Nothing in this article should be taken as legal advice. Every case is different.
If you hurt your hip in an accident at work in Virginia, workers’ compensation can pay for your medical treatment, including surgery, and part of your lost wages. It may also pay for a permanent loss of use of your leg. It does not pay for pain and suffering, and there is no set amount for a hip injury. What a hip claim is worth depends on how the injury happened, what treatment it needs, how long you are out of work, and what it leaves you unable to do.
The hip is a weight-bearing joint, so a hip injury affects how you walk, sit, stand, climb, and lift. That is also why insurance companies look hard at hip claims, especially when there is any sign of arthritis.
Common Hip Injuries at Work
The hip is a ball-and-socket joint. The ball is the top of the thighbone (the femoral head), and the socket is part of the pelvis (the acetabulum). A ring of cartilage called the labrum lines the socket and helps hold the ball in place.
Hip Fractures
A fall from a ladder, a fall on a hard floor, or a vehicle crash can break the femoral head, the neck of the femur just below it, or the socket itself (an acetabular fracture). Many hip fractures need surgery, and some lead to a hip replacement.
Labral Tears
A torn labrum can cause pain in the groin or the front of the hip, and a catching, clicking, or locking feeling when you move. It can come from a fall, a twist with your foot planted, or a sudden awkward movement. Labral tears usually need an MRI to diagnose, and many are treated with arthroscopic surgery.
Dislocations
A hard enough impact can force the ball out of the socket. A dislocated hip is a medical emergency, and it can damage the labrum, the ligaments, and the blood supply to the bone.
Bursitis, Strains, and Other Soft Tissue Injuries
Bursae are small fluid-filled sacs that cushion the hip. A direct blow, like landing on your side in a fall, can inflame them. Muscles and tendons around the hip can also be strained or torn. These injuries are often treated with rest, therapy, and injections, but they can keep you off your feet for weeks.
A Work Accident on Top of Arthritis
Many hip claims involve a worker who already had some arthritis, whether they knew it or not. That does not end the claim. The question is what the accident did to the hip, as explained below.
What Virginia Workers’ Comp Requires for a Hip Injury
Most Hip Claims Need a Specific Accident
Virginia workers’ comp covers a hip injury caused by a specific accident at work that produces a sudden structural or mechanical change in the hip. The accident must also arise out of and in the course of your job. Workers’ comp generally does not cover a hip that wore down slowly from years of standing, climbing, or heavy work, even if the job made it worse. Your doctor’s notes and your imaging often decide whether an injury is new or long-standing.
Arthritis and Other Pre-Existing Hip Problems
Purely degenerative arthritis, even when work makes it hurt more, is generally not covered by itself. But a pre-existing condition does not automatically end your claim. If a work accident caused a new structural or mechanical change, or a structural aggravation of the old condition, that injury can still be covered.
Here is an example. A warehouse worker has mild arthritis in one hip. If the hip slowly gets worse on the job until a doctor recommends a replacement, workers’ comp likely will not cover it. If the worker slips on a wet floor, lands on that hip, and an MRI shows a new tear, the claim may be covered even though the arthritis was already there.
This is where hip claims are most often fought. Expect the insurance company to say your problem is degenerative. What your doctor writes about the cause usually matters more than anything else.
Hip pain can also start months after a different work injury, from limping on a hurt ankle or knee. That can be covered too. Here’s when an injury from favoring the first one is covered.
Steps to Take After a Hip Injury at Work
- Get medical care. Tell every doctor that you hurt your hip at work and how it happened, so your records say so from the start. If your other hip, your back, or your knee hurts too, say so.
- Give your employer written notice within 30 days. Virginia law requires written notice to your employer within 30 days of the accident, although exceptions exist. Do it in writing. Late notice can limit or even bar your benefits. Include your name and address, the date and time of the accident, where it happened, what you were doing, and what part of your body you hurt.
- File your claim with the Virginia Workers’ Compensation Commission. Notice to your employer is not the same as a claim. The claim must generally be filed with the Commission within two years of the accident, although exceptions apply (Va. Code § 65.2-601). File it even if the insurance company accepts your injury and starts paying. Here’s how to file a workers’ comp claim.
- Watch for the insurance company’s answer. After you file, the Commission will order your employer’s insurance company to respond to your claim within 30 days. It may accept the claim or deny it. Whatever it decides, you can ask the Commission for a hearing, including if it delays your benefits or denies your claim.
What Benefits Can You Receive for a Hip Injury in Virginia?
Workers’ comp pays for specific things: medical care, part of your lost wages, and permanent loss of use of certain body parts. For a full overview, see what workers’ comp covers in Virginia.
Medical Care
Your employer’s insurance company must pay for medical treatment that is reasonable, necessary, and causally related to the work accident (Va. Code § 65.2-603). For a hip, that can include office visits, prescriptions, MRIs, injections, physical therapy, a cane or walker, and surgery, including hip replacement when the work injury causes the need for it. In the right circumstances, it can also include changes to your home or vehicle.
Lost Wages
Wage loss benefits are generally two-thirds of your average weekly wage over the 52 weeks before the accident, up to a weekly maximum, with exceptions and variations (Va. Code § 65.2-500).
- Temporary total disability (TTD) applies when your doctor says you cannot work at all.
- Temporary partial disability (TPD) applies when you are back at work on light duty but earning less than before. Getting TPD can require you to look for other work to make up the difference.
Hip injuries often mean a long stretch of light duty, because so many jobs require standing, walking, or climbing. Here’s how benefits are calculated and when Virginia workers’ comp starts paying.
Permanent Partial Disability (PPD)
Once you reach maximum medical improvement, meaning your doctor says you are as healed as you are going to get, a doctor may rate a permanent loss of use. Virginia’s schedule pays a set number of weeks for the loss of use of certain body parts (Va. Code § 65.2-503). The hip itself is not listed, but the leg is, at 175 weeks. A hip injury can lead to PPD benefits when it causes a permanent loss of use of the leg. For example, a 20 percent loss of use of the leg works out to 35 weeks of pay at your compensation rate. The doctor’s rating has to be to the leg, not just the hip. If you have a hip replacement, the loss of use is measured as it was before the replacement, not after.
Here’s more on how impairment ratings work in Virginia. How a hip injury gets rated is often disputed, and insurance companies frequently send injured workers to their own doctors for a second opinion. Here’s what happens after an IME in Virginia.
What If You Need Hip Surgery?
Doctors usually try medication, injections, and physical therapy first. When those don’t work, the common surgeries for a work hip injury are:
- Hip arthroscopy: small incisions and a camera, often used to repair a torn labrum.
- Fracture repair: screws, plates, or rods to hold a broken bone in place.
- Partial or total hip replacement: replacing the damaged ball, or the ball and the socket, with artificial parts.
If the surgery is reasonable, necessary, and related to your work injury, the insurance company is required to pay for it, along with follow-up care such as physical therapy. That does not mean it will. Hip replacements in particular draw the argument that the surgery is for arthritis, not for the accident. If the insurance company refuses, you can ask the Commission for a hearing. Your doctor’s written opinion on why the surgery is needed and how it connects to the accident is usually the key evidence.
What Is the Average Workers’ Comp Settlement for a Hip Injury?
There isn’t one, and anyone who quotes you a number for a hip injury before seeing your medical records is guessing. A labral tear that heals after arthroscopy and a fracture that ends in a hip replacement are worth very different amounts, and so are two identical surgeries with different wages, work restrictions, and ratings.
The things that move the value of a hip claim:
- Whether the accident qualifies at all, and whether the insurance company can blame arthritis
- Surgery, especially a recommended hip replacement
- Future medical care, since a full and final settlement closes your medical benefits for good
- Time out of work and whether you can go back to your old job
- The impairment rating to the leg
- Your average weekly wage
A settlement is optional, and the Commission must approve it. Here’s more on how much compensation you can get for a work injury and workers’ comp settlements in Virginia.
Talk to Pathfinder Injury Law About Your Hip Injury
Pathfinder Injury Law handles only Virginia workers’ compensation claims. Call 804-505-0633 or use our online contact form.