Anyone injured in a workplace accident or who becomes ill due to an occupational illness has the right to request that the employer pay workers’ compensation benefits. There is no requirement that the employee prove fault. Injured workers must report their injury to their employer or a supervisor.
Once the injury is reported (sometimes after emergency medical care is obtained), the worker can seek medical help. Virginia and North Carolina workers’ compensation will normally pay for all your medical bills.
Worker’s compensation should pay all your medical bills to get better and to stay better. That includes:
- The cost of emergency room care, ambulances, and other care you need immediately after an accident
- Any surgeries that are require and the cost of any hospital stay
- Checkups with your authorized treating physician and the work your that doctor does to coordinate all your other care
- Treatment with psychiatrists, psychologists, and health care counselors for any behavior health, anxiety, depression, or other emotional issues if properly referred by the authorized doctor;
- Treatment with pain management doctors, neurologists, and other specialists if properly referred by the authorized treating doctor;
- The care you need from a broad range of therapists. This can include, occupational therapy, physical therapy, speech therapy, work hardening, and many other types of therapy.
The time you need to spend with chiropractors is generally covered too, within limits.
In Virginia, unless you have already established a course of care with someone, you are able to choose from a list of 3 doctors (called a “panel”) provided by your employer. This applies for each type of specialist and care. If the doctors aren’t helping you or your employer doesn’t work with the medical providers you need, an experienced work injury lawyer may be able to help get authorization to see doctors of your own choosing.
In North Carolina, there is unfortunately no provision for a panel of three doctors. You must usually go to whomever you are directed by the workers comp insurance company; however, unlike Virginia, there are other provisions for a second opinion in the event you disagree with the findings of your authorized treating doctor.
If you need prosthetics, a wheelchair, braces, or other medical equipment; the cost of those devices is normally covered, too. Additionally, workers’ compensation should cover all your prescriptions and medications too.
Vocational rehabilitation
In some cases, workers need to be retrained because they’ll never be able to return to the type of work they did before the accident or illness. Skilled work injury lawyers help you get the funds you need to be to be retrained or reeducated if you need vocational help.
Disability Benefits (Your Workers Compensation Weekly Checks)
Employees, in general, are entitled to a percentage (66 and 2/3rds, or .66667) of their average weekly wages while they can’t work. The percentage is a compromise that ensures workers get a good part of their pay. Workers don’t get 100% because the compromise in the law that was agreed upon long ago was and is that the worker doesn’t have to prove the employer was at fault for the accident. There are some limitations such as that there is a one week waiting period and there is a maximum rate on how much a worker can be paid for work injuries. There is also a minimum amount, if your wage exceeds the minimum amount.
There are several different types of disability payments depending on the severity and the type of injury or illness:
- Temporary total disability. Here, the worker can’t work at any type of job at all and is being held completely out of all work by his or her doctor. BUT, if the worker comes under an AWARD, then if he or she is unable to return to the pre-injury job, the worker may still receive ongoing checks. The worker will hopefully though be able to return to work at some time. The worker gets the 2/3rd’s figure until there is a determination he/she can return to work at his or her pre-injury job, or is otherwise released to full duty.
Most workers receive temporary total disability. Their medical bills are covered for life as long as it can be proven that the treatment is related to the work injury, and reasonable and necessary to treat the condition.
- Temporary partial disability. Some employees can return to work but with restrictions. Examples of restrictions include not being able to stand for more than a half hour or not being to lift more than 20 pounds. Workers who return to work with restrictions or with restricted hours usually receive less pay then before they were injured. These workers, in addition to their lower pay, are entitled to partial wage loss work injury benefits – based on the fact they are losing some pay due to their injuries or illness. The rate is 2/3rds of the difference between the pre-injury and light duty wages.
- Permanent partial disability or impairment ratings. (PPD or PPI) Some workers can return to their prior job but have to cope with a permanent injury such as the loss of a finger, permanent damage to their legs, arms, hands or feet, loss of hearing, sight, or significant disfigurement due to scarring. The worker who returns to work is therefore still entitled to some extra pay for this permanent partial disability based on the type of injury and the severity of the injury. For example, in North Carolina, a worker who loses a leg is entitled to up to 200 weeks of compensation payments, even if they are able to return to work at a higher paying job after the accident. So what about if the worker has not lost the leg, but there is permanent damage due to surgical intervention? The doctor, in consultation with physical therapists, comes to an opinion on the percentage impairment in the leg. Then that percentage is used to determine how much of the 200 weeks the worker would be entitled to. So for instance, a 20% impairment would yield 40 weeks of comp checks, since that is 20% of 200 weeks. It is usually paid in lump sum. The same is true for all of the body parts eligible for an impairment rating.
It bears noting a very important difference between North Carolina and Virginia in this regard. In NC, the highest ratable body part for impairment is the back, which really includes the entire spine, even the neck. That comes in at up to 300 weeks.
In Virginia, not only is the back on the highest ratable body part, it is not considered a ratable body part at all. In other words, in Virginia, a back or neck injury is not eligible for an impairment rating at all. The spine is not a ratable body part.
- Permanent total disability. Here, the medical evidence confirms that the worker will never be able to return to his/her prior job or to any other job -even with retraining. This worker is entitled to his/her average weekly wage percentage for the rest of the worker’s life. To qualify in Virginia, the worker generally must have a severe brain injury; severe burns; the loss of both hands, eyes, arms, legs, and/or feet; or paralysis. In North Carolina, after
Death benefits in Virginia and death benefits in North Carolina due to a workplace accident
Tragically, some workers die due to falls, explosions and other causes. As a general rule, states like North Carolina and Virginia pay a significant part of the funeral and burial costs. Additionally, spouses and dependents normally entitled to a percentage of their loved one’s average weekly wages up to 500 weeks. It may be possible to obtain a lump sum payment. An experienced workers’ compensation lawyer can explain if stepchildren, adopted children, and other dependents, parents, and other relatives may qualify.
Contact a respected Virginia or North Carolina workers’ compensation attorney immediately
Delay can absolutely hurt your case. We have had to turn down many, many cases simply because the caller waited too long to contact a lawyer. At the North Carolina and Virginia Law office of Joe Miller Esq., we have the experience and resources to help you get justice for your work injuries or occupational illness. We’ll fight to get you ever dollar you deserve. For help now, call 1-(888) 694-1671 or complete my contact form. He’s been fighting for injured workers for more than 30 years.
