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When it comes to obtaining workers’ compensation benefits in Virginia, the trickiest part can be in the mechanics of following the claims process. Here, we will briefly take you through the basics of the Virginia workers’ compensation claims process and give you links to find more detailed information along the way.
While the Virginia claims process can be complicated, an easy way to make sure that you have dotted every “i” and crossed every “t” with regard to the process is to retain the services of a Virginia workers’ compensation attorney you can trust.
You can trust the expert lawyers at The Injured Workers Law Firm. We only handle Virginia workers’ compensation claims, and we can make sure that your claim is completed accurately and efficiently. We opened this firm to ensure that workers get justice after a work-related injury. Let us help you get the compensation you deserve. Call us at 804-755-7755 today.
What Exactly Is a Workers’ Compensation Claim?
There are a number of steps involved when making a workers’ compensation claim in Virginia. Here is a helpful roadmap to the vital claims process steps:
Step 1: Report the injury to your employer.
This is the beginning of the process, and it is an important part because it is the first report of the incident that caused your work-related injury. Be sure to notify your employer as soon as possible, with appropriate detail. You have up to 30 days to provide this notice in writing. But, it is best to notify your supervisor immediately.
Step 2: File a Claim Form with the VA Workers’ Compensation Commission.
Telling your employer is not enough. You must also inform the State of Virginia, through the Virginia Workers’ Compensation Commission, of your work-related injury. The claim you make to the Commission must be on a Commission claim form. The form is called a Claim Form.
Step 3: Your employer will file a report of the accident.
While you are not involved in this step of the process, it is important for you to know that your employer has an obligation related to your injury. Once you report the injury, your employer is required to notify its workers’ compensation insurer as well as the Virginia Workers’ Compensation Commission.
Step 4: You may receive a call from an insurance adjuster.
Once the insurance company is notified, an adjuster may call you and ask for you to make a recorded statement. The insurer may also give you a choice of three physicians for you to begin medical care. It would be recommended that you speak to a workers’ compensation attorney before answering the insurance company’s questions, just to make sure you are protected when interacting with the insurance company, which may be inclined to find reasons to deny your claim.
Step 5: Virginia Workers’ Compensation Commission gives the insurance company 20 days to accept or deny your claim.
Finally, when the Commission has been notified of your injury, the Commission will also issue a so-called “20-day order” to the insurance company. The order informs the insurance company that it has 20 days to act on your workers’ compensation claim.
The insurance company’s response to your claim will dictate what happens next. If the insurer denies your claim, then a hearing before the Virginia Workers’ Compensation Commission will be scheduled and evidence will be heard in front of the Commission.
However, if the insurer accepts your claim, then the insurer will provide you with agreement forms for you to execute. The Virginia Workers’ Compensation Commission will then enter an Award Order, confirming your eligibility for benefits.
The Injured Workers Law Firm has a very helpful video that provides additional details on the claims process. Click here to view our video.
When it comes to some of the forms you need throughout the claims process, there are forms to file a claim, to request mileage reimbursement for travel for medical treatment, and to request a cost of living adjustment. Luckily, The Injured Workers Law Firm has created a virtual library so you can find all the Virginia Workers’ Compensation Forms you need. Click here to tap into the most requested forms for Virginia Workers’ Compensation Claims.
When to File for Workers Compensation
Not only do you need to make sure you file certain claims and notices, but you need to file them within the proper time. To give you some important filing deadlines, here is a quick breakdown of the main deadlines:
- Provide written notice of an injury to your employer within 30 days of the injury.
- File a Claim Form with the Virginia Workers’ Compensation Commission, using a Claim Form within 2 years of the injury, or discovery of the occupational disease.
Failing to File a Claim
Even if it’s a minor claim you need to report it, simply because most serious injuries related to the neck, back, shoulders and knees seem minor and then they turn out to be more severe. With these types of permanent nerve damage, you may never return to your former physical abilities. Clearly, if you’re in a serious auto accident you’re not going to have an issue but it’s the more subtle injuries that can be the most overlooked. The second part is the failure to file a claim. Again, just because they’re making voluntary payments does not mean that they will continue to do so. They will only do so for two years unless you file the Claim Form. I’ve had many people come to me after the two-year statute of limitations has run and they have been devastated to find out that they thought the insurance adjusters were helping them when, in fact, they were just biding their time to be able to cut off benefits. It’s much cheaper for them to pay lost wages for two years than it is for them to pay lost wages for nine and a half years and medical benefits for life.
The Virginia Workers’ Compensation Commission provides a helpful electronic portal to allow you, as a workers’ compensation claimant, to view and track your workers’ compensation claim. The system is called “Webfile,” and it provides a number of benefits to claimants. It allows you to view claim information, view claim activity, and verify which Claims Administrator is handling your claim. It also allows you to file a Claim Form and request a workers’ compensation hearing online.
The system also has features for attorneys who represent claimants and claims administrators. If you do file a claim with the Virginia Workers’ Compensation Commission, you will have the ability to take advantage of the Webfile system online.
There is a lot to remember in connection with the Virginia workers’ compensation claims process. If you are injured, or if a loved one was killed on the job, you should be focusing on healing, not the complexities of a claims process.
How to File a Claim FAQs
How do I officially and legally notify my employer if I’ve been injured at work?
You should tell your supervisor if you’ve been hurt immediately, especially if you’ve suffered an injury that looks like it will require emergency medical treatment. As far as the Virginia worker’s compensation system goes, you have up to 30 days to file a report of the injury with your employer in writing. You should include as much detail about what happened as possible.
Do I need to file an official injury claim aside from reporting to my employer?
Yes. You will need to first report the injury to your employer, then you will have to file an official claim with the Virginia Workers’ Compensation Commission. This should be done using their official workers’ compensation claim form. It should be filled out as completely and accurately as possible.
What if I was not injured but have developed an illness through my work?
You can also file for workers’ compensation in Virginia if you have developed an illness or disease directly related to your job such as skin disease, lung disease, or some form of chemical poisoning. This is referred to as an occupational disease.
What if I make a mistake on my claim form?
Making a mistake on your claim could, at the very least, delay the processing of your claim and, at the worst, get it denied altogether. It’s always best to speak with a personal injury attorney that specializes in Virginia workers’ compensation cases to go over things with you before you actually file your claim.
How do I know which benefits to request from what is available on the form?
The benefits you can request depend on the type and severity of your injury. Again, it’s best to speak with a qualified workers’ compensation lawyer before finalizing and submitting your workers’ compensation claim form to the Virginia Workers’ Compensation Commission. A simple mistake, in the beginning, could turn into a big problem down the line.
We invite you to consult with one of our expert workers’ compensation attorneys at The Injured Workers Law Firm. We can handle the stress of making a workers’ compensation claim for you, so you can focus on what is most important – getting better. Call us at 804-755-7755 to set up a consultation and learn more about how we can take the stress off of your shoulders while working diligently to get you the highest compensation for your injuries and loss.
My name is Michele Lewane and I’m a workers comp attorney in Virginia. I work at the Injured Workers’ Lawfirm, and we believe that the world would be a better place if all injured workers could get their workers comp benefits quickly and efficiently so they can get back to work and back to their normal lives.
It’s very important to protect your medical benefits when you’re hurt on the job. One of the most common mistakes that I see is the issue of the paperwork that comes along with the workers comp injuries.
There are three documents, there’s the Claim Form, there’s the agreement form and then there’s the medical award order and different problems come along at different stages.
With the Claim Form, that’s the form that you can get online either at my website or at the commission that says what body parts you’re asking them to cover. What the mistake is that happens there is that you don’t list all of the body parts, if you list just your neck and you have a neck and shoulder injury your shoulder won’t be covered.
It’s better in my opinion to to list just as many body parts as you think could be hurt at that time. Once you file that Claim for Benefits form the insurance company has the obligation to generate what is called an agreement form, and again in there they might only list your neck and not your neck and shoulder. Again if you sign off on that paperwork you are giving up your right to medical care for your shoulder.
The third piece of paperwork comes from the workers’ comp commission and that’s the medical award order. How that’s generated is those agreement forms get mailed to the commission, they see everybody agrees and they generate the medical award order.
At that point, they are legally required to cover those particular body parts. What happens in that stage is many times insurance companies delay filing the agreement forms or they voluntarily pay for all medical care even though they have only put the neck on the paperwork, so you don’t even understand that there is even an issue, but there is because there is a two-year statute of limitations so that once that two years is up you’re prevented forever of getting the medical care on that shoulder if that the body part that had been left out.
If you’d like additional information you can go to my website and order The Ultimate Guide to Workers’ Compensation in Virginia. This would help you protect your benefits further and give you the information you need to be proactive and protect your rights.