Virginia Workers' Compensation Benefits: What Constitutes a Compensable Injury?

VIRGINIA WORKERS' COMPENSATION BENEFITS

What Constitutes a Compensable Injury?

 Virginia workers' compensation is a unique benefits system.  The concept is a promise by your employer to take care of your injuries and payment of lost wages if you are injured while working.  Unfortunately, that promise is not always honored.  Protection of your rights is critical to ensure continued eligibility for your benefits if you are injured.  

 Workers' compensation claims are under the jurisdiction of the Virginia Workers' Compensation Commission and are governed exclusively by Virginia Code section 65.2, et seq.,  known as the Virginia Workers' Compensation Act.  There are many, many nuances in Virginia workers' compensation for compensability and for continued benefits even after an award is entered by the Commission. 

 A claim for benefits in Virginia must meet three criteria to be compensable:  1.) the injury must "arise out of" the employment; 2.) the injury must "occur during" the employment; and 3.) the injury must be traumatic in nature (unless a work-related disease). 

 What do these terms mean?

1.)        Arising out of the employment - This means that the injury must have been directly related to your job, or have been unique to the performance of your duties. 

2.)        Occur During the employment - The injury must have occurred while the injured while you were "on the clock."

3.)        Traumatic injury - Although the workers' compensation act allows for potential recovery of certain diseases, claims typically must have occurred from a traumatic incident and have occurred from a specific incident.  Under the Act, this element is usulaly not included as a requirement; however, in reality, if the injury did not arise from a traumatic incident (one in which the claimant "heard a pop," or felt immediate pain) the claim is usually denied.

Virginia law requires that the employer MUST provide an injured worker with a "panel of physicians" when injured.  The physician panel is a choice of three (3) physicians from which the injured person may choose a treating physician to coordinate and manage all treatment related to the injury.

Remember, even if benefits are being voluntarily paid by the employer or the insurance carrier, your rights are NOT necessarily protected.  An employer/carrier may elect to voluntarily pay the claim and proceed to pay for medical treatment, lost wages and provide other benefits.  However, the statute of limitations to file a claim with the Virginia Workers' Compensation Commission is two (2) years.  As you may recall, the VWCC is the court of competent jurisdiction for workers' compensation claims; therefore, you MUST file with the VWCC.  Why?  Back to the statute of limitations of 2 years - if the claimant fails to file, the employer/carrier can simply STOP paying for the injury.  Seriously.  Without the filing before the Commission, once the statute runs out, there is no enforcement mechanism to force the employer/carrier to continue their duty.

You need an attorney who is skilled in workers' compensation claims and familiar with the inner workings of the workers' compensation system to ensure that you obtain all of the benefits that you deserve.  Mr. Ratliff has over twenty years of experience in workers' compensation as a Rehabilitation Counselor, Claimant Attorney and has served as defense counsel as well.

Workers' Compensation consultations are absolutely FREE at The Ratliff Law Firm.  If you do not collect benefits, there are no attorney's fees.  Don't lose your claim or any benefit to which you are rightfully entitled...call today (276) 522-1220.  www.ratlifflaw.net