This page provides answers to the following questions:
- I had an accident at work. How do I file a workers compensation claim in my state?
- Should my employer have workers compensation insurance? How do I know I am covered?
- What are the conditions that enable me or prevent me from claiming benefits under my state's law?
- What benefits might I be eligible to receive?
- How much time do I have to file my claim? What are the stages of the claim process? What should I expect?
- If I'm not happy with the determination, how do I appeal?
1. I had an accident at work. How do I file a workers compensation claim in my state?
If you are injured on the job, report your injury to your employer as soon as possible if not immediately. Upon notification, your employer is required to file a report of the accident with the Workers' Compensation Commission. The employer must file this report within ten days of learning about your accident or injury. If your employer fails to act on your behalf, you may contact the Commission and a file a report on your own.
2. Should my employer have workers compensation insurance? How do I know if I am covered?
Under Virginia state law, employers are required to provide workers' compensation insurance to those they employ.
3. What are the conditions that enable me or prevent me from claiming benefits under my state's law?
In order to receive benefits for an injury, your injury must be an accident that 1) Occurred at work or during a work-related function; 2) was caused by a specific work activity; and 3) happen suddenly at a specific time (no gradually onset injuries).
4. What benefits might I be eligible to receive?
The Virginia Workers' Compensation Act covers the following benefits:
- Wage Replacement-Temporary total or partial: Wage replacement that covers wages lost due to an inability to return to your present job for a period of seven (7) days or more or wage replacement that covers the difference between pre- and post-injury wages should you be able to return to work, but at a lesser capacity.
- Lifetime Medical Benefits: Payments for all reasonably related and necessary medical expenses associated with treating your injury or illness. These will be paid for as long as necessary.
- Permanent Partial Impairment: Benefits paid for the permanent loss of use of a body part or function to a body party.
- Permanent and Total Disability: Lifetime wage benefits if an individual loses both hands, arms, feet, legs, eyes or any of the two in the same accident or become paralyzed or disabled from a severe brain injury.
- Death Benefits: Payments of compensation and funeral expenses may be available to surviving spouses, children, parents, or qualifying dependents if you die as a result of your work-related accident or injury.
- Cost of Living Increase: Compensation may be available to individuals receiving Temporary Total, Permanent Total, or Death Benefits. This kind of benefit must be specifically requested by the employee.
- Vocational Rehabilitation: Services available to help you in regaining employment.
5. How much time do I have to file my claim? What are the stages of the claims process? What should I expect?
To ensure the protection of your rights and the receipt of a maximum amount of benefits, you must file a claim with the Workers' Compensation Commission within two (2) years of your accident.
It is important to exhaust all your options in claim dispute resolution before proceeding with more formal matters. The formal process can be lengthy and sometimes costly. Contacting your employer or employer's insurance provider and discussing why your claim was denied may be all it takes to resolve any pending issues.
Once you file a claim with the commission and request a hearing to discuss that claim, you and your employer and/or employer's insurance provider must present arguments with the respective views of whether the injury was caused by work. A written hearing opinion is issued with the determination of whether the employer is required to pay benefits to you. If you or the employer disagree with the written hearing opinion, either party may appeal the decision to the full commission within thirty (30) days. To appeal, you must complete and submit a Request for Review.
6. If I am not happy with the determination, how do I appeal?
If you continue to disagree with the determination, an appeal may be made to the state Court of Appeals within thirty (30) days of the full commission's decision. All court rules and procedures will apply.