(757) 552-6055If you suffer a work-related illness or injury in Virginia, then it will likely be handled through the workers’ compensation system. Most employers in the state are required to purchase workers’ compensation insurance. Through a workers’ comp claim, an injured worker can recover medical benefits, wage replacement, and disability benefits.
Many workers’ comp cases are resolved through a settlement. The total amount of the settlement will depend on many factors, including whether you are totally or partially disabled and if you can work in the future. Because you are giving up important rights as part of your agreement, you should never sign any settlement paperwork without first consulting with a Virginia workers’ compensation attorney.
Based in Virginia Beach, Poole, Brooke, Plumlee represent injured workers throughout Virginia who have suffered workplace accidents, injuries, and illnesses. We will work with you to help you maximize your workers’ comp settlement and will protect you from unscrupulous insurance companies. Reach out to schedule a consultation with a member of our legal team.
How Do Virginia Workers’ Compensation Settlements Work?
The Virginia Workers’ Compensation Act is designed to protect employees who suffer on-the-job injuries or who are diagnosed with occupational illnesses. This coverage extends to all workers, including part-time employees, seasonal or temporary workers, minors, family members who are working, interns, and immigrants.
Workers’ compensation is considered an exclusive remedy, which means that in most cases, you cannot file a personal injury claim against your employer for a work-related accident. However, it is a no-fault system, which means that you do not have to prove that your employer was negligent in order to access benefits.
After filing a workers’ compensation claim, you can access medical care (often through a physician or clinic provided by your employer). You may also be entitled to:
- Wage replacement
- Lifetime medical benefits
- Permanent and total disability benefits
- Partial disability benefits
- Death benefits
The process starts with an employee reporting a work-related illness or injury to their employer within 30 days. The employer should then file a report of accident or disease with the Virginia Workers’ Compensation Commission within 10 days.
In theory, once an employee files a workers’ compensation claim, they should receive the benefits that they are entitled to under the law. However, employers and insurance companies often dispute aspects of the claim, such as the severity of an injury, the need for ongoing disability payments, or the type of medical care necessary. A Virginia workers’ compensation lawyer can help to make sure that you get the benefits that you deserve by requesting a hearing with the Commission or even filing an appeal in civil court.
In many cases, it is more favorable for all parties to reach a settlement. Once you have reached what is known as maximum medical improvement (MMI), you may consider settling your workers’ compensation claim.
There are four primary types of workers’ comp settlements:
- Full and Final Settlement: with this type of settlement, the insurance company offers you a single lump-sum payment instead of a specified number of weeks of benefits to compensate for your injury. As the name indicates, it is a final settlement, so you will not be entitled to future workers’ compensation benefits for this injury. It is the most common type of workers’ comp settlement.
- Structured Settlement: as part of this agreement, you will receive payments for a specific amount of money over an agreed-upon number of years. As with a full and final settlement, you cannot access other benefits for this injury once you have signed this agreement.
- Lump Sum Settlement with Open Medical Benefits: this type of agreement involves a lump sum payment for indemnity, where you will get money for lost wage benefits related to your disability. Your employer will continue to pay for your medical care for your work-related illness or injury. While the insurance company will continue to pay your medical costs, they will not provide any further workers’ compensation benefits related to wage replacement or vocational rehabilitation.
- Full and Final Settlement with a Workers’ Compensation Medicare Set Aside (WCMSA): if you have Medicare at the time of your work-related injury or occupational illness, then settlements may look a little different. This type of settlement involves a lump sum payment plus money for a WCMSA for future medical expenses. The WCMSA funds will be used for future medical bills related to the injury or illness. This type of settlement plan often must be approved by the Center for Medicare and Medicaid Services (CMS).
Any type of workers’ comp settlement will involve giving up important legal rights. For this reason, you should never sign any settlement agreement before consulting with a Virginia workers’ compensation attorney. You should also never agree to a settlement before you understand the true scope of your disability and have reached MMI.
Virginia Workers’ Compensation Settlement Timelines and Amounts
The amount of time that it takes to settle a workers’ compensation claim can vary significantly. There are typically several factors at play in settlement negotiations: the type of injury, the length of time that it takes to reach maximum medical improvement, how quickly the insurance company investigates the claim, whether the insurer contests the claim, the willingness of both the injured worker and the insurance carrier to resolve the claim, and any unusual facts (like if you were intoxicated at work at the time of the accident). Some cases may settle quickly (in a matter of hours or days), while other claims may take over a year to resolve.
For example, consider a situation where you have suffered a serious work-related accident and are permanently disabled from a traumatic brain injury (TBI) as a result. After reviewing your medical records, the insurance carrier might claim that you can still work despite your TBI – but your own doctors have determined that you are unable to work. In this situation, it might take months or over a year for the parties to come to an agreement about an appropriate and fair settlement.
The average settlement amount for a workers’ comp claim can vary significantly based on things such as:
- The nature of the injury;
- The severity of the injury;
- The physical pain and emotional distress that the worker has suffered;
- Any past uncompensated medical expenses;
- Anticipated future medical costs;
- Any uncompensated wages;
- Reduced earning capacity; and
- The injured worker’s average weekly wage.
Certain types of injuries often result in higher settlements, such as any type of injury that results in permanent disability or disfigurement. For example, an amputation or a traumatic brain injury will often result in a higher settlement because the potential for permanent disability is much higher. Similarly, chronic illnesses that require lengthy treatment or that may reduce a worker’s life expectancy will often result in a larger workers’ compensation settlement.
Of course, each case is unique and it can be hard to predict exactly how long it will take to settle a claim or the ultimate value of the claim. The best way to get maximum compensation is by working with an experienced workers’ comp lawyer. They will evaluate your case, help you file the appropriate documents, and work with you to resolve the case for the highest possible value and as quickly as possible.
Hurt on the Job? Give Our Law Firm a Call to Protect Your Rights.
Being hurt on the job can be incredibly challenging. Not only are you out of work and dealing with health issues, but you must also deal with legal paperwork and bureaucracy. Our law offices will work with you to get the appropriate paperwork filed, and help you get the best possible outcome for your workers’ comp claim.
At Poole, Brooke, Plumlee, we work with employees who have suffered on-the-job injuries and have been diagnosed with occupational illnesses in Virginia. We have significant experience with all phases of workers’ comp claims, including favorable negotiating settlements with insurance companies. To learn more or to schedule a consultation with a Virginia workers’ comp attorney, give us a call at 757-499-1841 or fill out our online contact form.
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