The Virginia Workers' Compensation Act: A General Summary
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This Act provides benefits to an employee who sustains an injury  as a result of  an  accident  arising out of  and  in the course of  employment or who suffers from an occupational-related disease.  Learn how and when this Act is applicable.

The Virginia Workers' Compensation Act

The following is a brief summary of the Virginia Workers' Compensation Act. Use of the masculine gender is intended to refer to both the masculine and feminine gender.

The Act provides for benefits to an employee who has an
 
(1)  injury
      as a result of an 
      accident, or
(2)  occupational disease, or under certain circumstances, an 
      ordinary disease of life, 
(3)  arising out of and  
(4)  in the course of 
(5)  employment.

An occupational disease is one arising out of and in the course of  employment; an ordinary disease of life is one to which the general public would be exposed outside of employment.

Coverage

Any employer who has three or more regular employees is required to furnish workers' compensation insurance coverage. Part-time employees and officers of a corporation are considered employees. Farmers must provide coverage if they have three or more full-time employees. Domestic workers are not covered.

Benefits

Temporary Total Disability.
Any employee who is covered by workers' compensation is entitled to receive two-thirds of the average weekly wage up to the maximum set by law, for the time lost from work from a work-related injury by accident or occupational disease. The injured employee is not eligible for compensation for the first seven days of incapacity unless the incapacity continues for more than three weeks. These benefits may not be paid for more than 500 weeks. Click here for New Compensation Rates, effective July 1, of each year.
 
Temporary Partial Disability.
If an employee recovers from work-related injury by accident or disease to the point that the employee returns to light or part-time work, but, because of the injury, is not earning as much as before the injury or disease, the employee is entitled to recover two-thirds of the wage loss, up to the maximum set by law.
 
Permanent Partial Disability.
For permanent injuries to certain parts of the body, the employee is entitled to receive two-thirds of the average weekly wage for a certain number of weeks of compensation determined by applying the percentage of disability to the number of weeks designated in the law for a 100% disability to that part of the body.

If an employee is still disabled after receiving all payments for permanent disability, he may be entitled to additional compensation for work incapacity.

The following are the number of weeks of compensation for total loss of a particular part of the body:

Injury

Number of Weeks
Loss of thumb 60
Loss of first finger or index finger 35
Loss of second finger 30
Loss of third finger 20
Loss of fourth finger 15
Loss of 1st phalanx of the thumb 30
or any finger 1/2 of weeks for loss of entire finger
Loss of great toe 30
Loss of any other toe 10
Loss of 1st phalanx of any toe 1/2 of weeks for loss of entire toe
Loss of hand 150
Loss of arm 200
Loss of foot 125
Loss of leg 175
Loss of eye 100
Loss of hearing in one ear 50
Severely marked disfigurement 50
Pneumoconiosis 60
 1st stage
50
 2nd stage
100
 3rd stage
300
Byssinosis 50
There is no back, neck or general bodily disability rating. Such injuries are only compensable based on a loss of earnings.

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Total and Permanent Disability (Perm Total).
The employee is entitled to compensation and medical expenses for life if he loses both hands, both arms, both feet, both legs, both eyes, or any two, in the same accident, or suffers total paralysis or a brain injury which renders the employee permanently unemployable in gainful employment. Permanent loss of use of a member shall be equivalent to loss of the member. Proportional compensation may be awarded for partial loss of use of a member, loss of hearing or vision.
 
Medical Expenses.
An employee is entitled to receive all necessary medical treatment for his work-related injuries or occupational disease. At the time of the injury the employer must provide the employee with a panel of three doctors from which the employee may select the treating doctor. All medical treatment rendered by the treating doctor, or those to whom the employee is referred, will be paid for by the employer.
If the employee selects a doctor for treatment rather than choosing from the panel, the employee usually must pay this expense. Also, if after the claimant selects one of the doctors from the panel, he wants to change doctors, he must either get consent of the carrier or apply for a hearing.
 
Rehabilitation.
The employer is obligated to furnish, and the employee is obligated to accept, reasonable and necessary rehabilitation services. These may include prosthetic appliances, structural modifications such as handicap ramps, home health care and vocational services, including job placement. Unjustified refusal of the employee to accept such service may result in suspension of compensation payments.
 
Second Injury Fund.
This was created to encourage employers to hire the handicapped. The employer or insurance carrier may be able to claim from the Second Injury Fund partial reimbursement for medical treatment, rehabilitation services, and wage loss compensation. Under the Fund the employer is reimbursed for payments made to injured employees who meet the requirements specified in Va. Code Ann. § 65.2-1100 et. seq.
 
Death.
If an injury or occupational disease results in death, compensation is payable to the widow, widower, minor children or others who are dependents at the time of death. The amount of compensation is two-thirds of the deceased employee's average weekly wage, up to the maximum allowed by law, to be paid during the period of dependency, but not to exceed 500 weeks.
In addition, up to $5,000 is paid toward burial expenses plus an allowance of up to $500 for transportation of the body.
 
Cost of Living Supplements.
An employee is entitled to this if employee's combined workers' compensation and federal social security entitlement does not exceed 80% of employee's average monthly earnings. Each year the Workers' Compensation Commission determines the cost of living supplement for employees receiving benefits for temporary total disability, death benefits or permanent total disability. This benefit is payable as of October 1 of each year. The employee must request this from some carriers and employers; others pay it automatically.

 

Reporting Injuries, Change of Address, Change in Earnings

The employee must report any work-related injury promptly to a foreman or supervisor. The report should be in writing. Failure to do so may result in loss of compensation and payment of medical expenses.

Any employee entitled to payment of compensation must report to the Workers' Compensation Commission the current residential address and any changes of address as they occur, and to disclose immediately to the employer and to the insurer any return to work or increase in earnings.

The failure to make such disclosures may jeopardize receipt of benefits.

Administration and Hearings

The Virginia Workers' Compensation Act is administered by the Workers' Compensation Commission, located at 1000 DMV Drive, Richmond, Virginia, 23220-2036. Phone: (804) 367-8657.

The Commission consists of three Commissioners elected by the Virginia General Assembly.

There is one Chief Deputy Commissioner who supervises a number of Deputy Commissioners. The Commissioners and Deputy Commissioners adjudicate contested workers' compensation claims.

Approximately 90% of all claims are handled by agreements reached between the employer and employee and approved by the Commission. In those cases in which the parties are unable to agree, the claim is heard before a Commissioner or Deputy Commissioner, usually in the county or city where the accident occurred.

Hearings are usually held within four months from the date an employee or employer files an application for hearing with the Workers' Compensation Commission. Written decisions are usually received within two months following the hearing.

You must file a claim in writing with the Workers' Compensation Commission within the time limitations even if your employer filed an accident report.

You must file your claim with the Workers' Compensation Commission even if you have received payment of weekly compensation benefits, salary or medical expenses.

Requests for additional information may be directed to the following address:

Workers' Compensation Commission
Claims Department
1000 DMV Drive
Richmond, VA 23220-2036

Phone: (804) 367-8657