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How Workers’ Compensation Works: Are You Eligible?

How Workers’ Compensation Works: Are You Eligible?

Workers’ compensation is a system that provides workers who are injured on the job with monetary support to help them with medical expenses and lost wages. Each state has its own statutes to govern how workers’ compensation operates. It is the responsibility of the employer to pay for or have insurance to pay for their employee’s workers’ compensation expenses.

It is a stressful situation when you have been injured in a work-related accident and are unable to do your job. Your ability to work and bring home a paycheck in addition to mounting medical expenses is overwhelming for anyone. You may be unsure about your future and how to figure out the workers’ compensation claims process on your own.

When you have been injured at work and you want to pursue a worker’s compensation claim in Virginia, you need the help of an experienced Virginia Beach workers’ compensation attorney. Scott R. Barney, Esq., of Barney Injury Law can help. Born and raised in Virginia, Scott cares about helping the residents of Virginia obtain the highest amount of workers’ compensation payments possible.

What Injuries Qualify for Workers’ Compensation?

If an employee is injured at work, it must be either an “injury by accident” or an “occupational disease” to qualify for the benefit.

An injury by accident is one that occurs at work or for an employee attending a work-related function. The accident must also be work-related. The accident must have occurred during a specific work activity. The timing of the injury is also important. Those that develop over time from repetitive trauma, such as arthritis, are generally not covered. If an injury happens during a specific incident, such as a broken bone, this would be covered.

Accident cases have a statute of limitations within which the injured party can file a claim. In Virginia, that timeframe is two years from the date of the accident.

Occupational diseases must have been incurred as a direct result of the work an employee does. These diseases cannot be those of the back, neck, or spinal column.

Disease claim statutes of limitations are either two years or five years depending on whichever event is sooner. It is two years from the date your medical provider tells you that your disease is work-related. It is five years from the date you were exposed to the condition which caused your disease.

What Should You do if You are Injured at Work?

If you believe you have had a worker’s compensation accident, there are a couple of things you should do.

  • Report all accidents and injuries to your supervisor within 30 days. Even the most insignificant accidents should be reported without delay. Your human resources representative will offer you information about medical professionals you can go to for diagnosis and treatment of your injuries. If your employer does not offer you a specific list of medical providers, you can choose your own for your treatment.
  • Document everything. Write down every detail of the accident such as the location, the time, witnesses to the incident, to whom you reported the incident and when you reported it. Take pictures if possible, and describe the response from your employer after you reported the accident. Try to be specific with all your facts.
  • Seek medical attention when you need it. Even if you think that you can work through the pain, do not take chances. When you meet with your doctor, make sure that you thoroughly explain the details of the accident.
  • If your doctor deems you unable to work completely or in a specific capacity, you need written documentation of that. Ask your doctor to provide you with written restrictions or an excuse from work. Make a copy of this information for your own file and give another copy to your employer.
  • After all the conversations you have with your employer or the Virginia Workers’ Compensation Commission, take down the date, time, and name of the person with whom you spoke. It is also important to write down what was discussed in the conversation.
  • The insurance company is going to contact you, and what you say to them will impact your claim. It is highly advisable to consult with a Virginia personal injury attorney before you provide the insurance company with a recorded statement to maximize your ability to receive benefits. After they speak with you, they will launch an investigation into your claim, in which case they will either accept the claim, deny the whole claim, or deny parts of the claim.

If the insurance company denies any part of your claim, you may still be eligible for benefits. The Workers’ Compensation Commission will decide if your employer will pay. It is important that all workers who are injured filed a claim with the Virginia Workers’ Compensation Commission no matter what the insurance company decides to do.

Workers’ Compensation Covers Wages

  • Temporary Total Disability (TTD): After you have been unable to work for seven days if you will need temporary leave that won’t exceed 500 weeks this benefit will kick in.
  • Temporary Partial Disability (TPD): When you are unable to perform the duties of your job and must instead take on lesser responsibilities for lower wages.

Workers’ Compensation Covers Medical Bills

Workers’ compensation covers costs of medical expenses that are a result of conditions or diseases that have been caused by the accident. These benefits also include reimbursement for mileage when you are driving to and from your medical appointments.

  • Permanent Partial Disability (PPD): If you have lost a body part or use of a body part permanently, even if you can still work, you can receive this benefit. Additional injuries covered include loss of vision, loss of hearing, and disfigurement.
  • Permanent and Total Disability (PTD): Lifetime benefits may be possible through this benefit when a worker loses both hands, arms, feet, legs, eyes, or any two in the same accident. Additionally, those who are paralyzed or disabled from a brain injury qualify.
  • Death Benefits: Paid out for a maximum of 500 weeks to either a spouse, children under 18, and children under 23 who are in a full time accredited school. Capped funeral and transportation expenses are also included,
  • Cost of Living Adjustment (COLA) Increase: A yearly adjustment that is not automatic. It must be requested and have back up documentation from the Social Security Administration.
  • Vocational Rehabilitation: Those who are able to work a light-duty job must prove they are actively looking for one even if they are expected to return to their regular job.

Filing for workers’ compensation coverage after a workplace accident is a complicated process. Luckily, you do not have to navigate it alone. Scott R. Barney, Esq., is a Virginia Beach personal injury attorney who can help. Call me today to set up a free consultation at (757) 296-8343.

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