injury, the extent of disability, or the need for future surgery.

For example, the petition states that the employer disputes whether the claimant’s ongoing back pain is related to the work accident, and the parties wish to avoid the risk and expense of a hearing. An edge case is a fully accepted claim with no real dispute, where you explain that the parties are settling to give the worker finality and a lump sum.

The most common mistake is skipping this section or writing only “the parties wish to settle,” and the consequence is a request for more information that delays approval. A misconception is that the reason does not matter; the Commission uses the controversy to test whether the trade is fair to the worker.

6. Summary of Medical Treatment

This is a short medical history that focuses on the most recent exam and what the doctor expects for future care. You answer it by summarizing the injury, the treatment so far, the latest examination date and findings, and the doctor’s view on future medical needs, and you attach the recent medical reports.

A sample entry notes that the claimant underwent an L4-L5 fusion on 06/10/2023, reached maximum medical improvement on 02/01/2024, and Dr. Patel’s report dated 02/01/2024 recommends only periodic medication management going forward. An edge case is a case where future surgery is likely, which you must disclose so the Commission can weigh whether closing medical is wise.

The most common mistake is filing without the recent reports attached, and the consequence is rejection, since the requirements state that “recent medical reports must be submitted with the settlement documents.” A misconception is that a summary alone is enough; the Commission needs the actual records to confirm your summary.

7. Statement of the Agreement

This is the heart of the petition, where you spell out the deal terms. You answer it by stating at least four things: the amount of money to be paid to the employee, the agreement about medical treatment (open or closed), any other key terms, and the method of payment such as lump sum, installment, or annuity.

For example, Janet Wells’ petition states the employer and carrier shall pay $120,000.00 in a single lump sum, the claimant’s lifetime medical award shall remain open, and the parties certify there are no undisclosed ancillary agreements. An edge case is a structured settlement, where you add the annuity language and a beneficiary provision in case the worker dies before payments finish.

The most common mistake is being silent on whether medical is open or closed, and the consequence is a hold, because medical treatment is the most scrutinized term. A misconception is that the dollar figure is all that matters; the medical terms often matter more to the Commission than the cash.

8. Cost of Treatment Deadline

This clause names the last date the carrier will pay for the worker’s medical treatment. You answer it by stating the cutoff date, and if medicals are paid through approval, the Commission suggests language ordering that the defendants are responsible for treatment under § 65.2-603 incurred through the date of the Order, with the claimant responsible after that.

A sample entry reads: The defendants shall be responsible for medical treatment incurred by the claimant through the date of entry of this Order, and the claimant shall be responsible for any and all medical expenses incurred thereafter. An edge case is when medical is being closed before the Order date, which requires “a satisfactory explanation” or the Commission will reject the papers.

The most common mistake is leaving a gap where no one covers treatment between the agreement and the Order, and the consequence is unpaid bills and a likely denial. A misconception is that the deadline is automatic; you must state it clearly in writing.

9. Attorney Fees Clause

This clause tells the worker that the Commission will set an attorney fee taken out of the settlement. You answer it by including a statement that the employee understands the Commission will award attorney fees deducted from the settlement amount, unless the papers say otherwise, and you leave the fee and costs blank in the proposed Order for the Commission to fill in.

A sample entry reads the claimant understands that the Commission will award a reasonable attorney’s fee, to be deducted from the settlement proceeds. As one Virginia firm explains, fees on settlements are commonly around 20% of the lump sum, though the Commission notes it considers the time and effort rather than a fixed percentage. An edge case is a worker with no lawyer, where there may be no fee at all.

The most common mistake is typing a fee amount into the Order, and the consequence is that the papers come back, because the Commission says that portion “must be blank” so it can enter the amount. A misconception is that the worker pays the lawyer separately; the fee comes out of the settlement once the Commission approves it.

10. Payment Amounts Block

This is the space where the Commission writes the exact dollars going to the worker and to the attorney. You answer it by leaving a clearly labeled blank space for the Commission to specify the amount to the employee and the amount to the attorney.

A sample entry shows two blank lines: Amount to Claimant: $__ and Amount to Attorney: $__. An edge case is a case with reimbursable litigation costs, where a separate line for costs should also be left for the Commission to complete.

The most common mistake is pre-filling these numbers, and the consequence is that the Commission must reject or correct the math it is supposed to control. A misconception is that the parties divide the money; the Commission sets these figures in the final Order.

11. Spousal and Child Support

This part handles any support orders that attach to the worker’s money. You answer it by filing any legally enforceable spousal or child support order and including language that the defendants will comply with any enforceable Division of Child Support Enforcement Order to Withhold and deduct an appropriate sum from the net recovery.

A sample entry reads the defendants shall comply with any legally enforceable Division of Child Support Enforcement Order to Withhold and shall deduct an appropriate sum from the claimant’s net recovery. An edge case is a worker with a known child support arrearage, where the carrier can deduct once served with a valid Order to Withhold even without Commission approval.

The most common mistake is ignoring a known support order, and the consequence is that the settlement can violate that order and create new legal trouble. A misconception is that comp money is shielded from child support; an enforceable withholding order reaches it.

12. Social Security Disability and Medicare

This is the section that protects Medicare’s interests. You answer it by stating the worker’s Medicare status, and if the worker has Medicare, or the settlement tops $250,000.00 with a reasonable expectation of Medicare within 30 months, you must address the Medicare Secondary Payer Act, usually with a Medicare Set-Aside (WCMSA) in an amount approved by CMS, and attach the CMS approval letter.

A sample entry reads the claimant is not a Medicare beneficiary and has no reasonable expectation of Medicare enrollment within 30 months, so no Medicare Set-Aside is required. An edge case is a small settlement: CMS will not review a Set-Aside proposal for a Medicare beneficiary when the total settlement is under $25,000, though Medicare’s interests still must be considered. If the worker gets Social Security Disability, the petition should address a lifetime pro-ration of the net proceeds.

The most common mistake is omitting Medicare language on a qualifying case, and the consequence is a flat refusal to approve, plus possible loss of future Medicare coverage for the injury. A misconception is that an MSA is always required; it is only required when the worker’s Medicare status or settlement size triggers it.

13. Structured Settlement or Annuity Language

This part applies only when the money is paid over time or through an annuity. You answer it by stating that the annuity company is authorized by the State Corporation Commission to do insurance business in Virginia, that the employer or carrier remains responsible on default, that the employer and carrier own the policy, and that payments go directly from the annuity company to the claimant.

A sample entry reads the annuity shall be issued by a company authorized by the State Corporation Commission, and in the event of default the carrier remains responsible for payment. An edge case is a structured deal with no annuity, where the petition must state the employer and carrier are solely responsible for payment.

The most common mistake is forgetting the default-responsibility language, and the consequence is that the worker has no backstop if the annuity company fails. A misconception is that an annuity removes the carrier’s duty; the carrier stays on the hook if the annuity defaults.

14. Deferred Payment Beneficiary Provision

This clause protects payments if the worker dies before a deferred payout finishes. You answer it by stating that if the employee dies before payment is complete, payments continue unaccelerated to a named beneficiary, and if there is no beneficiary or the beneficiary dies first, payments go to the employee’s estate.

A sample entry reads if the claimant dies before all payments are made, the remaining payments shall be made to the named beneficiary, or to the claimant’s estate if no beneficiary survives. An edge case is a worker who never names a beneficiary, which is exactly why the estate fallback language is required.

The most common mistake is leaving out the beneficiary provision in a deferred deal, and the consequence is rejection, since the requirements demand it for deferred payments. A misconception is that this only matters for large settlements; any deferred payment needs this clause.

15. Deputy Commissioner Signature Line

This is the line where the Deputy Commissioner enters and signs the approving Order. You answer it by adding the exact closing format the Commission uses, with a blank date and a signature line.

The sample entry reads: Entered this _ day of _, ____. followed by a line for the Deputy Commissioner. An edge case is a regional case, where the documents go to the Deputy Commissioner’s regional office instead of Richmond if the file already sits there.

The most common mistake is omitting this block, and the consequence is that there is no place for the official approval that makes the deal binding. A misconception is that the parties’ signatures finalize the deal; only the Deputy Commissioner’s signature does.

Required Documents You Must File With the Petition

Beyond the petition itself, the Commission requires a full package, and missing items get the file kicked back. As one Virginia injury firm notes, the core package is the petition, the order, the affidavit, and the claimant’s confidential cover letter.

  • Medical reports that support the petition and back up your medical summary.
  • The attorney’s statement explaining why the settlement is in the claimant’s best interest.
  • The confidential informational letter with the worker’s procedural and personal history, dependents, income, current medical status, future medical costs, and a clear statement of how the worker will use the money; unrepresented claimants must use the Commission’s sample letter.
  • A notarized affidavit using the Commission’s mandatory sample.
  • Any child support order that is legally enforceable.
  • The CMS Medicare Set-Aside approval letter, if a Set-Aside applies.
  • A signed attorney fee agreement with an itemized time schedule and the worker’s acknowledgment of the fee request.

The confidential letter is filed sealed in WebFile under the “Petition and Order Informational Letter (sealed)” type, which keeps your private financial details out of the public file. If a worker plans to pay debts, the letter must list the total debts and payments; if money will be invested, it must identify the investment, amount, and terms.

Three Filled-Out Examples Using Real Scenarios

These three scenarios show how different workers complete the petition. Each follows one named person through the key parts.

Scenario 1 — Maria Lopez, full and final settlement closing medical. Maria settles a back injury for a lump sum and agrees to close her medical benefits.

Form Section What Maria Enters
Caption / Parties Maria Lopez v. Riverside Logistics, Inc.; Old Dominion Insurance Co.; VWC File No. VA00001234567
Introductory Paragraph Employee receives $85,000.00; employer and carrier released from all liability for the 01/08/2024 accident
Statement of Case Accident 01/08/2024; average weekly wage $910.00; TTD paid 01/09/2024–10/15/2024; award entered 10/20/2024
Payments to Date Employee $24,000.00; medical $39,500.00; voc rehab $0; total $63,500.00
Statement of Agreement $85,000.00 lump sum; medical benefits closed; no undisclosed ancillary agreements
Cost of Treatment Deadline Carrier pays medical through date of the Order
Medicare Not a Medicare beneficiary; no MSA required
Attorney Fees Claimant understands the Commission will set the fee; Order left blank

Scenario 2 — Carlos Mendez, lump sum keeping lifetime medical open. Carlos settles only his wage claim and keeps his medical award open.

Form Section What Carlos Enters
Caption / Parties Carlos Mendez v. Apex Construction LLC; Commonwealth Casualty Co.; VWC File No. VA00007654321
Introductory Paragraph Employee receives $60,000.00; release limited to indemnity benefits only
Statement of Case Accident 03/15/2023; average weekly wage $960.00; TTD paid 03/16/2023–11/30/2023
Statement of Agreement $60,000.00 lump sum; lifetime medical award remains open
Summary of Medical L4-L5 fusion; MMI 02/01/2024; future medication management expected
Cost of Treatment Deadline Medical stays open, so no cutoff; ongoing care continues
Medicare Not yet eligible; settlement under threshold; no MSA
Attorney Fees Order left blank for the Commission to set the fee

Scenario 3 — Janet Wells, large settlement with a Medicare Set-Aside. Janet, age 63, settles a serious shoulder injury and is close to Medicare eligibility.

Form Section What Janet Enters
Caption / Parties Janet Wells v. Tidewater Health Systems; Atlantic Indemnity Co.; VWC File No. VA00009998888
Introductory Paragraph Employee receives $310,000.00; employer and carrier released for the 05/02/2022 accident
Statement of Agreement $310,000.00 total, including a CMS-approved Medicare Set-Aside
Medicare Reasonable expectation of Medicare within 30 months; WCMSA funded and CMS approval letter attached
Summary of Medical Two shoulder surgeries; future injections projected in the Set-Aside
Child Support No support order on file
Structured Language Portion of the MSA funded by an annuity with default and beneficiary clauses
Attorney Fees Order left blank; signed fee agreement and time records attached

How to File the Completed Petition

Virginia settlements are filed through the Commission’s WebFile portal, which is the main channel attorneys use. The package must be uploaded together, and the confidential informational letter is uploaded as a sealed document type so it stays private.

  • Online (WebFile): Upload the petition, order, affidavit, medical reports, fee agreement, and sealed informational letter at webfile.workcomp.virginia.gov. Documents should be in PDF format. There is no Commission filing fee to submit a settlement, and your proof of filing is the WebFile confirmation and date stamp you should save.
  • By mail: Send the full package to the Virginia Workers’ Compensation Commission, 1000 DMV Drive, Richmond, VA 23220, unless the file already sits in a Deputy Commissioner’s regional office. Keep a certified mail receipt as proof of filing.
  • By fax: The Commission accepts filings by fax at 804-823-6956; keep the fax confirmation sheet as your proof.
  • In person: You may deliver the package to a Commission office; ask for a date-stamped copy as proof.

The Commission’s general phone line is 1-877-664-2566 if you need to confirm an address. Remember the Commission’s note that contacting it is “unnecessary” after filing, because it will write to you if it needs a conference or more information.

What Happens After You File

After filing, a reviewer first checks that the papers are “properly executed” and complete, then a Deputy Commissioner reviews whether the settlement is “in the best interest of the employee.” This two-step review is why the process commonly runs 60 to 90 days from filing to a signed Order.

If something is missing or unclear, the parties are notified in writing, and the Commission may require a conference with the employee before approving the deal. Once approved, the Deputy Commissioner signs the Order, the Commission sets the attorney fee, and the carrier pays the lump sum, usually within a set number of days after the Order becomes final. If the settlement is declined, the parties are told in writing and can fix the problem and refile.

Mistakes to Avoid When Filling Out the Petition

  • Filing an incomplete package. The Commission will not hold the file for missing documents, so an incomplete filing is returned and delayed.
  • Using a blanket release of all claims. This is rejected outright, because the release must be tied to specific accident dates and file numbers.
  • Leaving the medical terms unclear. Silence on open or closed medical triggers a hold, since medical is the most scrutinized term.
  • Forgetting recent medical reports. Without current records, the Commission cannot judge the deal and will reject the petition.
  • Omitting Medicare language on a qualifying case. This leads to a flat refusal and can cost the worker future Medicare coverage.
  • Pre-filling the attorney fee in the Order. The fee block must be blank, so a filled-in fee gets the papers returned.
  • Listing a wrong average weekly wage. A mismatch with Commission records causes a reconciliation hold.
  • Ignoring a child support order. This can violate the support order and create new legal problems.
  • Skipping the notarized affidavit. A missing or unsigned affidavit makes the package non-compliant.
  • Leaving out the beneficiary clause in a deferred deal. Deferred payments require it, or the petition is rejected.
  • Using the wrong employer or carrier address. The Commission cannot mail the Order, which delays everyone.
  • Writing a vague spending plan in the confidential letter. A weak plan can trigger a required conference before approval.

Do’s and Don’ts

Do:Do mirror the Commission’s lettered sections so reviewers can match each part fast. – Do attach current medical reports because the Commission requires proof behind your summary. – Do disclose every ancillary agreement and certify it in the petition, since hidden side deals get settlements declined. – Do leave the fee and payment blocks blank so the Commission can enter the figures. – Do file everything together to avoid the automatic return of incomplete packages. – Do address Medicare honestly to protect the worker’s future coverage.

Don’t:Don’t use a blanket release because it is rejected on sight. – Don’t let a non-attorney draft the papers, since the rules bar that and the filing will be invalid. – Don’t guess at the average weekly wage, because a mismatch stalls review. – Don’t bury bad news about future surgery, as the Commission needs the full picture. – Don’t pre-fill the attorney fee, which gets the Order returned. – Don’t skip the notary on the affidavit, because an unsworn affidavit is non-compliant.

Pros and Cons of Filing on Your Own vs. With an Attorney

Filing Pro Se (On Your Own) Filing With a Virginia Attorney
Costs no attorney fee, so you keep more of the lump sum, but the Commission’s rules effectively require a licensed attorney to prepare the petition
You control the timeline directly, yet a single missing part can reset the 60-to-90-day clock
You must use the Commission’s mandatory sample informational letter, which adds complexity for non-lawyers
You face the full risk of an overbroad release being rejected, with no professional to catch it
You handle Medicare and MSA issues yourself, where a mistake can cost future coverage
With Attorney — Strengths With Attorney — Tradeoffs
The lawyer drafts compliant papers, lowering the rejection risk that delays your money
The lawyer handles Medicare, MSA, and child support traps that are easy to miss
The fee is regulated and commonly around 20% of the lump sum, set by the Commission
The lawyer can argue the settlement is in your best interest at any required conference
You give up a slice of the settlement to the fee, which reduces your net recovery

Key Agencies, Statutes, and Related Forms

The central body is the Virginia Workers’ Compensation Commission, which receives and approves the petition. The governing statute is § 65.2-701 within Title 65.2, the Virginia Workers’ Compensation Act, and the medical-payment rule in § 65.2-603 governs the treatment-cost deadline.

On the federal side, the Centers for Medicare and Medicaid Services (CMS) reviews Medicare Set-Aside arrangements when a settlement triggers the Medicare Secondary Payer Act. The Virginia Division of Child Support Enforcement issues the Orders to Withhold that affect a worker’s net recovery, and the State Corporation Commission licenses any annuity company used in a structured settlement.

FAQs

Do I have to get my Virginia work injury settlement approved by the Commission?

Yes. Virginia Code § 65.2-701 requires every workers’ compensation settlement to be filed with the Commission for approval. Without a signed Order from a Deputy Commissioner, the deal is not binding.

Can I prepare the Compromise Settlement Petition myself without a lawyer?

No. The Commission’s rules require a Virginia-licensed attorney to prepare the petition and order, and non-attorney insurance representatives are barred from drafting them under Rule 1.7(B).

Do I write the attorney fee amount in the proposed Order?

No. You must leave the attorney fee and costs portion of the Order blank, because the Commission sets and enters those amounts itself after review.

Do I list every accident date in the release section?

Yes. A blanket release is rejected, so you must identify each specific accident date and VWC File Number that the settlement covers in the petition.

Do I have to state the average weekly wage on the petition?

Yes. The Statement of the Case must include the average weekly wage, and it should match the Commission’s records to avoid a reconciliation hold.

Do I need a Medicare Set-Aside for every settlement?

No. A Set-Aside is needed mainly when you already have Medicare, or the settlement tops $250,000 with Medicare expected within 30 months; CMS will not review proposals under $25,000.

Do I attach medical reports with the petition?

Yes. The Commission requires recent medical reports to be submitted with the settlement documents so it can confirm your medical summary and future-care needs.

Do I file all the documents at the same time?

Yes. The Commission will not hold the file for missing documents, so the petition, order, affidavit, letter, and supporting records must be filed together.

Do I write the dollar amounts the worker and attorney each receive?

No. You leave a blank space for those amounts, and the Commission specifies the sum to the employee and the sum to the attorney in the final Order.

Do I have to disclose side agreements related to the settlement?

Yes. Every petition must certify that there are no ancillary agreements or that all such agreements have been disclosed to the Commission.

Does the affidavit need to be notarized?

Yes. The package requires a notarized affidavit using the Commission’s mandatory sample, and an unsworn affidavit makes the filing non-compliant.

Do I have to explain how I will use the settlement money?

Yes. The confidential informational letter must state your intended use of the proceeds, including debts to be paid or investments planned, so the Commission can confirm the deal serves your best interest.

Does closing my lifetime medical benefits make approval harder?

Yes. The Commission carefully scrutinizes settlements and is “particularly reluctant to approve a settlement that ends lifetime medical benefits,” so you must explain why closing medical is in your best interest.

Do I file the settlement through WebFile?

Yes. Most filings go through the Commission’s WebFile portal, where the confidential informational letter is uploaded as a sealed document to keep your private details out of the public file.