There are many types of worker’s compensation benefits available to injured or sick workers under Virginia law. One of the most important benefits is the injured worker’s right to receive medical care for his workplace-related injury or illness.
When a workplace injury or occupational illness occurs, the worker is entitled to lifetime medical treatment to deal with, cure, or recover from that injury or illness. This is sometimes referred to as simply “lifetime medical”.
Rights Granted by a Lifetime Medical Award
Under Section 65.2-603 of the Virginia State Code, the cost of medical care is placed on the employer when an employee is injured in the workplace or develops an occupational illness. This benefit is unlimited as long as it can be proven that any medical treatment, prosthesis, or test is both reasonable and medically necessary and related to the work injujry.
This is why it is often referred to as a ‘lifetime medical award.’ The following are specific medical benefits available to sick or injured workers in Virginia:
The Worker’s Compensation Act requires your employer to provide a selection of at least three physicians for you to choose from. The doctor you choose will become your authorized physician for the duration of your treatment.
Your employers workers compensation insurance must pay for all visits, examinations, and referrals made by your physician. This workers compensation approved physician will obviously be a key part of the treatment you receive.
PAYMENT FOR HOSPITALIZATION
Your employer must pay for all hospitalization costs that are incurred as a result of your injury or illness. This includes any initial hospitalization such as a visit to an emergency room as well as being admitted as an inpatient.
PSYCHIATRIC AND MENTAL HEALTH CARE
Problems such as depression, anxiety, and post-traumatic stress disorder can occur after an injury or discovering that you have contracted an illness. If you suffer from any symptoms that indicate a mental health disorder, the commission may order your employer to pay for mental health care. This would include visits with psychiatrists, psychologist, or counselors as well as any medication that might be prescribed to deal with your symptoms.
SPECIALIZED MEDICAL TREATMENT
Your employer or their insurance company must also provide a specialist if either the commission or the treating physician deems it to be necessary. If the treating physician does not make a specific referral, a panel of specialists to choose from will be offered.
PAYMENT FOR SURGERIES AND PROCEDURES
Your employer is responsible for the cost of all reasonable and medically necessary surgeries, procedures, and injections as long as they are done by your treating physician or a doctor that your treating physician has referred you to.
PAYMENT FOR DIAGNOSTIC TESTS AND TREATMENT
If your injury or illness requires diagnostic tests such as x-rays, CT scans, MRIs or other radiological exams, your employer or the employers workers compensation insurance company is responsible for the cost of those as well.
OTHER LIFETIME MEDICAL BENEFITS
In addition to medical treatment, your employer may be required to provide other things that may be medically required to help you deal with your injury or illness. This could include things such as:
- Wheelchairs, walkers, canes, etc.
- Air conditioning or filtration devices
- Home and automobile modifications
- Ergonomic chairs
- Gym membership
- Physical therapy
- Occupational therapy
- Home nursing care
This list is by no means exhaustive. If your treating physician provides proof that something will help improve your condition, there is a good chance that it will be covered under your worker’s compensation claim.
HOW TO REQUEST LIFETIME MEDICAL BENEFITS
Your medical care coverage may be being paid “voluntarily”. This means that the bills are being covered, but there is no Award in place requiring that this continue into the future. This is why I’m always telling folks they need to be under an Award Order for their lifetime medical benefits in Virginia. To understand the importance of an Award Order go here.
To ask for your Award for the lifetime medical benefits, you need to complete and Claim for Benefits form. This can be done either by paper that can be faxed or mailed to the Virginia Workers Compensation Commission, or if you are computer savvy, you can complete the form on the Commission’s website.
Need help completing the Claim Form? Check out our video on this.
Contact an Experienced Lawyer to Protect Your Rights
Worker’s compensation claims can be tricky. To protect all of your rights you need to file your claim quickly and accurately. Filing incorrectly, failing to file in time, or signing documents you’re unsure of could hurt both your financial and physical well-being. Contact us today and we’ll be happy to go over the details of your worker’s compensation claim and show you exactly how we can help you. You can also call us at (804) 375-5490.
About the Author: Michele Lewane
The Injured Workers Law Firm is a Richmond, Virginia based firm solely focused on serving clients with workers' compensation claims in Virginia. If you have questions about your benefits or if you would like more information on the Virginia workers’ compensation system, order our book, “The Ultimate Guide to Workers’ Compensation in Virginia” , or call our office today (804) 755-7755.