Workers’ Compensation Workers’ compensation is a program administered in West Virginia by BrickStreet Mutual Insurance Company. Workers’ compensation provides medical treatment and rehabilitative services for individuals who sustain workplace injuries or illnesses. Below are links providing information about workers’ compensation. Reporting a Workplace Injury To report a workplace injury, you need to complete the Workplace Injury Report Form. This form must be completed and submitted within 24 hours of the accident/injury occurring. Setting up the Benefit Payment Option To set up the benefit payment option, the Workers’ Compensation Disability Benefit Payment Option Form needs to be completed. This form is to be completed by the employee who is claiming Workers’ Compensation benefits. West Virginia State Code Section 23-4-1 limits Workers’ Compensation disability benefit payments for time off from work due to a work-related injury or illness to either employer paid sick leave benefits or Workers’ Compensation Temporary Total Disability benefits. Claimants must elect a method of payment. This form must be submitted to HR Services within three days of the date of injury. If the employee is incapacitated or otherwise unable to complete the form, the sick leave option will apply.