What can I do if my employer denies my workers’ compensation claim?

If your employer (or its workers’ compensation insurer) rejects your claim for medical and/or lost-wage benefits, you should speak with a lawyer right away about filing a claim with the Virginia Workers’ Compensation Commission (WCC). You must file a claim with the WCC within two years after the date of your workplace accident resulting in an injury. So, it is important to move quickly if your employer has denied your claim. An attorney can help you with filing a claim and with requesting a hearing before the WCC. The attorney can also represent you at the hearing and present evidence to help the WCC make its decision on your claim, including medical records and testimony by medical experts.

What are workers’ compensation benefits?

Workers’ compensation benefits are medical expenses and a portion of your lost wages that your employer must cover if you suffer: An injury from a work accident An illness directly caused by your work, or an “occupational disease” The loss of a loved one due to a work-related injury or illness. Most employers in our state are required under the Virginia Workers’ Compensation Act to buy workers’ compensation insurance. This insurance pays benefits to employees. The benefits can play an important role in helping an injured or ill worker to get needed medical care and to pay their living expenses while they are unable to work.

Can I get workers’ compensation benefits if I can still work?

You should be eligible for temporary partial disability benefits if you can return to work – but only at a lighter duty, lesser-paying job. If you cannot work at all, then you would be eligible for temporary total disability benefits. These benefits would cover roughly two-thirds of your average weekly wage (subject to a weekly cap that is set each year by law).

Can I sue my employer if am injured at work?

Your ability to sue your employer for a work-related injury generally depends on whether your employer has purchased workers’ compensation insurance. Under Virginia law, any employer with three or more employees must have workers’ compensation insurance. However, some employers may operate in violation of this law. Also, if a company has fewer than three employees, it can still elect to carry workers’ compensation insurance. So, if you have suffered a work-related injury or illness, determining whether your employer has workers’ compensation coverage will be a primary consideration. An attorney can help you to make that determination.

Richmond Workers Compensation Lawyer

Item: Marks & Harrison
Rating: 5
Author: Edward

Under the Virginia Workers’ Compensation Act, an employee who has been injured on the job does not have to prove that anyone was specifically at fault in the accident, nor does he or she have to prove the negligence of the employer. Although the law was designed to take the issue of work-related injuries out of the court system and to provide injured workers swift and sure relief for their injuries, unfortunately, that is no longer the case.

Employers – and their insurance companies – often try to delay action on workers’ compensation claims or refuse to pay them altogether. They are out to protect their financial interests.

As a result, workers who suffer job-related injuries and illnesses need to take immediate, aggressive action to protect their rights. Getting help from an experienced workers’ compensation attorney is an important first step.

At Marks & Harrison, we have a history of standing up for workers that span more than 100 years. We truly appreciate the important role that workers’ compensation benefits play in the lives of our clients and their families.

A workers' compensation lawyer in Richmond speaks with his clients.

Understanding Your Rights: Workers’ Compensation Claims in Virginia

Workers’ Compensation is designed to protect workers and their dependents against the hardships of injury or death arising out of the work environment. There are many ways employees can be injured at work, including vehicle accidents, lifting, cutting or crushing trauma, and slips and falls.

Occupational illnesses are usually the result of long-term exposure or repetitive motion injuries (carpal tunnel), toxic chemicals, heart attacks, and exposure to toxic materials. Workers’ Comp laws provide money and medical benefits to an employee who has an injury as a result of an accident, injury, or occupational disease on the job.

If you have been injured on the job, you should:

Get medical attention if there is an emergency.
Report your injury as soon as possible by giving written notice to your supervisor or someone in a supervisory position. Failure to promptly give notice to your employer may affect your right to benefits. Your employer is not responsible for paying the medical treatment or wages until you give notice of the accident or disease.
If you work for a subcontractor, you should promptly give written notice of your accident or occupational disease to your direct employer and the general contractor.
Report all accidents, even if the injury seems minor. A small injury can develop into a serious problem.

In order to be covered under the terms of the Virginia Workers’ Compensation Act, an accident must have occurred as follows:

The accident must occur at work, or during a work-related function.
The accident must be caused by a specific work activity.
The accident must happen suddenly at a specific time.

Injuries occurring gradually or from repetitive stress or traumas are not covered. For example, if an employee lifts an object and feels a sudden pain causing him an injury, and he can identify that specific incident, the claim will be covered.

However, if an employee lifts objects for weeks at a time and gradually develops back pain, that is not a specific injury at a specific time, and the injury would not be covered. An occupational disease will be covered if it is caused by work and is not a disease of the back, neck, or spinal column.

Types of Workers’ Compensation Benefits in Virginia

Claimants may be eligible for the following types of benefits under Workers’ Compensation:

Medical Treatment Coverage:
- Payment for all necessary medical treatments, including:
  - Prescriptions
  - Medical supplies and equipment
  - Hospital costs
  - Doctors’ bills
Wage Replacement Benefits:
- A portion of weekly wages is provided during recovery.
- The amount depends on the type of disability:
  - Temporary Total Disability: For injuries that fully prevent work for a limited time.
  - Permanent Disability: For long-term or permanent impairments.
Compensation Calculation:
- Based on the employee’s average weekly wage before the injury or illness.
- Includes gross earnings during the previous 52 weeks.
- Additional employer-provided benefits are factored in, such as:
  - Overtime
  - Meal, uniform, car, and housing allowances

These benefits ensure financial support and medical care for workers injured on the job.

“Why You Need an Experienced Virginia Workers’ Compensation Attorney

The Virginia Workers’ Compensation attorneys of Marks & Harrison strongly advise injured employees to consult a professional who understands the Virginia Workers’ Compensation laws that apply to their specific circumstances. When a worker is injured, the claim is filed with the workers’ compensation insurance company (or self-insuring employer) which pays medical and disability benefits according to a state-approved formula.

A Virginia Workers’ Compensation lawyer qualified to interpret Workers’ Compensation laws will be able to provide legal guidance and assistance to ensure full recovery of all funds to which the injured worker is entitled. Your employer and its insurance company will always have an experienced attorney representing their interests.

You will also be dealing with insurance adjusters who work for the insurance company and whose job it is to pay as little as possible. Contact one of our workers compensation lawyers near me today.

Some of the issues associated with Workers’ Comp claims include:

The employer can deny Workers’ Compensation claims.
Employers can stop paying benefits.
Employer fraud may cause workers to be cheated out of part or all of their Workers’ Compensation claims.
Limitations to Workers’ Compensation laws and misunderstandings about what they mean.

A Richmond workers compensation lawyer representing your interests will help you deal with these issues as well as many others, including returning to work and how your claim is impacted by pension benefits and unemployment compensation.

With Marks & Harrison, there is never a charge for an initial consultation, and you will pay no legal fees unless you hire us. Our team of injury attorneys in Richmond VA and support staff strives to satisfactorily meet client objectives and goals by focusing on your case. Should you choose to have us represent you, we will do the following:

Meet with you to learn all the facts relating to your case
Explain to you all of your important legal rights
Review your medical records in order to obtain a full understanding of your injuries and medical condition
Meet with your physicians and health care providers.
Answer all of your questions regarding Workers’ Compensation
Keep you advised and informed about the progress of your case.

Virginia Workers’ Compensation FAQs

If you have been hurt on the job in Virginia, or if you have lost a loved one due to a work-related injury or illness, you will have many questions about your rights and options.

To help you get a better understanding, we present the following answers to questions that our lawyers frequently receive about workers’ compensation benefits in our state.

If you would like to discuss the specific facts of your case and get answers to your own questions, please contact Marks & Harrison to speak to a Worker’s Compensation lawyer. We serve clients in Richmond and from offices that are located in Virginia. We can provide a timely, free, and completely confidential consultation.

Simply call or click here today to get started.

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Contact a Richmond Workers’ Compensation Lawyer or Attorney Today

Contact us today by calling toll-free at 1-800-283-2202. Our phones are answered 24 hours a day, 7 days a week. You can also submit a Case Evaluation online.