Claims for physical injuries are the most common type of workers compensation claim.
In order for an injury to be covered, Virginia Workers’ Compensation has specific requirements that must be met in order for a claim to be compensable (or covered), just being on the clock is not enough.
You must prove three things in order for an injury to be covered under Virginia Workers Compensation rules:
- The injury was caused by an accident or specific and immediate event
- The injury arose out of your employment
- The injury occurred during the course and scope of your employment.
An injury by accident can normally be identified as a certain task that caused the injury – the change, pain or sensation in your body indicating an injury. For example, if you lifted a box and felt a sharp pain in your back, or a pop in your shoulder. The law also says that there must be a structural change in your body.
Arising out of your employment means that you can show there was something about the employment that caused your injury. For example, a task that you were performing, the workplace situation or environment or the equipment used. Falling down the stairs for no reason is not covered by workers’ compensation- you can fall down the stairs anywhere. If you fell because the particular steps were defective or you had a box in your hand and could not see the step, it would be covered.
During the “course and scope” of your employment means that you were doing your job, you were hurt at a time and place where you were expected or allowed to be because of your employment. Coming to or from work is generally not covered.
Virginia workers’ compensation benefits can cover preexisting conditions if you can show that the work injury made the preexisting injury worse by aggravating the already existing condition.
Insurance companies like to dispute these claims so if you are dealing with a situation like this you should consult a workers compensation lawyer.
Compensable Consequence Injuries
The workers’ compensation system provides benefits for injuries and conditions that are the result of overusing a healthy extremity (arm or leg) because of a covered work accident physical injury. For example, if you have a work injury to your right knee that alters your gait for an extended period of time that results in your left knee ( or low back) needing medical treatment, this medical treatment could also be covered as part of your claim because you are overcompensating for the weakened right knee.
Repetitive motion or cumulative trauma type injuries caused by overuse or continuous stress on the body, are NOT covered under the Virginia Workers Compensation Act. The only exception to this rule is in the case of Carpel Tunnel Syndrome, provided that the doctor can specifically say that the Carpel Tunnel Syndrome was caused by the employment. But this is really covered as an Ordinary disease of Life which has a much higher burden of proof and we talk about it in the next section.
Virginia workers who are diagnosed with a disease caused by their employment may also receive benefits under the Virginia Workers Compensation Act.
There are three categories of diseases under the workers’ compensation system:
• Occupational diseases
• Ordinary diseases of life
• Presumptive diseases
The burden of proof is different for each category of disease so if you are dealing with a disease that you believe is a result of your employment, you should consult an experienced workers compensation lawyer immediately.
There are two situations where you can receive benefits for psychological injuries under workers’ compensation in Virginia. The term “psychological injuries” can include Post-Traumatic Stress Disorder (PTSD), Depression, and Anxiety.
Covered Physical Injuries
You can receive benefits for a psychological injury if it is the result of a covered physical injury.
For example, a life altering physical injury, like the loss of a limb, can lead to psychological conditions that require the care of a mental health professional.
Sudden Shock or Fright
You can also receive benefits for a psychological injury if it is related to an “obvious sudden shock or fright” that happened at work.
For example, a gas station attendant being robbed at gun point or a housekeeping employee stumbling across a gory crime scene while cleaning rooms. This is a relatively new area of law and the rules are changing rapidly.
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.