What are the types of benefits an injured worker can receive (if his or her accident is compensable)?
There are many types of benefits that injured workers can receive. If you have any questions about benefits for which you may be eligible, call the Haig Law Firm today at (540)-777-1000 for a free and confidential consultation.
Wage Replacement Benefits
Temporary Total Disability Benefits: If an injured worker is unable to perform any work whatsoever, i.e. has a doctor’s note taking him or her out of work completely, then that injured worker is temporarily totally disabled and in an accepted claim can receive two-thirds of his or her gross average weekly wage (subject to state minimum and maximum weekly limits, which are updated yearly). An injured worker must be temporarily totally disabled for seven days before he or she can receive benefits; however, if the injured worker is temporarily totally disabled for more than three weeks, then he or she will receive payment for that initial seven-day period.
Temporary Partial Disability Benefits: If an injured worker cannot return to his or her pre-injury job but is able to work with some restrictions (as provided by a work note from the treating physician), then the injured worker is temporarily partially disabled. In such a case, the employer may be able to provide a light duty job that accommodates the restrictions provided by the treating physician. If the employer is able to accommodate those restrictions, then the employer may continue to pay the injured worker at his or her pre-injury average weekly wage, in which case the injured worker would not receive temporary partial disability benefits. However, if the employer pays the injured worker less than his or her pre-injury average weekly wage, then the employee can claim and potentially receive two-thirds of the difference between the pre-injury average weekly wage and the current weekly wage (again, subject to the state maximum and minimum limits). If an Award Order has not been entered for temporary partial disability benefits and an employer is unable to accommodate the injured worker’s work restrictions, then the injured worker similarly is required to conduct a light duty job search prior to entry of an Award of temporary partial disability benefits. This is true even if the injured worker has not been fired by the employer.
The Commission has developed a Marketing/Job Search Log with instructions and guidance about the duty to market residual work capacity in a workers’ compensation case, and this log can be found on the Commission’s website. Beware that the Virginia Employment Commission’s standard for what constitutes an adequate job search is not the same as the standard used by the Virginia Workers’ Compensation Commission. Remember, however, that such self-directed job search is required when there is no Award Order for wage loss compensation benefits for the current period of either total or partial incapacity.
Lifetime Medical Benefits
If the injured worker filed a claim within the required time period and the injured worker sustained a compensable injury, then the injured worker may be eligible to receive lifetime medical benefits. This means that a self-insured employer or an employer’s workers’ compensation insurance carrier would have to pay for authorized medical expenses for conditions caused by the compensable accident for as long as necessary. However, keep in mind that in Virginia an Award Order for medical benefits must be entered before an entitlement to such medical benefits arises.
Permanent Partial Disability
If an injured worker sustains a permanent loss of use of certain body parts (such as an arm, leg, finger, or eye) enumerated in the Virginia Workers’ Compensation Act, a permanent loss of vision or hearing, or permanent disfigurement (i.e. scarring) due to a compensable injury, then he or she may be eligible for permanent partial disability benefits once the injury has reached maximum medical improvement. As the law surrounding permanent partial disability benefits can be somewhat complex, you should consult with an experienced workers’ compensation attorney if you have questions about permanent partial disability benefits.
Permanent Total Disability
Benefits are available in cases of permanent and total incapacity. An injured worker may be eligible for lifetime wage loss compensation benefits if he or she has a permanent loss (or loss of use) of both hands, both arms, both feet, both legs, both eyes, or any two thereof in the same accident or is permanently unemployable in gainful employment due to an injury to the brain.
Death Benefits
A surviving spouse, children under 18, children under 23 enrolled full time in an accredited educational institution, parents in destitute circumstances, or other qualifying dependents may be entitled to receive wage loss benefits upon the death of their spouse, parent, or child. Death benefits also include funeral expenses and transportation costs (within certain dollar limits).
Cost of Living Adjustments
Individuals receiving temporary total disability benefits under an Award, permanent total disability benefits under an Award, or death benefits under and Award can request cost of living adjustments, which are payable if certain conditions are satisfied.
Vocational Rehabilitation
Injured workers who are released to light duty work by their treating physicians must cooperate with vocational rehabilitation efforts undertaken on their behalf. If an injured worker with light duty restrictions unjustifiably refuses vocational rehabilitation services or an offer of light duty employment, then an employer/claim administrator will likely move to have wage loss compensation benefits terminated. If you are participating in vocational rehabilitation activities in a workers’ compensation case, you should contact an attorney to discuss the potential pitfalls and traps that can await you in the vocational rehab phase of your claim.
