Virginia's system of workers' compensation is compulsory, meaning that employers are required to provide workers' compensation insurance to their employees. Workers' compensation insurance may be provided through private insurance carriers or self-insurance. Waivers may be permitted to exclude certain employees from coverage, including corporate officers.
Exemptions from coverage may apply to certain employees, including most agricultural workers, domestic employees employed by a private household, certain real estate agents and brokers, taxi drivers, and casual labor.
Medical Benefits are provided to employees entitled to workers' compensation benefits, including coverage for reasonable and necessary medical care.
Following an initial emergency room or office visit at the start of the claim, the employee may choose an initial treating physician from a network of providers established by the workers' compensation agency. The employee may subsequently change physicians with the consent of the employer or workers' compensation insurer, or if ordered by the workers' compensation agency. Employees may obtain unlimited independent medical examinations (IMEs) at their own expense. Employers are normally limited to one IME per year.
Indemnity benefits are payable to injured workers to help make up for lost income. There is a waiting period of 7 days before a worker is eligible for indemnity benefits, but if the worker's disability lasts more than three weeks indemnity benefits become retroactive to the date of the injury.
Benefits available to injured workers include the following:
Temporary Total Disability (TTD)
Temporary total disability (TTD) benefits are paid to workers who are unable to work due to injury, but who are expected to make full or partial recovery such that they may return to work. Benefits are based upon 2/3 of the injured worker's pre-injury wage, subject to a cap, and continue for up to 500 weeks.
Permanent Total Disability (PTD)
When a worker is not expected to recover from a total disability caused by a work-related injury, and as a result suffers a total loss of earning capacity, the worker becomes eligible for permanent total disability (PTD) benefits. In Virginia PTD benefits are calculated based upon 2/3 of the injured worker's pre-injury wage, subject to a cap. Benefits are periodically adjusted for inflation, and may continue indefinitely.
Permanent Partial Disability (PPD)
Once an injured worker has recovered to the maximum possible extent, the worker may be able to return to employment but nonetheless remain partially disabled, and may potentially qualify for permanent partial disability (PPD) benefits. In Virginia PPD benefits are determined based on a statutory schedule and an assessment of the injured worker's impairment, 2/3 of the injured worker's average weekly wage, subject to a cap.
Temporary Partial Disability (TPD)
When a worker suffers an injury that limits his ability to return to work, resulting in a reduction of income as a result of reduced hours or wages, the injured worker may be eligible to receive a benefit based on the difference between the worker's pre-injury earnings and their reduced, post-injury earnings. In Virginia, TPD benefits are paid based upon 2/3 of the difference between the injured worker's pre-injury and post-injury wage, subject to a cap. Benefits are payable for up to 500 weeks, with that limit calculated in combination with other indemnity benefits received by the injured worker.
For some, more serious injuries, workers' compensation indemnity benefits may be paid according to a statutory schedule, instead of following the standard model of the weekly benefit based on the duration of the disability. Scheduled injuries include such injuries as the amputation of an arm, the loss of a dominant hand, the loss of a leg, the loss of a foot, the loss of an eye, or loss of hearing in an ear.
Coverage may be available for cumulative trauma, disfigurement, mental stress and occupational hearing loss.
When a worker dies as the result of a work-related injury, workers' compensation pays additional benefits, including a burial allowance, reasonable transportation expenses for the deceased, and benefits for a surviving spouse and dependents. Survivor benefits are calculated based on 2/3 of the worker's average weekly wage, subject to a cap in amount and duration. Benefits may continue for minors until the age of 18, the age of 23 if the dependent is a student, or indefinitely in the event of disability, subject to the cap. Spousal benefits end upon remarriage.
Attorney fees are determined by the workers' compensation commission on a case-by-case basis.
This article provides a quick overview of the benefits available to injured workers, but the full formulas used for assessment of benefits, coordination of different types of benefits, and assessment of injuries and disability ratings can quickly complicate the determination of benefits. Also, states frequently revise their workers' compensation laws. Most workers who suffer a significant injury or wage loss as the result of a workplace injury will benefit from consulting a workers' compensation lawyer.
The state agency responsible for workers' compensation is:
Virginia Workers' Compensation Commission
1000 DMV Drive
Richmond, VA 23220