A workers' compensation claim can provide medical treatment and income reimbursement after an on-the-job injury, but the rules for obtaining benefits can be complex. As a result, there are many reasons why you may meet resistance when you try to collect the benefits you deserve.
Fortunately, a Richmond workers' compensation lawyer may be able to help you. An experienced personal injury attorney could work to demonstrate that your injury arose out of your employment and pursue an appeal if the insurance company denies your claim for benefits. En Español.Get Started
Workers’ Comp in Virginia
When you are injured on the job, you typically have the right to claim workers’ comp benefits. However, problems often arise for employees when exercising this right. Workers’ comp lawyers help injured workers tackle the issues they face and fight to get them the payout they are entitled to under the law.
The Commonwealth Law Group has represented numerous workers in various situations, all of whom faced issues with claiming the benefits they were entitled to. Our staff of workers’ comp attorneys understands how hard an injury can be on a worker and their family, so we work diligently to get our clients their payments.
Contact our office today to schedule a free consultation with an experienced workers’ comp lawyer in Richmond, VA.
The Purposes and Requirements of Workers' Compensation
Workers' compensation is a fairly new area of employment law. Prior to workers' compensation laws, the only way for an injured employee to obtain payments after a workplace injury was to sue their employer in court. Thankfully, Commonwealth laws require most employers in Richmond to obtain a workers' compensation insurance policy.
These policies should provide workers with prompt medical care and income benefits in case of an on-the-job injury. However, they also state that an injured worker forfeits the right to sue their employer in case of an injury. This trade-off forms the backbone of workers' compensation law.
Is the Claim Valid if it Does Not directly Involve Work Activity?
The most important part of a successful claim is proving that an injury or illness is connected to work activity. Specifically, there must be a direct causal connection between the conditions under which work was performed and the ailment. Exceptions to this rule do apply. For example, a person who suffers an injury while commuting to work does not qualify. A Richmond workers' compensation attorney could provide more information and evaluate an employee's eligibility for benefits.
Protecting a Worker's Rights Following a Denial
It is essential to remember that a workers' compensation insurance company is in business to make a profit. They accomplish this by collecting employer premiums and by denying benefits whenever possible. As a result, a less than perfect application for benefits, or one where there is a legitimate dispute over the law, may result in a denial. Common reasons for a denial include:
- A worker fails to file a notice with the Workers' Compensation Commission within two years of the injury, as required under VA Code §65.2-601
- There is no connection between the health condition and time on the job
- The injury is not severe enough to warrant an inability to return to work
Regardless of the reasons for a denial, all employees have the right to challenge the insurance company's denial of their claim. To start this process, a worker may file a claim for benefits form with the Worker's Compensation Commission requesting a hearing before a Deputy Commissioner.
At these hearings, both the worker and the employer will have the opportunity to call witnesses, to introduce documentary evidence, and to present their case to the hearing officer. Even if this hearing does not result in benefits, there is an opportunity to request an appeal.
Is it Possible to Appeal a Decision?
The Full Commission has the power to reexamine a Deputy Commissioner's decision. However, these appeals are not second chances to introduce evidence to the Commission. Instead, the Full Commission must evaluate the actions of the Deputy Commissioners for any errors that may have resulted in an incorrect decision. Finally, it is possible to ask the Court of Appeals to intervene if a worker believes that the Commission has still made a mistake of law. A Richmond workers' comp lawyer could guide employees through the appeals processes to seek the benefits they deserve.
Your Rights After a Work Injury
Workers’ comp exists to provide workers with fast and easy payments for on-the-job injuries. It is meant to replace lawsuits against employers and helps keep commerce and business on track. In other words, you may not bring a workers’ comp lawsuit against your employer if they have workers’ comp insurance.
If you are injured on the job and are found to have a valid workers’ comp claim, you will likely have most or all of your medical expenses covered. The coverage applies only to the necessary care and treatment of injuries caused by the work accident, including:
- Hospital and doctor’s visits
- Hospital stays
- Physical therapy
- Medical testing and evaluation services
You can also claim mileage reimbursement for your travel to and from your healthcare provider.
Wage replacement is available for workers who must take time off work or who are forced to work lighter workloads due to their injuries. Generally speaking, wage replacement provides 66.66% of your normal wage, which is defined as the weekly average of what you made during the 52 weeks prior to your work accident.
The nature and severity of your injuries will determine how long wage replacement lasts as well as how much of the 66.66% you will get. After a comprehensive assessment, your injury will be put into one of four categories of disability:
- Temporary total disability, which means you can’t work but will recover your ability to work normal hours
- Temporary partial disability, which means you can work a reduced workload but will recover your ability to work normal hours
- Permanent partial disability, which means a permanently reduced workload
- Permanent total disability, which means permanently unable to work
A person who suffers a permanent total disability may be entitled to receiving 66.66% of their normal wage, including cost-of-living adjustments (COLAs), for the rest of their life.
Sadly, workplace fatalities can happen; they typically devastate lives both financially and emotionally. Although workers’ comp does not provide compensation for non-monetary, emotional losses, it does provide victims’ families with monetary help for the financial pressures they face, such as:
- Compensation for funeral and burial expenses up to $10,000
- Compensation for reasonable transportation expenses up to $1,000
- Wage replacement for dependents
Dependents who are eligible for wage replacement of deceased individuals can be children, spouses, and other legal dependents.
Problems Workers Face When Filing a Claim
Various problems can occur during the workers’ comp claims process, some of which can lead to outright claim denial. For this reason, it is important and advisable to hire a skilled workers’ compensation attorney to manage your claim.
Although all manner of issues can creep up during the claim process, some of the more common ones we see at the Commonwealth Law Group include:
- Claim denials
- Employer problems (failure to file paperwork, disputing an injury’s cause or severity)
- Insurance company challenges (downplaying the seriousness of an injury)
- Clerical errors and subsequent delays
Each of these issues can present significant challenges to employees who need compensation. Take claim denials, for example. There are several reasons a claim might be denied initially. One of the most common reasons for a denial is that the accident is not covered by workers’ comp.
To be covered by workers’ comp, an accident must take place while the employee is engaged in their normal course of business while on the clock. If a worker is harmed before clocking in or while engaging in some activity that is not a part of their normal work duties, then workers’ comp likely does not apply.
As mentioned, you may not bring a workers’ comp lawsuit against your employer for your injuries in most cases. However, if your injury came about as the result of a third party, then you may be able to seek compensation from that third party.
Consider a delivery driver on their way to deliver a load of goods. If a drunk driver hits them, the delivery driver will likely have a strong claim for compensation against the drunk driver in addition to their workers’ compensation claim.
Additionally, claims against third parties can include demands for non-monetary damages, such as pain, suffering, and other non-economic losses not available under the workers’ compensation system.
Richmond Workers' Comp FAQ
Let a Richmond Workers' Compensation Attorney be Your Advocate
Workplace accidents can be stressful and demoralizing events. You rely on your job to support yourself and your family, and it seems unfair that your ability to do so is imperiled by an accident at work.
These situations are exactly the purpose of workers' compensation insurance. A successful claim will cover all necessary medical treatment, temporary payments for any time missed at work, and even lump-sum settlements in many situations.
However, denials of benefits are common. Whether this is the result of incomplete paperwork, a lack of connection between the condition and work, or some other reason, a Richmond workers' compensation lawyer could help. They can work with you to evaluate the stated reasons for denials, gather strong evidence, and pursue claims and appeals that may be necessary to get you the benefits that you deserve. Contact an attorney today to get started.
No matter what situation you are facing, when we take your case, we do everything we can to get you compensated.
A few of the tasks we typically help our workers’ compensation clients with include:
- Provide advice and counsel on your rights during the claim process
- Manage all essential documents and paperwork
- Negotiate a settlement in appropriate cases
- Represent you at hearings and in court
- File a third-party lawsuit when appropriate
- Keep you abreast of the progress of your claim
Additionally, working with our lawyers for workers’ comp will give you peace of mind that all that can be done is being done to get you compensation.
Reach out to the Commonwealth Law Group today and find out how we can help you get what is rightfully yours. We have a seasoned workers’ comp attorney ready to discuss your case.
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Our team at Commonwealth Law Group believes that students who dedicate themselves to serving their communities and people in need should be acknowledged and commended for their service. For this reason, Commonwealth Law Group is offering the Pursuing a Positive Impact Scholarship to recognize and reward students who have put considerable effort into improving their communities and the lives of their fellow neighbors. To apply for the Pursuing a Positive Impact Scholarship, visit our scholarship page here.
“Great law group. Everyone was kind and down to earth. Made me feel like I was their only client. Very attentive to me and my case.”Karen Jacobs
If you have been injured at work or through the negligence of another individual or entity, contact us at (804) 999-9999 or or use the form below to connect with our legal team. We will fight to get you the justice you deserve.