Virginia employers with three or more employees are generally required to carry workers’ compensation insurance, which provides no-fault coverage of employees’ work-related injuries and diseases. You don’t have to prove that your employer did anything wrong to cause your injury or disease in order to file a claim for benefits.
Even if you caused your own accident, you’re still eligible, and your employer may not fire you or retaliate against you for filing a claim. If your claim is accepted, workers’ comp should cover all medical expenses resulting from your work-related injury or disease:
- Visits to a doctor or emergency room
- Hospital stays
- Medical treatments
- Physical therapy
- Prescription medications
- Assistive equipment
- Home nursing care
Workers’ comp also covers approximately two-thirds of wages lost due to your injury and recovery, as well as disability benefits, vocational re-training in some cases, and death benefits if you’ve lost a loved one to a work-related injury or illness. In most cases, benefits can be paid for a maximum of 500 weeks unless a worker is permanently and totally disabled, in which case lifetime benefits are possible.
Work-Related Accidents and Injuries
Although Virginia employers are required by law to keep their workplaces safe for workers, accidents that commonly occur on the job include the impact from heavy or falling objects, slip-and-fall mishaps, damage from heavy lifting, company vehicle accidents, defective equipment problems, burns, contact with sharp or hot surfaces, and exposure to toxic fumes or materials. There are a number of common injuries that can result from such accidents, such as:
- Broken bones
- Sprained joints
- Back injuries and spinal cord damage
- Cuts and scarring
- Respiratory issues
- Traumatic brain injuries (TBIs)
- Psychological injuries
To be eligible for benefits, you must be able to prove that your injury happened on the job or at a work-related function, that it resulted directly from work activity, and that it happened suddenly at one specific time. A psychological injury that results from a covered physical injury is also compensable. Virginia workers’ comp does not cover repetitive motion injuries or injuries that result from a worker’s misconduct, horseplay, illegal activity, or use of drugs or alcohol on the job.
If you can show that performing your job duties aggravated, accelerated, or worsened a pre-existing condition, you might be eligible for benefits, but your employer’s insurance company could try to deny your claim. In such a case, the services of an attorney are recommended to increase your chances of filing successfully.
The Workers' Compensation Claims Process in Virginia
If you’re injured or become ill on the job in the course and scope of performing your duties, you should immediately report your injury to your supervisor or a claims administrator at your workplace. You have 30 days in which to do so, but you should not wait.
After receiving notice of your injury, your employer has 10 days to file a First Report of Injury (FROI) with the Virginia Workers’ Compensation Commission (VWCC), which will then communicate with you directly.
Your next step is to file your claim with the VWCC by submitting a Claim for Benefits Form (available from the VWCC website’s Injured Workers page). You may submit in person or via fax, mail, or Web file.
Although you actually have two years to file your claim with the VWCC, again, you should not wait. Any delay in reporting or filing can be cited by the employer’s insurer as evidence that you’re not as badly hurt as you say you are. The insurance company is in business to earn money, not to spend it.
While it might accept a claim and pay benefits for a minor injury resulting in low medical bills and little time off work, the insurer will do all it can to dispute or deny more expensive claims with serious injuries and long recovery times. Working with an experienced workers’ comp lawyer increases your chance of a successful claim for a serious injury or disease.
You should seek a medical diagnosis and treatment from a doctor approved by the insurer as soon as possible after your accident. Keep all medical appointments, follow all the doctor’s orders and treatment plans conscientiously, take all medications as prescribed, and keep receipts and other documentation of your treatment. It’s also a good idea to keep a daily journal of your recovery, focusing on your ability or inability to perform the physical functions required by your job.
If your claim is accepted, you’ll be notified with an Awards Agreement, and you should soon start receiving weekly benefits for a fixed period of time. If your employer denies your claim, is slow to approve necessary treatments, tries to force you back to work too soon, or retaliates against you for filing, you should contact a workers’ comp attorney immediately.
The Role of Your Attorney in Your Workers' Compensation Claim
Your workers’ compensation lawyer, who will be familiar with the complex filing process and all the paperwork it requires, can appeal a denied claim before the VWCC or in civil court by:
- Showing evidence to prove that your injury was work-related
- Evaluating your claim
- Fighting back against any retaliation by your employer
- Negotiating a compromise lump sum settlement agreement with the insurer
Your workers' comp attorney will also make sure that you meet all deadlines and comply with all procedural requirements in the claims process.
Your lawyer can advise and assist you in filing a third-party claim if someone other than your employer or a co-worker is responsible for your accidental injury. If, for example, an outside cleaning service spilled a cleaning product that caused you to slip and fall on the floor, or a piece of machinery serviced by an outside company malfunctioned and injured you, that third party might be found partially liable for your injuries and have to compensate you.
While you cannot sue your employer in court for your work-related injury, you can sue a third party. In such a case you might be awarded compensation to make up the one-third of your wages that workers’ comp doesn’t pay. You could also get compensation for your pain and suffering, which workers’ comp does not provide.
Have You Been Injured on the Job in Virginia?
An experienced workers’ compensation attorney can advise you on all aspects of your claim and help you seek fair benefits.
Contact us online or call us at 540-341-0007 to schedule your free consultation. You pay no attorney fees until we win your case.