Generally, under the workers’ compensation system, employers must purchase insurance coverage that provides benefits to employees who suffer a workplace injury and/or illness. The purpose of the workers’ compensation system is to strike a compromise between employers and employees. Specifically, under the workers’ compensation system, employees can receive benefits regardless of who was at fault for the injury or illness. In exchange for workers’ compensation benefits provided to the employee, the employer is protected from the injured or sick worker filing a lawsuit in court for money damages. This is also true for the workers’ compensation system covering employees who work in Alexandria.

Workers’ Compensation Law

All workers’ compensation systems are governed by state law, which slightly differs in the details. Of note, federal workers are covered by a separate federal workers’ compensation system. That being said, the structure and operation of the workers’ comp system – whether state or federally governed – is similar from state to state. Generally, the main differences between the systems are the rates paid to injured or sick employees as well as the procedural rules that all parties (employers, employees, and insurance companies) must follow.

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What Benefits Can I Receive for Workers’ Comp in Virginia?

Like other systems, Alexandria’s workers’ comp law only covers work-related injuries or illnesses. The injury or illness suffered by the worker, however, does not necessarily have to occur at the workplace. Indeed, as long as the injury or illness is job-related, workers’ comp insurance should cover the incident. For instance, if the employee becomes sick or is injured while running a work-related errand, while traveling for business, or attending a business-related social function, the employee should be covered under workers’ compensation.

If you have been hurt on the job, you may be eligible for workers’ compensation benefits. Ashcraft & Gerel can help.

Injuries and illnesses that are covered can range from sudden accidents to injuries that happen over time to illnesses that result from exposure to hazards. Not all work-related issues are covered under the workers’ compensation system. Some examples of non-covered injuries or illnesses include those caused by or resulting from:

• Intoxication or drugs;
• Self-inflicted injuries;
• A fight started by the employee;
• Horseplay or a violation of company policy;
• An employee while committing a felony;
• An injury suffered off the job and not job-related; and
• An injury or illness that occurred after an employee was laid off or terminated by the company.

Benefits provided by Alexandria workers’ comp include loss of income, survivor/death benefits, and rehabilitation benefits. Also, it is important to know that independent contractors are not covered by the workers’ compensation system.

When Can I Sue My Employer for a Workplace Injury?

While workers’ comp is supposed to protect an employer from being sued, employers are not immune from all employee lawsuits related to injuries or illnesses. There are limited exceptions that allow an employee to sue an employer in court. Employees may also be able to sue third parties. Examples of this include when an employee gets into a car accident that is the fault of another or when an employee is hurt by a defective piece of equipment. In Virginia, a company that has three or more employees must have workers’ compensation insurance.

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Workers’ Comp Claim Denials

If you or someone you know has been injured at work or become ill due to your work environment and your workers’ compensation claim has been denied by your employer, there are many options available to you to help you receive the monetary compensation to which you are entitled. There are several reasons why your workers’ compensation claim may have been denied and a denial does not mean your claim is not legitimate.

You reported the injury or illness too late. While every state has its own deadlines for reporting a workers’ compensation claim, residents of Virginia have 30 days from the date the accident occurs or the date the worker learns they are suffering from a work-related injury or illness to report it to the employer. Failure to provide your employer proper notice of your claim could cause you to become ineligible for benefits. Once you’ve notified your employer, they have 10 days to report the claim to the Virginia Workers’ Compensation Commission (the “Commission”).

Your employer disputes your injury or illness is work-related. This basis for denial highlights the reason why it’s important to (1) properly document the incident and (2) report the incident to your employer right away. Even if your injury or illness keeps you from performing your job, if the cause was not work-related or can be excluded under the policy, your employer will likely dispute the claim.

It is also important to understand that you still must file a workers’ compensation claim directly with the Commission within two (2) years of the accident or knowledge of the illness. The workers’ compensation claim may be filed in person, by mail or fax, or by a web file account.

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Compensation for Injured or Sick Workers

Even if your workers’ comp claim is approved, that does not mean the insurance company will automatically pay you full compensation for all of your treatment. Workers’ comp benefits should, however, cover the full extent of expenses you incur in order to recover from your injury or illness. These benefits can include:

• Medications and prescriptions;
• Nursing services;
• Hospital visits;
• Surgery or medical procedures;
• Medical devices; and
• Loss of wages or wage reimbursement.

If your injuries or illnesses are so severe that you will require medical treatment for a prolonged amount of time – or, unfortunately, for the remainder of your life – you could qualify for workers’ comp benefits for life. This means the workers’ compensation insurance company will provide you with economic aid from your employer, either in the form of a monthly or lump sum payment.  

Reach Out to an Alexandria Workers’ Compensation Attorney

Once your Alexandria workers’ compensation claim has been denied, you should immediately contact a knowledgeable attorney. The Alexandria workers’ comp lawyers at Ashcraft & Gerel, LLP can help ensure you properly file all of the paperwork on time and provide the correct documentation to your employer and the Commission. Beyond initial filing, if your workers’ compensation claim is denied or settlement becomes difficult, these attorneys will fight for you in court.