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Most companies with three or more employees on the payroll are required by Virginia law to carry workers’ compensation insurance, which provides no-fault coverage of employees’ accidental work-related injuries. To file a claim, you don’t have to prove your employee did anything wrong. Even if you’re responsible for your own accident, you’re still eligible for benefits as long as you didn’t injure yourself intentionally, didn’t violate any safety regulations, and weren’t under the influence of drugs or alcohol when you were hurt. If your claim is successful, all your medical expenses should be paid, and you should receive weekly benefits to replace two-thirds of your lost wages while you’re off work.
You cannot be fired or penalized for filing a workers’ comp claim, but your employer’s insurance company will look for ways to dispute your claim if it’s an expensive or complicated one. The best way to maximize your chances for fair benefits is to be proactive and thorough. Follow the steps of the claim process promptly and correctly. A workers’ comp attorney can help you to avoid the mistakes listed below, which could damage your claim and leave you with medical bills to pay and no salary with which to do so.
Mistakes to Avoid in a Virginia Workers' Comp Claim
Any of the common mistakes listed below could hurt your chances of collecting fair workers’ comp benefits after a work injury.
Failing to Report Your Accident and File Your Claim Promptly
The first step in the claims process is to report your accidental injury to your employer. The Virginia Workers’ Compensation Act gives you 30 days to do so. If you miss the deadline, you can lose the right to receive benefits, so you should not wait. As soon as possible after your accident, report it in writing or by email message to your supervisor, the human resources department, and the manager, director, or owner of the company.
Include details of where, when, and how the accident occurred, as well as names of any witnesses and photos of your injury, if possible. Your employer should file a First Report of Injury (FROI) form with the Virginia Workers’ Compensation Commission (VWCC). You may then file your claim by submitting a Claim for Benefits Form from the “Injured Workers” page of the VWCC website. Although you have two years to file, you should do so as soon as possible. Any delay on your part could weaken your claim.
Not Seeking Immediate Medical Care
Getting a prompt medical exam and diagnosis is a crucial part of the claims process. Even if you don’t feel you’re seriously injured after a work accident, you should see a doctor as soon as possible. The symptoms of some injuries can take time to surface, and immediate diagnostic testing can reveal a hidden problem. Prompt medical care gets you on the road to recovery and provides vital documentation of your work-related injury.
If you require emergency treatment, you should go to the ER of the nearest hospital. For ongoing care, however, you may not simply visit your own primary care physician. Instead, you must choose from a list of doctors approved by the insurance company. Their names and contact information should be made available to you. If, for any reason, this does not happen, you might be able to see your own doctor, but it’s best to work with an attorney who can make sure you don’t jeopardize your right to benefits by doing so. Follow the physician’s treatment plan, keep all appointments, take medication as prescribed, retain receipts for all your treatments, and keep a daily journal of your recovery process.
Communicating Directly With the Insurance Company
Your employer’s workers’ comp insurance company is not your friend. It is in business to earn profits for its shareholders, so it will make every effort to delay, dispute, or deny your claim in order to save money. Any statement you make to an insurance adjuster can be twisted and taken out of context to damage your claim. A workers’ comp attorney can handle all communications with the insurer and make sure you don’t say anything to hurt your chances of receiving fair benefits.
Not Consulting an Attorney
If your injury is minor, requiring minimal medical care and little or no time off work, you might be able to handle your own claim if you meet all deadlines and your employer does not dispute the claim. For a serious injury leading to high medical bills and significant time off work, however, you’re most likely to receive fair benefits with the help of an experienced workers’ comp attorney who can guide you through the claims process, represent you in a Commission review or a hearing before the VWCC, and appeal your denied claim in civil court if necessary.
