Filing a Virginia Workers Compensation Claim for Benefits
What is a Workers Compensation Claim?
You’re probably reading this article because you’re not a workers compensation expert. We get it. Corey Pollard is an experienced workers compensation attorney. So we’ll start from the beginning by explaining what is a workers compensation claim in Virginia.
Let’s break it down: A workers compensation claim is a claim against an insurance policy that every employer in Virginia who regularly employs 3 or more workers must carry. It doesn’t matter what caused your work accident: an unavoidable accident, a third party acting negligently, your own negligence, or a co-worker’s mistake. A workers compensation claim is an insurance claim seeking benefits for a work injury or occupational disease.
Filing a workers comp case is not the same as suing your employer. In fact you cannot sue your employer for a job injury or occupational illness, except in rare circumstances. This is why the Virginia General Assembly requires almost all employers to purchase workers compensation insurance.
Workers comp helps injured workers in that it provides benefits even if the accident was your fault. It helps employers by allowing them to avoid large jury verdicts that could cripple their business and force them to file for bankruptcy or close.
Workers compensation insurance pays two types of benefits in most cases:
- Medical benefits – you’ll receive medical treatment for the work injuries caused or exacerbated your accident; and,
- Indemnity benefits – these are cash payments for lost wages, permanent disability, and possibly a lump sum settlement to resolve your workers comp claim.
You should file a workers compensation claim against your employer’s insurance policy if you are hurt on the job. It doesn’t matter what type of accident (slip and fall, car accident, electrocution, etc.) or occupational disease (heart disease, lung disease, cancer, carpal tunnel syndrome, etc.), you should still file a workers compensation claim in Virginia.
What Information and Documents Should I Include with My Workers Compensation Claim?
There are specific steps you must follow to file a Virginia workers compensation claim. Failure to follow these steps can keep you from getting the benefits, medical care, and settlement you deserve.
The Virginia Workers’ Compensation Commission’s Rules require you to put your claim for benefits in writing and to sign your name. Your workers comp claim should include the following:
- Your name, address, and telephone number.
- Your employer’s name, address, and telephone number.
- The date of your work-related accident.
- A brief description of the accident. Do not make this too detailed. If you were injured in a car wreck, write “motor vehicle accident.” If you slipped on liquid and fell, write “slip and fall.”
- If you are claiming an occupational disease, and not an injury, write the date a doctor told you the occupational disease is related to your employment.
- All body parts injured. Do not leave any out. Err on the side of listing too many and being too specific. If you leave out a body part and your claim is litigated or you do not file a supplemental claim for workers comp, then you may waive a claim for that body part.
- Your pre-injury average weekly wage.
The Virginia Workers’ Compensation Commission provides a Claim for Benefits form. The form has two sections: Part A and Part B. Part A asks for the information discussed above. Part B asks you to specify which benefits you are seeking.
Even if you are not seeking benefits at this time, we recommend completing Part A of the Claim for Benefits. Why? Because you protect your legal rights to benefits when you complete and file Part A of the Virginia work comp claim form within the applicable statute of limitations. This is what’s known as an Assertion of Rights.
You do not have to use the commission’s Claim for Benefits form. If you write, sign, and file with the commission a letter that contains the details discussed above, the commission will consider that a valid workers’ comp claim.
What Documents Should I File with My Virginia Workman’s Comp Claim?
You do not have to file additional documents such as medical records with your workman’s comp claim. But you should.
The commission will not schedule your claim for a hearing before a deputy commissioner until you file medical evidence to support your claim. By not filing medical records with your claim, you are delaying the process. Delay helps the insurance company, not the injured employee.
There is another reason to include medical records and reports with your claim for Virginia work comp. It lets the insurance company know you are serious about protecting your rights. Though we understand you want to file your claim as soon as possible, it often makes more sense to wait until you get medical records and an opinion statement from your authorized treating physician.
Also, not filing medical records and reports with your work injury claim may lead to the employer filing a motion to dismiss your claim. Rule 1.3 of the Rules of the Virginia Workers’ Compensation Commission is titled “Dismissal Upon Failure to File Supporting Evidence.” Under the rule your claim may be dismissed if you do not file supporting evidence within 90 days after your claim for benefits is filed. So the clock starts ticking when you file a claim.
How Do I File a Claim for Workers Compensation Benefits in VA?
You have several options to file a claim for benefits with the Workers’ Compensation Commission in Virginia.
You can file your claim electronically using the commission’s WebFile system. Before filing electronically you should register for a WebFile account.
WebFile is the commission’s electronic portal. It came on line in 2010 when the commission began transitioning to a paperless system. Injured employees, attorneys, and claims administrators can access their case files through WebFile.
WebFile allows users to do a number of things. You can:
- File claims for benefits, change in condition applications, motions, and other pleadings
- File medical records, reports, and questionnaires
- File discovery answers and job search efforts
- View all documents that have been filed in your case, either by you, the insurance company, or the Commission
WebFile contains a number of other features. It has many “web forms” available, which it pre-populates with information about your claim. So if you want to file a change in condition application, you do not have to re-enter the caption of your case, file number, date of injury, or contact information for you or the employer.
You can view or file documents through WebFile around the clock. It is available 24 hours per day, 365 days per year, as long as it not going through a technical upgrade. So long as you file the document by midnight, it will be considered as filed on that day. You do not have to worry about going to the post office.
We recommend that all of our clients ask the commission for access to WebFile. We want you to follow along and stay informed on how your case is progressing as we battle for your benefits. Not only can an injured employee view all Virginia workers compensation claims for benefits filed, they can also see documents filed by the insurer and entered by the commission.
You can also file your claim for Virginia workers compensation by mail or in-person. The commission is headquartered at 1000 DMV Drive, Richmond, VA 23220. Or you can fax the claim for benefits form to (804) 367-6124. We recommend avoiding fax. If you cannot file your claim in person, then send it by certified mail return receipt requested.
Another option is to have your workers compensation lawyer file the initial claim for benefits and all other change in condition applications. We take care of all the paperwork when you hire us to help you with your work accident claim.
What Happens When I File a Workers Compensation Claim?
When you file a claim the commission gains jurisdiction over your case. Your claim puts into motion a series of events to determine whether you suffered an injury by accident or occupational illness that arose out of and in the course of your employment and what benefits you’re entitled to.
If you requested a hearing to determine your entitlement to temporary total disability, permanent partial disability, temporary partial disability, permanent total disability, or lifetime medical benefits then your claim will be referred to the hearing docket and scheduled for trial.
Filing a Virginia workers compensation claim does two other things as well.
It stays debt collection activities by medical providers for treatment related to your accident until the case is resolved. So if you get calls or letters from debt collection agencies because of unpaid medical bills, make sure you let your attorney and the commission know so that they can take action.
Second, filing a claim prevents medical providers from balance billing you for supplies and services related to the work accident.
Answers to Common Questions about Filing Virginia Workers Compensation Claims
Do I need my employer’s permission to file a claim in Virginia?
No. You do not need your employer’s permission to file for workers’ comp. If your employer is giving you a hard time about reporting a work-related accident, make sure you document your efforts to get the necessary information. And make sure you report and give notice of your accident!
Unfortunately it is common for employers to pressure injured employees not to file for work comp. Many companies have safety incentive programs that reward employees for consecutive days without injury. Or they may not want to have to deal with more paperwork. This puts internal peer pressure on the injured worker to not file. It does not, however, help out the injured worker when he or she needs medical care and payment for lost wages. Ignore the peer pressure.
Most employers will go the extra mile to help their injured employees get the benefits they need. But some will ignore your request for work comp information. Remember to do what is necessary to protect yourself. We recommend contacting a Virginia workers compensation lawyer to protect your legal rights.
Will my employer fire me if I file for workers comp?
We cannot predict what your employer will do. But if they fire you because you filed a claim then they are breaking the law. It is illegal for your employer to retaliate against you because you filed a workers’ compensation claim or testified as a witness at a workers’ compensation hearing.
Even though it is illegal to retaliate against you, your employer may try to pressure you into not filing a claim and using your private health insurance after a work injury. Some employers are direct and in your face about it. They may ask you to not file a claim.
Other employers are more subtle and will start to suggest they won’t have any work available for you if do not get released to full duty soon. Don’t give in to the pressure. You and your employer do not have the same interests. You must look out for your best interests!
I think my injury is minor. Why should I file a VA workers comp claim for benefits?
We see it time and time again. An employee gets hurt on the job and thinks he or she suffered a minor injury. Unfortunately the minor injury leads to major problems a few weeks or months later.
Or maybe the employer and insurer do not take the work-related injury seriously. What would ordinarily be a small, medical only claim with no time lost from work turns into a claim for long periods of lost time because the insurer did not provide adequate medical care to the injured employee – or stops providing medical care when there is a referral to a specialist.. This is exactly how minor work injuries turn into big workers comp claims. So file a claim to protect yourself.
Why file a Virginia workers’ compensation claim if my employer is paying for my medical treatment?
Paying for treatment or wage loss voluntarily does not mean the insurance company and your employer are accepting your claim. We see it happen often – the insurance company pays for medical treatment and sends temporary total disability benefits for a few weeks or months, then decides to deny the claim and stops making payments. By filing a claim for benefits you can reduce the delay while your claim is litigated. Don’t be lulled into a false sense of security.
Call an Attorney Before You File a Claim for Virginia Workers Compensation
Call, text, or e-mail us if you have a question following your work-related accident. It can be anything from, “How do I file for workers compensation in Virginia?” to “What doctor should I see?” We help injured workers obtain top-dollar Virginia workers compensation settlements across the state. And we want to help you get the benefits you deserve!