Regular Medical Insurance Does not cover work injuries.

I injured my shoulder at work lifting something heavy and have been seeing the doctor and physical therapist who put me on light duty. At the time I did not have my own health insurance so the company is paying for my visits, and paying me only for the time i was at the appointments and travel time. Should i be getting paid for the hours I missed on the days of my appointments due to the pain and soreness i had after the visits that caused me not to be able to work those days?


Answer form Attorney Michele Lewane

No, unfortunately, you cannot take yourself out of work. Only a Doctor can give restrictions and take you out of work. In Workers Compensation, what the doctor says goes. So, if your employer thinks you can work or if you think you can’t work does not matter. It’s what the doctor thinks. The good news is that this situation is fixable. At your next doctor’s visit ( or if is a long time from now, schedule one with him earlier), tell him how you are in such pain after physical therapy and ask him if he would take you out of work for 3 or 4 hours after physical therapy. This sounds reasonable to me.

Also, the way I read your question, I believe you are under a lot of misconceptions. First, it is not because you do not have health insurance that workers compensation is paying the bills. Workers compensation is required to pay the medical bills. Trust me they have large contracts with most medical providers and get significant discounts on the bills. Also, most (but I really think all) regular health insurance have specific exclusions that they will not pay for any medical treatment due to a work injury. Next, I am also concerned that you may not be under an award order with the Virginia Workers Compensation Commission. This is NOT the insurance company. This is the state agency that oversees all workers compensation matters. There are statutes of limitations that if you do not file paperwork with the Commission, you will permanently loose benefits. I suggest that you file a Claim for Benefits with the Commission. You can do that online at their website. This will start the process of getting an award order. You also need an award order each time you are out of work to protect your future benefits. Next, medical benefits includes all co pays and 50 ½ cents per mile to and from medical treatment. This means you do not pay for any prescriptions, etc. You can go back to the date of injury to get reimbursement. Lastly, you may be eligible for permanent partial disability benefits. Once the doctor says there is nothing more he can do and you will not get any better, he can give you an impairment rating to your arm. This is a math formula: 2/3rds your average weekly wage times the percentage of loss times 200 weeks. So, if the doctor says you have lost 15% use of your arm, you file it with the Commission and the insurance company would pay you your comp check for 13.33 weeks.

Michele Lewane

Injured Workers Lawfirm

7826 Shrader Road

Richmond, Virginia 23294

Phone: (804) 755-7755

Fax: (804) 612-1724


About the Author:

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.