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H 163

An act relating to workers' compensation

2025-2026 Regular Session Introduced by Abbey Duke and 4 co-sponsors

Expands Vermont workers' comp to include the market value of health insurance and in-kind benefits in wages, boosting benefits and protections for injured workers.

Read first time and referred to the Committee on Commerce and Economic Development
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Bill Summary · H 163

Summary — H.163 (2025): "An act relating to workers’ compensation" (Vermont)

Note: The provided packet contained unrelated materials from other states. This summary covers H.163 as introduced in Vermont (Introduced Feb. 6, 2025; effective date proposed July 1, 2025).

Purpose / Intent

H.163 updates Vermont’s workers’ compensation statutes to (1) broaden the statutory definition of “wages” to explicitly include the market value of health insurance and other in-kind benefits, (2) authorize and set process for medical case management services for injured workers, (3) require payment for translation services when injured workers are not fluent in English, and (4) increase penalties for late payment of weekly workers’ compensation benefits.

Key provisions

  • Definitions (21 V.S.A. § 601)

    • “Wages” is amended to include bonuses and the market value of health insurance, board, lodging, fuel, and other monetary-estimable advantages provided by the employer.
    • Adds a definition of “medical case management” including planning/coordination, case assessment (personal interview), developing/implementing care plans in consultation with the worker and family, and evaluating treatment results. Medical case managers may not provide medical care or adjust claims.

  • Medical case management (21 V.S.A. §§ 640b)

    • Medical case management services are treated as a “service” for preauthorization purposes.
    • Insurer must, within 14 days of a preauthorization request for medical case management, either: authorize, deny (if whole claim disputed or not reasonably supported), or notify that an independent exam/record review has been scheduled (in which case decision due within 45 days).
    • If insurer fails to act within 14 days, the injured worker or provider may ask the Department to issue an interim order; the Department must issue an interim order within 5 days (after notice and 5 days to respond). The Commissioner may authorize services on their own motion if evidence reasonably supports them.

  • Translation services (21 V.S.A. § 602)

    • When an injured employee does not speak English fluently, the employer must pay for translation services so the employee fully understands rights and can participate in medical recovery and the claims process.

  • Timing of payment and increased late-payment penalties (21 V.S.A. § 650)

    • Employers must establish a weekday for weekly benefit payments and notify claimant and Department.
    • Claimants may elect direct deposit.
    • If payments are late (not mailed/deposited by established day or within five business days of the pay period end), employer owes a late fee equal to the greater of $10 or a percentage of the benefit:
    • 5% for the first late payment;
    • 10% for the second;
    • 15% for the third;
    • 20% for the fourth;
    • 25% for the fifth and any subsequent late payments.
    • “Paid” is defined as mailed to claimant’s address or transferred into the designated account; proof by affidavit in disputes.

  • Effective date

    • The act would take effect July 1, 2025.

Who is affected

  • Injured employees: expanded wage definition (may affect benefit calculations), access to and clearer process for medical case management, language access via paid translation, and stronger remedies for late payments.
  • Employers: potential changes in wage basis calculations, obligation to pay for translation services, must establish reliable weekly payment practice and may face escalated late fees.
  • Insurers/carriers: new timelines and procedures for preauthorization of medical case management and exposure to interim orders; must comply with faster decision windows.
  • Department / Commissioner: new administrative responsibilities to issue interim authorizations and adjudicate disputes.
  • Medical case managers and providers: new role and defined process; cannot provide care or adjust claims.

Procedural status / timeline

  • Introduced Feb. 6, 2025.
  • As introduced, the bill sets an effective date of July 1, 2025.
  • Sponsors (as provided): Rep. Monique Priestley (primary) with cosponsors including Kirk White, Abbey Duke, Michael Marcotte, Herb Olson.
  • The draft has been amended in subsequent paperwork (a new draft referenced as H.4160 on 2025-05-29).

If you’d like, I can produce a one-page plain-language explainer for injured workers or a short memo summarizing fiscal and compliance implications for employers and insurers.

Compiled from official sources — confirm details with the bill’s official record.

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