If only I had a penny for every time I heard this question! First of all, let’s clarify what we mean when we are talking about an appeal. If you have been to a hearing at the Virginia Workers’ Compensation Commission and have been denied benefits by Opinion of the Commission and want to file an appeal of the findings of the Deputy Commissioner, then yes, you definitely need a lawyer. I don’t begin representing injured workers at this stage because, generally, it is too late. No more evidence can be heard and no more medical records can be entered. If I represented my client at the lower level then, of course, I represent them on appeal.
Some people confuse filing an “appeal” with filing their Claim for Benefits. The Claim for Benefits form is the form the injured worker files with the Virginia Workers’ Compensation Commission to request that their injury and benefits be recognized officially. This protects the injured worker. If the Claim for Benefits is accepted by the workers’ compensation insurance carrier and there is no dispute, then no hearing will be scheduled and you may not need a lawyer. As long as your medical treatment is being covered and you are being paid lost wages for your time off of work (with a doctor’s note of course), then you shouldn’t need one. If the Claim for Benefits is denied by the workers’ compensation insurance carrier in response to the Claim for Benefits that you file with the Commission, then a hearing will be scheduled before the Commission, at which time evidence will be presented by both sides to the Commissioner who will determine if you qualify for benefits under Virginia law.
When the insurance carrier denies your claim without and then you go and file your Claim for Benefits at the Commission, this is NOT an appeal. This is actually the 1st step in getting the Commission to facilitate an award for your benefits.
The general rule here is – if you are going to court, yes, you need a lawyer to help you. If you are filing paperwork, you may not need a lawyer. Most folks I come in contact with are more than capable of filing their own Claim for Benefits form and don’t need to pay a lawyer to do this for them.
However, even if things are going well, I cannot stress the importance of education enough!! Even if you don’t necessarily need a lawyer – talk to one just to make sure you understand what rules to follow and get any information the insurance company may not be willing to share with you! It is also very important to make sure you are filling out the Claim for Benefits form properly (call my office if you need help with this).
Taking this extra step and getting educated on the system can save you headaches in the future. I can’t tell you how many times people have told to me how much they wish they had known about my book and the information my office gives to people before they started this process. Knowledge truly is power!
If you are looking for a lawyer or if you just need some guidance, order my book, “The Ultimate Guide to Workers’ Compensation in Virginia,” or call our office today (804) 755-7755.
Michele Lewane, Esq.