* Nothing in this article should be taken as legal advice. Every case is different, and you should consult with an attorney before taking legal action on your case.
Like most of us, you’re a hard worker. When you head off to your job in the morning, you expect that your employer has all of the safety precautions in place to protect you from injury. Unfortunately, severe accidents happen even to the most conscientious employees, and they can affect you for the rest of your life. The work injury could impact whether you can work in the same field in the future. In those situations, having a knowledgeable workers’ compensation attorney is critical.
Severe injuries and accidents affect workers regularly. In fact, in 2021, the Virginia Workers’ Compensation Commission reported there were 48,201 major injuries and 69,080 minor injuries. Richmond City alone saw more than 5,000 injuries. As a result, you need to be prepared in case of a work injury.
Pathfinder Injury Law is here to help with many types of knee injury claims, from start to finish. Our law firm will be right by your side after a work accident to help you get the compensation you deserve. That money can help you address medical bills and provide critical funds for partial income replacement while you recover.
Your knee is one of the largest joints in your body. It is also extremely complex, which makes it especially vulnerable to injury. In addition, workers often regularly use their knees at work by bending, twisting, and lifting.
Below are some of the most common knee injuries leading to workers’ compensation claims. Remember that much of the damage that affects knees will not show up on an x-ray and instead will require more advanced imaging, but that does not mean it is any less severe.
The knee has articular cartilage at the ends of the femur and tibia. You can also find cartilage at the back of the patella. Further, two pieces of meniscal cartilage are also between your femur and tibia. Cartilage is critical for the knee to function properly. It helps the bones that connect in the knee glide smoothly over another as you bend and straighten your leg.
If you damage the cartilage in your knee, it can cause severe pain. If the bones rub together, it can also decrease your range of motion. A meniscus tear (or torn meniscus) is one of the most common cartilage damages an injured worker will experience.
Cartilage damage can be the result of arthritis. Purely degenerative arthritis, even if the symptoms are made worse by working, is generally not compensable as a work-related injury by itself in Virginia. Instead, there must be a structural or mechanical change in the knee to receive workers’ compensation for a knee injury.
However, if you had a serious knee injury at work that later caused you to develop arthritis in that joint, that damage is more likely to be compensable.
There are several ligaments in the knee, each serving a vital function to ensure the knee works properly. Each ligament connects the bones to one another. They provide stability to your knee and hold the entire joint together. Tears can occur in any of these ligaments.
There are two ligaments on the sides of the knee. These are the medial collateral ligament (inside) and the lateral collateral ligament (outside). They are commonly known as the MCL and the LCL. They control the side-to-side movement of the knee.
The other two ligaments are inside the knee joint. They cross each other to stabilize the front and back of the knee. They are the anterior cruciate ligament (ACL) and the posterior cruciate ligament (PCL).
Because Virginia workers’ comp only covers sudden structural or mechanical injuries in the knee. In other words, you cannot get benefits for injuries that happen due to degeneration over time. Accordingly, it is important to determine whether an acute or chronic problem exists.
In general, an MRI can show the specific type of tear. Often you can tell a tear is traumatic if it is deep and jagged on an MRI imagine. Chronic problems are more likely to be smooth and round. Newer injuries will often appear whiter on an MRI as well. Older injuries (which signal a chronic issue) are usually darker in color.
Two bones (the femur and tibia) meet to form the knee joint. The kneecap (patella) is another bone that sits on the front of the joint to provide some additional stability and protection. The femur sits just behind the larger joint.
Broken or fractured bones are one of the few knee injuries that can appear on an x-ray. The most common broken bone associated with the knee is the patella (kneecap). The ends of the femur and tibia are common locations for broken bones. Falls or blunt trauma (such as from a car accident) will often cause these broken bones.
A soft tissue injury is any damage to a non-bone, including damage to the tendons or torn ligaments. Soft tissue injuries include muscle damage, sprains, bursitis, dislocation, contusions, and other seemingly minor injuries.
Soft tissue injuries may seem minor, but in reality they can be very painful and significantly limit movement. The knee has two tendons that connect the bones together. If these tendons get stretched and torn, it can lead to severe pain and instability. Falls and landing awkwardly from a jump can lead to tendon injuries.
The hamstrings run at the back of the thigh muscle. Although they do not run through the knee, damage to your knee can also lead to problems with your hamstrings.
Although amputation injuries are rare, they can happen. This type of injury can occur because of a fall into equipment, a crush incident, or another severe lower leg injury.
Virginia workers’ compensation laws require that you give your employer notice of an injury within 30 days after it occurs. That means that unless it is an emergency, your first step is to report the injury to your supervisor or manager. In an emergency, address your health and safety first — get immediate medical attention if necessary.
Your notice of the injury should occur no later than 30 days after the accident. Ideally, you should provide notice in writing. This deadline is important because reporting the accident later can limit or even bar your right to workers’ compensation benefits. Your written notice of the injury should include the following information:
You might want to include whether you verbally reported the injury to anyone. Include who that person is and when the report occurred.
In addition to your initial reporting deadlines, you also have a separate period in which you can file a legal claim. This claim must be on file with the Virginia Workers’ Compensation Commission (VWC) no later than two years after the incident.
Once you file your claim with the Virginia Workers’ Compensation Commission, the VWC will contact your employer about the claim. They will require your employer or its insurance company to respond to the claim within 30 days. They must indicate whether they are either accepting or denying the claim.
Regardless of how your employer or their workers’ compensation insurance carrier treats the claim, they must make you aware of whether they are accepting or denying it. They can accept, deny, or state that they are still investigating the claim.
Like every personal injury, the severity of the damage will impact how much you can receive in workers’ compensation benefits. Many factors can affect your knee injury settlement and whether a settlement will even be available to you at all.
Workers’ compensation generally will not give you benefits for preexisting conditions related to your knee. Workers’ comp in Virginia only covers an “injury by accident,” which means there must be a sudden structural or mechanical change to the joint.
There must be an identifiable accident to prove that a change occurred, so if your injury was present before the accident and was not structurally changed by it, you could not receive compensation for it. Specifically, the damage cannot arise from repeated use or regular exertions of your job, and it cannot arise from a gradual deterioration of a pre-existing condition. However, a structural or mechanical aggravation or exacerbation of a pre-existing condition can potentially be awarded.
Consider an example. Imagine you are a construction worker with arthritis in your knee. If your knee continues to get worse until it causes an ACL tear, workers’ comp would likely not cover the ACL tear. There was no specific accident, so there is nothing to cover, even if your normal day-to-day job caused the resulting pain. On the other hand, if the tear was due to an accident, you might still get a payout even if you had arthritis before the accident. You should speak with a lawyer about the specific facts of your situation.
In workers’ compensation, the benefits you receive for wage replacement (indemnity) are based on how much you made before the accident. The benefits calculation uses your “average weekly wage” or “AWW” to determine how much you should receive. Your benefits are generally calculated at 2/3 of your average weekly wage for the 52 weeks before your accident, although there are exceptions and variations to this rule.
The amount you can potentially receive in a workers’ compensation settlement often depends on whether the employer has any viable defenses to the claim. In workers’ compensation, you do not have to prove that the employer was at fault for the accident. This is in direct contrast to a typical personal injury case that results in a verdict, like you would have if you suffered a non-work related car accident.
Nonetheless, the employer might still have some defenses available that could limit or bar your recovery. Examples of defenses might include:
Every situation is unique, so your employer might have several of these defenses or others. It is best to get tailored legal advice for your specific situation.
Because workers’ compensation is designed to pay for your medical bills and replace part of your lost wages while a doctor is keeping you out of work,, the amount of benefits you receive to address those losses may vary based on how severe your injury may be. For example, if you have soft tissue injuries that only last a few months, your settlement amount could be lower than someone who breaks their kneecap and is out of work for months on end.
Workers’ compensation benefits include medical care. Your employer is required to provide you with the medical treatment you need to address your injury, so long as that medical treatment is reasonable, necessary, and causally related to the work accident. When employers consider how much they will pay in a settlement, they often also think about how much money they might have to pay for your medical care in the future.
If you are expected to have ongoing medical needs for your knee, your settlement amount might be higher than someone who does not need long-term treatment or surgeries. Your overall recovery time can also affect your workers’ compensation benefit entitlement.
In Virginia, if a third party caused your work injury (i.e., not someone you work with or work for), you might also be able to sue that third party separately for your accident. This type of lawsuit is simply referred to as a “third-party lawsuit.” It is a normal personal injury case that occurs alongside your workers’ comp case. This could be for personal injuries, defective products, premises liability, medical malpractice, or other civil causes of action. These third-party cases do not involve your employer directly, but instead are filed against the individual or entity that caused your injury.
You should note you cannot bring this type of case against your employer. In almost all situations, the only remedy you have against your employer is through Virginia’s workers’ compensation laws.
Your doctor can do an evaluation of your knee to determine how well it functions after your work injury compared to a “normal” knee. This testing looks at how well your knee can support weight, whether it moves with the full range of motion, how well you walk, and other factors.
The whole FCE testing process can take several hours in a typical knee injury case. Then, the medical professional will compare the information gathered in this testing to “normal” ranges. This process is called a “functional capacity evaluation” or FCE.
FCEs are often performed to assess work restrictions and also provide impairment ratings. Impairment ratings are numerical representations of how much permanent damage you have suffered in a given body part as a result of a work accident. Impairment ratings are assessed in terms of a percentage. If your knee is functioning completely normally, for example, there will be a 0% impairment. If you are not quite where you need to be, you might have somewhere between 1% and 10% impairment. Severe knee injuries, or injuries causing knee replacements, might see impairment ratings over 50%. The larger your impairment rating, the higher your settlement value for your injury is likely to be because the more permanent partial disability benefits you could potentially be entitled to.
The Virginia Workers’ Compensation Act provides several different types of benefits. These benefits are designed to help workers get back on their feet after a work injury. However, in a workers’ comp case, you cannot recover for pain and suffering like in a regular personal injury case. But even though you cannot recover for pain and suffering in a workers’ comp case, there are still other benefits you can and should pursue.
The employer must pay all medical expenses for reasonable, necessary, and causally-related medical treatment for the injured worker. That treatment can be broad — from simple office visits and prescription costs to knee replacement surgery or physical therapy. Medical benefits can also include braces, boots, mobility devices, injections, and even home or vehicle modifications in appropriate circumstances.
Lost wage benefits are often called indemnity benefits. Virginia’s workers’ comp laws further break these benefits into “temporary total disability benefits” (TTD) and “temporary partial disability benefits” (TPD). These benefits allow workers to support themselves and loved ones when they cannot earn wages.
Temporary total disability benefits apply when the injured worker cannot work whatsoever per a doctor’s orders. Temporary partial disability benefits apply when the worker is back at work, generally in a light duty capacity, and not being paid as much as they were before the accident. The decrease in pay could result from working fewer hours or working in a job that pays less. Getting temporary partial disability benefits often requires a worker to look for work to offset their wage loss, even if they are back working at the job they had before they were injured. You should speak with a lawyer about this particularly complex area of the law if you find yourself on light duty and earning less than you did before you got hurt.
PPD benefits can be available when you have reached maximum medical improvement (MMI) and have a permanent loss of use in a ratable body part. Reaching MMI essentially means a medical professional has concluded you are as healed as you will ever be under the circumstances and have plateaued in your recovery. The body parts for which you can obtain PPD benefits include arms/hands/fingers, legs/feet/toes, eyes, and ears. You can also get PPD benefits if a spinal injury causes loss of use in one of these ratable body parts, although spinal injuries are not themselves entitled to PPD benefits in Virginia. There are also potentially PPD benefits available for severe scarring or disfigurement, and for amputation, whether whole or partial.
PPD benefits are designed to compensate you for partial, permanent loss of function. These benefits are based on your AWW and are expressed as a percentage. There is a statutory formula that a lawyer can help you calculate to determine how much you could be entitled to in PPD benefits.
In some serious work injuries, you may lose the ability to use two or more extremities in any sort of gainful employment. In those cases, you can receive permanent total disability benefits to account for that loss. Permanent total disability benefits mean the insurance company has to pay you ⅔ of your pre-injury average weekly wage for your entire life. The circumstances where you can obtain permanent total disability benefits are extremely rare, and you should speak with a lawyer about this complex area of law.
Unfortunately, there are situations where a knee injury cannot heal with medication, injections, physical therapy, and other conservative measures. In those situations, surgery may be necessary. For example, you might need to repair a torn ACL or undergo knee replacement surgery. Any surgery should be recommended and performed by an experienced orthopedic specialist and is likely to trigger considerable pushback from the workers’ comp insurance company.
If your doctor says your surgery is the result of your work injury, your employer or its insurance company should be on the hook to pay those medical bills. They should also provide follow-up care, including physical therapy, after your knee surgery.
However, if your employer has denied your claim, you need to speak with an experienced workers’ compensation attorney about your legal options.
You might be able to file for work comp benefits if you have osteoarthritis or another joint condition, but these cases are extremely difficult because causation can be very difficult to pin down. Keep in mind that there must always be a structural or mechanical injury caused by the work accident to trigger workers’ compensation benefits. This same requirement applies when you have a prior knee condition you are claiming was exacerbated by a work accident.
Knee injury settlements vary a great deal because a variety of factors must be considered. Every case is different, so it is important to get tailored legal advice for your situation from an experienced workers’ compensation lawyer.
By talking with Pathfinder Injury Law, you can get a better estimate of what your settlement might be. We will often consider the following information as part of our analysis.
The best way to get a realistic estimate of the value of your workers’ compensation case is to set up an appointment with an attorney who has dealt with cases like yours before — like Pathfinder Injury Law.
Although workers’ compensation benefits can provide significant value to employees, they can be tough to obtain in some situations. An attorney can help you assert your rights against your employer when you feel that your employer is not being fair to you.
Unfortunately, both employers and their insurance companies often try to pay as little as possible for a knee injury — even if they agree to accept the claim at first. An attorney can work to force the insurance company to treat you fairly and give you the workers’ comp benefits you deserve.
Research shows time and time again that accident victims get more compensation when they have a dedicated attorney compared to individuals who represent themselves. Don’t leave money on the table when it comes to your knee injury — contact Pathfinder Injury Law to schedule an appointment and get more information.