A Step-By-Step Guide to Understanding the Workers’ Compensation Process

Learn more about Virginia Workers' Compensation Process in this comprehensive guide

Workplace injuries and illnesses are among the leading causes of hospitalization and missed work in Virginia. According to a 2022 Virginia Department of Labor and Industry Report, there were approximately 52,600 nonfatal workplace injuries and illnesses in the state in 2020, representing a rate of 2.1 cases per 100 FTE workers. 

If you have been injured on the job or fallen ill due to an occupational illness, the medical costs and other damages related to your injury illness may be covered by workers’ compensation insurance. However, filing a workers’ compensation claim can be a tedious and complex process. This is why you need an experienced workers comp attorney to handle all the legalities of your claim as you focus on recovery.

At Renfro & Renfro, PLLC, our experienced attorneys can guide you through the entire process while ensuring you understand your rights and entitlements.

A Step-by-step Guide to Understanding the Workers’ Compensation Process in Virginia

Here is a breakdown of a workers’ comp claim process to assist you in understanding what to expect when injured in the workplace:

Step 1: Notify your employer

Virginia law requires an injured employee to report the injuries sustained to the employer as soon as they can report it. Generally, you are required to report the injury in writing within 30 days of the injury sustained. Reporting the incident promptly is crucial as there are specific timelines for making a claim. Failure to report the injury within the specified time frame could result in the denial of your claim. Besides, companies must file incident reports to help them learn from mistakes and maintain their workplace compliance.

Step 2: Seek medical attention

After notifying your employer, seek immediate medical attention for your injury or illness. If your injuries are severe or life-threatening, visit the nearest hospital or medical care facility. If the injuries are not as severe, your employer may provide a list of approved healthcare providers to visit in order to make the claim process easier. Your employer may also recommend that you see a company-appointed doctor for the initial evaluation. Virginia law requires that your employer or their insurance carrier offer you a “Panel of Physicians” which is a list of three different doctors for you to choose who provides your medical care resulting from the accident.

Step 3: Complete the necessary paperwork

Your employer will guide you regarding the essential paperwork that you must complete. Typically your employer will have you fill out an incident report, or they may fill it out and ask you to sign it. Before signing the incident report make sure that it accurately states how the accident occurred (every little detail can be important, especially in slip/trip and fall injuries, like what caused you to slip or trip). Your employer is also required to inform you about your rights under the workers’ comp insurance.

Step 4: File your claim

The next step involves filing a claim with the Virginia Workers’ compensation commission. Usually, it is your responsibility to complete the Claim for Benefits Form and file it with the workers’ comp commission. You are also required to file medical documents that support your claim.

Step 5: Employer reports the accident

As mentioned above, the employer should file a First Report of Injury to the Virginia Workers’ compensation commission notifying the Commission that an injury occurred. Additionally, the employer also reports workers’ injuries to its insurance company. They must do so within ten days of knowing about a severe injury or death and within 30 days for non-emergent injuries. Once they receive the First Report of Injury, the commission will acknowledge receipt and send you information regarding your rights. The commission will also issue a 20 Day order to all parties to inform the insurer that it has 20 days to respond to your claim.

Step 6: Investigation and decision

Once your claim is submitted, your employer’s insurance company will send an adjuster to investigate the claim’s validity. They may review medical records, talk to witnesses, and assess the circumstances of the incident. They will then make a decision on whether to approve or deny your claim.

Generally, the insurance adjuster doesn’t have your best interests at heart. They will look for any reason to reduce your claim or deny it entirely. For this reason, it is advisable to seek the guidance of an experienced workers’ comp attorney before talking to the insurance company.

Step 7: The insurance company offers a response

If the insurance company approves your claim, you need to take steps to start receiving workers’ compensation benefits. During this stage, the insurance company issues you with forms to execute your compensation benefits. Once all parties sign the agreement, it is filed with the commission. The workers’ compensation commission will then enter an Award Agreement with all parties.

However, if your claim is denied by the insurance company, you have the right to have a trial at the Virginia workers comp commission. The experienced attorneys from Renfro & Renfro, PLLC can help you file a Claim for Benefits, if you haven’t already done so, to start the litigation process and obtain the compensation you deserve. The following is a brief summary of the workers comp litigation process:

  1. A Claim for Benefits is Filed.
  2. The commission issues a 30 Day Order to the insurance company to see if they are accepting or denying your claim.
  3. If the claim is denied, the commission schedules a trial/hearing date for your case.
  4. An evidentiary hearing is held before a Deputy Commissioner (an Administrative Law Judge (ALJ) where both parties call witnesses, submit medical reports and other documents relevant to the issues in your case.
  5. After the hearing concludes, the judge issues a written decision after reviewing evidence and witness testimony. It usually takes between two to six months to receive the judge’s written opinion.
  6. If the verdict is unfavorable, you will have 30 days to file an appeal at the appellate courts.

Contact Richmond, Virginia, Workers’ Compensation Lawyers

If you have been injured in a workplace accident and need help with your case, Renfro & Renfro can help. Our experienced workers’ compensation attorneys are here to assist. We understand the process can be complex and intimidating, so call us today at (804) 601-4433 or contact us online for a free consultation. Let our team guide you through your claim and help you receive the compensation you deserve.

We look forward to representing you.


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