2019 US Virgin Islands Code
Title 24 - Labor
Chapter 11 - Workers' Compensation Administration
§ 254a. Medical rehabilitation

(a) For any injury covered by this chapter, and the employee shall be entitled to all medical services, including chiropractic, optometric and dental services, appliances, supplies and transportation which are required by the nature of his injury and which will relieve pain and promote and hasten his restoration to health and employment. This includes such services, appliances and supplies and necessary replacements or repairs of such appliances unless the need for such replacements or repair is due to lack of proper care by the employee. In addition to the income benefits otherwise payable, the employee, who is entitled to income benefits shall be paid an additional sum as for a medical benefit of not more than $200 weekly, as may be deemed necessary, when the service of an attendant is necessary constantly to be used by reason of the employee's being totally blind or having lost both hands or both feet or the use thereof being paralyzed and unable to walk, or by reason of other disability resulting from the injury actually rendering him so helpless as to require the constant attendance. An employee shall have the right to select the medical or chiropractic physician or dentist of his choice, however, the Administrator shall have the authority to determine the necessity, character and sufficiency of any medical services furnished or to be furnished and shall have authority to order a change of practitioner, hospital or rehabilitation facility when in his judgment such change is desirable or necessary.

(b) All practitioners attending injured employees shall comply with any rules and regulations adopted by the Administrator and shall make such reports as may be required by him at any and such times as required by him upon the condition or treatment of any injured employee, or upon any other matters concerning cases in which they are employed. Generally all medical information relevant to the particular injury shall, on demand, be made available to the employer, employee, fund, and the Administrator. No relevant information developed in connection with treatment or examination which compensation is sought shall be considered a privileged communication. When a physician willfully fails to make any report required of him under this section the Administrator may in his discretion order the forfeiture of his right to all or part of payments due for services rendered in connection with the particular case.

(c) If the employee unreasonably refuses to submit to medical examination or treatment, the Administrator shall, by order, suspend the payment of further compensation and his right to further proceedings during such time as such refusal continues.

(d) Whenever the Administrator deems it necessary, in order to assist him in resolving any issue of medical fact or opinion he shall cause such employee to be examined by a physician or physicians selected by the Administrator and obtain from such physician or physicians a report upon the condition or matter which is the subject of injury.

(e) All fees and other charges for medical services shall not be higher than such charges as prevail in the Virgin Islands for similar services to injured persons and shall be subject to approval by the Administrator.

(f) An employee shall be entitled to a maximum of $75,000 in benefits under this section, except that in cases determined by the Administrator to require specialized medical attendance in institutions outside of the Virgin Islands, the maximum allowable benefit shall be $200,000. However, an employee classified pursuant to section 371 of this title, as a member of any Class III bargaining unit that consists of police officers, corrections officers, firefighters, prison guards, or other persons employed in similar positions to protect the public safety and welfare or protect the property of a public employer, who is injured in the line of duty, is entitled to a maximum allowable benefit of $750,000, of which the first $250,000 must be covered by the Government Insurance Fund. Thereafter, the health care bills must be paid first by claimant's primary insurance carrier and second by the Government Insurance Fund up to the maximum allowable benefit of $750,000. For purposes of this subsection “injured in the line of duty” means the employee sustained an injury during the active performance and actual discharge of the duties of the position.

(g) Any bill for medical or hospitalization expenses which is submitted more than 30 days after a written request from the Administrator for such billing shall be uncollectible, from both the claimant and the Government Insurance Fund, provided that in the case of a private physician, the Administrator may, for good cause, permit a reasonable extension of this time.

(h) An employee who receives his initial treatment for a compensable injury in the out-patient or emergency ward at a Government facility shall be considered a public patient and billing for his care shall be made accordingly until such time as the employee designates a private physician in writing.

(i) A physician employed by the Virgin Islands Government may not charge for services rendered a claimant which are rendered during the time that the claimant is a public patient or during such time that the physician is performing his duties for the Government. No physician shall charge for the use of any facilities or for materials furnished by the Virgin Islands Government.