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
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.
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.
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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.