Compensable Consequence Injury Questions in Virginia

What is a Compensable Consequence Injury in Virginia?

This refers to a situation where a worker receives an injury at work, for which they file a worker’s compensation claim, then an additional injury or illness occurs as the result of the initial injury. This additional injury should be covered under the original worker’s comp claim and not addressed as a new injury.

Compensable Consequence Claims in the Virginia Compensation System

Here are some examples of compensable consequence injuries that could occur:

• A construction worker tears a ligament in his knee while working. He receives treatment for his injuries, which is covered by worker’s comp, but the worker still spends several months limping. This causes him to put more weight than normal on his left leg, and after a few months, the uneven distribution of strain when walking causes tendinitis in his left hip. This tendinitis should be treated as a compensable consequence injury and addressesd in the same worker’s comp claim.
• A grocery store employee slips and falls at work, injuring her back. She files a worker’s comp claim and sees a doctor for her back pain. The doctor prescribes physical therapy, which she has to attend twice a week. While driving to one of her physical therapy appointments, she gets into a car accident and suffers several broken bones. These injuries would also be treated as compensable consequence injuries. (It’s also possible she has a case against the driver who hit her car for damages not covered by worker’s compensation.)
• A delivery truck driver hurts his back carrying furniture into a customer’s home and his doctor recommends surgery to repair a slipped disc from the incident. During the surgery, the doctor damages the spinal cord and the truck driver is left permanently unable to walk. He can no longer deliver furniture and applies for total disability benefits from worker’s comp. These go along with his original claim for the back injury because the botched surgery resulted from the initial injury. (The truck driver may also have a separate malpractice claim against the surgeon.)
• A baker is pulling bread out of an oven at the casual-dining restaurant where he makes fresh baked goods when another worker backs into him. The baker is thrown against the hot oven and severely burns his arm. He gets his wounds treated, but an infection develops anyway and he later loses his arm. He too might apply for disability benefits under worker’s compensation, and this would be a compnsable consequence injury.
• An archaeologist is working in the field, searching for fossils on a very hot day. She develops heat stroke and receives treatment in a nearby first aid station. Walking back to the camp, she gets dizzy, falls, and hits her head, resulting in a traumatic brain injury. This would also be a compensable consequence injury.
• A nurse is attacked by a patient at work and suffers several broken bones and a head injury. Unable to work and plagued by memories of the attack, he becomes depressed and anxious, and starts having trouble sleeping. He seeks help from a mental health specialist and is diagnosed with PTSD due to the traumatic nature of his physical injuries. Under the specific rules for mental health injury compensable consequence claims in Virginia, this would count as a compensable consequence injury.

What is the Compensable Consequence Statute of Limitations?

This is an important question to answer, because sometimes the secondary injury doesn’t become obvious right away. Under Virginia law, you have two years from the date you last received lost wage benefits for the initial claim to file a compensable consequence claim for the same injury. In a few unusual situations a judge may agree to extend this statute of limitations, but you shouldn’t count on it as an option. For that reason, we recommend you see a doctor right away about any additional health problems that occur if you think there’s a chance they may be related to the original injury.

What are the Rules for Mental Health Injuries?

Mental health injuries should fall into one of four categories:

• • A mental injury caused by a compensable, on-the-job physical injury, such as PTSD from the trauma of losing an arm in an industrial accident.
  • Mental injury as an occupational disease due to on-the-job stressors, such as a doctor developing depression from long-term stress on the job.
  • Mental injury resulting from a single, particular incident that didn’t also cause a physical injury, such as anxiety or PTSD after a workplace shooting.
  • An exception rule was created allowing firefighters and law enforcement officers to receive compensation for PTSD due to qualifying events that happen in the line of duty.

What Expenses Are Covered for a Compensable Consequence Claim?

Compensable consequence injuries are covered in the same way as the initial claim. Your medical costs should be covered, although sometimes people run into issues with their claims being rejected. If for some reason a bill is rejected by the worker’s comp system, ask your Virginia worker’s compensation attorney about it. They may be able to help you appeal the decision. 

Your lost wages for time you were unable to work are usually paid at two-thirds of your typical pay, within minimum and maximum amounts set by the state. Most recently, the maximum rate was $1082.00 a week and the minimum was $270.50, but remember that these amounts are subject to change.

What If That Doesn’t Begin to Cover All Your Expenses?

This is a common source of frustration for people dealing with the worker’s compensation system for both initial and compensable consequence claims. It can be very difficult to get by on two-thirds of your paycheck, especially if you are out of commission for weeks or months at a time. Meanwhile you still have to pay your rent or mortgage, put food on the table, and pay for utilities, insurance, and various other necessities on less than you’d normally be bringing home. As a result, many people ask the following question:

Can You Sue Your Employer Directly for More Damages?

Unfortunately, this is not possible in most cases. In the state of Virginia, you can only sue your employer for your injuries if you can make a case that they intentionally caused you harm, which is fairly difficult in most situations. The worker’s comp system is supposed to create a simple, no-fault way for employees to receive compensation for their injuries. This benefits both the worker and the company, preventing them both from spending months in court arguing about whose fault the injury was. It allows the worker to start receiving benefits relatively quickly compared to the time it would take to resolve a lawsuit, even one that settled out of court. Both parties also avoid the stress and costs of a lawsuit. In exchange for this easier system, the option to sue an employer for injuries was eliminated except for cases of intentional harm.

However, in some scenarios, there may be other options for pursuing compensation. As noted in some of the above examples, you may be able to sue a third party whose negligence contributed to your compensable consequence injury – for example, a doctor whose error led to the secondary injury, the manufacturer of a medical device that malfunctioned, or another driver who caused an accident. This should not interfere with your compensable consequence claim, because the second injury still arose from the first, even if another party caused you harm.

If you have questions about compensable consequence or other Worker’s compensation claims in Roanoke, Virginia or the surrounding area, please contact a Worker’s comp attorney at Lugar Law right away for a consultation.