West Virginia Code § 23-4-15b

Determination of nonmedical questions; claims for occupational
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pneumoconiosis; hearing.
If a claim for occupational pneumoconiosis benefits is filed by an employee within three
years from and after the last day of the last continuous period of sixty days' exposure to the
hazards of occupational pneumoconiosis, the Insurance Commissioner, private carrier or
self-insured employer, whichever is applicable, shall determine whether thee claimant was
exposed to the hazards of occupational pneumoconiosis for a continuous period of not less
than sixty days while in the employ of the employer within three years rprior to the filing of
his or her claim, whether in the State of West Virginia the claimant was exposed to such
hazard over a continuous period of not less than two years during the ten years immediately
preceding the date of his or her last exposure to the hazard and whether the claimant was
exposed to the hazard over a period of not less than ten yearts during the fifteen years
immediately preceding the date of his or her last exposure to the hazard. If a claim for
occupational pneumoconiosis benefits is filed by an employee within three years from and
after the employee's occupational pneumoconiosis was made known to the employee by a
physician, the Insurance Commissioner, private carrier or self-insured employer, whichever
is applicable, shall determine whether the claimant filed his or her application within that
period and whether in the State of West Virginia the claimant was exposed to the hazard
over a continuous period of not less than two years during the ten years immediately
preceding the date of last exposure to the hazard and whether the claimant was exposed to
the hazard over a period of not less than ten years during the fifteen years immediately
preceding the date of last expoesure to the hazard. If a claim for occupational pneumoconiosis
benefits is filed by a dependent of a deceased employee, the Insurance Commissioner,
private carrier or self-inLsured employer, whichever is applicable, shall determine whether
the deceased employee was exposed to the hazards of occupational pneumoconiosis for a
continuous period of not less than sixty days while in the employ of the employer within ten
years prior toV the filing of the claim, whether in the State of West Virginia the deceased
employee was exposed to the hazard over a continuous period of not less than two years
during the ten years immediately preceding the date of his or her last exposure to the hazard
and whether the claimant was exposed to the hazard over a period of not less than ten years
during the fifteen years immediately preceding the date of his or her last exposure to the
hazard. The Insurance Commissioner, private carrier or self-insured employer, whichever is
applicable, shall also determine other nonmedical facts that, in the opinion of the Insurance
Commissioner, private carrier or self-insured employer, whichever is applicable, are
pertinent to a decision on the validity of the claim.
The Insurance Commissioner, private carrier or self-insured employer, whichever is
applicable, shall enter an order with respect to nonmedical findings within ninety days
following receipt by the Insurance Commissioner, private carrier or self-insured employer,
whichever is applicable, of both the claimant's application for occupational pneumoconiosis
benefits and the physician's report filed in connection with the claimant's application and
shall give each interested party notice in writing of these findings with respect to all the
nonmedical facts. The findings and actions of the Insurance Commissioner, private carrier or
self-insured employer, whichever is applicable, are final unless the employer, employee,
claimant or dependent, within sixty days after receipt of the notice, objects to the findings
and, unless an objection is filed within the sixty-day period, the findings are forever final, the
time limitation is a condition of the right to litigate the findings and therefore jurisdictional.
Upon receipt of an objection, the chief administrative law judge shall set a hearing as
provided in section nine, article five of this chapter. In the event of an objection to the
findings by the employer, the claim shall, notwithstanding the fact that one eor more hearings
may be held with respect to the objection, mature for reference to the Occupational
Pneumoconiosis Board with like effect as if the objection had not been rfiled. If the
administrative law judge concludes after the protest hearings that the claim should be
dismissed, a final order of dismissal shall be entered. The final order is subject to appeal in
accordance with the provisions of sections ten and twelve, article five of this chapter. If the
administrative law judge concludes after the protest hearingts that the claim should be
referred to the Occupational Pneumoconiosis Board for its review, the order entered shall be
interlocutory only and may be appealed only in conjunction with an appeal from a final order
with respect to the findings of the Occupational Pneumoconiosis Board.

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