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Workers’ compensation benefits are medical expenses and a portion of your lost wages that your employer must cover if you suffer:
- An injury from a work accident
- An illness directly caused by your work, or an “occupational disease”
- The loss of a loved one due to a work-related injury or illness.
Most employers in our state are required under the Virginia Workers’ Compensation Act to buy workers’ compensation insurance. This insurance pays benefits to employees. The benefits can play an important role in helping an injured or ill worker to get needed medical care and to pay their living expenses while they are unable to work.
You should note a few important facts about workers’ compensation benefits:
- If your employer has workers’ compensation insurance, then workers’ compensation benefits are your “exclusive remedy.” In other words, you cannot sue your employer for a work-related injury or illness.
- Workers’ compensation benefits are available, regardless of who was at fault. So, even if your own negligence partially contributed to workplace accident, you could still be eligible to receive benefits. You would not be eligible for benefits, however, if your injury or illness resulted from your own “willful misconduct” such as working while intoxicated.
- If you have a dispute about workers’ compensation benefits with your employer (or its insurer), you can file a claim with the Virginia Workers’ Compensation Commission (WCC).
- Receiving workers’ compensation benefits does not prevent you from filing a personal injury or wrongful death claim against a negligent non-employer, or “third party.”
Additionally, you should know that workers’ compensation benefits come with a few important restrictions, including:
- If your employer provides you with a panel or list of three doctors, you must get medical treatment from one of those doctors. Any change in doctors must be approved by your employer or ordered by the WCC.
- If you receive lost-wage benefits, they will be capped at roughly two-thirds of what you were earning each week before your injury occurred and cannot exceed an amount set by statute. Also, unless you are deemed to be totally and permanently disabled, your benefits will stop at 500 weeks.
- If a doctor finds that you have a permanent loss of use of a body part because of your work-related injury, then you may be eligible to receive payment that is based on a permanent partial impairment rating.
If you file a personal injury claim against a third party or against an employer who does not have workers’ compensation insurance, the above restrictions would not apply to your case. Also, in a lawsuit, you could seek compensation for non-economic damages such as pain and suffering.
If you or a loved one suffers a work-related injury or illness, it is important to speak with a lawyer to learn about your right to receive workers’ compensation benefits as well as all other options that may be available to you.