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Injured at work? What's the next step?

People get injured on the job every day, but many of them don't know what to do. How do you know if you have a claim or if a lawyer would be interested in hearing your case? Darren Shoen, with the Law offices of Darren Shoen, shares some of his top need-to-know tips.

The basics about work-related injuries

If you get hurt at work, notify your employer right away. Next, file a claim with the state agency that handles these situations. For people who reside within the state of Virginia, you can file for benefits with the Virginia Workers' Compensation Commission based in Richmond online, by phone, or by email. Do this as soon as possible. Delaying could prevent you from getting your benefits. Get medical care. Tell the doctor, assistant, or nurse about your aches and pains. Get a copy of your medical records, as well. Having documented proof of your injuries will significantly help your case. Seek legal help as soon as possible. Find an experienced, knowledgeable attorney and meet with them. Consultations are often free. Don't worry about upsetting the insurance company or your employer. You must protect yourself. Who else will?

Choose your doctor

In most cases, after an injury, employers should provide employees with a list, also called a "panel," of three doctors to choose from. However, in his experience, Shoen has seen insurance companies "guide" injured workers to use doctors they like. When this happens, that doctor has become your treating physician, it becomes harder to switch. The same applies if you need follow-up care from an Orthopedic doctor or pain management specialist. Do not let the insurance adjuster or case nurse pick the doctor. You have a right to a choice by law in Virginia. The workers' comp insurance company should provide a list of doctors and treatment providers. Remember to get quality legal help soon after you're injured.

Can I get fired because I got hurt?

If your employer has worker's compensation insurance, they are not allowed to fire you just because you got hurt and filed a workers' comp claim. However, this situation can get complicated and is another reason you need the advice and guidance of an attorney. An employer can terminate your employment when you have an open workers' compensation claim if their reason for doing so is unrelated to the filing. Employers with workers' compensation insurance should attempt to find a "light duty" job that fits within work restrictions, also known as a "reasonable accommodation." If you are unable to work, the employer has the right to fill a permanent position with a non-disabled person. If your doctor has you on "light duty" restrictions, you may be required to look for "light duty" employment to receive workers' compensation wage benefits. For more guidance on how to comply with job search requirements for works comp, click here.

Do I need a lawyer if the insurance company is paying for medical care or paying wages while I'm unable to work?

You have rights under the law that insurance companies will not discuss with you. Insurance companies are in the business to make money. For example, if you are on a "lifetime medical award," that award is only valuable if the insurance company honors it. The insurance company knows how to fight against the award in hope that you will give up. Shoen urges you not to give up and speak with an experienced workers' compensation attorney.

Why won't workers' comp cover my work injury?

The answer depends on your specific situation. However, Shoen suggests not relying on insurance adjusters to make the final decision. If an insurance company denies your claim, that doesn't necessarily mean your claim is denied. The Virginia Workers' Compensation Commission enforces your rights under the law in Virginia (and in every state in the U.S.). This means that you can demand a hearing. Judges make the final decision as to whether the workers' compensation insurance company covers your injury.

I don't want to "hurt" my boss by filing workers' comp claims

If you get hurt at work, a good employer will help you get the care and compensation you need. Shoen says if your employer makes you feel guilty about getting injured on the job, your loyalty is misplaced. Also, consider that a work injury could be with you for the rest of your life. If you have a spouse, children, or others that need your care, you need a healthy body to provide for yourself and others.

I got hurt while traveling out of state for my job. Will workers comp cover this?

If you were injured out of state, this doesn't mean workers' comp won't cover you, Shoen explains. If you are a Virginia worker, it doesn't mean you can't file a claim in Virginia. It depends on specific details about your case. It's best to seek the advice of an experienced injured workers' lawyer. The statements contained herein are for general information purposes only. This is NOT to be considered specific legal advice to your situation as Mr. Shoen would need to meet with you individually to ensure client confidentiality and would need additional information not provided in this question. This response does not create an attorney-client relationship. Please consult directly with an attorney for legal advice.  

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Workers' Comp Deposition

Ok, you got a letter saying you have to appear for a “deposition” in your workers’ comp case.  What do you do?  Well, first of all, make sure you show up.  You can lose your case if you don’t cooperate.  Second, as I always say in my blog, “first seek a competent, experienced workers’ compensation lawyer.”   If you are unrepresented, the lawyer for the insurance carrier may take advantage of your inexperience and uncertainty about the situation. Though I can’t give specific legal advice in this blog, since I do not know your particular case, if you have been unable to get legal help, a few tips might help: Don’t lie Only answer the question you have been asked Don’t hide your medical history Dress nice for the deposition and look your questioner in the eyes Don’t let them get you mad You are not on trial at the deposition You have the right to read the transcript of the deposition for accuracy once it is transcribed by the court reporter. The statements contained herein are for general information purposes only and are not considered specific legal advice regarding your situation as Mr. Shoen would need to meet with you individually to ensure client confidentiality and would need additional information from you personally. This article does not create an attorney-client relationship. Please consult directly with an attorney for legal advice. To learn more about the Law Office of Darren Shoen, or to speak with Darren Shoen by phone or in-person consultation, visit his website at shoenlaw.com, or call 540-586-5003.

Claim denied because Comp carrier says injury was a pre-existing condition?

Do not just accept an insurance carrier’s denial of your claim because they say it is a “pre-existing condition.”  Even if you have a pre-existing injury or condition related to the same body part injured in a work accident, you may still be entitled to medical benefits related to the work accident.  For instance, say (hypothetically) you had a sore knee over the course of a few weeks/months and decide to see a physician.  Your physician says you have degenerative arthritis and advises you to do home stretching exercises.  A few days later, you slip on an oil slick at work and hear (and feel) a “pop” in your knee.  You are seen by a physician shortly after and are advised that you have suffered an exacerbation of your condition and are now unable to work, or can only work in a restricted capacity.  Assuming the slip/accident at work is arising out of your employment (compensable as a work accident), your exacerbated knee injury should be covered by your employer’s workers’ compensation carrier. Remember, the injured worker has the burden to prove they sustained a compensable injury by a preponderance of the evidence.    The injured worker must show four things: 1) an identifiable incident; 2) that occurred at some reasonably definite time; 3) an obvious sudden change or mechanical or structural change in the body; and 4) a causal connection between the incident and the bodily change.”  Assuming you show these elements, you should prevail if you challenge the comp carrier’s denial of your claim. As always, make sure you contact a competent, knowledgeable workers’ compensation lawyer to discuss your claim.  You have rights under the law, don’t be fooled by the workers’ comp carrier. The statements contained herein are for general information purposes only and are not considered specific legal advice regarding your situation as Mr. Shoen would need to meet with you individually to ensure client confidentiality and would need additional information from you personally. This article does not create an attorney-client relationship. Please consult directly with an attorney for legal advice. To learn more about the Law Office of Darren Shoen, or to speak with Darren Shoen by phone or in-person consultation, visit his website at shoenlaw.com, or call 540-586-5003.

“How do I settle my workers’ compensation case or get a settlement?”

Are you wondering if you can get a settlement for your work injury? This blog can help you understand the Virginia workers’ compensation settlement process & hopefully get a better idea of what you should do.   A “settlement” of your claim can mean different things.  Some workers mistakenly think that when they get payment towards permanent partial disability (PPD), they have settled their claim, and it is all over.  Not true.  If you have a lifetime medical award or are on a wage award, your claim is still open.   In other situations, the insurance adjuster and/or case nurse may say they have “closed their file” and lead the injured worker to believe there is nothing they can do, and their case is over.  This is WRONG!  If you have an Award Order from the Virginia Workers’ Compensation Commission, your case is likely open unless YOU have agreed to a full and final settlement which has closed your claim regardless of what the insurance carrier says.   A full and final settlement usually is a situation where you receive an agreed upon amount of money in exchange for closing out your workers’ compensation claim.  If it is a complete and full settlement of your medical award and wage award, your case is over after the settlement is final.  In this case, you would no longer be eligible for ongoing medical or wage benefits from the insurance carrier even if you had a “Lifetime Medical Award.”  However, even if the case is fully settled, the insurance carrier may still be responsible for medical bills incurred before the settlement, if they have not been paid before the settlement.   In some instances, just the “wage” part of the award is settled separately from a medical award.  In this case, the injured worker would still be eligible for related medical benefits and expenses related thereto.   Most injured workers do not know how much compensation they should get for settling their claim.  If they do not have an experienced, knowledgeable attorney helping them, they are at the mercy of the “good will” of the insurance carrier.  No matter how nice the insurance adjuster may seem, you can rest assured they are not looking out for the interests of the injured worker.  Their goal is to save money.   A fair settlement should consider the severity of the injury and future medical costs, the amount of wages the worker is eligible for and how long they might receive wage benefits, and other potential future costs for which the carrier might be responsible.  Unfortunately, injured workers are not entitled to money for “pain and suffering” as they might be in a personal injury case.  Personal injury settlements and workers’ compensation settlements are different and take into account different factors. The statements contained herein are for general information purposes only and are not considered specific legal advice regarding your situation as Mr. Shoen would need to meet with you individually to ensure client confidentiality and would need additional information from you personally. This article does not create an attorney-client relationship. Please consult directly with an attorney for legal advice. To learn more about the Law Office of Darren Shoen, or to speak with Darren Shoen by phone or in-person consultation, visit his website at shoenlaw.com, or call 540-586-5003.