Suffering a workplace injury can be overwhelming, especially when medical bills and lost wages start adding up. Fortunately, Virginia’s workers’ compensation system provides benefits to help injured employees recover and stay financially stable.
However, the claims process can be complicated, and missing key steps or deadlines may result in delays or denials. From reporting an injury to appealing a denied claim, each stage plays a crucial role in determining whether an injured worker receives the benefits they need.
Steps in the workers’ comp claims process
Filing for workers’ compensation in Virginia involves several important steps. Understanding the process can help injured workers avoid mistakes that could impact their claim. Below is a breakdown of the key stages:
- Reporting the injury: The injured worker must notify their employer as soon as possible, preferably in writing, within 30 days of the accident. Failing to report on time may affect eligibility for benefits.
- Seeking medical treatment: The employer should provide a list of approved physicians. The worker must choose a doctor from this list and follow their prescribed treatment plan.
- Filing a claim with the Virginia Workers’ Compensation Commission (VWCC): A formal claim must be submitted to the VWCC within two years of the injury. This can be done online, by mail or in person.
- Employer’s response: The employer and their insurance carrier will review the claim and decide whether to accept or deny it. They may request additional information or medical evaluations.
- Receiving benefits: If approved, the worker may receive wage replacement benefits, medical treatment coverage and compensation for permanent disabilities. Payments typically begin after a waiting period.
- Dispute resolution: If the claim is denied or disputed, the worker can request a hearing before the VWCC. Evidence, medical records and witness testimony may be presented to support the claim.
- Appealing a decision: If the VWCC rules against the worker, they can file an appeal for further review. This may involve additional hearings or legal proceedings.
Navigating a workers’ compensation claim can be complex, especially when disputes arise. Seeking legal guidance can help injured workers understand their rights and improve their chances of securing the benefits they deserve.
