Nothing in this article should be taken as legal advice. Every case is different.
Not always. Virginia lets you file a workers’ comp claim and take it all the way through a hearing on your own, and a small claim that the insurance company accepts and pays, with a quick return to work, often goes fine without a lawyer. Where claims go wrong is in the parts nobody warns you about: a two-year filing deadline that the insurer’s payments don’t reliably protect, a wage figure on a form that sets every check, a 15-day window to answer a request to stop your checks, and a settlement that closes your medical care for good.
This page walks through each stage of a Virginia claim and what can go wrong at it, so you can judge your own.
Where Virginia Comp Claims Go Wrong
| Stage | What can go wrong | Law |
|---|---|---|
| Filing the claim | The insurer pays for a while, no claim is filed with the Commission, and the two-year deadline passes. Or the claim leaves out a body part. | Va. Code § 65.2-601 |
| The wage figure | Your average weekly wage is figured too low, for example by leaving out overtime, and every check is smaller for as long as you are paid. | Va. Code § 65.2-101 |
| Choosing a doctor | You treat with a doctor outside the insurer’s panel, or switch doctors without the insurer’s agreement or a Commission order, and the insurer may not have to pay those bills. | Va. Code § 65.2-603 |
| The insurer’s exam | The insurer’s doctor says you can work or that the injury isn’t from the accident, and that report becomes its reason to stop paying. | Va. Code § 65.2-607 |
| A request to stop your checks | The insurer files an application with the Commission, and you have 15 days from the date it was filed to answer with evidence. | 16VAC30-50-20(E) |
| A light-duty job offer | You turn down a job within your restrictions without a reason the Commission accepts, and your wage checks stop. Medical care continues. | Va. Code § 65.2-510 |
| The hearing | The deputy commissioner decides the case on the evidence put in at the hearing. If your doctor’s opinion on cause or work restrictions isn’t in writing, it may not be there, and new evidence usually can’t be added on review. | Va. Code § 65.2-704; Commission Rule 2 |
| Asking for review | You have 30 days from the date of the deputy commissioner’s decision to ask the full Commission to review it. | Va. Code § 65.2-705; Commission Rule 3 |
| Settlement | A full and final settlement ends wage checks and future medical care for the injury, and you can’t come back for more after the Commission approves it. | Va. Code § 65.2-701 |
Each of these has a way to fix it, but the fix often has its own deadline. And one step can change another: the wage figure on the agreement form becomes the base for every later check, including payment for a permanent rating, and it shapes any settlement talks.
Claims People Often Handle on Their Own
A claim is more likely to go smoothly without a lawyer when the injury is minor, the insurance company accepts it, you are back at your regular job at your regular pay within a short time, and there is no permanent injury. In those claims, the main things to get right are to report the injury, file a claim with the Commission even though the insurer is paying, and check the wage figure on any agreement form before you sign it.
The insurer paying your bills doesn’t open a claim with the Commission. Payments can pause the two-year clock in some situations, but not all, so don’t count on them to protect it. Here’s how to file a workers’ comp claim in Virginia.
Signs a Claim Is Getting Harder
Claims tend to get harder when one of these happens. Any list like this is a few of many.
- The insurer denies the claim, or accepts one body part and not another. You can ask the Commission for a hearing, no matter what the insurer decides.
- You need surgery, or the insurer refuses a test or treatment your doctor recommends.
- The insurer schedules an exam with its own doctor.
- Your checks are late, smaller than you expected, or stop.
- You get a light-duty job offer, or you are fired or laid off while on comp. Here’s what happens if you’re fired while on workers’ comp.
- A doctor gives you a permanent rating, or you are told you have reached maximum medical improvement.
- The adjuster asks for a recorded statement or brings up settlement. Here’s what to know about the recorded statement.
The insurance company has people who handle comp claims every day. At a hearing, the Commission says the employer and insurer will always be represented by a lawyer.
Can I Get a Lawyer Later?
Yes, you can hire a lawyer at any point in a Virginia comp claim, but some steps can’t be undone by then. A missed filing deadline, a settlement the Commission has already approved, and a 30-day review deadline that has passed are usually final. A recorded statement or a signed agreement form can be explained later, but not taken back.
What a Workers’ Comp Lawyer Costs in Virginia
In a Virginia comp case, the Commission must approve the attorney’s fee (Va. Code § 65.2-714). That applies to every lawyer representing an injured worker before the Commission. Ask about the fee, and what it is figured from, before you sign anything. Here are questions to ask a workers’ comp lawyer.
Questions About Hiring a Workers’ Comp Lawyer
Will a Lawyer Get Me a Bigger Settlement?
No one can promise that. What a lawyer changes is who is watching the parts listed above: the wage figure, the deadlines, the medical evidence, and what a settlement leaves out. Here’s what goes into a Virginia workers’ comp settlement.
Can I Represent Myself at a Workers’ Comp Hearing?
Yes. The Commission doesn’t require you to have a lawyer (Virginia Workers’ Compensation Commission). You will need your own evidence in the record, including medical opinions on cause and work restrictions, and the insurance company will have a lawyer.
Talk to Pathfinder Injury Law About Your Claim
Pathfinder Injury Law handles only Virginia workers’ compensation claims. Call 804-505-0633 or use our online contact form.