Virginia Employer Compliance Alert Paper Form

 

Use this form to report an employer who may be misrepresenting employee information or who may not have workers’ compensation coverage that is required by law. All submitted referrals will be kept confidential to the extent possible under the law.

This form may be submitted by:

  • Fax - 804-418-4917
  • Mail - 333 E. Franklin St., Richmond, Virginia 23219

Please mark the fax or envelope with "Attention: Insurance Investigation Unit".