|Workers Compensation Tasks and Forms|
|Contractor's Certificate of Insuring Liability for Worker's Compensation Form (State Requirement) ["Online" here will be automatically sent to the Worker's Comp Commission -- see below for additional instructions]||Online|
|Contractor's Certificate of Insuring Liability for Worker's Compensation Form (State Requirement) ["Online" here will be automatically sent to FC Commissioner of the Revenue]
|Virginia Workers' Compensation Commission Informational Sheet
Your Certificate of Worker's Compensation (Form 61A) MUST BE SUBMITTED ANNUALLY -- even if you are not required to carry Worker's Comp Insurance.
You can use the above first link to file it online directly with the Virginia Worker's Compensation Commission (WCC). If you are unable to open the link in your current browser, try using Google Chrome. A YouTube instructional video on how to complete and file the Form 61A is available at -- https://youtu.be/axr43dC2gMw. If completed & submitted online to the WCC, you will immediately receive an "Insurance Acknowledgment" of compliance. You need to "save" or "download & print" that email of "Insurance Acknowledgment" and send it to the Frederick County Commissioner's office.
Alternatively, an online link to file the form directly with the Commissioner's office as well as a link to the printable version of the form are accessible above.
The Insurance Acknowledgment you receive from the WCC or the completed printable form must be sent:
by fax to: 540-667-6487 OR
by email to: firstname.lastname@example.org OR
by mail to:
- Leighann Miller
Frederick County Commissioner of the Revenue's Office
PO Box 552
Winchester, VA 22604-0552
- Virginia law requires that an employer who regularly employs three or more employees carry workers' compensation insurance.
- The civil penalty imposed when an employer who is required to insure under the Worker's Compensation Act fails to do so has significantly increased -- up to $250 per day subject to a maximum of $50,000 plus costs.
- "Employee" covers a wide-range of types of employees including, but not limited to, part-time and full-time, corporate officers, seasonal workers, minors, aliens, trainees, working family members, etc. See complete definition of "employee" in the VA State Code § 65.2-101.
- If a business hires subcontractors to perform the same trade, business, or occupation, or to fulfill a contract of the business, the subcontractor's employees are included in adding up the business' total number of employees for purposes of determining if workers' compensation insurance is required.
- Pursuant to the Code, Frederick County cannot issue a business license to any contractor who has not filed their annual Workers Comp Insurance form.
- THE CONTRACTOR'S CERTIFICATE OF WORKERS' COMPENSATION INSURANCE FORM (Form 61-A) IS REQUIRED TO BE SUBMITTED ANNUALLY EVEN IF NO INSURANCE IS REQUIRED.
- A Certificate of Insurance as provided by your carrier will NOT be accepted in lieu of a completed Form 61-A.
An informational sheet regarding Virginia coverage requirements, contractor liability, and voluntary coverage has been provided by the Virginia Workers' Compensation Commission (WCC). More information can be obtained from the VA WCC by calling 877-664-2566 or via their website at www.workcomp.virginia.gov.