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Frequently Asked Questions

Workers' Compensation Questions and Answers

An injury at work does not always result in a case in Virginia. An injury has to be caused by work. For example, if an employee falls down the stairs and there is nothing wrong with the stairs and there is no risk of the work that caused the employee to fall, then there is no worker’s compensation claim. Also, breaking a safety rule can sometimes mean that the employee’s claim will not succeed.

This is a complicated question. I am happy to talk with you about this free of charge. The answer depends on many different factors. Sometimes the insurance company will want a recorded statement and try to frame the questions to make the injury not work related. Other times a claim can go very well in the beginning but issues develop later that a lawyer can help with. In some cases, the insurance company will not help getting an Award entered and the employee can lose all benefits after two years.

You may have both a workers’ compensation claim and a personal injury case. It is important to remember that you cannot settle the personal injury case without permission of the workers’ compensation insurance or you will lose your workers’ compensation benefits. You also have to pay back from the car accident recovery to the workers’ compensation insurance carrier what it has paid in wage and medical benefits. These issues are why having a lawyer that does both types of claims can be very helpful.

A nurse case manager is hired by the insurance company to help it, not you. Sometimes they are genuinely concerned for your health but not very often. The nurse case manager helps the insurance company get medical records and bills but will often try and schedule appointments for you and tell you where to get certain treatments. They often try and influence the doctor in ways that are not helpful to you.

All the law requires is that the nurse case manager be given copies of records and bills. Doctors do not have to meet with them. They do not have to be involved in your appointments with the doctor.

Is my average weekly wage calculated correctly? This depends on raises, overtime, food and travel allowances, and other “payroll” factors.

Mileage? The insurance company has to pay for mileage to and from healthcare providers.

Often an insurance company will pay benefits when no Award Order has been entered by the Virginia Workers’ Compensation Commission. The Award Order is extremely important. Without it you can lose all benefits after two years and you can be forced to look for work on your own when you are released to light duty.

If your wage loss payment is more than two weeks overdue, you may be owed a 20% penalty on all amounts overdue.

Download and use these PDF forms from the Virginia Workers’ Compensation Commission to help get started.

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Matt O’Herron has been litigating personal injury cases his entire career. For the first couple of years, he represented defendants and insurance companies. For the last 18 years, he has been representing the injured.

Having a lawyer with experience in both workers compensation claims and personal injury claims can be important because there are issues that impact each case. For example, it is malpractice for a lawyer to settle a personal injury case without the permission of the workers compensation insurance company. Also, a workers compensation insurance company is legally entitled to get some of its money paid back from a personal injury settlement.

For a free consultation, call our Roanoke office at (540) 345-5700.

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