There are many traps in Virginia Workers' Compensation.
Reading this brochure is not a substitute for contacting an experienced Workers' Compensation Attorney.
WHAT YOU NEED TO DO WHEN YOU SUFFER ANY INJURY AT WORK?
1. Notify your employer of the injury and fill out any forms.
NOTE: Insurance companies often deny claims if accidents are not reported right away.
2. Request a panel of three (3) doctors.
NOTE: The law requires the employer to furnish you a panel of three (3) doctors but if you don't ask for this within 30 days you can lose this right. You should call an attorney before you pick your doctor.
3. Talk to an attorney before giving a recorded statement.
NOTE: The reason why the insurer is taking a recorded statement is because they are looking for any possible reason to deny your claim. The adjuster will try to trap you so talk to an experienced Workers' Compensation attorney first or it may be too late. Anything you say on the recorded statement can and will be used against you if the insurer decides to contest your case.
WHAT IS A WORKERS' COMPENSATION ACCIDENT?
1. A workers' compensation accident is an injury at work caused by a "specific incident."
NOTE: A common defense to a workers' compensation claim is that the worker cannot identify the accident (For example, a worker lifts I 00 boxes and has a back injury, but does not know which box caused his injury.)
2. An injury that occurs while the worker is violating a safety rule may not be compensable.
NOTE: The insurer will take a recorded statement to find out if any safety rules were violated.
3. An injury that arises out of drunkenness or drugs may not be compensable.
NOTE: This is why employers will require alcohol and drug tests after an injury.
4. Injuries when the worker has a pre-existing condition may not be compensable.
NOTE: This is another reason why the claims adjuster I will take a recorded statement.
WHAT BENEFITS AM I ENTITLED TO WHEN I AM INJURED?
1. Compensation at two thirds of your average gross wages for up to 500 weeks.
NOTE: Insurance companies often make mistakes on this such as failing to include overtime.
2. Lifetime medical benefits.
NOTE: Insurance companies will refuse to pay if the treatment is not medically necessary and is not with an authorized doctor.
3. Compensation for the permanent loss of use of an arm, leg, hand, finger, etc.
NOTE: Insurance companies will often try to send you to doctors who give low ratings.
4. Annual cost of living adjustments. On October 1, 2006 the annual cost of living increase was 3.45%.
NOTE: You must request this.
5. Mileage to and from doctors at the rate of 32.5 cents a mile. However, on October 1, 2006 the mileage reimbursement rate was raised to 44.5 cents a mile. NOTE: You must request this.
6. Vocational Rehabilitation.
NOTE: Whereas most workers hope this means retraining most insurers look on it as simple job placement at dead end jobs.
WHAT IS A CLAIM AND WHEN MUST IT BE FILED?
1. The worker is required to file a written claim with the workers compensation commission for his injury.
NOTE: This may not be necessary if the insurer agrees to pay the claim, agrees to provide the necessary papers to document this claim, and files them.
NOTE: If the insurer fails to file, it is still the worker's responsibility to file the claim.
2. In the case of an injury, the claim must be filed with the Virginia Workers Compensation Commission within two (2) years of the date of the accident.
NOTE: Even if the claim has been accepted by the insurer the worker should still check to make sure the forms have been filed with the Commission and the worker must be careful "all injuries" are listed.
3. In the case of a disease, the claim must be filed within two (2) years of the date of diagnosis.
NOTE: This is an area that can be confusing and an experienced Workers' Compensation attorney needs to be consulted.
4. Claims are filed with the Virginia Workers' Compensation Commission at 1000 DMV Drive, Richmond, VA 23230 or call (804) 367-8600.
NOTE: A letter can suffice as a claim but it is best to use the claim form.
WHAT IF I CAN DO LIGHT DUTY WORK?
1. If your treating doctor releases you for light duty work, you may still be eligible for compensation if your employer does not provide light duty work.
NOTE: You may have a duty to look for light duty work on your own. You should consult an attorney about this.
2. If the light duty work pays less, then you may be eligible for compensation due to the difference between the 2 salaries.
NOTE: You may need to consult an attorney about this.
WHAT IF I REFUSED A LIGHT DUTY JOB OR IF I WAS FIRED FROM A LIGHT DUTY JOB?
1. Refusal of a light duty job can result in a suspension of benefits.
NOTE: A worker only has six (6) months to cure a refusal of a light duty job.
2. If the worker is fired for misconduct from a light duty job, then this can mean a permanent loss of compensation.
NOTE: It is essential for a worker to consult an attorney about this type of situation.
IF I HAVE A DISPUTE WITH THE INSURER AND IT GOES TO THE COMMISSION FOR A HEARING DO I NEED AN ATTORNEY?
1. The insurance company will be represented by an attorney so you will be at a great disadvantage if you try to represent yourself, and the hearing will be before a Commissioner and he will have to follow Rules of Evidence which can be technical.
2. The hearing is your only chance to present evidence; therefore, you should never take the of going to the hearing without an experienced Workers' Compensation attorney.
WHAT IF THE INSURER WANTS TO SETTLE MY CLAIM?
1. A settlement of a workers' compensation claim usually means a LOSS of all future rights; therefore, a worker should be very careful about settling a workers' compensation claim.
NOTE: Workers rarely know the true value of their claim and therefore they should never settle a claim without seeing an experienced Workers' Compensation attorney.
2. Settlement of a workers' compensation claim can have an adverse effect on other benefit claims such as Social Security.
NOTE: Gerald G. Lutkenhaus is experienced in both workers' compensation and social security disability. He can properly advise you about this matter.
WHAT IS THE ROLE OF THE REHAB NURSE AND/OR REHAB WORKER?
1. The insurer will often assign a medical nurse to insure that the worker receives his/her medical care to ensure you return quickly to work.
2. The insurer will assign a rehabilitation worker to ensure that the worker returns quickly to some form of light duty work.
3. If the worker has not been released to any form of light duty work, the rehab worker will often attempt to obtain a light duty release from the doctor in order to start job placement.
NOTE: You do have the right to have private treatment from your doctor & you need not allow the rehab worker to be present.
NOTE: But you should demand to be present when the rehab worker talks to your doctor.
4. Your failure to cooperate with the medical nurse or the rehab workers can result in a suspension of compensation.
NOTE: If this happens, call an experienced Workers' Compensation attorney.
5. If the rehab worker finds a light duty job for you, the general rule is you must accept the light duty job.
NOTE: If you do not like the job (due to the hours, type of job, commuting distance, etc.) call an experienced Workers' Compensation attorney.
WHY SHOULD I CHOOSE THE LAW FIRM OF GERALD G. LUTKENHAUS?
1. Gerald G. Lutkenhaus has over 30 years experience representing injured workers.
2. The July 1999 issue of Richmond Magazine in a survey of 2,000 attorneys recognized Gerald G. Lutkenhaus as one of the "Best Attorneys Doing Workers Comp" in Virginia.
3. Gerald G. Lutkenhaus is a member of the Virginia Trial Lawyers Committee on Workers Compensation, and has lectured on workers' compensation topics before many groups.
4. Gerald G. Lutkenhaus was awarded an "AV"rating by Martindale-Hubell in 2003, its highest rating for attorneys.
5. In 2005 he was invited to be in the Bar Register of Preeminent Lawyers as a result of his "AV" rating.
