Workers’ Compensation FAQ Series: What Benefits Are Available Under Workers’ Compensation?

Often, our clients ask why the insurance company is not required to pay more on their workers’ compensation case. Unfortunately, the benefits available in a workers’ compensation claim are far less than what would constitute full relief for the injuries and losses that our clients suffer. The benefits that are available consist of a variety of wage loss benefits and medical benefits, but do not include benefits for pain and suffering, inconvenience, impact on the quality of life, or numerous other collateral losses that are likely to result from an injury at work.[1]

A claimant with a compensable claim can receive lifetime medical benefits for reasonable and necessary medical care related to their work injuries with authorized treating doctors and referrals from those doctors. Medical benefits also include reimbursement for mileage to and from medical appointments. Wage loss benefits can include temporary total, temporary partial, permanent partial, or COLA (Cost of Living Adjustment). In unusual cases, and for the most catastrophic injuries, an injured worker may be entitled to lifetime wage loss payments. This is called permanent total disability. Additionally, if an injured worker dies as a result of their work injury, then their estate may be entitled to payment of funeral bills, payment of medical bills accrued before the date of death, and in some cases, there may be appropriate beneficiaries that are entitled to some wage loss benefits.

Person working on an electrical line high on a pole

Sadly, even if an injury is covered by workers’ compensation, the benefits are not full and complete compensation. The impact of a work injury often goes well-beyond the compensation that is provided, effecting every aspect of the victim’s life. This is true even though the injury may have been caused by negligence, recklessness, or even an intentional act. If workers’ compensation is available, that will likely be the exclusive remedy against the employer, and it is likely the employee will not be able to sue their employer or other employees.

The Virginia Workers’ Compensation Act specifically outlines what type and amount of wage loss and medical benefits you may receive if you have been injured on the job:

  1. You are entitled to receive temporary total disability benefits during the time that you are totally disabled from performing any type of work.[2] The amount of the temporary total disability benefits you will receive is dependent upon your pre-injury average weekly wage.[3] You will be paid two-thirds of your pre-injury average weekly wage.[4] For example, if your pre-injury average weekly wage is $1,200, your weekly temporary total disability check will be $800.00.[5] It is important to understand that your temporary total disability benefits are not taxed.
  2. If you return to light-duty work after your injury and you are earning less than your pre-injury wages, you are entitled to receive temporary partial disability benefits. [6] These benefits are paid based on two-thirds of the difference between your pre-injury average weekly wage and your post-injury wages.[7] So, if your pre-injury average weekly wage is $1,200 and your post-injury average weekly wage is $600.00, your weekly temporary partial disability check would be $400.00.[8] Again, these benefits are not taxed.
  3. You are also entitled to an award of lifetime medical benefits for your injuries. [9] This means that your medical treatment is covered, for your lifetime, so long as the treatment is reasonable, necessary, and causally related to your work accident.[10]
  4. Depending on your injury, you may also be entitled to permanent partial disability benefits.[11] These benefits are paid when you experience a documented loss of use to a specific body part (such as an arm, a leg, a hand, etc.).[12] Once your doctor gives you an impairment rating for the affected body part, you will be paid a certain number of weeks of disability benefits based upon that rating. Virginia does not provide for any permanent partial disability benefits for loss of use to the back or neck.[13]
  5. If you suffer a severe injury, you may be entitled to permanent total disability benefits.[14] These benefits entitle you to weekly disability benefits for the remainder of your lifetime. Permanent and total disability benefits are awarded if you suffer:
    1. Loss of both hands, both arms, both feet, both legs, both eyes (or a combination thereof) in the same accident; or
    2. You are totally paralyzed; or
    3. You suffer a brain injury that so is severe that you are incapable of gainful employment.[15]

 

[1] See Injured Worker’s Benefit Guide, Va. Workers’ Compensation Commission, http://www.workcomp.virginia.gov/sites/default/files/documents/Injured-Worker-Benefits-Guide_0.pdf (last visited Aug. 3, 2020).

[2] See Va. Code Ann. § 65.2-500(A).

[3] Id.

[4] Id.

[5] Id. (“employer shall pay . . . to the injured employee during such total incapacity, a weekly compensation equal to 66 2/3 percent of his average weekly wages”).

[6] See Va. Code Ann. § 65.2-502(A).

[7] Id.

[8] Id. (“employer shall pay . . . to the injured employee during such incapacity a weekly compensation equal to 66 2/3 percent of the difference between his average weekly wages before the injury and the average weekly wages which he is able to earn thereafter . . . .”).

[9] Va. Code Ann. § 65.2-603(A)(1).

[10] See Id.; Volvo White Truck Corp. v. Hedge, 1 Va. App. 195, 199 (1985).

[11] See Va. Code Ann. § 65.2-503.

[12] Va. Code Ann. § 65.2-503(B).

[13] Information for Employees, Va. Workers’ Compensation Commission, http://www.vwc.state.va.us/sites/default/files/documents/Injured-Workers-Guide_0.pdf (last visited Aug. 5, 2020).

[14] See Va. Code Ann. § 65.2-500.

[15] Va. Code Ann. § 65.2-503(C)(1)–(3).