Filing a Workers’ Compensation Claim in Virginia

If you’ve been injured on the job in Virginia, you may be eligible to file a workers’ compensation claim to get your medical bills and lost wages paid.  However, there are some things you must do right away after the injury occurs.

1)  First, you MUST give notice of your injury to your employer. If you fail to notify your employer within 30 days of your injury, you could lose your right to workers’ compensation benefits.

2)  Second, you MUST file a claim.  You can file a Claim for Benefits form with the Virginia Workers’ Compensation Commission within two (2) years of the date of the accident.  Even if you are receiving benefits from the workers’ compensation insurance carrier, a Claim for Benefits form must still be filed and must include all of the body parts you injured in the accident. Your claim form can be filed by any of the following methods:

• In person: Complete the Claim for Benefits Form and deliver it to any of the office locations of the Virginia Worker’s Compensation Commission. All visitors, including attorneys, parties and witnesses, may be required to present photo identification to enter Commission facilities.
• By mail: Complete the Claim for Benefits Form and mail it to: Virginia Workers’ Compensation Commission, 333 E. Franklin St., Richmond, VA 23219.
• By fax: Complete the Claim for Benefits Form and fax it to: 804-823-6956.
• By Webfile: Use your JCN and PIN number to create a WebFile account. You can then file a claim with the Commission online.

3)   Third, you MUST get medical treatment. Your employer must give you a list of at least 3 doctors to choose from.  You are required to choose a doctor from this list.  If your employer does not give you a list of doctors, you could choose your own.  In an emergency situation, you can get treatment at a nearby hospital or other emergency facility.  You should, however, notify your employer of your accident and treatment as soon as possible afterwards.

If Your Claim Is Accepted

If your workers’ compensation claim is accepted, your employer is required to pay for medical treatment provided by your treating doctor or by any physician the treating doctor refers you to.  Reasonable medical treatment also includes surgical treatment and prescriptions as well as medical supplies or equipment and mileage to doctor appointments. However, the employer does not have to pay for medical care which has not been authorized by your doctor or which is not necessary for treatment of your injury.  If the workers’ comp insurance company has denied your claim, you can pick any treating doctor that you want.  If your claim has been denied, see our article “My Virginia Workers’ Compensation Claim Was Denied”.

Seeing Your Doctor

When you visit your doctor for your workers’ compensation injuries, you should give him or her as much detail as possible.  You should describe the location and type of pain you experience, for instance sharp, dull, burning, tingling, numb, etc.  You should also tell the doctor how long your pain lasts and what activities tend to aggravate it.

Missing Time From Work

In addition to medical treatment benefits, you are also entitled to reimbursement of lost compensation.  In Virginia, an injured worker is not eligible for lost time benefits until after missing 7 days of work.  But, if your disability from work continues for more than 21 days, you will receive payment for the first 7 days that were missed.

The amount of compensation you receive will be based on your average weekly wage.  The average weekly wage is determined by calculating your weekly wage averaged out over the past 52 weeks.  Your compensation is then determined by calculating two-thirds of your average weekly wage.  As long as your doctor determines that you should not work, you can continue to collect wage benefits for a maximum of 500 weeks.  For more information on the types of benefits you may be entitled to, you can read our article on Pain and Suffering in Virginia Workers’ Compensation.

Returning To Work

If your doctor decides that you are able to return to work, the workers’ comp insurance carrier will send you a Termination of Wage Loss Award.  This form states that either you were able to return to work or did return to work on a certain day.  You should not sign this form unless you agree with all of the information on it.

When you are released by your doctor to return to light-duty work or work with restrictions, you are required to accept work offered by or found with the help of the employer, even if the job pays less than your pre-injury work. If the new job with restrictions pays less than you were making before the accident, the employer will be responsible for making up the difference in wages.  See our article on Light-Duty Employment here. Or, if you think you may have a permanent injury, you will want to read about Permanent Workers’ Comp Injuries.

If you have been released to light-duty work by your doctor and your employer isn’t helping your find work, you are required to do job searches on your own.  To satisfy this requirement, you should:

• Register with the Job Placement Division of the Virginia Employment Commission.
• Make a list of all of the job searches you do on a weekly basis.  The list should include:  the name of the potential employer contacted, the potential employer’s address, a statement that either an application was submitted or the business would not accept applications.  You can’t just ask a potential employer if they are hiring.  You must either apply for a job or note that they will not accept your application.
• You must contact and apply for at least 5 jobs per week.

Your Obligations As An Injured Worker

As an injured worker, you have numerous responsibilities.  Some of the most important are;

1.     You must notify your employer (and statutory employer, if applicable) about your injury as soon as possible.
2.     You must keep medical appointments with your doctor and follow the prescribed treatment plans.
3.     You must keep appointments for second opinion doctors (independent medical exams) scheduled by the workers’    comp insurance company.
4.     You must cooperate fully with anyone who is helping you find a job.  This includes attending appointments with employers and rehabilitation workers.  However, you are NOT required to reveal personal financial information to a rehabilitation worker.
5.      Notify your employer and insurance company if you find a job or have an increase in earnings while you are receiving workers’ comp benefits.
6.     Attend depositions and answer interrogatory questions that an attorney for the insurance company might send you.
7.     Attend all scheduled hearings.

Ritchie Law Firm is a personal injury law firm devoted to helping individuals who have suffered serious injuries as a result of a job injury. Ritchie Law Firm serves injured workers in all of Virginia, while helping clients in cities and surrounding areas of Harrisonburg, Charlottesville, Staunton, and Winchester.  Check out case studies from some of the cases we’ve handled by clicking here.

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