Compensation for Work-Related Amputation Injuries

The work-related injuries sustained every day by employees across the U.S. range from minor to catastrophic and even fatal. Among the most devastating and life-changing of such injuries are amputations, which occur most often in the transportation, agriculture, manufacturing, and construction sectors.

The Occupational Safety and Health Administration (OSHA) reports that most work-related amputation injuries are caused by vehicle accidents and by equipment or machinery that is unguarded or improperly guarded. Dangerous workplace tools include:

• Food slicers
• Power saws
• Trash compactors
• Milling machines
• Shears
• Power presses
• Meat grinders
• Roll forming machines

In some cases, a limb is completely severed at the time of the accident; in others, surgical amputation might be required after an accident. Either type of amputation is compensable under workers’ comp.

Workers’ Compensation for Amputation Injuries

If you’re an employee who suffers a work-related amputation injury in Virginia, you’re typically entitled to workers’ compensation benefits, which cover all your medical expenses and two-thirds of your lost wages. Most Virginia employers with three or more workers on the payroll are required to carry workers’ comp insurance.

To collect benefits, you don’t have to prove that your employer did anything wrong to cause your on-the-job injury. Even if you’re responsible for your own accident, you may file a claim, and you cannot be penalized by your employer for doing so. If your claim is an expensive or complicated one, however, you might encounter resistance from your employer’s insurance company, which actually pays workers’ comp claims and wants to spend as little money as possible on yours.

Potential Medical Expenses Following an Amputation

If your claim is accepted, workers’ comp should cover all medical expenses resulting from your amputation injury, including the following:

• Surgery to retain as much of your limb as possible and to enable you to use a prosthetic device
• A prosthesis after you’ve healed from surgery
• Replacement prostheses in the future
• All doctor’s visits and hospitalizations
• Physical therapy
• Occupational therapy
• Psychological counseling to deal with the emotional trauma of losing a limb
• Transportation to and from medical appointments
• Medication to prevent infection and manage pain

Although your medical benefits include the cost of pain medication, workers’ comp does not compensate you for pain and suffering. You can demand pain and suffering compensation only in a personal injury lawsuit, which you generally may not file against an employer that carries workers’ comp.

Do You Have a Third-Party Lawsuit?

In some cases, a third party not related to your employer could bear partial responsibility for your injury. You might drive a company vehicle on the job, for example, and lose a limb due to a car accident caused by a negligent driver. You could also be injured by a machine that malfunctions due to a manufacturing defect. An attorney can help you file a third-party insurance claim or lawsuit against the negligent driver or the at-fault manufacturer. If you’re successful, you could receive compensation for pain and suffering, as well as for the one-third of your lost wages that workers’ comp does not cover.

Workers’ Comp Disability Payments

After suffering an on-the-job injury that prevents you from working, you’re considered to be temporarily totally disabled (TTD). You’ll normally receive weekly wage loss benefits while you’re off work for treatment and recovery. When you reach the point of maximum medical improvement (MMI), your doctor should release you to return to your job, and your weekly workers’ comp benefits will end.

When you reach MMI after an amputation injury, however, you might remain partially disabled, in which case your doctor could give you restrictions that make it impossible for you to return to your previous position, especially if it requires significant physical activity. In such a case, you might be given a “light-duty” job that accommodates your restrictions. If that job pays less than your previous job, you could be entitled to ongoing weekly payments that make up two-thirds of the difference between your old and new salaries.

Permanent Partial Disability (PPD)

For an amputation that leaves you permanently partially disabled, the number of weeks for which you can receive wage loss benefits depends on your specific amputation injury. The current schedule in Virginia is as follows:

• Big toe: 30 weeks
• Any other toe: 10 weeks
• Index finger: 35 weeks
• Second (middle) finger: 30 weeks
• Third (ring) finger: 20 weeks
• Fourth (little) finger: 15 weeks
• Thumb: 60 weeks
• Hand: 150 weeks
• Leg: 175 weeks
• Arm: 200 weeks
• First phalange of a finger, thumb, or toe: 50% of the number of weeks awarded for the entire loss of a finger, thumb, or toe, respectively

In some cases, losing one body part might cause you to injure another body part due to compensation for the loss of the first. In such a case, if you lose the use of two or more of the body parts listed above, you could be entitled to benefits for life. The insurance company, however, is likely to dispute or deny such an expensive claim. When this happens, you need a workers’ comp attorney to represent you in the claims process and possibly in a hearing, Commission review, or appeal.

What to Do If You Sustain an Amputation Injury on the Job

If you suffer an amputation injury on the job in Virginia, your first priority should be to get emergency treatment at the nearest medical facility. Once your condition is stabilized, you should take the following steps to begin the workers’ comp claim process:

• Notify your supervisor or a claims representative at your workplace of your injury as soon as possible. Do so in writing and include the time, place, and details of your injury.
• Provide names of any witnesses to your accident. Your employer should then file a First Report of Injury (FROI) with the Virginia Workers’ Compensation Commission (VWC).
• Submit a Claim for Benefits form from the “Injured Workers” page of the VWC website.
• For ongoing medical care, make an appointment with a physician approved by your employer’s insurance company. Keep all appointments with this doctor and follow all treatment plans meticulously. Take medications exactly as they’re prescribed and retain documentation of all your treatments.
• Because your claim is likely to be expensive, you should contact a workers’ comp lawyer who can guide you through the claims process, make sure you meet all deadlines, organize your medical evidence, and present it convincingly to seek fair benefits.

Although the VWC gives you 30 days to report and injury and two years to file a claim, do both as soon as possible. Any delay could work against you. If your claim is denied for any reason, your lawyer can request and represent you at a hearing before the Commission to appeal the denial. If your claim remains denied, your attorney can appeal your case in civil court and fight to get you fair benefits for your amputation injury.