Labor & Employment Law

Questions to Answer Before Completing the Claim for Unpaid Wages Form

Please read the following questions carefully before completing the form.
This Virginia Department of Labor and Industry assists in the collection of unpaid wages, but can only collect wages for time worked; we do not collect fringe benefits.
A completed payment of wage form is required to initiate an investigation.
PLEASE DO NOT SUBMIT A PAYMENT OF WAGE CLAIM REGARDING THE FOLLOWING ISSUES:

1. Are you claiming VACATION PAY, SICK PAY, SEVERANCE PAY, HOLIDAY PAY, OTHER FRINGE BENEFITS, OR BUSINESS EXPENSES that you believe are owed to you? While you may be legally entitled to such claims under contract law, this Department does not accept these types of claims for investigation. You may wish to consult a private attorney to discuss your claim.
2. Is this a WORKERS' COMPENSATION issue? We do not have jurisdiction over these matters: please contact the Virginia Workers' Compensation Commission, 1000 DMV Drive, Richmond, Virginia, 23220, phone (804) 367-8600.
3. Are you an INDEPENDENT CONTRACTOR or a 1099 Employee rather than a direct employee? Whether you are legally an independent contractor is not determined by any documents that may have been signed, but by standards promulgated by the IRS. This Department has the authority to assist only employees; we do not have jurisdiction over independent contractors. You may wish to consult a private attorney to discuss your claim.
4. Are you EMPLOYED BY AN INDIVIDUAL AS A DOMESTIC WORKER, SUCH AS A BABY-SITTER, MAID OR GROUNDSKEEPER? We do not have jurisdiction over these matters: you must file in court. You may wish to consult a private attorney to discuss your claim.
5. Is this complaint for OVERTIME pay? Virginia law does not provide for time-and-a-half overtime: please contact the U.S. Department of Labor, Wage and Hour Division, 400 North 8th Street, Richmond, Virginia, 23240, phone (804) 771-2995. (USDOL)
6. Is this claim for money owed by a BANKRUPT EMPLOYER? We do not have jurisdiction over these matters; please contact the United States Bankruptcy Court. Click here for the Eastern District of Virginia, or click here for the Western District.
7. Is the Employer (or former Employer) or owner out-of-business? The Virginia Department of Labor and Industry cannot pursue wage claims against a closed business.
8. Was all of the WORK PERFORMED OUTSIDE VIRGINIA? We do not have jurisdiction over these matters; your claim should be filed in the state in which the work was performed.
9. Is this a claim for a BONUS? You are legally owed bonuses only if prior to performing the work, you were promised the compensation in return for the work. You are not legally owed bonuses given at the discretion of the employer after the work has been performed.
10. Is there a COURT CASE PENDING? The Department does not accept claims when a case has already been filed in court.
11. Did you work under a written employment agreement? If so, your recourse is through the appropriate court as the Department does not accept claims for investigation when a written employment agreement was entered into by the parties. You may wish to consult a private attorney to discuss your claim.
12. Is your wage claim for $15,000.00 or more? This agency investigates claims for wages, salaries or commissions under $15,000.00. If your wage claim is for more than $15,000.00, you may wish to consult with a private attorney who may be able to assist you in pursuing this matter.
13. Were you an Officer or Executive of the company? We do not investigate claims raised by corporate officers or executives with authority over the financial affairs of the company, or those by individuals whose cases are already in litigation. Nor do we investigate cases where a written employment agreement governs the employee's compensation.
    
    INSTRUCTIONS FOR COMPLETING "CLAIM FOR WAGES" FORM - Click to View Spanlish Version
    
    PLEASE READ THESE INSTRUCTIONS CAREFULLY
    The attached claim for unpaid wages form must be fully completed, printed-out, signed and returned by mail in order for your claim to be investigated. Please fill in all areas completely. If necessary, use a separate sheet of paper to provide additional information or explanation. Send the original claim form and include copies of all documents which will support your claim. You must be able to prove that you are owed unpaid or wrongfully deducted wages. Incomplete forms will be returned, causing a delay in the investigation of your claim. If you have not requested payment of your wages from your employer, you must do so before filing a claim. Only after you have been denied your wages should you file a claim with this office.
    
    EMPLOYEES PAID BY THE HOUR:
    If you are claiming wages based on an hourly wage, include the dates, days, and hours worked for which you were not paid and include the total amount of wages you are claiming. Please provide documentation, such as a paycheck stub to verify employment and rate of pay; otherwise, our enforcement may be limited.
    
    EMPLOYEES PAID BY SALARY:
    If you are claiming wages based on a salary rate, include the maximum number of hours and days you were required to work to receive the salary rate. Please provide documentation, such as a paycheck stub to verify that the salary or the deductions from salary you are claiming is accurate. Provide dates, days, and hours worked for which you were not paid and include the total amount of wages you are claiming.
    
    EMPLOYEES PAID BY COMMISSION:
    State the total amount of wages you claim are due and indicate how you arrived at the dollar amount of your claim. Please provide a copy of your commission agreement with your employer. Indicate what you had to do to earn the commission and under what circumstances the commission would become due and payable if no written commission document exists. Account for any and all "draws" you may have received. Identify each specific account for which you seek payment of a commission and state the dollar amount of the commission you claim for each account. Provide documentation such as a paycheck stub to verify employment and the commission rate you are claiming is accurate.
    
    ACCEPTANCE OF THIS CLAIM DOES NOT GUARANTEE COLLECTION OF WAGES
    Upon acceptance of your claim by the Virginia Department of Labor and Industry, do not assume that your claim is valid and collectible. In cases where the employer disputes your charges, it will be YOUR responsibility to provide documentary evidence of the amount and validity of your claim. Also, you must provide the company's complete name and mailing address along with the owner's or company representative's full name and address. Since wage claims are handled by individual compliance officers, we do not provide periodic progress reports. Requests for progress reports only hinder the prompt resolution of your claim. When a final determination has been made, or when additional information is needed, you will be notified. Please notify this office immediately in writing of any change in your address, telephone number, or if you receive payment from your employer. You may contact via U.S. Postal mail to the address below or by email to laborlaw@doli.virginia.gov .
    
    Directions for Filing the Initial Claim for Unpaid Wages
    U.S. Postal mail only. Faxed forms cannot be accepted!
    If you are claiming pay for work performed, please print out and submit your completed claim form to the following address by U.S. Mail:
    Division of Labor and Employment Law
    Virginia Department of Labor and Industry
    600 East Main Street, Ste. 207
    Richmond, Virginia 23219.
    Remember to sign the claim form and make sure to include the employer’s full address as well the total amount of wages claimed.
    
    Please include your email address for notices about your claim.
    Reminder: Faxed forms cannot be accepted.
    
    Download a Claim for Wages form here