Electronic Data Interchange (EDI): “The method used to exchange data electronically between the Commission and those organizations submitting claim reports to the Commission.” Employee: “Every person, including aliens and minors, in the service of another under any contract of hire or apprenticeship, written or implied, where lawfully or unlawfully employed.” Smaller employers, with three …
Denied Claim: When the Insurance Carrier or Claims Administrator disputes that the worker’s injuries or occupational disease were work-related. Injured workers have the right to contest the denial and request a hearing in writing by use of the Claim for Benefits form. By filling out part ‘B’ of the form, you are requesting your benefits. …
Date of Injury: This is the date the worker was injured at work or diagnosed with an occupational disease. Claims for benefits must usually be filed within two years from the date of the injury. Some exceptions, which your Virginia worker’s compensation lawyer should know, may apply. Date of Accident: See Date of Injury. …
Compensable Claim: When the Claims Administrator and/or Insurance Carrier agrees – or the Commission finds the injury or occupational disease was indeed work related and thus covered by the Virginia Workers’ Compensation Act. Compensation Rate: “The weekly amount of compensation to which the injured worker is entitled by an award from the Commission:” In …
Claim Administrator: This is the organization that administers the workers’ compensation claims. This can include paying the worker and scheduling the medical appointments. The Claim Administrator can be a “self-administered insurance carrier, self-administered self-insured employer, or a third party administrator hired by an insurance company or self-insured employer to handle their workers’ compensation claims.” …
Cease and Desist – The Virginia Commission may “order an employer to Cease and desist all business transactions and operations in Virginia upon a finding that the employer failed to insure when required by the Act.” Change in Condition: Often, a worker’s physical status will change with time. Sometimes his/her physical or mental condition …
Benefits Covered under the Act: Injured workers may be entitled to some of the following benefits if the appropriate facts apply: Lifetime medical benefits Permanent partial impairment benefits Total disability benefits Partial Disability benefits Death benefits Cost of living increases Vocational rehabilitation Mileage reimbusement Burden of Proof: “The legal requirement of a party …
Attending Physician’s Report: A form completed by the attending physician that describes the nature and extent of an injury. The use of this form is optional. Average Weekly Wage (AWW): The earnings of the injured worker in the employment in which he/she was working at the time of the injury. This is usually calculated …
Alternative Dispute Resolution: This is a way for the worker and employer to try to reach an understanding without a formal hearing. It is also called a mediation. It is a confidential and voluntary process. A neutral person, a mediator, helps the parties try to identify the issues, clarify misunderstandings and work towards solutions. Either …
The Virginia Worker’s Compensation Commission has a glossary of relevant terms. The definitions are not legal advice. They are just guides. For precise definitions, it is best to consult with an experienced Virginia work injury lawyer. 20-day Order Claim Filed: After an injured worker makes a request for benefits, an official court document orders …
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If you are looking at this site, you or a loved one has probably been hurt. If that's true, you've come to the right place. Helping people who have been hurt is what we do. In fact, it is all we do. Joe Miller Law is a law firm concentrating exclusively on representing people who are injured by the carelessness of others or those hurt on the job. We provide the highest quality legal services to people who have been seriously injured. We practice Personal Injury law and Workmens' Compensation law in both Virginia and North Carolina.
