Medical Treatment and Workers’ Compensation

Any and all types of injuries can lead to workers' compensation claims in Virginia. An injury that might be excluded will be an idiopathic condition that did not arise out of the injured workers' employment. For example, if someone is sitting at their desk and goes into a diabetic shock and hits their head on the table, their injuries will not be compensable under Virginia law. Diabetes would be the idiopathic condition that the claimant already had before they were employed. In that situation, the employer did not put the injured worker in a position of heightened risk.

Whenever someone has an injury at work, it is crucial that they seek medical care as soon as possible. If you have any questions regarding medical treatment and workers' compensation in Richmond, contact an attorney. A seasoned workers' compensation lawyer can advocate for you and help you recover the benefits you deserve after an injury on the job.

An injured person who qualifies for workers' compensation may have to seek medical treatment from a specific healthcare provider. If an employer offers a panel of treating providers to the injured worker after they report their injury, then the employee needs to select a provider from that panel of three doctors as long as the panel is valid. The panel itself has to meet certain criteria under the law.

The insurance company can dictate medical treatment as the insurance carrier has the opportunity to offer a panel of three doctors to choose from. In that sense, they are dictating the provider and the insurance carrier also can approve or deny any procedure, referral, or recommendation by the treating provider at any point. The insurance company is able to control some aspects of the medical treatment. Also, if a treating provider refers the claimant to a different type of specialist, the insurance carrier can either approve a certain specialist that was named by that doctor or they can offer a panel in that situation as well.

An injured worker may feel that their medical treatment has been insufficient. If the carrier has offered a panel of general practitioners and the injured worker needs to see a specialist, but the insurance carrier will not approve it, then this may be a situation where they might feel they had sufficient medical treatment.

If the carrier denies any sort of referral, procedure, or medication, then the injured worker could be in a situation where they are receiving insufficient medical treatment. The most difficult situation is when the injured worker's claim is completely denied by the insurance carrier and they have to seek treatment on their own. Many times, injured workers cannot afford to handle medical care costs on their own. In this situation, the individual may want to obtain an attorney who is knowledgeable about medical treatment and workers' compensation in Richmond.

A medical-only claim is when the injured worker has not sustained any wage loss as of the date of the filing. For example, if someone has injured their back at work but is not on restrictions and has continued to work making the same amount of money that they have been making throughout the course of their employment, then they could file a claim for treatment for their back but they would not have a claim for a wage loss or permanency at that time. At some point, if the injured worker starts to sustain wage loss, then they can file for wages benefits.

Maximum medical improvement is when the doctor has given an opinion that the claimant's injury is basically as good as it is going to get and that there is not much more that can be done for it. Maximum medical improvement means that the claimant's injury has stabilized.

If a person has reached maximum medical improvement, but are still unable to return to work, it does not mean that they are not still restricted in some capacity. If an injured worker is restricted from work and is making less money than their pre-injury average weekly wage, then they are still entitled to wage loss benefits.

Call today to learn more about medical treatment and workers' compensation in Richmond. An accomplished attorney can explain your rights and protect your best interests.