CHAPTER 1: INTRODUCTION TO THE WORKERS’ COMPENSATION ACT AND THE WORKERS’ COMPENSATION COMMISSION (back to top) 1.1 HISTORY AND DEVELOPMENT OF WORKERS’ COMPENSATION
1.101 The European Experience
1.102 The Common Law
1.103 Modern Workers’ Compensation Laws
1.104 Virginia Workers’ Compensation Law
1.2 GOALS AND PURPOSES OF WORKERS’ COMPENSATION LAWS
1.201 In General
1.202 Objectives
1.203 Economic and Social Purposes
1.3 VIRGINIA WORKERS’ COMPENSATION COMMISSION
1.301 Role of the Commission
1.302 Role of Other Agencies
1.303 Operation of the Commission
1.304 Other Responsibilities of the Commission
1.305 Organizational Structure of the Commission
1.306 Confidentiality of Records
APPENDIX 1-1: HEARING DOCKETS
APPENDIX 1-2: RULES OF THE VIRGINIA WORKERS’ COMPENSATION
COMMISSION
CHAPTER 2: COVERAGE OF ACCIDENTAL INJURIES (back to top) 2.1 INTRODUCTION
2.2 EMPLOYER-EMPLOYEE RELATIONSHIP
2.201 Employments Covered and Excluded
2.202 Definitions
2.203 Creation of Relationship
2.3 “INJURY BY ACCIDENT” “ARISING OUT OF” AND “IN THE COURSE OF”
EMPLOYMENT
2.301 In General
2.302 “Injury” Defined
2.303 Compensability
2.304 Two-Pronged Test
2.4 “ARISING OUT OF” DEFINED
2.401 In General
2.402 Injuries by Co-employees
2.403 Unexplained Death During Employment
2.404 Assault
2.405 Robbery
2.406 Recreational Injury
2.407 Natural Environmental Causes
2.5 “IN THE COURSE OF” EMPLOYMENT
2.501 In General
2.502 Deviation from Employment
2.503 “Going and Coming” Rule
2.6 INJURY BY ACCIDENT
2.601 Definition
2.602 Causal Relationship
2.603 Second Accident
2.604 Absence of External Trauma
2.605 Protracted Exposure (Cumulative Trauma)
2.606 Pre-Existing Conditions
2.607 Idiopathic and Unexplained Injuries
2.608 Heart Cases
2.609 Back Injuries
2.610 Burden of Proof
2.7 DEFENSES
2.701 Willful Misconduct
2.702 Fraud and Misrepresentation in the Employment Application
CHAPTER 3: OCCUPATIONAL DISEASES (back to top)3.1 INTRODUCTION
3.2 BACKGROUND
3.201 In General
3.202 Ordinary Diseases of Life
3.203 Cumulative Trauma Caused by Repetitive Motion
3.204 Posttraumatic Stress Disorder
3.205 Occupational Disease Cases
3.206 Carpal Tunnel Syndrome and Hearing Loss
3.207 Pre-Existing Conditions Excluded
3.3 BENEFITS FOR OCCUPATIONAL DISEASES
3.4 CHECKLIST FOR OCCUPATIONAL DISEASE CLAIMS
3.401 In General
3.402 Accident or Occupational Disease
3.403 Communication of Diagnosis of an Occupational Disease
3.404 Statute of Limitations
3.405 Timely Notice to Employer
3.406 “Injurious Exposure”
3.407 Employer at the Time of the Last Injurious Exposure
3.408 Heart, Respiratory, and Cancer Presumptions
3.409 Infectious Disease Presumption
3.410 Pneumoconioses
3.411 Cumulative Trauma Caused by Repetitive Motion
3.412 Occupational Disease and Ordinary Disease of Life
3.413 Aggravation of an Ordinary Disease of Life
3.414 Medical Evidence
3.415 Employee Able to Return to Light Duty Work: Evidence of Marketing
3.416 When Do Benefits Begin
3.417 When Do Benefits End?
3.418 Calculating the Compensation Rate
3.5 MISCELLANEOUS OCCUPATIONAL DISEASES
3.501 AIDS/HIV
3.502 Allergic Reaction to Poplar Dust
3.503 Asthma, Bronchitis, and Other Respiratory Conditions
3.504 Carpal Tunnel Syndrome
3.505 Chemical Exposure
3.506 Deep Vein Thrombosis
3.507 Dermatitis
3.508 Digital Neuroma
3.509 Frostbite
3.510 Fume and Dust Exposure
3.511 Gastroenteritis
3.512 Hearing Loss
3.513 Hepatitis
3.514 Hernia
3.515 Histoplasmosis
3.516 Hypertension
3.517 Interstitial Lung Disease
3.518 Latex Allergy and Sensitivity
3.519 Legionellosis
3.520 Lyme Disease
3.521 Manganism and Carbon Disulfide Exposure
3.522 Mesothelioma
3.523 Methicillin-Resistant Staphylococcus Aureus
3.524 Mixed Connective Tissue Disorder
3.525 Photosensitivity
3.526 Plantar Fasciitis
3.527 Pneumonitis
3.528 Pneumothorax/Collapsed Lung
3.529 Psychological Conditions
3.530 “Sick Building Syndrome”
3.531 Sinusitis
3.532 Tobacco Smoke Exposure
3.533 Tuberculosis
3.534 Vaccines
3.535 Vision
APPENDIX 3-1: MARKETING GUIDELINES
CHAPTER 4: BENEFITS AVAILABLE TO INJURED WORKERS (back to top) 4.1 IN GENERAL
4.2 BASIC COVERAGE
4.201 In General
4.202 Benefit Period
4.203 Average Weekly Wage Calculation
4.204 Limitations
4.205 Cost-of-Living Supplement
4.3 COVERAGE FOR INCAPACITY
4.301 Total Incapacity
4.302 Partial Incapacity
4.303 Scheduled Loss
4.4 DEATH BENEFITS
4.401 Nature of Benefits and Entitlements
4.402 Amount of Compensation
4.403 Dependency
4.5 MEDICAL BENEFITS
4.501 Scope
4.502 Required Services
4.503 Reasonableness of Care and Peer Review
4.504 Refusal of Medical Attention
4.505 Miscellaneous Considerations
4.506 Vocational Rehabilitation Training
4.6 SUBSEQUENT INJURIES AND THE SECOND INJURY FUND
4.601 In General
4.602 Type of Injury and Employment
4.603 The Second Injury Fund
APPENDIX 4-1: WAGE CHART
CHAPTER 5: PREPARATION OF A CLAIM (back to top) 5.1 THE INTERVIEW
5.101 In General
5.102 The Facts
5.103 Medical and Vocational Information
5.104 Client’s Rights
5.105 Conclusion
5.106 Follow-Up
5.2 INVESTIGATION
5.201 In General
5.202 Medical Reports
5.203 Witnesses
5.204 Visiting the Scene of an Accident
5.3 DISCOVERY
5.301 In General
5.302 Medical Examination
5.303 Powers of Commission
5.4 PROCEDURE IN AN UNCONTESTED CLAIM
5.401 In General
5.402 Award Agreement
5.403 Termination of Wage Loss Award
5.404 Subsequent Periods of Compensation Benefits
5.5 SETTLEMENTS
5.501 Compensation Claims
5.502 Third-Party Suits
5.6 ETHICAL CONSIDERATIONS
5.601 In General
5.602 Pitfalls
APPENDIX 5-1: CLIENT INTERVIEW SHEET
APPENDIX 5-2: AUTHORIZATION TO DISCLOSE HEALTH
INFORMATION
APPENDIX 5-3: AWARD AGREEMENT
APPENDIX 5-4: FATAL AWARD AGREEMENT
APPENDIX 5-5: TERMINATION OF WAGE LOSS AWARD
APPENDIX 5-6: SUPPLEMENTAL AGREEMENT TO PAY BENEFITS
APPENDIX 5-7: SUPPLEMENTAL AGREEMENT TO PAY VARYING
TEMPORARY PARTIAL BENEFITS
APPENDIX 5-8: CONFIDENTIAL INFORMATIONAL LETTER FOR AN
EMPLOYEE WHO IS NOT REPRESENTED BY COUNSEL
AND SETTLEMENT CONTAINS A BLANKET RELEASE
APPENDIX 5-9: CONFIDENTIAL INFORMATIONAL LETTER FOR AN
EMPLOYEE WHO IS NOT REPRESENTED BY COUNSEL
APPENDIX 5-10: REQUIRED INFORMATION FOR STRUCTURED
SETTLEMENTS
APPENDIX 5-11: AFFIDAVIT
CHAPTER 6: CLAIMS HANDLING (back to top) 6.1 THE ELECTRONIC SYSTEM
6.101 In General
6.102 Electronic Case Files
6.103 WebFile
6.2 CLAIMS REPORTS
6.201 In General
6.202 Electronic Filing Required
6.203 First Report of Injury
6.204 Subsequent Report of Injury
6.205 Minor Injuries
6.206 Penalty
6.3 UNCONTESTED CLAIMS
6.301 In General
6.302 Award Agreement
6.303 Agreements to Terminate Benefits
6.304 Practical Considerations.
6.4 CONTESTED CLAIMS
6.401 Filing a Claim
6.402 Concurrent Jurisdiction
6.403 Medical Evidence
6.404 Order to Carrier
6.405 Employer’s Application for Hearings
6.406 Referral to Docket
6.5 TYPES OF COMMISSION HEARINGS
6.501 In General
6.502 On-the-Record Hearings
6.503 Evidentiary Hearings
6.6 DISCOVERY
6.601 In General
6.602 Scope
6.603 Subpoenas
6.604 Depositions
6.605 Interrogatories
6.606 Requests for the Production of Documents
6.607 Requests for Admissions
6.608 Production of Wage Information
6.609 Failure to Comply With Discovery
6.7 HEARING PROCEDURE
6.701 Nonsuit or Withdrawal
6.702 Identifying Medical Reports
6.703 Hearsay
6.704 Witnesses
6.705 Motions and Amendments
6.8 POST-HEARING PROCEDURE
6.801 Post-Hearing Evidence
6.802 Motions for Reconsideration or for Errors in Opinions
6.9 REVIEW BY THE COMMISSION
6.901 In General
6.902 Reviews of Decisions Accepting or Rejecting Claims and Applications
6.903 Reviews of Hearing Decisions
6.904 Reviews of Awards Based on Agreement
6.10 COMPROMISE SETTLEMENTS
6.1001 In General
6.1002 Procedural Requirements
6.1003 Requirements for Petition and Order
6.11 PROCESSING SETTLEMENTS
6.1101 Settlement Papers
6.1102 Payment Generally
6.1103 Lump Sum Payments
6.1104 Fees and Costs
6.12 MEDIATION SERVICES
6.1201 In General
6.1202 Mediation Defined
6.1203 Issues Appropriate for Mediation
6.1204 Procedure
APPENDIX 6-1 20-DAY ORDER--PAYMENTS MADE
APPENDIX 6-2 CLAIM FOR BENEFITS
APPENDIX 6-3 20-DAY ORDER--CLAIM FILED
APPENDIX 6-4 EMPLOYER’S APPLICATION FOR HEARING
APPENDIX 6-5 MEDIATION REQUEST FORM
CHAPTER 7: CONTESTED CLAIMS PROCEDURES (back to top)7.1 NOTICE OF ACCIDENT OR DISEASE
7.101 Notice to Employer
7.102 Failure to Give Timely Notice
7.103 Employer’s Report of Accident
7.2 FILING A CLAIM
7.201 Form
7.202 Statutes of Limitations
7.203 Computation of Time
7.204 Estoppel
7.3 HEARINGS
7.301 Application for Hearing
7.302 Hearing Procedures
7.4 COMPROMISE SETTLEMENTS
7.401 Subject to Spousal and Child Support
7.402 Subject to Commission’s Approval
7.403 Procedure for Approval
7.5 PAYMENT OF AWARDS
7.501 To Whom Paid
7.502 Penalty for Non-Payment
7.503 Interest
7.6 REVIEW BY THE FULL COMMISSION
7.601 Procedure
7.602 Hearing Officer Does Not Participate on Review
7.603 Standard of Review
7.7 APPEAL TO THE COURT OF APPEALS
7.701 In General
7.702 Notice of Appeal
7.703 Appeal Bond
7.704 Record on Appeal
7.705 Briefs
7.706 Argument
7.707 Rehearing
7.8 APPEAL TO THE VIRGINIA SUPREME COURT
CHAPTER 8: CIVIL SUITS AND THIRD-PARTY ACTIONS (back to top) 8.1 INTRODUCTION
8.101 General Considerations
8.102 Plaintiff’s Perspective
8.103 Defendant’s Perspective
8.104 Illustrative Cases
8.105 Statutory Employer
8.106 Borrowed Servant Doctrine
8.107 Specific Instances in Which the Act May Control the Injured Person’s Cause of Action
8.2 PROCEDURAL CONSIDERATIONS
8.201 Forum Selection, Estoppel, and Res Judicata
8.202 Jurisdiction
8.203 Conflict of Laws
8.3 INJURIES CAUSED BY FELLOW EMPLOYEES OR THIRD PARTIES
8.301 In General
8.302 Intentional and Negligent Infliction of Emotional Distress, Defamation, and Sexual Harassment
8.303 Assault
8.304 Medical or Health Care Negligence
8.305 Racial Discrimination
8.4 SUBROGATION
8.401 Employer-Insurer’s Rights
8.402 Intervention of Employer
8.403 Management of Third-Party Claims
8.404 Consent for Third-Party Settlements
8.405 Disposition of Third-Party Recovery
8.406 Workers’ Compensation Commission Approval
8.5 INDEMNIFICATION AND CONTRIBUTION
8.501 Express Agreements
8.502 Implied Agreements
TABLE OF AUTHORITIES
INDEX