Richmond Workers' Compensation Attorney

Workers’ compensation benefits are medical expenses and a portion of your lost wages that your employer must cover if you suffer:

• An injury from a work accident
• An illness directly caused by your work, or an “occupational disease”
• The loss of a loved one due to a work-related injury or illness.

Most employers in our state are required under the Virginia Workers’ Compensation Act to  buy workers’ compensation insurance. This insurance pays benefits to employees. The benefits can play an important role in helping an injured or ill worker to get needed medical care and to pay their living expenses while they are unable to work.

You should note a few important facts about workers’ compensation benefits:

• If your employer has workers’ compensation insurance, then workers’ compensation benefits are your “exclusive remedy.” In other words, you cannot sue your employer for a work-related injury or illness.
• Workers’ compensation benefits are available, regardless of who was at fault. So, even if your own negligence partially contributed to workplace accident, you could still be eligible to receive benefits. You would not be eligible for benefits, however, if your injury or illness resulted from your own “willful misconduct” such as working while intoxicated.
• If you have a dispute about workers’ compensation benefits with your employer (or its insurer), you can file a claim with the Virginia Workers’ Compensation Commission (WCC).
• Receiving workers’ compensation benefits does not prevent you from filing a personal injury or wrongful death claim against a negligent non-employer, or “third party.”

Additionally, you should know that workers’ compensation benefits come with a few important restrictions, including:

• If your employer provides you with a panel or list of three doctors, you must get medical treatment from one of those doctors. Any change in doctors must be approved by your employer or ordered by the WCC.
• If you receive lost-wage benefits, they will be capped at roughly two-thirds of what you were earning each week before your injury occurred and cannot exceed an amount set by statute. Also, unless you are deemed to be totally and permanently disabled, your benefits will stop at 500 weeks.
• If a doctor finds that you have a permanent loss of use of a body part because of your work-related injury, then you may be eligible to receive payment that is based on a permanent partial impairment rating.

If you file a personal injury claim against a third party or against an employer who does not have workers’ compensation insurance, the above restrictions would not apply to your case. Also, in a lawsuit, you could seek compensation for non-economic damages such as pain and suffering.

If you or a loved one suffers a work-related injury or illness, it is important to speak with a lawyer to learn about your right to receive workers’ compensation benefits as well as all other options that may be available to you.

Your ability to sue your employer for a work-related injury generally depends on whether your employer has purchased workers’ compensation insurance.

Under Virginia law, any employer with three or more employees must have workers’ compensation insurance. However, some employers may operate in violation of this law. Also, if a company has fewer than three employees, it can still elect to carry workers’ compensation insurance.

So, if you have suffered a work-related injury or illness, determining whether your employer has workers’ compensation coverage will be a primary consideration. An attorney can help you to make that determination.

If your employer does not have workers’ compensation coverage, then yes, you can file a personal injury claim against the employer. However, unlike a workers’ compensation claim, you would need to prove that your employer was at fault (and your own fault can be taken into account, too.)

If your employer does have workers’ compensation insurance – in reality, most employers do – then you cannot sue your employer. Your “exclusive remedy” would be to file a claim for workers’ compensation benefits.

Keep in mind: If you suffered an injury due to the negligence of a “third party,” or non-employer, then you could pursue a personal injury claim against that party. However, your recovery would be “offset” by the amount that you have received in workers’ compensation medical and lost-wage benefits.

If you suffer a work-related injury or illness, you should be entitled to receive payment of all reasonable and related medical expenses for as long as your treatment is needed.

However, if your employer provides you with a panel or list of three doctors, you will be required to get your treatment from one of those doctors. If you do not go to one of those doctors or comply with the treatment they order, you can lose your right to receive workers’ compensation benefits.

Of course, you can change doctors if your employer (or its workers’ compensation insurer) approves the change. If the employer refuses to authorize the change, you can seek an order from the Virginia Workers’ Compensation Commission.

A lawyer can play an important role in seeking authorization or an order that allows you to change doctors. For instance, an attorney can help you to show that a change is needed so you will receive adequate treatment. This is why you should seek legal help if you are seeking a change in doctors.

You should be eligible for temporary partial disability benefits if you can return to work – but only at a lighter duty, lesser-paying job.

If you cannot work at all, then you would be eligible for temporary total disability benefits. These benefits would cover roughly two-thirds of your average weekly wage (subject to a weekly cap that is set each year by law).

To calculate your “average weekly wage,” you must add up your gross earnings (or earnings before taxes) during the 52-week period before your injury occurred and divide that amount by 52.

If you receive temporary partial disability benefits, the amount would be equal to two-thirds of the difference between your average weekly wage before your injury and your average weekly wage after your injury.

It is important to note that temporary disability benefits are terminated when you return to regular work or after 500 weeks – unless you are deemed to have a total and permanent disability.

If your employer (or its workers’ compensation insurer) rejects your claim for medical and/or lost-wage benefits, you should speak with a lawyer right away about filing a claim with the Virginia Workers’ Compensation Commission (WCC).

You must file a claim with the WCC within two years after the date of your workplace accident resulting in an injury. So, it is important to move quickly if your employer has denied your claim.

An attorney can help you with filing a claim and with requesting a hearing before the WCC. The attorney can also represent you at the hearing and present evidence to help the WCC make its decision on your claim, including medical records and testimony by medical experts.

If your claim is denied by the WCC, your attorney can help you with filing a written request for a review by the WCC or with any further appeals.

In many cases, an attorney can represent you in mediation that is aimed at resolving your claim without the need for a hearing.

It is important to pay close attention to the amount of time you have to file a claim with the Virginia Workers’ Compensation Commission. Generally speaking, you must file a claim:

• Within two years from the date of your injury from a workplace accident
• Within two years from the date you were diagnosed with an occupational disease or within five years from the date of your “last injurious exposure” at work, whichever comes first
• Within two years from the date of a loved one’s work-related death.

If you return to work and are disabled by a work-related injury again, then you have two years from the date you were last paid workers’ compensation benefits in which to file a claim.

However, in your case, an exception may apply that extends the filing time period. It is important to have your case reviewed by a lawyer as soon as possible to ensure that your claim is timely filed.

If your workers’ compensation claim is approved, you may be asked to sign a form called an “Agreement to Pay Benefits.” This form typically will state that you were injured on the job or disabled by an occupational disease, list your period of disability and contain other information about your claim.

You should make sure that all of the information is correct – especially the stated average weekly wage and the body parts that were injured or affected.

The Agreement to Pay Benefits will be sent to the Virginia Workers’ Compensation Commission (WCC) for an award to be entered on the information on the Agreement. The award requires your employer’s workers’ compensation carrier to pay your benefits.

Note: You must be disabled for at least seven days before your benefits can be paid. However, if you are disabled for a period beyond three weeks, then you can receive payment for those first seven days.

You should receive your benefits check each week. If your employer fails to send you a check as ordered by the WCC, the employer may be hit with a late penalty.

The benefits you receive are not taxable.

If your claim for medical benefits is approved, then all medical bills should be sent directly to your employers’ workers’ compensation insurer for payment. You will not need to pay any deductible.

If you are a dependent of a worker who dies from work-related injury, you may be eligible to file a claim for workers’ compensation death benefits in Virginia. The amount of benefits you can receive will depend on the extent of your dependency.

If you were wholly dependent, you could receive two-thirds of your loved one’s average weekly wage (subject to the statutory cap) for 500 weeks. If you are among several dependents, the amount would be divided amongst you.

On the other hand, if you were partially dependent, you would be eligible to receive an amount that reflects the extent of your dependency.

You may also be eligible to receive up to $10,000 in burial expenses.

You should keep in mind that you may able to pursue a third-party liability claim against a non-employer who caused your loved one’s death. This claim would seek damages available through Virginia’s wrongful death law.

The workers’ compensation lawyers of Marks & Harrison have extensive experience with helping injured workers and their families to obtain the medical and lost-wage benefits they deserve.

We would welcome the opportunity to provide a free consultation about your case in our Richmond office or at any of our firm’s other offices located throughout Virginia.

We can provide services that include:

• Taking the time to learn all the facts relating to your case
• Explaining to you all of your important legal rights
• Answering all of your questions regarding workers’ compensation
• Reviewing your medical records in order to obtain a full understanding of your injuries and medical condition
• Meeting with your physicians and other health care providers
• Seeking a settlement with your employer and its workers’ compensation insurer
• Helping you to file a claim with the Virginia Workers’ Compensation Commission and representing you in any hearings before the WCC
• Pursuing all appeals on your before (if necessary).
• Keeping you advised and informed about the progress of your case at all times.

It all starts by getting in touch with us. Please call or connect with us online today.

You may be asked to sign a form called an Agreement to Pay Benefits. This form states that you were injured on the job or disabled by an occupational disease, lists any period of disability and has other information about your claim. Make sure that all the information is correct, especially the stated average weekly wage and the body parts that were injured or affected. The Agreement to Pay Benefits will be sent to the Virginia Workers’ Compensation Commission for an award to be entered on the information on the Agreement. The award requires the carrier to pay your benefits.

For more information on Workers’ Compensation claims in Virginia, please review our Workers’ Compensation page.