When employees incur injuries during their working hours, get an occupational disease, or suffer an accident due to improper work conditions or their employer’s negligence, the latter is responsible for paying workers’ comp benefits. In Alexandria, Virginia, workers’ comp benefits may include:
- Lifetime Medical Benefits: Expenses related to the treatment of the injury or occupational disease, including payments for or reimbursements of already paid medical assistance, prescriptions, and transportation costs
- Wage Loss Replacement: Partial or full wage loss replacement in case of medically authorized Temporary Total Disability or Temporary Partial Disability
- Permanent Partial Disability: Compensates body part amputation or loss of use, vision or hearing loss, bodily scarring or disfigurement, lung disease, and more
- Permanent Total Disability: Replaces one’s lifetime wage after losing both arms, hands, legs, feet, eyes or any other two limbs in the same accident, or remaining disabled or paralyzed as a result of brain injury
- Death Benefits: They are payable in cases where the injuries lead to the death of the employer, having the surviving spouse, children, or other dependents as beneficiaries, and replacing wage loss and funeral costs
- Other: In certain cases, the employer may be responsible for mileage reimbursement, including total loss of wage and/or fatal benefits
Depending on the particularities of each case, in Alexandria, workers’ comp benefits may take the form of lifetime payments, regular payments for a set period, several fixed payments, or one single payment. In order to find out when their benefits end and make sure they receive the compensation they deserve, injured workers should discuss their case with an experienced Alexandria workers’ comp attorney.
That is because the obvious goal of the employer and their insurer is to end payments as soon as possible, even if this goes against the injured employee’s interests. Here are the main circumstances that may lead to the termination of one’s workers’ compensation benefits.
5 Reasons Why Alexandria Workers’ Comp Benefits May Be Terminated
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1. The Beneficiary Reaches the Maximum Medical Improvement
In some cases, full recovery is impossible. When the patients reach the maximum medical improvement possible in their case, they have to undergo a permanent impairment evaluation according to the AMA Guides. The evaluating doctor will assign a permanency rating to the evaluated patient. This rating will serve as a basis for the calculation of the permanent partial disability benefits the patient is to receive.
When your workers’ comp benefits are terminated, you may be left footing the bill for your expenses. Ashcraft & Gerel can help.
An Alexandria VA workers’ compensation attorney can be of great help at this stage, taking over the bureaucracy and overseeing the relationship with the doctor and the evaluation. As an attorney may explain, one cannot receive both permanent partial disability benefits and temporary total disability benefits.
Usually, the permanent partial disability benefits mark the closing of the workers’ compensation case. Should the injured employee’s condition worsen, one can request the Workers’ Compensation Commission to re-open one’s case within one year. After that, the case is officially closed.
2. The VA Workers’ Compensation Commission Denies the Employee Further Medical Treatment or Benefits
Sometimes, the injury occurs due to one’s work conditions but aggravates due to pre-existing conditions. In the preliminary phase, the employer may agree to pay for one’s medical treatment and lost wages. When the employer realizes that expensive long-term treatments are necessary and that the work injury alone could not have caused such health problems, they may refuse to authorize further medical treatments.
The employee usually has to submit an application for condition change and treatment payment authorization. The employer or insurer can dispute this claim, and allow the Commission to decide whether the aggravation is due to the work injury or to some pre-existing condition. If the Commission rules in favor of the employer and insurer, the worker’s compensation case is closed. The employee can appeal the decision with the help of an Alexandria workers’ comp lawyer.
3. The Employee Has Received Wage Loss Benefits for 500 Weeks
The General Assembly limits the period during which one can receive workers’ compensation benefits in Alexandria for 500 weeks unless one meets the requirements for permanent and total disability. These requirements are complex and difficult to meet, so most applicants choose to enlist the services of an Alexandria workers’ comp attorney.
Employees who have received wage loss benefits for 500 weeks and do not qualify for permanent and total disability will continue to benefit from lifetime medical benefits related to their work injuries, but their case will be practically closed when it comes to compensations for lost wages and permanent partial disability.
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4. The Employee Accepts a Full and Final Settlement
Sometimes, Virginia workers’ comp benefits make the object of a full and final settlement between the parties, where the injured employee receives a lump sum in exchange for giving up one’s right to additional benefits. The settlement marks the closing of the case, so employees should consult an Alexandria workers’ comp attorney before accepting any settlement offers.
5. The Employee Dies from Causes Unrelated to the Work Injuries or Occupational Disease
If the employee’s death has nothing to do with the workers’ compensation case, the dependents do not receive death benefits, and the case closes automatically.
Consult with an Alexandria Workers’ Comp Lawyer Today
To avoid paying workers’ comp benefits, Alexandria, VA insurers will do everything in their power to close cases as soon as possible. If you are worried your employer may terminate your benefits, the best solution is to consult an experienced Alexandria workers’ comp attorney. At Ashcraft & Gerel, we’ll gladly review your case and help you find the best strategy for your case. Contact us now and let us protect your interests!