The key to any Virginia Workers' Compensation claim is an Award. An Award protects your legal rights. If you are not sure whether you have an Award or how the Award affects your legal rights, you should consult an attorney.
B = BENEFITS
There are many types of benefits available under the Act. TTD, TPD, PPD, PTD, Vocational Rehabilitation, COLA, Medical, Survivor's Benefits, Funeral Expenses, Penalties, Judgement Interest, Dependant Care Expense, Home Modifications, Mileage Reimbursement. Do you know which ones you are entitled to?
C = CHANGE IN CONDITION
After your award has been terminated, many injured employees assume their claim is over, however, Virginia law allows you to file a claim for a change in your condition within the statutory time limitations to seek additional benefits. An experienced attorney can help guide you through this legal process.
D = DEFENSES
There are many defenses available to Employers to prevent injured Employees from receiving benefits under the Virginia Workers' Compensation Act. If your claim has been denied, you should immediately consult an experienced workers' compensation attorney to see if the denial of your claim is valid or not.
E = EAR
EAR stands for the Employer's Accident Report. When you are injured on the job in Virginia, you should immediately report your accident to your supervisor. The notice should be given within 30 days of the occurrence of the accident or death and should be in writing.
F = FIREFIGHTERS
Firefighters, Police Officers, and certain other specified EMT workers are given specific protections under the Virginia Workers' Compensation Act that is not available to other workers. Specifically, these public servants are given legal presumptions to help them prove their claim for hypertension, heart disease, certain cancers and respiratory diseases. If you have a question about what is covered or whether this applies to you, consult with an experienced attorney.
G = GARNISHMENT
Virginia law exempts workers' compensation from being garnished by most all creditors claims with the exception of child or spousal support.
H = HEARING APPLICATION BY EMPLOYER
Even if you are receiving benefits pursuant to an Award, the Employer has the right to file an application suspending your benefits until a hearing can be held to determine whether you will continue to receive additional benefits. The Employer's application for hearing must be 1) in writing; 2)be under oath; 3)state the grounds for relief; and 4)state the date for which compensation was last paid. See Rule 1.4 of the Rules of the Virginia Workers' Compensation Commission.
I = INDEPENDENT CONTRACTORS
Many Employers attempt to classify their Employees as "Independent Contractors" in an effort to avoid providing benefits under the Virginia Workers' Compensation Act. Just because you are called an Independent Contractor does not necessarily mean you are one. If you have been denied benefits because you were told you are an independent contractor, you should have an experienced attorney discuss this issue with you.
J = JURISDICTION
Many Employees are hired in one state and hurt in another. If you were hired in Virginia or hurt in Virginia, then most likely Virginia will have jurisdiction over your claim. If you are not sure where it is best to file your claim, you should have an experienced Attorney advise you.
K = KIN
Relatives or dependents may also have claims based on an injured employees accident or death. When an injured employee is incapacitated and requires medical assistance at home, relatives may be awarded dependent care expenses. When an Employee is killed on the job or dies as a result of a work related accident, then his dependents may be entitled to benefits.
L = LIMITATION OF ACTIONS
Virginia has many confusing time limitations included in the Virginia Workers' Compensation Act and the Rules of the Virginia Workers' Compensation Commission. If you don't have an experienced Attorney helping you to navigate the system, it is easy to miss a filing deadline to recover benefits.
M = MEDICAL TREATMENT
Many times, injured Employees don't get the medical treatment they deserve in a workers' compensation claim. The Injured Employee is usually sent to a panel physician who does their best to keep the claim from turning into a lost time claim. As a result, many injured Employees are put back to work against their better judgement. An experienced attorney can help make sure you get the treatment you are entitled to.
N = NOTICE
During the course of a serious workers' compensation claim, an injured Employee will give and receive many notices. When you are injured, you have to provide notice of the accident. The Employer then must respond to a 20 day Order to notify the injured Employee whether the claim has been accepted or denied. Injured Employees are required by statute to provide notice to the Commission of any change in earnings, remarriage, change in student status, incarceration or change in address. If the injured Employee receives an adverse decision, then a Notice of Appeal must be filed. These notices can be difficult to keep up with unless you are experienced in handling Workers' Compensation Claims.
O = OCCUPATIONAL DISEASE
An Occupational Disease means a disease arising out of and in the course of employment, but not an ordinary disease of life to which the general public is exposed outside of the employment. A disease shall be deemed to arise out of the employment only if there is apparent to the rational mind, upon consideration of all the circumstances. There are six requirements set forth in the Code that have to be met in order to prove a compensable occupational disease.
P = PANEL OF PHYSICIANS
After an accident is reported and the Employer's Accident Report is completed, the Employer is required to offer the injured Employee a valid panel of 3 physicians. These physicians should be in 3 separate offices
Q = QUALIFICATION AND COORDINATION OF OTHER BENEFITS
Most seriously injured Employees have access to other benefits beyond Workers' Compensation, such as short term disability, long term disability, Social Security Disability Benefits, credit disability policies. It is important to look at all potential avenues of recovery and coordinate those benefits for the best possible recovery.
R = RULES OF THE VIRGINIA WORKERS' COMPENSATION COMMISSION
The Commission has a set of Rules to help administer the Virginia Workers' Compensation Act. These Rules require certain actions on behalf of the injured Employee as well as the Employer and their insurance carrier. These Rules can affect how much retroactive benefits you are entitled to, as well as the time you have to respond to certain requests. It is important to know and understand the Rules of the Commission.
S = SUPPORTING EVIDENCE
In order for a claim for benefits to be referred to the hearing docket, you must have supporting evidence. In most cases, this means you need written evidence from your physician that supports the benefits you are seeking. In other words, if you are seeking payment for lost time, you will need supporting evidence to substantiate the lost time you are seeking and relate that lost time to your accident.
T = TOTAL DISABILITY
Many people assume if a physician has kept them from returning to their job because he has placed restrictions on them that are inconsistent with their pre-injury job, then they are entitled to total disability benefits. In Virginia, if your Employer cannot accommodate your work restrictions, then you are required to "Market Your Residual Capacity" in order to receive total disability benefits. In short, this means you have to make a good faith effort to look for work within your restrictions. The Commission has recently set forth a Guideline that indicates you should make at least 5 job contacts per week if you are under restrictions, your Employer cannot accommodate those restrictions and you expect to receive temporary total disability benefits.
U = UNJUSTIFIED REFUSAL OF EMPLOYMENT
If an injured Employee unjustifiably refuses employment within his physical capacity, then he will not be entitled to certain benefits under the Act until that refusal is cured. The Virginia Workers' Compensation Act provides a limitation of six months to cure any unjustified refusal of selective employment.
V = VOCATIONAL REHABILITATION
If an injured Employee is under an Award, and is placed on restrictions, the Employer has the option of attempting to accommodate those restrictions. If those restrictions are not accommodated, then the insurance carrier will typically provide vocational rehabilitation. Vocational Rehabilitation is generally job search. The carrier will provide a rehabilitation consultant to meet with the injured Employee on a regular basis in an effort to secure employment within the injured Employee's capacity.
W = WILLFUL MISCONDUCT
The Virginia Code provides an affirmative defense that no compensation shall be awarded to an Employee or his Dependents for an injury or death that is the result of willful misconduct. This can take several forms, such as intoxication, failure or refusal to use a safety appliance or perform a duty required by statute, or willful breach of an Employer's safety rule. Willful misconduct cases are typically tried before a Deputy Commissioner. If your Employer has accused you of willful misconduct, then you should have your case evaluated by an Attorney.
X = X-RAY
X-rays are fundamental to a coal workers' pneumoconiosis, silicosis, or asbestosis claim. The Rules of the Virginia Workers' Compensation Commission, as well as the Virginia Workers' Compensation Act set forth how x-rays are used in these types of claims.
Y = YOUR OTHER CLAIMS
Although Virginia Workers' Compensation provides your "exclusive remedy" if you are injured at work, you may have other claims that arise out of your accident. In many cases a third party is liable for the accident and a separate claim can be brought for damages against the negligent third party. Additionally, an Injured Employee may also have discrimination or retaliation claims that impacts her case. An experienced attorney should review any serious accident to determine what claims exists and how they relate to each other.
Z = ZERO PERCENT RATINGS
Once your physician states you are as good as you will get, then you should receive an impairment rating, if your injury is to a "scheduled member". Many panel physicians like to give zero percent impairment ratings or in the alternative very low impairment ratings. There is a great disparity between physicians in how they calculate impairment ratings. If you have been given a zero percent or very low impairment rating, then you should discuss your options with an Attorney.
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