The Law
The Virginia Workers’ Compensation Act is intended to compensate covered employees for injuries or diseases caused by their employment. 

Although originally intended as a simple remedy to replace the delay and expense of lawsuits over workplace injuries, the system has grown more complicated.

The injured employee faces a bewildering array of laws and procedures which may seem to make no sense.  Employers and insurance companies will generally have legal representation.  The injured worker is often unfamiliar with the system and procedures, and should get legal advice.

Workers' Compensation Benefits 
The benefits available to the injured employee include compensation payments for a percentage of lost income, medical benefits, and vocational rehabilitation benefits. 

In general, an employee must report an injury to the employer immediately, and at the latest within 30 days from the date of the accident.  If medical attention is required, the employer should offer a selection of at least three doctors from which the employee can choose a treating physician. 

Once a physician is selected, he or she provides all treatment, or refers the worker to any needed specialists.  If no panel of doctors is offered, the employee may select his or her own treating physician. 

Disputed Claims
The Workers’ Compensation Commission decides disputes between the employee and the insurance company, holding hearings to determine what benefits should be awarded when the employee and insurance company cannot agree. 

Employees need legal advice before going to a hearing, before entering into a settlement of the claim, and at any time that he or she does not fully understand what rights are available. 

The process is started when the injured employee files a written Claim for Benefits with the Virginia Workers' Compensation Commission in Richmond. If the claim is filed by mail, it should be sent certified mail, return receipt requested. Although the Commission prefers that their claim form be used, a letter stating the claimant's name, address, Social Security number, the date of injury, the nature of the injury, the name and address of the employer, and the nature of the relief being sought is sufficient. A claim may also be filed online using the Commission's website.

After the Workers' Compensation Commission receives the claim, it will notify the insurance company, and ask that the insurance company let them know within 20 days whether they will accept or deny the claim. If the claim is to be accepted, the insurance company will normally send agreement forms to the employee. If the claim is to be denied, the insurer should send to the employee a written explanation of the reasons why the claim is being denied. In the event of such a denial, the Workers' Compensation Commission will then refer the claim to its hearing docket, so that each side can present evidence in support of its position. Hearings are normally scheduled either in the city or county where the accident happened, or in an adjoining city or county.

At the hearing, in order to prove a claim for an injury by accident, the employee must be able to prove that there was a sudden, specific incident which caused the injury; that the incident occurred at a reasonably specific time; and that the accident caused the injury, meaning a structural or mechanical change in the body. For a claim of occupational disease, the employee must be able to prove a diagnosis of the disease by the treating physician, and that the disease was caused by exposure at work, and not by exposures outside of the employment.

The Workers’ Compensation Commission and the insurance company are not responsible for protecting the employee’s interests; that responsibility is solely that of the employee and his or her lawyer.  More information can be obtained from the website maintained by the Virginia Workers’ Compensation Commission at www.vwc.state.va.us.

Benefits Available
Available benefits for an injured employee include money benefits for loss of income, medical benefits, and vocational rehabilitation assistance. 

Money benefits are based on the employee's pre-injury average weekly wage, which is normally two-thirds of the gross pay over the 52 weeks leading up to the date of the accident.  Temporary total disability benefits, amounting to two-thirds of the pre-injury average weekly wage, are paid when the employee is completely unable to work in the opinion of the treating physician. 

If the employee is able to engage in light duty work, temporary partial disability benefits are paid, amounting to two-thirds of the difference between the pre-injury average weekly wage and what the employee can earn on light duty. 

If the employee suffers a permanent disability to an arm or a leg, or certain other listed parts of the body, additional compensation payments may be paid based on the severity of that disability.  These are called permanent partial disability benefits. 

Compensation payments are limited to a maximum of 500 weeks.  An employee may qualify for lifetime compensation payments, called permanent total disability benefits, where there is the loss, or loss of use of, two or more limbs; total paralysis; or such physical brain injury that the employee is unable to work.

Medical benefits are lifetime, and include all reasonable and necessary medical treatment resulting from the accident, including doctor, hospital, prescription medication, physical therapy, and other related treatments. 

The employee may be reimbursed mileage for travel to and from medical attention; the reimbursement rate for travel beginning October 1, 2006, is 44.5 cents per mile.  A cost of living allowance may be paid under some circumstances. 

If an employee is unable to return to the pre-injury employment, vocational rehabilitation services may be provided.  These usually involve job placement activities, but may also include retraining. 

Claim Deadline
The employee must file a claim for benefits with the Virginia Workers’ Compensation Commission, or have an award for compensation entered, within two years from the date of the accident. 

Failure to do so may result in loss of all workers’ compensation benefits.