Lebanon Virginia Workers’ Compensation Attorney

The short answer is, “yes.” In fact, J. Aaron Thomas has recovered several million dollars in combined settlement money for his clients over the course of his career. In the event an injured worker is interested in settling their case, Thomas & Thomas will conduct a settlement analysis of the case and will discuss with the injured worker what a settlement demand might look like. If the injured worker agrees with the proposed settlement demand, Thomas & Thomas will then work on obtaining the maximum settlement value for the injured worker. It is important to remember that being interested in settling a case does not obligate an injured worker to settle. It only means that if the insurance adjuster offers an amount that is pleasing to the injured worker the case can then settle. If the offered amount never arises to the level that satisfies the injured worker, the injured worker simply says, “no thank you,” and the case proceeds along its natural course. If Thomas & Thomas, however, is successful in settling the case, the Workers’ Compensation Commission provides 20% of the lump sum settlement to Thomas & Thomas. This is an excellent value, as personal injury attorneys routinely receive 33.3% of any settlement money they recover.

This answer to this question is heavily fact dependent. The answer, however, is that if your injury occurred out of the Commonwealth of Viriginia, you still have VA workers’ compensation case as long as your employment is rooted in Virginia. Your employment, however, must meet three criteria for a VA claim.

• Your contract of hire was finalized in Virginia;
• Your employer has a place of business in Virginia;
• Your preinjury employment included at least some work inside the Commonwealth of Virginia.

"Concurrent Jurisdiction"

It is not uncommon for multiple states to have authority over a single injury, where an employee has a traveling position (e.g., traveling nursing or trucking).

For example, if you live in Virginia, your employer is headquartered in North Carolina, but you get hurt while performing a job in Delaware, all three states might technically have a stake.

Even if an employment contract you signed explicitly states, "All workers' compensation claims must be filed in North Carolina," Virginia law invalidates that clause if (i) the contract for employment was finalized in Virginia, (ii) the work you perform included Virginia, and (iii) your employer has a place of business within Virginia.

What to Look Out For
Illegal Coercion: It is illegal for a Virginia employer to threaten, harass, or fire you for attempting to file a claim in Virginia.

If a State has shared Jurisdiction with Another State, what to do?
Find out which state offers better workers’ compensation benefits. Many injured workers would decide to file a claim for benefits in a state that offers superior workers’ compensation coverage.

The "Credit" System: You can technically file paperwork in two states to see which one grants better benefits, but you cannot receive double payouts. If an employer initiates payments to you under another state's laws, Virginia will simply apply a dollar-for-dollar credit for those amounts if you successfully switch the claim to Virginia.

If you believe your accident occurred outside Virginia but still want to pursue Virginia coverage OR if your employer is trying to force you to file in a state outside Virginia, it is recommended you speak with a workers’ compensation attorney today.

This is the first error many injured workers make, simply accepting the doctor their employer or insurance adjuster wants them to see.

The unfortunate truth is that not are all doctors are equal; some are better for an injured worker than another, and some are more insurance company friendly. The Workers’ Compensation Commission recognizes this and as a result the prevailing law is that “an employer or insurance company” cannot medically manage an injured workers’ medical care.

The “rub,” however, is that once treatment from a physician is accepted—regardless of how an injured worker gets there—and a treating relationship has been established (in many cases this may occur in just a couple of visits) the Workers’ Compensation Commission then recognizes that physician as the authorized treating physician. The authorized treating physician enjoys a very special status with the Workers’ Compensation Commission. This becomes the sole doctor--and any referrals that doctor makes--whose medical treatment the insurance carrier must make payment. In most cases, the opinion of the authorized treating physician also is given the most amount of weight when the Commission decides a case. Often the outcome of a case hinges upon their opinion. While a change in treating physician is possible, it is in most cases very difficult without the insurance adjuster’s consent. For this reason, the choice of treating physician is a very important decision, and it should only be made after careful contemplation of which doctor is the best for an injured worker.

To combat being sent to a physician,“friendly” to the insurance company, the Workers’ Compensation Commission requires that if medical care is authorized by the employer or insurance company that an injured worker be provided with a panel of 3 doctors from which to choose. A valid panel must be comprised of doctors from different practices, who are specialists in the field of the injury, and are within a reasonable distance from the home of the injured worker. If medical care for your injury has been authorized, it is the responsibility of the injured worker to request a medical panel and not simply accept the doctor his or her employer wishes that worker to see. This also applies to any referrals an authorized treating physician makes. If a referral does not direct an injured worker to a specific provider, the insurance carrier must provide a valid panel to the injured worker from which to choose.

If, however, the claim has been denied or insurance company refuses to issue a panel of medical providers, the injured worker is free to choose any doctor as their authorized treating physician. If the insurer then refuses to pay for those medical visits, reimbursement of medical expenditures related to the work place accident and injury can be pursued before the Commission.

An Award Order is a judicial order—recognition by the VA Workers’ Compensation Commission—that an injury is protected under the Workers’ Compensation Act. An award order is critically important as it is what places the Workers’ Compensation insurance company on the hook for providing an injured worker with life time medical care and wage loss benefits during the period of complete or partial disability. If an award order is not in place, an insurance adjuster’s willingness to approve medical care and pay wage loss benefits is strictly voluntary. He or She can decide to take care of an injured worker or not, and choosing not to provide medicals and wage loss benefits is not illegal. Once an award order is in place, however, fines and penalties can be assessed against the insurance company for failure to provide medical care and wage loss benefits to an injured worker.

The short answer is, it depends, in large upon whether the insurance adjuster agrees with you or if your current doctor refers you to another provider. If your situation, is not one of the foregoing, you will likely meet far more significant resistance. The difficult part is that in Virginia, once you have chosen your treating physician, from an insurer provided panel, you cannot change your doctor unilaterally.

In Virginia, once you choose a physician from your employer's "panel of three," that physician becomes your authorized treating physician. Making a switch on your own without formal approval will likely result in the workers' compensation insurance company refusing to pay for your medical bills.

If you want to switch to a new doctor and have your treatment covered, you must use one of the following three approved routes:

• Get a Referral from Your Current Doctor
  This is the easiest and most common way to change doctors. Under Va. Code § 65.2-603, the insurance carrier must cover medical care within your authorized physician's chain of referral. If your doctor agrees that you need a specialist, a second opinion, or a different type of care, ask them to write a direct referral to a specific new physician.
• Request Permission from the Insurance Carrier
  You or your attorney can contact the workers' compensation insurance adjuster and directly request a change. The insurer ‘may’ voluntarily authorize a new doctor or provide you with a completely new three-doctor panel to choose from. However, insurance companies rarely grant this unless there is a clear, practical reason (such as your doctor retiring or you are relocating far away).
• File a Claim with the Virginia Workers' Compensation Commission
  If your current doctor refuses to refer you and the insurance company denies your request, you can file a formal motion for a change of physician with the Virginia Workers' Compensation Commission (VWC). To win this request at a hearing, you must provide medical proof showing a valid justification, such as:
  • The current medical treatment is inadequate or your health is failing to improve.
  • The physician refuses to refer you to a necessary specialist.
  • The doctor is using unconventional or questionable treatment methods.
  • There is a severe communication or language barrier preventing proper care.

Note: You are always permitted to see any doctor for a second opinion entirely at your own expense, but those visits and any treatment they recommend will not be covered by workers' compensation unless later authorized.

Sometimes, an insurance adjuster will hire a private investigator to follow an injured worker and video them without their consent. Unfortunately, in many cases, there is nothing illegal about this practice. The purposes of such surveillance is for the insurance adjuster to try and obtain evidence that the injured worker is not injured to the extent that is claimed or to try and catch the injured worker engaging in activities beyond the light duty restrictions issued by the treating physician. Such video graphic evidence can be very damaging to a workers’ compensation case and can provide a solid basis to terminate the receipt of wage replacement benefits.

Therefore, if you suspect you are being followed, immediately do the following:

1. Contact your workers’ compensation attorney for further advice;
2. Do not approach the private investigator. It is far better that you know where they are and who is watching you. Alerting a private investigator to the fact you know they are watching will only guarantee a different investigator will be placed on the case, which will be more difficult to detect.

The most important way, however, to protect yourself from any evidence collected by a private investigator is to make sure you comply entirely with the light duty restrictions issued by your treating physician. The clients of Thomas & Thomas tend to be very hard working individuals who push themselves, wanting to return to their pre-injury status. While this work ethic is commendable, it does not help a workers’ compensation case. Rather, listening to your treating doctor and complying with their orders is the best way to ensure your wage replacement and medical benefits continue in an uninterrupted fashion while you are disabled.

As most things in law, the answer is ‘it depends.’ Most of the time, the answer would be no.

In the case of settlement, usually there is only one attorney’s fee, awarded by the Commission. At that point, the prior attorney and the current attorney will decide how that awarded fee is split. Where things can get a little complicated is when the prior attorney was already awarded an attorney’s fee by the Commission for past work but did not collect that attorney’s fee before being discharged as the representing attorney.

That unpaid attorney’s fee could become part of the prior attorney’s lien against their client’s ongoing case. When confronted with such a situation, our firm seeks to consider and calculate such a lien into the fee split, after there has been a full and final settlement on a case.