Workers’ Compensation Benefits
Workers’ compensation covers seven categories of benefits. Your employer must pay you for each category that applies to your specific situation. Here is a brief explanation of the seven categories:
1. Wage Replacement: You are entitled to 2/3 of your gross average weekly wage, up to 500 weeks, but not including the first seven days you are injured unless the disability lasts more than 3 weeks.
2. Lifetime Medical Benefits: As long as you file a claim within the time limit, your employer must pay your medical expenses from covered conditions for as long as necessary.
3. Permanent Partial Impairment: If you have lost the use of a body part such as an arm, you are entitled to benefits based on the percentage of loss, even if you are working, as long as you have reached maximum medical improvement. Unfortunately, back, neck, and whole body impairment is not included.
4. Permanent and Total Disability: If you have lost your hands, arms, feet, legs, eyes, or any two in the same accident, or if you were paralyzed or disabled from a severe brain injury, you are entitled to lifetime wage benefits.
5. Death Benefits: Some family members, such as a surviving spouse or minor child, may be entitled to benefits for lost wages when their loved one has died on the job. They may also be entitled to up to $10,000 in funeral expenses and up to $1,000 in transportation costs.
6. Cost of Living Increase: If you are receiving temporary total, permanent total, or death benefits, you can request this benefit each October if the combination of workers’ compensation and Social Security benefits is less than 80% of pre-injury earnings.
7. Vocational Rehabilitation: If you are well enough for a light duty job and are actively looking for one, even if you expect to return to your regular job, you may be entitled to retraining at no expense to you.
If I’m Receiving Workers’ Compensation Benefits, Can I Ever Lose Those Benefits?
Yes, you can lose your benefits, or even have your benefits terminated. The Virginia Workers’ Compensation Commission may suspend or terminate your benefits if you:
- Refuse to cooperate with vocational rehabilitation
- Refuse “reasonable” medical treatment
- Go back to full duty work
- Become incarcerated
- Collect 500 weeks of disability payments
- Receive a lump sum settlement
Workers’ Compensation Commission Hearing
First, you did the right thing by requesting a hearing. Generally, your hearing will be held in the city or county where the accident occurred, within 6-8 weeks of your request. A Deputy Commissioner will make the initial decision at this hearing, usually through a written opinion issued several weeks after the hearing.
There are two types of initial hearings: evidentiary and on-the-record. At an evidentiary hearing, you and your witnesses testify under oath about your accident or disease. You also submit evidence to support your claim for benefits. An evidentiary hearing is formal, like a court hearing. Sometimes the Commission will determine an evidentiary hearing is not necessary. In this case, you have an on-the-record hearing. Instead of appearing in person, you submit written statements and documents for the deputy commissioner to review. On-the-record hearings usually have quicker results than evidentiary hearings.
If you or your employer disagrees with the deputy commissioner’s decision, you both have the right to appeal the decision within 30 days to the Full Commission. You may be asked to submit written statements that it reviews along with the documents and statements submitted to the deputy commissioner. Sometimes the Commission will require oral arguments before making a decision. In either case, the Commission will review all the evidence and issue an opinion.
If the Full Commission decides against you, you still have two more appeals for review (and so does your employer) with the Court of Appeals of Virginia and the Supreme Court of Virginia. Few cases are appealed to this level, but it does happen.
Having an attorney represent you for your hearing can be extremely beneficial. An experienced workers’ compensation attorney can help you gather the documents you need and make sure you are prepared for each step in the process. If you have filed for a hearing and are unsure what to do next, we encourage you to contact us for a free consultation.