Nearly every Virginia employer with three or more workers on the payroll is required to carry workers' comp, which provides no-fault insurance coverage for injured workers. This means you don't have to prove that your employer negligently caused your accident, and you cannot be fired for filing a claim. You have the right to be treated fairly during the claims process, but today it's often necessary to fight your employer's insurance company to get fair treatment, especially if your claim is an expensive or complicated one. In such a case, an experienced workers' comp lawyer can help you to demand your rights and seek the benefits you deserve.
Work-Related Accidents and Injuries
On-the-job accidents resulting in injury or illness include heavy lifting, slipping or tripping and falling, being struck by a falling object, exposure to toxic substances, company vehicle accidents, and equipment malfunctions. The injuries that commonly result from such mishaps are:
- Damage to upper extremities
- Muscle or joint strains and sprains
- Back injuries
- Injuries to the trunk and lower extremities
- Head and neck injuries
- Cuts and scarring
- Eye injuries
- Damage to or loss of limbs or digits
To file a successful claim for workers' comp benefits after any such injury, you must be able to prove that your accident occurred while you were in the process of doing your job. (Virginia workers' comp does not cover repetitive-strain injuries that develop over time.) You must also follow specific guidelines and meet all deadlines and procedural requirements in the claim process.
The Workers' Comp Claim Process
It's important to remember that your employer's insurance company earns profits by collecting premiums and paying out as little as possible in claims. The insurer will look for every way possible to dispute or deny an expensive claim, often insisting that your injury is not work-related or is the result of a pre-existing condition. You can't afford to make any errors in the claim process.
Report Your Accidental Injury
Although the VWCC gives you 30 days to report your accidental injury to your supervisor or a claims representative at work, you should do so (in writing) as soon as possible. Give a detailed account of exactly what happened, when, and where, as well as the names of any witnesses to the accident. If your injury is external and visible, take photos and include them with your report.
See a Physician
Your employer should provide you with a list of doctors certified and recommended by the insurer for work-related injuries. Select a doctor from the list and make an appointment as soon as you can. (Do not simply go to your own doctor; doing so could damage your claim.) Follow the doctor's advice, go to all your appointments on time, follow up on all referrals, take all medication as it's prescribed, and keep receipts and records from all your treatments.
File Your Claim
Fill out and submit a Claim for Benefits form from the Injured Workers page of the VWCC website. You should be informed of the Commission's decision on your claim within a couple of weeks. Even though you have two years to file your claim, again, you should not wait. Any delay in reporting or filing enables the insurance company to insist your injury did not result from a work accident or is the result of a pre-existing condition.
Wait for a Decision
Continue with your medical treatment as you await the VWCC's decision. If your claim is successful, you'll receive an Awards Agreement, which allows your health care provider(s) to bill the insurer for your treatment. You should then begin receiving weekly wage benefits to cover approximately two-thirds of the income you lose while off work.
When to Contact an Attorney
Seek help from a workers' comp attorney in any of the following circumstances:
- Your claim is denied.
- You're dissatisfied with your medical care.
- The insurer is slow to approve medical treatments and procedures.
- Weekly benefits are not paid in a timely manner.
- You're coerced to return to work before you've recovered.
- Your employer retaliates against you for filing a claim.