Key Steps to Follow for Consideration
Within 30 days of receiving the Program’s denial letter for a claim, a claimant may appeal this decision to the Board of Directors of the Program.Step 1: Contact the Program’s Executive Director, Ms. Dawn McCoy, via email address at admasst@vabirthinjury.com with subject line: Claim Appeal Request. Telephone voice messages and not acceptable. If unable to find resolution, as noted below from Page 10 of the Program Handbook, you may request that the Board make a determination regarding the claim during their next scheduled meeting with a quorum. Proceed to Step 2.
Step 2: You may submit a letter addressed to the Director and the Board of Directors (as an entity, not to individual members of the board), with a written explanation, a summary of the dispute of your claim with supporting documentation, such as letters of medical necessity and the specific resolution you would like to see.
This request may be sent via mail or email to the Director (not to individual board members) at admasst@vabirthinjury.com or mailed to 7501 Boulder View Drive, #600, Richmond, Virginia 23225. You may also attend the meeting. Appeal requests, telephone calls, or email/mail sent to individual board members are not acceptable.
Step 3: Within 30 days of receipt of written notification of the board’s decision, if a dispute is not resolved by the Board, a petition of appeal may be filed with the Clerk of the Virginia Workers’ Compensation Commission at 333 East Franklin Street, Richmond, Virginia 23219. (Va. Code § 38.2-5002.1, 14VAC10-10-230).
